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Saturday, March 8, 2014
Recent Insurance Law Decisions, Attorney's Fees, and lump crab cakes atop arugula and mustard-cumin pudding
Amzak Capital Mgmt. v. Stewart Title
Court: U.S. 5th Circuit Court of Appeals
Docket: 13-30675
Opinion Date: February 27, 2014
Judge: Jones
Areas of Law: Banking, Bankruptcy, Insurance Law,
Real Estate & Property Law
Amzak appealed the district court's summary judgment
on its loan loss claims against its title insurance policy provider and related
entities. The court concluded that Amzak failed to show that it suffered actual
loss because of a failure of title and STL could not be held responsible for
any harm suffered by Amzak. The court formalized the holding in First State
Bank v. American Title and likewise rejected the guarantee rationale of
Citicorp Savings of Illinois v. Stewart Title Guaranty Co., and agreed with the
district court's rejection of Amzak's argument that STL breached the title
policy at the time of the loan because its mortgage was voidable at that time.
The court also disposed of Amzak's negligence claim where STL's delay in making
a complete filing of Amzak's mortgage was not a legal cause of Amzak's loss.
Accordingly, the court affirmed the judgment of the district court.
http://j.st/ZZJA
Crain v. State Farm Mut. Auto. Ins. Co.
Court: U.S. 8th Circuit Court of Appeals
Docket: 13-1903
Opinion Date: March 6, 2014
Judge: Riley
Areas of Law: Insurance Law
Plaintiff filed suit against State Farm in Missouri
state court, seeking to recover underinsured motorist (UIM) benefits under
plaintiff's policy with State Farm (the Pontiac policy). State Farm removed to
district court based on diversity of citizenship and then the district court
granted summary judgment in favor of State Farm. The court affirmed the
district court's conclusion that the State Farm policy unambiguously prohibited
stacking UIM coverage limits. Plaintiff's argument was foreclosed in Daughhetee
v. State Farm Mut. Auto. Ins. Co. where the court affirmed the lower court's
determination that the language in an identical State Farm automobile policy
unambiguously precluded policy stacking of UIM coverage limits under Missouri
law.
http://j.st/ZZYT
Lester v. Allstate Prop. & Cas. Ins. Co.
Court: U.S. 6th Circuit Court of Appeals
Docket: 13-6070
Opinion Date: February 24, 2014
Judge: Sutton
Areas of Law: Insurance Law
After a fire damaged her house, Lester filed a claim
with Allstate. The company asked Lester and her husband to answer questions
under oath. Lester responded that they would submit to examinations only if Allstate
first showed them its investigative files. Allstate refused to turn over the
files, stating that doing so “could jeopardize the integrity” of its inquiry.
Allstate eventually gave Lester 10 days to schedule an examination, warning
that, if she did not submit to an examination, it would deny the claim. Lester
never responded, but sued the company. The district court granted Allstate
summary judgment. The Sixth Circuit affirmed, noting that the insurance policy
requires Lester to “submit to examinations under oath” at Allstate’s request
and that Tennessee law permits denial of a claim when the policyholder refuses
to participate in an examination under oath. The company’s refusal to share its
investigative files before examining her is reasonable and did not breach a
duty of good faith. Tennessee presumes that failure to participate in an
examination results in prejudice to the insurer, and makes it the
policyholder’s burden to demonstrate that the company suffered no harm. Lester
never introduced any evidence to rebut the presumption.
http://j.st/ZkzJ
Univ. of Notre Dame v. Sebelius
Court: U.S. 7th Circuit Court of Appeals
Docket: 13-3853
Opinion Date: February 21, 2014
Judge: Posner
Areas of Law: Constitutional Law, Health Law,
Insurance Law
The Affordable Care Act, 42 U.S.C. 300gg-13(a)(4),
requires health insurance providers (including third party administrators) to
cover certain preventive services without cost to the insured, including, “with
respect to women … preventive care and screenings,” including all FDA-approved
contraceptive methods, sterilization, and patient education for women with
reproductive capacity. The University of Notre Dame self‐insures employees’
medical expenses; Meritain administers the employee health plan. For students’
medical needs, Notre Dame has a contract with Aetna. Because Catholic doctrine
forbids the use of contraceptives, Notre Dame has never paid for contraceptives
for employees or permitted Aetna to insure the expense of contraceptives.
Because of those religious objections and the Religious Freedom Restoration
Act, 42 U.S.C. 2000bb‐1(a), the government created a religious exemption,
45 C.F.R. 147.130(a)(1)(iv)). New regulations enlarged the exemption, so that
Notre Dame came within its scope. To exercise its right to opt out of paying
for coverage for contraceptives, the university completed a form that alerts
insurers that Notre Dame is not going to pay, so they will have to pay. The
government will reimburse at least 110 percent of the third‐party administrator’s
costs and Aetna can expect to recoup its costs from savings on pregnancy
medical care. Several months after the regulations were promulgated, the
University unsuccessfully sought a preliminary injunction. The Seventh Circuit
affirmed, noting that the University had not indicated exactly what it wanted
enjoined at this stage. The insurance companies were not parties, and,
therefore, could not be enjoined from providing the required coverage. A
religious institution has no right to prevent other institutions from engaging
in acts that merely offend the institution and the University has complied by
completing the required form.
http://j.st/ZkLM
Employee benefit plans -- Defined contribution
401(k) Plan -- Employee Retirement Income Security Act -- Breach of fiduciary
duty -- Breach of statutory duties of prudence and loyalty -- Limitation of
actions -- Action by former employee on behalf of Plan alleging, among other
claims, that defendant-benefits committee members imprudently selected as
investment options certain of plan sponsor's proprietary mutual funds and
imprudently failed to remove those funds from the menu of investment options
despite their continuing poor performance and high management fees -- Documents
attached to defendants' motion to dismiss count asserting claims of imprudent
selection and failure-to-remove as barred by ERISA's shorter three-year
limitations period were insufficient to make requisite showing that plaintiff
had actual knowledge of breaches where there was no showing that the attached
documents had been provided to plaintiff or that plaintiff obtained knowledge
of the facts in the documents from another source -- Claim of imprudent
selection was barred by ERISA's six-year limitations period, which was
triggered by defendants' initial selection of the funds for inclusion in the
401(k) plan -- Because claims concerning committee defendants' failure to
remove certain funds were in all relevant respects identical to the allegations
concerning the selection process, complaint contained no factual allegation of
a material change in circumstances that would allow appellate court to
distinguish between the alleged imprudent acts occurring at selection from the
alleged imprudent acts occurring thereafter -- Accordingly, six-year limitations
period for failure-to-remove claims was also triggered at time funds were
initially selected as investment options
BARBARA J. FULLER, and all others similarly
situated, Plaintiff-Appellant, SELETHIA PRUITT, et al., Plaintiffs, v. SUNTRUST
BANKS, INC., THE SUNTRUST BANKS, INC. BENEFITS PLAN COMMITTEE, JORGE ARRIETA,
HAROLD BITLER, MIMI BREEDEN, et al., Defendants-Appellees, TRUSCO CAPITAL
MANAGEMENT, INC., et al., Defendants. 11th Circuit.
Guardianship -- Incapacitated person -- Attorney's
fees -- Attorney who acted as co-counsel for ward in guardianship proceeding --
Trial court abused discretion in reducing amount of attorney's fees and
charging attorney with costs on ground that attorney's services did not benefit
ward -- Actions of attorney who contacted member of initial examining committee
at ward's request to obtain a reassessment benefitted ward where reassessment
brought to court's attention problems with committee's report, resulting in
appointment of second examining committee -- Attorney's action of obtaining a
reassessment by contacting an examining committee member was not clearly
prohibited by law
In re Guardianship of Carol Padlina Rawl, an
incapacitated person. LANCE M. McKINNEY, Appellant, v. GREGORY R. RAWL, as
Guardian of the Property of Carol Padlina Rawl, an incapacitated person,
Appellee. 2nd District.
Insurance -- Attorney's fees -- Trial court properly
denied attorney's fees and costs where insurer did not wrongfully cause
insureds to resort to litigation
ANA VIVAS, et al., Appellants, vs. STATE FARM
FLORIDA INSURANCE COMPANY, Appellee. 3rd District.
Insurance -- Personal injury protection --
Exhaustion of benefits -- Where reasonableness of a medical provider's claim is
still in dispute, post-suit exhaustion of benefits extinguishes provider's
right to further payments, so long as exhaustion is prior to the establishment
of the amount to which the medical provider is entitled under PIP -- Once PIP
benefits are exhausted through payment of valid claims, insurer has no further
liability on unresolved pending claims absent bad faith in the handling of the
claim by the insurance company -- Appeals -- Certified questions from county
court -- Court discharges jurisdiction of one of the two cases before it in
which county court certified three questions, as district courts have already
ruled on one issue and have answered the question uniformly, and county court
expressly did not rule or make any judicial determination on issues raised in
the other two certified questions -- Appeal in that case transferred to circuit
court
NORTHWOODS SPORTS MEDICINE AND PHYSICAL
REHABILITATION, INC., (a/a/o SUZANNE CABRERA), and WELLNESS ASSOCIATES OF
FLORIDA, INC., (a/a/o DANIEL NORTH), Appellants, v. STATE FARM MUTUAL
AUTOMOBILE INSURANCE COMPANY and USAA CASUALTY INSURANCE COMPANY, Appellees.
4th District.
Torts -- Automobile accident -- Discovery -- Law
firm's financial relationship with plaintiff's treating physician -- Trial
court did not depart from essential requirements of law by ordering law firm to
provide list of payments made to plaintiff's treating physician over last 3
years
LYTAL, REITER, SMITH, IVEY & FRONRATH, L.L.P.,
Petitioner, v. JANET MALAY, as Personal Representative of the Estate of MAURICE
BAKER, Respondent. 4th District.
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Saturday, January 25, 2014
Judge chastises BigLaw firm for overbilling and seeking fees for research on ‘basic and banal’ legal principles
"Mayer Brown took a thrashing last week from a Manhattan judge who
denied the firm’s $126,000 fee request for helping two tenants [ son of a corporate CEO who is a client of the law firm] recover a
$6,400 security deposit and treble damages from their landlord.
Judge Frank Nervo said a junior associate spent “a grossly unnecessary amount of time” on simple matters, and the firm had “unabashedly invoiced” oversight work by a senior associate with a billing rate of $615 an hour and a partner with a rate of $895 an hour." More.
Originally posted Jan 21, 2014 6:15 AM CST
By Debra Cassens Weiss in ABA Journal
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Judge Frank Nervo said a junior associate spent “a grossly unnecessary amount of time” on simple matters, and the firm had “unabashedly invoiced” oversight work by a senior associate with a billing rate of $615 an hour and a partner with a rate of $895 an hour." More.
Originally posted Jan 21, 2014 6:15 AM CST
By Debra Cassens Weiss in ABA Journal
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Sunday, January 5, 2014
Taxation, alimony, bank fraud, and simple roasted chicken with lemon, butter, and thyme
Civil procedure -- Stay -- Trial court departed from
essential requirements of law by denying motion to stay Florida action pending
resolution of earlier-filed federal lawsuits in U.S. District Court for
District of Delaware -- Parties in lawsuits are substantially similar and
related, and various claims and counterclaims are overlapping
BENIHANA OF TOKYO, INC., et al., Petitioners, v. BENIHANA,
INC., et al., Respondents. 3rd District.
Dissolution of marriage -- Alimony -- Abuse of discretion to
award former wife permanent periodic alimony where evidence did not reflect
permanent inability on part of wife to become self-sustaining -- Equitable
distribution -- Abuse of discretion to order wife to pay husband his one-half
interest in marital home at rate of $150 a month, plus interest -- Installment
payments spanning course of twenty years effectively deprived former husband of
his present one-half interest in marital home
CHARLES D. EVANS, FORMER HUSBAND, Appellant, v. TALITHA
NICOLE EVANS, FORMER WIFE, Appellee. 1st District.
Dissolution of marriage -- Attorney's fees -- Appeals --
Order determining entitlement to fees and costs without setting the amount is
nonfinal and nonappealable
BRAD GREENBERG, Appellant, v. FRANCYNE GREENBERG, Appellee.
2nd District.
Torts -- Banks -- Action against bank seeking to recover
damages allegedly suffered when bank allowed fraudulent or unauthorized conduct
by an employee -- Error to dismiss fourth amended complaint based on finding
that, as matter of law, plaintiff failed to allege any theory of liability or
independent duty owed to plaintiff by bank distinct from contractual
relationship based on depository agreement -- Plaintiff alleged independent
torts and causes of action separate from bank's wrongful disbursement of funds
on deposit -- Jury trial -- Error to find plaintiff was not entitled to jury
trial based on a jury trial waiver contained within bank's “Rules and
Regulations for Deposit Accounts” -- Waiver does not apply to independent torts
or other causes of action asserted by plaintiff where wrongful acts alleged are
acts or omissions separate from breach of depository agreement -- Fact that
losses arising out of various claims of negligence or other causes of action
may be same damages as those resulting from breach of depository agreement does
not bar claims and does not control entitlement to jury trial arising out of
separate wrongful acts alleged
MARIAN FARMS, INC., ETC., Appellant, v. SUNTRUST BANKS,
INC., ETC., Appellee. 5th District.
Ford Motor Co. v. United States
Docket: 13-113
Opinion Date: December 2, 2013
Judge: per curiam
Areas of Law: Government & Administrative Law, Tax Law
The IRS advised Ford Motor that it had underpaid its taxes
from 1983 until 1989. Ford remitted $875 million to stop the accrual of
interest that Ford would otherwise owe once audits were completed and the
amount of its underpayment was finally determined. Eventually it was determined
that Ford had overpaid its taxes in the relevant years, entitling Ford to a
return of the overpayment and. Ford argued that “the date of overpayment” for
purposes of 26 U.S.C. 6611(a) was the date that it first remitted the deposits
to the IRS. The IRS countered that the relevant date was the date that Ford
requested that the IRS treat the remittances as payments of tax. The difference
between the competing interpretations is worth some $445 million. The district
court granted judgment on the pleadings in favor of the government. The Sixth
Circuit affirmed, concluding that section 6611 is a waiver of sovereign
immunity that must be strictly construed in favor of the government. The
Supreme Court vacated and remanded, noting that the government was arguing, for
the first time, that the only general waiver of sovereign immunity that
encompasses Ford’s claim is the Tucker Act, 28 U. S. C. 1491(a). Although the
government acquiesced in jurisdiction in the district court, the Tucker Act
applies, jurisdiction over this case was proper only in the Court of Federal
Claims. The Sixth Circuit should have the first opportunity to consider the
argument.
http://j.st/tPj
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Friday, December 13, 2013
9th Circuit's Kozinski Opinion talks of ‘Epidemic of Brady violations’
"The chief judge of the San Francisco-based 9th U.S. Circuit Court of
Appeals is taking a stand against failure to disclose exculpatory
evidence in a case involving a ricin suspect and a lab analyst who was
later fired for alleged incompetence.
Chief Judge Alex Kozinski highlighted the issue in a Dec. 10 dissent (PDF) to the denial of an en banc rehearing. He begins this way: “There is an epidemic of Brady violations abroad in the land. Only judges can put a stop to it.” His dissent was joined by four other 9th Circuit judges."
. . . .
"
Kozinski argues that prosecutors are rarely penalized for Brady violations, and the panel opinion sends the wrong signal. “By turning a blind eye to this grave transgression,” he writes, “the panel has shirked its own duty and compounded the violence done to the Constitution by the Assistant U.S. Attorney.”"
Originally posted by Debra Cassens Weiss, Dec. 11, 2013, in ABA Journal News
The Law Lady. For more info about us, click here. To be added to our email circulation with MUCH, MUCH more law, click here and specify whether you wish to be added to our CRIMINAL, CIVIL, HEALTH & INSURANCE, 11th CIRCUIT, or all FEDERAL Recent Decisions of Interest.
Chief Judge Alex Kozinski highlighted the issue in a Dec. 10 dissent (PDF) to the denial of an en banc rehearing. He begins this way: “There is an epidemic of Brady violations abroad in the land. Only judges can put a stop to it.” His dissent was joined by four other 9th Circuit judges."
. . . .
"
Kozinski argues that prosecutors are rarely penalized for Brady violations, and the panel opinion sends the wrong signal. “By turning a blind eye to this grave transgression,” he writes, “the panel has shirked its own duty and compounded the violence done to the Constitution by the Assistant U.S. Attorney.”"
Originally posted by Debra Cassens Weiss, Dec. 11, 2013, in ABA Journal News
The Law Lady. For more info about us, click here. To be added to our email circulation with MUCH, MUCH more law, click here and specify whether you wish to be added to our CRIMINAL, CIVIL, HEALTH & INSURANCE, 11th CIRCUIT, or all FEDERAL Recent Decisions of Interest.
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