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Insurance

Insurance – Life – ERISA – Equitable Claims – Coverage of Ex-Wife

Israel v. Prudential Insurance Co. of America Plaintiff alleges that his employer’s benefits department informed him (contrary to the plan language) that he could continue to carry life insurance on his wife after their divorce, and defendants continued to accept premium payments after the divorce; nevertheless, defendants denied plaintiff’s claim when his ex-wife died. Plaintiff may be able to make out equitable claims against defendants.

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Insurance – Liability – Garage Policy – Water Damage

BMW of North America, LLC v. Complete Auto Recon Services, Inc. The defendant-insurer’s garage policy only provided liability coverage to plaintiff, the owner of the cars in the defendant-insured’s garage. Since no third party had any claim against plaintiff, the policy provided no coverage to plaintiff when garage employees left the windows down on six cars during a rain storm.

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Insurance – ERISA – Accidental Death – Sickness Exclusion — MS Sufferer – Fall & Environmental Exposure

Genal v. Prudential Insurance Co. of America The insured’s accidental death policy contained an exclusion for death caused directly or indirectly by sickness. Although the insured’s multiple sclerosis prevented him from getting up and walking inside after he fell, since his death resulted from environmental exposure after the fall and not from his MS, the exclusion does not apply.

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Insurance – CGL Policy – Duty to Indemnify – Construction – Slab – ‘Your Work’ & ‘Professional Liability’ Exclusions

Penn National Security Insurance Co. v. Design-Build Corp. The defendant-engineering and contracting firm (the firm) designed and installed the slab for the defendant-owners’ building. A commercial general liability policy issued to the firm does not provide coverage for damage to or loss of use of the building arising from defects in the slab.

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Insurance – Life – Beneficiary — Domestic Relations – Separation Agreement – Designated Amount

State Mutual Insurance Co. v. Ard Where a couple’s separation agreement required the husband to maintain his $50,000 life insurance policy for the wife’s benefit, but where the husband failed to name the wife as beneficiary of his life insurance policy, the wife is entitled to $50,000 plus interest from the date of the husband’s death, but the named beneficiary is entitled to the increase in the policy’s value. We affirm the circuit court’s judgment.

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Insurance – Disability – Additional Policies – Different Terms – Time Limitations – Mental Disorders – ECT – Tort/Negligence

Doe v. Northwestern Mutual Life Insurance Co. Where neither plaintiff nor her insurance agent can remember what the agent said when, in 2002 and 2003, plaintiff purchased two additional disability policies pursuant to an additional purchase benefit (APB) rider in her 1996 disability policy, plaintiff cannot make out a claim for negligent misrepresentation.

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Insurance – Duty to Defend – Exclusion – Tort/Negligence – Defamation – Labor & Employment

Universal North America v. Frey The homeowners’ policy issued by the insurer to defendant excludes coverage for “personal injury” that is “sustained by any person as a result of an offense directly or indirectly related to the employment of this person by an ‘insured.’”

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Insurance – Fire – Fraudulent Application – Purchase Price – Past Claims

Scottsdale Insurance Co. v. Collins Although defendant contends he merely answered questions posed to him by an insurance agent and then signed the application that the agent printed out, when he signed the application, defendant asserted that he had read the application and that the statements in it were true. However, the application indicated that the purchase price for the house being insured was $390,000 when defendant knew the purchase price was only $20,000.

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Insurance – Life – Labor & Employment – ERISA – Equitable Relief – Breach of Fiduciary Duty

McCravy v. Metropolitan Life Ins. Co. A bank employee who paid for life insurance for her daughter through her employee benefit plan, but who was denied insurance benefits when her 25-year-old daughter died, has her claim for “equitable relief” for the insurance carrier’s breach of fiduciary duty reconsidered by the 4th Circuit, in light of CIGNA Corp. v. Amara, 131 S. Ct. 1866 (2011).

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