Source: http://insuranceclaimsissues.typepad.com/insurance_claims_and_issu/2016/08/index.html
Timestamp: 2017-06-28 19:21:57
Document Index: 98295262

Matched Legal Cases: ['art 1040', '§ 1040', '§ 1040', '§ 1040', '§ 1040', '§1040', '§ 5481', '§ 1040', '§ 5481', '§ 5481', '§ 5481', '§ 5481']

Insurance Claims And Issues: Insurance Claims And Issues
FILED Insurance RATE DOCTRINE? BE CAREFUL WHAT YOU RULE FOR, YOUR HONOR.
Filed rate increases for "revised homeowners' insurance rates and revised homeowners' R.insurance territory definitions" would have raised premiums in North Carolina 25% to 55%, depending on whether the policyholders paying the premiums were tenants, owners, or "condominiums." The filed rate increases were at issue in an appeal from the North Carolina Insurance Commissioner's order disapproving the filed rates. State ex rel. Commissioner of Insurance v. North Carolina Rate Bureau, ___ S.E.2d ___, No. COA15-402, 2016 WL 4087919, at *1-*2 (N.C. Ct. App. August 2, 2016).
The 26 published pages of the Westlaw report of this decision reveal the complexity of insurance rate filings. This case alone shows the impossibility of applying "the filed rate doctrine" as a defense to bar any claims that insurance rates include unauthorized charges such as kickbacks.
The complexity of insurance rate filings displayed across these 26 pages alone, completely repudiate any notion that something so abstract as a "doctrine" can even begin to describe insurance rate filings. Perhaps such a "doctrine" exists and can be applied by Judges in utility or other rate cases, but it is not a "doctrine" which can stand in the insurance field, including lender force-placed insurance practices ("LFPI") cases but extending to all insurance cases of any kind that involve contentions of filed insurance rates.
Posted by Dennis Wall on August 31, 2016 at 05:58 AM in Filed Insurance Rates, Force Placed Insurance | Permalink
Carolina, filed, force, insurance, North, placed, practices, rates
BREACH OF A CONDITION BARS "BAD-FAITH" INADEQUATE DEFENSE CLAIM …
But breach of which condition?
In Doe v. Onebeacon Am. Ins. Co., 639 F. App'x 627 (11th Cir. 2016), a panel of the Eleventh Circuit was confronted with many issues of Florida law surrounding a liability carrier's duty to defend and an insured's settlement without the carrier's consent. The panel side-stepped all of those issues.
The Court held both that the insured breached a policy condition and also that there was insufficient evidence that the carrier provided a legally inadequate defense in the underlying case. For either reason, the claim of a "bad-faith" or legally inadequate defense could not stand. (In Florida, an inadequate defense is a breach of contract and cannot really be called "bad faith," although given the outcome in this case, the panel never had to reach this or any similar issue.)
It is difficult to determine from this brief opinion which condition the Eleventh Circuit panel was addressing. The panel appeared to equate the policy prohibition on the insured's settlement without the carrier's consent, with the insured's duty to cooperate:
As a matter of law, the insured—at the time it settled the case in advance of trial—breached its duty to cooperate with its insurer in the investigation and defense of the underlying tort claim. So, the insurer has no duty to indemnify the insured in this case.
Doe v. Onebeacon Am. Ins. Co., 639 F. App'x 627, 628 (11th Cir. 2016).
In the final analysis, it does not matter which condition the insured breached in this case. It may have breached one of them or it may have breached both of them. In any case, there was no coverage and so there was no claim here, the Eleventh Circuit effectively held.
Posted by Dennis Wall on August 29, 2016 at 06:29 AM in Contract , Settlement | Permalink
bad, condition, consent, cooperate, defense, faith, inadequate, policy, settlement
Posted by Dennis Wall on August 26, 2016 at 06:31 AM in Commercial General Liability ("CGL") Insurance | Permalink
558, CGL, Chapter, commercial, construction, contractor, Florida, general, liability
Please Read The Disclaimer. Copyright by Dennis J. Wall. All Rights Reserved. Posted by Dennis Wall on August 24, 2016 at 02:30 PM in Catastrophe Claims | Permalink
Posted by Dennis Wall on August 24, 2016 at 08:58 AM in Cyber Risks & Cyberinsurance, Duty to Defend | Permalink
cyber, cyber, defend, duty, evidence, extrinsic, insurance, risks, Utah
Posted by Dennis Wall on August 22, 2016 at 06:33 AM in Catastrophe Claims | Permalink
catastrophe, claims, flood
Please Read The Disclaimer. ©by Dennis J. Wall. All Rights Reserved. Posted by Dennis Wall on August 19, 2016 at 06:19 AM in Computer Models to Predict Premium Rates | Permalink
computer, hurricanes, models, predict, premiums
Posted by Dennis Wall on August 17, 2016 at 05:55 AM in Cyber Risks & Cyberinsurance | Permalink
cyber, cyberinsurance, risks
LIFE INSURANCE EXPOSED.
Wondering why life insurance premiums are on the rise? Answers are explored in terms easy for me and for your clients to understand, by Julie Creswell and Mary Williams Walsh in "Why Some Life Insurance Premiums Are Skyrocketing" (New York Times Online, published in Sunday "Business Day" Section, August 14, 2016; posted on Saturday, August 13, 2016), or accessible in your browser by pasting http://www.nytimes.com/2016/08/14/business/why-some-life-insurance-premiums-are-skyrocketing.html?ribbon-ad-idx=4&rref=business&module=ArrowsNav&contentCollection=Your%20Money&action=click&region=FixedLeft&pgtype=article.
Many "what," "when," "who," "how" -- and also why" -- type of questions were addressed several months ago in an article that is still timely, again in an easy-to-understand way, by Tara Siegel Bernard, "Life Insurance Buyer's Guide: What Type, How Much and Who Will Benefit" (New York Times Online, posted February 19, 2016), and once again as an alternative to clicking on a hyperlink you can post the web address in your internet browser: http://www.nytimes.com/2016/02/20/your-money/life-insurance-buyers-guide-what-type-how-much-and-who-will-benefit.html?ref=business.
Life Insurers' Captive Reinsurance Subsidiaries Capture Investments.
Posted by Dennis Wall on August 15, 2016 at 06:19 AM in Life Insurance, Premiums | Permalink
insurance, life, premiums
Posted by Dennis Wall on August 10, 2016 at 06:41 AM in "Property Damage", Interpretation and Application of Insurance Contracts, Property Insurance | Permalink
application, damage, instructions, insurance, insurance, interpretation, jury, policies, property, property
Posted by Dennis Wall on August 08, 2016 at 05:25 AM in Crop Insurance, Settlement | Permalink
INSURANCE, WAIVERS, AND THE CFPB'S PROPOSED ARBITRATION RULE.
What follows is a Public Comment I am submitting today to the Consumer Financial Protection Bureau concerning the CFPB's proposed Arbitration Rule and Interpretation. Leave a Comment by sending the CFPB an EMail of your own. The EMail Address is on my Comment below. The deadline for Public Comments is August 22, 2016.
FederalRegisterComments@cfpb.gov.
Re: Docket No. CFPB-2016-0020 or RIN 2 3170-AA51.
Comment of Dennis J. Wall to Consumer Financial Protection Bureau's Proposed 12 C.F.R. § Part 1040; specifically, Comment adding text to proposed Rule and to Interpretation of Proposed 12 C.F.R. § 1040.2.
My proposed Comment offers brief additions to the CFPB's proposed Rule and Interpretation of 12 C.F.R. § 1040.2. It will add a new "b" to proposed § 1040.2, so that the existing subsections/Definitions in § 1040.2 will each be renumbered by one, with "Consumer" now Definition (c), "Provider" becomes Definition (d), and "Pre-dispute arbitration agreement" ends the proposed Definitions with subsection/Definition (e).
Here is my proposed text addition to become §1040.2(b):
(b) Business of insurance has the same definition as in 12 U.S.C.A. § 5481(3).
Here is my proposed addition to the CFPB's Interpretation of § 1040.2--Definitions:
2(b) Business of Insurance
Whenever a separate charge is made for the creditor's contractual agreement to cancel or waive all or part of any remaining amounts due on a finance agreement in the event that the subject of the sale or lease contract suffers a total physical damage loss or unrecovered theft, as a result of which the consumer does not maintain collateral protection insurance as required by the contract or fulfill guaranteed asset protection obligations assumed in the sale or lease contract, the inclusion of the charge for the waiver agreement in the sales or lease transaction is not the "business of insurance." This language is based partly on the prevailing and generally understood definition of "GAP (or guaranteed asset protection) Waiver" employed, for example, in Revenue Ruling 01-16-1 issued by the Nebraska D.O.R. on March 7, 2016. As you know, GAP Waivers are most often found in automobile financing agreements.
My proposed Interpretation is not limited to a GAP Waiver in an automobile financing agreement.
I am offering this proposal as a result of my research into arbitration agreements in the context of insurance. See Dennis J. Wall, "More Than Just Coverage Questions: Preemption and Validity Issues of Arbitration Provisions and Class Action Waivers in Insurance Policies" (Lexis-Nexis New Appleman on Insurance, forthcoming in October, 2016). Judges, lawyers, and litigants often conflate provisions with insurance that are nothing of the kind. This occurs most often when the provision at issue carries within itself the word or the sound of "insurance." Agreements to waive "collateral protection insurance" requirements and "guaranteed asset protection" obligations are not themselves insurance or the business of insurance. The brief additions to the proposed Rule and Interpretation that are suggested in this proposal will leave no foothold for anticipated contrary contentions.
To say again, what is at issue extends beyond simply GAP Waivers in automobile financing agreements, to reach any creditor's contractual waiver of creditor's rights upon a consumer-debtor's failure to maintain collateral protection insurance or to perform any guaranteed asset protection obligations under any loan agreement for the sale or lease of any financial product or service by a consumer, in any instance when the subject of the contract has suffered a total physical damage loss or unrecovered theft. In addition to addressing the context of this broader issue, this proposal reaches beyond Waiver agreements made at the time of the originating/initial sale or lease agreement. It addresses any contractual Waiver agreement, including one for which the creditor imposes a charge at any time during the sale or lease relation.
This Interpretation applies whenever such a charge is included in the cost of "credit," see 12 U.S.C.A. § 5481(7), in connection with a sale or lease to a consumer-debtor, i.e., whenever such a charge is included in the cost of any "financial product or service" defined by 12 U.S.C.A. § 5481(15)(A).
In sum, a creditor's waiver of a consumer's default in obtaining collateral protection insurance or of a consumer's failure to perform GAP obligations are not parts of "the writing of insurance or the reinsuring of any risks by an insurer" and so are not any part of the "business of insurance" as defined in 12 U.S.C.A. § 5481(3) and thereby excluded from the CFPB's jurisdiction. See 12 U.S.C.A. § 5481(15)(C). A creditor's waiver of a consumer's default in obtaining collateral protection insurance or of a consumer's failure to perform GAP obligations are instead well within the CFPB's jurisdiction. This proposal leaves no opportunity for a reasonable contrary contention by offering brief additions to the CFPB's proposed Rule and Interpretation.
Posted by Dennis Wall on August 05, 2016 at 08:10 AM in Arbitration | Permalink
Arbitration, CFPB, Rule
DEFENDING PROFIT-MAKING "CAREER COLLEGE" MARKETERS.
A for-profit marketer of "career college" services ("career college" in this case including what once was called "technical college") and its subsidiary provider of "post-secondary" courses were sued for alleged wrongful advertising in marketing education services for allegedly little or no education, as the Court put it, "for alleged wrongful advertising in connection with services they performed (or did not perform) to students at career colleges." Education Affiliates, Inc. v. Federal Ins. Co., No. -JFM-15-1624, 2016 WL 4059159, at *1 (D. Md. July 28, 2016).
Their D&O liability carrier refused to defend them against these claims. Not surprisingly, a Court held that under the universal liability insurance policy provision that provides virtually everyone with a defense regardless of whether the claims to be defended are false or not, so these defendants also were entitled to a defense under their liability policy. Education Affiliates, Inc. v. Federal Ins. Co., No. -JFM-15-1624, 2016 WL 4059159, at *2-*3 (D. Md. July 28, 2016).
Posted by Dennis Wall on August 03, 2016 at 06:05 AM in Duty to Defend | Permalink
Please Read The Disclaimer. ©by Dennis J. Wall. All Rights Reserved. Posted by Dennis Wall on August 01, 2016 at 06:10 AM in Exclusions, Interpretation and Application of Insurance Contracts | Permalink