Insurance Coverage Cases
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Insurance Coverage

Massachusetts Appeals Court
Uncategorized

New England Carpenters v. Arch Insurance — Fringe-Benefit Fund Trustees Are Intended Third-Party Beneficiaries Exempt from G.L. c. 149, § 29 Notice Requirement

The Massachusetts Appeals Court vacated summary judgment for the surety, holding that fringe-benefit fund trustees who are intended third-party beneficiaries of a collective bargaining agreement have a “contractual relationship” with the general contractor under G.L. c. 149, § 29, exempting them from the statute’s sixty-five-day written notice requirement.

Texas Court of Appeals, Thirteenth District (Corpus Christi–Edinburg)
Uncategorized

In Re Germania Farm Mutual — Texas Appeals Court Compels Insurance Appraisal Despite Insurer’s Full Claim Denial

The Thirteenth Court of Appeals conditionally granted mandamus compelling appraisal in a homeowner’s insurance dispute, holding that Germania’s outright claim denial did not preclude appraisal and that the policyholder failed to establish waiver or prejudice from any delay in demanding the process.

Appellate Division, Fourth Department
Uncategorized

Shattuck v. Dryden Mutual — Wrongful Disclaimer Is Anticipatory Repudiation, Bad Faith Claims Reinstated

The Fourth Department held that Dryden Mutual’s wrongful coverage disclaimer was an anticipatory repudiation excusing the insured from forwarding suit papers, barring the insurer from challenging the $2.8 million default judgment in a § 3420 direct action, and requiring reinstatement of bad faith claims under the Pavia “gross disregard” standard.

Ninth Circuit
Uncategorized

Roggenkamp v. Morgan Stanley Medical Plan — Ninth Circuit Reverses ERISA Denial Where Administrator Relied on Internal Policy Instead of Plan Document

The Ninth Circuit reverses an ERISA denial of a disc replacement surgery, holding that Cigna abused its discretion by relying on its own internal policy rather than the governing plan document, and that the district court improperly affirmed using rationales never raised during the administrative pr

Texas Court of Appeals, Fifteenth District
Uncategorized

Public Utility Commission v. City of Denton — Court Affirms Rate Decision Reversing Commission’s Mid-Proceeding RFP Change for Municipal Transmission Utility

The Texas Fifteenth Court of Appeals affirmed a district court ruling that the PUC’s mid-proceeding modification of its rate filing package without Texas Register publication was arbitrary and capricious, requiring application of the pre-amendment 0.25x debt service coverage adder presumption, while upholding the Commission’s exclusion of a municipal utility’s general fund transfer return-on-investment component as insufficiently substantiated.

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