“Arise out of ” or “Relate in Any Way” People who write contracts with conditions requiring that one party provides insurance protection for another must be able to read and understand all of the terms, conditions and limitations of a policy of insurance. Failure to do so will usually result in litigation that is, more […]
1011 Fake Claims Results in more than $500,000 Penalty When a chiropractor is caught billing insurers for services not performed he should never fail to appear to defend himself at an administrative hearing. Of course, if he or she has no defense delay is possible but dangerous. In The Matter Of Proceedings By The Commissioner […]
Arbitrators have Substantial Discretion to Determine the Scope of Their Contractual Authority to Fashion Remedies Arbitration is controlled by strong public policies favoring arbitration as a speedy and relatively inexpensive means of dispute resolution. For that reason arbitration awards are almost never overturned unless the aggrieved party can prove the arbitrators exceeded their powers, acted […]
Business Exclusion Clear and Enforceable When a farmer allows individuals access to the farm so they can pick cherries off trees in the orchard and buy the cherries at a lesser price than pre-picked cherries it is doing the business of farming. That is a reason why most farmers will buy a business liability policy […]
Living in New Jersey but Insured in Florida is Fraud No one like to pay insurance premiums. However, in a state like New Jersey, insuring a vehicle with No Fault insurance is mandatory. Since insurance in Florida is less expensive than in New Jersey a resident of New Jersey was tempted to and, in fact, […]
Guilty Of Disability Fraud ?Insurance criminals today define the Yiddish word “Chutzpah!” Their unmitigated gall to challenge a conviction for fraud is without bound. They appeal and waste the time of courts of appeal. More often than not the attempt fails, even in the very liberal Ninth Circuit Court of Appeal. In United States Of […]
Bar Negligent for not Seeking Arrest of Drunk & Disorderly Customer ?It is axiomatic among plaintiffs’ personal injury lawyers that the more serious the injury the less the need for legal niceties. In a case of the wrongful death of a young woman at the hands of a violent, intoxicated and unlicensed driver a clear […]
No Coverage Before Policy In Effect People who sue insurance companies seem to forget that an insurance policy is a contract – not an entitlement provided by a government. Insurance contracts must be read as a whole document and all clear and unambiguous terms must be applied as written. In Atlantic Specialty Insurance Company v. […]
Agent Defrauds Insurer by Not Remitting Premium Collected Insurance agents, by contract with insurers they represent, must place all premium collected on behalf of the insurer and place the funds in a separate trust account. Depending on the terms of the contract the agent then deducts the agreed commission and remits the remainder to the […]
An “Occurrence” Must Be Fortuitous Ohio, bucking the majority of court opinions, has interpreted the standard Commercial General Liability (CGL) policy to require for coverage to exist that a loss is fortuitous. An “occurrence” to Ohio courts require that the damage is accidental, fortuitous, and not a normal business risk of a person in the […]
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