Defining Catastrophic Injury Claims
December 16, 2019 —
Bremer Whyte Brown & O'Meara LLPHow do we define circumstances and injuries that go beyond a typical claim and severely impact a person’s life? How do we characterize the types of claims where an individual’s enjoyment of life is affected in an extraordinary manner? Typically, attorneys refer to these types of cases as “catastrophic injury” claims. These are the type of personal injury claims where the health of an individual has been so seriously impacted that their life has been irreparably altered. Defining these claims legally is somewhat murky and case law has done little to provide attorneys with a specific definition of the term. However, a recent Workers Compensation Appeals Board ruling attempted to list factors in order to establish a catastrophic injury claim. These include:
- An intensity and seriousness of treatment received for an injury;
- The ultimate outcome when a person’s physical injury is permanent and stationary;
- Whether the severity of the physical injury impacts the person’s ability to perform daily activities;
- Whether the physical injury is closely analogous to one of the injuries specified in various statutes, including loss of a limb, paralysis, severe burns, or a severe head injury; and
- If the physical injury is incurable or progressive. Wilson v. State of California CAL Fire (5/10/19) 2019 Cal.Wrk.Comp. LEXIS 29.
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Dreyer v. Am. Natl. Prop. & Cas. Co. Or: Do Not Enter into Nunn-Agreements for Injuries that Occurred After Expiration of the Subject Insurance Policy
January 20, 2020 —
Jean Meyer - Colorado Construction LitigationWhile Nunn-Agreements[1] may be appealing for both plaintiffs and defendants where an insurer unreasonably fails to defend a lawsuit, a recent opinion from The Honorable Marcia Krieger in the United States District Court of Colorado[2] (“Opinion”) demonstrates the importance of first confirming that there exists a viable insurance claim before proceeding with such a Nunn- Agreement.
The facts giving rise to the Opinion were as follows. In March 2015, a Homeowner couple (the “Homeowners”) suffered damages to their home resulting from a brushfire. Fortunately, the Homeowners were insured, they submitted their claim to their homeowners’ insurance carrier which was in effect at the time of the brushfire (the “Insurance Carrier”), and the Insurance Carrier paid the claim. Ostensibly as part of the Homeowners’ remediation efforts to their home they removed a large bush which left a hole in the ground. After paying the claim, in August 2015 the Insurance Carrier cancelled or elected not to renew the Homeowners’ policy. In October 2015, a repairman working on the Home (the “Repairman”) was injured after his ladder fell over allegedly because of the hole in the ground caused by the bush that had been removed.
As a result of injuries caused by the fall from the ladder, the Repairman brought suit against the Homeowners. In response to the Repairman’s claim, the Homeowners again tendered to their Insurance Carrier. This time, however, the Insurance Carrier denied coverage on the basis that the Repairman’s injuries occurred after the expiration of the relevant policy. Without insurance coverage, the Homeowner’s entered into a Nunn-Agreement with the Repairman, conceding liability, and assigning any claims they might have had against the Insurance Carrier in lieu of execution of any judgment against the Homeowners.
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Jean Meyer, Higgins, Hopkins, McLain & Roswell, LLCMr. Meyer may be contacted at
meyer@hhmrlaw.com
No Coverage Under Ensuing Loss Provision
September 09, 2011 —
Tred R. Eyerly - Insurance Law HawaiiThe cost of removing and replacing cracked flanges to prevent future leakage was not covered as an ensuing loss under a builder’s risk policy in RK Mechanical, Inc. v. Travelers Prop. Casualty Co. of Am., 2011 U.S. Dist. LEXIS 83958 (D. Colo. Aug. 1, 2011).
The insured, RK Mechanical Inc., was a subcontractor hired to install plumbing for a residential construction project. RK was an additional insured on the general contractor’s policy with Travelers. RK installed approximately 170 CPVC flanges on the project. Subsequently, two of the flanges cracked, allowing water to overflow and causing water damage to the project. Travelers was notified of the flange failure and resulting water damage.
RK subsequently removed and replaced the two cracked flanges and began water remediation. Travelers paid for the cost of the water damage due to the cracked flanges.
RK then examined all of the flanges installed in the project and discovered many were cracked and/or showed signs of potential failure. RK removed and replaced the cracked flanges. RK tendered a claim and demand for indemnity to Travelers for these repair costs. Travelers denied the claim. RK then sued for breach of contract and declaratory relief. The parties filed cross motions for summary judgment.
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Reprinted courtesy of Tred R. Eyerly, Insurance Law Hawaii. Mr. Eyerly can be contacted at te@hawaiilawyer.com
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Second Circuit Certifies Question Impacting "Bellefonte Rule"
December 15, 2016 —
Ellen Burrows – White and Williams LLPCalling into question the continued validity of the so-called “Bellefonte Rule,” on December 8, 2016, the United States Court of Appeals for the Second Circuit certified to the New York Court of Appeals the question whether a facultative reinsurance contract limit is presumptively all-inclusive and “caps” the reinsurer’s total exposure even where the reinsured policy pays defense costs in addition to the limit. Global Reinsurance Corporation v. Century Indemnity Company Docket No. 15-2164-cv (December 8, 2016).[1]
In Bellefonte Reinsurance Company v. Aetna 903 F.2d 910 (2d Cir. 1990), the court ruled that a reinsurer was not liable to pay defense costs above the stated reinsurance contract limit. Although litigants argued that this ruling was dependent on the fact that the reinsured policy limits were defense cost-inclusive, a later panel of the Second Circuit applied the “cap” ruling in Bellefonte to a situation where the reinsured policy limit was not cost-inclusive and where the insurer was obligated to pay defense costs in addition to the policy limit. Unigard Security Insurance Company v. North River Insurance Company 4 F.3d 1049 (2d Cir. 1993).
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Ellen Burrows, White and Williams LLPMs. Burrows may be contacted at
burrowse@whiteandwilliams.com
Haight’s John Arbucci and Kristian Moriarty Selected for Super Lawyers’ 2020 Southern California Rising Stars
July 20, 2020 —
T. Giovanni “John” Arbucci & Kristian B. Moriarty - Haight Brown & BonesteelCongratulations to attorneys T. Giovanni “John” Arbucci and Kristian Moriarty who were selected to the Super Lawyers 2020 Southern California Rising Stars list. Each year, no more than 2.5% of the lawyers in the state are selected by the research team at Super Lawyers to receive this honor.
Reprinted courtesy of
T. Giovanni “John” Arbucci, Haight Brown & Bonesteel and
Kristian B. Moriarty, Haight Brown & Bonesteel
Mr. Arbucci may be contacted at jarbucci@hbblaw.com
Mr. Moriarty may be contacted at kmoriarty@hbblaw.com
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BWB&O is Recognized in the 2024 Edition of Best Law Firms®!
November 16, 2023 —
Dolores Montoya - Bremer Whyte Brown & O'Meara LLPBremer Whyte Brown & O’Meara, LLP is honored to announce the firm has been recognized for its fourth consecutive year in the 2024 edition of Best Law Firms® and is ranked by Best Lawyers® regionally in three practice areas. To read the publication, please click
here.
Regional Tier 1
Las Vegas: Litigation – Construction
Orange County: Litigation – Construction
Regional Tier 2
Orange County: Family Law
Regional Tier 3
Orange County: Commercial Litigation
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Alleging and Proving a Florida Deceptive and Unfair Trade Practices Act (FDUTPA) Claim
December 13, 2021 —
David Adelstein - Florida Construction Legal UpdatesWhen it comes to construction disputes, a Florida Deceptive and Unfair Trade Practices Act (known by its acronym “FDUTPA”) claim is not commonly asserted. A FDUTPA claim is a statutory claim under Florida Statute s. 501.201 en seq. This claim is NOT easy to prove, particularly in the construction context. Sometimes, a party will assert a FDUTPA claim to create a basis for attorney’s fees; however, that basis cuts BOTH ways, i.e., you can be liable for fees if you fail to prove the FDUTPA claim. In a construction dispute, a FDUTPA claim is one that really should be pled with caution after a party understands and fully considers what it MUST prove including the all-important consideration of how actual damages are determined under FDUTPA, which requires an actual loss. Nevertheless, it is good to know what you need to prove to support a FDUTPA claim in case you believe you have facts that can support a FDUTPA claim and actual damages under FDUTPA (known as benefit-of-the-bargain damages).
Reprinted courtesy of
David Adelstein, Kirwin Norris, P.A.
Mr. Adelstein may be contacted at dma@kirwinnorris.com
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Hurricane Ian: Discussing Wind-Water Disputes
October 10, 2022 —
Randy J. Maniloff - White and Williams LLP“Most of the Florida homes in the path of Hurricane Ian lack flood insurance, posing a major challenge to rebuilding efforts, new data show. In the counties whose residents were told to evacuate, just 18.5 percent of homes have coverage through the National Flood Insurance Program, according to Milliman, an actuarial firm that works with the program.”
That’s how a September 29th article on The New York Times website begins.
When it comes to insurance coverage for hurricanes, the oft-stated maxim is that homeowner’s policies cover damage caused by wind but not flood waters.
Such a low take-up rate for flood insurance policies would seemingly create an incentive for those affected by Hurricane Ian to argue, when feasible, that their property damage, despite appearing to have been caused by flood, was also caused by wind. [And, of course, businesses looking to make business interruption claims, under commercial property policies, will be in the same boat.]
Further, even when someone has a homeowner’s policy and a flood policy, there may still be a reason to argue that the loss was caused by wind, as homeowner’s policies often have greater limits than flood policies.
[As an important aside, when hurricane damages are covered, homeowner’s policies can have a significant deductible, perhaps up to 10% of a home’s insured value.]
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Randy J. Maniloff, White and Williams LLPMr. Maniloff may be contacted at
maniloffr@whiteandwilliams.com