On March 18, 2005, the Quebec Court of Appeal handed down an important decision confirming that the evidence relating to the behaviour and practices of a “reasonable insurer” need not be provided by an expert witness. In CGU Compagnie d’assurances du Canada v. Sylvain Paul et al., (J.E. 2005-705), Justices Louise Mailhot, René Dussault and Marie-France Bich dealt with this issue in connection with an objection to evidence made by the attorney representing the insured, Mr ...
In employees’ compensation or personal injuries claims, it is not uncommon for the employer or its insurers to directly settle a claim with the injured person before any legal proceedings are commenced. The recent case of Chan Kwok Man v New World First Bus Services Limited DCEC No.186 of 2013 highlights the importance of ensuring that the wording used in discharge forms is clear, unambiguous and consistent and that the discharge form is properly executed ...
The U.S. Court of Appeals for the Sixth Circuit, in Massachusetts Bay Insurance Company v. Christian Funeral Directors, Inc., No. 18-5267 (6th Cir. Dec. 26, 2018), recently upheld a district court’s declination of jurisdiction over an insurer’s declaratory judgment action on coverage ...
The U.S. Court of Appeals for the Sixth Circuit, in Massachusetts Bay Insurance Company v. Christian Funeral Directors, Inc., No. 18-5267 (6th Cir. Dec. 26, 2018), recently upheld a district court’s declination of jurisdiction over an insurer’s declaratory judgment action on coverage ...
Can the cost of remedying a manufacturing defect be considered as damage resulting from an “accident” covered under a liability insurance policy? This is the question the Quebec Court of Appeal considered in CGU, Compagnie d’Assurance du Canada v. Soprema Inc., [2007] QCCA 113 ...
The U.S. Department of Justice (DOJ) Fraud Section released its 2021 annual report earlier this month, and the numbers show that the DOJ continues to ramp up enforcement despite ongoing logistical challenges presented by the COVID-19 pandemic. The annual report reflects only prosecutions handled by the DOJ’s Fraud Section itself (not all federal prosecutions handled by individual U.S ...
In EBSA Disaster Relief Notice 2021-01, the Department of Labor (DOL) has issued a critical interpretation of prior guidance that extended certain deadlines for employee benefit plans, participants, and beneficiaries due to COVID-19. We discussed the original guidance in this prior article ...
The access to records clause, sometimes called the inspection or audit clause, is a common fixture in reinsurance agreements and serves an important function. It enables the reinsurer to track the performance of the agreement and maintain an accurate view of the business ceded. More specifically, it allows the reinsurer to ensure the cedent is complying with the terms and conditions of the agreement, including timely reporting of losses and calculation of premiums ...
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On the 2nd of February 2023, the European Insurance and Occupational Pensions Authority (hereinafter referred to as “EIOPA”) published a Supervisory Statement on the use of governance arrangements in third countries to perform functions or activities (hereinafter referred to as the “Statement”) ...
It is normal that an insurance contract does not cover all the different events that are part of the entire risk, since this would imply that the contract was becoming more expensive every day, in the face of the appearance of catastrophic risks or risks that due to different factors do existed before. In this sense, the delimitation of the scope of the insurance contract becomes an important situation to analyze ...
The Embedding ESG in Insurance webinar is being held as part the Mamo TCV Sustainable Finance Week being held between 24 October & 28 October 2022. Please click here for the programme of events ...
As a growing number of the workforce is being affected by the COVID-19 virus, employers are being asked to respond to benefit-related questions from employees. In the coming days, the Employee Benefits Group at Hanson Bridgett will be providing updated information on possible issues arising in the benefits area through Benefits Alerts and postings on Hanson Bridgett's Online COVID-19 Resource Center ...
Under final rules issued last month, employers can offer two new types of health reimbursement arrangements or HRAs: individual coverage HRAs ("ICHRAs") and excepted benefit HRAs ("EBHRAs"). HRAs are self-funded, account based plans that reimburse employees for qualified medical expenses on a tax-free basis. The final rules apply for plan years beginning on or after January 1, 2020. While the rules are complex, the new ICHRAs and EBHRAs offer new planning opportunities for employers ...
Empezaron las eliminatorias al próximo Mundial pero las investigaciones por sobornos de la FIFA continúan – tendrán cobertura bajo pólizas de seguros las compañías y altos ejecutivos siendo investigados?El Comité de Ética de la FIFA anunció el 8 de octubre la suspensión provisional por 90 días de Joseph Blatter, presidente de la FIFA, y de Michel Platini, presidente de UEFA y vicepresidente de FIFA, entre otras suspensiones que fueron anunciadas en ese mismo momento ...
As seen in Law Journal Newsletters The False Claims Act (FCA or Act) can be a real punch in the gut for businesses on the wrong side of an FCA claim. The Act, codified at 31 U.S.C. §§ 3729-3733, is designed to prevent private companies contracting with the government from knowingly submitting false or fraudulent claims for their services ...
ON SEPTEMBER 23, 2010, THE SUPREME COURT OF CANADA ISSUED AN UNANIMOUS JUDGMENT IN THE CASE OF PROGRESSIVE HOMES LTD. V. LOMBARD GENERAL INSURANCE CO. OF CANADA(1) , REVERSING TWO LOWER COURT JUDGMENTS OF BRITISH COLUMBIA WHICH HAD CONCLUDED THAT THE INSURER, LOMBARD, HAD NO DUTY TO DEFEND THE GENERAL CONTRACTOR PROGRESSIVE HOMES, AGAINST A CLAIM FOR DEFECTS AND DAMAGES CAUSED BY WATER INFILTRATION IN FOUR BUILDINGS BUILT BY IT ...
The Fifth Circuit Court of Appeals has held that a contractor’s breach of an express warranty to repair does not constitute an “assumption of liability in a contract or agreement” for purposes of the “contractual liability” exclusion found in most general liability policies ...
Yesterday, January 26, 2010, Judge David Hittner of the United States District Court for the Southern District of Texas issued an important opinion in the Stanford Financial case that paves the way for targets of criminal and civil enforcement proceedings to obtain insurance coverage for costs of defending themselves ...
In a recent opinion out of the U.S. District Court for the District of Columbia, U.S. District Court Judge Rudolph Contreras held that the U.S. Department of Health and Human Services (HHS) exceeded its authority when it substantially reduced the amount Medicare pays for 340B-acquired medications ...
FIFA Kickback and Bribery Allegations & Insurance For Related Third-Party Investigations Bribes of $40,000 stuffed in envelopes, a flight to Europe solely to retrieve a briefcase full of cash and a$10 million payoff to secure votes for choosing the World Cup host country are among the allegations in the recent indictment against FIFA representatives and related business associates ...
On March 1, the Fifth Circuit Court of Appeals ruled that $750 million of primary and excess coverage issued to Transocean Holdings, Inc. (“Transocean”) “imposes no relevant limitations upon the extent to which BP [BP American Production Company] is covered” as an additional insured in connection with the Deepwater Horizon incident in April 2010 ...
In a win for policyholders relying on multiple coverage layers, the Fifth Circuit held on June 23, 2014 that an excess liability insurance policy could be triggered by exhaustion of a “retained limit” - equal to the limits of underlying insurance - even if the amounts paid to meet the “retained limit” were not covered by the excess policy. Indemnity Insurance Co. of N. Am., et. al. v. W & T Offshore Inc., -- F.3d --, No. 13-20512 (5th Cir. June 23, 2014) ...
