Recent Publications - Appeals


Circuit Court Rejects FMLA Interference Claim Against Secondary Employer
November 30, 2013 | Appeals | Insurance Coverage

Keppel Amfels L.L.C., which builds and repairs offshore drilling platforms and marine vessels at the Port of Brownsville, Texas, relies on lease-labor and temporary staffing agencies, including Perma-Temp Personnel Services, Inc., to staff about half of its local work assignments. Although these agencies fill “temporary” positions, some placements last for several years.

Keppel Amfels and

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The Case for Allowing Insurers to Recover Attorneys’ Fees in Fraud Suits
November 1, 2013 | Appeals | Insurance Coverage

AMERICAN BAR ASSOCIATION – MASS TORTS & DEVELOPMENTS

After an employee of Glasbern Inc. was injured, the company’s Workers’ Compensation insurer, Zenith Insurance Company, began paying Workers’ Compensation benefits to him. Thereafter, Zenith sued Glasbern, Glasbern’s owner, Albert Granger, and its insurance broker, alleging that it only had issued and renewed the policy as a

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Employment Agreement’s Requirement that Employee Bring Legal Actions Within Six Months Is Ruled Invalid with Respect to FLSA and Equal Pay Act Claims
October 31, 2013 | Appeals | Labor & Employment | Insurance Coverage

The plaintiff in this case worked for FedEx Customer Information Services, Inc., under an employment agreement that provided, in part, that “[t]o the extent the law allows an employee to bring legal action against Federal Express Corporation, I agree to bring that complaint within the time prescribed by law or 6 months from the date

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Court Rules Same-Sex Spouse Entitled to Survivor Annuity under ERISA Profit Sharing Plan
September 30, 2013 | Appeals | Labor & Employment | Insurance Coverage

After Sarah Ellyn Farley began working at a law firm in 2004, she became a participant in the firm’s profit sharing plan.  In 2006, Farley married Jean Tobits in Toronto, Canada, as authorized under Canadian law. Shortly after her wedding, however, Farley was diagnosed with cancer and died in 2010.

The profit sharing plan required that,

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Growing Role of Discovery in Providers’ Cases Seeking No-Fault Benefits
September 6, 2013 | Appeals | Insurance Coverage

In recent years, more and more no-fault[1] insurance carriers and health care providers have become parties to an escalating battle over providers’ requests to obtain payment from no-fault insurers for care the providers allegedly provided to injured people (so-called “assigned first-party no-fault benefits”). At the heart of the dispute is State Farm Mutual Automobile Ins.

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Court Dismisses Breach of Fiduciary Duty Claim against Disability Plan Administrator for Failing to Provide Plan Summary
August 31, 2013 | Appeals | Labor & Employment | Insurance Coverage

After her claim for benefits was denied, the plaintiff in this case, a former employee of Corning Incorporated and a participant in the Corning Incorporated Long Term Disability Plan, sued the plan administrator – the Corning Benefits Committee – for breach of fiduciary duty by virtue of its alleged failure to furnish her with a

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Breach of Duty to Defend Stands Out Among Noteworthy Issues
August 26, 2013 | Appeals | Insurance Coverage

The past term’s significant insurance law decisions by the New York Court of Appeals resolved a variety of issues that will alter the practice of insurance law in important ways. Among the most notable of these decisions was K2 Investment Group, LLC v. American Guarantee & Liability Ins. Co.,[1] where the court evaluated the consequences to

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Circuit Upholds Sanctions against Plaintiff’s Attorney in Case Involving Alleged Breach of Disability Insurance Policy
July 31, 2013 | Appeals | Labor & Employment | Insurance Coverage

The plaintiff in this case sued Paul Revere Life Insurance Co., alleging that Paul Revere had engaged in bad faith and that Paul Revere had breached his disability insurance policy by terminating his disability benefits. The district court dismissed the plaintiff’s bad faith claim, and denied the plaintiff’s two motions for reconsideration.

Shortly before trial

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Statute and Common Law Provide Immunity for Insurers Reporting Fraud
July 5, 2013 | Appeals | Insurance Coverage

After a fire damaged a house in Wilson, North Carolina, that was owned by Cully’s Motorcross Park, Inc., its president and sole stockholder, Laurie Volpe, submitted a claim to North Carolina Farm Bureau Mutual Insurance Company, the insurer for Cully’s. Farm Bureau began an investigation and ultimately denied the claim, citing its suspicion that the

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Court Dismisses Complaint Seeking Payment for MUA Procedures
June 30, 2013 | Appeals | Insurance Coverage

Montvale Surgical Center, LLC, an outpatient ambulatory surgery center, performed three “medically necessary” spinal manipulation under anesthesia (MUA) procedures on New Jersey resident Gerald Tyska at its facility. Tyska subscribed to a fully-funded group health insurance plan maintained by Coventry Health Care, Inc., and assigned his rights under the plan to Montvale.

Montvale submitted requests

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