Reinsurance Focus

New reinsurance-related and arbitration developments from Carlton Fields

MOTION TO SET ASIDE DISCOVERY ORDER ON LOSS RESERVES DENIED

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In the latest development in the ongoing litigation between Granite State Insurance Company and Clearwater Insurance Company, Granite unsuccessfully moved to set aside a magistrate judge’s discovery order. As we reported in July 2011, Granite was ordered to produce certain asbestos loss reserve documents in response to Clearwater’s request for production of documents. The motion objecting to that order was denied, the district judge concluding that, first, the magistrate judge’s order was not contrary to law as the crucial issue was not merely, as Granite suggested, whether a ceding insurer has any practices in place regarding providing notice and, second, the order was not “clearly erroneous” because the notice procedures were relevant to the ultimate issue in dispute. The district judge explained that Granite’s arguments were largely tied to the merits of its defenses rather than to the permissibility of the discovery sought. Granite State Insurance Co. v. Clearwater Insurance Co., Case No. 09-10607 (USDC S.D.N.Y. Apr. 20, 2012).

This post written by John Black.

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REHABILITATION PLAN DISAPPROVED FOR FAILURE TO INCLUDE SURETY BOND LIABILITIES IN PRIORITY CLASS OF “CLAIMS UNDER POLICIES”

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On July 22, 2009 and November 2, 2011, we reported on certain disputes involving long-time rehabilitating insurer, Frontier Insurance Company. Frontier’s rehabilitator recently submitted to the supervising court a plan of rehabilitation that included a runoff of Frontier’s liabilities, with additional protection for liabilities deemed “claims under policies.” Frontier’s plan defined such claims as those made under policies of insurance, but excluded claims under its significant book of surety bonds, fidelity bonds, and similar instruments. Based on this definition, the rehabilitator contended that Frontier’s surety liabilities were entitled to low priority and could be discounted. The court rejected the proposal and disapproved the plan, siding with objectors who contended that the proposed definition of “claims under policies” unlawfully discriminated within a single priority class of Frontier’s liabilities. Surety claims fall within the same class as insurance claims, and must be paid to the same extent as all other traditional insurance claims. The court ordered the rehabilitator to either propose a revised plan or apply for an order of liquidation. In re Frontier Insurance Co., Index No. 97-06 (N.Y. Sup. Ct. May 23, 2012).

This post written by Michael Wolgin.

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APPELLATE COURT AFFIRMS DENIAL OF MOTION TO COMPEL ARBITRATION

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A California appellate court upheld denial of a motion to compel arbitration of an underlying labor employment dispute. Martha Hoover brought a wrongful termination class action against American Home Life Insurance Company, arising from its termination of her agent contract, which American Home characterized as creating an independent contractor relationship with Hoover. Her claims were brought under state labor laws, relying on her assertion that she and other similarly situated agents should be treated as statutory employees, and that American Home violated the class members’ statutory employment rights. American Home moved to compel arbitration of the dispute pursuant to the Collective Bargaining Agreement that incorporated Hoover’s agency contract, and which contained an arbitration clause. Nevertheless, the trial court denied the motion to compel, finding that, (1) the agreement did not apply to Hoover’s claims, to the extent she was a statutory employee, and so was not in dispute; and (2) even if it did, American Home waived its right to arbitration by waiting a year to invoke its right to arbitrate. Hoover v. American Income Life Ins. Co., No. E052864 (Cal. App. May 16, 2012).

This post written by John Pitblado.

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NO RES JUDICATA EFFECT FOR UNCONFIRMED ARBITRATION AWARD

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The Greers entered into a contract with Town Construction for construction of their home. After a dispute arose regarding costs, workmanship, and other issues, Town Construction filed an arbitration demand with AAA for unpaid balances. The Greers counterclaimed for damages for repairs and diminution in home value due to construction defects, specifically alleging that their home had cracks in the walls due to Town Construction’s faulty workmanship. The arbitrator awarded damages on Town Construction’s claims and the Greers’ counterclaims. There was no evidence in the record, however, that the award had been confirmed by a court.

Three years later, the Greers discovered more cracks in the walls and filed a lawsuit in state court for damages. The trial court dismissed the claims as barred by res judicata because the Greers’ claims had already been litigated in the AAA arbitration proceeding. The Court of Appeal reversed. The court held that, under Louisiana Supreme Court precedent, an unconfirmed arbitration award is not a “valid final judgment” because it was not “rendered by [a] court” and thus has no res judicata effect. Greer v. Town Constr. Co., No. 2011 CA 1360 (La. Ct. App. Mar. 23, 2012).

This post written by Ben Seessel.

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TEXAS HIGH COURT HOLDS THAT STOP-LOSS INSURANCE SOLD TO EMPLOYEE-HEALTH PLANS IS NOT REINSURANCE

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The Texas Supreme Court ruled that stop-loss insurance sold to self-funded employee health benefit plans is “direct insurance in the nature of health insurance” and not reinsurance. As we reported earlier, the Court of Appeals had ruled that such policies were reinsurance beyond the scope of DOI regulation. The issue arose when the Texas DOI discovered, during a routine audit, that American Insurance Company had sold stop-loss policies from 1998-2002 without paying taxes or complying with other regulatory requirements. American argued that employers that self-fund employee health benefit plans are “insurers” engaged in the “business of insurance.” The Texas high court disagreed, holding that, although employers that self-fund health benefit plans in some respects act like insurers, they are not regulated as insurers under the Texas Insurance Code. Further, the court reasoned, ERISA generally precludes the states from deeming such plans to be insurers or engaged in the business of insurance. Texas Dep’t of Ins. v. Am. Nat’l Ins. Co., No. 10-0374 (Tex. May 18, 2012).

This post written by Ben Seessel.

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