Insurance

If you’re getting Long-Term Disability (LTD) benefits, you might wonder: can I work part-time when I’m on Long-Term Disability?  

The answer is usually yes! Long-Term Disability policies are all different and so it’s important to consult the terms of your specific policy (also called the “plan documents.”) If you don’t have a copy of the policy terms, you should be able to obtain them from either the Long-Term Disability insurance company or your employer. The plan documents are usually
Continue Reading The Hidden Dangers of Working Part-Time While on Long-Term Disability

I devote a not-so-small portion of my practice to serving as a guardian ad litem in cases involving minor settlements. I scratched my head a number of times last year at anecdotes I heard and things I witnessed myself when it came to dealing with minor settlements.

And that got me thinking; maybe we should all think a bit more about how to most effectively and efficiently approach settlements offered to minors.

I am hopeful that anyone reading this
Continue Reading Some Thoughts on Minor Settlements and GALs in Personal Injury Cases

Cincinnati Insurance Company v. James Ropicky, et al., No. 2023AP588, 2024 WL 5220615 (Wis. Ct. App. Dec. 26, 2024)

On December 26, 2024, the Court of Appeals of Wisconsin issued is decision in Cincinnati Insurance Company v. James Ropicky, et al., No. 2023AP588, 2024 WL 5220615 (Wis. Ct. App. Dec. 26, 2024), addressing whether an ensuing cause of loss exception to a Construction Defect Exclusion, Fungi Exclusion, and Fungi Additional Coverage endorsement contained in a homeowner’s insurance policy issued
Continue Reading Wisconsin Appellate Court Interprets Construction Defect Exclusion and Fungi Exclusion

Policyholders nationwide are frustrated with the insurance industry in general. The recent murder of one of the nation’s largest healthcare insurers by a disgruntled policyholder is just one glaring example.[1] Or consider the 26.4% premium increase homeowners across the country experienced over the past three years on average.[2] Here in Wisconsin, homeowners saw their premiums jump 21.4% on average since 2018. While policyholder dissatisfaction is certainly expected in the wake of national headlines and skyrocketing premiums, it
Continue Reading Climate Change: Are Insurers Really ‘Covering Less’?

Oftentimes, when an insured sues their insurance company for not providing benefits the insured believes they are entitled to under their policy, the insured alleges that the insurance company breached the applicable contract and did so in bad faith. Wisconsin law makes clear that breach of contract and bad faith are distinctly separate claims, with different elements that the insured must establish.

Wisconsin first recognized the tort of bad faith in the state Supreme Court’s seminal decision in the
Continue Reading Standards for Insurance Bad Faith Under Wisconsin Law

Miller v. West Bend Mutual Insurance Company
No. 2023AP1697 (Wis. Ct. App. Oct. 22, 2024) (recommended for publication)

In Miller v. West Bend Mutual Insurance Company, the Wisconsin Court of Appeals considered whether Wisconsin law permits insurers to define “underinsured motor vehicle” to exclude government-owned vehicles in a UIM policy. No. 2023AP1697 (Wis. Ct. App. Oct. 22, 2024). The court answered in the affirmative and recommended the opinion for publication, thereby confirming that the 2011 amendments to Wisconsin’s auto
Continue Reading Contractually Defining UIM Coverage

In last week’s post, we talked about the Connelly case before the U.S. Supreme Court, which involved a fight between an estate and the IRS about whether money from a Key Person Insurance policy (that a company takes out on the lives of its shareholders) should count toward the company’s fair-market valuation for the purposes of estate taxes for the shareholder’s estate. The link for last week’s post can be found here.

With the context and case last
Continue Reading Connelly: How to Pull the Wrench from the Works

Posted on August 21,2024 in Insurance Coverage Litigation
Few of us enjoy paying our insurance premiums every month, yet we do so because we understand that catastrophes can happen and we may need a safety net to cover our health, home, and finances in an emergency.

When an insurance company tries to deny or reduce coverage for illegitimate reasons, this is called “bad faith insurance.” The law prohibits insurance companies from acting this way, and people who
Continue Reading Can I Sue My Insurance Company for Denying Coverage? 

McLaughlin v. Gaslight Pointe Condominium Association, LTD
No. 2023AP1011 (Wis. Ct. App. Apr. 17, 2024)

In McLaughlin v. Gaslight Pointe Condominium Association, LTD, the Wisconsin Court of Appeals contributed to Wisconsin’s ever-growing body of caselaw examining when an insured’s intentional conduct may constitute an “occurrence” within the meaning of a CGL policy. No. 2023AP1011 (Wis. Ct. App. Apr. 17, 2024) (recommended for publication). The court also examined several exclusions commonly found in CGL policies. In brief, the facts of
Continue Reading The Wisconsin Court of Appeals’ Provides Further Guidance on the Intersection Between Volitional Acts and Occurrences

In the business world, there is always the risk of litigation–even for small businesses. Unfortunately, as a business continues its operations, the possibility of litigation turns from an “if” to a “when.” Litigation can be expensive, time-consuming, and stressful. Here are some basic considerations that can help mitigate the risk of litigation for a small business.

1. Put it in writing in definite terms.

As stated in Field of Dreams, “If you build it, they will come. . .”
Continue Reading Mitigating Litigation Risk for Small Businesses

Robert Bolger v. Massachusetts Bay Insurance Company, 2022AP742

In Bolger, Massachusetts Bay Insurance Company (MBIC) issued a homeowner’s insurance policy to Bret and Amy Achtenhagen that covered their primary home and further provided personal liability and medical payments to others coverage. The policy contained an exclusion for bodily injury “arising out of the ownership, maintenance, use, loading or unloading of …motorized land conveyances …owned or operated by …an ‘insured,’” subject to an exception for “[a] vehicle or conveyance not
Continue Reading Policy Exceptions – A Tale of Two Interpretations

Irrevocable Life Insurance Trusts may alleviate heavy tax burdens on your estate. Are you aware your life insurance policy may bring a heavy tax burden along with it? Many individuals and families are unaware of how their life insurance policies may affect their estate plans, especially those with significant wealth. But fear not, there’s a solution that might just alleviate this stress: Irrevocable Life Insurance Trusts (ILITs) and Crummey Letters.

Let’s break it down into simpler terms.
What’s an
Continue Reading Irrevocable Life Insurance Trusts Make Your Estate Tax Efficient

Suffering a personal injury is a challenging experience, and the first settlement offer may seem like a lifeline.

However, before accepting it, it is important to carefully reconsider for several reasons.
Assessing the full extent of injuries
One key reason to reconsider the initial settlement offer is the need to fully understand the extent of your injuries. Often, immediate medical expenses are evident, but some injuries may not manifest immediately. It is important to give yourself time to assess
Continue Reading Is the first settlement offer the right move for your claim?

On December 19, 2023, the Appellate Court of Illinois, First District, held that the “violation-of-law” exclusion1 found in a general liability policy precluded insurance coverage for a BIPA action brought against an insured. See National Fire Insurance Company of Hartford v. Visual Pak Company, Inc., 2023 IL App (1st) 221160 (Ill. App. Ct. 2023). The Illinois court’s decision squarely conflicts with Citizens Insurance Company of America v. Wynndalco Enterprises, LLC, 70 F.4th 987 (7th Cir. 2023), a Seventh Circuit
Continue Reading Appellate Court of Illinois and Seventh Circuit Issue Conflicting Decisions Regarding Applicability of ‘Violation-of-Law Exclusion’ in BIPA Actions

As the traditional health system continues to fail patients and providers alike, more people are turning to wellness to fill in the gaping hole left by traditional health care. For those wellness practitioners wanting to serve clients as a health, wellness or lifestyle coach, aruveyda or reiki practitioner, yoga instructor, personal trainer, massage therapist, holistic health practitioner, functional medicine practitioner, nutrition counselor or many of the other titles that identify as wellness, a critical question you may ask is
Continue Reading If Wellness Practitioners Don’t Bill Health Insurance, Are they Subject to HIPAA Privacy Rules?

There are a variety of situations where disputes about insurance coverage may arise, including cases involving injuries that occurred because of a person’s actions. In these situations, insurance companies may deny claims for numerous reasons, claiming that exceptions to coverage apply or that injuries were not accidental. This can put people in a difficult situation as they seek compensation in personal injury cases or similar matters, and they may need to take legal action to fight against the denial
Continue Reading Wisconsin Supreme Court Addresses Reckless and Intentional Conduct in Insurance Disputes