Mansell, Engel & Cole

Oklahoma City Insurance Law Blog

Competing claims in insurance breach of contract case

The chance of a policyholder in Oklahoma or elsewhere prevailing in a damage claim filed with an insurer obviously increases exponentially when damage allegations can be supported by compelling evidence.

And when a claimant tells the truth.

Federal court finds that crime insurance covers phishing attacks

Should your crime insurance policy cover computer crimes? Not long ago, both the Second and Sixth Circuit courts of appeal ruled that phishing-related losses are covered. Now, the Eleventh Circuit has also found that phishing losses are covered by a crime policy that includes "fraudulent instructions."

Phishing is a scam where a fraudster attempts to manipulate a victim through use of emails or fake websites. Typically, the goals are to get the victim to transfer money into the fraudster's control or to give access to information in computer systems.

Is a jumbo, decorative beach ball an amusement device?

It all happened at an event called "RumFest" in another state. A pair of local night clubs that were sponsoring the event put jumbo-sized, decorative inflatable beach balls in a fountain pond. They were never intended to be used as actual balls but merely to lend ambiance, according to the night clubs.

Unfortunately, an unknown attendee set the balls loose. A man named Hunt saw a ball coming at his head and reflexively pushed it into the air. Unfortunately, the motion caused serious tendon and ligament injuries in his shoulder and elbow.

Is computer damage from ransomware a direct physical loss?

If your policy requires a "direct physical loss" before a claim will be paid, you will be interested in a recent decision by a federal court in another state. Although the ruling would only be used as persuasive authority, not precedent, in Oklahoma, federal judges here would be likely to see the argument as quite persuasive.

The situation involved a company called National Ink & Stitch, which does screen printing and embroidery. The company suffered a ransomware attack in December 2016 and made a claim against its insurance policy through State Auto Property and Casualty Insurance Co. The claim sought replacement of a computer server that had been damaged, and perhaps permanently compromised in the attack.

What does it mean to say a claim denial was in bad faith?

If your insurance claim was denied in bad faith, you could win extra damages in a lawsuit. In addition to the cost of the loss you were claiming, you could be awarded compensation for any other financial losses caused by the bad faith of the insurance company, for emotional distress caused by the misconduct, and for any embarrassment or loss of reputation you suffered due to the improper claim denial. In some cases, you may be eligible for punitive damages, which are meant to punish bad actors.

But what is a bad faith denial? In Oklahoma, it must be more than a reasonable difference of opinion about what your policy covers. To be considered a bad faith actor, the insurer can't have made an honest mistake. At the same time, their conduct does not have to have been reckless.

Why did your health insurance deny your claim?

Like many in Oklahoma, you may have insurance on your own dime and not through your employer. Since this is often expensive, it can be frustrating to have the insurer deny a claim you feel is legitimate. Often these issues arise when a policyholder is not familiar with the terms of the policy, but they can also come about through intentionally deceptive, or "bad faith," actions on the insurer's part.

It can be a mistake to assume that your health insurance policy will cover everything health-related. In fact, there are many situations that your policy may exclude, and you may find those exclusions listed on your policy documents. However, it is not always clear what the insurer will decide about a claim.

National insurer under fire for alleged fraud in OK lawsuit

Did insurance giant Farmers play fair?

Eight Oklahoma plaintiffs insist that the company did not concerning its conduct regarding their claims for storm-linked property damage. Their stated dismay with the national insurer has led to their filing of a lawsuit in Cleveland County.

U.S. maternity costs: singularly high and challenging

Having a baby is of course an epochal event for American mothers, with virtually every aspect of the procedure being markedly memorable.

Including the bill and, often, the related challenges imposed by insurers centrally involved in the process.

The universe of insurance bad faith is both broad and varied

Our first order of business in today’s Mansell, Engel & Cole blog post is a heartfelt communication to our readers residing in Oklahoma and elsewhere across the country.

Namely, we want to express our gratitude and appreciation for your online visits and perusal of our pro-policyholder insurance law pieces.

Don't assume your homeowner's insurance covers everything

If you are like many others here in Oklahoma City, you probably assume that your homeowner's insurance will cover any claim related to your home. Unfortunately, you would probably be wrong.

Homeowner's insurance policies often have exclusions for certain types of property. In order to obtain coverage for them, you may need to purchase a rider to add to your policy.

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