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February 21, 2025
No Coverage for Criminal Acts

Concealing a Weapon Used in a Murder is an Intentional & Criminal Act

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In Howard I. Rosenberg; Kimberly L. Rosenberg v. Chubb Indemnity Insurance Company Howard I. Rosenberg; Kimberly L. Rosenberg; Kimberly L. Rosenberg; Howard I. Rosenberg v. Hudson Insurance Company, No. 22-3275, United States Court of Appeals, Third Circuit (February 11, 2025) the Third Circuit resolved whether the insurers owed a defense for murder and acts performed to hide the fact of a murder and the murder weapon.

FACTUAL BACKGROUND

Adam Rosenberg and Christian Moore-Rouse befriended one another while they were students at the Community College of Allegheny County. On December 21, 2019, however, while at his parents’ house, Adam shot twenty-two-year-old Christian in the back of the head with a nine-millimeter Ruger SR9C handgun. Adam then dragged Christian’s body across the road in front of his parents’ home and left it in a wooded park.

After their adult son shot and killed his twenty-two-year-old former classmate at their house, the parents allegedly delayed discovery of the murder weapon and the victim’s body. Based on that delay, the victim’s mother sued the homeowners in state court for the intentional infliction of emotional distress. The homeowners then sought legal representation under two of their insurance policies – their homeowner’s policy and their umbrella policy.

It took over two months for the police to find Christian’s body. The gun turned up a month after Christian’s killing – produced by Martha Laux. She told police that she had found a handgun along a trail while walking her dog in North Park, a large public park in Allegheny County. Over a month after receiving the handgun, homicide detectives found Christian’s body. They later learned not only that the weapon used to kill Christian was already in police custody but also that Laux was the marriage counselor for Adam’s parents, Kimberly and Howard Rosenberg.

Based on the delayed discovery of her son’s body, Christian’s mother, T. Lee Rouse, sued the Rosenberg parents in the Court of Common Pleas of Allegheny County, Pennsylvania.

District Court Decision

The District Court rejected the claims by the homeowners and upheld the insurers’ denial-of-coverage decisions. The District Court’s decision in this appeal brought by the homeowners’s insurer denied coverage on several grounds, including that the claim against the homeowners did not relate to an accident. The umbrella insurer likewise denied coverage on that basis as well as several other grounds, including that an insurer’s promise to defend an insured for criminal acts is contrary to public policy and thus unenforceable under Pennsylvania law.

Was There an Accident?

The District Court examined whether the injuries alleged in the complaint resulted from an accident. Under the Rosenbergs’ homeowner’s policy, Chubb’s duty to defend depended on whether the injuries resulted from an accident. The allegations against the Rosenbergs involved intentional actions, specifically the concealment of the handgun that would have implicated their son and led to the earlier discovery of the victim’s body. The District Court concluded that the injuries did not result from an accident, and Chubb had no duty to defend under the homeowner’s policy.

Public Policy Against Insuring Criminal Acts

The court also addressed the issue of public policy. The Hudson policy included an unexpected-or-unintended injury clause, which introduced subjective considerations into the meaning of ‘occurrence’. However, the District Court held that any duty to defend would not be enforceable because Pennsylvania law forbids insuring criminal acts as contrary to public policy.
Discussion

Under the Rosenbergs’ homeowner’s policy, Chubb’s duty to defend depended on whether Rouse’s alleged injuries resulted from ‘an accident.’ Although the policy itself does not define ‘accident,’ Pennsylvania courts have defined that term as meaning the culmination of forces working without design, coordination or plan. The allegations against the Rosenbergs do not involve such chance. Rather, Rouse alleged that the Rosenbergs acted intentionally by concealing the handgun that would have implicated Adam and led to the earlier discovery of Christian’s body.

ZALMA OPINION

For liability insurance to respond to a request for defense or indemnity of a tort lawsuit the suit must allege that the actions of the defendants were neither intended nor expected by the insured, i.e., an accident. The acts of the parents, hiding the gun used in the killing and making the discovery of the body more difficult they acted intentionally to cause harm to the family of the deceased and to protect their son from responsibility for his criminal act. In addition the Third Circuit concluded that it is against the public policy of the state to allow insurance protection for criminal acts.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:08:09
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14 hours ago
Ambiguity in Insurance Contract Resolved by Jury

Jury’s Findings Interpreting Insurance Contract Affirmed
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Madelaine Chocolate Novelties, Inc. (“Madelaine Chocolate”) appealed the district court’s judgment following a jury verdict in favor of Great Northern Insurance Company (“Great Northern”) concerning storm-surge damage caused by “Superstorm Sandy” to Madelaine Chocolate’s production facilities.

In Madelaine Chocolate Novelties, Inc., d.b.a. The Madelaine Chocolate Company v. Great Northern Insurance Company, No. 23-212, United States Court of Appeals, Second Circuit (June 20, 2025) affirmed the trial court ruling in favor of the insurer.

BACKGROUND

Great Northern refused to pay the full claim amount and paid Madelaine Chocolate only about $4 million. In disclaiming coverage, Great Northern invoked the Policy’s flood-exclusion provision, which excludes, in relevant part, “loss or damage caused by ....

00:07:02
June 23, 2025
The Clear Language Of The Insurance Contract Controls

Failure to Name a Party as an Additional Insured Defeats Claim
Post 5104

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Contract Interpretation is Based on the Clear and Unambiguous Language of the Policy

In Associated Industries Insurance Company, Inc. v. Sentinel Insurance Company, Ltd., No. 23-CV-10400 (MMG), United States District Court, S.D. New York (June 16, 2025) an insurance coverage dispute arising from a personal injury action in New York State Supreme Court.

The underlying action, Eduardo Molina v. Venchi 2, LLC, et al., concerned injuries allegedly resulting from a construction accident at premises owned by Central Area Equities Associates LLC (CAEA) and leased by Venchi 2 LLC with the USDC required to determine who was entitled to a defense from which insurer.
KEY POINTS

Parties Involved:

CAEA is insured by Associated Industries Insurance Company, Inc. ...

00:08:22
June 20, 2025
Four Corners of Suit Allows Refusal to Defend

Exclusion Establishes that There is No Duty to Defend Off Site Injuries

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Attack by Vicious Dog Excluded

In Foremost Insurance Company, Grand Rapids, Michigan v. Michael B. Steele and Sarah Brown and Kevin Lee Price, Civil Action No. 3:24-CV-00684, United States District Court, M.D. Pennsylvania (June 16, 2025)

Foremost Insurance Company (“Foremost”) sued Michael B. Steele (“Steele”), Sarah Brown (“Brown”), and Kevin Lee Price (“Price”) (collectively, “Defendants”). Foremost sought declaratory relief in the form of a declaration that

1. it owes no insurance coverage to Steele and has no duty to defend or indemnify Steele in an underlying tort action and
2. defense counsel that Foremost has assigned to Steele in the underlying action may withdraw his appearance.

Presently before the Court are two ...

00:08:29
May 15, 2025
Zalma's Insurance Fraud Letter - May 15, 2025

ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional

See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.

Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:

Health Care Fraud Trial Results in Murder for Hire of Witness

To Avoid Conviction for Insurance Fraud Defendants Murder Witness

In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...

May 15, 2025
CGL Is Not a Medical Malpractice Policy

Professional Health Care Services Exclusion Effective

Post 5073

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This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.

In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:

Insurance Coverage Dispute:

Travelers issued a Commercial General Liability ...

April 30, 2025
The Devil’s in The Details

A Heads I Win, Tails You Lose Story
Post 5062

Posted on April 30, 2025 by Barry Zalma

"This is a Fictionalized True Crime Story of Insurance Fraud that explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help everyone to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the ­­­Perpetrators than any Other Crime."

Immigrant Criminals Attempt to Profit From Insurance Fraud

People who commit insurance fraud as a profession do so because it is easy. It requires no capital investment. The risk is low and the profits are high. The ease with which large amounts of money can be made from insurance fraud removes whatever moral hesitation might stop the perpetrator from committing the crime.

The temptation to do everything outside the law was the downfall of the brothers Karamazov. The brothers had escaped prison in the old Soviet Union by immigrating to the United...

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