Dismissal for Failure to Allege Facts to Establish Breach of Contract
Post 5005
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Boat Owner Only Gets Insurance he Asked the Broker to Obtain
After a boating accident in Greece the boat owner, Nicholas Galakatos (“plaintiff” or “Galakatos”), made claims against defendants, Marsh & McLennan Companies, Inc. and others (collectively, “defendants”) for negligence, breach of contract and breach of fiduciary duty. The case arose from a boating accident in Greece involving Galakatos’ boat, “Galani,” which collided with another vessel in September 2018. This resulted in damage to both vessels and personal injuries to some passengers.
Nicholas Galakatos v. Marsh & McLennan Companies, et al., Civil Action No. 24-11259-NMG, United States District Court, D. Massachusetts (February 24, 2025)
Court’s Decision
The court granted the defendants’ motion to dismiss. The court found that Galakatos failed to state a viable claim for breach of contract because he did not allege any specific provision of the purported agreement that the defendants allegedly breached.
Background
Plaintiff is a resident of Massachusetts and Vermont and owns property in Greece. In 2015, he purchased a boat (“Galani”) to use in Greece. Defendants are associated entities that offer professional services including insurance brokerage. Plaintiff retained defendants’ insurance brokerage services for the first time in 2006 and have purportedly relied since then on their advice to procure insurance.
Plaintiff purchased a one-year, $10,000,000 excess coverage liability policy from American International Group (“AIG”). The AIG policy was to provide coverage for losses sustained “anywhere in the world.” Plaintiff also purchased third party liability insurance for Galani from Groupama Insurances (“Groupama”) in May, 2018. He contends that he disclosed his ownership of Galani and his Groupama insurance policy to defendants that same month.
In September, 2018, Galani collided with another vessel off the coast of Greece, resulting in damage to both vessels, as well as personal injuries to some passengers aboard the other vessel. Plaintiff informed defendants of the accident, and they requested information concerning all of his property and liability exposures, even those for which it may not be providing coverage.
The collision spawned litigation as a result of which plaintiff paid an undisclosed amount in settlement of claims against him. He then made a claim on his AIG policy, which was denied, allegedly because defendants failed to add the Groupama policy to the AIG policy.
Plaintiff sued claiming defendants failed to place and procure adequate liability insurance coverage for Galani.
Legal Standard
Under Massachusetts law, breach of contract claim requires a plaintiff to demonstrate that 1) a valid, binding contract existed, 2) the defendant breached the terms of the contract and 3) the plaintiffs sustained damages as a result of the breach. Similarly, a breach of contract claim under New York law requires a plaintiff to allege 1) the existence of a contract, 2) the defendant’s breach of his or her contractual obligations and 3) damages resulting from the breach.
Galakatos failed to state a viable claim for breach of contract because his complaint does not allege any specific provision of the purported agreement between plaintiff and defendants that defendants allegedly breached.
Plaintiff’s negligence claim is deficient because he does not allege that defendant was duty-bound to procure insurance in the manner he asserted. According to the complaint, defendant had a duty of care to plaintiff to procure adequate third party liability insurance for Galani up to $20 million.
Breach of Fiduciary Duty
Finally, defendant contends that plaintiff’s breach of fiduciary duty claim is not actionable because the complaint does not allege sufficient facts to show that a fiduciary relationship existed between plaintiff and defendants. A fiduciary duty between a broker and an insured arises only in the narrow instance where there is a “special circumstance” or “special relationship” between them which, ordinarily, is a question of fact. Because, Plaintiff failed to state a claim for breach of fiduciary duty he did not adequately allege a fiduciary relationship existed between him and defendants.
ZALMA OPINION
Galakatos’ complaint was that he received the insurance he asked Marsh to acquire rather than the insurance coverage he needed. Insurance brokers, like Marsh, owe a duty to buy the insurance requested by the insured. The facts alleged revealed that they did so and that there was no allegation of a special relationship requiring that Marsh deal with the insured as a fiduciary. Insurance brokers are not required to be clairvoyant and purchase the coverage the insured, like Galakatos, needed rather than what he ordered.
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Concurrent Cause Doctrine Does Not Apply When all Causes are Excluded
Post 5119
Death by Drug Overdose is Excluded
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Southern Insurance Company Of Virginia v. Justin D. Mitchell, et al., No. 3:24-cv-00198, United States District Court, M.D. Tennessee, Nashville Division (October 10, 2024) Southern Insurance Company of Virginia sought a declaratory judgment regarding its duty to defend William Mitchell in a wrongful death case pending in California state court.
KEY POINTS
1. Motion for Judgment on the Pleadings: The Plaintiff moved for judgment on the pleadings, which was granted in part and denied in part.
2. Duty to Defend: The court found that the Plaintiff has no duty to defend William Mitchell in the California case due to a specific exclusion in the insurance policy.
3. Duty to Indemnify: The court could not determine at this stage whether the Plaintiff had a duty to ...
GEICO Sued Fraudulent Health Care Providers Under RICO and Settled with the Defendants Who Failed to Pay Settlement
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Post 5119
Default of Settlement Agreement Reduced to Judgment
In Government Employees Insurance Company, Geico Indemnity Company, Geico General Insurance Company, and Geico Casualty Company v. Dominic Emeka Onyema, M.D., DEO Medical Services, P.C., and Healthwise Medical Associates, P.C., No. 24-CV-5287 (PKC) (JAM), United States District Court, E.D. New York (July 9, 2025)
Plaintiffs Government Employees Insurance Company and other GEICO companies (“GEICO”) sued Defendants Dominic Emeka Onyema, M.D. (“Onyema”), et al (collectively, “Defendants”) alleging breach of a settlement agreement entered into by the parties to resolve a previous, fraud-related lawsuit (the “Settlement Agreement”). GEICO moved the court for default judgment against ...
ZIFL – Volume 29, Issue 14
Post 5118
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You can read the full 20 page issue of the July 15, 2025 issue at https://lnkd.in/giaSdH29
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
This issue contains the following articles about insurance fraud:
The Historical Basis of Punitive Damages
It is axiomatic that when a claim is denied for fraud that the fraudster will sue for breach of contract and the tort of bad faith and seek punitive damages.
The award of punitive-type damages was common in early legal systems and was mentioned in religious law as early as the Book of Exodus. Punitive-type damages were provided for in Babylonian law nearly 4000 years ago in the Code of Hammurabi.
You can read this article and the full 20 page issue of the July 15, 2025 issue at https://zalma.com/blog/wp-content/uploads/2025/07/ZIFL-07-15-2025.pdf
Insurer Refuses to Submit to No Fault Insurance Fraud
...
Rulings on Motions Reduced the Issues to be Presented at Trial
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CASE OVERVIEW
In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.
FACTS
Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.
Prior to trial Bernier had three remaining claims against State Farm:
1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.
Both Bernier and State Farm dispositive motions before ...
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 ...
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 ...