Tortious Interference Requires Intent to Harm
Defamation is a Covered Personal Injury Tortious Interference with Business Is Not
Post 5031
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Robert Hole, M.D., appealed from the March 3, 2023 order granting plaintiff State Farm Fire and Casualty Company’s motion for summary judgment denying Dr. Hole coverage under the policy issued by State Farm.
In State Farm Fire And Casualty Company v. Dr. Robert Hole, M.D., and Dr. Michael Russonella, D.O., and North Jersey Orthopaedic And Sports Medicine Institute, LLC, No. A-2522-22, Superior Court of New Jersey, Appellate Division (March 21, 2025) a lawsuit filed against Dr. Hole by Michael Russonella, D.O. that alleged Dr. Hole made false statements regarding Dr. Russonella’s alleged misconduct at St. Mary’s Hospital in Passaic.
Dr. Hole sought coverage from his insurer, State Farm, to defend the action. The central question in this matter is whether State Farm was required to defend the action and indemnify Dr. Hole once the tortious interference count was the only remaining claim.
Initially Dr. Russonella sued Dr. Hole only alleging defamation. State Farm defended Dr. Hole under a reservation of rights. Because of the potential for an excess verdict and the punitive damages alleged, the letter also advised Dr. Hole of his right to obtain personal counsel and that State Farm’s “defense of this action by the attorney on your behalf is not to be considered a waiver of such policy defense or of any policy defenses which may be involved in this suit.”
In September 2017, the trial court dismissed Dr. Russonella’s defamation complaint as untimely under the statute of limitations. Dr. Russonella subsequently filed an amended complaint alleging tortious interference with business.
State Farm sued seeking declaratory relief claiming it had no duty to defend or indemnify Dr. Hole regarding the claims asserted by Dr. Russonella. It asserted Dr. Russonella alleged Dr. Hole “intentionally “interfered with his business relationships. State Farm further asserted that in allegedly making “untrue” and “malicious[]” statements “targeted to injure Dr…. Russonella” that Dr. Hole knew were “untrue,” “the policy exclusion for personal and advertising injury arising out of oral or written publication of material . . . with knowledge of its falsity precludes coverage.”
When the facts present a single, unavoidable resolution and the evidence is so one-sided that one party must prevail as a matter of law, then a trial court should grant summary judgment. Dr. Hole argued a tortious interference claim “does not require an intention to cause the injury alleged.” Rather, he asserts “the intent required in tortious interference claims is an intent to interfere.”
ANALYSIS
The interpretation of an insurance policy, like any contract, is a question of law.
Coverage provisions are to be read broadly, exclusions are to be read narrowly, potential ambiguities must be resolved in favor of the insured, and the policy is to be read in a manner that fulfills the insured’s reasonable expectations. By contrast, if the plain language of the policy is unambiguous, the court will not engage in a strained construction to support the imposition of liability or write a better policy for the insured than the one purchased.
A complaint based on tortious interference must allege facts claiming that the interference was done intentionally and with “malice”. Malice is defined to mean that the harm was inflicted intentionally and without justification or excuse.
A tortious interference cause of action is an excluded claim because not only does the tort require intentional interference, it also further requires malice or an intent that the harm was inflicted intentionally. That is, the tortious interference claim intrinsically includes an intent to harm.
The Appellate Division concluded that trial court did not err in concluding Dr. Hole was not entitled to coverage under the State Farm policy.
Even though State Farm initially provided a defense for the defamation claim, it was not required to also defend Dr. Hole because the amended complaint for tortious interference alleged similar facts but supported intentional conduct.
ZALMA OPINION
Liability insurance provides defense and/or indemnity only for fortuitous conduct. Intentional acts are excluded by every liability insurance policy since providing such coverage would encourage wrongful or illegal conduct. The court concluded, properly, that although the defamation claim was a fortuitous loss the tortious interference claim required intentional conduct, was not fortuitous, and State Farm was entitled to a judgment it owed no defense or indemnity to Dr. Hole after it successfully protected him from the Defamation claim.
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Notice of Claim Later than 60 Days After Expiration is Too Late
Post 5089
Injury at Massage Causes Suit Against Therapist
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Hiscox Insurance Company (“Hiscox”) moved the USDC to Dismiss a suit for failure to state a claim because the insured reported its claim more than 60 days after expiration of the policy.
In Mluxe Williamsburg, LLC v. Hiscox Insurance Company, Inc., et al., No. 4:25-cv-00002, United States District Court, E.D. Missouri, Eastern Division (May 22, 2025) the trial court’s judgment was affirmed.
FACTUAL BACKGROUND
Plaintiff, the operator of a massage spa franchise, entered into a commercial insurance agreement with Hiscox that provided liability insurance coverage from July 25, 2019, to July 25, 2020. On or about June 03, 2019, a customer alleged that one of Plaintiff’s employees engaged in tortious ...
ZIFL – Volume 29, Issue 11
The Source for the Insurance Fraud Professional
Posted on June 2, 2025 by Barry Zalma
Post 5087
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Read the full article and the full issue of ZIFL June 1, 2025 at https://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-06-01-2025.pdf
Zalma’s Insurance Fraud Letter – June 1, 2025
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ZIFL – Volume 29, Issue 11
The Source for the Insurance Fraud Professional
Read the full article and the full issue of ZIFL June 1, 2025 at https://lnkd.in/gTWZUnnF
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 ...
No Coverage if Home Vacant for More Than 60 Days
Failure to Respond To Counterclaim is an Admission of All Allegations
Post 5085
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In Nationwide Mutual Insurance Company v. Rebecca Massey, Civil Action No. 2:25-cv-00124, United States District Court, S.D. West Virginia, Charleston Division (May 22, 2025) Defendant Nationwide Mutual Insurance Company's (“Nationwide”) motion for Default Judgment against Plaintiff Rebecca Massey (“Plaintiff”) for failure to respond to a counterclaim and because the claim was excluded by the policy.
BACKGROUND
On February 26, 2022, Plaintiff's home was destroyed by a fire. At the time of this accident, Plaintiff had a home insurance policy with Nationwide. Plaintiff reported the fire loss to Nationwide, which refused to pay for the damages under the policy because the home had been vacant for more than 60 days.
Plaintiff filed suit ...
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 ...
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...