“Accident” Includes Continuous or Repeated Exposure to Conditions
Post 5176
“Occurrence” is an Accident & Includes Repeated Damage
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In The Cobblestone Lofts Condominium v. Great American Insurance Company, Admiral Indemnity Company et al., Appeal No. 4265, 2025 NY Slip Op 04749, Index No. 653189/21, Case No. 2024-01860, Supreme Court of New York, First Department (August 21, 2025) the court resolved the issues.
FACTS
The Supreme Court of New York, First Department (trial court) dealt with a declaratory judgment action concerning an insurance coverage dispute. The plaintiff, a condominium association, was being sued for property damage and bodily injury caused by unintended water and moisture infiltration, resulting in toxic contamination of a condominium unit. The infiltration was allegedly caused by the plaintiff’s breaches of its contractual obligations under its bylaws and condominium declarations, as well as violations of statutory duties under the Multiple Dwelling Law and the Administrative Code of the City of New York.
PRIMARY ISSUE
The was asked to resolve whether the Great American Insurance Company was obligated to provide coverage for the plaintiff under its policy. The policy covers liability for bodily injury and property damage caused by an “occurrence,” which includes continuous or repeated exposure to harmful conditions.
Great American argued that the alleged damages were caused by the plaintiff’s breaches of its bylaws and condominium declarations, and not by an accident. However, the term “occurrence” in the policy includes continuous exposure to harmful conditions caused by breaches of contract or statutory violations.
THE ORDER
The Supreme Court, New York County (Louis L. Nock, J.), order granted plaintiff’s motion for summary judgment on its second cause of action declaring that defendant Great American Insurance Company was obligated to provide coverage for plaintiff.
Great American issued a “direct, definitive notice” to plaintiff disclaiming coverage. By letter dated September 17, 2018, Great American notified plaintiff that its policy does not afford coverage because:
1. a breach of contract is not an accident and, therefore, does not constitute an “occurrence” under the Primary Policy or Umbrella Policy and
2. because the Primary Policy excludes coverage for breach of contract.
Contrary to Great American’s argument, the denial letter is a repudiation of plaintiff’s rights. Great American will be obligated to indemnify plaintiff for any liability imposed upon it in the underlying action that is in excess of the policy issued by Admiral Indemnity Company the primary insurer to Great American’s umbrella policy.
The Great American policy covers liability for bodily injury and property damage “that takes place during the Policy Period and is caused by an ‘occurrence’ happening anywhere…” The term “occurrence” is defined, in relevant part, to mean “an accident, including continuous or repeated exposure to substantially the same general harmful conditions.” Under this definition, the term “occurrence” includes within its scope continuous exposure to a harmful condition alleged, as in the underlying action, to have been caused by the insured’s breaches of contract or violations of statutory or regulatory duties.
Great American argued that the alleged “bodily injury” and “property damage” were caused by plaintiff’s breaches of its bylaws and condominium declarations, and not by an accident. The policy defines “accident” to include “continuous or repeated exposure to substantially the same general harmful conditions,” which is exactly what was alleged in the underlying action.
The court declared that Great American is obligated to indemnify the plaintiff for any liability imposed in the underlying action that exceeds the policy issued by Admiral Indemnity Company.
ZALMA OPINION
Fortuity is a required element of every liability insurance policy determined by the definition of “occurrence” in the policy. Since the cause of damage was found by the trial court to be a result of continuous or repeated exposure to harmful conditions, it concluded the loss was due to a fortuitous “occurrence” and Great American must pay damages that could be found against the Plaintiff Condominium.
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Summary Judgment Against Plaintiff’s Bad Faith Case and Insurer Granted Attorneys Fees
Post 5177
Posted on August 28, 2025 by Barry Zalma
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Contumacious Conduct to Texas Court Causes Insured Plaintiff and her Lawyer to Have a Judgment in Favor of the Insurer and Both Charged to Pay More Than $137,000
In Carmen Aleman, Eric B. Dick, And The Dick Law Firm, PLLC v. Standard Casualty Company, No. 01-23-00572-CV, Court of Appeals of Texas, First District (August 26, 2025)
Background
Carmen Aleman, along with Eric B. Dick and the Dick Law Firm, PLLC, filed a lawsuit against Standard Casualty Company for breach of contract, breach of the duty of good faith and fair dealing, fraud, and violations of the Texas Deceptive Trade Practices Act (DPTA) and the Texas Insurance Code.
According to Aleman, at some point, “someone . . . stop[ped] by to look at [the property] and there was some damage,” ...
Killer Abuses Court System With Multiple Attempts to Get Out of Prison
Post 5178
Posted on August 29, 2025 by Barry Zalma
See the full video at https://rumble.com/v6y6ule-convicted-of-arson-murder-must-stay-in-jail.html and at https://youtu.be/nnUpStLmDoM
Attempted Arson for Profit that Resulted in Death Requires Life in Prison
In Suresh Kumar v. United States, No. 1:22-cv-4874 (MKV), United States District Court, S.D. New York (August 26, 2025) Kumar, convicted of arson for profit where four people died sought to be let out of jail by filing a Habeas Corpus motion.
BACKGROUND
Suresh Kumar was convicted by a jury of multiple felonies for his role in burning down a hotel he owned for insurance money. Four people died, and fifteen others were injured. Kumar was only sentenced to life in prison.
Kumar pursued multiple previous challenges to his conviction and sentence, which have withstood both direct appeal and collateral attacks. Kumar now petitions for a writ of habeas corpus arguing actual innocence and citing Supreme ...
Court Limits Lengthy Decision to Decide Case Can Go to Trial
USDC Tries to Keep it Simple
Post 5175
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In Todd F. Stevenson, an individual et al v. Massachusetts Mutual Life Insurance Company; et al, No. CV 24-109-M-DLC, United States District Court, D. Montana, Missoula Division (August 13, 2025) Plaintiffs alleged various claims including ordinary and professional negligence, negligent misrepresentation, breach of fiduciary duty, statutory violations, constructive fraud, actual fraud, fraudulent inducement, unjust enrichment, punitive damages, rescission and restitution.
Claims and Legal Theories:
Plaintiffs have alleged various claims including ordinary and professional negligence, negligent misrepresentation, breach of fiduciary duty, statutory violations, constructive fraud, actual fraud, fraudulent inducement, unjust enrichment, punitive damages, rescission and ...
Is Injury in the Course of Self-Defense an Occurrence?
Post 5171
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When There is no Accident the Intentional Acts Exclusion is Irrelevant
The case involves a tragic incident where Kimberly Mollicone was killed during a gunfight between her husband, Matthew Mollicone, and Daniele Giannone. The central issue is whether Giannone’s actions, taken in self-defense, are covered under his State Farm homeowner’s insurance policy.
In State Farm Fire And Casualty Company v. Daniele Giuseppe Giannone; Heidi C. Aull, personal representative for the estate of Kimberly Ann Mollicone, Nos. 24-1264, 24-1265, United States Court of Appeals, Sixth Circuit (August 5, 2025) resolved the dispute.
THE INSURANCE COVERAGE
Although rare in insurance contracts the policy in question provides coverage for the insured’s liability to third parties who are injured ...
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
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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 ...
