Justia U.S. 7th Circuit Court of Appeals Opinion Summaries

From 1998 to 2012 Abbott marketed the anticonvulsant medication Depakote for applications that had not been FDA-approved (off-label uses). Physicians may prescribe drugs for off-label uses, but pharmaceutical companies are generally prohibited from marketing drugs for those same applications. Qui tam actions were filed under the False Claims Act. In 2009, Abbott disclosed in an SEC filing that the Department of Justice was investigating its marketing. Abbott pleaded guilty to illegally promoting Depakote from 2001 through 2006 and agreed to pay $1.6 billion to settle the criminal and qui tam actions. Employee benefits funds filed suit 15 months later, alleging that Abbott misrepresented Depakote’s safety and efficacy for off-label uses, paid kickbacks to physicians, established and funded intermediary entities to promote the drug for off-label uses, and concealed its role in these activities, in violation of the Racketeer Influenced and Corrupt Organizations Act. The district court dismissed, finding that the statute of limitations for the RICO claim began to run in 1998, when the funds initially reimbursed a prescription for off-label use. The court refused to toll the limitations period until the guilty plea, finding that Abbott’s concealment efforts were not designed to hinder potential lawsuits. The Seventh Circuit reversed, finding that dismissal was premature without an opportunity for discovery into when a reasonable fund should have known about its injuries from off-label marketing. View "Sidney Hillman Health Ctr. of Rochester v. Abbott Labs., Inc." on Justia Law

France had a Chicago dental business and fraudulently billed insurers for city employees. France closed his practice after being injured in an accident and started collecting benefits from a disability income policy. In 1999, he exchanged monthly payments, for a limited time, for a lump sum of $300,000. He transferred this money to other people, including his wife, Duperon, before filing a Chapter 7 bankruptcy petition. He failed to disclose the payment or transfers. He later pleaded guilty to mail fraud, 18 U.S.C. 1341, and to knowingly making a false declaration under penalty of perjury, 18 U.S.C. 152(3). The district court sentenced France to 30 months in prison and ordered him to pay $800,000 in restitution. The bankruptcy trustee obtained title to ongoing disability insurance payments. France and Duperon divorced. A California court approved a settlement with payments for child support from the disability payments. France’s insurance company sued in California to resolve conflicting claims. The parties reached an agreement, which the bankruptcy court approved, purporting to control all other judgments, but did not mention the criminal restitution lien. The government filed Illinois citations to discover assets. France moved to quash, but the insurance company responded and began withholding $9,296 that had been going to France. The government moved to garnish the entire distribution under the Mandatory Victims Restitution Act (MVRA), 18 U.S.C. 3613(a). The Seventh Circuit affirmed a ruling allowing the government to garnish the entire disability payment. View "United States v. France" on Justia Law

A large commercial development in Kansas City, Missouri was aborted in the middle of construction due to cost overruns. When the developer would not cover the shortfall, the construction lender stopped releasing committed loan funds, and contractors filed liens against the property for their unpaid work on the unfinished project. Bankruptcy followed, and the contractors’ liens were given priority over the lender’s security interest in the failed development, leaving little recovery for the lender. The lender looked to its title insurer for indemnification. The title policy generally covers lien defects, but it also contains a standard exclusion for liens “created, suffered, assumed or agreed to” by the insured lender. The Seventh Circuit affirmed judgment in favor of the title company. The exclusion applies to the liens at issue, which resulted from the lender’s cutoff of loan funds, so the title insurer owed no duty to indemnify. The liens arose from insufficient project funds, a risk of loss that the lender, not the title company, had authority and responsibility to discover, monitor, and prevent. View "BB Syndication Servs, Inc. v. First Am. Title Ins. Co" on Justia Law

Lodholtz was injured in the Pulliam factory and sued, seeking compensation. Pulliam filed a claim with its insurer, Granite State, which retained a claims adjuster, York. Pulliam assumed, erroneously, that Granite would provide a defense and defaulted on the state court claim. Neither Granite nor York ever had communicated to Pulliam whether they believed Granite had a duty to defend Pulliam under the terms of the policy. Pulliam subsequently entered into a settlement agreement with Lodholtz, assigning to Lodholtz any claims it had against Granite or its agents for failing to undertake a defense. The agreement also provided that Lodholtz would not seek to recover its damages from Pulliam. Granite sought a declaratory judgment that it had no duty to indemnify Pulliam. Lodholtz later filed a complaint against Granite, alleging breach of contract, bad faith, and negligence, and against York for negligence. The district court consolidated the cases. After the district court entered a final judgment in favor of York, Lodholtz appealed. The Seventh Circuit affirmed. The Court of Appeals of Indiana has held that an insurance adjuster owes no legal duty to the insured, and Lodholtz failed to establish that the Indiana Supreme Court would disagree with that decision. View "Lodholtz v. York Risk Servs. Grp., Inc." on Justia Law

Footstar operated the footwear departments in various Kmart stores as though they were islands. Footstar employees could only work in those departments unless they had written permission from Kmart. In 2005, a Footstar employee tried to help a customer get an infant carrier off a shelf outside the footwear department and the customer was injured. She sued. Kmart sought indemnification from Footstar and its insurer, Liberty Mutual. A magistrate judge found that Footstar and Liberty Mutual both had a duty to defend beginning the day Kmart formally requested coverage since the injury was potentially coverable under the agreement between Kmart and Footstar and the insurance policy. The Seventh Circuit reversed, holding that neither Liberty Mutual nor Footstar had a duty to indemnify Kmart because the injury did not occur “pursuant to” or “under” the agreement between Kmart and Footstar. That agreement specifically precluded Footstar employees from working outside of the footwear department, where the injury occurred, and actions taken in contravention of the agreement were not “pursuant to” or “under” it. Liberty Mutual did not deny coverage in bad faith and that Kmart did not breach the relevant notice provisions such that Liberty Mutual and Footstar could withhold defense costs. View "Kmart Corp. v. Footstar, Inc." on Justia Law

Visteon, a worldwide manufacturer headquartered in Michigan, sued National Union, from which it had purchased liability insurance between 2000 and 2002. The policy excluded liability resulting from pollution caused by Visteon, except liability arising from a “Completed Operations Hazard.” In 2001, the toxic solvent TCE that was used to clean machinery in Visteon’s Connersville, Indiana plant was discovered to have leaked into the soil and groundwater. Neighboring landowners sued Visteon. National Union has refused to indemnify or defend. Indiana does not enforce standard pollution-exclusion clauses. Michigan law does enforce the more general kind of pollution-exclusion clause found in the policy. The district court ruled that Michigan law governed and held that Visteon was not entitled to coverage under the Completed Operations Hazard clause. The Seventh Circuit affirmed. The risk materialized in Indiana, but that could not have been foreseen. The Indiana victims were compensated by Visteon, and it is unclear what benefit the state would have derived from reimbursement of Visteon’s costs by National Union.” The court rejected Visteon’s argument that its “work” was “completed” each time a contract to supply products made at the plant was performed and concluded that the exception did not apply. View "Visteon Corp. v. Nat'l Union Fire Ins. Co. of Pittsburgh" on Justia Law

Jonas and his wife purchased life insurance: each owned the policy on his or her life, with the other as beneficiary. When they divorced, the court reassigned ownership: Troy owned the policy on Jennifer’s life. Each policy provided that change in ownership “does not change the Beneficiary Designation.” Troy thought it unnecessary to redesignate himself as beneficiary. Jennifer died. Troy claimed the proceeds ($1 million). State Farm did not pay, concerned that the proceeds might belong to the children (named secondary beneficiaries) or to Jennifer’s estate under Tex. Family Code 9.301, which provides that if a divorce occurs after one spouse has designated the other as beneficiary of an insurance policy, the designation lapses. Texas law requires an insurer to pay within 60 days of receiving a claim and provides for “damages” at 18% a year plus reasonable attorneys’ fees. An insurer that receives “notice of an adverse, bona fide claim” may defer payment and file an interpleader action not later than the 90th day. State Farm did not receive any other claim, but filed an “interpleader” before the 60 days had run. The district court treated concerns about the potential rights of the children and Jennifer’s estate as equivalent to a claim and disbursed the money to Troy, who argued on appeal that he was entitled to attorneys’ fees and interest at 18%. The Seventh Circuit vacated for dismissal. When the litigation began, there was no justiciable controversy. View "State Farm Life Ins. Co. v. Jonas" on Justia Law

Accretive provides cost control, revenue cycle management, and compliance services to non-profit healthcare providers. Accretive and Fairview entered into a Revenue Cycle Operations Agreement (RCA), accounting for about 12% of Accretive’s revenue during the class period, and a Quality and Total Cost of Care (QTCC) contract, promoted as the future for healthcare services. In 2012, the Minnesota Attorney General sued Accretive for noncompliance with healthcare, debt collection, and consumer protection laws. Accretive wound down its RCA contract short of its term, expecting a loss of $62 to $68 million. The AG released a damaging report on Accretive’s business practices. Fairview cancelled its QTCC contract. Accretive’s stock fell from over $24 to under $10 per share. Plaintiffs filed a class action under Sections 10(b) and 20(a) of the Securities Exchange Act of 1934, alleging that Accretive concealed its practices to artificially inflate its common stock. The parties negotiated a settlement of $14 million: $0.20 per share ($0.14 with attorneys’ fees and expenses deducted). Notice was sent to 34,200 potential class members. Only one opted out; only Hayes filed an objection. At the fairness hearing, the district court granted approval, awarding attorneys’ fees of 30% and expenses of $63,911.14. Hayes did not attend. The Seventh Circuit affirmed. View "Hayes v. Accretive Health, Inc." on Justia Law

The Strauss home in Mequon was built in 1994. They insured the home with policies issued by Chubb from October 1994 to October 2005. Water infiltrated and damaged the home through a defect present since the completion of construction; the damage went undiscovered until 2010, after those policies expired. Chubb denied coverage, contending that because the damage manifested in 2010 and the “manifestation” trigger applies to first-party property insurance, it could not be responsible for the damage. Chubb also asserted that the claim was submitted after expiration of the applicable statute of limitations. The district court concluded that the “continuous” trigger theory applied due to the language of the Policy such that coverage existed for the entire loss and that the claims were not time-barred. The Seventh Circuit affirmed. In Wisconsin, under the continuous trigger theory, a progressive loss “occurs continuously from exposure until manifestation.” Here, the loss was ongoing and occurred with each rainfall and the policy itself states that “[c]ontinuous or repeated exposure to substantially the same general conditions unless excluded is considered to be one occurrence.” The loss, for purposes of the statute of limitations, occurred all the way up until the damage manifested in October 2010. View "Strauss v. Chubb Indem. Ins. Co." on Justia Law

In 2006 Western Capital made a $2.77 million loan to finance a Chicago development, which failed. Western initiated foreclosure, resulting in allegations that Western had breached its contract, committed fraud, and violated consumer protection statutes. Western requested that its insurers cover costs associated with its defense. Philadelphia Indemnity is Western’s general liability insurer. The mortgages were insured by CT on the standard ALTA form, which covers losses sustained because of defects in title and lien priority, and requires CT to pay costs, attorneys’ fees and expenses incurred in defense of the title or the lien, but excludes “fees, costs or expenses incurred by the insured in the defense of those causes of action which allege matters not insured against by this policy.” The district court declined to enforce the limitation, applied the “complete defense” rule, and held that CT had a duty to defend the entire lawsuit. The Seventh Circuit reversed. An insurer’s duty to defend is contractual. Title insurance, unlike general liability insurance, only indemnifies against losses incurred by reason of defects in title and specifically limits the duty to defend to claims within that coverage. The Illinois Supreme Court has never applied the complete-defense rule to title insurance. View "Western Capital Partners, LLC v. Chicago Title Ins. Co." on Justia Law