James T. Nyeste

 Mr. Nyeste has over 46 years of experience in insurance law and  coverage, personal injury, disability, ERISA benefits, commercial  litigation, contracts, and civil litigation generally. Presently, he  concentrates his practice on insurance matters.

He has been selected by his peers as a Leading Lawyer in the area of insurance coverage law. Likewise, he has been named an Illinois Super Lawyer, and he has a Martindale.com AV(R) Peer Rating of "Preeminent" with a score of 5.0 out of 5.0.

He represents  insureds and claimants in all types of matters relating to insurance.  His clients have recovered tens of millions of dollars from the  insurance industry.

Mr.  Nyeste is often retained by, or referred clients by, other law firms  needing insurance law and coverage expertise. He works with many of  Chicago's leading personal injury lawyers to maximize their clients'  recoveries.

Mr. Nyeste  practices regularly in Illinois state and federal courts on both the  trial and appellate levels and has practiced on numerous occasions in  other state and federal courts by permission from the court. Mr. Nyeste is admitted to practice in the following courts:

• Illinois Supreme Court and all courts of the State of Illinois (1979) 
• United States District Court for the Northern District of Illinois (1979) and its Trial Bar (1984) 
• United States Court of Appeals for the Seventh Circuit (1983) 
• United States Claims Court (1987) 
• United States Supreme Court (1992) 
• United States District Court for the Southern District of Illinois (1994)
• United States District Court for the Eastern District of Wisconsin (1995)

Mr. Nyeste has practiced by specific permission in numerous state and  federal courts in Indiana, Michigan, Ohio, Oklahoma, Pennsylvania, New  York, California, and Arizona. 

• $30K in attorney's fees and costs awarded for defeating insurer's baseless declaratory action seeking to avoid its duty to defend. Massachusetts Bay Ins. Co. v. Celano Design of NY, Inc., 2022 CH 10343 (Cir. Ct. Cook Co., Ill.) (July 2024).
  
• $600,000 settlement with insurance company despite insurer's claim of late notice of accident and lawsuit (Feb. 2024).
  
• Summary judgment for policyholder that its insurance company's has duty to defend underlying wrongful death suit (Jan. 2024).
  
• $800,000 accidental death and dismemberment claim: advised  c0-counsel in successfully persuading insurance company to reverse its  decision that death was a suicide, resulting in recovery of ADD benefits  (Dec. 2023).
  
• $5,000,000 collected from insurance company that  failed to defend at-fault driver in suit arising from auto accident.  Following default judgment against the driver, Mr. Nyeste brought action  to collect the judgment from the insurance company. The policy limit  was only $1 million but also covered the post-judgment interest that  accrued on the judgment against the driver (March 2022).
  
• Summary  Judgment for $1.517 million against Harco National Insurance Company  for "permissive user" coverage under its umbrella policy. Although Harco agreed that its primary auto policy covered the liability of the permissive user of the auto,  it refused to provide coverage to the permissive user under its umbrella  policy. Court held that the umbrella applied and entered judgment for  the amount of the liability that exceeded the primary policy (July  2021).
  
• Another bad faith award against Direct Auto Insurance Company: After  bench trial by Zoom, the court denied Direct Auto's attempt to rescind  or void client's auto insurance policy and awarded client the full value  of her totaled vehicle ($10,000) plus a 60% penalty. As a further  penalty against Direct Auto, the court awarded Mr. Nyeste the full  amount of his fee petition ($46,00). Direct Auto has chosen not to  appeal (May 2021).
  
• $255,000 life insurance settlement where insurance company had refused payment to beneficiaries, claiming  that the deceased insured under the policy had misrepresented her health  condition (May 2021).
  
• After filing suit for mandatory injunction, health insurer agreed to pay for client's liver transplant. Client had colorectal cancer with unresectable liver metastases.  Insurer had denied coverage for surgery as experimental or  investigational. Client has had transplant and is doing well (May 2021).
  
• Succeeded on health insurance external review in reversing CIGNA's denial of authorization for client's lumbar fusion. Client was only 28 years old, but for more than six months had been  disabled due to excruciating pain from rapidly advancing degenerative  disc disease at L5-S1. She had been confined to a recliner chair, unable  to lay down in a bed, having to use a walker to get around, and needing  help with basic needs such as showering and using the bathroom. A  microdiscectomy to repair the herniated disc and subsequent conservative  treatment had provided no relief. External review organization reversed  CIGNA's denial for the lumbar fusion. Client has now had the surgery  and is  doing well (July 2020).
  
• $113,000 health insurance win. Blue Cross Blue Shield of Illinois denied coverage for client's back  surgery--two level artificial disc implantation--as medically  unnecessary. Obtained reversal of BCBS's denial decision through  external review process. (February 2019).
  
• $14 million settlement. Acted as co-counsel for plaintiff and provided insurance coverage  advice in fraternity hazing death case that went to Illinois Supreme  Court and eventually settled for $14 million. Bogenberger v. Pi Kappa Alpha, 2018 IL 120951. (November 2018).
  
• ERISA case for health insurance benefits settled for 100% of the benefits owed by UnitedHealthcare, plus 100% of Mr. Nyeste's fee and a penalty  for untimely production of the Plan document. (August 2018).
  
• The Illinois Appellate Court, First District, affirmed our $87,160.80 judgment against Direct Auto. Read appellate decision at Robert Gregory v. Direct Auto Ins. Co., 2017 IL App (1st) 163302-U (December 19, 2017). On February 5, 2018, the appellate court tacked on  another $11,325.00 against Direct Auto for our attorney's fees on  appeal due to Direct Auto's bad faith.  With interest, the total amount  paid by Direct Auto on my client's claim (which could have been settled  for less than $11,500) was $107,426.35.
  
• $650,000 settlement (as jury was about to begin deliberations) for client in breach of  contract trial against insurance producer Gerald S. Adelman for  Adelman's failure to procure life insurance for client as promised.  (October 2017).
  
• $87,160.80  judgment against Direct Auto Insurance Company for failing to cover  theft of client's car worth $11,500. Judgment included penalties and  attorneys' fees under Illinois bad faith statute for Direct Auto's  "vexatious and unreasonable conduct and delay." (November 2016). Read  trial court's decision on Direct Auto's bad faith:  2016-10-20 13-M1-120296 Gregory v DAIC opinion and judgment.pdf
  
• $36,410.37  full payment of cash value of annuity where elderly annuitant died six  months after mistakenly choosing the life-only pay-out option of $445  per  month. (March 2016).
  
• $57,715.98  settlement of claim under legacy (pre-1992) Medicare Supplement policy  providing extended coverage for skilled nursing facility care for the  the 101st through 365th day of confinement. Settlement includes over  $10,000 in attorney's fees. (February 2016).
  
• $371,563.85  settlement with Cincinnati Insurance Company for woodworking company  that suffered a computer system crash. Claim was for loss of business  income, restoration of electronic data, and loss of accounts receivable.  Cincinnati initially offered to pay only $126,255.46. (December 2015).
  
• ​Court  ordered $7,500 sanction against Direct Auto Insurance Company for its  "deliberate and pronounced disregard for the discovery process."
  ​(October 2015).
  
• $129,256  to life insurance beneficiary from Globe Life and Accident Insurance  Co. (full policy proceeds plus interest plus court costs) where Globe  represented to beneficiary that life insurance policy had not been  issued until after the insured died and that policy never took effect.  We filed suit on March 16, 2015, and Globe paid up on May 14, 2015. (May  2015).
  
• For  eighteen months United HealthCare refused to pay for client's two  surgeries to remove mesh used in two prior hernia repair surgeries. We  filed suit on September 17, 2014, and case settled on November 6, 2014  for full payment under the health plan. (November 2014).
  
• Direct  Auto Insurance Company denied coverage for client's auto that was  totaled in a snow storm accident and falsely accused client of making  misrepresentations on his insurance application. Through affidavits from  disinterested parties, we showed that client had not made any  misrepresentations on application. Direct Auto had to pay full value of  client's vehicle plus the registration and license fees for his  replacement vehicle.
  (October 2014).
  
• Replaced  client's prior attorney and got nearly two-year old property damage  claim settled within a month. Hanover Insurance needed reminding that it  was bad faith not to pay portion of claim that was not in dispute. When  faced with clear bad faith exposure for penalties and fees, whole  matter was soon resolved. (May 2014).
  
• After  denying coverage and filing a declaratory judgment action in federal  court, Tower Insurance Company paid over $300,000 to resolve claim for  property damage to a crane. We filed a counterclaim for bad faith, and  Tower agreed to pay 100% of my attorney fees. (March 2014).
  
• After  denying coverage, The Medical Protective Company paid its policy limit,  $1 million, to resolve a medical malpractice liability claim against my  client, an anesthesiology group. (February 2014).
  
• Settlement  of claim under legacy (pre-1992) BlueCross BlueShield of Illinois  Medicare Supplement policy providing extended coverage for skilled  nursing facility care for the the 101st through 365th day of  confinement. Such coverage has not been offered since the federal  standardization of Medicare Supplement policies in 1992. BlueCross  BlueShield issued misleading EOBs stating that the policy did not  provide coverage after the patient's Medicare benefits ended (on the  100th day of confinement). Terms of settlement are confidential. (October 2013).
  
• $65,000  settlement from State Farm Fire and Casualty Company for storm damage  caused to roof of home. State Farm had denied coverage, contending that  this classic Chicago bungalow had been defectively designed  and constructed, despite the fact that it withstood 90 years of Chicago  weather) until the record storm of July 22, 2011. (September 2013).
  
• Settlement  of claim for Applied Behavior Analysis therapy for autistic child  under ERISA health plan. Issues included number of hours of therapy and  who could be the provider under the terms of the plan. (August 2013).
  
• Auto  insurance claim against Mendakota Insurance Company (a/k/a KAI  Advantage Auto):  Auto insurer denied client's claim for the theft of  his auto without providing any reason apart from "certain  inconsistencies." We were forced to file suit. On the eve of trial, this  substandard company paid the claim in full rather than submitting its  claims persons for cross-examination at trial.
  (August 2013).
  
• Settlement  of $959,000 life insurance interpleader action involving four claimants  under contested beneficiary designations. (October 2012).
  
• Successfully  recovered disability benefits for parking garage car hiker after   insurer refused coverage despite client's limited ability to walk or  stand. Client suffered from post thrombotic syndrome in left leg, which  caused swelling, stiffness, and pain. (October 2012).
  
• $155,000  settlement of claim against insurance broker who failed to provide  client with copy of property insurance policy or advise of exclusion for  theft. Building under renovation by client was broken into, and copper  piping was stolen. Property insurer denied coverage due to the theft  exclusion, so client sued broker and recovered from the broker's E&O  insurer. (March 2012).
  
• Health  insurance company refused coveragve for prostate cancery surgery based  on pre-existing condition exclusion, contending that one elevated PSA  result demonstrated pre-exising cancer. After we sued, the insurance  company paid the full amount of coverage under its health insurance  policy, plus a premium for attorney's fees. (September 2011).
  
• Recovered  $185,000 against former American Family insurance agent who failed to  place insurance coverage on boat that was subsequently stripped.
  (September 2011).
  
• Defended lawfirm  sued for legal malpractice. On March 9, 2011, the plaintiff dismissed  his action against our client without any recovery but continued to sue  other attorneys involved in the case. (March 2011).
  
• Successfully  appealed Hartford's termination of disability benefits for HIV+  client, recovering all back benefits and obtaining reinstatement of full  benefits going forward. ​(January 2011).
  
• Defended  manufacturer of roofing products and defeated warranty claim by roofing  contractor. Trial court found that problems with roof were due to  improper installation rather than product defects. (January 2011).
  
• $545,000  and $80,000 settlements for injuries and loss of consortium under   Uninsured Motorist coverage from risk pooling trust of an order of the  Catholic Church. (June 2010).
  
• -$4.25  million settlement in insurance coverage action on behalf of injured  claimant against Hartford Insurance Company and Fireman’s Fund Insurance  Company where the carriers had denied any insurance coverage for the  accident. (March 2010).
  
• $170,000 settlement for ERISA disability claimant against Unum Life Insurance Company of America. (October 2009).
  
• $101,000 recovered in disputed life insurance case. (October 2009).
  
• In  a health insurance appeal, succeeded in getting coverage for client’s  hiatal hernia repair and Roux-en-Y gastric bypass for gastroesophageal  reflux disease. (August 2009).
  
• In  a health insurance appeal, succeeded in getting coverage for magnetic  resonance-guided focused ultrasound ("MRgFUS") treatment of uterine  fibroids, a procedure that the insurance companied had denied as  experimental. (June 2009).
  
• On  behalf of factory owner, successfully sued property insurer for damage  to building roof and contents caused by severe storm. (April 2009).
  
• Defended slate roofing supplier and succeeded in getting complaint dismissed. (January 2009).
  
• $374,000  settlement for ERISA disability claimant against Prudential, recovering  100% of client's back benefits plus interest, full attorney's fees, and  reinstatement of benefits going forward. (June 2008)
  
• ERISA  disability settlement for three years of back disability benefits plus  reinstatement of monthly payments for a guaranteed period going forward.
  (February 2007)
  
• Successfully  represented 10 members of a 79-member housing cooperative to dissolve  the corporation and for the directors' and officers' illegal,  fraudulent, and oppressive acts. Clients have received deeds to their  homes and will receive a distribution of the corporate assets. Trial  court’s decision affirmed by Illinois Appellate Court in 100-page  decision. (January 2007).
  
• Hired  specially as appellate counsel and succeeded in getting the appellate  court to reverse the dismissal of our client's claim and allow it to go  to trial.
  (September 2006).
  
• $110,000 settlement of residential construction defect claim. (January 2006).
  
• $1.5 million settlement of insurance coverage dispute where insurance company had denied any liability. (2004).
  
• $250,000 judgment on guaranty, affirmed on appeal; was both trial and appellate counsel. (July 2003)
  
• $625,000 auto accident settlement, partial vision loss. (March 2002).
  
• $537,000 contract judgment for Mexican artist against Chicago gallery
  (January 2001).