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The panel certified the following question to the Washington Supreme Court: Under Washington law, is an insurer bound by representations made by its authorized agent in a certificate of insurance with respect to a party's status as an additional insured under a policy issued by the insurer, when the certificate includes language disclaiming its authority and ability to expand coverage? View "T-Mobile USA Inc. v. Selective Insurance Company of America" on Justia Law

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The Eighth Circuit affirmed the district court's entry of judgment for the insured in a dispute over property coverage of a building that was destroyed by fire. The court held that the district court correctly entered judgment for the insured on the bad faith claim where Met could not prove misrepresentation or deception by the insured, or any reliance thereupon by Met. The court also held that the district court properly calculated the economic damages the insured suffered as a result of Met's bad faith refusal to pay pursuant to the provisions of the improperly rescinded contract. Furthermore, the district court did not abuse its discretion in awarding reasonable attorney fees. View "Hayes v. Metropolitan Property & Casualty Insurance" on Justia Law

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Plaintiff-petitioner Charissa Schultz was injured in a 2015 car accident in which the other driver failed to stop at a stop sign. The other driver’s insurance company settled for its $25,000 policy limit, and Schultz made a demand on her own uninsured/underinsured motorist benefits under her GEICO policy, which also had a $25,000 limit. In April 2017, after months of correspondence and apparent review of an MRI performed on Schultz in April 2015, GEICO offered Schultz its full policy limit, and it did so without requesting that she undergo an independent medical examination (“IME”). Indeed, GEICO’s claim logs reveal that at the time GEICO decided to offer Schultz its policy limits, it “concede[d] peer review wouldn’t be necessary,” indicating an affirmative decision not to request an IME. A few months later, Schultz filed the present lawsuit asserting claims for bad faith breach of an insurance contract and unreasonable delay in the payment of covered benefits. GEICO denied liability, disputing the extent and cause of Schultz’s claimed injuries and asserting that causation surrounding the knee replacement surgeries was “fairly debatable” because Schultz had preexisting arthritis, which GEICO claimed may independently have necessitated her surgeries. To establish its defense, GEICO ordered the IME and the district court granted that request. The Colorado Supreme Court concluded GEICO’s conduct had to be evaluated based on the evidence before it when it made its coverage decision and that, therefore, GEICO was not entitled to create new evidence in order to try to support its earlier coverage decision. The Court also concluded the district court abused its discretion when it ordered Schultz to undergo an IME over three years after the original accident that precipitated this case and a year and a half after GEICO had made the coverage decision at issue. View "Schultz v. GEICO Casualty Company" on Justia Law

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At issue was the implications of the statutory language found in Ky. Rev. Stat. 186A.220 to the sale of a vehicle that was involved in an accident that killed both Jonathan Elmore and Craig Armstrong. Charles Armstrong sued Martin Cadillac, Inc.; The Travelers Indemnity Company, Martin’s insurer; Elmore’s estate, and other parties for the wrongful death of his son, Craig. Elmore was driving the vehicle, and Craig was a passenger when the vehicle was involved in the accident. This litigation centered around who owned, operated, or was financially responsible for the vehicle Elmore was driving. The circuit court found that Elmore was the owner of the vehicle, and therefore, that Martin and Travelers were not financially liable for the loss. The Supreme Court affirmed the circuit court’s order granting summary judgment on all claims against Martin and Travelers, holding that, pursuant to section 186A. 220, Martin was not the “owner” of the vehicle, and therefore, Martin and Travelers were not responsible for coverage of the vehicle. View "Travelers Indemnity Co. v. Armstrong" on Justia Law

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The Supreme Court affirmed the decision of the court of appeals reversing the trial court’s grant of summary judgment against Plaintiffs in this insurance dispute, holding that summary judgment was improper. Plaintiffs sought chiropractic treatment for injuries sustained in an automobile accident. The bills were submitted to GEICO for payment under Plaintiffs’ basic reparations benefits (BRB). GEICO denied coverage and refused to pay for certain medical treatments Plaintiffs had already received. Plaintiffs then brought suit alleging that GEICO improperly denied coverage under their BRB based upon a medical records review and arguing that Ky. Rev. Stat. 304.39-270 requires an independent medical examination before GEICO can deny them BRB. In entering summary judgment against Plaintiffs, the trial court ruled that section 304.39-270 was permissive. The court of appeals reversed and remanded the case to the trial court for further proceedings. The Supreme Court affirmed, holding (1) section 304.39-270 fails to address when and how GEICO could deny BRB; and (2) because the trial court based its decision to grant summary judgment on the implications of section 304.39-270 rather than examining the remaining parts of the Motor Vehicle Reparations Act, Ky. Rev. Stat. 304.39-020(2), it was improper for the trial court to grant summary judgment without further review of the statutes. View "Government Employees Insurance Co. v. Sanders" on Justia Law

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The Eighth Circuit affirmed the district court's judgment in favor of defendant in an action brought by Lincoln Life for damages it incurred in a lawsuit brought by a policyholder who purchased a Lincoln policy through defendant. Defendant counterclaimed, seeking withheld commissions and bonuses from the sale of that policy. The court held that the district court did not err in granting Wilson summary judgment on Lincoln's claim for damages on the ground the claims were collaterally estopped by the New York judgment finding coverage under the policies; by precluding Lincoln from asserting as a defense against defendant's counterclaim for commissions that he breached his agent's contract in connection with the sale of the policies; and in granting defendant prejudgment interest on his liquidated damage claims. View "Lincoln Benefit Life v. Wilson" on Justia Law

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In this insurance dispute, the Supreme Court reversed the decision of the court of appeals affirming the circuit court’s interlocutory order that determined that the fire at issue constituted multiple occurrences instead of a single occurrence, holding that the fire constituted a single occurrence pursuant to the commercial general liability (CGL) policy. The court of appeals concluded (1) under the CGL policy, there was an occurrence each time the fire spread to a new piece of real property, and (2) therefore, the $2 million aggregate limit applied rather than the $500,000 per-occurrence limit for property damage due to fire arising from logging and lumbering operations. Both the circuit court and court of appeals purported to apply the “cause theory.” The Supreme Court reversed, holding that the court of appeals’ approach was unpersuasive and had unreasonable consequences and that the $500,000 per-occurrence limit for property damage applied. View "SECURA Insurance v. Lyme St. Croix Forest Company, LLC" on Justia Law

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Plaintiff-Appellant Jeffrey Allen was injured in a car accident in May 2013. His automobile insurance policy included coverage for medical expenses arising from car accidents, but this coverage contained a one-year limitation period such that he could not obtain reimbursement for medical expenses that accrued a year or more after an accident. Allen sought reimbursement for medical expenses accruing more than a year after his accident, arguing this limitation period was invalid on two grounds: (1) a 2012 disclosure form that his insurer sent him stated that his policy covers reasonable medical expenses arising from a car accident, Colorado’s reasonable-expectations doctrine rendered the one-year limitations period unenforceable; and (2) Colorado’s MedPay statute, which required car insurance companies to offer at least $5,000 of coverage for medical expenses, prohibited placing a one-year time limit on this coverage. The district court granted summary judgment in favor of the insurer. After review, the Tenth Circuit rejected both of Allen’s arguments and affirmed the district court order. View "Allen v. USAA" on Justia Law

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Kimberly Blalock appealed a circuit court order holding Crimson Sutphin was the rightful beneficiary of a policy insuring the life of Loyd Sutphin, Jr. ("Loyd"), issued by New York Life Insurance Company. Loyd took out a $250,000 individual whole life-insurance policy, naming his daughter, Sutphin, as the sole beneficiary. In October 2012, Loyd married Blalock, and they lived together at his home in Henegar. Soon after, in December 2012, Loyd submitted a change-of-beneficiary-designation form to New York Life, designating Blalock and Sutphin each as a 50% beneficiary under the policy. A few years later, in February 2016, Loyd and Blalock divorced; however, the life-insurance policy was not addressed in the divorce judgment, and Loyd never changed the beneficiary designation following the divorce. Loyd died later that year on December 23, 2016. In April 2017, Sutphin filed a action seeking a judgment declaring that she was the rightful beneficiary of the entire proceeds of the New York Life policy because, she asserted, pursuant to section 30-4-17, Ala. Code 1975, Blalock's beneficiary designation had been revoked upon her divorce from Loyd. Blalock moved to dismiss the action, arguing that Tennessee, not Alabama, law should govern and, thus, that the DeKalb Circuit Court did not have subject-matter jurisdiction to hear the case. The circuit court denied the motion to dismiss; Blalock filed a motion to reconsider the denial. At an evidentiary hearing on her motion to reconsider, Blalock again argued that the DeKalb Circuit Court lacked subject-matter jurisdiction but also asserted that the application of 30-4-17 in this instance violated section 22 of the Alabama Constitution of 1901; the circuit court denied Blalock's motion to reconsider. The case proceeded to a bench trial, at which Blalock argued that she and Loyd had established a common-law marriage after their divorce and before his death, thereby reviving her beneficiary designation under the policy. The circuit court heard testimony from numerous witnesses on this issue, most of whom testified on Blalock's behalf. In 2018, the circuit court issued a final order in the case, holding that Sutphin was the rightful beneficiary under the policy because Blalock's beneficiary designation had been revoked by virtue of 30-4-17 and no common-law marriage existed to revive that designation before Loyd's death. Finding that Blalock's beneficiary designation was revoked under 30-4-17 by virtue of her divorce, the Alabama Supreme Court affirmed the circuit court. View "Blalock v. Sutphin" on Justia Law

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The Supreme Court reversed the decision of the Court of Appeals affirming the decision of the district court granting summary judgment to The Bar Plan Mutual Insurance Company on Daniel Becker’s insurance coverage dispute with the company, holding that the lower courts erroneously relied upon certain caselaw in granting summary judgment and that, under the correct caselaw, questions of fact remained that were inappropriate for summary judgment. Specifically, the Court held (1) the lower courts erred in relying on the “expansion of coverage” rule in concluding that Becker was asking for the coverage to be expanded beyond the insurance contract’s terms and that that courts should instead have continued their analysis to see if estoppel was appropriate to apply to the facts under the “reservation of rights” rule; and (2) because several genuine issues of material fact remained on the issue of estoppel, this case must be remanded for further proceedings. View "Becker v. Bar Plan Mutual Insurance Co." on Justia Law