Justia Insurance Law Opinion Summaries

by
Rather than using the insurance agency’s in-house presiding officer, American Property Casualty Insurance Association (Association) requested an adjudicative hearing before an administrative law judge (ALJ) pursuant to RCW 48.04.010(5). The request was denied. The Association sought a writ of mandamus against Insurance Commissioner Mike Kreidler, requiring him to transfer the hearing. The Washington Supreme Court concluded the Association could have sought judicial review by way of the Administrative Procedure Act (APA), ch. 34.05 RCW, thus, the Association failed to demonstrate it had “no plain, speedy, and adequate remedy” at law, one of the three requirements for a writ to issue. Accordingly, the Supreme Court dismissed the petition. View "Am. Prop. Cas. Ins. Ass'n v. Kreidler" on Justia Law

by
The Supreme Court affirmed the order of the circuit court granting summary judgment in favor of Municipal Health Benefit Fund and dismissing this class action complaint challenging the Fund's decision to deny payment for portions of Plaintiff's daughter's medical bills based on its interpretation of the uniform, customary, and reasonable charges (UCR) exclusion in the Fund's policy booklet, holding that there was no error.Through his employment with a municipal police department, Plaintiff obtained health benefits coverage through the Fund. After Plaintiff's daughter was injured in a car accident the Fund denied payment for portions of her medical bills based on its interpretation of the UCR exclusion. Plaintiff then brought this class action against the Fund challenging the enforcement of the UCR term. The circuit court granted class certification and later granted summary judgment in favor of the Fund. The Supreme Court affirmed, holding that the circuit court did not err in granting summary judgment in favor of the Fund. View "Hendrix v. Municipal Health Benefit Fund" on Justia Law

by
The Supreme Court affirmed the judgment of the circuit court granting a "First Amended Complaint in Interpleader with Accompanying Prayer for Declaratory Relief" filed by Allstate Insurance Company and apportioning the interpleaded funds, holding that there was no error.Hartford Underwriters Insurance Company and The Shoe Department brought this appeal, arguing that the circuit court erred in its construction and application of Va. Code 65.2-309 and 65.2-311 and Williams v. Capital Hospice & Property & Casualty Insurance Co., 66 Va. App. 161 (2016) to this case. The Supreme Court affirmed, holding (1) the circuit court did not err by failing to award the available Allstate coverage "to Hartford in full" or, alternatively, by failing to "permit [the requested] intracompany arbitration to proceed because there was no issue to be resolved in the requested arbitration; and (2) the circuit court provided the requisite "verdict or settlement" from which competing claims could be satisfied, and there was no error in the circuit court's apportionment of the funds. View "Hartford Underwriters Insurance Co. v. Allstate Insurance Co." on Justia Law

by
Wade Chapman (“Wade”) and his six siblings (“Siblings”) were the children of Wilford (“Bill”) Chapman. Bill had a life insurance policy for $7,000,000 that named the Chapman Family Multiple Power Liquidity Trust (“Trust”) as its owner. Wade, along with Siblings, were named as the Trust’s beneficiaries. Wade was also named a trustee. After Bill passed away, Wade learned that he was listed as the sole beneficiary of the life insurance policy and retained the entirety of the death benefit for himself. Siblings sued Wade for breach of fiduciary duty, among other causes of action, arguing that the policy was a Trust asset, and its proceeds should have been distributed equally among them. The district court agreed and granted summary judgment in favor of Siblings. It also awarded prejudgment interest against Wade under Idaho Code section 28-22-104 and attorney fees under Idaho Code section 15-8-201, a provision of the Trust and Estate Dispute Resolution Act (“TEDRA”). The Idaho Supreme Court affirmed the district court’s grant of summary judgment to Siblings, affirmed in part and reversed in part the award of prejudgment interest, and reversed the grant of attorney fees to Siblings under TEDRA. View "Vouk v. Chapman" on Justia Law

by
GWG DLP Funding V, LLC was the policy owner and beneficiary of a life insurance policy issued by PHL Variable Insurance Company. After GWG transferred beneficiary rights and ownership to Wells Fargo, PHL terminated the policy. GWG and Wells Fargo disputed the termination, and the parties attempted to settle the dispute. After some negotiations, the insured died, and PHL refused to honor the alleged agreement the parties had reached. GWG and Wells Fargo sued PHL for breach of contract and breach of the covenant of good faith and fair dealing and sought a declaratory judgment that prevents PHL from terminating the policy. Plaintiffs appealed the district court’s dismissal of their claims.   The Eighth Circuit affirmed. The court concluded that the alleged agreement in early February was incomplete and that Plaintiffs have failed to state a claim for breach of contract. Further, the court wrote that Plaintiffs have failed to state a claim for breach of the covenant of good faith and fair dealing. First, there is no enforceable agreement based on the email exchange. Thus, there was no contract under which PHL could have breached the duty of good faith. Second, even if the parties were bound by the early February communications, Plaintiffs alleged no dishonest motive on PHL’s part. View "GWG DLP Funding V, LLC v. PHL Variable Insurance Co." on Justia Law

by
The Supreme Court reversed the judgment of the circuit court granting summary judgment to Liosha Miles on the issue of whether each of the two insurance policies in this case provided separate tranches of insurance of uninsured motorist (UM) coverage and underinsured motorist (UIM) coverage, holding that the circuit court erred.Given her disagreement with GEICO Advantage Insurance Company and GEICO Choice Insurance Company (collectively, GEICO), Miles filed this action seeking a declaration that each policy at issue contained separate $50,000 limits for UM and UIM coverage and that GEICO owed her addition amounts for her UIM claims related to a single automobile accident caused by the negligence of two different drivers other than herself. The circuit court granted summary judgment in favor of Miles. The Supreme Court reversed, holding (1) UIM coverage is a constituent part of UM coverage; and (2) consequently, the circuit court erred in concluding that Va. Code 38.2-2206(A) required each policy to provide Miles with separate UM and UIM coverage limits for injuries arising from a single accident. View "GEICO Advantage Insurance Co. v. Miles" on Justia Law

by
Plaintiffs in these 177 consolidated appeals1 were participants in a 401(k) Profit Sharing Plan (the “Plan”) provided to employees by DST Systems, Inc. (“DST”), a financial and healthcare services company based in Kansas City, Missouri. At the time in question, DST was the Plan’s sponsor, administrator, and a designated fiduciary. Ruane Cunniff & Goldfarb Inc. (“Ruane”) was a Plan fiduciary involved in managing the Plan’s investments. Between October and December 2021, the district court issued seven largely identical orders confirming the arbitration awards to 177 claimants and granting their requests for substantial costs and attorneys’ fees. Defendants appealed, raising numerous issues.   The Eighth Circuit vacated the district court’s judgment including the awards of attorney’s fees, and the consolidated cases are remanded to the district court for determination of transfer and subject matter jurisdiction issues, to the extent necessary. The court concluded that transfer under Section 1631 is an issue that can be addressed before the district court’s subject matter jurisdiction is resolved. The court declined to consider the issue because Badgerow has changed underlying circumstances that may affect whether transfer “is in the interest of justice.” View "Theresa Hursh v. DST Systems, Inc" on Justia Law

by
In this insurance coverage dispute the Supreme Court held that State Farm Fire and Casualty Company was not required to cover repair costs to masonry under either Minn. Stat. 65A.10, subd. 1 or the State Farm policy at issue.Before the Supreme Court was the interpretation and application of Minn. Stat. 65A.10, subd. 1, which generally requires replacement cost insurance to cover the cost of repairing damaged property in accordance with state or local authorities' minimum code. Specifically in question was whether State Farm must cover the cost of repairing cracks in masonry that preexisted a storm that damaged the property of St. Matthews. Because the cracks violated the City of St. Paul's building code, the City would not allow St. Matthews to replace the drywall without also repairing the masonry. The district court granted summary judgment to State Farm, determining that because the storm did not damage the masonry, which led to the code upgrade requirements, no coverage existed. The Supreme Court affirmed, holding that, while State Farm was responsible for providing replacement cost coverage to the damaged drywall, it was not required to cover repair costs to the masonry. View "St. Matthews Church of God & Christ v. State Farm Fire & Casualty Co." on Justia Law

by
Sheckler rented residential property from McIntosh. The lease provided McIntosh “shall maintain fire and other hazard insurance on the premises only” and that Sheckler was responsible for insurance on possessions contained in the premises. The lease's indemnification clause exculpated McIntosh from any damages or injury occurring on the premises. McIntosh obtained insurance from Auto-Owners; first-party dwelling coverage provided coverage for fire damage and third-party landlord liability coverage provided coverage for claims brought by third parties that the insured “becomes legally obligated to pay as damages because of or arising out of bodily injury or property damage.” The third-party coverage provided a duty to defend any claim covered by the policy, excluding “property damage to property occupied or used by an insured or rented to or in the care of, any insured.” The policy listed McIntosh as the only named insured. McIntosh claims no money received from Sheckler was used to pay the annual premium.Sheckler notified McIntosh that the gas stove was not working. McIntosh placed a service call. The technician’s efforts resulted in a fire that caused substantial property damage. Auto-Owners paid McIntosh for damages incurred due to the fire and lost rental income and filed a subrogation action against the technician (Workman), who filed a third-party contribution complaint against Sheckler. Sheckler tendered the defense to Auto-Owners, which rejected the claim. The Illinois Supreme Court reinstated the rejection of Sheckler’s claim. An insurer’s duty to defend or indemnify does not extend to the tenant of an insured property against a third-party negligence contribution claim when the tenant is not identified as a person insured under the policy. View "Sheckler v. Auto-Owners Insurance Co." on Justia Law

by
The First Circuit affirmed the conclusion of the district court conclusion that the insurance policy issued by Motorists Commercial Mutual Insurance Company to the dealership that owned a motor vehicle that killed and injured several people did cover the accident at issue in this case, holding that the district court did not err.This dispute arose from an auction at which a motor vehicle being displayed for bidding suddenly accelerated into a group of auction attendees, killing five people and injuring several more. Motorists brought this action seeking a declaration that its policies did not provide coverage for the victims' claims against the auctioneer or its employee who was behind the wheel of the vehicle when it struck the victims. The district court granted summary judgment for Motorists. The First Circuit affirmed, holding that the policies at issue did not provide coverage for the accident. View "Motorists Commercial Mutual Insurance Co. v. Hartwell" on Justia Law