Justia Insurance Law Opinion Summaries

Garold Charles was in an accident while riding as a passenger in a vehicle belonging to Tara and Anthony Stout. He brought negligence claims against the Stouts and Credit Union 1, the lienholder of the Stouts’ vehicle. Credit Union 1 moved for summary judgment. Charles opposed the motion, relying on testimony from Tara’s deposition and contending in part that he was a third-party beneficiary of an alleged contract between Credit Union 1 and the Stouts by which the credit union agreed to provide liability insurance. The superior court struck Tara’s testimony and granted summary judgment to Credit Union 1. Charles appealed. Finding no error in the trial court's decision, the Supreme Court affirmed. View "Charles v. Stout" on Justia Law

Appellant Hugo Rosales suffered an injury working on a fish-processing vessel. He filed both a workers' compensation claim and a maritime lawsuit. Appellant and the employer ultimately entered into a global settlement of both cases. The state Workers' Compensation Board initially rejected the settlement. Appellant later tried to withdraw from the settlement but changed his mind. At a hearing, he testified that the though the settlement was in his best interests. The Board approved the settlement after the hearing. Several months later, appellant moved to have the agreement set aside. The Board denied this request. The Workers' Compensation Appeals Commission affirmed the Board's decision. Finding no error in the Commission's decision, the Supreme Court affirmed. View "Rosales. v. Icicle Seafoods, Inc." on Justia Law

Fifteen-year-old Kevin Michaud fired a single shot from a revolver belonging to his parents, killing one friend and seriously wounding another. The parents of the two victims sued Kevin, his parents, and their insurance company, United Services Automobile Association (USAA). The Michauds' liability policy provided a $300,000 limit for "Each Occurrence" of "Personal Liability." The superior court ruled that the policy afforded $900,000 of coverage because there had been a single occurrence and Kevin and his parents were each entitled to a separate per-occurrence policy limit. USAA appealed, arguing that the policy affords a single per-occurrence policy limit of $300,000 regardless of the number of insureds. The victims' parents also appealed, arguing that not only were there three individual coverage limits, one each for Kevin and his parents, but there were also multiple occurrences. Upon review, the Supreme Court concluded that USAA's position was most in accord with the express language of the policy, the reasonable expectations of an insured, and case law, and therefore reversed the superior court's decision. View "United Services Automobile Association v. Neary" on Justia Law

Appellant Tommie Patterson was involved in a motor vehicle accident. His insurance company paid his medical providers to the policy limit. Two years later, Appellant sued the insurance company, arguing it had shown bad faith following the accident. The company moved for summary judgment, which was granted. A month after that decision, Appellant filed a second lawsuit, alleging the company falsely advertised its services, breached his insurance contract, embezzled money from him, falsified documents and threatened to make him at fault for the accident. The company moved for summary judgment again, which was granted. After review, the Supreme Court concluded that because Appellant's embezzlement claim in the second lawsuit alleged a different cause of action than in the first, the trial court improperly granted summary judgment with regards to that claim. All other claims were barred by res judicata. Therefore the Supreme Court affirmed the trial court in all other respects. View "Patterson v. Infinity Insurance Co." on Justia Law

A driver caused injury to the passenger of another car in a two-car accident. The passenger brought suit for damages, including her insurer's subrogated claim for medical expenses. The driver made an early offer of judgment, which the passenger did not accept. The driver's insurer then made a direct payment to the subrogated insurer, thereby removing that amount from the passenger's potential recovery. The driver then made a second offer of judgment, which the passenger did not accept. After trial both parties claimed prevailing party status; the driver sought attorney's fees. The superior court ruled that the first offer of judgment did not entitle the driver to fees, but the second offer did. Both parties appealed, arguing the superior court improperly considered the subrogation claim payment in its rulings. Upon review, the Supreme Court concluded that the subrogation claim payment had to be taken into account when evaluating the first offer of judgment and affirmed the decision that the driver was not the prevailing party based on the first offer of judgment. But because the nature of the payment on the subrogation claim was not clear, the Court vacated the decision that the second offer of judgment entitled the driver to attorney fees and remanded the case for further proceedings on this issue. View "Dearlove v. Campbell" on Justia Law

Following a car accident with an uninsured motorist, Lori McDonnell filed suit against her insurer State Farm Mutual Automobile Insurance Company on behalf of herself and her minor son, Luke. McDonnell sought a declaratory judgment that: (1) she was entitled to have her personal injury claims settled by appraisal under the mandatory appraisal statute; and (2) a provision in her State Farm insurance policies requiring her to file suit against the insurance company within two years of the accident was void as against public policy. The superior court ruled that the mandatory appraisal statute did not apply to personal injury claims. The court further ruled that the contractual two-year limitations provision was enforceable, but only if State Farm could show that it was prejudiced by an insured's delay in bringing suit, and that the appropriate accrual date for the limitations period was the date State Farm denied an insured’s claim, rather than the date of the accident. McDonnell and State Farm both appealed that decision. Finding no error in the trial court's decision, the Supreme Court affirmed. View "McDonnell v. State Farm Mutual Automobile Ins. Co." on Justia Law

The question before the Supreme Court in this appeal was whether a defendant who pled no contest to disorderly conduct in a criminal action could be collaterally estopped from relitigating the elements of that crime in a related civil declaratory judgment action regarding insurance coverage, thereby precluding coverage. Kent Bearden pled no contest to disorderly conduct for punching Paul Rasmussen. Rasmussen subsequently filed a civil complaint against Bearden, and Bearden tendered the lawsuit to State Farm Insurance Company to defend and indemnify him under his homeowners insurance policy. State Farm sought declaratory relief and moved for summary judgment on the ground that Bearden's conduct could not be considered an "accident" within the meaning of the insurance policy because his no-contest plea collaterally estopped him from relitigating the issues of mens rea and self-defense. The superior court granted the motion. Finding no error with the superior court's decision, the Supreme Court affirmed. View "Bearden v. State Farm Fire & Casualty Co." on Justia Law

An employee filed an affidavit of readiness for hearing in her workers' compensation case approximately four years after her employer filed a controversion of her written workers' compensation claim. The employer petitioned to dismiss her claim based on the statutory deadline for a hearing request. After a hearing, the Alaska Workers' Compensation Board dismissed her claim, and the Alaska Workers' Compensation Appeals Commission affirmed the Board's decision. Because the employee did not file a timely request for a hearing and was not excused from doing so, the Supreme Court affirmed the Commission's decision. View "Pruitt v. Providence Extended Care" on Justia Law

A hotel worker fell and injured her back while cleaning a room. Her employer initially paid benefits, but it filed a controversion of benefits after its doctor doubted the accident’s occurrence and said any work injury was not the substantial cause of the worker’s continuing need for medical care. The Alaska Workers’ Compensation Board decided that the fall was the substantial cause of the worker’s disability, finding the worker’s testimony about the injury credible and the employer’s doctor’s testimony not credible. Based on the testimony of the worker and her treating physician, as well as an MRI showing a herniated disc, the Board decided that the injury was compensable. The Alaska Workers’ Compensation Appeals Commission reversed the Board’s decision because, in the its view, substantial evidence did not support the decision. Because the Commission incorrectly decided the substantial evidence question, the Supreme Court reversed the Commission’s decision. View "Sosa de Rosario v. Chenega Lodging" on Justia Law

While receiving workers' compensation benefits for an injury, an employee periodically endorsed benefit checks that included a certification that she had "not worked in any employment or self-employment gainful or otherwise." Her employer obtained surveillance videos of her activities at an herb store owned by her boyfriend and filed a petition with the Workers' Compensation Board alleging that she had fraudulently misrepresented her employment status for the purpose of obtaining benefits. The Board denied the petition, finding credible the employee's testimony that she did not consider her activities to be work that needed to be reported. On appeal, the Alaska Workers' Compensation Appeals Commission concluded that the Board erred in determining that the employee had not "knowingly" misrepresented her work status, but it affirmed the Board's denial of the petition on the alternative ground that the employer had not shown the requisite causal link between the allegedly fraudulent check endorsements and the payment of benefits. Upon review of the matter, the Supreme Court concluded that the Commission erred in its interpretation of the "knowingly" element of the test for fraud. Nevertheless, the Court affirmed the Commission's decision because, based on the Board's binding credibility determination, the employee's statements were not knowingly false and therefore not fraudulent. View "ARCTEC Services v. Cummings" on Justia Law