Justia Insurance Law Opinion Summaries

The underlying tort action in this appeal resulted from a car accident in which the insured, while driving a rental truck, hit a person who was lying in the middle of the road. Both the driver and the person struck were intoxicated, in addition to a passenger in the truck. The person who was struck died from his injuries. The victim's estate sued. The insurance company offered to settle the case against both the driver and the passenger (who may have faced liability for his actions after the accident) for policy limits. These offers were rejected. The estate offered to settle for the release of the named insured only, but the insurer rejected that offer. The occupants of the vehicle later settled with the estate. Unable to reach settlement, the insurer filed a declaratory action to clarify its duties under the policy and resolve issues of who was driving the vehicle, the number of occurrences, and possible breaches of the insurance contract by the insureds. The insureds assigned their claims against the insurer to the estate, which answered and counterclaimed for breach of contract and bad faith. The insurer prevailed on nearly all issues. The personal representative of the estate, for herself and as assignee of the insureds, appealed that result. After review, the Supreme Court found that the insurer did not breach its duties to the insured, and accordingly the Court affirmed the superior court's decision. View "Williams v. GEICO" on Justia Law

A healthcare worker was sprayed in the eye with fluids from an HIV-positive patient. She received preventive treatment and counseling. Her employer initially paid workers' compensation benefits; it later filed a controversion based on its doctor's opinion that the employee was able to return to work. The employee asked for more benefits, but the Alaska Workers' Compensation Board denied her claim. The employee appealed, but the Alaska Workers' Compensation Appeals Commission affirmed the Board's decision. Because the Supreme Court agreed with the Commission that substantial evidence supported the Board's decision, the Court affirmed the Commission's decision. View "Runstrom v. Alaska Native Medical Center" on Justia Law

The passenger of a car was injured in a two-car accident. The passenger brought suit against the other car's driver; the passenger's requested recovery included her insurer's subrogation claim for medical expenses. The driver made an early offer of judgment, which the passenger rejected. The driver then paid the subrogation claim, thereby removing it from the passenger's expected recovery. The driver then made a second offer of judgment, which the passenger rejected, and the case proceeded to trial. After trial the jury awarded the passenger damages and both parties claimed prevailing party status; the driver sought attorney's fees under Alaska Civil Rule 68. The superior court ruled the first offer of judgment did not entitle the driver to Rule 68 fees, but the second offer did. Both parties appealed, arguing the superior court improperly considered the subrogation claim in its Rule 68 rulings. Upon review, the Supreme Court concluded the subrogation payment had to be taken into account when evaluating the first offer of judgment, but not the second. The Court therefore affirmed the superior court's rulings. View "Dearlove v. Campbell" on Justia Law

An employer petitioned the Alaska Workers' Compensation Board for reimbursement from the Second Injury Fund for payments it made to a disabled worker. The Fund opposed the petition. After a hearing, the Board granted the petition. The Fund asked the Board to reconsider its decision in December 2009. The hearing officer told the parties that he would inform them in writing by the end of January 2010 about what action the Board was taking on the reconsideration request. Instead, in April 2010 the hearing officer sent a prehearing conference summary indicating that the reconsideration request had been denied by operation of statute. The next day the Fund filed a notice of appeal and a motion to accept a late-filed appeal with the Alaska Workers' Compensation Appeals Commission. The Commission denied the Fund's request to file its appeal late and dismissed the appeal. Because the Supreme Court concluded that the Fund filed a timely appeal, it reversed the Commission's decision and remand for consideration of the Fund's appeal.

Lawrence Trudell was injured when he fell while trying to descend a ladder from the roof of a structure on which he was working. At the time he was employed by Phillips Construction Co. (Phillips), a construction contracting company principally owned by Clayton Phillips and Trish Dorman. Phillips did not have workers' compensation insurance, even though it was licensed by the State. The structure Trudell was working on was owned by John Brent and Debra Hibbert. Trydell filed suit for workers' compensation benefits against Phillips and the Hibberts, alleging that the owners were "project owners" as defined in the Alaska Workers’ Compensation Act and thus liable for securing workers' compensation. Phillips then filed for bankruptcy. The Hibberts denied liability on the basis that they were not "project owners." After a bench trial solely about whether the building owners were "project owners" or Trudell's employers, the superior court decided that they were neither and that they were not liable to pay worker's compensation, and awarded attorney’s fees against the Trudell. Upon review, the Supreme Court concluded it was error to interpret "project owners" as excluding the building owners, and reversed the superior court's decision.

Appellant Jacob Ennen was seriously injured while he was a passenger in Gordon Shanigan's car. Shanigan's insurer, Integon Indemnity Corporation (Integon), paid $50,000 to cover Shanigan's possible liability to Appellant. Under Alaska insurance statutes, Appellant would also likely have been entitled to underinsured motorist benefits under Shanigan's policy. However, Integon's policy was inconsistent with these statutes, and Integon told Ennen that he was not entitled to any additional money. Six years later, some time after Integon learned that its underinsured motorist provision violated Alaska insurance statutes, Integon paid Appellant underinsured motorist benefits plus interest and fees. Appellant sued Integon for bad faith. Integon filed a third-party complaint against Appellant's attorney, Craig Allen. Before trial, the superior court dismissed Integon’s claims against Allen on the ground that allowing Integon to implead Appellant's attorney would violate public policy. The superior court held that because Appellant did not own the insurance policy, Integon did not owe him a duty of good faith and fair dealing. Accordingly, the superior court concluded that Appellant had no cause of action for bad faith. But, in the event this ruling were to be reversed on appeal, the superior court made an alternate finding that while Integon had committed the tort of bad faith, Appellant had suffered no damages as a result. Upon review, the Supreme Court reversed on both counts. "The superior court was justifiably cautious about extending the bad faith cause of action to a new class of plaintiffs, but we conclude that Ennen, as an insured, is eligible under our existing case law to bring a cause of action for bad faith." The Court concluded that Appellant established facts that would entitle him to damages. Furthermore, the Court affirmed the dismissal of Integon's third-party claim against Allen on the alternative ground that Allen was not a proximate cause of Appellant's harm.

Appellant James Grace suffered permanent brain injuries when his helmet failed after he braked to avoid hitting a dog and was thrown over the handlebars of his motorcycle. Appellant and his wife, Kathleen, filed personal injury and loss of consortium claims against the helmet retailer and manufacturer. The Graces received disbursements from the receiver of one of the manufacturer's second-tier insurance providers that had filed for bankruptcy and gone into liquidation, and entered a settlement agreement with the third-tier insurance carrier. Appellant and his wife separated at some point after the accident, divorced for a month, and remarried. Except for a partial disbursement of funds that occurred while their final divorce hearing was pending, the Graces were unable to agree upon how the remaining settlement and insurance proceeds should be divided. The Graces' lawyer filed an action for interpleader asking the superior court to determine how to divide the remaining funds. After a one-day trial, the superior court concluded that: (1) based on the "analytic" approach in "Bandow v. Bandow," the portion of the recovery from the receiver for the manufacturer's second-tier insurance carrier that was allocated for past economic loss, past medical loss, and rehabilitation services was marital property and should have been divided equally; and (2) the recovery from the third-tier insurance carrier was the result of a jointly-assigned bad faith insurance claim and belonged to both parties. Upon review, the Supreme Court affirmed the superior court's division of the proceeds from the second-tier insurance carrier, but reversed its division of the proceeds from the third-tier insurance carrier.

A worker was involved in a fight in a logging camp bunkhouse. He did not file a report of injury related to the fight for over a year. When he finally filed a report of injury, he alleged that he had injured his hip, lower back, and ear in the fight. His employer denied the worker benefits because he did not give timely notice of the injury. The worker then alleged that he had verbally informed his supervisor of the injuries. After a hearing, the Alaska Workers’ Compensation Board determined that the worker’s claim was barred because he did not give his employer timely notice of the injury. The Board performed an alternative analysis assuming the worker had given timely notice and decided that the claim was not compensable. The Alaska Workers’ Compensation Appeals Commission affirmed the Board’s decision. Because the Commission correctly determined that substantial evidence in the record supports the Board’s decision on the compensability of the claim, the Supreme Court affirmed the Commission’s decision.

After a minor collision between two vehicles in the drive-through line of a Taco Bell, Jack Morrell, the driver of one vehicle, stabbed and killed Eric Kalenka, the driver of the other vehicle. Morrell was uninsured and Kalenka’s policy provided coverage for liabilities arising out of the “ownership, maintenance, or use” of an uninsured motor vehicle. Kalenka’s automobile insurer filed an action in superior court, seeking a declaration that Kalenka’s policy did not provide coverage for Kalenka’s death. The superior court concluded that there was no general liability coverage under the policy. Appellant Uwe Kalenka, the personal representative of Eric Kalenka’s estate, appealed the denial of liability coverage. Upon review, the Supreme Court affirmed the superior court’s determination that Kalenka’s policy did not provide liability coverage.

An elderly woman requiring long-term medical care gave $120,000 to her son in February 2007. The mother believed that the gift would not prevent her from receiving Medicaid coverage if she lived long enough to exhaust her remaining assets. She relied on a provision in Alaska's Medicaid eligibility manual that suggested prospective Medicaid beneficiaries could give away a portion of their assets while retaining sufficient assets to pay for their medical care during the period of ineligibility that Medicaid imposes as a penalty for such gifts. But by the time the mother applied for Medicaid in September 2008, the Alaska legislature had enacted legislation with the retroactive effect of preventing the kind of estate planning the mother had attempted through her gift. The State temporarily denied the mother's application. The son appealed pro se on behalf of his mother, who died in 2009. Upon review, the Supreme Court found that the Alaska legislature's retroactive change to the Medicaid eligibility rules was valid. The Court thus affirmed the State's temporary denial of the mother's application.