Justia Insurance Law Opinion Summaries

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.

At issue in this case were coverage limits associated with underinsured motorist (UIM) insurance and whether coverage provided under disputed insurance policies complies with the requirements of Alaska insurance statutes. The Respondent families hold UIM policies. They alleged they suffered emotional distress and loss of consortium as a result of a collision that killed one familyâs child and severely injured the other familyâs child. The insurer accepted that the policyholders incurred damages. However, it contended that the families exhausted the coverage limits available to them under the UIM policies because the family members seeking damages were not âinâ the fatal collision. The superior court concluded that the families had not exhausted their UIM coverage under Alaska insurance statutes and reformed the insurance policies to allow the emotional distress claims to proceed to arbitration. The superior court dismissed the familiesâ loss of consortium claims as outside the coverage of the policies. Because the Supreme Court concluded that the families exhausted the coverage limits available under their policies and that these policies were consistent with statutory requirements, the Court reversed the superior courtâs decision to reform the policies. Because coverage limits are exhausted, the Court declined to consider whether loss of consortium was covered under the policies.

Appellant Zebuleon Whitney collided with a bicyclist in his pick-up truck, seriously injuring the bicyclist. The bicyclist sought a settlement agreement in excess of the maximum coverage of the driverâs insurance policy. Appellee State Farm Mutual Automobile Insurance Company (State Farm) responded with an offer to tender policy limits, which the bicyclist refused. After a series of court proceedings in both state and federal court, Appellant sued his insurance company, complaining in part that his insurance company had breached its duty to settle. State Farm moved for partial summary judgment on a portion of the duty to settle claims. The superior court granted the motion. The parties then entered a stipulation by which Appellant dismissed all remaining claims, preserving his right to appeal, and final judgment was entered in the insurance companyâs favor. Because State Farmâs rejection of the bicyclistâs settlement demand and its responsive tender of a policy limits offer was not a breach of the duty to settle, the Supreme Court affirmed the superior courtâs grant of summary judgment to that extent. But because the superior courtâs order exceeded the scope of the insurance companyâs motion for partial summary judgment, The Court reversed the superior courtâs order to the extent it exceeded the narrow issue upon which summary judgment was appropriate. The Court remanded the case for further proceedings concerning the surviving duty to settle claims.