Justia Insurance Law Opinion Summaries

In separate petitions, the Hampton Insurance Agency and Ginger Spencer, Acceptance Indemnity Insurance Company and Ashland General Agency all defendants in an action filed by Mary Alice Patton, d/b/a Hole in the Wall Lounge, petitioned the Supreme Court for a writ of mandamus to direct the trial court to transfer the action to the Tuscaloosa Circuit Court. Ms. Patton purchased insurance for her lounge from Ms. Spencer, an independent insurance agent for Hampton. At issue was the nature and extent of the coverage Ms. Patton sought. The lounge was destroyed by fire in 2009. Upon filing her insurance claim, Ms. Patton was informed that her policy did not include coverage for property damage. Accordingly, Ms. Patton sued because "defendants were negligent and/or wanton in their procurement of full coverage insurance for [Patton] on her lounge building and its contents." Hampton responded with a motion to dismiss or in the alternative, to transfer the case on grounds that the case was filed in an improper venue. Upon review, the Supreme Court found that the defendant insurance companies met the requirements for the writ of mandamus. The Court directed the trial court to vacate its order denying defendants' motions to transfer, and to enter orders granting those motions to transfer to the Tuscaloosa Circuit Court.

Plaintiff John Ensey was employed by both Defendant Ozzie’s Pipeline Padder, Inc. (Ozzie’s) and Rockford Corporation when he was severely injured. He sued Ozzie’s but was denied relief on the ground that Ozzie’s was protected by the exclusive-remedy provision of the New Mexico Workers’ Compensation Act. Plaintiff appealed, contending that Ozzie’s could not invoke the exclusivity provision because it failed to show that it contributed to paying for the workers’ compensation policy obtained by co-employer Rockford. Upon review, the Tenth Circuit concluded that under New Mexico law Ozzie’s was protected by the exclusivity provision because its contract with Rockford required Rockford to obtain workers’ compensation insurance for Plaintiff, and Plaintiff failed to produce evidence to overcome the inference that Ozzie’s therefore contributed to paying the insurance premium. Accordingly, the Court affirmed the district court's judgment that denied him relief.

Plaintiff Darlene Howsden was injured on premises that were leased to her employer by a legally distinct entity that was owned and operated by the same shareholders as her employer. Plaintiff sued Defendant, the entity that owned the premises, for negligence. The district court granted summary judgment to Defendant, concluding that Plaintiff's exclusive remedy was under the Nebraska Workers' Compensation Act. The Supreme Court reversed, holding that the district court erred in concluding that the exclusive remedy rule extended to Defendant because (1) Defendant was a legally separate entity from Plaintiff's employer, despite their corporate kinship, and there was no equitable basis to justify piercing the corporate veil between the two entities; and (2) therefore, Defendant was a third party to the employment relationship between Plaintiff and her employer, so Plaintiff's third-party claim against Defendant was not barred by the exclusive remedy provisions of the Act.

This case involved a legal malpractice claim brought by Plaintiff MB Industries, LLC (MBI) against attorneys Steven Durio and John Weinstein. The attorneys represented MBI in an ultimately unsuccessful lawsuit against former MBI employees. Rather than appeal the unfavorable judgment, MBI chose to sue its former attorneys. The issues before the Supreme Court were: (1) whether a party's failure to appeal an underlying judgment waived any right to bring a legal malpractice claim based on that judgment; and (2) whether summary judgment was properly granted in light of MBI's failure to introduce expert testimony to establish the applicable standard of care which would have demonstrated the attorneys' actions fell below that standard. After careful review, the Court found that Louisiana law does not impose a "per se" rule requiring an appeal before a client can sue his former attorney. Furthermore, the Court found that a party alleging legal malpractice must introduce expert testimony to establish a standard of care "except in those rare cases involving malpractice so egregious that a lay jury could infer the defendant's actions fell below any reasonable standard." The Court found that under the particular facts of this case, there were no genuine issues of material fact, and that MBI failed to establish it could satisfy its evidentiary burden of proof at trial. The attorneys were entitled to judgment as a matter of law. Accordingly, the Court reversed the appellate court and reinstated the trial court's original judgment in favor of the attorneys.

Plaintiffs Thomas and Margaret McGoff appealed a superior court order that granted Defendant Acadia Insurance Company summary judgment with respect to Plaintiffs’ underinsured motorists (UIM) claim arising from an automobile accident in which Thomas McGoff was injured. Thomas McGoff was employed by A.R. Sandri, Inc., a Massachusetts corporation that operates gas stations and other businesses in New England and New York. At the time of the accident that led to the instant lawsuit, Sandri had supplied McGoff with a company car which he kept at his Barre, Vermont home. The Plymouth was owned by Sandri, registered in Massachusetts, and insured by Acadia. Sandri had two fleet insurance policies with Acadia—one for vehicles registered in Massachusetts and one for vehicles registered in other states. The Plymouth was covered by the policy issued for vehicles registered in Massachusetts. The policy listed the vehicles as being garaged in Massachusetts, apparently based on Sandri’s representation. McGoff made a claim against the other driver and a claim for additional UIM coverage against Acadia. Acadia denied coverage because the policy’s UIM coverage was less than the alleged tortfeasor’s liability coverage. Based on this, Acadia moved for summary judgment. In May 2010, the court granted Acadia’s motion, ruling that Vermont’s uninsured/underinsured (UM/UIM) insurance requirements do not apply to the Acadia fleet policy because the policy was not "delivered or issued for delivery in this state." Without setting forth "[a] statement of the issues presented for review," Plaintiffs generally claimed on appeal that the superior court erred by granting Acadia summary judgment. Specifically, Plaintiffs argued the court erred in ruling that Vermont’s UIM requirements do not apply to the instant policy on grounds that the policy was not delivered or issued for delivery in Vermont. Because the Plymouth was garaged in Vermont rather than in Massachusetts (as indicated in the Acadia policy), they maintained the vehicle should have been registered in Vermont rather than Massachusetts and the Vermont UIM requirements should apply. Upon review of the parties briefs and the trial record, the Supreme Court found that Plaintiffs' position was contrary to the plain language of the UIM statute as well as the nearly unanimous relevant case law, and therefore the Court decline to adopt it under the present circumstances. The Court affirmed the superior court's grant of summary judgment to the insurer.

The superintendent of insurance, in her capacity as the liquidator of an insolvent insurer, filed an action in the county court of common pleas against an independent accounting firm that provided auditing services to the insurer, alleging negligence and that the firm had received preferential or fraudulent payments. The accounting firm moved to dismiss the complaint or to stay the proceedings and compel arbitration based on an arbitration clause that was contained in an engagement letter signed by the insurer and accounting firm. The trial court denied the motion. The court of appeals affirmed, holding that because the liquidator had not signed the arbitration agreement, there was a presumption against arbitration. The Supreme Court affirmed but in part for different reasons, holding that the liquidator was not bound by the insurer's agreement when the liquidator's claims did not arise from the contract that contained the arbitration provision.

Franklin Electric formed two new subsidiaries and started new unemployment experience accounts with a low introductory contribution rate for each one, which equaled about half the experience rating of Franklin Electric. The Department of Workforce Development later canceled the subsidiaries' experience accounts, and all experience balances and liabilities reverted to Franklin Electric. The Department also demanded back payments, interest, and a ten percent penalty. A liability administrative law judge (LALJ) affirmed the Department's determination that the three entities were a single employer but waived the penalty imposed by the Department. The court of appeals affirmed. The Supreme Court granted transfer and vacated the opinion of the court of appeals and affirmed the determination of the LALJ, holding (1) the new subsidiaries were not new employers because they were not distinct and segregable from Franklin Electric; (2) Franklin Electric's experience rating should have applied to contributions made by the subsidiaries; and (3) because there was no evidence suggesting improper conduct on the part of Franklin Electric, the penalty was not appropriate.

Appellant Greg Bell requested that County Risk Sharing Authority (CORSA), a joint self-insurance pool whose members included the majority of Ohio's counties, provide him with certain CORSA records pursuant to Ohio Rev. Code 149.43 and Ohio Rev. Code 149.431. David Brooks, the managing director of property and casualty insurance for CORSA, refused to provide copies of the records, asserting that they were not public records and that CORSA was a private corporation and not a public office subject to section 149.43. Bell filed for writs of mandamus to compel Brooks to provide copies of the requested CORSA records. The court of appeals denied the requested writs. The Supreme Court (1) affirmed the judgment of the court of appeals insofar as it denied the writs relating to Bell's claim for CORSA's board meeting minutes on grounds that CORSA was not the functional equivalent of a public office for purposes of section 149.43, but (2) reversed to the extent that the court of appeals failed to consider Bell's records requests for CORSA's financial and compensation records as CORSA's status as a private, nonprofit corporation was not dispositive in regard to these claims. Remanded.

When it was sued by its former president and CEO, the Equine Assisted Growth and Learning Association (EAGALA) requested coverage for the costs of its defense from its insurance carrier, Carolina Casualty. Carolina Casualty denied coverage, contending that the complaint was brought "by, on behalf of, or in the right of" EAGALA, a type of claim excluded from coverage by the insurance policy. EAGALA sued Carolina Casualty to establish coverage for the costs of defending the suit. The district court granted Carolina Casualty's motion for judgment on the pleadings and dismissed EAGALA's complaint after determining that it was unnecessary and improper for the court to consider extrinsic evidence to discern whether Carolina Casualty had a duty to defend EAGALA. The court of appeals reversed, concluding that under the language of the insurance policy, extrinsic evidence was admissible to determined whether the complaint was actually filed by, on behalf of, or in the right of EAGALA. On review, the Supreme Court affirmed the court of appeals' decision, holding that the district court erred when it refused to consider extrinsic evidence as required by the terms of the insurance policy.

The City of New York sued defendants under federal and New York State antitrust laws, seeking to prevent the companies from merging. The city appealed from a judgment of the district court granting summary judgment to defendants and dismissing the city's complaint without leave to amend. The court agreed with the district court that the alleged relevant market definition, as the "low-cost municipal health benefits market[,]" was legally deficient and concluded that the district court's denial of leave to amend was not an abuse of discretion. Accordingly, the court affirmed the judgement of the district court.