Justia Insurance Law Opinion Summaries

Marcus A. Fear was involved in a rear-end collision in 2018, resulting in injuries and medical treatment. He held an underinsured motorist (UIM) policy with GEICO and settled with the tortfeasor's insurer for $25,000. Fear sought additional compensation from GEICO, which offered $2,500 and later $4,004, but Fear did not accept these offers. He then sued GEICO for statutory bad faith under section 10-3-1115, alleging unreasonable delay in payment of his UIM claim.The case proceeded to a bench trial where experts disagreed on GEICO's handling of the claim. The district court found that $3,961 of Fear's non-economic damages were undisputed and ruled that GEICO violated section 10-3-1115. GEICO appealed, and the Colorado Court of Appeals reversed, concluding that non-economic damages are inherently subjective and that admitting GEICO's claim evaluation as evidence of undisputed benefits violated CRE 408.The Supreme Court of Colorado reviewed the case and agreed with the lower court that CRE 408 bars the admission of internal settlement evaluations to show undisputed benefits owed. However, it noted that such evaluations might be admissible for other purposes, such as establishing an insurer's good or bad faith. The court also concluded that non-economic damages could be undisputed or not subject to reasonable dispute in some cases, contrary to the appellate court's ruling that they are always reasonably disputable.Ultimately, the Supreme Court affirmed the appellate court's judgment, finding that Fear did not provide admissible evidence to show that any portion of his non-economic damages was undisputed or not subject to reasonable dispute. View "Fear v. GEICO Cas. Co." on Justia Law

Jeromy McCrackin filed a wrongful death action against Tynan Mullen for the death of McCrackin’s son, who was shot and killed outside a pool hall in 2019. Safeco Insurance Company of America had issued a homeowners insurance policy to Mullen’s grandmother, with whom Mullen allegedly lived at the time. Mullen was indicted for first-degree murder and armed criminal action but pleaded guilty to first-degree involuntary manslaughter and armed criminal action. McCrackin offered to settle the wrongful death claim against Mullen in exchange for Safeco’s agreement to pay the total liability coverage limits, which Safeco declined, stating the policy excluded coverage for intentional acts.The Circuit Court of Jackson County overruled Safeco’s motion to intervene in the wrongful death action for the purpose of seeking a stay until a separate federal declaratory judgment action could be resolved. Safeco had filed the federal action to determine whether it had a duty to defend or indemnify Mullen. The circuit court held a bench trial in the wrongful death action, overruled Safeco’s motion to intervene, and entered a judgment against Mullen, awarding McCrackin $16.5 million in damages.The Supreme Court of Missouri reviewed the case and held that Safeco had a right to intervene in the wrongful death action pursuant to Rule 52.12(a)(2) for the limited purpose of seeking a stay. The court found that Safeco had an interest in the wrongful death action and that the disposition of the action could impair or impede its ability to protect that interest. The court vacated the circuit court’s judgment and remanded the case for further proceedings consistent with its opinion. The court did not direct how the circuit court should rule on the motion to stay, leaving that decision to the lower court. View "McCrackin vs. Mullen" on Justia Law

Joe David Hudson was injured while working for Joplin Regional Stockyards, Inc. (JRS) in 2002. In 2005, Hudson, JRS, and JRS' insurer, Star Insurance Company, entered into a settlement agreement where Hudson received an $80,000 lump sum. The settlement left future medical expenses for Hudson's left ankle open. In 2011, Hudson had a below-the-knee amputation, which Star refused to cover. Hudson filed the settlement in circuit court in 2013, and the court rendered judgment in accordance with the settlement. Hudson later filed an equitable garnishment action, leading Star to pay $92,000 for his medical bills. In 2015, Star agreed to reimburse Hudson up to $610,311.75 for future medical expenses. In 2016, Hudson and JRS entered into a subordination agreement, acknowledging all payments due under the judgment had been received.In 2022, Hudson filed a motion to revive the judgment, which JRS opposed, arguing the judgment had been satisfied and the Division of Workers' Compensation had not determined the future medical care provision. JRS also filed a motion for relief from the judgment, claiming it was void due to lack of due process. The Circuit Court of Jasper County sustained Hudson's motion to revive the judgment and overruled JRS' motion for relief.The Supreme Court of Missouri reviewed the case and determined that JRS had standing to appeal. The court found that the circuit court erred in reviving the judgment because JRS had satisfied the judgment by paying the $80,000 lump sum. The court reversed the circuit court's order sustaining Hudson's motion to revive the judgment and overruled Hudson's motion to revive the judgment. Hudson's motion for damages for a frivolous appeal was also overruled. View "Hudson v. Joplin Regional Stockyards, Inc." on Justia Law

Donna Miller Bruenger, the ex-wife of the late Coleman Miller, filed a petition for declaratory judgment against Courtenay Ann Miller, Coleman’s daughter, seeking entitlement to Coleman’s Federal Employee’s Group Life Insurance (FEGLI) benefits. Coleman had failed to designate a beneficiary for his FEGLI benefits before his death, and MetLife distributed the benefits to Courtenay. Bruenger argued that Coleman’s legal obligation under a Qualified Domestic Relations Order (QDRO) to assign her the benefits should prevail.The Jefferson Circuit Court ruled against Bruenger, concluding that federal law precluded her claim because Coleman’s employer did not receive the QDRO before his death. Bruenger’s subsequent appeal was dismissed by the Court of Appeals as untimely, and the court also imposed sanctions for filing a frivolous appeal. Bruenger then sought relief under CR 60.02, which the trial court granted, allowing her to refile the appeal. The Court of Appeals dismissed the refiled appeal as frivolous and awarded attorney’s fees to Courtenay.The Supreme Court of Kentucky reviewed the case and determined that the Court of Appeals had jurisdiction to consider the merits of the CR 60.02 relief. The Supreme Court held that RAP 11(B) authorizes the award of attorney’s fees as a sanction for frivolous appeals but found that the imposition of sanctions in this case violated due process because Bruenger was not given notice or an opportunity to be heard. The Supreme Court affirmed the dismissal of the appeal for lack of jurisdiction but reversed the sanctions imposed by the Court of Appeals. View "BRUENGER V. MILLER" on Justia Law

In this case, the plaintiff, David Yaffee, was awarded $3,299,455 in damages by a jury for past and future economic earnings and noneconomic loss due to injuries sustained when his vehicle was rear-ended by a truck driven by Joseph Skeen, who was employed by KLS Transportation, Inc. The accident occurred in 2015, and Yaffee experienced significant medical issues, including back pain and leg tingling, leading to multiple medical treatments and surgeries.The Superior Court of Sacramento County entered a judgment on the jury's verdict, which included awards for past and future medical expenses, lost earnings, and noneconomic damages. Defendants, including National Liability & Fire Insurance Company, challenged the awards on several grounds, including the reasonableness of past medical expenses, the speculative nature of future medical expenses, and the sufficiency of evidence supporting lost earnings.The Court of Appeal of the State of California, Third Appellate District, reviewed the case. The court found that the trial court had erred in its interpretation of the Hospital Lien Act (HLA) regarding the measure of past medical damages, leading to the improper admission of evidence on the reasonable value of services. The court concluded that the HLA only applies to services provided while the patient remains in the hospital or affiliated facility following emergency services. Consequently, the award for past medical expenses was reversed.The court also found that the award for future medical expenses was not supported by substantial evidence, particularly regarding the speculative nature of the need for a dorsal root ganglion stimulator. The court reversed the award for future medical expenses and remanded for a new trial on this issue.The awards for past and future lost earnings were upheld, as the court found sufficient evidence supporting the jury's findings. The award for future noneconomic damages was also upheld, as the evidence established a reasonable certainty of future pain and suffering.The court vacated the award for costs and prejudgment interest, as these were based on the reversed portions of the judgment. The case was remanded for a new trial on the issues of past and future medical expenses. View "Yaffee v. Skeen" on Justia Law

Autumn Bertels was severely injured in a car accident involving her grandmother, Elizabeth Bertels, and another driver, Denver Barr, who both died in the crash. Autumn later filed a lawsuit against Elizabeth's estate, and they reached an agreement where the estate assigned its claims against Elizabeth's insurer, Farm Bureau Property & Casualty Insurance Company, to Autumn. The agreement stipulated that Autumn would not seek to collect from the estate's assets and would cover the estate's litigation expenses. A judge awarded Autumn a $15.75 million judgment against the estate, and she subsequently sued Farm Bureau for breach of contract and bad faith.The United States District Court for the District of Kansas dismissed Autumn's suit against Farm Bureau, ruling that she lacked standing because the assignment from the estate was invalid. The court determined that Autumn provided no consideration for the assignment, as her promises were already required by the Kansas nonclaim statute, which bars claims against a deceased person's estate after a certain period and requires the claimant to pay the estate's litigation expenses.The United States Court of Appeals for the Tenth Circuit reviewed the case and affirmed the district court's decision. The appellate court agreed that the nonclaim statute barred Autumn's claim against the estate's assets and required her to pay the estate's expenses, rendering her promises in the agreement illusory and without consideration. Consequently, the assignment was invalid, and Autumn lacked standing to sue Farm Bureau. The court also rejected Autumn's arguments regarding tolling of the nonclaim statute due to her minority and other constitutional claims, finding them unpersuasive or procedurally barred. View "Bertels v. Farm Bureau Property & Casualty Insurance Co." on Justia Law

Dionicio Rodriguez, an employee of SIR Electric LLC (SIR), was injured while working and filed for workers' compensation benefits under SIR's policy with Hartford Underwriters Insurance Company (Hartford). After receiving benefits, Rodriguez filed a personal injury lawsuit against SIR, alleging negligence, gross negligence, recklessness, and intentional wrongdoing. SIR requested Hartford to defend against the lawsuit, but Hartford refused, citing policy exclusions. SIR then filed a third-party complaint against Hartford, claiming wrongful disclaimer of defense coverage.The trial court granted Hartford's motion to dismiss SIR's complaint, ruling that the policy excluded intent-based claims. SIR's motion for reconsideration and to amend its complaint, arguing that the policy's enhanced intentional injury exclusion (EII exclusion) violated public policy, was denied. The Appellate Division affirmed the trial court's decision.The Supreme Court of New Jersey reviewed the case and held that Hartford has no duty to defend SIR. The court determined that Rodriguez's claims of negligence, gross negligence, and recklessness are subject to the workers' compensation exclusivity bar and are not covered under Part One of the policy. These claims are also excluded from coverage under Part Two of the policy. Additionally, Rodriguez's claims of intentional wrongdoing are excluded under the policy's EII exclusion.The court concluded that the trial judge properly denied SIR's motion to amend its third-party complaint, as the EII exclusion does not violate public policy. The court affirmed the Appellate Division's judgment, upholding the dismissal of SIR's third-party complaint against Hartford. View "Rodriguez v. Shelbourne Spring, LLC" on Justia Law

Erin Hughes, the plaintiff, obtained two homeowner’s insurance policies for her property in Malibu. One policy, through the California FAIR Plan Association (FAIR Plan), covered fire loss, while the other, issued by Farmers Insurance Exchange (Farmers), did not. After a fire caused significant damage to her property, Hughes filed a lawsuit against Farmers, alleging it was vicariously liable for the negligence of its agent, Maritza Hartnett, who assisted her in obtaining the FAIR Plan policy, resulting in underinsurance for fire loss.The Superior Court of Los Angeles County granted Farmers’ motion for summary judgment, ruling that Hartnett was not acting within the scope of her agency with Farmers when she assisted Hughes in obtaining the FAIR Plan policy. The court also denied Hughes’s motion for leave to amend her complaint.The Court of Appeal of the State of California, Second Appellate District, reviewed the case. The court affirmed the lower court’s decision, holding that Hartnett was not acting as Farmers’ actual or ostensible agent when she helped Hughes obtain the FAIR Plan policy. The court found that Hartnett’s agent appointment agreement with Farmers did not include authority to transact insurance business on behalf of Farmers for policies issued by unrelated carriers like FAIR Plan. Additionally, the court determined that Hughes failed to present evidence showing that Farmers’ conduct could have led her to reasonably believe Hartnett was acting as its agent in procuring the FAIR Plan policy. The court also upheld the trial court’s denial of Hughes’s motion for leave to amend her complaint, citing her failure to provide an excuse for the delay in filing the motion and the potential prejudice to Farmers. View "Hughes v. Farmers Insurance Exchange" on Justia Law

Jennings Plant Services, LLC, and its members, Spencer and Tarin Jennings, filed a lawsuit against Ellerbrock-Norris Agency, Inc., and Elliot Bassett, alleging that Ellerbrock-Norris failed to provide competent insurance advice. Specifically, Jennings claimed that Ellerbrock-Norris advised them not to add a company-owned vehicle, a Ford F-150, to their commercial insurance policies, which led to a lack of coverage when the vehicle was involved in a fatal collision. This resulted in a significant judgment against Jennings in a federal wrongful death case brought by Kacey Kimbrough, the special administrator of the estate of Shawn Thomas Kimbrough.In the U.S. District Court for the District of Nebraska, Kimbrough obtained a judgment of $5,436,266.87 against Jennings Plant Services. As part of a partial settlement, Jennings assigned Kimbrough a right to 85% of any proceeds from their state lawsuit against Ellerbrock-Norris. Kimbrough then sought to intervene in the state lawsuit under Neb. Rev. Stat. § 25-328, claiming an interest in the litigation due to her assigned right to a portion of the proceeds.The District Court for Washington County denied Kimbrough's motion to intervene, finding that she had no direct cause of action against either Jennings or Ellerbrock-Norris and no legal interest in the subject matter of the underlying litigation. The court determined that Kimbrough's interest was indirect and insufficient to warrant intervention under § 25-328.The Nebraska Supreme Court affirmed the district court's decision, holding that Kimbrough's alleged interest in the proceeds of the lawsuit was too attenuated to constitute a direct and legal interest in the litigation. The court concluded that Kimbrough, as a mere creditor with an indirect interest, did not meet the statutory requirements for intervention. View "Jennings Plant Services, LLC v. Ellerbrock-Norris Agency" on Justia Law

Erin Hughes, the plaintiff, obtained two homeowner’s insurance policies for her property in Malibu. One policy, through the California FAIR Plan Association (FAIR Plan), covered fire loss, while the other, issued by Farmers Insurance Exchange (Farmers), did not. After a fire caused significant damage to her property, Hughes filed a lawsuit against Farmers, alleging it was vicariously liable for the negligence of its agent, Maritza Hartnett, who assisted her in obtaining the FAIR Plan policy, resulting in underinsurance for fire loss.The Superior Court of Los Angeles County granted Farmers’ motion for summary judgment, concluding that Hartnett was not acting within the scope of her agency with Farmers when she assisted Hughes in obtaining the FAIR Plan policy. The court also denied Hughes’s motion for leave to amend her complaint.The Court of Appeal of the State of California, Second Appellate District, reviewed the case. The court affirmed the lower court’s decision, holding that Hartnett was not acting as Farmers’ actual or ostensible agent when she helped Hughes obtain the FAIR Plan policy. The court found that Hartnett was acting as an independent broker for the FAIR Plan policy and not on behalf of Farmers. Additionally, the court determined that Hughes failed to present evidence that could establish a triable issue regarding Farmers’ vicarious liability for Hartnett’s actions.The court also upheld the trial court’s denial of Hughes’s motion for leave to amend her complaint, noting that Hughes offered no explanation for the delay in filing the motion and that allowing the amendment would have prejudiced Farmers and Hartnett. The judgment in favor of Farmers was affirmed, and Farmers was entitled to recover its costs on appeal. View "Hughes v. Farmers Insurance Exchange" on Justia Law