Justia Insurance Law Opinion Summaries

In March 2010, a motor vehicle accident occurred on Interstate 95 South in Cranston, Rhode Island, involving Julie DeOliveira, her daughter Maxine, and a truck driven by Greg Trecaso, who was insured by Star Insurance Company. Julie and Maxine claimed that Mr. Trecaso negligently operated his truck, causing their injuries. After Mr. Trecaso and his business were dismissed from the case due to lack of service, Star Insurance remained as defendant. The case proceeded to a jury trial where the key dispute was whether Mr. Trecaso’s actions caused the accident, as described by conflicting accounts from Julie, Maxine, Mr. Trecaso (via deposition), and a police officer.The Providence County Superior Court admitted contested evidence, including Mr. Trecaso’s deposition and a police report, over plaintiffs’ objections. During trial, the jury heard testimony from the plaintiffs, Mr. Trecaso’s deposition, and Trooper Hanley, who investigated the accident. The jury found that neither Julie nor Maxine proved by a preponderance of evidence that Star Insurance’s insured was negligent. Plaintiffs’ motion for a new trial was denied by the Superior Court, as was Star’s motion for judgment as a matter of law.On appeal, the Supreme Court of Rhode Island reviewed several alleged errors, including evidentiary rulings, jury instructions, statements by defense counsel, and the verdict sheet. The Court applied an abuse of discretion standard to evidentiary and procedural rulings and found no error by the trial justice. The Court concluded that the jury instructions were proper, the verdict sheet was not misleading, and the empty chair doctrine was not violated. The Supreme Court affirmed the denial of the plaintiffs’ motion for a new trial and the judgment in favor of Star Insurance Company, declining to address the defendant’s cross-appeal. View "DeOliveira v. Trecaso" on Justia Law

This case centers on a car accident between an insured driver, Ortiz, and an uninsured motorist, Camacho, in Colorado. At the time of the collision, Camacho lacked insurance, drove with only a learner’s permit, and was unsupervised. Ortiz, insured by Progressive Direct Insurance Company, sought uninsured motorist (UM) benefits from Progressive after the accident. Progressive denied the claim, asserting Ortiz was more than 50% at fault. Ortiz then sued both Camacho for negligence and Progressive for breach of contract, insurance bad faith, and unreasonable delay and denial of benefits.Camacho did not respond to the lawsuit, leading the District Court for Garfield County to enter a clerk’s default against her. Progressive had been served but did not object at that time. Progressive’s answer to Ortiz’s complaint included general affirmative defenses but did not specifically assert comparative fault. After Ortiz moved for partial summary judgment, Progressive, for the first time, sought to participate in the liability and damages components of the default judgment hearing. The district court permitted Progressive to contest damages but barred it from contesting liability, finding Progressive had not timely or specifically pleaded its legitimate defenses as required under State Farm Mutual Automobile Insurance Co. v. Brekke, 105 P.3d 177 (Colo. 2004). Progressive paid the damages awarded in the default judgment and then proceeded to trial on Ortiz’s bad faith claims, where Ortiz prevailed.On appeal, the Colorado Court of Appeals affirmed the district court’s decision, holding Progressive failed to meet the Brekke standards for timely and particularized pleading of its legitimate defenses. The Supreme Court of Colorado reviewed whether Brekke’s requirements should be reconsidered. The Court clarified that pleading with particularity under Rule 9(b) is only necessary if fraud or mistake is asserted, and otherwise, insurers must plead legitimate defenses specifically and as soon as practicable. The Court affirmed the appellate judgment, reaffirming Brekke and declining to overrule it. View "Progressive Direct Ins. Co. v. Ortiz" on Justia Law

Carissa Daniels filed a complaint in August 2023 alleging that Patrick R. O’Brien committed timber trespass on her property by cutting trees and bushes. O’Brien’s homeowner’s insurer, MMG Insurance Co., initially defended him under a reservation of rights but later withdrew that reservation and settled the claim with Daniels. Daniels then moved to dismiss her complaint with prejudice as part of the settlement. O’Brien objected to both the settlement and the dismissal, arguing he should have the opportunity to defend against Daniels’s claim and thereby preserve a potential wrongful use of civil process claim against her.The Superior Court (Oxford County) held a hearing on the motions. During the hearing, MMG moved to intervene to support Daniels’s dismissal, while O’Brien moved to keep the matter on the court’s docket. The court granted Daniels’s motion to dismiss with prejudice in February 2025 and denied O’Brien’s motion for further findings of fact and conclusions of law. O’Brien then appealed, raising procedural objections and challenging MMG’s authority to settle over his objection.The Maine Supreme Judicial Court reviewed the case and found no abuse of discretion by the Superior Court in granting the dismissal with prejudice. The Court explained that under Maine Rule of Civil Procedure 41(a)(2), whether to allow a voluntary dismissal is within the trial court’s discretion and does not require a hearing unless evidence is taken. The Court further held that there was no procedural error, and that the merits of the settlement and MMG’s authority to settle were not at issue in this proceeding. The judgment of the Superior Court was affirmed. The main holding is that a trial court does not abuse its discretion by granting a plaintiff’s motion to dismiss with prejudice, even over a defendant’s objection based on potential future claims. View "Daniels v. O'Brien" on Justia Law

After a boat owned by Bryan and Bethea Crabtree was severely damaged by fire while in storage in Florida, the Crabtrees sought coverage under their insurance policy with Great Lakes Insurance. Great Lakes denied their claim, alleging noncompliance with policy conditions, and subsequently filed a declaratory judgment action against the Crabtrees in the United States District Court for the District of Montana, based on the policy’s forum-selection clause and the Crabtrees’ Montana address.The parties agreed that Great Lakes would voluntarily dismiss the Montana case and refile in the United States District Court for the Southern District of Florida (SDFL), with the understanding that the Crabtrees would not contest jurisdiction or venue. Great Lakes dismissed the Montana action and refiled in SDFL. In response, the Crabtrees initiated a state court action and moved to stay or dismiss the SDFL federal suit. Instead of opposing the motion, Great Lakes voluntarily dismissed the SDFL suit as well. That same day, Great Lakes refiled a third action in Montana, which was later transferred back to SDFL at the Crabtrees’ request and with Great Lakes’s consent.Upon return to SDFL, the United States District Court for the Southern District of Florida considered whether, under Federal Rule of Civil Procedure 41(a)(1)(B), Great Lakes’s second voluntary dismissal barred further litigation of the same claim. The court granted summary judgment for the Crabtrees, holding that Rule 41(a)(1)(B) means what it says: a second voluntary dismissal acts as an adjudication on the merits, i.e., a dismissal with prejudice, even if the first dismissal was by agreement. The United States Court of Appeals for the Eleventh Circuit affirmed, concluding that Great Lakes was precluded from relitigating its claim in SDFL. View "Great Lakes Insurance SE v. Crabtree" on Justia Law

A company was the beneficiary of life insurance policies held in a trust formed by Daniel Carpenter. After the insurer paid proceeds to the trust, the beneficiary sought to recover the full amount and alleged that Carpenter hid assets through hundreds of shell companies. Carpenter was convicted of fraud, and the beneficiary obtained a judgment in the United States District Court for the Southern District of New York, later registering the judgment in the United States District Court for the Western District of Oklahoma. That court entered judgment against several Carpenter entities, including a limited liability company that owned another company incorporated in Oklahoma. A receiver was authorized to preserve the assets of the debtor company.An entity called Phoenix Charitable Trust, apparently linked to Carpenter, entered the Oklahoma proceedings as an “interested party” through its counsel, who had represented Carpenter and related entities in other courts. Phoenix objected to several orders issued by the district court: an award of attorney fees and costs against Carpenter, an order authorizing the sale of the Oklahoma company’s insurance portfolio, and an order denying Phoenix’s motion to vacate a prior injunction against Carpenter and his entities.On appeal, the United States Court of Appeals for the Tenth Circuit considered whether Phoenix had standing to challenge these orders. The court found that Phoenix failed to demonstrate it was injured by the attorney fees order or the sale-of-assets order, as required for Article III standing. Regarding the injunction, the court concluded that Phoenix lacked prudential standing because it was asserting the rights of others rather than its own. The Tenth Circuit dismissed the appeal for lack of standing and did not reach the merits of Phoenix’s challenges. View "Universitas Education v. Phoenix Charitable Trust" on Justia Law

A tornado struck Goodhue County, Minnesota, damaging the roof of a mall owned by Rymer Companies, LLC. The roof had preexisting water damage, and the dispute centered on whether the insurance company, Cincinnati Insurance Company, was liable only for the tornado-related damage or for the cost of a full roof replacement, which was necessary to comply with local building codes. Cincinnati estimated its liability at about $10,000 for the tornado damage, while Rymer argued that a new roof was required, costing up to $1.7 million. After the parties could not agree, Cincinnati initiated a declaratory judgment action in federal court, and an appraisal panel awarded $23,226 for "mall roof repair."The United States District Court for the District of Minnesota initially concluded that any increased repair costs were Rymer’s responsibility, finding that the costs resulted from preexisting damage rather than the tornado. On appeal, the United States Court of Appeals for the Eighth Circuit held that it was sufficient if the tornado was a "but-for" cause of the county’s enforcement of the building code, and remanded the case for further proceedings, including clarification of the ambiguous appraisal award.Upon remand, the district court sought clarification from the appraisal panel as to whether the award covered repairs to the roof’s surface or just the flashing. The majority of the panel clarified that only flashing replacement was included. Rymer attempted to introduce later statements by the panel’s umpire to expand the scope of the award, but the district court held that such testimony is relevant only to allegations of panel misconduct, not to reinterpret or enlarge an award. The United States Court of Appeals for the Eighth Circuit affirmed this decision, holding that under Minnesota law, district courts may seek clarification of ambiguous appraisal awards, and that appraiser testimony cannot be used to expand or alter an award unless there is evidence of fraud or wrongdoing. View "Cincinnati Insurance Company v. Rymer Companies, LLC" on Justia Law

A certified nursing assistant employed by a home health provider sustained injuries to her right shoulder and lower back during the course of her employment. She received medical treatment from several providers and was paid mileage reimbursements for traveling between patient homes. Following her injuries, the employer’s insurance carrier denied further payment of temporary disability and medical benefits, including an outstanding medical bill, and ultimately terminated her employment. The worker secured new employment at a higher wage and subsequently filed for workers’ compensation benefits, claiming entitlement to disability benefits and payment of the disputed medical bill. The employer denied liability.The Administrative Law Judge found that the worker had a compensable lower back injury with a 12% impairment rating, entitling her to temporary total and permanent partial disability benefits, but excluded mileage reimbursements from her average weekly wage and denied payment for the outstanding medical bill based on the provider’s failure to submit it within the statutory 45-day deadline. The Workers’ Compensation Board affirmed the ALJ’s findings. The Kentucky Court of Appeals affirmed the exclusion of mileage reimbursements and dismissed the issue of the unpaid medical bill as moot after the employer voluntarily paid it during the appeal. The Court of Appeals also rejected a motion for leave to file an amicus brief, deeming it unauthorized.The Supreme Court of Kentucky affirmed the exclusion of mileage reimbursements from the wage calculation, holding such payments were reimbursements for actual expenses and not “wages.” The Court reversed the dismissal of the medical bill claim as moot, applying the “voluntary cessation” exception, and held that denial of compensability constitutes reasonable grounds to excuse noncompliance with the 45-day rule for submitting medical bills. The Court also found the Court of Appeals erred in rejecting the amicus motion. The decision was affirmed in part and reversed in part. View "HARRIS V. MERCY HOME HEALTH" on Justia Law

Toy Quest Ltd. purchased an insurance policy from General Star Indemnity Company, which covered personal injury claims arising from certain specified torts, including malicious prosecution. When ASI, Inc. sued Toy Quest in federal district court in Minnesota for abuse of process, General Star agreed to defend Toy Quest under a reservation of rights but then filed a separate lawsuit seeking a declaratory judgment that it had no duty to defend against ASI’s claim. Toy Quest and ASI contended that the policy covered abuse of process, that California rather than Minnesota law should apply, and that the court should abstain from deciding the case until the underlying litigation was resolved.The United States District Court for the District of Minnesota granted General Star’s motion for judgment on the pleadings, holding that the policy did not cover abuse of process claims and that Minnesota law applied. The court also declined to abstain from hearing the declaratory judgment action and denied Toy Quest’s motions to certify the coverage issue to the Minnesota Supreme Court and to disqualify ASI’s counsel. Toy Quest and ASI appealed these rulings.The United States Court of Appeals for the Eighth Circuit affirmed the district court’s judgment. The court held that the district court did not abuse its discretion in declining to abstain, as the cases were not parallel and the federal court had jurisdiction. It further held that the insurance policy’s express coverage for malicious prosecution did not extend to abuse of process claims, as these are distinct torts under Minnesota law, and similar reasoning would apply under California law. The court also held that there was no actual conflict of law and denied the motions to certify and to disqualify counsel. View "General Star Indemnity Company v. ASI, Inc." on Justia Law

This case arises from multi-district litigation involving claims that certain aqueous film-forming foam products caused injuries, and that Illinois Union Insurance Company issued excess liability policies to BASF Corporation, which allegedly designed and sold components of those products. Plaintiffs, who originally filed their cases in Wisconsin state court, assert that Illinois Union is directly liable under Wisconsin law for BASF’s conduct. After removal to federal court, the cases were consolidated for pretrial proceedings in the United States District Court for the District of South Carolina under the multi-district litigation statute.The District Court for the District of South Carolina, managing the consolidated proceedings, had entered case management orders requiring motions either to be signed by lead counsel or, if not, to be preceded by a motion for leave of court. Illinois Union sought leave to file a motion to stay the proceedings against it pending arbitration, contending that its insurance policies required arbitration of the dispute. The district court denied Illinois Union’s motion for leave, first citing a failure to consult with lead counsel as required, but then acknowledging that consultation had ultimately occurred. The decisive reason for denial was that lead counsel did not consent to Illinois Union’s motion, and the district court ruled that, absent such consent, the motion could not be filed.The United States Court of Appeals for the Fourth Circuit reviewed the district court’s order. It held that, while district courts have broad discretion to manage multi-district litigation, they may not exercise this authority in a way that prevents a party from asserting its statutory right under the Federal Arbitration Act to seek a stay of litigation pending arbitration. Because the district court’s order effectively barred Illinois Union from filing its stay motion based on lack of lead counsel’s consent, the Fourth Circuit vacated the district court’s order and remanded for further proceedings. View "Bouvet v. Illinois Union Insurance Company" on Justia Law

Two individuals were involved in a car accident in 2020 and received a payment from the other driver’s insurer. Seeking further compensation, they pursued a claim against their own underinsured motorist policy with their insurance company. After the insurer offered less than the policy limit, the insureds initiated a breach of contract lawsuit. Ultimately, the insurer settled by paying the full policy limit, and that litigation was dismissed. Subsequently, the insureds filed a second lawsuit alleging that the insurer acted in bad faith by delaying settlement, leading to emotional and financial distress.During discovery in the bad-faith action, the insureds requested the insurer’s claims file, including documents generated after the prior litigation began. The insurer withheld certain documents, citing attorney-client privilege and the work-product doctrine, and provided a privilege log. The Hamilton County Court of Common Pleas ordered production of the entire unredacted claims file up to the date of payment, without conducting an in camera review. The insurer appealed, arguing that the trial court erred by not applying statutory requirements for privilege and failing to conduct an in camera inspection.The First District Court of Appeals affirmed the trial court’s order, relying on Boone v. Vanliner Insurance Co., holding that in bad-faith claims, materials created prior to denial of coverage are discoverable. The appellate court reasoned that the insureds’ allegations of bad faith were sufficient to override privilege protections and rejected the insurer’s arguments about statutory requirements and the need for an in camera review, concluding that the insurer had not asserted privilege with sufficient detail.The Supreme Court of Ohio reversed the appellate court’s judgment. It held that the Boone decision had been superseded by statute: attorney-client communications are subject to discovery only after a prima facie showing of bad faith and an in camera review under R.C. 2317.02(A)(2). The work-product doctrine is governed by Civil Rule 26(B)(4) and allows disclosure only upon a showing of good cause. The case was remanded to the trial court for compliance with these standards. View "Eddy v. Farmers Property Cas. Ins. Co." on Justia Law