Justia Insurance Law Opinion Summaries

The United States Court of Appeals for the Tenth Circuit certified two questions of law to the Oklahoma Supreme Court. Plaintiff-appellant George Morgan was driving drunk and hit Jesse Atkins with his truck at more than 40 miles per hour. Atkins was severely injured, and his resulting medical bills totaled more than $2 million. Defendant-appellee State Farm Mutual Automobile Insurance Company provided liability insurance to Morgan at the time of the accident under a policy with a $100,000 limit. State Farm negotiated and executed a settlement with Atkins whereby State Farm paid its policy limit to Atkins and Atkins released his claims against Morgan. During the same timeframe, Atkins pursued a workers' compensation claim because he had been traveling for work when he was injured. The workers' compensation court issued a preliminary order for compensation, and the workers' compensation insurer began making payments to Atkins. The workers' compensation insurer's subrogee, New York Marine and General Insurance Company (NYM), sued Morgan in Oklahoma state court in June 2011 for reimbursement of the amounts paid to Atkins. Morgan retained personal counsel to represent him in the action. State Farm also provided counsel to Morgan and mounted a vigorous defense. A jury would later return a verdict in favor of NYM in the amount of $844,865.89, finding that State Farm knew about NYM's potential claim but failed to apprise NYM of its pending settlement with Atkins. The Oklahoma Court of Civil Appeals affirmed the judgment, and the Oklahoma Supreme Court denied certiorari. Morgan then filed suit against State Farm alleging State Farm's failure to secure NYM's release as part of its settlement with Atkins amounted to: (1) breach of the implied duty of good faith and fair dealing; and (2) breach of contract. The United States District Court for the Western District of Oklahoma found that Morgan's claims accrued in 2010, when State Farm negotiated the original settlement with Atkins and, therefore, concluded the applicable two and five year statutes of limitations for the tort and contract claims, respectively, barred Morgan's suit. Morgan appealed to the Tenth Circuit Court of Appeals. The Tenth Circuit asked: (1) where a plaintiff is injured by entry of an adverse judgment that remains unstayed, is the injury sufficiently certain to support accrual of a tort cause of action based on that injury under 12 O.S. 95 before all appeals of the adverse judgment are exhausted?; and (2) does an action for breach of an insurance contract accrue at the moment of breach where a plaintiff is not injured until a later date? The Oklahoma Court answered the first question with a "no:" the claim accrues when the appeal is finally determined in the underlying case. The Court answered the second question with a "yes:" an action for breach of contract accrues when the contract is breached, not when damages result; the limitations period may be tolled if the defendant fraudulently concealed the cause of action. View "Morgan v. State Farm mutual Automobile Insur. Co." on Justia Law

Plaintiff filed suit against two defendants: a property owner and her alleged liability insurer. The insurer was served with the petition, but plaintiff withheld service on the property owner. The insurer filed an answer on its own behalf within three years of suit being filed, but no action was taken in the suit by any party relative to the property owner within that three years. The Louisiana Supreme Court granted this writ application to determine whether plaintiff’s action against the property owner was abandoned pursuant to La. C.C.P. art. 561(A)(1). The court of appeal found the filing of an answer by the insurer within the three-year abandonment period was effective to interrupt the abandonment period as to the property owner. The Supreme Court held the filing of the insurer’s answer did not serve to interrupt the abandonment period as to the property owner; therefore the appellate court was reversed because plaintiff’s original action against the property owner was abandoned by operation of law. However, the Court found plaintiff’s underlying claims against the property owner, that were subsequently reasserted by amended petition, were not necessarily prescribed due to the potential interruption of prescription resulting from the pending suit against an alleged solidary obligor. Because a determination regarding prescription could not be made based on the existing record, the court of appeal’s ruling on the property owner’s exception of prescription was affirmed, and the matter remanded to the district court for an evidentiary hearing on that exception. View "Williams v. Foremost Ins. Co. et al." on Justia Law

Kristina Knight agreed to an endorsement to her Nationwide automobile insurance policy providing the coverage in the policy would not apply to her husband. During the policy period, Danny Knight was tragically killed in a motorcycle accident. Knight, as personal representative of Danny's estate, recovered $25,000 in UIM coverage under Danny's motorcycle insurance policy with Progressive Casualty Insurance Company and $25,000 in UIM coverage under a policy with ACCC Insurance Company insuring a different vehicle Danny owned. Knight made a claim with Nationwide to recover an additional $25,000 in UIM coverage under her insurance policy. Nationwide denied the claim and filed this lawsuit asking the trial court to declare Nationwide did not have to pay the $25,000 because Danny was excluded from all coverages under the policy. On appeal, Knight claimed the endorsement excluding coverage for her husband violated public policy and Nationwide could not enforce it. The South Carolina Supreme Court found the exclusion was clear and unambiguous and was not in violation of any statute. Therefore, the Court held the exclusion was enforceable. View "Nationwide Insurance Company of America v. Knight" on Justia Law

The United States District Court for the District of South Carolina certified a question to the South Carolina Supreme Court on whether a homeowner's insurance policy that did not define the term "actual cash value," an insurer could depreciate the cost of labor in determining the "actual cash value" of a covered loss when the estimated cost to repair or replace the damaged property includes both materials and embedded labor components. This issue arose in two cases in which the homes of Miriam Butler and Joseph Stewart were damaged in separate fires. Butler and Stewart each purchased a homeowner's insurance policy from one of the defendants, both of whom were subsidiaries of The Travelers Companies, Inc. Butler and Stewart elected not to immediately repair or replace their damaged property. Each thus elected not to receive replacement cost but instead to receive a cash payment for the ACV of the damaged property. The certified question addressed whether Travelers properly calculated the ACV payments Travelers offered to Butler and Stewart to settle their property damage claims. The Supreme Court responded affirmatively: “the fact the labor cost is embedded makes it impractical, if not impossible, to include depreciation for materials and not for labor to determine ACV of the damaged property. Rather, the value of the damaged property is reasonably calculated as a unit. Therefore, we answer the certified question "yes," because it makes no sense for an insurer to include depreciation for materials and not for embedded labor.” View "Butler v. The Travelers Home" on Justia Law

In September 2016, defendant Trend Motors, Ltd. (Trend), provided defendant Mary Aquilar with a loaner vehicle for her personal use while her vehicle was being serviced. Aquilar’s negligent operation of the loaner vehicle caused it to strike plaintiff Tyrone Huggins’s car. Huggins sustained serious injuries as a result. GEICO insured Aquilar through an automobile policy. Trend held a garage policy with Federal Insurance Company (Federal) that insured Trend’s vehicles for up to $1,000,000 in liability coverage. The definition of an “insured” in the Federal policy purported to extend liability coverage to Trend’s customers using Trend’s vehicles only if the customer lacked the minimum insurance required by law. Huggins filed a complaint seeking compensation for the injuries and loss of income he suffered as a result of the accident. Federal disclaimed liability, arguing that Aquilar did not fit the policy’s definition of an insured because she held $15,000 in bodily injury coverage through GEICO. The trial court held that the Federal policy’s definition of an insured constituted an illegal escape clause and held Federal to the full policy limit of $1,000,000 in liability coverage. The Appellate Division declined to review the trial court’s ruling. The New Jersey Supreme Court concurred with the trial court’s ruling that the provision in the garage policy at issue constituted an illegal escape clause which could not be used to evade the minimum liability requirements for dealership vehicles set by the Chief Administrator of the Motor Vehicle Commission (MVC). The Court ordered the reformation of Federal’s policy to the $100,000/$250,000 dealer-licensure minimum liability coverage required by N.J.A.C. 13:21-15.2(l). View "Huggins v. Aquilar" on Justia Law

This appeal consolidates seven separate cases that three related corporate entities, MSP, originally filed in Florida state court against seventeen insurance companies. The district court granted MSP's motions to remand but declined to order the insurance companies to pay MSP's attorney's fees and costs.The Eleventh Circuit concluded that it does not have jurisdiction over the cross-appeals brought by Travelers, Northland, and Owners insurance companies. In this case, the remand orders fall within the scope of 28 U.S.C. 1447(c) and are unreviewable. Therefore, the court dismissed the cross-appeals for lack of jurisdiction. The court also concluded that the district court did not abuse its discretion in denying MSP's motions for attorney's fees and costs. The court held that it is not an abuse of discretion for a district judge to decline to award attorney's fees and costs under section 1447(c) simply because that judge or other district court judges within the same district have previously remanded in similar cases. Accordingly, the court affirmed the district court's orders. View "MSP Recovery Claims, Series LLC v. The Hanover Insurance Co." on Justia Law

MAO-MSO acquired rights to collect conditional payments that Medicare Advantage Organizations (MAOs) made if a primary insurer (such as automobile insurance carriers) has not promptly paid medical expenses. MAO-MSO sued those primary payers. The district court proof of required actual injury. Specifically, MAO-MSO needed to identify an “illustrative beneficiary”— a concrete example of a conditional payment that State Farm, the relevant primary payer, failed to reimburse to the pertinent MAO. MAO-MSO alleged that “O.D.” suffered injuries in a car accident and that State Farm “failed to adequately pay or reimburse” the appropriate MAO. The district court determined that these allegations sufficed for pleading purposes to establish standing.As limited discovery progressed, MAO-MSO struggled to identify evidence supporting the complaint. One dispute centered on whether O.D.’s MAO made payments related to medical care stemming from a car accident before State Farm reached its limit under O.D.’s auto policy so that State Farm should have reimbursed the MAO. The payment in question was to a physical therapist. State Farm argued that the physical therapy services had no connection to O.D.’s car accident and related only to her prior knee surgery.The district court determined no reasonable jury could find that the payment related to O.D.’s car accident, meaning that MAO-MSO lacked standing. The Seventh Circuit affirmed the dismissal. The Medicare Act may authorize the lawsuit but MAO-MSO fail to establish subject matter jurisdiction by establishing an injury in fact. View "MAO-MSO Recovery II, LLC v. State Farm Mutual Automobile Ins. Co." on Justia Law

The United States Court of Appeals for the Eleventh Circuit certified to three questions of law to the Georgia Supreme Court relating to a lawsuit brought in federal district court by Fife Whiteside, the trustee of the bankruptcy estate of Bonnie Winslett. Whiteside sued GEICO to recover the value of Winslett’s failure-to-settle tort claim against GEICO so that the bankruptcy estate could pay creditor Terry Guthrie, who was injured in an accident caused by Winslett. The certified questions certified asked the Supreme Court to analyze how Georgia law applied to an unusual set of circumstances that implicated both Winslett’s duty to give GEICO notice of suit and GEICO’s duty to settle the claim brought against Winslett. The Supreme Court was unable to give unqualified “yes” or “no” answers to two of the certified questions as they were posed; rather, the Court answered the questions only in the context of the circumstances of this particular case. "Winslett remains liable to Guthrie, even if her bankruptcy trustee succeeds on the failure-to-settle claim against GEICO; therefore, if the bankruptcy estate does not recover enough from GEICO to satisfy Guthrie’s judgment, the estate would not be fully compensated for Winslett’s damages, and GEICO would escape responsibility for breaching its settlement duty to Winslett. Such an outcome would deny Winslett the full measure of compensatory damages allowed under Georgia law." View "GEICO Indemnity Co. v. Whiteside" on Justia Law

Bennie Stapleton sued GEICO for abusing the judicial process after GEICO obtained a default judgment against him that was later set aside. An interlocutory appeal arose from the circuit court's denial of GEICO’s motion to dismiss Stapleton’s complaint on statute-of-limitations grounds. The Mississippi Supreme Court took the opportunity presented by this case to overrule the recent judicial expansion of Mississippi Code Section 15-1-35 (Rev. 2019) because earlier Supreme Court decisions "strayed too far from the statute’s clear text." The Supreme Court affirmed the circuit court’s order and remanded the case for further proceedings. View "GEICO Casualty Company, et al. v. Stapleton" on Justia Law

The Supreme Court granted writs of prohibition and mandamus to prevent Cuyahoga County Common Pleas Court Judge John O'Donnell from exercising jurisdiction over a civil action that was transferred from the Lyndhurst Municipal Court but denied the writ of mandamus ordering Lyndhurst Municipal Court Judge Dominic Coletta to dismiss the case upon its return from the common pleas court.Plaintiff filed a complaint against State Farm Mutual Insurance Company in the small claims division of the Lyndhurst Municipal Court. Judge Coletta granted Plaintiff's subsequent motion to transfer the case to Cuyahoga County Court of Common Pleas, where it was assigned to Judge O'Donnell. State Farm filed a motion to return the case to the municipal court, but Judge O'Donnell denied the motion. State Farm then brought this action. The Supreme Court granted a writ of prohibition to prevent Judge O'Donnell from hearing the case in the Cuyahoga County Court of Common Pleas and granted a peremptory writ of mandamus ordering Judge O'Donnell to return the matter to the Lyndhurst Municipal Court, holding the peremptory writ was appropriate. View "State ex rel. State Farm Mutual Insurance Co. v. O'Donnell" on Justia Law