Justia Insurance Law Opinion Summaries

In this case before the Supreme Court of the State of Washington, a consortium of over 130 institutions of higher education sued a group of 16 insurance carriers for denying their COVID-19 related claims. The insurance carriers had issued identical “all risk” property insurance policies to the institutions via the Educational & Institutional Insurance Administrators Inc. (EIIA). The colleges, including three in Washington, filed the suit in Pierce County Superior Court, Washington, seeking a declaratory judgment that their COVID-19 related losses were covered under the insurance policies. However, two of the defendant insurers filed a similar suit in Illinois, seeking a declaratory judgment that the losses were not covered by the policies.The insurers argued that the Washington court should dismiss the case based on forum non conveniens, asserting that Illinois was a more convenient forum due to the geographical distribution of the colleges. They also argued that the Illinois action should be allowed to proceed. The colleges, on the other hand, argued that the insurance policies' "suit against the company" clause allowed them to choose the forum and prohibited the insurers from seeking to alter that choice.The Supreme Court of the State of Washington affirmed the lower court's decision, denying the motion to dismiss on forum non conveniens grounds and issuing an injunction against further proceedings in the Illinois action. The court held that the insurers had contractually agreed to submit to the jurisdiction of any court chosen by the insured and could not seek to transfer, change venue, or remove any lawsuit filed by the insured in such a court. The court also found that an injunction was appropriate under the circumstances to protect the colleges' contractual rights and prevent a manifest wrong and injustice. View "Pacific Lutheran Univ. v. Certain Underwriters at Lloyd's London" on Justia Law

After being involved in a car accident, Kenan Watkins filed a diminished value claim with his insurer, Allstate Property and Casualty Insurance Company ("Allstate"), which was denied. Watkins then filed an action in the United States District Court for the Southern District of Mississippi, alleging that the denial of his claim violated Mississippi law. However, the district court ruled in favor of Allstate, holding that Allstate's policy did not violate Mississippi law and that Watkins failed to state a plausible claim, which led to Watkins' appeal to the United States Court of Appeals for the Fifth Circuit.In the background of the case, Watkins had an insurance policy with Allstate for his 2021 Chevrolet Tahoe. After the accident, Watkins' vehicle sustained substantial damages, and Watkins alleged that his car sustained an additional diminished value. Allstate denied Watkins' diminished value claim, relying upon a provision in its policy that excludes any decrease in the property's value resulting from the loss and/or repair or replacement. Watkins did not dispute this policy exclusion, but argued that Allstate's exclusion provision violates the Mississippi Uninsured Motorist Statute. Allstate moved to dismiss the case under Rule 12(b)(6), arguing that Watkins did not plausibly allege that the other driver's vehicle was an "uninsured motor vehicle" under Mississippi law, and that even if it was, Allstate's provision excluding diminished value is valid under Mississippi law.Upon review, the United States Court of Appeals for the Fifth Circuit affirmed the district court's decision. The court held that Watkins failed to make a plausible claim for relief under Rule 12(b)(6) due to insufficient factual content in the complaint. The court also held that Allstate’s diminished value exclusion is valid under Mississippi law and does not violate public policy. The court reasoned that Watkins had not pointed to any legislative or judicial pronouncement requiring that diminished value be a part of all automobile insurance policies. Therefore, in this instance, the plain meaning of Allstate’s policy controlled, and Allstate’s diminished value exclusion was upheld as valid under Mississippi law. View "Watkins v. Allstate Property & Casualty Insurance Co." on Justia Law

In this case heard in the United States Court of Appeals for the Seventh Circuit, an accident occurred at a construction site which resulted in bodily injuries to Gaylon Cruse and Mark Duckworth. During the installation of roof trusses, a power crane operated by Douglas Forrest was prematurely released, causing a truss to fall and collapse onto other trusses, injuring Cruse and Duckworth. Southern Truss, the owner of the truck to which the crane was attached, had two insurance policies - a commercial auto policy from Artisan and Truckers Casualty Company (Artisan) and a commercial general liability policy from The Burlington Insurance Company (Burlington). Both insurance companies denied a duty to defend in the underlying lawsuit initiated by Cruse and Duckworth.Artisan filed a suit in federal court seeking a declaration that it owed no duty to defend under its auto policy due to an operations exclusion clause and that Burlington owed a duty to defend. The district court denied both companies' motions for judgment, finding an ambiguity in Artisan's policy that should be construed in favor of the insured and that Burlington had a duty to defend some claims not covered by Artisan's policy. Both Artisan and Burlington appealed.The appeals court, applying Illinois law and conducting a de novo review, found no ambiguity in Artisan's policy. The court concluded that the operations exclusion applied because the injuries arose from the operation of the crane attached to the truck, whose primary purpose was to provide mobility to the crane. As such, Artisan had no duty to defend. Since Artisan had no duty to defend, the court determined that Burlington did have a duty to defend under its policy. Thus, the court affirmed in part and reversed in part the decision of the district court. View "Artisan and Truckers Casualty Company v. Burlington Insurance Company" on Justia Law

In a workers' compensation case, an employee was injured and sought compensation from her employer and its insurance carrier. The employee failed to provide her expert witness's evidence in a timely manner, serving them only two weeks before the arbitration hearing began. The employer and its insurance carrier objected, arguing that this late submission of evidence was unfairly prejudicial. The deputy workers’ compensation commissioner agreed with the employer and excluded the evidence. This decision was affirmed by the commissioner, but was later reversed on judicial review by the district court. The court of appeals affirmed the district court’s ruling. However, the Supreme Court of Iowa held that the commissioner’s decision to exclude untimely evidence was entitled to deference. The court found that the commissioner did not abuse his discretion by excluding the untimely evidence since the employee had disregarded multiple deadlines and submitted the reports only about two weeks before the hearing. Moreover, the reports were not from the employee’s treating physicians and the vocational report reached a conclusion that no other expert in the case shared. Therefore, the supreme court vacated the court of appeals decision, reversed the district court decision, and remanded the case back to the district court to enter a judgment affirming the commissioner's decision to exclude the untimely evidence. View "Hagen v. Serta/National Bedding Co., LLC" on Justia Law

In this case, the United States Court of Appeals for the Second Circuit heard an appeal from Ezrasons, Inc., a company engaged in the garment trade, against The Travelers Indemnity Company. Ezrasons suffered a loss of insured goods exceeding $600,000 due to a fire at a warehouse owned by Chamad Warehouse, Inc., in Marion, North Carolina. Travelers paid $250,000, but declined to pay more, asserting that the policy's coverage was limited to $250,000 because the warehouse where the goods were destroyed was not an "Approved Location" under the policy. The district court ruled in favor of Travelers, finding that the warehouse was unambiguously not an "Approved Location" under the policy.On appeal, the Second Circuit Court found that the policy was ambiguous as to whether the warehouse where the destruction occurred was an "Approved Location." It further held that the district court erroneously excluded admissible evidence by which Ezrasons sought to prove that the warehouse was an "Approved Location." As the extrinsic evidence did not provide a basis for favoring either possible meaning of "Approved Location," the ambiguity should be resolved in favor of Ezrasons under New York law. Accordingly, the judgment was vacated and the case remanded with instructions to enter judgment in favor of Ezrasons. View "Ezrasons, Inc. v. Travelers Indemnity Co." on Justia Law

In this case, the Supreme Court of North Carolina was asked to determine whether defendant Cassie Herring, who was injured in a car accident, qualifies for benefits under the underinsured motorist (UIM) coverage of her mother and stepfather's automobile insurance policy. The policy defined an "insured" to include any "family member" who is a resident of the named insured’s household. The question was whether Herring was a "resident" of her mother's household.Herring was injured while riding in a car with her father, and the driver of the other car was insured. The other driver's insurance company tendered the limit of its policy to Herring. Herring then sought additional coverage under the UIM provision of her mother and stepfather's policy. The insurer, North Carolina Farm Bureau Mutual Insurance Company (Farm Bureau), filed a declaratory judgment action, claiming that Herring was not a resident of her mother’s household and thus did not qualify for the UIM benefits.The trial court granted summary judgment for Herring and her parents, and the Court of Appeals affirmed. Farm Bureau appealed to the Supreme Court of North Carolina, arguing that there were genuine issues of material fact about Herring’s residency.The Supreme Court of North Carolina agreed with Farm Bureau and reversed the decision of the Court of Appeals. The court held that the evidence, when viewed in the light most favorable to Farm Bureau, raised genuine issues of material fact as to whether Herring was a resident of her mother's household at the time of the accident. The court noted that there were discrepancies between Herring's testimony and the affidavits submitted by her and her parents, which created credibility issues that should be resolved by a jury. Therefore, the court concluded that summary judgment was not appropriate, and the case was remanded for further proceedings. View "N.C. Farm Bureau Mut. Ins. Co. v. Herring" on Justia Law

In this case, a joint venture between Watershed Ventures, LLC and Patrick M. McGrath failed, leading to bankruptcy and litigation. McGrath and two investment vehicles he controlled sought coverage from Watershed's insurer, Scottsdale Insurance Company, under a directors and officers liability policy. Scottsdale denied coverage and sought a declaratory judgment as to its coverage obligations. McGrath countered with claims against Scottsdale and third-party claims against Watershed. The district court issued two summary judgment decisions. The first ruled that McGrath is an insured under the policy, while the second dismissed one of McGrath's counterclaims. The parties agreed to a "Stipulated Conditional Final Judgment Subject to Reservation of Rights of Appeal," which would become void if either of the district court’s two summary judgment rulings were partly vacated or reversed on appeal. The parties appealed, but the U.S. Court of Appeals for the Second Circuit dismissed both Scottsdale's appeal and McGrath's cross-appeal for lack of appellate jurisdiction, concluding that the Stipulated Conditional Final Judgment was not a "final decision" under 28 U.S.C. § 1291. The court reasoned that the Stipulated Conditional Final Judgment did not resolve all claims of all parties, was not entered under Federal Rule of Civil Procedure 54(b), and did not finally resolve whether Scottsdale breached its duty to defend under the policy. View "Scottsdale Ins. Co. v. McGrath" on Justia Law

In this case before the Supreme Court of Pennsylvania, Joseph Tambellini, Inc. and HTR Restaurants, Inc., along with other businesses, had their business interruption insurance claims related to the COVID-19 pandemic denied by their insurer, Erie Insurance Exchange. The businesses had sued Erie in various courts across Pennsylvania. Due to the factual and legal overlap among these claims, the businesses moved for all state-wide litigation to be coordinated in Allegheny County for all pre-trial and trial purposes under Rule of Civil Procedure 213.1.Erie appealed to the Superior Court, which affirmed in part and reversed in part. According to the Superior Court, the trial court exceeded the authority of Rule 213.1 by ordering the coordination of similar actions against Erie that had not yet been filed. The Superior Court further held that the businesses were parties who were empowered by Rule 213.1 to file the motion for coordination.Upon the parties’ cross-appeals, the Supreme Court of Pennsylvania granted review of both holdings. The Supreme Court of Pennsylvania agreed with the Superior Court that the trial court lacked authority to coordinate actions that had not yet been filed. Furthermore, the Supreme Court found that Erie had waived any argument that the businesses could not seek coordination when it failed to raise this issue in the trial court. Therefore, the Supreme Court affirmed the Superior Court’s order. View "Tambellini v. Erie Insurance" on Justia Law

In a dispute arising from insurance coverage for business interruption losses during the COVID-19 pandemic in the Supreme Court of Pennsylvania, various businesses, including Joseph Tambellini, Inc. and HTR Restaurants, Inc., had sued their insurer, Erie Insurance Exchange, for denial of their claims. The businesses moved for the coordination of all state-wide litigation, including future filings, in Allegheny County under Rule 213.1 of the Pennsylvania Rules of Civil Procedure, which allows for the coordination of actions in different counties that involve a common question of law or fact. The motion was granted by the trial court, but on appeal, the Superior Court held that the trial court exceeded the authority of Rule 213.1 by ordering the coordination of similar actions against Erie that had not yet been filed.On further appeal, the Supreme Court of Pennsylvania agreed with the Superior Court. The court found that the term "pending" in Rule 213.1 clearly refers to cases that have already been filed, and does not include cases that are imminent or impending. The court further noted that Erie had waived the argument that the plaintiffs were not entitled to seek coordination as it had not raised this issue in the trial court. The Superior Court's order was affirmed, holding that Rule 213.1 does not permit the coordination of actions that have not been filed at the time of the coordination motion and Erie had waived its argument that the plaintiffs were not entitled to seek coordination. View "HTR Restaurants v. Erie Insurance" on Justia Law

Brian Smith, a Rhode Island resident, sued Prudential Insurance Company of America for breach of fiduciary duty after the company terminated his long-term disability benefits under an insurance policy. The policy stated a three-year limitations period to file a lawsuit, which began on the date Smith was required to submit proof of his disability, not on the date Prudential allegedly breached the policy by stopping payment. Consequently, by the time Smith filed his lawsuit, the limitations period had expired. Smith appealed to the United States Court of Appeals for the First Circuit after the United States District Court for the District of Rhode Island granted summary judgment in favor of Prudential on the grounds that Smith's lawsuit was filed too late.Smith argued that enforcing the limitations scheme would violate Rhode Island public policy. While the Court of Appeals found compelling reasons to believe that the limitations scheme might indeed contravene Rhode Island public policy, they also recognized that reversing and remanding on that ground would potentially expand Rhode Island law. Consequently, the Court of Appeals decided to certify the public policy question to the Rhode Island Supreme Court. The certified question is whether, in light of specific state laws and Rhode Island public policy, Rhode Island would enforce the limitations scheme in this case to bar Smith's lawsuit against Prudential. View "Smith v. Prudential Insurance Company of America" on Justia Law