Justia Insurance Law Opinion Summaries

A construction company (Constructor) retained Defendant to arrange insurance for a new housing development. Defendant procured insurance from two insurance companies (Peerless and Hartford). Peerless denied coverage for a house destroyed by fire that was built on a lot not listed in Peerless's policy. Haynes claimed against Defendant for its negligent omission of the lot. Defendant gave notice of the loss to Plaintiff, from whom Defendant had purchased errors and omissions coverage. Defendant and Plaintiff settled with Constructor for $354,000. Constructor assigned its rights against Peerless and Hartford to Plaintiff and Defendant collectively. Defendant and Plaintiff then proceeded against the insurers for the $354,000. After the parties settled, $208,000 was deposited in an escrow account. Plaintiff sought a declaration that it was entitled to all of the escrow funds. Defendant counterclaimed for a declaration that, under Connecticut's make whole doctrine, it was entitled to recover the $150,000 deductible it contributed to the $354,000. The district court granted summary judgment for Plaintiff. The Supreme Court accepted certification from the appellate court and answered its questions by holding (1) the make whole doctrine is the default rule under Connecticut law; and (2) the make whole doctrine does not apply to insurance policy deductibles. View "Fireman's Fund Ins. Co. v. TD Banknorth Ins. Agency, Inc." on Justia Law

In 2003, multiple residents of a nursing home (Greenwood) died or were injured when another resident set fire to the facility. Consequently, thirteen negligence actions seeking damages for serious bodily injury or wrongful death were filed against Greenwood, the owner of the property housing Greenwood, the lessee of the property (Lexington Healthcare), and the operator of Greenwood. Plaintiff issued a general liability and professional liability insurance policy to Lexington Healthcare. At issue in this case was the amount of liability insurance coverage available for the claims. The trial court determined the amount available under the policy and rendered judgment accordingly. The Supreme Court reversed in part, holding (1) the trial court improperly interpreted a policy endorsement in the policy relating to the aggregate policy limit; and (2) the trial court improperly applied a self-insured retention endorsement to reduce the available coverage. Remanded. View "Lexington Ins. Co. v. Lexington Healthcare Group, Inc." on Justia Law

Plaintiffs served as the general contractor and the project developer for construction of a student housing complex at the University of Connecticut (UConn). UConn procured a commercial general liability (CGL) policy for the project, which insured Plaintiffs and their work. Defendant, American Motorists Insurance Company (AMICO), was the issuing insurer's successor in interest. UConn alleged that Plaintiffs breached the agreement with UConn, and Plaintiffs demanded that AMICO defend against UConn's claims. AMICO denied coverage. Plaintiffs settled their claims with UConn and then brought this action against Defendant for breach of contract and bad faith. The U.S. district court certified three questions of law for the Connecticut Supreme Court's consideration. The Court answered (1) allegations of unintended defective construction work by a subcontractor that damages nondefective property may trigger coverage under a CGL policy; (2) under the plain language of the insurance policy in this case, there is no cause of action based on AMICO's failure to conduct a discretionary investigation of claims for coverage; and (3) in global settlements encompassing multiple claims, the insured has the burden of proving that a pre-suit settlement is reasonable in proportion to claims that the insurer has a duty to defend. View "Capstone Bldg. Corp. v. Am. Motorists Ins. Co." on Justia Law

Plaintiff was an additional insured on a commercial general liability insurance policy, which was issued to Plaintiff's tenant (Tenant) by Defendant, Travelers Property Casualty Company (Travelers). Plaintiff sought to invoke Travelers' duty to defend under the policy after Sarah Middeleer was injured in a fall on Plaintiff's property and brought the underlying action against Plaintiff. Plaintiff's insurer, the Netherlands Insurance Company (Netherlands), provided a defense to Plaintiff after Travelers denied any duty to defend Plaintiff in the underlying action. Plaintiff then brought the present action claiming Travelers had a duty to defend Plaintiff in the underlying action and Travelers was obligated to reimburse Netherlands for the defense costs it had expended. The trial court granted Plaintiff's motion for summary judgment. The appellate court reversed, concluding that Middeleer's injuries did not arise out of the use of the leased premises under the terms of the policy. The Supreme Court affirmed, holding that the appellate court correctly construed the governing policy language and properly concluded that Travelers did not have a duty to defend Plaintiff. View "Misiti, LLC v. Travelers Prop. Cas. Co. of Am." on Justia Law

Plaintiff and her husband were traveling in Plaintiff's automobile when Tortfeasor collided with the automobile, causing significant injuries to Plaintiff and her husband. At the time of the collision, the motor vehicle driven by Tortfeasor was underinsured. Plaintiff submitted a claim for underinsured motorist coverage to her Insurer. Insurer refused to provide coverage in light of Plaintiff's recovery under a settlement agreement with Tortfeasor. Subsequently, Plaintiff brought this action seeking underinsured motorist coverage under her policy. The trial court granted summary judgment for Insurer, concluding Insurer was entitled to a setoff equal to the amount of the entire settlement. The Supreme Court affirmed, holding that Insurer was entitled to a reduction of its limits of liability for underinsured motorist coverage by an amount equal to the sum of punitive damages paid to Plaintiff. View "Anastasia v. Gen. Cas. Co. of Wis." on Justia Law

This case arose out of a motor vehicle accident caused by an underinsured motorist in which Plaintiff, an employee of defendant City (Defendant), sustained injuries while operating a private passenger motor vehicle owned by Defendant and acting within the scope of his employment. Plaintiff sought coverage for his remaining damages from Defendant pursuant to its obligation to provide underinsured motorist coverage pursuant to Conn. Gen. Stat. 38a-336(a)(2). Defendant denied Plaintiff's claim because Plaintiff's $50,000 recovery exceeded the purported $20,000 coverage limit of Defendant's plan. The trial court rendered in favor of Defendant, determining the limits of Defendant's underinsured motorist coverage in its capacity as a self-insurer to be the statutory minimum of $20,000 per person and $40,000 per occurrence. The Supreme Court affirmed, albeit under different reasoning, holding that pursuant to the statutory insurance scheme, a self-insurer is deemed to provide the minimum statutory underinsured motorist coverage of $20,000 per accident and $40,00 per occurrence for the benefit of occupants of its private passenger motor vehicles. View "Garcia v. Bridgeport" on Justia Law

The predecessor insurance companies to Plaintiff, Arrowood Indemnity Company, brought a declaratory judgment action in the U.S. district court claiming they did not have a duty to defend or to indemnify Defendants, the King family, for liability arising out of injuries sustained by a third party while the King's child was driving his parents' ATV on a private road in a private residential community, claiming that the accident had not occurred on an insured location and the Kings' notice of a claim was untimely. The district court rendered summary judgment in favor of Plaintiff. The Supreme Court accepted certification to answer questions of unresolved state law and concluded (1) with respect to a claim for negligent entrustment under a liability policy that provides coverage for accidents involving ATVs that occur on insured locations, the relevant location is the site of the accident; (2) the private road in this case did not fall under the coverage provision; and (3) social interactions between the insured and the claimant making no reference to an accident do not justify delayed notice, but an insurer must prove prejudice to disclaim its obligation to provide coverage based on untimely notice.

Two houseguests suffered serious injuries after their host left her car running overnight in an attached garage and the house filled with carbon monoxide. Plaintiff, the insurer with whom the homeowner had a homeowner's insurance policy, brought a declaratory judgment action against Defendants, the homeowner, the houseguests, and the homeowner's automobile insurer, seeking a declaration that the homeowner's policy did not cover the injuries suffered by the houseguests. The trial court granted summary judgment in favor of Plaintiff, finding that the policy did not cover the injuries because they fell within the policy exclusion for injuries arising out of the use of a motor vehicle. The Supreme Court affirmed, holding that the injuries suffered by the houseguests fell under the policy's motor vehicle exclusion.

Plaintiffs brought a declaratory judgment action seeking a determination that certain medical malpractice claims that they had asserted in an action against a medical association were covered under an insurance policy issued to the facility by Insurer. Due to Insurer's insolvency during the pendency of the action, Connecticut Insurance Guaranty Association assumed liability for Insurer's obligations to the extent that claims were covered under the Connecticut Insurance Guaranty Act. The Association filed a counterclaim, contending that the claims against the medical association were not covered because they were subject to a policy provision that excluded them from corporate coverage liability. The trial rendered rendered judgment in Plaintiffs' favor. The Supreme Court affirmed, holding that that the policy exclusion was inapplicable to the medical association's coverage for claims brought against it predicated solely on liability that it may have occurred through the acts of one of its nurse practitioners.

Defendant in this case issued health care insurance policies to provide coverage for medical services and entered into contracts with practitioners of the healing arts to provide those services. Plaintiffs, three individual podiatrists and the Connecticut Podiatric Medical Association, brought an action against Defendant, alleging that Defendant's practice of reimbursing individual podiatrists at a lower rate than medical doctors for the same service constituted unfair discrimination in violation of the Connecticut Unfair Insurance Practices Act (CUIPA) and the Connecticut Unfair Trade Practices Act (CUTPA). The trial court granted summary judgment in favor of Defendant. The Supreme Court affirmed, holding that CUIPA, by prohibiting unfair discrimination, bars the denial of reimbursement on the basis of the particular license held by a practitioner of the healing arts, but does not preclude setting different reimbursement rates on the basis of the particular license held by a practitioner of the healing arts.