Justia Insurance Law Opinion Summaries

The United States Court of Appeals for the Eleventh Circuit certified two questions to the Georgia Supreme Court: "(1) Did the Georgia Insurance Commissioner act within his legal authority when he promulgated Ga. Comp. R. & Regs. 120-2-20-.02, such that a multiple-line insurance policy providing first-party insurance coverage for theft-related property damage must be reformed to conform with the two-year limitation period provided for in Georgia's Standard Fire Policy, Ga. Comp. R. & Regs. 120-2-19-.01?; and, (2) is this action barred by the Policy's one-year limitation period?" These questions arose from a dispute over Petitioner Ricardo White's purchase of a homeowner's insurance policy from Respondent State Farm Fire and Casualty Company. The insurance policy was a first-party insurance contract that provided multiple-line coverage, including coverage for loss or damage caused by both fire and theft. The policy contained a limitation provision stating that a lawsuit against State Farm must be brought "within one year of the date of loss or damage." After his home was burglarized in January 2008 (within the period of coverage), Petitioner filed a claim for the loss of more than $135,000 in personal property. State Farm denied the claim based on its determination that Petitioner misrepresented material information in filing his claim. Waiting more than one year after his date of loss, Petitioner filed a June 2009 complaint against State Farm in state court alleging claims for breach of contract, bad faith, and fraud. Upon review of the facts of this case, the Supreme Court found that: (1) the Georgia Insurance Commissioner did not act within his legal authority and (2) this action was barred by the one-year limitation period in his insurance policy. View "White v. State Farm Fire & Casualty Co." on Justia Law

This case involved a policy for uninsured-motorist (UM) coverage issued by Defendant State Farm Mutual Automobile Insurance Company which contained a 30-day notice provision regarding hit-and-run motor vehicle claims. Upon review, the Court held that an unambiguous notice-of-claim provision setting forth a specified period within which notice must be provided is enforceable without a showing that the failure to comply with the provision prejudiced the insurer. Therefore, State Farm properly denied the claim for UM benefits sought in the instant case because it did not receive timely notice, a condition precedent to the policy's enforcement. In this case, the Court reversed the judgment of the Court of Appeals and remanded the case to the trial court for entry of summary disposition in favor of State Farm.

This appeal arose from an insurance coverage dispute where the City sought coverage from Genesis for 42 U.S.C. 1983 claims in the nature of malicious prosecution. Genesis filed suit against the City, seeking a declaratory judgment that its policies provided no coverage for the underlying actions. The district court granted summary judgment to Genesis and the City appealed, arguing that the district court erred in ruling as a matter of law that the policies did not provide the City insurance coverage for the claims. Because Genesis did not have an insurance contract with the City in 1977, when the underlying charges were filed, it did not have a duty to defendant and indemnify the city in the suits. Accordingly, the court affirmed the judgment.

A 2011 amendment to Section 71-3-51 provides that, "from and after July 1, 2011," decisions of the Mississippi Workers' Compensation Commission may be appealed directly to the Supreme Court, rather than to the circuit court, as required under the previous version of the statute. On July 1, 2011, the Commission denied Petitioner Joseph Dewayne Johnson’s claim for benefits, so he appealed to the Supreme Court. The ordered the parties to brief two issues: whether Section 71-3-51, as amended was constitutional; and whether the Court had appellate jurisdiction over direct appeals from the Commission. Upon review, the Court concluded that Section 71-3-51 was constitutional, and that the Court had appellate jurisdiction over direct appeals from the Commission.

Following the destruction of his home in Hurricane Katrina, plaintiff sued Liberty Mutual for negligent misrepresentation to recover the difference between his flood insurance coverage he had and the coverage he could have purchased under the preferred riskier insurance policy. The district court concluded that plaintiff's claim was not preempted by federal law and sent the case to the jury which awarded plaintiff in compensatory damages. Because plaintiff's dispute with Liberty Mutual related to his renewal of a policy already in place, Campo v. Allstate Ins. Co. did not control and the court held that plaintiff's state law claim was preempted. Because the Federal Emergency Management Agency (FEMA) was presumed to be paying both the litigation expenses and any resulting damage award, the district court erred in submitting this case to the jury. Because Liberty Mutual was not offering insurance advice, was not a fiduciary of plaintiff, and did not offer any statement to plaintiff to imply the lack of alternative insurance options, Mississippi law would not recognize negligent misrepresentation as a cause of action against Liberty Mutual and the submission of negligent misrepresentation to the jury was error. Accordingly, the court reversed with instructions to dismiss plaintiff's claim

Mary Arnold, who was injured in an automobile collision, brought a negligence action against the other driver, Jonathan Wallace, who was uninsured. Travelers Insurance Company, Arnold's carrier, defended the suit pursuant to its uninsured motorist coverage. The jury awarded a verdict for Arnold in the amount of $9,134. Arnold appealed. The Supreme Court affirmed, holding that the circuit court (1) did not err in admitting medical records under the business records exception, as there was established a sufficient foundation for the admission of the evidence; and (2) did not abuse its discretion in finding an expert physician qualified to testify when her partner previously had been retained by the opposing counsel.

Plaintiff's son, Hayden, was involved in a near-drowning accident in which he suffered severe permanent injuries. Plaintiff subsequently sought coverage for the cost of his treatment from Wasatch Crest Mutual Insurance, under which Hayden was insured. Wasatch Crest was later declared insolvent, and Plaintiff filed a claim against the Wasatch Crest estate. The liquidator of the estate denied Plaintiff's claim, concluding that Wasatch Crest had properly terminated coverage under the language of the plan. The Supreme Court reversed, interpreting the plan in favor of coverage. Plaintiff resubmitted her claim for medical expenses to the liquidator for payment under the Utah Insurers Rehabilitation and Liquidation Act. One year later, Plaintiff filed a motion for summary judgment with the district court. The liquidator subsequently issued a second amended notice of determination denying Plaintiff's claim on the merits. The district court then denied Plaintiff's motion for summary judgment, as Plaintiff had not yet challenged the second amended notice of determination and could do so under the Liquidation Act. Plaintiff appealed the district court's order. The Supreme Court dismissed the appeal because Plaintiff did not appeal from a final judgment and had not satisfied any of the exceptions to the final judgment rule.

Casey Stuivnga and Britni Evans were injured in a single-vehicle accident. The vehicle was owned by Stuivenga. Both Stuivenga and Evans claimed the other person was driving and was liable to the other for their injuries. They both sought proceeds available under an automobile insurance policy issued to Stuivenga by Progressive Direct Insurance Company. Progressive determined that Evans' and Stuivenga's competing claims could not be settled in an amount equal to or less than the policy's per person liability limit of $25,000. Progressive commenced an interpleader action and deposited the $25,000 with the district court, asking the court to determine to whom the funds should be issued. Ultimately, a jury found that Evans was the driver at the time of the accident and released the $25,000 to Stuivenga. The Supreme Court affirmed, holding (1) this appeal was not moot, as the issue presented at the outset of the action of who was driving had not ceased to exist, and Stuivenga's payment of the funds to third parties did not render the Court unable to grant effective relief; and (2) the district court did not abuse its discretion in denying Evans' motion for a new trial.

Claimant Carl Wynne was a truck driver. While he was in Tennessee driving a truck for his former employer, he heard that Triad Transport, Inc. was hiring. Claimant called Triad’s headquarters in McAlester and spoke to a recruiter who had hiring authority. Claimant requested that an application be sent by fax to Odessa, Texas, where he lived. He completed the application and sent it by fax to McAlester. A week or so later, the recruiter phoned while Claimant was driving somewhere between Georgia and Arizona that his application had been approved. Claimant agreed to travel to McAlester for orientation. He returned his prior employer's truck to a terminal in Tuscon, Arizona, and a Triad employee gave him a ride to a Triad satellite terminal in Laveen, Arizona. There, he passed a drug test, was provided a fuel card, and dispatched to Rockwall, Texas with a load. In 2010, Claimant was injured in a motor vehicle accident in Colorado while he was driving Triad’s truck. He filed a Form 3 claim for benefits in the Oklahoma Workers' Compensation Court which Triad opposed. The trial tribunal conducted a hearing solely on the issue of the court's jurisdiction. Two witnesses were presented, Claimant and the President of Employer. Claimant testified concerning when and where he was actually hired, and Employer's President testified to the general hiring practices of his company. The recruiter was not called to testify. The trial tribunal made several findings of fact and concluded that it had jurisdiction to hear the case of Claimant's subsequent injury as Claimant's hiring and final assent to permanent employment relationship between claimant and respondent occurred in Oklahoma. A three-judge panel of the Workers' Compensation Court unanimously affirmed the decision. The Supreme Court’s de novo review of the record, the testimony of the witnesses, and the arguments of the parties lead to the conclusion that Claimant's final assent to employment did not occur until he attended the orientation in Oklahoma, “[t]hat process began when Claimant first made contact with [Triad’s] recruiter, but it did not end until Claimant gave his final assent to employment during the orientation in Oklahoma. The Workers' Compensation Court did not err in determining that it has jurisdiction to hear the claim.”

Plaintiff-Appellant Allen Perius appealed a district court judgment following a jury verdict in favor of Appellee Nodak Mutual Insurance Company. In 2004, Plaintiff was involved in a motor vehicle accident with an uninsured driver, Jacob Kessler. Plaintiff insured his vehicle with Nodak for basic no-fault benefits and uninsured motorist benefits. Nodak paid Plaintiff no-fault benefits as a result of the accident. Plaintiff did not seek further medical treatment until March 2005, when he saw a chiropractor. Plaintiff submitted the bills to Nodak for payment as no-fault benefits. After Plaintiff submitted to an independent medical examination, Nodak denied him payment for any medical treatment after December 31, 2004, concluding such treatment was unrelated to the accident. In 2007, Plaintiff brought suit against Kessler, alleging he negligently operated his motor vehicle and caused Plaintiff's injuries. Plaintiff also sued Nodak, alleging the company breached its insurance contract with him. Nodak denied liability, and asserted a cross-claim against Kessler regarding Plaintiff's uninsured motorist claim. Kessler did not answer the claims against him. In 2009, Nodak moved for summary judgment, arguing no competent, admissible evidence established his claimed injuries were caused by the accident. Plaintiff resisted the motion, and submitted the affidavits of two of his treatment providers who stated their belief that Plaintiff's injuries and treatment were due to the accident. The district court granted Nodak's motion for summary judgment, and this Court reversed and remanded, finding disputed issues of material fact existed. A trial was set on remand. Shortly after, Plaintiff sent Nodak amended responses to Nodak's interrogatories. Prior to trial, Nodak was informed of Plaintiff's intent to call a chiropractor, as an expert witness. Nodak filed a motion in limine seeking to exclude the expert witness, alleging the expert was not properly disclosed.The district court granted Nodak's motion, but ordered the doctor would still be allowed to testify as a fact witness. The jury returned a verdict in Nodak's favor. The Supreme Court concluded that Plaintiff did not properly disclose his witness and that the district court did not abuse its discretion excluding the expert's testimony as a discovery sanction.