Justia Insurance Law Opinion Summaries

Plaintiff filed a class action suit in an Illinois circuit court against Ernida, LLC alleging that Ernida had faxed unsolicited advertisements to Plaintiff and more than thirty-nine other recipients without first obtaining their permission. Ernida’s insurer, American Economy Insurance Company (American), took up Ernida’s defense in Illinois. While the Illinois action was ongoing, Plaintiff filed suit in federal district court against American, asserting diversity jurisdiction and seeking a declaration that American had a duty to defend Ernida in the Illinois action and had a responsibility to indemnify and pay any judgment in that action. The district court granted American’s motion to dismiss, concluding that Plaintiff had not presented a justiciable controversy. On appeal, American claimed that Plaintiff’s claim did not meet the amount-in-controversy requirement for diversity jurisdiction since Plaintiff had expressly waived any right to recover anything over $75,000 in its Illinois complaint. The First Circuit Court of Appeals vacated the district court’s order dismissing the case for lack of standing and remanded with instructions to dismiss for lack of subject-matter jurisdiction, as the matter in controversy did not not exceed the sum or value of $75,000. View "CE Design, Ltd. v. Am. Economy Ins. Co." on Justia Law

Richard Feingold’s mother purchased a life insurance policy from an Insurer listing her husband as the only beneficiary. Feingold's mother died in 2006. In 2012, Richard informed Insurer of his mother's death. The Insurer issued Feingold a check for death benefits but did not provide a copy of his mother's life insurance policy. Feingold filed a class action complaint against Insurer in 2013, alleging that the Insurer owed Feingold and the putative class of similarly situated beneficiaries damages based on the Insurer’s handling of unclaimed benefits under its life insurance policies. Specifically, Feingold claimed that the Insurer had an obligation, arising from a regulatory agreement (“Agreement”) between the Insurer and several states, to discover the death of its insureds and notify beneficiaries. The district court dismissed the complaint for failure to state a claim, noting that the Agreement was a contract only between Insurer and participating states. The First Circuit affirmed, holding that because Feingold was neither a party nor a third-party beneficiary of the Agreement, he had no authority to enforce the terms of the Agreement. View "Feingold v. John Hancock Life Ins. Co." on Justia Law

Mead Johnson, purchased a primary Commercial General Liability policy from National Union, with a limit of $2 million for liability for “personal and advertising injury” and an excess liability policy from Lexington, with a limit of $25 million. Mead’s main product, Enfamil infant formula, is sold worldwide. Mead’s competitor, PBM, sued Mead for false advertising and consumer fraud and Mead sued PBM for trade dress infringement. PBM claimed that Mead had falsely asserted that PBM’s generic formula lacked key fats that promote brain and eye development. The suit sought $500 million in damages for product disparagement, a tort that the policies cover as a form of “advertising injury.” Mead did not notify the insurers of the suit until December 2009, after the suit ended in the $13.5 million verdict against Mead. Mead wanted its insurers to pay that judgment, plus a $15 million settlement that it made to resolve the class action suit. The insurers obtained declaratory judgments that they were not required to pay. The Seventh Circuit reversed the summary judgment in favor of the insurers in the suit relating to the PBM litigation, but affirmed the judgment in favor of National Union in the suit arising from the class action against Mead. View "Nat'l Union Fire Ins. Co. v. Mead Johnson & Co., LLC" on Justia Law

State Farm Fire and Casualty Company appealed an adverse judgment entered on a jury verdict in in favor of homeowner and policyholder Shawn Brechbill on his claim of "abnormal" bad-faith failure to investigate an insurance claim. "A bad-faith-refusal-to-investigate claim cannot survive where the trial court has expressly found as a matter of law that the insurer had a reasonably legitimate or arguable reason for refusing to pay the claim at the time the claim was denied. Because State Farm repeatedly reviewed and reevaluated its own investigative facts as well as those provided by Brechbill, it is not liable for a tortious failure to investigate." The Supreme Court reversed the trial court's judgment and remanded the case for further proceedings. View "State Farm Fire and Casualty Company v. Brechbill " on Justia Law

A class of Plaintiffs brought suit against Insured, a hotel proprietor, alleging that Insured violated the Telephone Consumer Protection Act (TCPA). The class and Insured subsequently reached a settlement. The class then filed a garnishment action against Insurer. Insurer sought a declaratory judgment that its policy with Insured did not provide coverage because the policy did not cover damages awarded related to the TCPA. The trial found (1) Insurer owed Insured a duty to defend in the class actions because the class's claims were covered under the policy; and (2) Insurer had a duty to indemnify Insured for the full settlement plus interest. The Supreme Court affirmed, holding (1) the trial court correctly determined that Insurer wrongly refused to defend Insured under its policy coverage; (2) Insurer was not entitled to a reassessment of the reasonableness of the settlement; and (3) policy limits did not bar Insurer's indemnification of the settlement. View "Columbia Cas. Co. v. HIAR Holding, LLC" on Justia Law

At issue in this case was whether insurance practices that violate the Unfair Insurance Practices Act (UIPA) can support an Unfair Competition Law (UCL) action. In 1988, the Supreme Court held in Moradi-Shalal v. Fireman's Fund Insurance Companies that the Legislature did not intend to create a private cause of action under the UIPA for commission of various unfair practices listed in Cal. Ins. Code 790.03(h). In this case, Plaintiff sued Insurer for, among other causes of action, violation of California's unfair competition law (UCL) for engaging in false advertising. The trial court concluded that the UCL claim was an impermissible attempt to plead around Moradi-Shalal's bar against private actions for unfair insurance practices under section 790.03. The court of appeal reversed. The Supreme Court affirmed, holding (1) private UIPA actions are absolutely barred, and litigants may not rely on the proscriptions of section 790.03 as the basis for a UCL claim; (2) however, when insurers engage in conduct that violates both the UIPA and obligations imposed by other statutes or the common law, a UCL action may lie; and (3) here, Plaintiff alleged causes of action that provided grounds for a UCL claim independent from the UIPA. View "Zhang v. Superior Court" on Justia Law

State Farm filed a complaint for negligence against Appellant, alleging that Appellant was at fault in an automobile accident with State Farm's insured. Appellant counterclaimed, alleging that State Farm was unjustly enriched as a result of having engaged in the deceptive and unlawful business practice of causing collection-style letters to be mailed in an attempt to collect unadjudicated, potential subrogation claims as debts. Appellant's counterclaim identified two putative classes. State Farm filed a motion to strike the class allegations. Rather than granting the motion to strike class allegations, the circuit court denied class certification "for the reasons stated in State Farm's motion." The Supreme Court reversed, holding that the circuit court acted without due consideration of the Court's foregoing case law on typicality, commonality, and predominance and therefore abused its discretion in prematurely denying class certification at the early pleading stage of this case. Remanded. View "Kersten v. State Farm Mut. Auto. Ins. Co." on Justia Law

Plaintiff was injured in an automobile accident and received medical treatment at Benefis Health System, Inc. Plaintiff had healthcare coverage as a TRICARE beneficiary and also had medical payments coverage through his insurance carrier, Kemper. Plaintiff's medical treatment costs totaled $2,073. Benefis accepted $662 from TRICARE as payment in full satisfaction of the bill pursuant to a preferred provider agreement (PPA) between Blue Cross Blue Shield and Benefis. Benefis subsequently received $1,866 from Kemper, upon which Benefis reimbursed TRICARE's payment in full. Plaintiff filed an individual and class action complaint, claiming that he was entitled to the additional $1,204 that Benefis received from Kemper over and above the TRICARE reimbursement rate. Plaintiff filed a motion for judgment on the pleadings, asking the district court to find Benefis breached its contract with TRICARE and that Benefis was liable for Plaintiff's damages. The district court converted the motion into a motion for summary judgment and granted summary judgment to Plaintiff. The Supreme Court reversed the grant of summary judgment, holding (1) Plaintiff was not entitled to pocket the difference between the TRICARE reimbursement rate and the amount Benefis accepted from Kemper; and (2) Plaintiff failed to establish any damages that resulted from the alleged breach. View "Conway v. Benefis Health Sys., Inc." on Justia Law

The issue before the Supreme Court in this case was whether particular officers and employees of a bank owed a quasi-fiduciary duty to particular bank depositors. Michael and Theresa Annechino deposited a large amount of money at a bank specifically to ensure that their savings would be protected by the Federal Deposit Insurance Corporation (FDIC). The Annechinos relied on bank employees’ recommendations of how to structure their accounts to meet FDIC coverage rules. Unfortunately, the bank went into receivership, and the FDIC found that nearly $500,000 of the Annechinos’ deposits were not insured. The Annechinos alleged that individual officers and employees of the bank owed them a duty, the breach of which resulted in their loss. The trial court granted summary judgment in favor of the individual defendants, and the Court of Appeals affirmed. Upon review, the Supreme Court affirmed the Court of Appeals. The officers and employees of the bank did not owe the Annechinos a quasi-fiduciary duty. Holding the officers and employees personally liable under these facts would have contravened established law regarding liability for acts committed on behalf of a corporation or principal. View "Annechino v. Worthy" on Justia Law

Owners of a duplex insured a building through two concurrently issued, identical policies - one for each unit. A fire damages the entire structure, and Insurer paid the owners' claims under both policies. Insurer then brought this action to determine its subrogation rights against the tenant (Tenant) of one of the duplex units, who was allegedly negligent in starting the fire. Insurer conceded the pursuant to Tri-Par Investments v. Sousa, Tenant was an implied coinsured under the policy covering the unit he lived in. Therefore, Insurer sought to recoup payments made for the damage only to the unit Tenant did not live in. The district court granted Tenant's motion for summary judgment and dismissed the action. The Supreme Court affirmed, holding that the district court did not err in (1) granting Tenant's motion for summary judgment, as the rule in Tri-Par Investments applies to bar subrogation against a duplex tenant as to both sides of the building; (2) ruling that Tenant was a coinsured with Owners under Nebraska law; (3) failing to rule that Insurer was allowed to subrogate against Tenant; and (4) denying Insurer's request for declaratory judgment. View "Buckeye State Mut. Ins. Co. v. Humlicek" on Justia Law