Justia Insurance Law Opinion Summaries

Maria Wilson purchased an insurance policy from Union National Fire Insurance Company (UNFIC) through agent Robin Wilson. The policy covered personal property at 2170A Tillman Chapel Road, which included a house and a travel trailer. Maria, who is illiterate, relied on Robin's verbal description of the policy. After a fire destroyed the house and her personal property, Maria filed a claim, which was denied by UNFIC, citing that she did not live in the house, a purported requirement for coverage.Maria sued UNFIC, Kemper Corporate Services, Robin Wilson, and others in the Circuit Court of Claiborne County, Mississippi, alleging breach of contract, negligence, fraud, and other claims. The defendants removed the case to federal court, asserting diversity jurisdiction and claiming that the non-diverse defendants were improperly joined. The district court agreed, denied Maria's motion to remand, and compelled arbitration based on the policy's arbitration clause. The arbitrator ruled in favor of the defendants, and the district court confirmed the arbitration award.The United States Court of Appeals for the Fifth Circuit reviewed the case. The court held that the district court erred in denying Maria's motion to remand because non-diverse defendant Robin Wilson was properly joined. The court found that the insurance policy did not clearly require Maria to live in the house for her personal property to be covered, thus her negligence claim against Robin Wilson was viable. Consequently, the Fifth Circuit reversed the district court's denial of the motion to remand, vacated the order compelling arbitration and the confirmation of the arbitration award, and remanded the case to the district court with instructions to remand it to state court. View "Wilson v. Kemper Corporate Services" on Justia Law

US Framing International LLC entered into a subcontract with Continental Building Company for framing services on two student-housing projects. Disputes arose, leading US Framing to leave the Knoxville project. Continental then filed an insurance claim alleging US Framing's breach of the subcontract. US Framing sued Continental and its officers, claiming insurance fraud under Tennessee law. The district court dismissed the case, stating US Framing failed to plead any injury directly caused by the alleged fraudulent insurance claim.The United States District Court for the Eastern District of Tennessee initially reviewed the case. The court granted Continental's motion to dismiss, concluding that US Framing did not demonstrate any direct injury resulting from Continental's insurance claim. US Framing then appealed the decision.The United States Court of Appeals for the Sixth Circuit reviewed the case. The court affirmed the district court's dismissal, holding that US Framing did not plausibly allege any economic damages directly resulting from Continental's alleged insurance fraud. The court also determined that US Framing could not recover attorney's fees or statutory penalties, as it did not establish itself as a prevailing party entitled to such relief. The court's decision was based on the interpretation of Tennessee law, which requires a direct causal link between the alleged fraud and the claimed damages. View "US Framing International LLC v. Continental Building Co." on Justia Law

Plaintiffs, E&I Global Energy Services, Inc. and E&C Global, LLC, sued Liberty Mutual Insurance Company for breach of contract and tort claims related to a construction project. The United States, through the Western Area Power Administration (WAPA), contracted with Isolux to build a substation, and Liberty issued performance and payment bonds for Isolux. After Isolux was terminated, Liberty hired E&C as the completion contractor, but E&I performed the work. Plaintiffs claimed Liberty failed to pay for the work completed.The United States District Court for the District of South Dakota granted summary judgment for Liberty on the unjust enrichment claim and ruled in Liberty's favor on all other claims after a bench trial. The court denied Plaintiffs' untimely request for a jury trial, excluded an expert witness report filed after the deadline, found no evidence of an assignment of rights between E&C and E&I, and ruled against Plaintiffs on their fraud, deceit, and negligent misrepresentation claims.The United States Court of Appeals for the Eighth Circuit reviewed the case. The court held that the district court did not abuse its discretion in denying the jury trial request, as Plaintiffs failed to timely file the motion and did not justify the delay. The exclusion of the expert report was also upheld, as the district court properly applied the relevant factors and found the late report was neither substantially justified nor harmless. The court affirmed the district court's finding that there was no valid assignment of rights from E&C to E&I, meaning Liberty's promise to pay was to E&C, not E&I. The court also upheld the findings that Liberty did not have the intent to deceive or induce reliance, and that Bruce did not reasonably rely on Mattingly's statements. Finally, the court declined to address the unjust enrichment claim as Plaintiffs did not raise the argument below. The Eighth Circuit affirmed the district court's rulings in their entirety. View "E&I Global Energy Services v. Liberty Mutual Insurance Co." on Justia Law

Ellen Williams purchased a residential property in Houma, Louisiana, which was mortgaged by Flagstar Bank. Since Williams did not insure the home, Flagstar obtained a lender-placed hazard insurance policy from Integon National Insurance Company at Williams's expense. The policy named Flagstar as the "Insured" and Williams as the "Borrower." Williams paid all premiums and complied with all policy requirements. The policy included a provision stating that if the loss amount exceeded Flagstar's insurable interest, Integon would pay Williams any residual amount due for the loss, not exceeding the policy limit.In August 2021, Williams's home was damaged by Hurricane Ida. Although Integon inspected the property and exchanged repair estimates with Williams, it ultimately refused to pay for the full property repairs. Williams sued Integon in the 32nd Judicial District Court for the Parish of Terrebonne, asserting breach-of-contract and bad-faith claims under Louisiana law. Integon removed the case to the United States District Court for the Eastern District of Louisiana and filed a Rule 12(b)(6) motion to dismiss, arguing that Williams lacked standing to sue under the policy. The district court agreed with Integon, ruling that Williams was not a named insured, additional insured, or third-party beneficiary, and dismissed the case without allowing Williams to amend her complaint.The United States Court of Appeals for the Fifth Circuit reviewed the case. The court found that the policy's loss payment provision clearly manifested an intent to benefit Williams, provided a certain benefit when the loss amount exceeded Flagstar's insurable interest, and that this benefit was not merely incidental. The court held that Williams might be able to plead plausible facts supporting her status as a third-party beneficiary. Consequently, the Fifth Circuit reversed the district court's decision and remanded the case with instructions to allow Williams to amend her complaint. View "Williams v. Integon National Insurance" on Justia Law

JohnsonKreis Construction Company, Inc. ("JohnsonKreis") served as the general contractor on a hotel-construction project in Birmingham, with Howard Painting, Inc. ("Howard") as a subcontractor. The subcontract agreement included an indemnity provision requiring Howard to indemnify JohnsonKreis for personal injury or death arising from Howard's negligence. Domingo Rosales-Herrera, an employee of a subcontractor working for Howard, died after falling from a window while attempting to load equipment into a trash box on a telehandler owned by JohnsonKreis. The personal representative of Rosales-Herrera's estate filed a wrongful-death lawsuit against both JohnsonKreis and Howard.The Jefferson Circuit Court granted summary judgment in favor of Howard and its insurers, Auto-Owners Insurance Company and Owners Insurance Company (collectively "Owners"), determining that the indemnity provision in the subcontract agreement was legally unenforceable. The court held that Alabama law does not allow for the apportionment of damages in a wrongful-death case, thus precluding proportional indemnification.The Supreme Court of Alabama reviewed the case and reversed the trial court's decision. The Supreme Court held that the subcontract agreement's proportional indemnity provision was legally enforceable under Alabama law. The court noted that parties may enter into agreements allowing for indemnification even for claims resulting solely from the negligence of the indemnitee. The court emphasized that such agreements are valid and enforceable if expressed in clear and unequivocal language.The Supreme Court remanded the case for further proceedings consistent with its opinion, instructing the trial court to consider the parties' evidentiary submissions and arguments regarding the interpretation and application of the disputed provisions of the subcontract agreement and the additional-insured endorsement. View "JohnsonKreis Construction Company, Inc. v. Howard Painting, Inc." on Justia Law

Kaufman Lynn Construction was hired to build a corporate campus for JM Family Enterprises in South Florida. Kaufman obtained a commercial general liability policy from Liberty Surplus Insurance to cover itself and its subcontractors. After completing several buildings, Tropical Storm Eta caused significant water damage to the completed structures. Kaufman sought indemnification from Liberty, which denied the claim based on the policy's Course of Construction Exclusion (COCE), stating that coverage did not apply until the entire project was completed. Kaufman disputed this and filed a lawsuit against its subcontractors and initiated a claims process with Liberty.The United States District Court for the Southern District of Florida granted Liberty's motion for summary judgment, concluding that the COCE excluded coverage for the water damage because the entire project was not completed. The court also dismissed Kaufman's counterclaim for declaratory relief as duplicative and ruled that Kaufman's breach of contract counterclaim was moot. Additionally, the court dismissed Kaufman's reformation counterclaim for lack of standing, reasoning that Kaufman had not demonstrated a cognizable injury.The United States Court of Appeals for the Eleventh Circuit reviewed the case and determined that Kaufman had Article III standing to seek reformation of the policy, as it suffered a cognizable injury by receiving a policy different from what was bargained for. The court affirmed the district court's ruling that the COCE precluded coverage for the water damage, as the entire project was not completed. The court also affirmed the district court's denial of Liberty's motion for attorney's fees, as Liberty's settlement proposal did not comply with the requirements of Florida's offer of judgment statute and Rule 1.442(c)(2)(B). The case was remanded for further proceedings on the reformation counterclaim. View "Liberty Surplus Insurance Corp. v. Kaufman Lynn Construction, Inc." on Justia Law

First Baptist Church, located in Fort Smith, Arkansas, had property insurance policies with Zurich American Insurance Company. The church experienced leaks over the years and hired roofing companies to repair portions of its roofing system in 2016, 2017, and 2018. In 2022, a roofing company representative determined the roofing system had hail damage, and First Baptist filed a claim with Zurich, alleging the damage occurred on April 28, 2017. Zurich denied the claim, citing no damage from the alleged hail event and evidence of excluded causes such as wear and tear. First Baptist sued Zurich for breach of contract and insurance bad faith.The United States District Court for the Western District of Arkansas granted summary judgment in favor of Zurich, concluding that First Baptist failed to comply with the prompt notice provision in the insurance policy. The court based its decision on evidence first discussed in Zurich’s reply brief, which indicated that First Baptist knew of past loss or damage to its property as early as 2016. The court held that no reasonable jury could find that First Baptist promptly notified Zurich of the loss or damage nearly six years later in January 2022. First Baptist filed a motion to reconsider, which the district court denied.The United States Court of Appeals for the Eighth Circuit reviewed the case and concluded that there were potential genuine disputes of material fact not properly litigated. The court noted that First Baptist did not have a fair opportunity to counter Zurich’s evidence and arguments about past leaks and repairs. The court reversed the district court’s grant of summary judgment and remanded the case for further consideration of the issues related to past loss or damage and the effect on First Baptist’s claims. The court also reversed and remanded the grant of summary judgment on First Baptist’s bad faith claim. View "First Baptist Church v. Zurich American Insurance Co." on Justia Law

Francine Pickett sued American Bankers Insurance Company of Florida, American Modern Property and Casualty Insurance Company, Davison Insurance Agency, and various fictitiously named defendants. Pickett alleged that she sought to replace her existing mobile home insurance policy with American Bankers for a lower premium through Davison. She claimed that Davison advised her to purchase a policy from American Modern, which she did. However, American Bankers canceled her previous policy for nonpayment without her knowledge. When her mobile home was damaged by fire, American Modern refused to pay the claim, alleging fraud due to non-disclosure of the previous policy's cancellation. Pickett alleged bad faith, breach of contract, negligent procurement of insurance, civil conspiracy, and negligence against the defendants.The Wilcox Circuit Court denied American Bankers' motion to compel arbitration and stay litigation. American Bankers argued that Pickett had agreed to arbitration through a binder and previous insurance applications. The trial court found that Pickett never received a policy or arbitration agreement in 2022 and thus could not have accepted or rejected the arbitration clause. The court also found that previous policies or arbitration agreements were irrelevant to the current matter.The Supreme Court of Alabama reviewed the case and reversed the trial court's decision. The court held that the binder, which included an arbitration agreement, was a contract that Pickett relied upon for her claims. Therefore, she could not seek the benefits of the binder while avoiding its arbitration provision. The court concluded that Pickett's claims against American Bankers arose from and relied on the binder, making her bound by its terms, including the arbitration agreement. The case was remanded for further proceedings consistent with this opinion. View "American Bankers Insurance Co. of Florida v. Pickett" on Justia Law

Sterling Senechal submitted a claim to Allstate Vehicle and Property Insurance Company for water damage caused by a broken water heater. Allstate issued three payments totaling $12,410.48. After a dispute over the loss amount, an appraisal determined the actual cash value to be $58,396.58, which Allstate paid minus the deductible and prior payments. Senechal then filed a lawsuit alleging breach of contract, violations of the Texas Prompt Payment of Claims Act (TPPCA), bad faith claims under Chapter 541 of the Texas Insurance Code, and breach of the common law duty of good faith and fair dealing. Allstate removed the case to federal court and paid what it calculated as the maximum potential interest owed.The United States District Court for the Southern District of Texas granted summary judgment in favor of Allstate on all claims. Senechal conceded the breach of contract claim but opposed summary judgment on the other claims. The district court ruled that Allstate's payment of the appraisal award and interest defeated Senechal's claims.The United States Court of Appeals for the Fifth Circuit reviewed the case. The court affirmed the summary judgment on Senechal's bad faith claims under Chapter 541 and common law, citing the Texas Supreme Court's decision in Ortiz v. State Farm Lloyds, which held that payment of an appraisal award and interest precludes recovery for bad faith claims unless there is an independent injury. However, the court vacated the summary judgment on Senechal's TPPCA claims, noting that payment of an appraisal award and interest does not automatically absolve an insurer of TPPCA liability. The case was remanded for further proceedings to determine whether Allstate's initial payment "roughly corresponds" with the appraisal award and whether Allstate is liable under the TPPCA. View "Senechal v. Allstate" on Justia Law

The plaintiff, New England Property Services Group, LLC (NEPSG), appealed from a summary judgment in favor of the defendant, NGM Insurance Company (NGM). NEPSG had been assigned the insurance claim benefits by the policyholders, Stephen and Betty Callahan, for storm-related damage to their residence. NGM initially covered some damages but denied others, leading to a series of inspections and disagreements over the loss amount. Eventually, an appraisal process was conducted, resulting in an award that NEPSG found unsatisfactory due to updated labor costs published after the award was signed.The Superior Court granted summary judgment to NGM, finding that NEPSG was not entitled to a modification of the appraisal award or a second appraisal. The court also found that NEPSG failed to establish its claims for breach of contract, bad faith, unjust enrichment, and tortious interference with contractual relations. NEPSG argued that the award should be modified due to a miscalculation of labor costs and that NGM acted in bad faith by using unlicensed appraisers, among other claims.The Rhode Island Supreme Court reviewed the case de novo and affirmed the Superior Court's judgment. The court held that the appraisal award was akin to an arbitration award and thus subject to limited judicial review. NEPSG's request for modification based on post-award labor cost updates was not supported by admissible evidence. The court also found no basis for a second appraisal or for NEPSG's claims of breach of contract and bad faith, as NGM had fulfilled its contractual obligations and there was no evidence of bad faith. Additionally, the court rejected NEPSG's claims of unjust enrichment and tortious interference, finding no inequitable benefit retained by NGM and no evidence of intentional harm to NEPSG's contract with the policyholders. View "New England Property Services Group, LLC v. NGM Insurance Company" on Justia Law