Justia Insurance Law Opinion Summaries

Articles Posted in Contracts
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Jon Willis, an employee of Shamrock Management, L.L.C., was injured while working on an offshore oil platform operated by Fieldwood Energy, L.L.C. The injury occurred when a tag line slipped off a grocery box being delivered by a vessel operated by Barry Graham Oil Service, L.L.C. Willis sued Barry Graham for negligence. Barry Graham then sought indemnification, defense, and insurance coverage from Shamrock and its insurer, Aspen, based on a series of contracts linking the parties.The United States District Court for the Western District of Louisiana denied Barry Graham's motion for summary judgment and granted Shamrock and Aspen's motion, ruling that Barry Graham was not covered under the defense, indemnification, and insurance provisions of the Shamrock-Fieldwood Master Services Contract (MSC). Willis's case was settled, and Barry Graham appealed the district court's decision on its third-party complaint.The United States Court of Appeals for the Fifth Circuit reviewed the case de novo. The court concluded that the MSC required Shamrock to defend, indemnify, and insure Barry Graham because Barry Graham was part of a "Third Party Contractor Group" under the MSC. The court also determined that the cross-indemnification provisions in the contracts were satisfied, and that the Louisiana Oilfield Anti-Indemnity Act (LOAIA) did not void Shamrock's obligations because Fieldwood had paid the insurance premium to cover Shamrock's indemnities, thus meeting the Marcel exception.The Fifth Circuit reversed the district court's judgment and remanded the case for further proceedings consistent with its opinion. View "Barry Graham Oil v. Shamrock Mgmt" on Justia Law

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Yolanda Bell obtained an automobile insurance policy from Shelter General Insurance Company. In February 2018, her vehicle was damaged, and Shelter determined it was a total loss, paying her $11,787 after deductions. Bell filed a class action suit in February 2022, alleging that Shelter breached its contractual duties by not including taxes and fees required to acquire a replacement vehicle in its payment. Bell argued that the policy did not require her to replace the vehicle before being reimbursed for these costs.The Circuit Court of Jackson County dismissed Bell's petition without prejudice, agreeing with Shelter's argument that the policy only covered taxes and fees if they were actually incurred by purchasing a replacement vehicle. Bell appealed the decision, standing on her original petition rather than amending it.The Supreme Court of Missouri reviewed the case de novo. The court found that Bell's petition adequately pleaded a breach of contract claim by alleging the existence of the insurance policy, her performance under the policy, Shelter's failure to pay the required taxes and fees, and the resulting damages. The court emphasized that the interpretation of the policy's terms was a matter for summary judgment or trial, not for a motion to dismiss. Consequently, the Supreme Court of Missouri reversed the circuit court's judgment and remanded the case for further proceedings. View "Bell vs. Shelter General Insurance Company" on Justia Law

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Centaur, L.L.C. entered into a Master Services Contract (MSC) with United Bulk Terminals Davant, L.L.C. (UBT) in 2015 to build a concrete containment wall at UBT's dock facility. River Ventures, L.L.C. provided vessel transportation for Centaur’s employees working on the project. Centaur employee Devin Barrios was injured while transferring a generator from a River Ventures vessel to a barge leased by Centaur. The district court found River Ventures 100% at fault for the accident and imposed a $3.3 million judgment. River Ventures and its insurer, XL Specialty Insurance Company, satisfied the judgment and subsequently brought breach of contract claims against Centaur under the MSC.The United States District Court for the Eastern District of Louisiana held a bench trial on the breach of contract claims. The court dismissed the claims, finding an ambiguity in the MSC regarding Centaur’s insurance procurement obligations. Specifically, the court found that requiring Centaur to procure a Protection & Indemnity (P&I) policy with crew/employee coverage would result in an absurd consequence due to potential duplicative coverage with the Worker’s Compensation policy.The United States Court of Appeals for the Fifth Circuit reviewed the case. The appellate court found that the MSC unambiguously required Centaur to procure a P&I policy that included crew/employee coverage. The court disagreed with the district court’s finding of absurdity, noting that mutually repugnant escape clauses in the Worker’s Compensation and P&I policies would result in both policies being liable on a pro rata basis. The appellate court also reversed the district court’s dismissal of the excess/bumbershoot breach of contract claim, as it was contingent on the P&I claim. The Fifth Circuit reversed the district court’s judgment and remanded the case for further proceedings consistent with its opinion. View "Centaur v. River Ventures" on Justia Law

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A construction company chartered a barge and obtained insurance through a broker. Upon returning the barge, the owner discovered damage and sued the construction company in federal court. The construction company requested its insurer to defend it, but the insurer refused, citing lack of coverage. After the federal court awarded damages to the barge owner, the construction company sued the insurer and broker in state court, alleging breach of contract, insurance bad faith, and negligence.The Superior Court of Alaska denied the construction company's motion for summary judgment against the broker and insurer. The court granted summary judgment to the broker and insurer, finding that the construction company's claims were barred by the statute of limitations. The court held an evidentiary hearing and concluded that the construction company had not relied on any reassurances from the broker that would have delayed the filing of the lawsuit.The Alaska Supreme Court reviewed the case and affirmed the Superior Court's decision. The court held that the construction company's claims against the broker were time-barred, as the statute of limitations began to run when the insurer first denied coverage. The court also held that the construction company's claims against the insurer were time-barred, as the statute of limitations began to run when the insurer refused to defend the construction company in the federal lawsuit. The court concluded that the construction company's claims were untimely and affirmed the summary judgment in favor of the broker and insurer. View "Swalling Construction Company, Inc. v. Alaska USA Insurance Brokers, LLC" on Justia Law

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In 2020, First United Pentecostal Church in DeQuincy, Louisiana, sustained significant damage from Hurricanes Laura and Delta. The church was insured by Church Mutual Insurance Company (CM), which covered several buildings on the property. After the hurricanes, First United submitted a claim to CM, but CM delayed the inspection and payment process. CM eventually made two payments totaling $191,832.28, which the church used for repairs. Dissatisfied with the amount and timing of the payments, First United filed a lawsuit against CM, alleging breach of contract and violations of Louisiana insurance statutes.The United States District Court for the Western District of Louisiana held a bench trial and found in favor of First United. The court concluded that CM had acted in bad faith by failing to make timely payments and awarded First United $1,101,122.87 in unpaid losses, along with statutory penalties, attorney fees, and costs, bringing the total award to $2,073,838.96. The court later amended the judgment to $2,052,335.09 after correcting some errors. CM's motions for a new trial and for judgment as a matter of law were denied, leading to this appeal.The United States Court of Appeals for the Fifth Circuit reviewed the case and affirmed the district court's decisions on several points, including the denial of CM's motion to exclude First United's expert, Kermith Sonnier, and the use of Sonnier's estimate to calculate damages. However, the appellate court reversed the district court's imposition of statutory penalties, attorney fees, and costs, finding that CM's actions were not arbitrary, capricious, or without probable cause. The case was remanded for further proceedings consistent with the appellate court's opinion. View "First United v. Church Mutual Insurance" on Justia Law

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Following an accident, Jeremy Marchek sued his auto insurer, United Services Automobile Association (USAA), claiming that the company breached the terms of the policy it issued to him. Marchek argued that USAA wrongfully failed to compensate him for sales taxes and mandatory fees necessary to purchase a replacement vehicle after USAA declared his vehicle to be beyond repair. USAA paid Marchek the pre-accident value of his vehicle minus a deductible but did not include taxes and fees in the payment.The United States District Court for the Western District of Michigan dismissed Marchek’s complaint, ruling that USAA was not contractually obligated to compensate him for taxes and fees. The district court found that the insurance policy did not require USAA to cover these additional costs when calculating the actual cash value (ACV) of the vehicle.The United States Court of Appeals for the Sixth Circuit reviewed the case and reversed the district court’s decision. The appellate court held that the plain language of the insurance policy plausibly requires USAA to compensate Marchek for the sales taxes and mandatory fees necessary to purchase a replacement vehicle. The court found that the policy’s definition of ACV, which is “the amount that it would cost, at the time of loss, to buy a comparable vehicle,” does not unambiguously exclude taxes and fees. Therefore, the case was remanded for further proceedings to determine whether USAA breached the contract by not including these costs in its payment to Marchek. View "Marchek v. United Services Automobile Association" on Justia Law

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Torrey Kath brought a personal injury lawsuit against Michael Prochnow and Prochnow Farms, alleging that Prochnow moved a semi-truck while Kath was underneath, causing significant injury. Kath and Prochnow entered into a Miller-Shugart agreement, where Prochnow accepted damages, and Kath agreed to collect solely from Prochnow’s insurers. The case was dismissed with prejudice after a stipulation of dismissal was filed.Kath then filed a declaratory judgment action against Farmers Union Mutual Insurance Company (FUMIC), which insured Prochnow under a farm liability policy. Kath sought declarations that the policy covered his injuries and that the Miller-Shugart agreement was reasonable and binding on FUMIC. The District Court of Stutsman County granted Kath summary judgment on the coverage issue, interpreting the policy’s motor vehicle exclusion as not applying to the coverage added by a farm employer liability endorsement.FUMIC moved for summary judgment, arguing it had no duty to indemnify Prochnow because the personal injury action had been dismissed with prejudice. While this motion was pending, Kath and Prochnow successfully moved to vacate the dismissal and entered a $2 million judgment against Prochnow, to be paid solely by FUMIC. The district court then denied FUMIC’s motion for summary judgment, holding that the judgment in the personal injury action rendered FUMIC’s motion moot and granted summary judgment in favor of Kath on the second count of his complaint.The North Dakota Supreme Court reviewed the case and reversed the district court’s judgment. The Supreme Court held that the policy’s motor vehicle exclusion applied to Kath’s injuries, and thus, the policy did not provide coverage. The court concluded that the endorsement did not supersede the motor vehicle exclusion and that the policy, when read as a whole, excluded coverage for injuries related to the use of motor vehicles. View "Kath v. Farmers Union Mutual Ins. Co." on Justia Law

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Baxter Senior Living, LLC, an assisted living facility in Anchorage, Alaska, obtained an insurance policy from Zurich American Insurance Company covering various types of losses, including those caused by microorganisms. In response to the COVID-19 pandemic, Baxter implemented several operational restrictions and incurred additional costs. Despite these measures, the facility experienced COVID-19 cases among staff and residents. Baxter filed a claim with Zurich for loss of business income due to the pandemic, which Zurich denied.Baxter then filed a complaint in February 2022, alleging breach of contract and other claims, arguing that the presence of COVID-19 and related governmental orders caused a loss of use of its property, constituting "direct physical loss of or damage to" the property under the insurance policy. Zurich moved to dismiss the case, arguing that neither the presence of the virus nor the governmental orders constituted "direct physical loss of or damage to" property. The U.S. District Court for the District of Alaska certified two questions to the Alaska Supreme Court regarding the interpretation of this phrase in the context of the pandemic.The Alaska Supreme Court reviewed the certified questions and concluded that neither the presence of the COVID-19 virus at an insured property nor the operational restrictions imposed by pandemic-related governmental orders constitute "direct physical loss of or damage to" the property under a commercial insurance policy. The court emphasized that "direct physical loss" requires some physical alteration or deprivation of possession of the property, and "direct physical damage" requires a tangible alteration of the property. The court noted that the presence of the virus does not physically alter the property but merely attaches to it, and the operational restrictions do not cause a physical alteration or deprivation of possession. Therefore, the court answered both certified questions in the negative. View "Baxter Senior Living, LLC v. Zurich American Insurance Company" on Justia Law

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In March 2013, Woodsboro Farmers Cooperative contracted with E.F. Erwin, Inc. to construct two grain silos. Erwin subcontracted AJ Constructors, Inc. (AJC) for the assembly. AJC completed its work by July 2013, and Erwin finished the project in November 2013. However, Woodsboro noticed defects causing leaks and signed an addendum with Erwin for repairs. Erwin's attempts to fix the silos failed, leading Woodsboro to hire Pitcock Supply, Inc. for repairs. Pitcock found numerous faults attributed to AJC's poor workmanship, necessitating complete deconstruction and reconstruction of the silos, costing Woodsboro $805,642.74.Woodsboro sued Erwin in Texas state court for breach of contract, and the case went to arbitration in 2017. The arbitration panel found AJC's construction was negligent, resulting in defective silos, and awarded Woodsboro $988,073.25 in damages. The Texas state court confirmed the award in September 2022. In December 2018, TIG Insurance Company, Erwin's insurer, sought declaratory relief in the United States District Court for the Southern District of Texas, questioning its duty to defend and indemnify Erwin. The district court granted TIG's motion for summary judgment on the duty to defend, finding no "property damage" under the policy, and later ruled there was no duty to indemnify, as the damage was due to defective construction.The United States Court of Appeals for the Fifth Circuit reviewed the case. The court found that there were factual questions regarding whether the damage constituted "property damage" under the insurance policy, as the silos' metal parts were damaged by wind and weather due to AJC's poor workmanship. The court determined that the district court erred in granting summary judgment for TIG and concluded that additional factual development was needed. The Fifth Circuit reversed the district court's decision and remanded the case for further proceedings. View "TIG Insurance Company v. Woodsboro Farmers Coop" on Justia Law

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In 2007, Dennis Collins, Suzanne Collins, David Butler, and Lucia Bott purchased long-term care insurance policies from Metropolitan Life Insurance Company (MetLife). They also bought an Inflation Protection Rider, which promised automatic annual benefit increases without corresponding premium hikes, though MetLife reserved the right to adjust premiums on a class basis. In 2015, 2018, and 2019, MetLife informed the plaintiffs of significant premium increases. The plaintiffs filed a class action in 2022, alleging fraud, fraudulent concealment, violations of state consumer protection statutes, and breach of the implied covenant of good faith and fair dealing under Illinois and Missouri law.The United States District Court for the Eastern District of Missouri dismissed the case, ruling that the filed rate doctrine under Missouri and Illinois law barred the plaintiffs' claims. Additionally, the court found that the plaintiffs bringing claims under Missouri law failed to exhaust administrative remedies. The plaintiffs appealed, arguing that the filed rate doctrine did not apply, they were not required to exhaust administrative remedies, and their complaint adequately alleged a breach of the implied covenant.The United States Court of Appeals for the Eighth Circuit reviewed the case de novo and affirmed the district court's dismissal. The appellate court held that the plaintiffs' complaint failed to state a claim upon which relief could be granted. The court found that MetLife's statements about premium expectations were not materially false and that the plaintiffs did not sufficiently allege intentional fraud or fraudulent concealment. The court also concluded that the statutory claims under the Missouri Merchandising Practices Act and the Illinois Consumer Fraud and Deceptive Business Practices Act were barred by regulatory exemptions. Lastly, the court determined that the implied covenant of good faith and fair dealing was not breached, as MetLife's actions were expressly permitted by the policy terms. View "Collins v. Metropolitan Life Insurance Co." on Justia Law