Justia Insurance Law Opinion Summaries

The issue before the Supreme Court in this case centered on whether Delaware’s personal injury protection (PIP) statute requires insurers to reserve PIP benefits for lost wages when requested. The plaintiff suffered severe injuries as a passenger in a car accident. While he was in a coma, his mother signed an assignment of insurance benefits in favor of the hospital. Plaintiff did not challenge the validity of the assignment. The hospital was promptly paid by the insurance company. When plaintiff later requested the insurers to reserve his PIP benefits for his past and future lost wages, he was informed that the benefits had been exhausted by the payment to the hospital. The Superior Court held sua sponte that the unchallenged assignment to the healthcare provider was invalid. Upon review of the facts of this case, the Supreme Court concluded the Superior Court erred as a matter of law in deciding that uncontested issue. Because the assignment on behalf of the plaintiff resulted in the exhaustion of his PIP benefits before the plaintiff requested the reservation of PIP benefits for his lost wages, the legal issue of whether the insurer was required to reserve PIP benefits for lost wages is moot. View "State Farm Mutual Automobile Insurance Co. v. Davis" on Justia Law

Sweet Valley Missionary Baptist Church filed a complaint against its insurance carrier, Alfa Insurance Corporation. Based on Sweet Valley’s failure to cooperate in discovery, the trial court entered an order of dismissal. Sweet Valley then filed a motion to set aside judgment, or, in the alternative, a motion for new trial. The trial court denied the motion, and, in response, Sweet Valley filed a second complaint against Alfa the same day. The trial court dismissed the second claim based on the expiration of the statute of limitations. Sweet Valley appealed. On rehearing, the Court of Appeals reversed the trial court’s judgment and remanded for further proceedings. Alfa filed a petition for writ of certiorari, and the Supreme Court granted it. Upon review, the Supreme Court held that a motion filed pursuant to Mississippi Rule of Civil Procedure 59(e) tolls the applicable statute of limitations, and it reversed the decision of the trial court. View "Sweet Valley Missionary Baptist Church v. Alfa Insurance Corporation" on Justia Law

This case involved an uninsured motorist benefits claim filed in connection with injuries allegedly sustained by the appellant in a 2001 motor vehicle accident. Appellant was driving a truck insured by Harleysville Insurance Company when he rear-ended another vehicle. The police report contained no mention of a phantom vehicle being involved in the accident. Appellant later reported the accident to his employer, explaining he momentarily took his eyes off the road, and when he looked again, a vehicle was stopped in front of him; he was unable to stop and rear-ended the vehicle. Twenty days later, appellant completed a written Workers’ Compensation Employee’s Statement in which he reported the accident occurred due to the other vehicle stopping suddenly in front of him. But again, no phantom vehicle was reported. Over eight months later, appellant filed a claim for uninsured motorist benefits, alleging the accident was caused by a phantom vehicle pulling out in front of the other vehicle, causing appellant to stop suddenly. Harleysville denied appellant’s claim and sought a declaratory judgment that he was not entitled to uninsured motorist benefits. The Superior Court reversed the order of the Court of Common Pleas of Luzerne County, which held appellee Harleysville Insurance Company did not suffer prejudice as a result of appellant’s failure to report the phantom vehicle within a 30-day time requirement established by the Motor Vehicle Financial Responsibility Law (MVFRL). Upon review, the Supreme Court affirmed the Superior Court decision. View "Vanderhoff v. Harleysville Ins. Co." on Justia Law

Thomas Warner filed a complaint against Robert and Rebecca Hanke for conversion and negligence after Robert Hanke asserted ownership over some personal property Warner was storing on the Hanke's property. At the time the action was filed, Robert and Rebecca Hankes maintained home insurance coverage from a subsidiary of Horace Mann Insurance Company. The Hankes filed a claim with Horace Mann to request a defense against Warner's suit. Horace Mann filed a declaratory judgment action requesting a determination whether the insurance policy required Horace Mann to defend the Hankes. The district court concluded that Horace Mann did not owe coverage to the Hankes for the Warner dispute. The Supreme Court affirmed in part, reversed in part, and remanded, holding that the district court (1) properly determined that the Hankes' insurance policy failed to cover the Warner dispute; (2) correctly determined that Horace Mann's decisions to provide a defense and to pay the settlement of Warner's claims nevertheless allowed Horace Mann to pursue reimbursement for the Hankes' share of the settlement; and (3) abused its discretion in awarding attorney's fees to Horace Mann. View "Horace Mann Ins. Co. v. Hanke" on Justia Law

Plaintiff, a school, was sued by two of the school's donors who sought a return of a monetary gift to the school, claiming that the gift had been induced by misrepresentations. The case settled, and Plaintiff sought defense costs and indemnity under a directors and officers liability insurance policy issued by Defendant. The district court granted summary judgment for Defendant based on a provision in the policy excluding from coverage any losses involving any matter disclosed in connection with "Note 8" of the school's financial statement. Note 8 set forth a description of the gift. Plaintiff appealed. The First Circuit Court of Appeals affirmed, holding that because the language of the policy clearly excluded coverage "in any way involving" the disputed gift, Plaintiff had no reasonable expectation of coverage. View "Clark Sch. for Creative Learning, Inc. v. Philadelphia Indem. Ins. Co." on Justia Law

In 2000, the Schuchmans purchased homeowner’s insurance from State Auto to insure a residence in Junction City, Illinois. About 10 years later, a fire severely damaged the insured house and the Schuchmans made a claim against the homeowner’s policy. After a lengthy investigation, State Auto denied the claim on the basis that the Schuchmans were not residing on the “residence premises,” as that term is defined by the policy, and were maintaining a residence other than at the “residence premises,” in violation of the policy’s Special Provisions. The district court entered summary judgment in favor of State Auto. The Seventh Circuit reversed, agreeing that the term “residence premises” is ambiguous and should be liberally construed in favor of coverage. View "Schuchman v. State Auto Prop. & Cas.Ins. Co." on Justia Law

After Dolly Romprey was involved in an accident, Romprey and her husband (Plaintiffs) sought to recover from their insurer (Defendant) under the uninsured/underinsured motorist provisions of their automobile insurance policy. The trial court granted summary judgment in favor of Defendant, concluding that Plaintiffs' action was time-barred under the relevant statute of limitations, and the tolling provision did not apply in this case because Plaintiffs failed to satisfy the threshold requirement that their claim involved an underinsured vehicle. The Supreme Court reversed, holding (1) a genuine issue of material fact existed concerning whether Plaintiffs had met the statutory tolling provisions of the relevant statute; and (2) therefore, the trial court erred in requiring Plaintiffs to submit evidence that they had met the requirements of the statutory tolling provision. Remanded. View "Romprey v. Safeco Ins. Co. of Am." on Justia Law

Plaintiff, the owner of an apartment building, complained when Armory Plaza, the owner of the lot next to Plaintiff's building, began excavating the lot to make way for a new building. The excavation purportedly caused cracks in the walls and foundations of Plaintiff's building. After Plaintiff's insurer (Defendant) rejected Plaintiff's claims under its policy, Plaintiff brought suit. The U.S. district court granted summary judgment for Defendant, holding that the alleged conduct of Armory and its contractors was not "vandalism" within the meaning of the policy. On appeal, the Second Circuit Court of Appeals certified two questions of law to the New York Court of Appeals, which answered by holding (1) for purposes of construing a property insurance policy covering acts of vandalism, malicious damage may be found to result from an act not directed specifically at the covered property; and (2) the state of mind required to find malicious damage is a conscious and deliberate disregard of the interests of others that the conduct in question may be called willful or wanton. View "Georgitsi Realty, LLC v. Penn-Star Ins. Co." on Justia Law

Manpower, an international staffing firm, is the parent of Right Management in Paris, France. A building in which Right leased space collapsed, so that Right’s offices were inaccessible. Right relocated without having access and incurred replacement costs and lost income from the interruption of operations. A local insurance policy, issued by ISOP’s French affiliate, provided primary coverage, and a master policy, issued by ISOP and covering Manpower’s operations worldwide, provided excess coverage over the local policy’s limits. Right received $250,000 under the local policy pursuant to a provision covering losses caused by lack of access by order of a civil authority. Another $250,000 was paid under the master policy, exhausting the $500,000 sublimit under a similar lack‐of‐access provision. Manpower also claimed that, under the master policy, it was entitled to reimbursement for business interruption losses and the loss of business personal property: about $12 million. ISOP denied the claim. The district court held that Manpower was covered under the master policy for business interruption losses and loss of business personal property and improvements, but excluded Manpower’s accounting expert, without whom Manpower could not establish those damages and held that the master policy was not triggered because the losses were also covered under the local policy, which had to be fully exhausted before master policy coverage was available. The Seventh Circuit reversed exclusion of the expert and entry of judgment against Manpower on the business interruption claim, but affirmed judgment for ISOP on the property loss claim. The master policy did not provide coverage for Manpower’s property losses.View "Manpower, Inc. v. Ins. Co. of the State of PA" on Justia Law

Appellants purchased property that was subject to a Master Plan that restricted the use and development of the property. Appellants obtained title insurance from Insurer, but the policy did not mention the Master Plan. Appellants only later learned of the Master Plan when they were informed they were in violation of the Master Plan and faced substantial penalties if they failed to comply with the Plan. Appellants sued Insurer, claiming a breach of the terms of the title insurance policy, negligence, and bad faith. The district court granted summary judgment in favor of Insurer on all claims brought in Appellants' complaint. The Supreme Court affirmed, holding that the district court did not err in entering judgment in favor of Insurer. View "Sonnett v. First Am. Title Ins. Co." on Justia Law