Justia Insurance Law Opinion Summaries

Heath and Vail Freyer, the parents of Alicia Freyer, were all riding in their vehicle, which was insured by State Farm, when the vehicle rolled over, causing Health's death. In Freyer I, the Court held that the subject policy provided coverage for Alicia's claim for derivative damages stemming from Health's death. After remand, State Farm paid the disputed coverage amounts. The Freyers then brought claims against State Farm for the wrongful denial of coverage for Alicia's derivative claims. The district court granted summary judgment to State Farm. The Supreme Court reversed in part and affirmed in part, holding that the district court (1) erred in concluding that State Farm had not breached the insurance contract when it failed to indemnify Vail for Alicia's derivative claims based on State Farm's "reasonable basis in law" defense; (2) properly granted summary judgment to State Farm on the common-law bad faith and breach of the covenant of good faith and fair dealing claims; and (3) did not err in granting summary judgment to State Farm on the Unfair Trade Practices Act claims. View "State Farm Mut. Auto. Ins. Co. v. Freyer" on Justia Law

YA, a nonprofit corporation serving at-risk youth, transported young people to an event using vans that it owned. After the event four people were unable to board because a van was full. A YA employee requested that 16-year-old Lee, a YA participant who had driven to the event in a separate vehicle, drive them home. Lee agreed. Lee did not possess a valid driver’s license and the car that he was driving had been stolen during a carjacking. Police saw Lee driving erratically, ran a license plate check, and gave chase. Lee lost control and hit a tree. Lee survived, but all four passengers were killed. Their estates filed suit. YA requested defense and indemnification under policies issued by Indemnity: a commercial general liability policy with a $1 million limit and a commercial excess liability policy with a $2 million limit. Indemnity provided a defense, but disputed coverage and sought a federal declaratory judgment. YA counterclaimed that Indemnity breached its duty of good faith and violated the Kentucky Unfair Claims Settlement Practices Act, by misrepresenting coverage and failing to affirm liability within a reasonable time. The district court held that Indemnity was obligated under the CGL policy but not under the excess policy. The state court action settled with Indemnity’s payment of the $1 million limit of the CGL policy, plus $800,000 of the excess policy. The federal court dismissed the bad-faith counterclaims, reasoning that, as a matter of law, Indemnity’s coverage position had not been taken in bad faith. The Sixth Circuit affirmed. View "Philadelphia Indem. Ins. Co. v. Youth Alive, Inc." on Justia Law

Defendant was insured under three homeowners' policies issued to his parents (the Zamskys) by Plaintiff. Each policy covered a separate parcel of residential real estate owned by the Zamskys and required Plaintiff to defend and indemnify the insureds against claims stemming from bodily injury caused by a covered occurrence. One exclusion to the policy, the UL exclusion, pretermitted coverage for injuries arising out of a premises owned by an insured but not itself an "insured location." This case involved an fire that occurred on a piece of real estate owned by the Zamskys that was not insured by Plaintiff. An individual injured in the fire sued Defendant for bodily injuries. Plaintiff subsequently brought this declaratory judgment action seeking a declaration that the UL exclusions pretermitted its obligation to defend Defendant in the negligence suit or to indemnify him against any damage award. The district court held that the UL exclusion did not apply and that Plaintiff owed Defendant a duty to defend. The First Circuit Court of Appeals affirmed, holding that because the occurrence at issue here did not arise out of a condition of the premises, the district court did not err in determining that the UL exclusion did not apply. View "Vt. Mut. Ins. Co. v. Zamsky" on Justia Law

Petitioners, who had a liability policy with State Farm, were involved in a motor vehicle accident. Petitioners filed an underinsured motorist claim with State Farm. Based on the absence of underinsurance coverage in Petitioners' policy, State Farm denied coverage. Petitioners filed a complaint against State Farm, asserting that a "knowing and intelligent" waiver of underinsurance coverage had not occurred. The circuit court granted Petitioners' motion for partial summary judgment, concluding (1) State Farm's underinsured motorist selection/rejection form did not precisely comply with the state Insurance Commissioner's prescribed form; and (2) State Farm's failure to use the Commissioner's prescribed forms resulted in underinsured motorists coverage being added to the policy as a matter of law. The Supreme Court answered the circuit court's certified question by holding that an insurance company's failure to use the Commissioner's prescribed forms pursuant to W. Va. Code 33-6-31(d) results in the loss of the statutory presumption that the insured provided a reasonable offer which was knowingly rejected and a reversion to the lower standards set forth in Bias v. Nationwide Mutual Insurance Co. View "Thomas v. McDermitt" on Justia Law

Plaintiffs Kylie and Michael D. Shuba appealed the Superior Court's denial of their cross-motion for summary judgment and its grant of summary judgment in favor of Defendant United Services Automobile Association's ("USAA") motion for summary judgment. The Shuba's sought to be covered persons for the wrongful death of their mother under an insurance policy issued by USAA and held by the Shubas' step-mother. It was undisputed that their mother was not a named insured under the policy or a resident of the stepmother's household as the Shubas were. The Shubas claimed the trial court erred in finding the Shubas could not recover uninsured motorist benefits under the USAA policy. In making their claim, the Shubas asked the Supreme Court to overrule two Superior Court cases, "Temple v. Travelers Indemnity Co" and "Adams-Baez v. General Accident Co.," the latter of which the Supreme Court affirmed based on the trial court opinion. The Supreme Court declined to overrule those cases as precedent, and affirmed the Superior Court's judgment. View "Shuba v. United Services Automobile Association" 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

Plaintiff sued the servicer of his loan (Bank) in a putative class action, asserting that the Bank's requirement that he maintain flood insurance coverage in an amount sufficient to cover the replacement value of his home breached the terms of his mortgage contract. The mortgage was insured by the Federal Housing Administration (FHA). Specifically, Defendant contended that the Bank, under a covenant of the mortgage contract, could not require more than the federally mandated minimum flood insurance. The covenant was a standard uniform covenant prescribed by the FHA pursuant to federal law. The district court dismissed the complaint for failure to state a claim. The judgment of dismissal was affirmed by an equally divided en banc First Circuit Court of Appeals, holding that Plaintiff failed to state a claim for breach of contract, as (1) the Bank's reading of the contract was correct and Plaintiff's was incorrect; (2) Plaintiff could not avoid dismissal on the grounds that his specific understanding or the actions of the parties created an ambiguity; and (3) the United States' position articulated in its amicus brief, which stated that Plaintiff's interpretation of the contract was incorrect, reinforced the Court's conclusion. View "Kolbe v. BAC Home Loans Servicing, LP" on Justia Law

Plaintiff was a Pennsylvania resident who was injured in Kentucky. Plaintiff's daughter, with whom Plaintiff resided, was driving the vehicle involved in the accident. Plaintiff brought suit against her insurance carrier, State Farm Mutual Automobile Insurance Company, for underinsured motorist (UIM) coverage under a policy issued in Pennsylvania and covering a vehicle that Plaintiff registered and used exclusively in Pennsylvania. The trial court and court of appeals concluded that Pennsylvania law governed the dispute between Plaintiff and State Farm, but the two courts reached different results. The trial court concluded that Plaintiff was not entitled to UIM coverage because her policy disallowed coverage when she was injured in an underinsured vehicle owned or regularly used by a "resident relative." The court of appeals found Kentucky public policy would prohibit enforcement of the policy provision and concluded Plaintiff was entitled to UIM coverage despite the plain language of her policy. The Supreme Court reversed, holding (1) Pennsylvania law applied to this dispute; and (2) there was no prohibition on the type of UIM exclusion at issue in this case. View "State Farm Mut. Ins. Co. v. Hodgkiss-Warrick" on Justia Law

Bennett was walking her dog in Garfield Heights, Ohio when she was struck on the left knee by a vehicle driven by Pastel. The accident threw Bennett onto the car’s hood. Bennett sued Pastel’s insurer, State Farm, which characterized as “ridiculous” her assertion that she was an “occupant” of the car, as that term is defined by State Farm’s policy, at the time she was on the vehicle’s hood. The district court granted summary judgment to State Farm. The Sixth Circuit reversed. The policy defines “occupying” as “in, on, entering or alighting from.” The court stated that “we have no reason to explore Bennett’s relationship with the car… the policy marks out its zone of coverage in primary colors.” View "Bennett v. State Farm Mut. Auto. Ins." on Justia Law

Claimant suffered a lower back injury during the course of his employment and filed notice of a workers' compensation claim. Employer later informed Claimant he would be discharged from his employment. Claimant signed a termination agreement in order not to forfeit his severance pay. The agreement stipulated that Claimant released his previously accepted workers' compensation claim. The Workers' Compensation Commissioner refused to approve the termination agreement, finding there was no consideration offered by Employer to Claimant in exchange for Plaintiff's release of the workers' compensation clim. The Workers' Compensation Review Board affirmed. The Supreme Court affirmed, holding that the Board properly affirmed the Commissioner's decision not to approve the agreement as a "voluntary agreement" or stipulation in light of its finding that Claimant's release of his workers' compensation claim was not supported by consideration. View "Leonetti v. MacDermid, Inc." on Justia Law