Justia Insurance Law Opinion Summaries

An Oklahoma City car dealer, Automax Hyundai South, sued its insurance company for refusing to defend it when the dealership was sued by customers. Two aggrieved customers brought claims against Automax relating to car purchases they made. The customers won their cases at the state court. The district court ruled that the insurance company had no duty to defend or indemnify Automax in the underlying lawsuits. Upon review of the district court record and the policy at issue, the Tenth Circuit agreed with Automax and concluded the insurance company had a duty to defend. View "Automax v. Zurich, et al" on Justia Law

William Shapley appealed the district court’s dismissal of his breach of contract and negligence claims against Centurion Life Insurance Company and Wells Fargo Financial. Shapley and his wife applied for credit life insurance with Centurion on the same day they closed on a real estate loan with Wells Fargo. The Shapleys were provided with a notice of insurance underwriting practices. The application papers stated that the Shapleys would receive insurance coverage only if Centurion approved their application. Centurion never had a chance to have a phone interview with Mrs. Shapley (a requirement for the policy). The day after the Shapleys closed on their loan, Mrs. Shapley suffered a brain hemorrhage from which she died four days later. Mr. Shapley contacted Centurion the same day to claim benefits in connection with Mrs. Shapley’s passing. Centurion denied the claim because it never issued an insurance policy on Mrs. Shapley. Because the interview never took place, Centurion issued insurance solely to Mr. Shapley. Mr. Shapley argued on appeal that the district court's dismissal was in error. Upon review, the Supreme Court affirmed the district court’s decisions, finding that while the district court incorrectly concluded that there must be a contract for estoppel to apply, the denial of Mr. Shapley’s motion to amend was appropriate because his estoppel claim was futile. View "Shapley v. Centurion Life Ins Co" on Justia Law

Plaintiff filed a complaint against State Farm, alleging that State Farm was intentionally engaging in delaying tactics to avoid paying on insurance policies. The court affirmed the district court's grant of summary judgment as to any breach of contract claim. Because plaintiff established, as a matter of law, that State Farm had no arguable or legitimate basis for certain periods of delay, she was entitled to present her compensatory damages claim to a finder of fact upon remand. The court reversed the district court's summary judgment as to plaintiff's bad faith claims and remanded for further proceedings. View "James v. State Farm Mutual Auto Ins. Co." on Justia Law

Plaintiff filed suit seeking interest on benefits she received under an Accidental Death and Dismemberment (ADD) insurance policy issued by Hartford. The parties disagreed on whether Tennessee law or Missouri law applied. Plaintiff did not dispute Hartford's argument that under Missouri law and the policy language, Hartford paid the benefit to her when it was payable. Accordingly, the court concluded that plaintiff was not entitled to interest under Missouri law. Assuming Tennessee law applied, the court relied on Performance Sys., Inc. v. First Am. Nat'l Bank, to conclude that the Tennessee Supreme Court would likely construe "due" in Tenn. Code Ann. 7-14-109(b) to mean the time of payment designated in the policy, not the date of loss. In this instance, Hartford paid the benefit to plaintiff within the time of payment designated in the policy and, therefore, plaintiff was not entitled to interest under subsection (b). Accordingly, the court affirmed the judgment. View "Williamson v. Hartford Life & Accident, etc." on Justia Law

Lisbeth Cherrington entered into a contract with the Pinnacle Group for the construction of a home. Anthony Mamone worked with Cherrington during the contract and construction process. After the construction was completed, Cherrington filed this action against Pinnacle and Mamone, alleging, inter alia, negligence, misrepresentation, and breach of fiduciary duty. Pinnacle and Mamone requested Erie Insurance Property and Casualty Company, with whom they had insurance policies, to provide coverage and a defense. Because Erie denied both coverage and a duty to defend, Pinnacle and Mamone filed a third-party complaint against Erie seeking a declaration of the coverage provided by their policies. The circuit court granted Erie's motion for summary judgment, finding that the three policies issued to Pinnacle and Mamone did not provide coverage for the injuries and property damage allegedly sustained by Cherrington. The Supreme Court (1) affirmed the circuit court's finding that neither Mamone's homeowners policy nor his umbrella policy provided coverage under the facts of this case; but (2) reversed the circuit court's ruling finding no coverage to exist under Pinnacle's commercial general liability policy. Remanded. View "Cherrington v. Erie Ins. Prop. & Cas. Co." on Justia Law

This diversity case involved a dispute over insurance coverage between Starr and SGS. The district court, relying on Matador Petroleum Corp. v. St. Paul Surplus Lines Ins. Co., held that Starr did not need to show prejudice before denying coverage to SGS for late notice under the pollution buy-back provision. Bound by Matador, which concluded that a notice requirement in this type of supplemental pollution endorsement was essential to the bargained-for coverage, the court affirmed the judgment and found SGS's arguments unpersuasive. View "Starr Indemnity & Liablity Co. v. SGS Petroleum Serv. Corp." on Justia Law

This appeal arose out of an allision between a vessel owned by Settoon and an oil well. On appeal, Settoon challenged the district court's grant of summary judgment in favor of the umbrella insurers. The court concluded that the umbrella insurers were not liable for damages resulting from the allision because Settoon failed to provide them notice within 30 days; SNIC was liable to Settoon because delayed delivery prevented SNIC from relying on the exclusions in the policy and the conditions precedent of the exceptions to the exclusions; and prejudgment interest should be calculated from the date Settoon paid for the allision. Accordingly, the court reversed and remanded for calculation of prejudgment interest and affirmed the district court's judgment in all other respects. View "In Re: Settoon Towing, L.L.C." on Justia Law

The United States District Court for the Northern District of Georgia certified two questions to the Georgia Supreme Court. The questions related to the Automobile Insurance Company of Hartford Connecticut's umbrella policy issued to Louis and Betty Wilson. At the time, Georgia law required policies to have uninsured motorist coverage unless the insured rejected that coverage in writing. The Wilsons did not reject uninsured motorist coverage; their policy excluded such coverage despite being required by law. Because it was not written into the policy but required, it was implied by operation of law. In 2010, Louis Wilson was seriously injured in an accident, and gave notice of a claim for uninsured motorist benefits. The insurance company denied the claim, contending that a 2008 amendment to the Georgia law specifically excluded umbrella policies from mandatory uninsured motorist coverage. The questions from the federal court centered on whether the amendment to the applicable Georgia law applied to the Wilson's umbrella policy after 2009, and whether the notice requirements of the amended law applied to umbrella policies. After review, the Georgia Court concluded that the amendment in question here did not apply to the Wilson's umbrella policy, nor did the notice requirement. View "Wilson v. Automobile Insurance Co. of Hartford, Connecticut" on Justia Law

Plaintiff, an in-home registered nurse, was injured in an automobile accident while driving her employer's vehicle to to a patient's home to perform her nursing duties. Plaintiff incurred $382,849 in medical expenses as a result of the accident. After Plaintiff's employer's workers compensation carrier (AIG) denied Plaintiff's workers compensation claim, Plaintiff filed a medical payments claim with Allstate, with whom Plaintiff had a personal automobile insurance policy that provided $100,000 in medical payments coverage. Allstate failed to provide medical payments benefits immediately to Plaintiff. Plaintiff and AIG later settled Plaintiff's worker's compensation claim for $150,000. Plaintiff then commenced this breach of contract and bad faith action against Allstate based on Allstate's failure to pay medical benefits. The circuit court granted judgment as a matter of law for $33,000 on the breach of contract claim and awarded $150,000 in compensatory damages and $1,500,000 in punitive damages on the bad faith claim. The Supreme Court reversed in part, holding that the circuit court erred in excluding Allstate's evidence of AIG's acceptance of the worker's compensation claim, and that exclusion prejudiced Allstate's ability to defend the bad faith and punitive damages claims. View "Bertelsen v. Allstate Ins. Co." on Justia Law

Doe Run commenced a declaratory action seeking to enforce Lexington's contractual duty to defend Doe Run per its Commercial General Liability (CGL) policies in two underlying lawsuits (the Briley Lawsuit and the McSpadden Lawsuit). These underlying lawsuits sought damages arising out of Doe Run's operation of a five-hundred-acre waste pile (Leadwood Pile). The court concluded that the pollution exclusions in the CGL policies precluded a duty to defend Doe Run in the Briley Lawsuit. The court concluded, however, that the McSpadden Lawsuit included allegations and claims that were not unambiguously barred from coverage by the pollution exclusions in the policies. The McSpadden Lawsuit alleged that the distribution of toxic materials harmed plaintiffs, without specifying how that harm occurred. The McSpadden complaint also alleged that Doe Run caused bodily injury or property damage when it left the Leadwood Pile open and available for use by the public without posting warning signs. Accordingly, the court affirmed in part, reversed in part, and remanded. View "Doe Run Resources Corp. v. Lexington Ins. Co." on Justia Law