Justia Insurance Law Opinion Summaries

The insureds in this case filed suit against their insurers claiming they were unaware their insurance policy had a $250,000 per-claim deductible and alleging that the insurer breached its insurance contract by refusing to provide a defense until the they paid the $250,000 deductible for each of five separate claims. The circuit court granted summary judgment for the insurers and the insureds appealed. Upon review of the circuit court record, the Supreme Court affirmed the circuit court’s grant of summary judgment. View "Southern Healthcare Services, Inc. v. Lloyd's of London" on Justia Law

Pearl Archambault died while in the care of Haven Health Center of Greenville (Haven Health) after a nurse mistakenly administered a lethal overdose of morphine. The administratrix of her estate, Plaintiff, filed a medical malpractice action against Haven Health. Health Haven subsequently filed for Chapter 11 bankruptcy. Thereafter, Plaintiff amended her complaint to add Columbia Casualty Company, the professional liability insurer of Health Haven, as a defendant and asserted two counts against Columbia directly based on R.I. Gen. Laws 27-7-2.4, which permits an injured party to proceed against an insurer when the insured has filed for bankruptcy. The superior court entered default judgment against Haven Health. The court then granted summary judgment in favor of Columbia. The Supreme Court reversed and remanded with instructions to enter judgment against Columbia, holding that the superior court erred in interpreting Rhode Island law and that the insurance contract between Columbia and Health Haven should be construed in Plaintiff's favor. View "Peloquin v. Haven Health Ctr. of Greenville, LLC" on Justia Law

Dean Pepper, the owner and sole shareholder of D.F. Pepper Construction (DFP) was driving one of his trucks home in the early winter morning. An icy road caused the truck to slide into Pepper's house and crash through the foundation and west wall. The house was later condemned and demolished as a result of the damage. The house was insured by Nationwide Casualty Insurance Company. Nationwide paid the loss. As subrogee of Pepper, Nationwide then sued DFP, the registered owner of the truck, alleging vicarious liability for the negligence of its employee, Pepper. The superior court issued judgment in favor of Nationwide, finding that Pepper had been negligent and that the antisubrogation rule did not apply in this case. The Supreme Court affirmed, holding that the trial court did not err in its judgment. View "Nationwide Prop. & Cas. Ins. Co. v. D.F. Pepper Constr., Inc." on Justia Law

DWS Properties (DWS) owned rental property. The sole member of DWS was Dustin Shore. After a pipe burst at the property causing substantial damage, Shore executed contracts with Performance Adjusting Public Insurance Adjusters (Performance) and Multi-State Restoration (Multi-State), in which Performance agreed to provide public adjusting service relative to the loss, and Multi-State agreed to perform emergency clean-up work at the property. Performance and Multi-State (Plaintiffs) were never paid for the services they provided, and after Shore filed for personal bankruptcy, Shore's debts to Plaintiffs were discharged. Plaintiffs subsequently filed suit against DWS, seeking damages for book account, breach of contract, quasi-contract, and unjust enrichment. DWS filed a motion to dismiss, which the hearing justice converted into a motion for summary judgment and granted, reasoning that Shore had signed the contracts in an individual capacity without making any reference to DWS. The Supreme Court vacated the judgment of the superior court and remanded, holding (1) summary judgment was inappropriate on Plaintiffs' contract claims; and (2) the fact that DWS was not explicitly named on the contracts did not entitle it to judgment as a matter of law on Plaintiffs' equitable claims. View "Multi-State Restoration, Inc. v. DWS Props., LLC" on Justia Law

Jared Crook was driving a Cadillac leased for him by his father, Calvin Crook, when he collided with Jessica Ahlquist's vehicle. Ahlquist sustained severe personal injuries as a result of the accident. The Cadillac was insured by Calvin through a policy issued by Allstate Insurance Company. Allstate paid the policy limits, and Ahlquist sought to recover additional compensation through another Allstate policy issued to Cheryl, Calvin's former wife. The policy was issued for Cheryl's vehicle. Allstate filed a declaratory judgment action arguing that Cheryl's insurance policy did not apply to the accident. The trial justice granted summary judgment in Allstate's favor. Ahlquist appealed, contending that the trial justice erred in granting summary judgment because Calvin, who was a named driver under Cheryl's insurance policy, provided the Cadillac to Jared. Ahlquist also argued that there was an ambiguity as to whether the policy covered the accident. The Supreme Court affirmed, holding that the trial court did not err in its judgment. View "Allstate Ins. Co. v. Ahlquist" on Justia Law

The Hancock Center in Chicago is managed by Shorenstein (several related companies). Shorenstein hired an architectural firm, MCA, to design and oversee renovation of windows and exterior walls; MCA hired a general contractor. In 2002, a scaffold fell from the 42nd floor in a high wind and killed three people in cars, severely injuring several others. Shorenstein settled with plaintiffs in 2006 for a total of $8.7 million. MCA’s contract with Shorenstein had required MCA to obtain liability insurance covering the owner, Shorenstein, and any other party specified by the owner. MCA obtained the required insurance policy from AMICO, covering “any person or organization to whom [MCA is] obligated by virtue of a written contract.” There was a dispute concerning which Shorenstein entities were covered. Shorenstein was awarded $959,866.02 by the district court. The Seventh Circuit affirmed in part and reversed in part, holding that the court erred in apportioning the award among the Shorenstein entities. The court rejected AMICO’s arguments that the claim was barred by an exclusion of coverage for injuries “due to rendering or failure to render any professional service” by an insured and that Shorenstein gave up its right to indemnity by AMICO by asking its other insurer for indemnification. View "Nat'l Union Fire Ins. Co. of Pittsburgh v. Am. Motorists Ins. Co." on Justia Law

Basic Research, LLC marketed the weight-loss product Akavar. Customers who purchased Akavar filed lawsuits against Basic Research claiming false advertising, defective product, and failure to perform as promised. Basic Research was insured by Admiral Insurance under a policy that provided coverage for "personal and advertising injury." After the underlying claims were filed, Basic Research invoked its coverage and asked Admiral to defend it. Admiral refused to defend, alleging that the underlying claims were not covered by the terms of the policy. Thereafter, Basic Research brought this suit for declaratory relief. The district court granted Admiral's motion for summary judgment, finding that the underlying claims were specifically excluded from coverage. The Supreme Court affirmed, holding (1) the asserted claims were not covered by the policy and were in fact squarely excluded by its terms; and (2) therefore, Admiral had no duty to defend Basic Research. View "Basic Research, LLC v. Admiral Ins. Co." on Justia Law

An Arizona couple was injured on their motorcycle by another biker. The accident occurred in South Dakota. Because the other motorcyclist left the scene, the couple sought uninsured motorist benefits from their insurer. The couple's policy was issued in Arizona for a motorcycle registered and principally garaged in Arizona. The insurer tendered the policy's full uninsured motorist benefits of $15,000 per person. However, the couple would have recovered $25,000 per person in South Dakota had they been able to obtain the other biker's liability insurance. The circuit court declared that the terms of the Arizona insurance policy, rather than South Dakota law, governed the applicable coverage. The Supreme Court affirmed, holding that altering the terms of the parties' contracts in these circumstances was not supported by law. View "Milinkovich v. Progressive Cas. Ins. Co." on Justia Law

Gerald Kirchner accidentally shot and killed Robbie Bragg while both men were working for Grimmett Enterprises (Grimmett). Kirchner's mother, Barbara Surbaugh, filed a complaint against Bragg and Grimmett. The parties settled, after which Defendants assigned all claims they might have against their respective insurers for refusing to provide a defense and coverage. Thereafter, Surbaugh filed a declaratory judgment action against Grimmett's insurer, American States. Both parties filed motions for summary judgment. At issue was whether an employee exclusion in the policy was ambiguous and whether the exclusion had been brought to the attention of Grimmett. The circuit court denied the motions. After a jury trial, the circuit court concluded that the employee policy exclusion was unenforceable because the exclusionary language had not been brought to the attention of Grimmett. The Supreme Court reversed, holding that summary judgment should have been granted in favor of American States, as American States established at the summary judgment stage that no material issue of fact was in dispute as to the exclusion being unambiguous and disclosed to Grimmett. Therefore, the exclusion was enforceable. View "Am. States Ins. Co. v. Surbaugh" on Justia Law

Petitioners sought underinsured motorist coverage (UIM) under a policy issued by Auto-Owners Insurance Company (Owners) as a result of an automobile accident caused by an allegedly negligent driver of a rental vehicle owned by Avis Rent-a-Car (Avis). Avis, as a car rental company, was statutorily required to pay $50,000 as a result of the accident. Owners denied Petitioners' UIM claim, asserting that because Avis was a self-insurer, the rental vehicle was not an underinsured automobile under the terms of the policy. The circuit court ruled in favor of Owners, determining that Avis was unambiguously a self-insurer, and therefore, the Avis vehicle did not fall within the policy definition of underinsured automobile. The court of appeals affirmed. The Supreme Court reversed, holding (1) as applied, the policy term "self-insurer" is ambiguous, and therefore, the policy is interpreted in favor of Petitioners to afford coverage; and (2) even if the term "self-insurer" appears to be unambiguous, interpreting it to exclude self-insured rental vehicles from coverage leads to an absurd result here. Remanded. View "Bethke v. Auto-Owners Ins. Co." on Justia Law