Justia Insurance Law Opinion Summaries

The case arose following an insurance dispute between Travelers Property Casualty Company of America (“Travelers”) and Ocean Reef Charters LLC (“Ocean Reef”), a Florida Limited Liability Company. On cross-motions for summary judgment, the district court granted summary judgment for Travelers, agreeing with it that federal law applied and that Ocean Reef, therefore, forfeited its insurance coverage. On appeal, the Eleventh Circuit reversed, holding that under Wilburn Boat Co. v. Fireman’s Fund Insurance Co., Florida law applied. At issue is whether, under Florida’s anti-technical statute, the insurance company must prove that the breach of the Captain Warranty “contribute[d] to” the specific accident. Further, in meeting its burden of proof under Florida law, Travelers needed to introduce expert testimony in its case-in-chief about what would have been different if Ocean Reef had complied with the applicable warranties.   The Eleventh Circuit affirmed on remand. The court held Travelers offered no expert witness— such as a licensed captain competent to speak to the issue—to prove that the lack of a full-time captain and crew played a role in the destruction of the yacht during Irma. The court explained that the Captain—whom Travelers did not disclose as an expert witness—could not provide his opinion on what would have happened to the My Lady if a licensed, professional captain were employed full-time. He could discuss the weather forecasts he observed. But those facts would leave the jury to speculate about what a captain would have done differently to avoid the storm under the specific circumstances of this case. View "Travelers Property Casualty Company of America v. Ocean Reef Charters LLC" on Justia Law

This dispute began in 2016 when Defendants sued a motorist in state court for damages stemming from an automobile accident. The motorist fled the scene of the accident, was criminally charged for failing to provide his name, address, and insurance information, and pleaded nolo contendere to a criminal misdemeanor. The motorist was insured by Allstate Fire & Casualty Insurance Company (“Allstate”). Allstate paid Defendants claims for property damages, but Defendants rejected Allstate’s offers to resolve their physical injury claims, demanding the policy limit of $50,000. The district court determined that it had subject matter jurisdiction over the lawsuit, denying Defendants’ motion to dismiss pursuant to Federal Rule of Civil Procedure 12(b)(1). It subsequently granted summary judgment in favor of Allstate, finding that the motorist’s failure to cooperate in the underlying suit prejudiced Allstate and barred any legal obligation to pay Defendants the judgment amount of $163,822.   The Fifth Circuit affirmed the district court’s determination that it had subject matter jurisdiction. The court held that where the claim under the policy exceeds the value of the policy limit, courts considering declaratory judgments should ask whether there is a legal possibility that the insurer could be subject to liability in excess of the policy limit. The party seeking diversity jurisdiction should establish this possibility by a preponderance of the evidence. View "Allstate Fire and Casualty v. Allison Love" on Justia Law

Bennett, an oral and maxillofacial surgeon, purchased three disability income insurance policies from National in 1984, 1991, and 1995. Under the policies, monthly benefits were payable for life if he was totally disabled due to injury; if due to sickness, benefits would only be paid until the age of 65. National initially approved Bennett’s 2014 claim that he was totally disabled due to an injury sustained when thrown from his horse. In June 2015, National notified him of its determination that his disability was due to sickness, not an injury. National continued to pay disability benefits until September 2018, the policy year Bennett turned 65 years old.Bennett sued. The trial court granted National summary judgment, concluding his claims were barred by the statutes of limitation — four years for breach of contract and two years for breach of the implied covenant of good faith and fair dealing–both of which accrued when National issued an unconditional denial of liability in June 2015. The court of appeal reversed, agreeing with Bennett that his causes of action did not accrue until all elements — including actual damages — were complete. Bennett suffered no harm as of June 2015, because National continued to pay disability benefits. Only in September 2018 — when National began withholding benefits, and Bennett thereby incurred damages — did his causes of action accrue. View "Bennett v. Ohio National Life Assurance Corp." on Justia Law

Plaintiffs brought this action against West Bend Mutual Insurance Company (“West Bend”) after West Bend refused to pay claims for uninsured/underinsured (“UM/UIM”) benefits under an insurance policy that insured Plaintiffs. The district court granted summary judgment in favor of West Bend. Plaintiffs contended the district court erred in concluding that British Columbia law rather than Iowa law determines the extent of Plaintiffs’ recoverable damages under the Policy.   The Eighth Circuit affirmed. The court explained that while Plaintiffs assert contract conflict of laws principles set forth in the Restatement (Second) of Conflict of Laws (“Restatement”) require that Iowa law determine the extent of their recovery, Hall v. Allied Mutual Insurance Co specifically held that no conflict of laws problem exists when the tortfeasor is only subject to personal jurisdiction in courts that would apply identical law. Further, the court wrote that Section 516A.1 only requires that insurance companies offer the type of coverage at issue in this case. The statute does not define what it means for an insured to be “legally entitled to recover” damages from an uninsured or underinsured motorist such that it could abrogate Hall. Finally, the court found that the plain language of this provision provides only that West Bend may “reduce” its otherwise applicable coverage by certain other amounts available. Where, as here, the insurer has no liability under the Policy’s coverage provisions, the Available Insurance Provision does not operate as an affirmative grant of coverage extending to what are otherwise uncovered losses. View "Gregg Geerdes v. West Bend Mutual Insurance Co." on Justia Law

The Supreme Court affirmed the decision of the court of appeals in this insurance dispute over damages allegedly caused by the poor construction of an in-ground pool, holding that this Court overrules the portions of Wisconsin Pharmacy Co. v. Nebraska Cultures of California, Inc., 876 N.W.2d 72 (Wis. 2016), stating that "property damages" must be to "other property" for purposes of determining an initial grant of coverage in a commercial general liability (CGL) policy.Due to the damages caused by the cracking of Homeowner's pool, Homeowner was forced to demolish the entire pool structure and construct a new one. Two insurers on appeal had issued CGL policies to the pool's general contractor, and a third insurer issued a CGL policy to the supplier of the pump mix used for the pool's construction. All three insurers sought a declaration that their policies did not provide coverage to Homeowner. The Supreme Court held, under the circumstances of this case, that none of the insurers were entitled to summary judgment and accordingly remanded the cause back to the circuit court for further proceedings. View "5 Walworth, LLC v. Engerman Contracting, Inc." on Justia Law

After Wynndalco Enterprises, LLC was sued in two putative class actions for violating Illinois’ Biometric Information Privacy Act (“BIPA”), its business liability insurer, Citizens Insurance Company of America, filed an action seeking a declaration that it has no obligation under the terms of the insurance contract to indemnify Wynndalco for the BIPA violations or to supply Wynndalco with a defense. Citizens’ theory is that alleged violations of BIPA are expressly excluded from the policy coverage. Wynndalco counterclaimed, seeking a declaration to the contrary that Citizens is obligated to provide it with defense in both actions. The district court entered judgment on the pleadings for Wynndalco.   The Seventh Circuit affirmed. The court explained that the narrowing construction that Citizens proposes to resolve that ambiguity is not supported by the language of the provision and does not resolve the ambiguity. Given what the district court described as the “intractable ambiguity” of the provision, the court held Citizens must defend Wynndalco in the two class actions. This duty extends to the common law claims asserted against Wynndalco in the other litigation, which, as Citizens itself argued, arise out of the same acts or omissions as the BIPA claim asserted in that suit. View "Citizens Insurance Company of America v. Wynndalco Enterprises, LLC" on Justia Law

The Supreme Court affirmed the judgment of the court of appeals denying State Farm Mutual Automobile Insurance Company's petition for a writ of prohibition to prevent Judge Brian Edwards of the Jefferson Circuit Court from enforcing certain discovery orders, holding that State Farm was not entitled to the writ.Betty Irvin was involved in an automobile collision with Deborah Combs, who was insured by State Farm. Irvin brought suit, alleging a negligence claim against Combs and a third-party statutory bad faith claim under Kentucky's Unfair Claims Settlement Practices Act, Ky. Rev. Stat. 304.12-230, against State Farm. The trial court bifurcated the bad faith claim against State Farm from the other claims. Later, State Farm filed this petition seeking to prevent Judge Edwards from enforcing his discovery orders on the grounds that Irvin's bad faith claim against it was not yet ripe. The court of appeals denied the writ petition. The Supreme Court affirmed, holding that the court of appeals did not err. View "State Farm Mutual Automobile Insurance Co. v. Honorable Edwards" on Justia Law

Dr. Robert P. Rothenberg (Rob) tragically suffered a fatal heart attack prior to paying the initial premium on his term life insurance policy issued by Principal National Life Insurance Company (Principal). Principal filed this action in the district court, seeking a declaratory judgment that Appellant— the policy’s intended beneficiary—was not owed death benefits in light of the nonpayment. Appellant filed a counterclaim, asserting claims against Principal for breach of contract, vexatious denial of proceeds, and negligence, as well as claims against Appellee, the couple’s insurance broker and financial planner, for negligence. After the parties filed cross-motions for summary judgment, the district court granted summary judgment in favor of Principal and Appellee, finding, in part, that the policy was not in effect at the time of Rob’s death. Appellant appealed, arguing that the district court erred in concluding (1) that the Policy was not in effect at the time of Rob’s death and (2) that, assuming the Policy was not in effect, neither Principal nor Appellee were negligent because neither owed a duty to Appellant.   The Eighth Circuit affirmed. The court explained that Appellant did not pay the initial premium until after Rob’s death, at which time he was not in a similar state of health as when he applied for the policy. Moreover, any “privileges and rights” Rob (or Appellant) had to retroactively effectuate the Policy were terminated at Rob’s death pursuant to the Policy’s termination provision. Second, Rob’s signature on the EFT Form alone did not render the Policy effective on April 26, 2019, or earlier. View "Principal National Life Insurance Company v. Donna Rothenberg" on Justia Law

Two individuals were involved in a car accident in St. Louis, Missouri. One of the cars crashed into White Knight Diner, resulting in property damage to the restaurant. At the time, White Knight was insured by Owners Insurance Company (Owners)pursuant to a policy that provided coverage for property damage and loss of business income (the Policy). After the insurers brought several motions to dismiss, the district court dismissed all parties except for Owners and White Knight. White Knight then filed an amended complaint against Owners only, adding new causes of action, including breach of contract and breach of the implied covenant of good faith and fair dealing. Owners filed a motion for summary judgment on all claims. The district court granted Owners’ motion. White Knight appealed, arguing that disputed material facts remain as to whether Owners’ subrogation efforts were conducted in breach of the Policy.   The Eighth Circuit affirmed. The court explained that even assuming Owners’ actions were taken pursuant to the Policy, White Knight’s claim still fails because it does not establish that it suffered any damages as a result of Owners’ failure to abide by the contracted-for procedures. White Knight, as an insured party under the Policy, contracted for and paid premiums to receive insurance. And Owners settled White Knight’s claim under the Policy when Owners paid White Knight a total of $66,366.27 for property damage and business income loss. White Knight has not shown that it suffered any damages beyond the compensation it received from Owners. Without evidence of damages, a breach of contract claim fails. View "White Knight Diner, LLC v. Owners Insurance Company" on Justia Law

AM Grand Court Lakes LLC and AM 280 Sierra Drive LLC (collectively “AM Grand”) owned a group of buildings that were operated as an assisted living facility. AM Grand submitted a claim to its insurer, Rockhill Insurance Company, for damage caused by Hurricane Irma. Rockhill denied the claim because it determined that the hurricane caused only minor damage to the property. AM Grand sued Rockhill for breach of the policy. The case went to trial, where a jury found that Rockhill had breached the terms of the insurance policy and that AM Grand’s covered losses amounted to $9,280,000. Based on the jury’s findings, the district court entered judgment in AM Grand’s favor. After the district court entered judgment, Rockhill filed a motion for a new trial arguing that the jury’s damages award was excessive. The district court denied the motion. Rockhill argues on appeal that the district court erred in denying its motion for a new trial because there was no evidence in the record to support the jury’s finding that AM Grand sustained a loss of $9,280,000.   The Eleventh Circuit affirmed, holding that the evidence was sufficient to sustain the verdict. The court held that Rockhill is correct that the amount of damages depended on the extent to which AM Grand’s buildings were damaged in Hurricane Irma. But the court disagreed that the jury’s options were as limited as Rockhill describes. Instead, the court concluded—based on the evidence presented at trial—that the verdict was within the range of damages that a jury reasonably could have awarded. View "AM Grand Court Lakes LLC, et al. v. Rockhill Insurance Company" on Justia Law