Justia Insurance Law Opinion Summaries

These consolidated appeals arose from the same facts: in 1990, Richard L. Parker applied to American Family Life Assurance Company of Columbus (Aflac) for a cancer-indemnity insurance policy. Aflac issued Parker a policy. The term of the 1990 policy was month-to-month; the monthly premium was $28.50. Aflac received payments for the 1990 policy from August 25, 1990, to August 17, 1996. Parker applied for a new policy in May 1996 for when the 1990 policy was set to terminate. The 1996 policy took effect August 16, 1996, and used the same number as the 1990 policy. Parker renewed the policy once again in 2009, but the 2009 policy contained an arbitration clause. By a special waiver, the 2009 policy's language stated that Parker would give up his "current" policy and its benefits for the benefits in the new one. Parker paid according to the term of the 2009 policy. But in 2010, Parker sued Aflac asserting a claim of bad faith for Aflac's alleged failing to pay policy benefits owed under the 1990 policy. Aflac responded by filing a motion to compel arbitration according to the terms of the 2009 policy. The circuit court conducted a hearing on the motion and denied it. Upon review, the Supreme Court concluded that Aflac satisfied its burden of proving that an arbitration agreement existed that applied to Parker's claims against it. Because there was no issue as to whether the contract containing the arbitration agreement affected interstate commerce, the burden then shifted to Parker to offer evidence refuting the evidence offered by Aflac and Hunter; Parker offered no evidence to refute that evidence and presented "no persuasive argument" that Aflac failed to meet its burden. The Court reversed the circuit court's decision and remanded the case for further proceedings.

In 2008, MDS purchased a vessel and executed a note in favor of FirstBank, secured by a preferred ship mortgage, under an agreement that required that they maintain insurance. In 2009, Customs and Border Protection seized the vessel as part of a drug enforcement action. The search and seizure damaged the vessel, significantly decreasing its value. Customs notified FirstBank, which initiated an administrative forfeiture proceeding, intervened in the criminal case, obtained voluntary dismissal of the indictment against the vessel, then submitted an insurance claim for "loss of the vessel including, without limitation, the value of the Bank's collateral, legal fees incurred in attempting to secure its release, as well as any applicable costs and interests." The insurer denied the claim. The district court granted FirstBank partial summary judgment and awarded $74,512.50 in attorneys' fees for costs and expenses incurred in securing release of the vessel and defending the validity of the policy. The First Circuit affirmed, finding no genuine issues of material fact.

Vicor manufacturers electronic equipment, including power converters. Ericsson designs, manufactures and sells electronic equipment, including radio base stations (RBSs) used to operate cellular telephone towers and networks. Ericsson purchased Vicor power converters for use in RBSs sold to wireless providers worldwide. The power converters began failing due to a manufacturing change in a component computer chip. Severe outages occurred in wireless networks. Ericsson sued Vicor and obtained a settlement of $50 million. Vicor's insurers paid $13 million. Vicor sought the additional $37 million. A jury awarded $17.3 million. The district court reduced the verdict by $4 million. The First Circuit vacated. The policies refer to "loss of use of property that is not physically injured." The district court should fashion jury instructions making clear that classic loss of use damages (lost profits or rental value of substitute property) incurred while repairs are pending may be recovered, but the actual costs of repairs may not. The court also may instruct the jury regarding the duty to mitigate loss and explain that costs of reasonable mitigation measures are recoverable, provided that the mitigation measures are distinguishable from ordinary repairs and result in a net savings.

In 1989 Dominguez was arrested and in 1990 he was convicted of home invasion and sexual assault. In 2002 he was exonerated by DNA; in 2005 he received a pardon. Under Illinois law, his claim for malicious prosecution accrued in 2002. Under federal law, constitutional claims (42 U.S.C. 1983) accrued in 1989 and 2002. Wrongful arrest claims accrue on the date of arrest, but wrongful conviction claims accrue when conviction is invalidated. The Seventh Circuit affirmed an award of about $9 million for malicious prosecution and concealment of exculpatory evidence. The city has been insured by different companies and each asserted that the policy for another year applied. None provided a defense. The district court held that the issuer of the "occurrence" policy in force at exoneration must defend and indemnify. The Seventh Circuit affirmed. The city's misconduct occurred in 1989 and 1990, but the policy does not define the "occurrence" as misconduct by a law-enforcement officer. It defines the occurrence as the tort under state or federal law, and, in both, the tort occurs witn its last element, exoneration. Until then, Dominguez could not establish "malicious prosecution" or "violation" of section 1983.

In 2009, fire severely damaged the insureds' home. They submitted a claim to under their homeowners’ policy the next day. The insurer began requesting documents, authorizations, and interviews and learned that the insureds had at least two businesses, held numerous personal and business accounts, and were involved in several lawsuits. A fire investigator concluded that the fire was intentionally set. The insurer requested additional documents: detailed phone records, bank histories, tax returns, and mortgage information and reminded the insureds that proof of loss was due by May 2. The insurer granted extensions; on the day of the final deadline the insureds delivered almost 1,000 pages of documents. Several months later, the insurer had not received most of the requested documents or an explanation why they could not be produced. After initially acknowledging their failure to produce the documents, the insureds attempted to impose a deadline for settlement of the $2.6 million claim. The district court entered summary judgment for the insurer in the insureds' breach of contract suit. The Seventh Circuit affirmed. The insureds failed to perform the specific "duties after loss" listed in the policy.

In an insurance coverage dispute, the court was required to determine, under Florida law, what constituted "property damage" under a post-1986 standard form commercial general liability (CGL) policy with products-completed operations hazard (PCOH) coverage. Specifically, whether such a policy issued to a general contractor for damage to the part of the completed project performed by a subcontractor, but not to any other project component, caused by a subcontractor's defective work. In light of Florida precedent addressing the scope of similar CGL policies, the court concluded that the policy provided no coverage in this case. Therefore, the court affirmed the judgment of the district court, holding that the damage at issue was not covered under the policy.

Insured held a life insurance policy issued as part of a federal employee benefit plan. When Insured divorced from his first wife, the divorce decree and property settlement required Insured (1) to maintain the life insurance policy, and (2) to designate the first wife and their grandchildren as equal beneficiaries. Subsequently, Insured remarried, designated his second wife as the sole beneficiary to the life insurance policy, and increased the insurance coverage. Insured and second wife later divorced. When Insured died, the second wife remained the sole beneficiary on the life insurance policy. The first wife and grandchildren filed suit, asserting equitable claims over the life insurance proceeds. The trial court granted summary judgment to the second wife, determining that federal employee benefit law preempted the equitable state law claims and that the policy proceeds accordingly belonged to the second wife. The Supreme Court reversed, holding that the Federal Employees' Group Life Insurance Act did not preempt the equitable claims and that the first wife and grandchildren were entitled to a constructive trust over at least a portion of the proceeds. Remanded.

Joel and Evelyn Hirschhorn filed suit against their homeowners insurer, Auto-Owners Insurance Company, for breach of contract and bad faith, claiming that Auto-Owners was liable for the total loss of their vacation home. The Hirschhorns alleged that their vacation home became uninhabitable and unsaleable as a result of the accumulation of bat guano between the home's siding and walls. The circuit court granted summary judgment in favor of Auto-Owners, concluding that Auto-Owners' insurance policy's pollution exclusion clause excluded coverage for the Hirschhorns' loss. The court of appeals reversed, concluding that the pollution exclusion clause was ambiguous and therefore must be construed in favor of coverage. The Supreme Court reversed, holding that the circuit court properly dismissed the Hirschhorns' complaint against Auto-Owners, as the pollution exclusion clause excluded coverage for the loss of the Hirschhorns' home that allegedly resulted from the accumulation of bat guano.

In April and June of 2008, Best of the Best Auto Sales, Inc. purchased seven vehicles from Dealers Auto Auction of Idaho and Brasher's Idaho Auto Auction with checks that were returned for insufficient funds. As a result, Dealers and Brasher refused to provide Best of the Best with the titles to the vehicles. Best of the Best then sold the vehicles to Idaho consumers without providing them with titles. Dealers and Brasher filed claims with CNA Surety d/b/a Western Surety Company which acted as a surety for a "$20,000 Vehicle/Vessel Dealer Bond." Best of the Best was the principal. Upon Best of the Best's failure to provide evidence or defenses for Dealers' and Brasher's claims, Western Surety alleged that it lawfully settled those claims in good faith upon the condition that the consumers received their titles, even though they were not based on final judgments. Plaintiff Nick Hestead submitted his claim, which was based on a final judgment. Plaintiff's claim involved fraud and fraudulent representation concerning a separate vehicle that he purchased from Best of the Best that was previously branded a lemon in California. Western Surety responded by asserting that the Dealer Bond was exhausted. Plaintiff contended that the plain meaning of I.C. 49-1610(4) provides that his claim should be given priority because it was submitted thirty days after a final judgment was entered, unlike Dealers' and Brasher's claims. Western Surety asserted that the plain meaning of I.C. 41-1839(3) permits sureties to settle Dealer Bond claims in good faith. Upon review, the Supreme Court found that the payments on the surety bond were lawfully made in good faith pursuant to I.C. 49-1610(1) and I.C. 41-1839(3) because Dealers' and Brasher's claims were undisputed and supported by competent evidence.

This declaratory judgment action was brought by Secura, an insurer for Horizon, a subcontractor on a troubled construction project. Horizon's two other insurers, State Auto and Federated later joined. Their dispute with Weitz arose out of a construction project in which Weitz was the general contractor for Metropolitan. After Weitz and Metropolitan brought breach of contract claims against each other, both filed third party complaints against Horizon for defective plumbing. Horizon's insurers defended and settled all claims against it and reimbursed Weitz for its defense of claims against Horizon. Weitz then contended that since it was an "additional insured" on Horizon's policies, the insurers should pay for attorney fees and costs it incurred in defending against Metropolitan's entire counterclaim. The insurers filed this action seeking a final judgment that they not be required to pay the attorney fees and costs. Applying Missouri law, the court rejected Weitz's argument that Metropolitan's counterclaim asserted potentially covered losses under the policies. Therefore, the court affirmed summary judgment in favor of the insurers because Metropolitan's counterclaim did not state an "occurrence" giving rise to a possibility of coverage under the policies.