Justia Insurance Law Opinion Summaries

Petitioner Lachlan MacLearn and Intervenor Simon Hutchings appealed a superior court order that denied their motion for summary judgment. Petitioner was driving his 2006 Prius when he was involved in an accident with Hutchings. At the time of the accident, Petitioner also owned a 2000 Audi A6 that was insured by Respondent Commerce Insurance Company. Hutchings sued Petitioner for damages from his injuries. Hutchings made a demand upon Commerce for defense and indemnification. Commerce denied the claim, stating that coverage was barred by the terms of the policy it held on Petitioner's Audi. Petitioner petitioned for a declaratory judgment that Commerce was obligated to defend and indemnify him against Hutchings' suit. The trial court granted Commerce's motion and denied Hutchings', finding the policy barred coverage. Upon review of the policy and the arguments submitted by the parties, the Supreme Court affirmed the trial court, finding the policy did not cover Petitioner's use of the Prius, nor grant him indemnification from Commerce for the accident arising out of his use of it.

Michael Warfel filed a sinkhole claim with Universal Insurance Company, with whom he had an all-risks homeowners insurance policy that covered sinkhole claims. Universal relied on a report by an outside firm, which determined that the damage was caused by factors that were excluded from coverage under the policy, to deny the claim. Warfel subsequently filed an action against Universal for breach of contract, seeking the recovery of insurance benefits for the loss caused by damage to his home. The trial court granted Universal's motion to apply Fla. Stat. 90.304 to the burden shifting presumption articulated in Fla. Stat. 627.7073(1)(c). The jury returned a verdict in favor of Universal. The court of appeal reversed, holding that the trial court misapplied the presumption at work in this case and gave the jury an instruction improperly shifting the burden of proof. The Supreme Court affirmed, holding that the language of section 627.7073(1)(c) does not create a presumption affecting the burden of proof under section 90.304 nor does the language create a presumption affecting the burden of producing evidence under Fla. Stat. 90.303.

Employee was injured in an automobile accident while working for Employer. Employer had a state-certified workers' compensation plan in effect that provided coverage to Employee, and some of Employee's medical bills were paid by the workers' compensation carrier. Employee had a policy with State Farm that included no-fault medical coverage. State Farm, however, denied coverage to Employee under a policy exclusion that denied coverage for an insured if any workers' compensation law applied to the insured's bodily injury. Employee filed an action against State Farm, seeking recovery of benefits under the no-fault medical provision. The circuit court granted summary judgment in favor of State Farm. The Supreme Court affirmed, holding that Employer was entitled to judgment as a matter of law where, in accordance with previous precedent, the exclusion clearly applied in all scenarios where workers' compensation benefits either had been paid in whole or in part or could be paid in whole or in part.

As a result of Hurricane Katrina, the Mississippi Windstorm Underwriting Association (MWUA) sustained great losses well in excess of its reinsurance. MWUA assessed its members to cover the loss. Members are required to share in MWUA’s expenses, profits, and losses based on their percentages of wind and hail insurance premiums written in the previous calendar year. After the initial assessments, several member companies complained that they had incorrectly reported the previous year's figures. The Board of Directors gave the members a one-time opportunity to submit corrected data (a true-up). Some members (most of whom did not submit corrected data) appealed the assessment following the true-up. The Board denied their appeals. The members appealed their claims to the Insurance Commissioner, and the Commissioner denied their requested relief. Thereafter, the members appealed the Commissioner’s decision to the chancery court, which granted the members relief on all but one issue. Aggrieved, MWUA appealed the chancery court's judgment, and the members filed a cross-appeal. MWUA presented eight issues on appeal to the Supreme Court. Upon review, the Supreme Court affirmed the chancellor's judgment on two issues: grouping and reinsurance allocation. But the Court reversed and remanded the chancellor's judgment on the remaining issues.

Airline insurance (USAUI) issued to Pace covered certain risks assumed by Pace in contractual arrangements with other companies, which generally consisted of charter programs. The policy referenced "legally obligated to pay as damages." Pace entered into a charter program contractual arrangement with Patriot, which entered into an agreement to transport L&M customers to destinations that L&M had booked for travelers. L&M purchased a required surety bond. In 2002, L&M claimed that Patriot had unlawfully refused to provide aircraft for scheduled flights, and Patriot contended that L&M not fulfilled payment obligations. Patriot terminated the agreement and, two months later, filed for bankruptcy under Chapter 11. L&M filed a proof of claim. The bankruptcy court disallowed the claim. In 2005, L&M filed suit, claiming coverage by policies, including the USAUI policy. The district court held that the policy did not provide coverage for a breach of contract claim. The First Circuit affirmed, finding no ambiguity in policy language.

The insured was driving his pickup truck when he was injured after swerving to avoid a cardboard box lying in the middle of his lane. Allstate stipulated that an unidentified vehicle dropped the box, but rejected a claim for uninsured motorist benefits and sought a declaratory judgment. The insured responded with counterclaims for breach of contract and insurance bad faith under 42 Pa. Cons. Stat.8371. The district court entered judgment for Allstate, finding that the injuries did not "arise out of ownership, maintenance or use of an uninsured auto." The Third Circuit reversed, rejecting an argument that the harm was caused by a box, not a vehicle. Physical contact with an uninsured vehicle is not required for an accident to "arise out of" the use of an uninsured vehicle. Accepting for purposes of appeal that an unidentified vehicle that dropped the box was an uninsured vehicle, there is a sufficient causal connection. The court noted that the insurance law is to be liberally construed in order to afford the greatest possible coverage to injured claimants.

James Whealon was employed by the Anaconda School District pursuant to a series of employment contracts. Upon retirement, Whealon filed a formal grievance, asserting that, under the terms of his contract, he was entitled to payment of his health insurance premiums by the District until he reached the age of sixty-five. The District denied his claim. The County Superintendent granted summary judgment to the District, holding that the language of the contract was unambiguous and that Whealon was not entitled to the claimed benefits beyond the date of his retirement. The State Superintendent of Public Instruction reversed and remanded for an evidentiary hearing, holding that the language of the contract was ambiguous. The district court reversed and reinstated the County Superintendent's ruling. The Supreme Court affirmed the district court, holding (1) the district court did not err in holding that a county superintendent has authority to grant summary judgment; and (2) the district court did not err in reinstating summary judgment in favor of the district where the language of the agreement was unambiguous and the District was entitled to judgment.

Mark Cookson purchased two homeowner's insurance policies from Liberty Mutual, one to cover his primary residence in West Newfield and another to cover property in Acton, where he was constructing a house. Cookson would drive his tractor along public roads between the properties. Cookson's tractor was subsequently destroyed by fire. Cookson filed a claim for loss of the tractor, which Liberty Mutual denied based on a personal property exclusion in both policies. Cookson filed a complaint seeking, in part, a declaratory judgment that the Liberty Mutual policies provided coverage for his tractor. The superior court granted summary judgment in favor of Liberty Mutual, concluding that Cookson's policies excluded the tractor from loss coverage. The Supreme Court affirmed, holding (1) Cookson's tractor was not the type of vehicle that fell within the limited exception for "vehicles not subject to motor vehicle registration" to the otherwise broad personal property exclusion of all "motor vehicles or all other motorized land conveyances," and (2) Cookson's tractor was not the type a homeowner would commonly purchase and employ simply to service his or her residence.

This case concerned an arbitration provision that allowed each party to appoint one arbitrator to a panel, subject to certain requirements. At issue was whether Americo wavied its objection to the removal of the arbitrator it selected. The underlying dispute concerned the financing mechanism for Americo's purchase of several insurance companies from Robert Myer. Pursuant to the financing agreement, Americo and Myer submitted their dispute to arbitration under American Arbitration Association (AAA) rules. The arbitrators found in favor of Myer, and Americo filed a motion to vacate the award. The trial court granted the motion, holding that Americo was entitled to any arbitrator that met the requirements set forth in the financing agreement and that the arbitrator removed by the AAA met those requirements. The court of appeals reversed, holding that Americo had waived these arguments by not presenting them to the AAA. Because the record demonstrated otherwise, the court rejected the court of appeals' judgment and remanded the case to that court for further proceedings.

Appellant Jacob Ennen was seriously injured while he was a passenger in Gordon Shanigan's car. Shanigan's insurer, Integon Indemnity Corporation (Integon), paid $50,000 to cover Shanigan's possible liability to Appellant. Under Alaska insurance statutes, Appellant would also likely have been entitled to underinsured motorist benefits under Shanigan's policy. However, Integon's policy was inconsistent with these statutes, and Integon told Ennen that he was not entitled to any additional money. Six years later, some time after Integon learned that its underinsured motorist provision violated Alaska insurance statutes, Integon paid Appellant underinsured motorist benefits plus interest and fees. Appellant sued Integon for bad faith. Integon filed a third-party complaint against Appellant's attorney, Craig Allen. Before trial, the superior court dismissed Integon’s claims against Allen on the ground that allowing Integon to implead Appellant's attorney would violate public policy. The superior court held that because Appellant did not own the insurance policy, Integon did not owe him a duty of good faith and fair dealing. Accordingly, the superior court concluded that Appellant had no cause of action for bad faith. But, in the event this ruling were to be reversed on appeal, the superior court made an alternate finding that while Integon had committed the tort of bad faith, Appellant had suffered no damages as a result. Upon review, the Supreme Court reversed on both counts. "The superior court was justifiably cautious about extending the bad faith cause of action to a new class of plaintiffs, but we conclude that Ennen, as an insured, is eligible under our existing case law to bring a cause of action for bad faith." The Court concluded that Appellant established facts that would entitle him to damages. Furthermore, the Court affirmed the dismissal of Integon's third-party claim against Allen on the alternative ground that Allen was not a proximate cause of Appellant's harm.