Justia Insurance Law Opinion Summaries

Petitioners sought review of the decision of the First District Court of Appeal in Geico Indemnity Co. v. Shazier on the basis that it conflicted with the decisions of the court in Susco Car Rental System of Florida v. Leonard and Roth v. Old Republic Insurance Co. In Shazier, the district court resolved a question regarding an insurer's duty to defend and indemnify its insured in favor of the insurer. In doing so, the First District relied on a very constricted definition of "consent" and employed an unauthorized driver provision in contradiction of the court's clear precedent to the contrary under Florida's dangerous instrumentality doctrine to defeat coverage. Accordingly, the court quashed the First District's decision and directed that judgment be entered in favor of the insureds and injured parties.

Amerisure appealed the district court's summary judgment ruling determining that Louisiana law prohibited the consideration of extrinsic evidence to prove mutual mistake; ranking Amerisure as the primary insurer; and allowing another third-party insurer to bring a cross-claim for defense fees. The court held that because the district court erred in refusing to consider extrinsic evidence to prove the theory of mutual mistake, the court reversed and remanded without considering ranking or standing.

Employee submitted a claim for workers' compensation under Employer's policy with Insurer, which claim was paid in full. Employee also filed a deliberate intent lawsuit against Employer. After assuming the attorney's fees and costs associated with defending and settling the action, Employer filed a complaint against Insurer, alleging various claims related to Insurer's denial of coverage in the defense of the deliberate intent action. The circuit court granted Employer's motion for partial summary judgment on its bad faith claim against Insurer and awarded damages to Employer. The Supreme Court reversed, holding (1) Insurer met its obligation under W. Va. Code 23-4C-6 to make deliberate intent coverage available to Employer upon the Employer's voluntary request; and (2) because the language of the policy was plain, and the exclusion of deliberate intent coverage was clear, the circuit court erred in concluding that the policy was ambiguous and therefore resulted in deliberate intent coverage being included in the policy under the doctrine of reasonable expectations.

Defendant National Security Fire & Casualty Company appealed a circuit court order that certified a class for a class action lawsuit. Plaintiff Maurice DeWitt's mobile home was damaged by Hurricane Katrina, and at the time of his loss, Plaintiff was insured by National Security. In 2007, Plaintiff filed suit in circuit court against National Security and other insurance companies alleging that the Defendants breached his insurance policy when they did not include a 20% "general contractor overhead and profit" (GCOP) amount in its loss payment. Specifically, Plaintiff alleged the insurance companies did not take into account Plaintiff's loss and the need for additional general contractor services in rebuilding his home. Plaintiff sought to represent similarly situated policyholders whose claims were allegedly miscalculated in the same fashion. Upon review, the Supreme Court concluded that Plaintiff did not satisfy his burden of establishing the predominance and superiority requirements to certify his class action. Accordingly, the Court held that the trial court exceeded its discretion in cerfifying the class.

In separate petitions, the Hampton Insurance Agency and Ginger Spencer, Acceptance Indemnity Insurance Company and Ashland General Agency all defendants in an action filed by Mary Alice Patton, d/b/a Hole in the Wall Lounge, petitioned the Supreme Court for a writ of mandamus to direct the trial court to transfer the action to the Tuscaloosa Circuit Court. Ms. Patton purchased insurance for her lounge from Ms. Spencer, an independent insurance agent for Hampton. At issue was the nature and extent of the coverage Ms. Patton sought. The lounge was destroyed by fire in 2009. Upon filing her insurance claim, Ms. Patton was informed that her policy did not include coverage for property damage. Accordingly, Ms. Patton sued because "defendants were negligent and/or wanton in their procurement of full coverage insurance for [Patton] on her lounge building and its contents." Hampton responded with a motion to dismiss or in the alternative, to transfer the case on grounds that the case was filed in an improper venue. Upon review, the Supreme Court found that the defendant insurance companies met the requirements for the writ of mandamus. The Court directed the trial court to vacate its order denying defendants' motions to transfer, and to enter orders granting those motions to transfer to the Tuscaloosa Circuit Court.

This case stemmed from a controversy between the insured and their insurer over whether the insurer breached its obligations under a commercial general liability insurance policy that the insureds had with the insurer at the time of the accident. The coverage dispute arose out of a personal injury lawsuit filed against the insured by an injured homeowner. Because the case involved unanswered questions of Florida law that were central to the appeal and because these questions were determinative of the cause in this case and there were no controlling precedents from the Supreme Court of Florida, the court certified these questions for resolution.

Appellees executed a credit application and retail installment contract (RIC) for the purchase of an automobile. The application contained an arbitration agreement. The RIC provided an option for Appellees to purchase credit-life insurance coverage with Insurer. Appellees subsequently filed a class action against Insurer seeking the refund of unearned credit-life insurance premiums from the date they paid off their loan until the original maturity date of the loan. Insurer filed a motion to compel arbitration pursuant to the terms of the arbitration agreement. The circuit court denied the motion after finding that the dispute was governed by Ark. Code Ann. 16-108-201(b), thereby preventing Insurer from compelling Appellees to arbitrate a dispute under an insurance policy. The Supreme Court affirmed, holding (1) the McCarran-Ferguson Act did not allow the Federal Arbitration Act to preempt section 16-108-201(b), and section 16-108-201(b) prohibited arbitration under these facts; and (2) the principles of equitable estoppel did apply to allow Insurer to compel arbitration.

This appeal stemmed from an explosion that severely injured Robbie Griffin at a worksite in Stephens County, Oklahoma. At the time of the explosion, Mr. Griffin was working as an independent contractor for S&W Transports, Inc. Through a settlement agreement, S&W agreed to pay Mr. Griffin for his injuries. The issue before the Court was which of S&W’s insurers had a duty provide coverage for that payment. Mid-Continent Casualty Company covered S&W under a general commercial insurance policy. Union Insurance Company covered S&W under a commercial umbrella insurance policy. Mid-Continent and Union agreed that if Mr. Griffin caused, in whole or in part, his injuries, Mid-Continent must provide coverage. If not, Union provided coverage. Both companies moved for summary judgment in the district court. The court held that Mr. Griffin caused his injuries under Oklahoma insurance law and granted summary judgment for Union. Mid-Continent appealed. Because, after its review, the Tenth Circuit agreed that Mr. Griffin caused, at least in part, his injuries, the Court affirmed the district court's judgment in favor of Union.

Pursuant to ORS 742.061, Plaintiffs Zidell Marine Corporation petitioned to recover attorney fees that they incurred for the preparation of appeals before both the Court of Appeals and Supreme Court. Defendant Lloyds of London contended that as a result of a 2005 amendment to the statute, Zidell could not recover fees incurred after the effective date of the amendment. In the alternative, Lloyds argued that Zidell was only entitled to fees for work it did to establish Lloyds had a duty to defend, or that the billing records Zidell submitted did not support its request for fees. Upon review of the applicable legal authority, as well as the billing records and the Lloyds insurance contract, the Supreme Court held that Zidell could recover the attorney fees in incurred to establish Lloyds' duty to defend and for the preparation of the fee petition.

Plaintiff's lawsuit arose from defendant's refusal to pay some or all of plaintiff's claims for reimbursement for medical-device procurement and financing services provided in connection with over 2,000 patients insured under the Employee Retirement Income Security Act (ERISA), 29 U.S.C. 1001 et seq., plans administered by defendant. Plaintiff subsequently appealed a summary judgment for defendant. At issue was whether plaintiff's state-law claims of promissory estoppel, quantum meruit, unjust enrichment, negligent misrepresentation, and violations of the Texas Insurance Code, 541.051(A) & (B) and 541.061(1) & (2), were preempted by ERISA. The court reversed with respect to plaintiff's promissory estoppel, negligent misrepresentation, and Texas Insurance Code claims because these claims were premised on allegations and evidence that plaintiff provided the services in reliance on defendant's representations that it would pay reasonable charges for plaintiff's services. The court affirmed with respect to plaintiff's quantum meruit and unjust enrichment claims because these claims depended on plaintiff's assertion that without its services the patients' ERISA plans would have obligated defendant to reimburse a different provider for the same services.