Justia Insurance Law Opinion Summaries

Gregory Latterell, on behalf of his stepson Jared Boom's estate, sued Progressive Northern Insurance and AIG Insurance to recover underinsured motorist (UIM) benefits following Boom's death from a motor vehicle accident. Progressive, the insurer of Boom's vehicle, denied Latterell's claim for UIM benefits because of a business-use exclusion in Boom's insurance policy. AIG, Lattrell's insurer, also denied Latterell's claim. Latterell sued, and the district court granted summary judgment to Progressive and AIG. The court of appeals affirmed, holding (1) the business-use exclusion in the Progressive policy was enforceable under the Minnesota No-Fault Automobile Insurance Act and unambiguously excluded UIM coverage under the specific circumstances of this case, and (2) Latterell could not recover UIM benefits under the AIG policy. The Supreme Court reversed the denial of Latterell's summary judgment as to Progressive, holding that Progressive's business-use exclusion was unenforceable under the No-Fault Act. Remanded with instructions to enter judgment in favor of Latterell against Progressive.

After Homeowners' house burned down, Homeowners' insurer denied coverage, stating that payment was not timely delivered, the money order was not signed, and the damaged house was the secondary house and Insurer's underwriting policies required insurance on the primary house also to be purchased through Insurer in order to have coverage in place for the secondary residence. Homeowners filed suit, asserting that no reasonable basis in fact or law existed for denial of the claim and seeking damages and a declaratory judgment that the loss was covered. The district court granted Insurer's motion for summary judgment and denied Homeowners' motion for partial summary judgment with respect to their declaratory judgment action. The Supreme Court reversed in part and affirmed in part, holding (1) the district court erred in granting summary judgment to Insurer as genuine issues of material fact remained, and (2) the district court did not abuse its discretion in denying Homeowners' motion for partial summary judgment.

Virginia King was injured in an automobile accident and was treated for her injuries at Toledo Hospital. Although King informed the hospital staff that she was covered by a health-insuring corporation, the hospital billed King's automobile insurer for the services rendered. King sued the hospital and ProMedica Health System (Appellants). Each of King's causes of action was based on the claim that Appellants violated Ohio Rev. Code. 1751.60(A) by billing the automobile insurer instead of the health-insuring corporation. Section 1751.60(A) stated that every provider that contracts with a health-insuring corporation to provide health-care services to an insured shall seek payment solely from the corporation. The trial court granted Appellants' motion to dismiss, and the court of appeals reversed. At issue on appeal was whether section 1751.60(A) prohibited a provider from seeking payment for medical treatment rendered to an insured injured in an automobile accident from the insured's automobile insurance medical benefits. The Supreme Court reversed the court of appeals, holding (1) section 1751.60(A) applies only when a health-care provider seeks payment from an insured, and (2) section 1751.60(A) does not conflict with Ohio's law on the coordination of insurance benefits.

Stephen and Dawn Steadele contracted with Montana Component Housing Corporation (MCHC) to construct a home. MCHC did not complete the home by the deadline and eventually abandoned the project without completing the home. The Steadeles filed suit against MCHC. The district court entered a default judgment against MCHC when it failed to respond to the suit. The Steadeles then requested payment from Colony Insurance Company, MCHC's insurer. Colony denied coverage and refused to pay because MCHC never notified it of the Steadeles' claim. The Steadeles then filed this action, arguing that Colony's refusal to issue payment on the underlying judgment was a violation of Mont. Code Ann. 33-18-201, which prohibits unfair claim settlement practices. The district court granted summary judgment to Colony. The Supreme Court affirmed, holding that the district court did not err in granting summary judgment to Colony because MCHC's failure to notify Colony of the Steadeles' claim was a material breach of MCHC's obligations under the policy.

Timothy Hop's automobile was damaged in an accident with a driver insured by Safeco Insurance Company. In addition to the costs of repair, Hop sought "residual diminished value" (RDV) for his vehicle. When Safeco failed to pay RDV, Hop filed a class action complaint for declaratory relief in the district court, seeking a declaration that Safeco was required to investigate and pay class members, people whose vehicles were damaged by a Safeco insured and who were not paid RDV by Safeco, for RDV of their vehicle. The district court granted Hop's motion for class certification. The Supreme Court reversed, holding that the district court abused its discretion in certifying a class action before Hop had satisfied the statutory requirements to bring an individual third party action against Safeco. Remanded with instructions to dismiss Hop's class action without prejudice.

Jefferson Block submitted a claim under the London OPA Insurance Policy for Offshore Facilities (OPA Policy) for indemnification of the removal costs it incurred in responding to a pipeline leak. Underwriters denied the claim and Jefferson filed suit against Underwriters in district court, alleging that Underwriters wrongfully refused to indemnify it for oil pollution removal costs. The court held that the district court erred when it refused to apply the contra-insurer rule where the OPA Policy was ambiguous with respect to the issue of coverage for Jefferson Block's 16-inch pipeline and extrinsic evidence in the record did not conclusively resolve this ambiguity. Therefore, the court held that, since Jefferson Block offered a reasonable interpretation of the policy and did not completely draft the ambiguous provisions of the OPA Policy, the contra-insurer rule should apply and the ambiguity should be resolved in favor of the insured, Jefferson Block.

At issue in this case were coverage limits associated with underinsured motorist (UIM) insurance and whether coverage provided under disputed insurance policies complies with the requirements of Alaska insurance statutes. The Respondent families hold UIM policies. They alleged they suffered emotional distress and loss of consortium as a result of a collision that killed one familyâs child and severely injured the other familyâs child. The insurer accepted that the policyholders incurred damages. However, it contended that the families exhausted the coverage limits available to them under the UIM policies because the family members seeking damages were not âinâ the fatal collision. The superior court concluded that the families had not exhausted their UIM coverage under Alaska insurance statutes and reformed the insurance policies to allow the emotional distress claims to proceed to arbitration. The superior court dismissed the familiesâ loss of consortium claims as outside the coverage of the policies. Because the Supreme Court concluded that the families exhausted the coverage limits available under their policies and that these policies were consistent with statutory requirements, the Court reversed the superior courtâs decision to reform the policies. Because coverage limits are exhausted, the Court declined to consider whether loss of consortium was covered under the policies.

While away for a competition in a school-supported event, students caused damage to a motel where they were lodging. The motel's property insurer paid to repair the damage then exercised its right of subrogation pursuant to its insurance contract with the motel to seek to recover compensation for those responsible for the loss. The insurer filed a complaint against the school district, alleging it was liable for breach of contract based on its failure to protect and safeguard the property from damage during the period of occupancy and to refrain from activities that would damage the property. The superior court granted the school district's motion for summary judgment. The Supreme Court affirmed, holding that because the school district did not undertake to be responsible to pay damages in a subrogation action, the insurer's action against the school board was barred.

This case was an interlocutory appeal. Riverbend Utilities alleged that the trial court erred by: (1) adding Arch Insurance Company as an involuntary counterplaintiff, and (2) ordering Riverbend to make four individuals available for deposition. In August 2006, sewage backed up into a home occupied by Hugh Brennan, Shanda Brennan, Meranda Brennan, Diana Marut, and Sarah Marut1 (âthe Brennansâ) in Saucier. During discovery, Riverbend learned that the Brennansâ home had suffered damage from Hurricane Katrina in August 2005. In August 2009, with leave of the trial court, Riverbend counterclaimed, alleging that the Brennans had submitted the same invoices to Riverbend that they previously had submitted to their homeownerâs insurance provider and that they had been paid by that insurer. Upon review of the trial court record, the Supreme Court found that the trial court erred in ordering that Arch be made a party to the counterclaim. Furthermore, the Court held that the individuals noticed for depositions were not parties, Mississippi residents, or Riverbend employees, and concluded the trial court abused its discretion in ordering Riverbend to make them available for deposition. The Court reversed the trial court and remanded the case for further proceedings.

After self-insured Employer filed for bankruptcy, it continued to take payroll deductions from Employees for medical coverage but stopped paying the provider hospital for the covered charges. The hospital then directly billed Employees for services that should have been paid by Employer. Employees filed suit to stop the hospital's attempts to collect payment, seeking relief under the theories of declaratory judgment, injunction, breach of contract, negligent infliction of emotional distress, and bad faith breach of contract. The circuit court granted summary judgment in favor of the hospital on all of Employees' claims. The Supreme Court reversed, holding (1) Employees had standing as third party beneficiaries to enforce the provisions of the hospital agreement and payer agreement; and (2) Employees were not obligated to pay for covered medical services under the agreements. Remanded.