Justia Insurance Law Opinion Summaries

Plaintiff appealed the district court’s summary judgment of his claims against Safeco Insurance Company of Indiana (“Safeco”) for violating Section 541 and Section 542 of the Texas Insurance Code.   The Fifth Circuit explained that in 2017, the Texas legislature amended Section 542, raising an important issue of Texas insurance law as to which there is no controlling Texas Supreme Court authority, and the authority from the intermediate state appellate courts provides insufficient guidance. Thus, the court certified the following question of state law to the Supreme Court of Texas: In an action under Chapter 542A of the Texas Prompt Payment of Claims Act, does an insurer’s payment of the full appraisal award plus any possible statutory interest preclude recovery of attorney’s fees? View "Rodriguez v. Safeco" on Justia Law

The Supreme Court reversed the judgment of the court of appeals reversing the judgment of the trial court determining that Plaintiff could not recover under a commercial general-liability (CGL) insurance policy issued by United Specialty Insurance Company, holding that when a CGL insurance policy excludes coverage for injuries arising out of an "assault or battery," the subjective intent of the person who committed the assault or battery is irrelevant.Brown County Care Center, an adult care facility, contracted with United for CGL insurance. The policy excluded coverage for bodily injury arising from "any actual, threatened or alleged assault or battery." Plaintiff was living at the Center when he was attacked by another resident, who was later found by the trial court to be not guilty of felonious assault by reason of insanity. Plaintiff sued, and he and the Center entered into a settlement. Plaintiff later brought a declaratory judgment action against United to collect on the judgment. The trial court determined that Plaintiff could not recover under the policy. The court of appeals reversed. The Supreme Court reversed, holding (1) the attack on Plaintiff qualified as a civil-law assault; and (2) because the policy excluded coverage for bodily injuries arising for civil assaults the trial court did not err in its judgment. View "Krewina v. United Specialty Insurance Co." on Justia Law

Rosenberg-Wohl had a State Farm homeowners insurance policy, covering her San Francisco home. The policy required lawsuits to be “started within one year after the date of loss or damage.” In late 2018 or early 2019, Rosenberg-Wohl noticed that an elderly neighbor twice stumbled on Rosenberg-Wohl’s outside staircase and learned that the pitch of the stairs had changed. The staircase needed to be replaced. In April 2019, Rosenberg-Wohl authorized the work and contacted State Farm. On August 9, she submitted a claim for the money she had spent. On August 26, State Farm denied the claim. Rosenberg-Wohl’s husband, an attorney, later contacted State Farm “to see if anything could be done.” In August 2020 a State Farm adjuster said it had reopened the claim. Days later, it was denied.In October 2020, Rosenberg-Wohl filed suit, alleging breach of the policy and bad faith. That lawsuit was removed to federal court and was dismissed based on the one-year limitation provision. It is currently on appeal. Another action alleges a violation of California’s unfair competition law. The California court of appeal affirmed the dismissal of that suit, rejecting arguments that the one-year limitation provision does not apply to the unfair competition claim, and that State Farm waived the limitation provision. View "Rosenberg-Wohl v. State Farm Fire and Casualty Co." on Justia Law

A Listeria outbreak led to a shutdown of Blue Bell factories and a nationwide recall of its products. Consequently, Blue Bell suffered a substantial financial loss. A shareholder of Blue Bell Creameries brought a derivative action against Blue Bell’s directors and officers, alleging a breach of fiduciary duties. The shareholder, on behalf of Blue Bell, alleged that Blue Bell’s officers and directors breached their fiduciary duties of care and loyalty by failing “to comply with regulations and establish controls.” The Blue Bell Defendants appealed the district court’s grant of summary judgment in favor of Discover Property & Casualty Insurance Company and the Travelers Indemnity Company of Connecticut.   The Fifth Circuit affirmed. Here, only the duty to defend is at issue because the parties have stipulated that “If the district court finds there is no duty to defend, it may also find there is no duty to indemnify, but otherwise the duty to indemnify will not be a subject of the Parties’ motions.” Accordingly, the court wrote that it is confined by Texas’s “eight-corners rule,” which directs courts to determine an insurer’s duty to defend based on: (1) the pleading against the insured in the underlying litigation and (2) the terms of the insurance policy. The court explained that while it disagrees with the district court’s determination as to whether the directors and officers are “insureds” in relation to the shareholder lawsuit, it agreed with its determination that the complaint in the shareholder lawsuit does not allege any “occurrence” or seek “damages because of bodily injury.” Each issue is independently sufficient for affirmance. View "Discover Property Cslty v. Blue Bell" on Justia Law

This appeal arose out of an insurance dispute between Plaintiff and Safeco Insurance Company of Illinois. After an accident in which her vehicle suffered substantial damage, Plaintiff made a claim under her Safeco-issued insurance policy for the damage. Safeco declared her vehicle a total loss and paid her what it deemed to be the actual cash value of her vehicle. The district court granted summary judgment to Safeco.   The Eleventh Circuit affirmed. The court explained that as proof that a policyholder is reasonably likely to need to incur dealer fees, Plaintiff pointed to the facts that (1) she incurred dealer fees in purchasing both the Lexus that was totaled and her Subaru replacement vehicle, (2) approximately 50-70% of Safeco policyholders are likely to purchase a vehicle from a dealer, and (3) approximately 85-95% of dealerships charge dealer fees. These facts, viewed in the light most favorable to Plaintiff, do not give rise to a genuine dispute of material fact. Plaintiff’s three data points show a reasonable likelihood that a policyholder will incur dealer fees if she chooses to purchase her replacement vehicle from a dealer. And they show that a policyholder is reasonably likely to purchase a replacement vehicle from a dealer. But they do not show that a policyholder is reasonably likely to need to purchase a replacement vehicle from a dealer. Plaintiff has failed as a matter of law to satisfy the Mills standard; therefore, the district court correctly awarded Safeco summary judgment on this issue. View "Gina Signor v. Safeco Insurance Company of Illinois" on Justia Law

Penn-Star Insurance Company (Penn-Star) appealed a trial court’s denial of its motion for summary judgment. The Mississippi Supreme Court found after review of the trial court record that because the commercial general liability policy at issue did not cover the sustained losses, the trial court’s order was reversed, judgment was rendered in favor of Penn-Star, and this case was remanded to the trial court for consideration of the remaining issues. View "Penn-Star Insurance Company v. Thompson, et al." on Justia Law

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