Justia Insurance Law Opinion Summaries

The Court of Appeals answered in the affirmative a certified question asked by the United States Court of Appeals for the Second Circuit asked the Court of Appeals in this case centering around a life insurance policy providing that "assignment will be effective upon Notice" in writing to the insurer.Specifically, the Court of Appeals answered that, when a life insurance policy provides that "assignment will be effective upon Notice" in writing to the insurer, the insured's failure to provide to the insurer written notice of the policy's assignment voids the assignment so that the purported assignee does not have contractual standing to bring a claim under the policy. Accordingly, the Court held that the insured in this case lacked authority under the contract at issue to sue the insurer. View "Brettler v. Allianz Life Insurance Co. of North America" on Justia Law

The Supreme Court affirmed the decision of the district court granting summary judgment in favor of C.H. Yarber Construction in this action brought by West American Insurance Company seeking subrogation and asserting claims of negligence and breach of contract, holding that West could not pursue its claims against C.H. Yarber in subrogation.C.H. Yarber was the tenant leasing Profile Properties' commercial property in Cheyenne when the property sustained damage from a fire. West, the insurer of the property, covered Profile's fire damages and proceeded against C.H. Yarber in subrogation. The district court concluded that West could not pursue its claims in subrogation because D.H. Yarber was a co-insured under Profile's insurance policy. The Supreme Court affirmed, holding that because the relevant lease evidenced that Profile did not intend to look to C.H. Yarber to cover the insured loss, West could not pursue its claims against C.H. Yarber in subrogation. View "West American Insurance Co. v. Black Dog Consulting Inc." on Justia Law

Medical providers sued insurance company to enforce their perfected medical liens for professional services rendered to a person injured in a car accident. Insurance company disputed the: (1) reasonableness of the charges; and (2) necessity of the services. The providers argued the insurance company had no legal standing to dispute these issues, absent an assignment from the injured party. Although Insurance company prepared the "Release" with the injured person, it failed to include such an assignment. Insurance company argued that in spite of this omission, there was an "implied" assignment from the injured party as evidenced by precontract settlement discussions. The trial court ruled that there was no assignment in the executed written release and that insurance company was barred by the Parol Evidence Rule from presenting evidence to establish an implied assignment. The Oklahoma Court of Civil Appeals reversed the trial court holding that summary judgment was not proper when there was a question of fact surrounding the issue of an assignment. The Oklahoma Supreme Court found there was no assignment in the executed release and there was no question of fact on material issues. Without evidence of fraud, the Court found precontract negotiations and all discussions were merged into and superseded by the terms of an executed written release. The decision of the Court of Civil Appeals was vacated; and this matter was remanded to the trial court for proceedings. View "Accident Care & Treatment Center v. CSAA General Insurance Co." on Justia Law

The Supreme Court affirmed the judgment of the court of appeals in this dispute arising out of environmental-cleanup and remediation work at two Superfund sites in Bronson, Michigan, holding that Restatement (Second) 193 does not govern the choice-of-law analysis for bad faith claims.Scott Fetzer Company filed this action asserting a breach of contract claim against certain insurance companies, including Travelers Casualty and Surety Company, alleging breaches of certain insurance contracts. Fetzer also asserted a tort claim against each company, arguing that they had acted in bad faith when handling his claims. As to Travelers, an administrative judge concluded that Ohio law applied to a discovery dispute concerning Scott Fetzer's bad faith claim. The court of appeals affirmed, determining that Ohio law governed the bad-faith discovery dispute because the cause of action was a tort. In affirming, the court applied the choice-of-law rules set forth in section 145 of the Restatement. Travelers appealed, arguing that section 193 governs the choice-of-law analysis for bad faith claims because they arise out of insurance contracts. The Supreme Court affirmed, holding that the court of appeals correctly ruled that the choice-of-law analysis applicable to a bad-faith claim as provided by section 145. View "Scott Fetzer Co. v. American Home Assurance Co." on Justia Law

Monarch Casino & Resort, Inc. appealed a district court’s grant of Affiliated FM Insurance Company’s (“AFM”) motion for partial judgment on the pleadings, which denied Monarch coverage under AFM’s all-risk policy provision, business-interruption provision, and eight other additional-coverage provisions. Monarch also moved the Tenth Circuit Court of Appeals to certify a question of state law or issue a stay. Monarch presented AFM with claims incurred through business interruption losses from COVID-19 and government orders directing Monarch to close its casinos. AFM denied certain coverage on the ground that COVID-19 did not cause physical loss of or damage to property. Monarch sued for breach of contract, bad faith breach of insurance contract, and violations of state law. The Tenth Circuit denied Monarch’s motions to certify a question of state law and issue a stay. And it affirmed the district court’s judgment: (1) AFM’s policy had a Contamination Exclusion provision that excludes all-risk coverage and business-interruption coverage from the COVID-19 virus; and (2) Monarch could not obtain coverage for physical loss or damage caused by COVID-19 under AFM’s all-risk provision, business-interruption provision, or eight additional-coverage provisions because the virus could not cause physical loss or damage and no other policy provisions distinguished this case. Accordingly, Monarch could not obtain the coverage that the district court denied. View "Monarch Casino & Resort v. Affiliated FM Insurance Company" on Justia Law

Explosives manufacturer Dyno Nobel tendered an action to its commercial general liability insurance policyholder, Steadfast Insurance Company (“Steadfast”), after being sued in Missouri for damages caused by the release of a nitric oxide plume from one of its Missouri plants. Steadfast denied the claim based on the insurance policy’s clauses precluding indemnification and defense of pollution-related bodily injury actions. Dyno Nobel thereafter filed an action in Utah state court seeking a declaratory judgment that Steadfast had a duty to indemnify and defend against this action under an endorsement titled “Vermont Changes – Pollution” (“Vermont Endorsement”). Contrary to Coverages A, B, and C in the insurance policy, the Vermont Endorsement would have required Steadfast to defend and indemnify against pollution-related bodily injury claims up to an aggregate amount of $3 million. Steadfast removed the action to federal court, and the federal district court entered judgment for Steadfast, concluding the Vermont Endorsement applied only to claims with a nexus to Vermont. Dyno Nobel appealed. After its review, the Tenth Circuit affirmed, finding the plain language of the insurance contract did not cover Dyno Nobel’s claim in the underlying action. View "Dyno Nobel v. Steadfast Insurance Company" on Justia Law

The Court of Appeals answered in the negative the question of whether Insurance Law 3203(a)(2), which requires insurers to refund a portion of a life insurance premium "if the death of the insured occurs during a period for which the premium has been paid," holding that the plain language of section 3203(a)(2) does not apply to discretionary payments like those at issue in this case.In this action concerning a contract for a life insurance policy entered into between a family trust with Defendant, Plaintiff, as trustee of the trust, filed this putative class action against Defendant for breach of contract, alleging that its refusal to refund a prorated portion of the final year's planned premium violated section 3203(a)(2). The federal district court granted Defendant's motion to dismiss, concluding that section 3203(a)(2) did not require the refund. The federal court of appeals certified to the Court of Appeals a question of law. The Court of Appeals answered that section 3203(a)(2) did not apply to discretionary payments like those at issue in this case. View "Nitkewicz v. Lincoln Life & Annuity Co. of N.Y." on Justia Law

The Supreme Court reversed the judgment of the court of appeals concluding that Acuity was not required to provide coverage for the car accident in this case, holding that Acuity must provide coverage for the accident.Ashton Smith, who was insured by Acuity and had borrowed a friend's car, was involved in an accident. The car's owner was insured by Progressive Speciality Insurance Company. Under the Progressive policy, Smith was not an "insured person" when he was driving his friend's car, but he was covered by the plain language of the Acuity policy. The trial court found Acuity responsible for providing liability coverage. The court of appeals reversed. The Supreme Court reversed, holding that under the plain language of the two policies at issue, Acuity was responsible for providing coverage. View "Acuity, A Mutual Insurance Co. v. Progressive Specialty Insurance Co." on Justia Law

The Supreme Court affirmed the judgment of the district court dismissing the complaint brought by a first deed of trust holder against its title insurance company for breach of contract and related claims, holding that there was no error.The insurer in this case denied coverage to a first deed of trust holder for its loss of interest in property following a foreclosed upon a "superpriority piece." At issue was whether the first deed of trust holder could recover for its loss of interest in the subject property by making a claim on its title insurance policy. The district court granted the title insurance company's motion to dismiss as to all claims, concluding that no coverage existed under the policy. The Supreme Court affirmed, holding (1) the claims for declaratory judgment, breach of contract, and breach of the covenant of good faith and fair dealing were properly dismissed; and (2) the first deed of trust holder was not entitled to relief on its remaining allegations of error. View "Deutsche Bank National Trust v. Fidelity National Title Insurance Co." on Justia Law

Sixteen professional models (the Models) sued three Texas strip clubs (the Clubs) following the Clubs’ use of the Models’ likeness for advertising campaigns without the Models’ consent. Relevant to those claims, Princeton Excess and Surplus Lines Insurance Company (PESLIC) filed this declaratory judgment action. PESLIC issued two commercial liability insurance policies to the Clubs covering the time period relevant to the Models’ claims. PESLIC named both the Models and the Clubs as Defendants. The parties disputed whether that policy’s Exhibitions and Related Marketing Exclusion rendered illusory the Personal and Advertising Injury coverage. The district court agreed with the Models and the Clubs that it did. The district court also held that PESLIC had a duty to indemnify the Clubs under the 02 Policy. PESLIC appealed.   The Fifth Circuit reversed, rendered in part, and remanded. The court explained that PESLIC does not have a duty to defend the Clubs under the 01 Policy. Its duty to indemnify under the 01 Policy depends on the final resolution of the state case. As for the 02 Policy, PESLIC does not have a duty to defend or indemnify under it because the 02 Policy does not provide coverage for the claims alleged by the Models. The court held that the district court erred by concluding otherwise. Accordingly, the court reversed the district court’s summary judgment, rendered in part, and remanded the remaining issue of indemnity under the 01 Policy with instructions for the district court to stay disposition of that issue pending final resolution of the underlying state court lawsuit. View "Princeton Excess v. AHD Houston" on Justia Law