Justia Insurance Law Opinion Summaries

The Supreme Court answered a question certified by the United States Court of Appeals for the Ninth Circuit by holding that, under a policy without a contractual duty to defend, the objective reasonableness of an insurer's decision to withhold consent is assessed from the perspective of the insurer, not the insured.National Union Fire Insurance Company of Pittsburgh, PA, which insured Apollo Education Group, Inc.'s directors and officers for liability up to $15 million under a policy that included no duty to defend the insured if sued. A class action suit against Apollo resulted in an agreement to settle. Apollo refused to consent to the settlement but entered into the agreement. Apollo then sued National Union to recover the settlement amount, alleging breach of contract and bad faith. The district court granted summary judgment to National Union. On appeal, the Ninth Circuit certified the question to this Court. The Supreme Court held that an insurer must, in deciding whether to consent to a settlement, give the matter full and fair consideration, but need not approve a settlement simply because the insured believes it is reasonable. View "Apollo Education Group, Inc. v. National Union Fire Insurance Co." on Justia Law

The Supreme Judicial Court affirmed the summary judgment entered by the superior court in favor of Concord General Mutual Insurance Company on Arthur Bibeau's complaint for alleged breaches and violations of the homeowner's insurance policy issued to him by Concord, holding that the policy did not unambiguously exclude from coverage losses caused by earth movement.Bibeau insured his home through a policy issued to him by Concord. Bibeau submitted a notice of claim to Concord alleging that his home was damaged by a water line leak that pushed sand and other material under the foundation of his home. Concord denied the claim based on the policy's earth movement exclusion and its anti-concurrent-causation clause. Bibeau then brought this action. The superior court granted summary judgment for Concord on all counts. The Supreme Judicial Court affirmed, holding that the superior court did not err in determining that the policy was unambiguous and that Bibeau's losses were excluded from coverage pursuant to the earth movement exclusion. View "Bibeau v. Concord General Mutual Insurance Co." on Justia Law

The Supreme Court answered in the negative a question certified by the Fifth District Court of Appeal, holding that in a first-party breach of insurance contract action brought by an insured against its insurer not involving suit under Fla. Stat. 624.155, Florida law does not allow the insured to recover extra-contractual, consequential damages.The insureds in this case sought to recover from the insurer extra-contractual, consequential damages for lost rental income. The trial court granted the insurer's motion for partial summary judgment regarding the breach of contract claim for lost rental income. The Fifth District reversed the partial summary judgment regarding the consequential damages claim, concluding that the insurer was not statutorily immune from this aspect of the insureds' claim. The Supreme Court quashed the Fifth District's decision and remanded the case, concluding that extra-contractual, consequential damages are not available in a first-party breach of insurance contract action. View "Citizens Property Insurance Corp. v. Manor House, LLC" on Justia Law

In this dispute between a boat owner and his insurance company, the First Circuit affirmed the judgment of the district court in favor of the insurer, holding that the district court properly applied the doctrine of uberrimae fidei in this case.When Defendant applied for an insurance policy for his yacht from an entity later acquired by Plaintiff he failed to disclose that he had grounded a forty-foot yacht in Puerto Rico. Plaintiff later sought a declaratory judgment voiding the policy on the grounds that Defendant had failed to honor his duty of utmost good faith, known as uberrimae fidei in maritime law, in acquiring the policy and had therefore breached the warranty of truthfulness contained in the policy. The district court concluded that Plaintiff was entitled to void the policy. The First Circuit affirmed, holding that the district court correctly concluded that the uberrimae fidei doctrine entitled Plaintiff to a declaration that the policy was void. View "QBE Seguros v. Morales-Vazquez" on Justia Law

In this insurance dispute, the First Circuit affirmed the district court's grant of summary judgment to Ameriprise Auto & Home Insurance, holding that the arguments on appeal brought by Government Employees Insurance Company (GEICO) were unavailing.An accident that occurred in Florida damaged a Toyota Highlander insured by Ameriprise and a Lamborghini insured by GEICO and injured the driver of the Highlander. Ameriprise rescinded coverage, alleging that its insureds breached their obligations under the policy. Ameriprise brought this suit seeking declaratory relief in federal district court to approve the company's rescission and to confirm that Ameriprise had satisfied its compulsory coverage requirements under Massachusetts law. The district court granted summary judgment in favor of Ameriprise. The First Circuit affirmed, holding (1) the district court did not err in finding that Ameriprise could rescind the insureds' coverage as a matter of law because the insureds' misrepresentation of certain information breached the insureds' duty to inform Ameriprise about about dates to the Highlander's principal place of garaging and customary drivers; and (2) Ameriprise was not estopped from rescinding the insureds' coverage, and GEICO's waiver arguments failed as a matter of law. View "IDS Property Casualty Insurance Co. v. Government Employees Insurance Co." on Justia Law

In a matter of first impression, the Pennsylvania Supreme Court granted review in this case to consider whether Section 310.74(a) of the Insurance Department Act of 1921 prohibited a licensed insurance producer from charging fees in addition to commissions in non-commercial, i.e. personal, insurance transactions. During its investigation, the Department discovered that, between March 2011 and October 2015, appellants charged a non-refundable $60- $70 fee to customers seeking to purchase personal insurance products. These fees were collected from the customers before appellants prepared the insurance policy applications. One consumer complaint indicated appellants kept an “un- refundable broker application fee” when the consumer declined to buy a policy. The Department’s investigation also revealed appellants paid a “one-time” $50 referral fee to car dealership sales personnel when they referred their customers in need of insurance. The Department concluded appellants’ fee practices included improper fees charged to consumers “for the completion of an application for a contract of insurance” and prohibited referral payments to the car dealerships. The Supreme Court held lower tribunals did not err when they determined Section 310.74(a) of the Act did not authorize appellants to charge the $60-$70 non-refundable fee to their customers seeking to purchase personal motor vehicle insurance. The Commonwealth Court’s decision upholding the Commissioner’s Adjudication and Order was affirmed. View "Woodford v. PA Insurance Dept." on Justia Law

The Supreme held that the trial court did not err in determining that Defendants were not afforded underinsured motorist and medical payments coverage under an insurance policy issued by Plaintiff, an insurance company, to a family member.Defendants argued that they were entitled to medical payments and underinsured motorist coverage under Plaintiff's policy because they were "residents" of the insured's "household." Plaintiff disputed coverage and filed a declaratory judgment action in superior court, arguing that Defendants were not residents of the insured's household at the time of the accident. The trial court entered summary judgment for Plaintiff, concluding as a matter of law that Defendants were not entitled to coverage under the policy. The court of appeals affirmed. The Supreme Court affirmed, holding that the court of appeals did not err in determining that Defendants are not entitled to coverage under the policy and that the trial court appropriately awarded summary judgment in favor of Plaintiff. View "N.C. Farm Bureau Mutual Insurance Co., Inc. v. Martin" on Justia Law

The First Circuit reversed the order of the district court granting summary judgment in favor of General Star Indemnity Company, the excess insurer of Performance Trans., Inc. and Utica Mutual Insurance Company (collectively PTI) in this Massachusetts breach of contract and unfair and deceptive insurance practices action under Mass. Gen. Laws ch. 93A, 11, holding that the district court erred in finding the relevant excess policy provisions unambiguously excluded coverage.In 2019, a PTI tanker-truck spilled approximately 4,300 gallons of gasoline, diesel fuel, and dyed diesel fuel onto the roadway and into a nearby reservoir. After cleanup costs exceeded PTI's primary insurance limit, PTI made a claim with General Star under the excess liability policy. General Star disclaimed any coverage obligation. When this suit was brought, the district court granted summary judgment in favor of General Star on the breach of contract claim and dismissed the chapter 93A, section 11 claim with prejudice. The First Circuit reversed, holding (1) the excess policy was ambiguous; and (2) because ambiguity in the policy must be construed in favor of the insured, coverage was available to PTI. View "Performance Trans., Inc. v. General Star Indemnity Co." on Justia Law

Tokiko Johnson's real property was damaged in a storm and she filed a claim with her insurance company. Johnson also executed an assignment of her insurance claim for the purpose of repairing the property with the execution in favor of Triple Diamond Construction LLC (the construction company). An appraiser retained by the construction company determined storm damage to the property in the amount of $36,346.06. The insurer determined the amount of damage due to the storm was $21,725.36. When sued, the insurer argued the insured property owner was required to obtain written consent from the insurer prior to making the assignment. The Oklahoma Supreme Court determined an insured's post-loss assignment of a property insurance claim was an assignment of a chose in action and not an assignment of the insured's policy. Therefore, the insured's assignment was not prohibited by either the insurance policy or 36 O.S. section 3624. Judgment was reversed and the matter remanded for further proceedings. The insurer's motion to dismiss the appeal was thus denied. View "Johnson v. CSAA General Insurance Co." on Justia Law

Todd McLaughlin was riding his bicycle on a Seattle street when the door of a parked vehicle opened right into him. McLaughlin fell, suffered injuries, and sought insurance coverage for various losses, including his medical expenses. McLaughlin’s insurance policy covered those expenses if McLaughlin was a “pedestrian” at the time of the accident. McLaughlin argued a bicyclist was a pedestrian, relying on the definition of “pedestrian” found in the Washington laws governing casualty insurance. The trial court held a bicyclist was not a pedestrian, reasoning that the plain meaning of "pedestrian" excluded bicyclists. The Court of Appeals affirmed, relying largely on its view that the Washington statute defined pedestrian for purposes of casualty insurance, excluded bicyclists. The Washington Supreme Court reversed. The Washington legislature defined “pedestrian” for purposes of casualty insurance in Washington broadly in RCW 48.22.005(11). The Supreme Court found that definition included bicyclists and applied to the insurance contract at issue here. "Even if we were to hold otherwise, at the very least, the undefined term 'pedestrian' in the insurance contract at issue must be considered ambiguous in light of the various definitions of 'pedestrian' discussed in this opinion. Being ambiguous, we must construe the insurance term favorably to the insured. Accordingly, we reverse the Court of Appeals and remand for further proceedings." View "McLaughlin v. Travelers Commercial Ins. Co." on Justia Law