Justia Insurance Law Opinion Summaries

In this original jurisdiction proceeding, the Supreme Court granted a writ of prohibition sought by Petitioners, out-of-state Blue Cross Blue Shield Plans, to prevent the enforcement of the circuit court's order concluding that it had jurisdiction over Petitioners in this action, holding that jurisdiction over Petitioners was clearly not appropriate in this case.Respondent alleged that the circuit court had jurisdiction over Petitioners for several reasons. Petitioners filed a motion to dismiss for lack of jurisdiction, asserting that they had no relevant jurisdictional contacts with West Virginia. The circuit court denied the motion, concluding that Petitioners purposefully availed themselves of the privilege of conducting business in West Virginia. Petitioners then filed the instant writ, arguing that any attempt to exercise specific jurisdiction over them violated due process because there was no allegation or evidence showing that they developed or maintained a substantial relationship with West Virginia or purposefully engaged in forum-related conduct that gave rise to Respondent's claims. The Supreme Court granted the writ, holding that Petitioners were entitled to the writ of prohibition. View "State ex rel. Blue Cross & Blue Shield of Kansas, Inc. v. Honorable Shawn D. Nines" on Justia Law

The Supreme Court affirmed the circuit court's dismissal of West Virginia Counties Group Self-Insurance Risk Pool, Inc.'s (WVCoRP) claims against Great Cacapon Volunteer Fire Department, Inc. (VFD), holding that the circuit court did not err.When a fire destroyed the building where VFD was housed, the owner of the building, the Morgan County Commission, was reimbursed for the loss by WVCoRP. Seeking to recover the funds it expended, WVCoRP sued the VFD and other parties for negligence. In the process, WVCoRP invoked a contractual right to subrogation. The circuit court determined that the claims against VFD were barred by W. Va. Code 29-12A-13(c), which prohibits claims against political subdivisions made under a right of subrogation. The Supreme Court affirmed, holding (1) WVCoRP's claims spring from its coverage contract with the Commission and fall within any plain meaning of subrogation; and (2) section 29-12A-13(c) is not an insurance law of the State from which WVCoRP is exempt. View "West Virginia Counties Group v. Great Cacapon Volunteer Fire Department, Inc." on Justia Law

Pogue, believing that he had a severe anxiety disorder that prevented him from practicing as a family doctor, submitted a disability claim to his long-term disability insurers: Northwestern Mutual and Principal Life. Pogue failed to disclose that the Tennessee Board of Medical Examiners had suspended his license for mis-prescribing painkillers. His insurers found out and denied both of his claims. Pogue sued, alleging breach of contract and breach of the duty of good faith and fair dealing.In Pogue’s lawsuit against Northwestern, the district court granted Northwestern summary judgment on two alternative grounds: the suspension occurred before Pogue became disabled, and the suspension caused stress and anxiety and thus contributed to his disability. The Sixth Circuit court affirmed on the first ground and declined to consider the second ground. When Pogue’s lawsuit against Principal reached summary judgment, the district court applied issue preclusion and relied on the Northwestern district court’s holding that the suspension of Pogue’s license contributed to his disability. The court did not address whether the suspension occurred before Pogue became disabled and also granted summary judgment on Pogue’s bad-faith claims. The Sixth Circuit reversed. The district court erred by giving preclusive effect to an alternative holding on which the Sixth Circuit declined to rule. View "Pogue v. Principal Life Insurance Co." on Justia Law

In 2016, an unidentified driver struck a flagpole owned by 100 Renaissance, LLC, causing $2,134 in damage. Renaissance filed a claim with its insurance company, Travelers Property Casualty Company of America. Renaissance sought coverage under its automobile liability-insurance policy, which included uninsured-motorist(UM) coverage. Travelers denied the claim, determining there was no coverage under the UM policy because the flagpole was not a covered "auto." Renaissance's attorney sent an email to Travelers' claims handler, setting forth the Renaissance's legal arguments as to why coverage should be afforded under Mississippi's UM statute. The claims handler forwarded the email to Travelers' in-house counsel. When the claim was still denied, Renaissance filed suit on a bad-faith failure-to-pay theory. Renaissance took the claim handler's deposition, and asked her to explain the reasons Travelers denied the claim. In an effort to resolve the matter, Travelers paid the full amount for damage to the flagpole. Renaissance, however, continued to litigate its bad-faith claim. Travelers moved for summary judgment. Renaissance responded by asking for a continuance to conduct additional discovery. The additional discovery Renaissance claimed it needed was a production of the emails between the claims handler and the in-house counsel. The trial court granted the request for Travelers to produce the emails for in camera review. After that review, the trial court found that “Travelers ha[d] waived the attorney-client privilege as it relates to attorney Jim Harris.” The trial court ordered Travelers to produce the emails and to produce Harris (in-house counsel) for a deposition. Travelers filed a petition for interlocutory appeal, which the Mississippi Supreme Court granted. The Supreme Court did not disagree with the trial court's determination that the privilege was waived, and affirmed its judgment. View "Travelers Property Casualty Company of America v. 100 Renaissance, LLC" on Justia Law

Plaintiffs enrolled in a Group Variable Universal Life Insurance (GVUL) policy offered by MetLife. During the enrollment process, neither plaintiff indicated that he smoked tobacco, but MetLife nevertheless designated them as tobacco smokers, thus triggering their payment of higher insurance premiums. Plaintiffs filed suit after MetLife refused to refund the amount of overpayments, alleging breach of contract and tort violations under New York law.The Second Circuit affirmed the district court's dismissal of plaintiffs' claims as time-barred under New York's applicable statute of limitations. The court held that the continuing-violation doctrine did not toll the limitations period for the breach of contract claim where the issue in this case rests on a single allegedly unlawful act, namely MetLife's initial designation of both plaintiffs as smokers. The court noted that determining whether the Securities Litigation Uniform Standards Act bar applies here is a fraught and unnecessary endeavor. View "Miller v. Metropolitan Life Insurance Co." on Justia Law

Auburn Woods I Homeowners Association (HOA) and its property manager Frei Real Estate Services (FRES), tendered the defense of two lawsuits filed against them by a member of HOA under HOA’s condominium/association policy. HOA’s insurer, State Farm Insurance Company (State Farm), denied the tender for the first lawsuit, but accepted defense of the second lawsuit as to HOA only. HOA and Al Frei, individually and doing business as FRES, sued State Farm and its agent Frank Lewis for, among other things, breach of contract and breach of the implied covenant of good faith and fair dealing. The trial court entered judgment in favor of State Farm and Lewis after a bench trial. HOA and Frei appealed, contending: (1) the trial court erred in concluding that State Farm did not owe a duty to defend HOA and FRES against the first lawsuit; (2) HOA had a reasonable expectation that FRES would be covered under the directors and officers liability provision of its policy; (3) State Farm failed to reimburse HOA for post-tender expenses related to the second lawsuit; (4) Lewis breached his contract with HOA by failing to include FRES as an additional insured and failing to alert HOA and Frei that itwas not possible to include FRES under the directors and officers liability provision; (5) State Farm breached the covenant of good faith and fair dealing implied in HOA’s policy; and (6) the trial court erred in denying HOA and Frei’s motion to tax the expert witness fees State Farm and Lewis sought to recover under Code of Civil Procedure section 998. After review, the Court of Appeal concluded: (1) State Farm did not have a duty to defend HOA and FRES against the first lawsuit; (2) HOA and Frei failed to establish that FRES should have been deemed an insured under the directors and officers liability provision; (3) substantial evidence supported the trial court’s finding that HOA did not present State Farm with a clear statement of the amount of attorney’s fees and costs HOA incurred in defending against the second lawsuit; (4) HOA and Frei did not establish the alleged contract between Lewis and HOA; (5) HOA and Frei failed to demonstrate error with regard to their breach of implied covenant cause of action; and (6) State Farm and Lewis’s pretrial offer to compromise was effective to trigger cost shifting under section 998. View "Auburn Woods I Homeowners Assn. v. State Farm General Ins. Co." on Justia Law

The Supreme Court granted a writ of prohibition prohibiting the circuit court from enforcing its sua sponte order dismissing count three of Respondents' complaint and finding that West Virginia law applied to all of Respondents' bad faith claims but declined to extend the writ to find that Georgia law applies to the entire dispute, holding that a writ of prohibition was not the proper avenue for such relief.After Petitioners denied insurance coverage for certain damages Petitioners filed a declaratory judgment action in the State of Delaware to determine their rights and responsibilities under the relevant insurance policies. Respondents subsequently filed the underlying complaint asserting five separate counts, including breach of contract and bad faith under Georgia law (count three). Petitioners sought to dismiss the West Virginia proceeding. The circuit court denied the motion but, sua sponte, dismissed count three. Petitioners then filed the instant petition. The Supreme Court granted the writ as moulded, holding (1) the circuit court exceeded its lawful authority when it sua sponte dismissed count three of the complaint and held that West Virginia law applied to Respondents' bad faith claims; and (2) this Court declines Petitioners' invitation to find that the Georgia choice-of-law provisions in the policies govern this action. View "State ex rel. National Union Fire Insurance Co. of Pittsburg, Pennsylvania v. Hummel" on Justia Law

The Supreme Court affirmed in part and reversed in part the judgment of the district court granting class certification in this action alleging breach of contract and violation of Montana's Unfair Trade Practices Act (UTPA), Mont. Code Ann. 33-18-101 et seq., holding that a sufficient factual basis was established to justify certification of the classes.Plaintiffs filed this action against Fergus Farm Mutual Insurance Company (FFM), alleging that FFM breached its insurance contract with Plaintiffs and all other insureds by failing to include general contractor overhead and profit in the cost to repair or replace Plaintiffs' property. The district court granted Plaintiffs' motion for class certification. The Supreme Court reversed in part, holding (1) the district court did not abuse its discretion by determining that common questions of law predominate the litigation and support certification of the class; but (2) certain conclusions reached by the district court were a "bridge too far" at this stage of litigation. View "Kramer v. Fergus Farm Mutual Insurance Co." on Justia Law

In October 2015, Amy Downing purchased a life insurance policy from Country Life Insurance Company. She purchased both an “executive whole life” policy that would pay a flat amount of $500,000 to her beneficiaries upon her death and a “Paid-Up Additions Rider” (PUAR) that provided an additional death benefit and an investment opportunity. Although Amy's father Tom worked for Country, another employee, Robert Sullivan, met with Amy and Tom to describe the terms of the policy. Amy asked Sullivan why she needed one and a half million dollars in insurance coverage because it was a larger benefit than she expected to need and it required higher yearly premiums. Sullivan explained that although she might not need the large death benefit, the structure of the PUAR provided an investment opportunity because it maximized the policy’s cash value. Sullivan later testified that he never represented to Amy that the death benefit associated with the PUAR was a flat amount. After paying the premiums for a year, Amy informed her parents that she intended to abandon the policy and withdraw its existing cash value. Her mother Kathleen decided to look into the policy as an investment. Kathleen decided to take over payment of the premiums on Amy’s life insurance policy, including the PUAR, as an investment. With Tom’s assistance, Amy assigned her policy to Kathleen. Four months later, on January 27, 2017, Amy died in an accident. Her death occurred in the second year of her policy coverage. Country paid the death benefit of $500,000 on Amy’s whole life policy. Country also paid $108,855 on Amy’s PUAR. Kathleen sued, alleging that she was entitled to $1,095,741 on Amy’s PUAR, minus the $108,855 already paid. Judgment was rendered in favor of Country, and Kathleen appealed. The Alaska Supreme Court determined the superior court did not err in its interpretation of the insurance policy at issue, and affirmed the decision. View "Downing v. Country Life Insurance Company" on Justia Law

Following two operation-disabling accidents, Noranda Aluminum Holding Corporation, an insured aluminum-products manufacturer, whose “all-risks” property-insurance policy included business- interruption coverage, did not rebuild its damaged facility and consequently did not resume operations. Noranda and its insurers agreed that the failure to rebuild and resume operations did not negate the business-interruption coverage. But when Noranda submitted its business-interruption claim, the parties could not agree on how to calculate the Noranda's gross-earnings loss, which was the measure of the insurers’ liability under the relevant policy. After a seven-day trial, a jury found in favor of Noranda, and the insurers appealed. At trial, Noranda's damages expert employed a model that measured the insured’s gross-earnings loss by comparing the value of the insured’s production had the accident not occurred with the value of its production after the accidents had it repaired and resumed operations with due diligence. Although the parties disputed whether the insurers took issue with this methodology at trial in this appeal, the insurers contended that the model was inconsistent with the policy’s formula for calculating gross-earnings loss and that it grossly exaggerated the amount of the Noranda's claim. The insurers also challenged Noranda's expert’s factual assumptions and claimed he improperly included amounts that the insured had waived in an earlier property-damage settlement. The Delaware Supreme Court concluded Noranda's expert's damages model was consistent with the relevant policy provisions, and that the trial court's determination that the factual assumptions made by the expert were sufficiently reliable for the jury to consider was not an abuse of discretion. Likewise, the Court held the insurers' claim that the earlier property-damage settlement precluded a portion of Noranda's recovery was without merit. Therefore, the Supreme Court affirmed. View "XL Insurance America, Inc., et al. v. Noranda Aluminum Holding Corporation" on Justia Law