Justia Insurance Law Opinion Summaries

Mercury Casualty Company filed an action seeking declaratory relief regarding its obligation to students Hung Chu and his roommate Tu Pham. Mercury issued an automobile policy to Chu insuring his 1995 Honda Accord. Chu was driving, and Pham was a passenger, when Chu collided with a vehicle driven by Krystal Nguyen Hoang. Pham filed a personal injury action against Chu and Hoang and obtained a $333,300 judgment against Chu. Mercury sought a judicial determination confirming Mercury’s decision Chu’s policy excluded coverage for Pham’s judgment under a “resident exclusion.” Mercury also sought an order requiring Chu to reimburse Mercury the fees and costs it incurred in defending him against Pham’s lawsuit. Chu cross-complained against Mercury for breach of contract, bad faith, and general negligence. Mercury prevailed on the issue of whether the policy provided coverage for Pham’s judgment. The court determined Mercury had no duty to indemnify Chu with respect to the judgment. It granted Mercury’s motion for judgment on the pleadings (JOP) on Chu’s cross-complaint but determined Mercury could not seek reimbursement of its attorney fees and costs in defending Chu because such damages were not sought in the JOP. Both parties appealed. Chu and Pham appealed the determination that Mercury’s policy excluded coverage for Pham’s personal injury lawsuit against Chu. Mercury appealed the court’s ruling Chu was not required to reimburse Mercury for the defense fees and costs. After its review of the record, the Court of Appeal reversed, concluding the policy provision excluding Pham from coverage was an overbroad expansion of the statutorily permitted exclusion and was also contrary to public policy. Based on this ruling, the Court did not address the issue raised in Mercury’s cross-appeal regarding its entitlement to defense costs and fees.View "Mercury Casualty v. Chu" on Justia Law

The Georgia Department of Corrections (GDOC) entered into a construction contract with Lewis Walker Roofing (Walker Roofing) to re-roof several buildings at Valdosta State Prison. The Contract contained two “no assignment” clauses, and as a prerequisite to contracting with GDOC, Walker Roofing was required to obtain payment and performance bonds. It obtained such payment and performance bonds from Developers Surety and Indemnity Company. Walker Roofing did not complete its work within the time frame required by the Contract, and GDOC declared Walker Roofing in default. Developers Surety did not notify GDOC within 25 days of receipt of GDOC's notice of default regarding whether it would remedy the default or perform the contract. However, approximately three months after the declaration of default, Developers Surety gave GDOC the option of entering into a contract with another company for the completion of the work. GDOC then contracted with that company to finish the project. Under the payment and performance bonds and prior to Walker Roofing's default, Developers Surety had provided financial assistance to Walker Roofing. Developers Surety filed suit against GDOC for breach of contract and for a declaratory judgment that it had no obligation under the payment and performance bond it issued to Walker Roofing on behalf of GDOC. GDOC filed a counterclaim for breach of contract. The parties filed cross-motions for summary judgment, and the trial court determined that Developers Surety's claims were not barred by sovereign immunity and that GDOC had breached the construction contract as a matter of law. It concluded that GDOC waived its sovereign immunity by entering into the contract with Walker Roofing, and that the doctrine of equitable subrogation gave Developers Surety the ability to file suit against GDOC once it incurred liability and paid the obligations of its principal under the bond. Consequently, the trial court granted summary judgment to Developers Surety and denied it to GDOC; in the same order, the trial court entered judgment in favor of Developers Surety in the amount equal to the "financial assistance" Developers Surety provided to Walker Roofing. The Supreme Court granted certiorari to the Court of Appeals to consider whether the State’s sovereign immunity was waived for the claim Developers Surety made on its contract with the State. The Supreme Court found that immunity was indeed waived in this instance, and accordingly, it affirmed the judgment of the Court of Appeals. View "Georgia Dept. of Corrections v. Developers Surety & Indemnity Co." on Justia Law

Mid-Continent Casualty Company brought a declaratory judgment action to settle an issue with its commercial commercial general liability (CGL) policy issued to Pennant Service Company. In 2001, True Oil Company, an owner and operator of oil and gas wells, entered into a master service contract (MSC) with Pennant for work on a well in Wyoming. The MSC included a provision whereby Pennant agreed to indemnify True Oil resulting from either Pennant or True Oil's negligence. In July 2001, Christopher Van Norman, a Pennant employee, was injured in an accident at True Oil's well. Van Norman sued True Oil in Wyoming state court for negligence. In accordance with the MSC's indemnity provision, counsel for True Oil wrote to Pennant requesting indemnification for its defense costs, attorney fees, and any award that Van Norman might recover against it. Mid-Continent refused to defend or indemnify True Oil based on Wyoming's Anti-Indemnity Statute, which invalidates agreements related to oil or gas wells that "indemnify the indemnitee against loss or liability for damages for . . . bodily injury to persons." In May 2002, True Oil brought a federal action against Mid-Continent for declaratory relief, breach of contract (CGL policy), and other related claims. In February 2005, the district court granted Mid-Continent summary judgment, determining that the MSC's indemnity provision, when invoked with respect to claims of the indemnitee's own negligence was unenforceable as a matter of public policy. The court held that Mid-Continent was not required to defend or indemnify True Oil in the underlying suit as it then existed because "where an indemnification provision in a MSC is void and unenforceable, the insurer never actually assumed any of the indemnitee's liabilities under the policy." The district court granted summary judgment to True Oil, determining Mid-Continent breached its duty to defend and indemnify True Oil. As damages, the court awarded True Oil the amount it paid to settle the underlying suit and the attorney fees and costs incurred in defending itself. Mid-Continent appealed the district court's judgment. Finding no reversible error, the Tenth Circuit affirmed.View "Mid-Continent v. True Oil Company" on Justia Law

Manuel Lainez had been independently driving commercial vehicles for eight and a half years. He owned his own truck and his own business, Lainez Trucking. He purchased a trucker’s liability policy from Scottsdale Indemnity Company with a $1 million liability limit. Lainez entered into a motor carrier agreement with Western Transportation Services. Western did not own tractors or trailers, but contracted with owner/operators or drivers. The agreement provided that Lainez was an independent contractor and was responsible for all costs and expenses incidental to the performance of transportation services. He agreed to maintain liability insurance and to name Western Transport as an additional insured. Western Transport, through the California Automobile Assigned Risk Plan (CAARP), purchased a commercial assigned risk policy from National Continental Insurance Company (NCI), which stated "'Named Insured’s Business: 1 Trucker for Hire-Excess'" and named Lainez as a driver. It did not list, describe, or rate any vehicle. It was rated on an excess cost of hire basis at a premium that was 4 to 10 percent of the cost of a policy rated on a primary cost of hire basis. The issue this case presented for the Court of Appeal's review was whether the two insurance companies were coprimary insurers or whether NCI was an excess insurer for an underlying fatality involving Lainez. The trial court granted NCI’s motion for a summary judgment, concluding that Scottsdale was the primary insurer pursuant to California Insurance Code section 11580.9, subdivisions (d) and (h). The Court of Appeal agreed that Scottsdale was the primary insurer and NCI was the excess insurer and affirmed the judgment. View "Scottsdale Indemnity v. National Continental Insurance Co." on Justia Law

Rose’s Bidwell, Ohio home was insured by State Farm. Rose also had a Personal Articles Policy that covered two Rolex watches. In 2009, a fire destroyed the house. Later that day, Rose made a claim of $696,373.30 for the dwelling, $512,765.57 for damage to personal property, $30,000 for living expenses, and $29,850 for one Rolex watch. State Farm’s investigator took a recorded statement from Rose and his wife and spoke with Rose’s ex-wife; gathered information by searching public records; and retained a fire investigator, who issued a report, finding that the fire originated in the kitchen, that electrical items did not appear to be the source of the fire, and that neither smoking nor cooking was suspected as a cause. The report indicated that non-reported human action could not be eliminated as a cause, but did not specify that the fire was deliberately ignited. State Farm denied Rose’s claims, alleging that Rose violated “Intentional Acts” and “Concealment or Fraud” conditions of his policies. Rose sued, alleging breach of contract and bad faith. The district court declined to grant summary judgment on the “Intentional Acts” clause, but found that some answers Rose gave, failing to identify multiple tax liens and judgments, in statements to State Farm were misleading and material, and granted summary judgment on the other claim. The Sixth Circuit reversed, finding material questions of fact concerning whether Rose misled investigators.View "Rose v. State Farm Fire & Cas. Co." on Justia Law

In December 2010, Cost-U-Less Insurance assisted plaintiffs by telephone, through an InsZone Insurance Services employee, in obtaining a homeowner’s insurance policy with Fidelity. In 2011, a fire damaged plaintiffs’ home. They made a claim with Fidelity. Fidelity property claims representative Fowler sent a letter advising that Fidelity was investigating coverage for the fire incident, indicating that Fidelity had obtained information suggesting plaintiff did not live in the home and that the property had been used and operated as a residential care facility. After an investigation, Fidelity rescinded the homeowner’s policy on the grounds that plaintiffs’ insurance application contained material misrepresentations about various facts concerning plaintiffs’ and their home. The trial court entered judgment in favor of plaintiffs in the amount of $807,058.10, plus interest and costs of suit. Plaintiffs appealed the trial court’s decision to strike the jury’s $1.9 million punitive damages award. Fidelity appealed that the court committed jury instructional error. The appeals court remanded, holding that the trial court prejudicially erred in refusing to give certain jury instructions concerning whether the application formed an insurance contract.View "Douglas v. Fidelity Nat' Ins.Co." on Justia Law

Homeowner lived in a house that she insured with Farmers Insurance Exchange. The policy contained a clause suspending dwelling coverage if the house was vacant for more than sixty days. Homeowner subsequently moved into a retirement community. While the policy was still effective, fire from a neighboring house spread to Homeowner’s house and damaged it. Farmers denied Homeowner’s claim on the basis that the house had been vacant for more than sixty days. Homeowner sued Farmers for breach of contract. The trial court granted summary judgment for Homeowner on the contract claim. The court of appeals reversed and rendered judgment for Farmers, concluding that Farmers was not required to establish that the vacancy contributed to cause the loss in order to assert the vacancy clause as a defense. The Supreme Court affirmed, holding that Farmers was not precluded from relying on language in the vacancy clause in response to Homeowner’s claim, and the vacancy provision must be applied according to its terms.View "Greene v. Farmers Ins. Exch." on Justia Law

Dr. Steven Hayne appealed the trial court’s grant of summary judgment in favor of his former medical malpractice insurer, The Doctors Company and The Doctors Company Insurance Services (collectively, “The Doctors”). The Doctors refused to cover Hayne for lawsuits brought by exonerated criminal defendants against whom Hayne had testified as a State’s witness. Kennedy Brewer sued Hayne for malicious prosecution, fraud, and negligent misrepresentation in the Circuit Court of Noxubee County, Mississippi, and later in federal district court. Hayne sought coverage under a medical malpractice insurance policy he had purchased from The Doctors. The Doctors declined to provide coverage, arguing that Brewer was not a "patient" under Hayne’s medical malpractice insurance policy, and that the company therefore was under no obligation to cover Hayne in relation to the suit brought by Brewer. Hayne argued in his suit against The Doctors that The Doctors knew when it issued the policy exactly what kind of medicine he practiced, and that the insurance policy covered him for the types of medical malpractice suits he might face, including the suit filed by Brewer. The Doctors moved for summary judgment, arguing that the policy language was clear and unambiguous in the kind of coverage provided, and that the suit by Brewer did not fall within the policy’s coverage. The Circuit Court agreed, and, despite a lack of in-depth discovery, granted the motion for summary judgment. Finding no reversible error, the Supreme Court affirmed. View "Hayne v. The Doctors Company" on Justia Law

Defendant, a law firm, contracted with Plaintiff for Plaintiff to provide title insurance on two mortgages that Defendant took as security from a client indebted to Defendant. Upon foreclosure of liens that were superior to those of Defendant, Defendant sought coverage from Plaintiff under the insurance policies, which seemingly provided coverage for priority liens. Defendant requested indemnification, and Plaintiff sought declaratory judgment, arguing that coverage for priority liens was not intended by either party. A federal district court granted summary judgment in favor of Plaintiff, concluding that because Defendant was aware of the prior mortgages, it could not expect to receive coverage it did not bargain for. The First Circuit affirmed, holding that Plaintiff had conclusively shown that Defendant was aware that its bargain with the client for security of its debt would result in junior mortgages, and the insurance policies clearly excluded such encumbrances from coverage.View "First Am. Title Ins. Co. v. Lane Powell PC" on Justia Law

In 1987, Joseph Bagley purchased a cancer and dread-disease policy through his friend and insurance agent, Jackie McPhail. The policy was issued by American Heritage Life Insurance Company. McPhail worked as an independent insurance broker, and she was a registered agent with American Heritage at the time the policy was written. The policy indicated that Bagley purchased coverage concerning cancer and dread disease, a home-recovery rider, and a hospital intensive-care rider. Bagley also had an option to purchase life insurance; however, McPhail testified that Bagley did not purchase life insurance under this policy because he had purchased a separate life-insurance policy. In 2008, Bagley was diagnosed with cancer. Bagley contacted McPhail to file a claim under the policy and to "change the beneficiary" of the policy from his estate to Michael and Betty Strait. McPhail testified that she had ceased writing policies for American Heritage; however, she still retained the authority to service Bagley's policy, and she acquired his written consent to receive information regarding his policy from the insurance company. While Bagley was in the hospital, McPhail presented an American Heritage change-of-beneficiary form, which Bagley ultimately signed. The signature was witnessed by Bagley's physician, a nurse, and McPhail. Bagley orally communicated that he wished for the beneficiary to be changed from his estate to the Straits. At the time that Bagley signed the form, the Straits had yet to be listed as beneficiaries on the form. McPhail met with the Straits after the form was signed to confirm their correct legal names to be placed on the change-of-beneficiary form at a later time. McPhail provided that she did not fully complete the form because she was attempting to contact American Heritage to confirm the correct procedure for completing the process; however, American Heritage's office was closed because of Hurricane Fay, and McPhail never succeeded in speaking with American Heritage regarding the matter. Bagley's physician, who witnessed Bagley signing the form, later communicated to Betty Strait that his attorney advised that the form could not be used because the Straits' names were not listed on the form prior to Bagley's signature. Betty Strait relayed this to McPhail, who then attempted to contact American Heritage's legal department. McPhail called the company on multiple occasions, but she never received a return phone call. Soon thereafter, Bagley passed away, and the form was never completed. The estate was probated and the Straits did not contest the passage of the policy proceeds to the estate at the time that the estate was being settled. The executor of Bagley's will, William Kinstley, petitioned for the approval of the estate's final accounting, which included the policy proceeds. The Straits initiated legal action against McPhail and American Heritage in Hinds County Circuit Court, arguing that Bagley intended for them to receive the proceeds from the cancer policy. The Straits alleged breach of contract, tortious breach of contract, negligence and gross negligence, breach of fiduciary duties and the duty of good faith and fair dealing, bad-faith refusal to pay benefits and to promptly and adequately investigate the claim, misrepresentation and/or failure to procure, promissory and/or equitable estoppel, and they sought a claim for declaratory relief. McPhail filed a motion to dismiss, which was granted by the circuit court. The circuit court found that the issue had been previously litigated and resolved in chancery court, and that no appeal had been taken from the chancery court judgment. Likewise, the circuit court granted American Heritage's motion for summary judgment, finding that there were no genuine issues of material fact to be resolved. The Court of Appeals reversed the judgment and remanded the case, finding that genuine issues of material fact did exist and that res judicata and collateral estoppel did not bar the Straits' claims. Because the Straits failed to raise any issues upon which relief may be granted, the circuit court's grant of McPhail's motion to dismiss was proper. However, the circuit court erred in granting the motion to dismiss based on res judicata and collateral estoppel. Furthermore, the circuit court properly granted American Heritage's motion for summary judgment: the Straits were never eligible to be third-party beneficiaries under the policy, and they have failed to show any equitable entitlement to reimbursement. For those reasons, the Supreme Court reversed the judgment of the Court of Appeals and reinstated the circuit court's judgment. View "Strait v. McPhail " on Justia Law