Justia Insurance Law Opinion Summaries

In January 2007, the Bank of Idaho made two construction loans to developers who planned to construct a fourplex on each of two adjoining lots in Idaho Falls. The bank loaned one sum of money to build a fourplex on Lot 1 and another sum for a fourplex on Lot 2. The bank secured a separate policy of title insurance for each lot that was issued by the predecessor of First American Title Insurance Company. Each policy included an endorsement that the parties understood would insure against loss or damage that the bank might sustain by reason of a multifamily residence not being constructed on the lot. After discussion with representatives of the city, the developers changed their original plans and built both fourplexes on Lot 2 and built a parking lot with storm water retention and landscaping on Lot 1. The developers later defaulted on their loans, and the bank foreclosed on both deeds of trust. At the foreclosure sale, the bank acquired each lot by making a full credit bid on all amounts due and owing on the note secured by the deed of trust. In 2010, the bank submitted a claim under the title policy issue with respect to Lot 1 to recover under the endorsement. The insurance company rejected the claim and the bank filed suit to recover under the policy. The district court granted the insurance company’s motion for summary judgment and dismissed this action. The bank then appealed. The Supreme Court concluded after its review that the district court erred in holding that the title insurance company had no liability under the policy. The endorsement provided that "[t]he Company hereby insures the owner of the indebtedness secured by the insured mortgage against loss or damage which the insured shall sustain by reason of the failure of [a multifamily residence to be built on Lot 1]." The endorsement insured against "loss or damage" that the bank argued was the failure of the multifamily residence to be constructed on the lot. It did not define what constituted "loss or damage." Subsections of the pertinent indemnity clause stated limits on the insurance company's liability, but it did not define loss or damage. Accordingly, the district court was reversed and the case remanded for further proceedings. View "Bank of Idaho v. First American Title" on Justia Law

On November 14, 2009, sewage entered into and damaged the home of plaintiffs Justin and Brandy Porter. At the time, Plaintiffs' home was insured by defendant Oklahoma Farm Bureau Mutual Insurance Company under a "Homeowners Special Coverage Policy." Plaintiffs filed a claim for their loss, which defendant denied. Subsequently, plaintiffs filed a petition in the district court for breach of contract and breach of the duty of good faith and fair dealing. Plaintiffs argued that the district court should follow "Andres v. Oklahoma Farm Bureau Mutual Insurance Co.," (227 P.3d 1102, cert. denied, (Nov. 23, 2009)) to find that the policy was ambiguous because it contained conflicting provisions on loss caused by water damage and that the doctrine of reasonable expectations required the ambiguity to be construed in favor of coverage. Plaintiffs also argued that defendant committed bad faith when defendant wrote a policy that both includes and excludes a named peril and then denied plaintiffs coverage under the policy. Plaintiffs amended their petition to bring classwide claims on behalf of others similarly situated. Plaintiffs amended their petition a second time to allege "breach of the implied covenant of good faith and fair dealing and/or fraud," individually and classwide. Plaintiffs' motion for leave to file a second amended petition did not address an individual or class-action fraud claim. Defendant moved to dismiss the class-action claims and the fraud claim for failure to state a claim upon which relief can be granted. Defendant subsequently stated that the motion to dismiss "[did] not address any other claims" and that "a dispositive motion challenging the merits of Plaintiffs' individual breach of contract and bad faith claims [would] likely be filed in the future." The district court, however, dismissed all claims. The issue before the Supreme Court on appeal was whether the district court erred in granting defendant's motion to dismiss. The resolution of this issue turned on two questions: (1) whether plaintiffs' homeowners policy was ambiguous when the policy covers loss to personal property "caused by . . . accidental discharge or overflow of water from within a plumbing . . . system" (the accidental-discharge-coverage provision) and excluded coverage for loss to real and personal property "resulting directly or indirectly from . . . water which backs up through sewers or drains" (the sewer-or-drain-backup exclusion); (2) if the policy was ambiguous, whether the doctrine of reasonable expectations required the ambiguity to be construed in favor of coverage. The Supreme Court found the district court erred in dismissing the petition in its entirety when the allegations taken as true stated a claim for breach of contract. View "Porter v. Oklahoma Farm Bureau Mutual Ins. Co." on Justia Law

Plaintiff Thomas P. Whelan, Jr.'s decedent father, Thomas P. Whelan, Sr., was in Plaintiff's parked truck when it was hit by a moving vehicle. The collision allegedly resulted in severe injuries and medical costs in excess of $100,000 and ultimately in the decedent's death a few years later. At the time of the accident, occupants of Plaintiff's truck were insureds under the terms of a $50,000 liability policy issued by State Farm, facially providing no UM/UIM coverage. In the Supreme Court's decision in "Jordan v. Allstate Ins. Co.," the effective rejection of an insured's statutory rights to UM/UIM coverage equal to liability limits had to be made in writing and as part of the insurance policy delivered to the insured. Because the result in "Jordan" was foreshadowed by other precedents, the Supreme Court declined to make Jordan applicable only to cases arising in the future, and held that policies that failed to comply with Jordan's rejection requirements would be judicially reformed to provide full statutory coverage. In 2011, following the 2010 issuance of Jordan, Plaintiff made a demand on his insurer State Farm for reformation of his policy that was in effect at the time of the accident. Relying on a clause in the policy that purported to bar UM/UIM claims made more than six years after the date of the underlying accident, State Farm rejected the claim. Plaintiff then instituted a declaratory judgment action against State Farm for reformation of the policy. Upon review of this matter, the Supreme Court held that a limitations clause based solely on the date of the accident without consideration of the actual accrual of the right to make a UM/UIM claim was unreasonable and unenforceable as a matter of law. But addressing the merits of Plaintiff's action, the Court also held that judicial reformation under Jordan did not extend to historical insurance contracts formed before another precedential opinion was issued in 2004. Because the policy in this case was issued before that date, it was not subject to retroactive reformation of its facial lack of UM/UIM coverage. View "Whelan v. State Farm Mutual Auto Ins. Co." on Justia Law

Plaintiff, a Milwaukee County sheriff’s deputy, was injured while on duty by a motorist to whom she had just given directions and was allegedly helping to get back into the lane of moving traffic. Plaintiff sought coverage under her employer’s underinsured motorist policy, which pays sums owed by an underinsured tortfeasor to an insured person who is injured while “using an automobile” within the scope of her employment or authority. Plaintiff claimed that she was “using” the automobile that hit her because she was essentially controlling the vehicle. The circuit court granted summary judgment to the insurer. The court of appeals reversed. The Supreme Court reversed the court of appeals, holding that Defendant was not using the vehicle at the time of her injury. View "Jackson v. Wis. County Mut. Ins. Corp." on Justia Law

At issue in this case was which party was entitled to insurance funds under an insurance policy on a parcel of property that sustained water damage. Stanley Gurnick and Phoenix-Gurnick, RIGP claimed they owned the property as a result of a foreclosure sale. Navigant Credit Union claimed it was entitled to the funds as the named mortgagee/loss payee in the insurance policy. The superior court decided that Navigant was entitled to the insurance proceeds because the funds were personal property under the insurance contract and Navigant was named a loss payee under that contract. The Supreme Court affirmed, holding that the hearing justice correctly determined that Navigant was entitled to the insurance proceeds.View "R.I. Joint Reinsurance Ass’n v. O’Sullivan" on Justia Law

After four people died from carbon monoxide poisoning while sleeping in a room above a pool heater in a motel, the motel sought coverage for the deaths from its insurer. The insurer denied coverage based on two provisions of the motel’s general liability policy, the absolute pollution exclusion and the indoor air quality air quality exclusion. The federal district court determined that the policy exclusions were ambiguous and interpreted the ambiguity in the motel’s favor. On appeal, the federal court of appeals certified questions of Nevada law to the Nevada Supreme Court. The Court answered the questions in the negative, concluding that neither the pollution exclusion nor the indoor air quality exclusion clearly excluded coverage for carbon monoxide exposure under the circumstances of this case.View "Century Sur. Co. v. Casino W., Inc." on Justia Law

Plaintiff, an Indiana resident, was driving a semi-tractor trailer on behalf of Werner Transportation, a Georgia company, when he was injured in West Virginia after another truck hit his rig. Werner insured the truck under a policy from Empire Fire and Marine Insurance Co., which provided $5 million liability coverage. Empire, however, claimed that the policy included only $75,000 in underinsured motorist coverage. Applying Georgia law, the trial court granted summary judgment in favor of Empire, finding there was sufficient evidence that Werner made the affirmative choice to purchase underinsured motorist coverage in a lower amount than the liability policy limit. The court of appeals determined that Indiana law applied but nonetheless affirmed the trial court, concluding the evidence was sufficient under Indiana law to establish that Werner had explicitly rejected the default $5 million coverage limit and instead purchased coverage only in the amount of $75,000. The Supreme Court reversed, holding that the issue of whether Werner waived the higher liability limit for underinsured motorist insurance was “unsuitable for summary judgment and best left to the fact-finder.”View "Asklar v. Gilb" on Justia Law

In 2011, defendant S.G.'s vehicle collided with a motorcycle driven by John Allmer. S.G. was fifteen years old at the time. The parties stipulated Allmer suffered significant injuries, had medical expenses in excess of $1 million and continued to incur medical expenses for his care and treatment. Defendant Sandy Goetz and S.G.'s father were divorced, and S.G.'s father owned and insured the vehicle S.G. was driving. S.G. had exclusive possession of the car for six months prior to the accident. Her father's policy had an underlying liability limit of $250,000 and an umbrella policy of $1 million, which her father's insurance company offered in settlement of the claims against him. Goetz had an insurance policy with State Farm that listed Goetz and her vehicle as covered under the policy. Goetz signed S.G.'s driver's license application sponsorship form for drivers under the age of eighteen, assuming financial liability for S.G.'s negligent acts arising from operation of a motor vehicle under sections 39-06-08 (2011) and 39-06-09 (2011), N.D.C.C. State Farm filed a motion for summary judgment, arguing no dispute existed that S.G.'s vehicle was not covered under Goetz's policy. Goetz and S.G. filed a motion for summary judgment and Allmer filed a motion for summary judgment, arguing the language in Goetz's State Farm's insurance policy should be construed to provide coverage for the accident. State Farm did not dispute Goetz was liable for S.G.'s negligent acts; therefore, the district court addressed only whether State Farm's policy provided coverage for the claim. The district court found for the purposes of Goetz's policy that S.G. was considered a "resident relative" and S.G.'s Oldsmobile was a "non-owned" vehicle. The district court also determined State Farm was not required to cover S.G.'s vehicle because the vehicle was not designated on the policy. The district court granted State Farm's motion for summary judgment, and denied Goetz and S.G.'s motion for summary judgment and Allmer's motion for summary judgment. Allmer appealed, arguing that Goetz's signature on S.G.'s sponsorship form for her driver's license application imputed S.G.'s negligence to Goetz and created coverage for S.G.'s accident under Goetz's insurance policy. Finding no reversible error, the Supreme Court affirmed. View "State Farm Mutual Automobile Insurance Co. v. Gruebele" on Justia Law

The issue this case presented to the Delaware Supreme Court centered on whether coverage existed under certain management liability insurance policies. A bankruptcy trust sought a determination that those insurance policies covered potential future expenses and liabilities that might have arisen out of pre-bankruptcy wrongful acts allegedly committed by the insured debtor company’s directors and officers. XL Specialty Insurance Company and certain excess insurance carriers, appealed a Superior Court order denying their motion to dismiss the action. They claimed that the plaintiff-appellee, WMI Liquidating Trust lacked standing to prosecute its coverage claims, and, that the dispute did not present a ripe "actual controversy" susceptible of adjudication. Because the Supreme Court held that the Trust’s complaint must be dismissed on ripeness grounds, it did not reach the issue of standing. The parties’ dispute was not ripe because it has not yet assumed a concrete or final form. View "XL Specialty Insurance Co., et al. v. WMI Liquidating Trust" on Justia Law

Franklin Quick Cash, LLC, a payday and title lending company, was sued for wrongfully repossessing a vehicle. Franklin had a commercial general liability insurance policy with Continental Western Insurance Co. that covered liability for accidents but precluded coverage of liability for property damage “expected or intended” by the insured. Continental Western refused to provide a defense on the grounds that Franklin’s actions leading to the suit were intentional. Franklin sued Continental Western for wrongful refusal to defend. The circuit court granted summary judgment for Franklin. The Supreme Court reversed, holding that Continental Western did not have a duty to defend because Franklin intended to repossess the vehicle, and therefore, there was no potential for coverage at the outset of the underlying lawsuit.View "Allen vs. Continental W. Ins. Co." on Justia Law