Justia Insurance Law Opinion Summaries

Appellant was injured while working for Employer, which had an insurance policy issued by Zurich American Insurance Company. The policy included an underinsured motorist (UIM) endorsement. After settling with the tortfeasor, Appellant sought damages from the UIM coverage in the Zurich policy. After Zurich refused Appellant’s claim, Appellant sued Zurich. Ultimately, the trial court granted summary judgment in favor of Zurich on the grounds that the UIM coverage included in the policy was the result of a mutual mistake in the making of the insurance contract. The Supreme Court reversed and remanded for entry of an order granting Appellant’s motion for partial summary judgment on the issue of UIM coverage, holding that reformation of the insurance contract on the grounds of mutual mistake was improper because (1) the facts did not establish that at the time the insurance contract was formed, the minds of the contracting parties met with the common intent to execute a policy that excluded UIM coverage; and (2) Zurich did not assert the mistake or deny the existence of UIM coverage until after Appellant had released the tortfeasor. View "Nichols v. Zurich Am. Ins. Co." on Justia Law

Plaintiffs brought legal malpractice claims against Jeffrey Daniels, American Guarantee & Liability Insurance Company’s insured. American Guarantee wrongly refused to defend the claims. A default judgment was entered against Daniels, who assigned his rights against American Guarantee to Plaintiffs. Plaintiffs then brought the present action seeking to enforce American Guarantee’s duty to indemnify Daniels for the judgment. Summary judgment was awarded in favor of Plaintiffs. The Appellate Division affirmed. The Court of Appeals affirmed, concluding that American Guarantee’s breach of its duty to defend barred it from relying on policy exclusions as a defense to the present lawsuit. The Court later granted reargument, vacated its prior decision, and reversed the Appellate Division’s order, holding (1) under controlling precedent, American Guarantee was not barred from relying on policy exclusions as a defense; and (2) the applicability of the exclusions American Guarantee relied on presented an issue of fact sufficient to defeat summary judgment. View "K2 Inv. Group, LLC v. Am. Guar. & Liab. Ins. Co." on Justia Law

Filippo Gallina and his wife (Plaintiffs) commenced a personal injury action against Preferred Trucking Services Corp. Preferred Trucking was insured by County-Wide Insurance Company under a policy that required insureds to cooperate with Country-Wide in its investigation of a claim or defense against a lawsuit. The next year, Country-Wide disclaimed its obligation to defend and indemnify Preferred Trucking based upon Preferred Trucking’s refusal to cooperate in the defense. Supreme Court subsequently awarded judgment to Plaintiffs. Thereafter, Country-Wide filed this action against Preferred Trucking and Plaintiffs seeking a declaration that it was not obligated to defend and indemnify Preferred Trucking in the underlying action. Supreme Court concluded that Country-Wide was obligated to defend and indemnify Preferred Trucking. At issue on appeal was whether Country-Wide’s disclaimer was timely as a matter of law. The Appellate Court affirmed, concluding that Country-Wide’s disclaimer was untimely because it came four months after Country-Wide learned of the ground for the disclaimer. The Court of Appeals reversed, holding that Country-Wide was not obligated to defend and indemnify Preferred Trucking, as Country-Wide established as a matter of law that its delay was reasonable. View "Country-Wide Ins. Co. v. Preferred Trucking Servs. Corp. " on Justia Law

In late 2005 or early 2006, Corey Culverhouse began constructing a house for himself on a five-acre lot in Hartford. He obtained a policy from Alfa Mutual Insurance Company to insure the house during the remainder of the construction process and after construction was completed. In 2009, a minor fire damaged the kitchen of the house. Culverhouse submitted a claim to Alfa, which paid for a remediation company to clean and repair the smoke damage caused by the fire. During this process, Culverhouse moved out of the house and into a barn on his property. After about two weeks of living in the barn, Culverhouse moved into a house he was constructing for eventual sale across the road from his house. Later that year, another fire damaged the house. This time, the fire could not be extinguished, and the house, its contents, and an adjacent swimming pool were completely destroyed. Culverhouse promptly informed Alfa. Alfa immediately questioned the Culverhouse's claim because he had not submitted with his claim an inventory of the contents of the house and supporting documentation, and he had not submitted any evidence supporting the large claim he had submitted for loss of use in the two-month period prior to the second fire. Culverhouse ultimately sued Alfa for payment of the claim. A hearing on the summary-judgment motion was held on in 2013, and the trial court granted Alfa's motion and dismissed each of Culverhouse's claims; the trial court also dismissed an Alfa counterclaim as moot. Culverhouse thereafter retained a new attorney and, on moved the trial court to alter, amend, or vacate its order. The trial court granted Culverhouse's motion in part and amended its summary-judgment order so as to exclude Culverhouse's breach-of-contract claim from the judgment, leaving it as the only remaining claim in the case. Alfa's argument on appeal did not relate to the merits of Culverhouse's breach-of-contract claim. Rather, it concerned only whether the trial court acted properly by amending its summary-judgment order to resurrect that claim in response to Culverhouse's motion to alter, amend, or vacate the judgment pursuant to Rule 59(e). Finding no reversible error, the Supreme Court affirmed the trial court's decision. View "ALFA Mutual Insurance Co. v. Culverhouse " on Justia Law

Plaintiff had a $1 million insurance policy from Defendant on an office building. On February 23, 2007, the building was severely damaged in a fire. Defendant paid Plaintiff the actual cash value of the destroyed building in the amount of $757,812 but withheld the cost of replacing the destroyed property until Plaintiff could replace the property. The replacement building was completed in October 2010. Plaintiff brought an action against Defendant seeking payment of the unpaid portion of the policy limits. The U.S. district court granted Defendant’s motion to dismiss, concluding that the policy barred any suits commenced more than two years after the date of the damage and that the two-year limitation period was reasonable. The Court of Appeals answered a question from the Second Circuit Court of Appeals and held that such a contractual limitation period, applied to this case in which the property could not reasonably be replaced in two years, was unreasonable and unenforceable. View "Executive Plaza, LLC v. Peerless Ins. Co." on Justia Law

VP & PK purchased an insurance policy from Lexington Insurance Company for work on a construction site. Kila Kila, one of VP & PK’s subcontractors, purchased an insurance policy from Nautilus Insurance Company. Both policies contained an “other insurance” provision and included duties to defend and indemnify. When VP & PK and Kila Kila were sued for damages resulting from the construction, Nautilus funded the defense of both Kila Kila and VP & PK. Lexington satisfied the judgment against VP & PK but did not contribute to the defense costs. Nautilus filed a complaint seeking (1) a declaration that Lexington owed VP & PK a duty to defend, which it breached; and (2) equitable contribution from Lexington for defense costs. The U.S. district court granted summary judgment for Lexington, holding that Lexington’s policy was in excess to Nautilus’s policy, and therefore, Lexington’s duty to defend was not triggered. The Hawaii Supreme Court accepted certified questions from the court of appeals and held, inter alia, that (1) an “other insurance” clause purporting to release an otherwise primary insurer of the duty to defend if the insurer becomes excess as to liability is enforceable, but only as between two or more insurers seeking to allocate or recover defense costs; and (2) an otherwise primary insurer who becomes an excess insurer by operation of an “other insurance” clause has a duty to defend as soon as a claim is tendered to it and there is the mere possibility that coverage of that claim exists under its policy. View "Nautilus Ins. Co. v. Lexington Ins. Co." on Justia Law

Machon Lyons suffered severe injuries as the result of an automobile accident. The accident occurred when a vehicle operated by Roderick Holliday left the road and collided with a tree. As a result, Lyons obtained a default judgment of $72,500 against Holliday. Holliday's mother, Daisy Lang, insured the vehicle through Direct General Insurance Company of Mississippi. Lang's policy included a provision specifically excluding Holliday from any coverage under the policy. Accordingly, Direct denied coverage for the judgment. Lyons sought a declaratory judgment, asking the Circuit Court to hold that Lang's policy covered the judgment against Holliday. Lyons acknowledged the policy exclusion, but argued that Lang's policy covered the judgment against Holliday because Mississippi law required minimum-liability coverage for all permissive drivers, and because Lang's insurance card failed to mention any permissive-driver exclusions. The circuit court granted summary judgment in favor of Direct, finding that the policy clearly and specifically excluded coverage of Holliday. The Court of Appeals reversed, finding that 63-15-4(2)(a) required liability insurance for all vehicles operated in Mississippi and that Mississippi Code Section 63-15-43 required that the liability insurance policy "pay on behalf of the named insured and any other person, as insured, using any such motor vehicle or motor vehicles with the express or implied permission of such named insured." Although the Court of Appeals reached the right result, it cited as its authority the incorrect statute, so the Supreme Court granted certiorari. The Court concluded the policy exclusion violated Mississippi law: even though Holliday was an excluded driver under the Direct General policy issued to Daisy Lang, the exclusion did not operate to eliminate liability coverage in the minimum amounts required by statute. The trial court's grant of summary judgment was reversed and the case remanded for further proceedings. View "Lyons v. Direct General Insurance Company of Mississippi " on Justia Law

Retired Employees and their spouses filed suit against the County, alleging that the Retired Employees have an implied vested right to the pooling of their health care premiums with those of current employees ("pooled premiums"). The court affirmed the district court's order granting the County's motion for summary judgment, concluding that Retired Employees failed to raise a genuine issue of material fact where they did not show any link to Retired Employees' claim of an implied right to an ongoing pool premium; a practice or policy extended over a period of time did not translate into an implied contract without clear legislative intent to create that right - and intent that Retired Employees has not demonstrated in this case; Retired Employees' assertions that its involvement in negotiations with the County revealed an implied contract right to the pooled premium also lacked evidentiary support; and the nature of Retired Employees' evidence underscored the absence of any definitive intent or commitment on the part of the County to provide for the pooled premium. Accordingly, the court affirmed the district court's grant of the County's motion for summary judgment. View "REAOC v. County of Orange" on Justia Law

Appellant, Century Indemnity Company (CIC) appealed a Superior Court order that granted Respondent Roger Sevigny, Commissioner of Insurance and Liquidator of the Home Insurance Company (Home) an award of statutory prejudgment interest on certain monies owed to Home by CIC. Home is an insurance company, organized under the laws of New Hampshire, which was declared insolvent and placed in liquidation in 2003. CIC is an insurance company organized under the laws of Pennsylvania. CIC and Home have a set of co-insurance and reinsurance relationships. In prior litigation, the Supreme Court held that an asserted $8 million setoff claim by CIC, which had been waived and then reacquired by CIC in a pair of settlement agreements with PECO, was impermissible under New Hampshire law. The New Hampshire Court explicitly declined, without prejudice, to decide the issue at issue here: whether Home’s estate was entitled to prejudgment interest on the payments CIC wrongfully withheld based upon setoff. The Court denied CIC’s motion for reconsideration in the "Home IV" appeal; after remand, the Liquidator filed a motion in superior court for interest on amounts withheld by CIC based upon improper setoff, to which CIC objected. CIC removed the PECO setoff from its monthly statement to Home and paid the previously withheld $8 million to the Liquidator. The trial court entered an order granting the motion and finding that Home was entitled to prejudgment statutory interest under RSA 524:1-a (2007) accruing from October 2007 (the date of the Liquidator’s letter notifying CIC of his determination to disallow the PECO setoff). This appeal followed. Finding no reversible error in the Superior Court's order, the Supreme Court affirmed. View "In the Matter of the Rehabilitation of the Home Insurance Company" on Justia Law

In 2007, Steven and Valerie Hruza sought to obtain a loan from Clearwater Mortgage (Clearwater). Clearwater requested Defendant-Respondent Wade Massey to perform an appraisal of their real property located in Caldwell. Massey owned co-defendant Capitol West Appraisals and is a professional appraiser licensed to practice in Idaho. Massey performed the appraisal and sent a Summary Appraisal Report to Clearwater indicating that market value of the property was $1,150,000. Clearwater decided to deny the Hruzas' loan application before considering the appraisal. Massey admitted that both he and Clearwater were aware that the appraisal contained errors. Clearwater's president and Massey agreed that Massey would not fix the errors and Clearwater would not pay Massey for the appraisal. The Hruzas submitted a subsequent loan application to Idahy Federal Credit Union (now known as Icon). Icon approved the loan, secured by a deed of trust on the Hruzas' property. Icon sent a check to Capitol, and Capitol accepted payment. Plaintiff-Appellant CUMIS Insurance Society, Inc. was the fidelity bond insurer for Icon. It paid Icon as a result of the Hruzas' default on their loan. As Icon's subrogee, CUMIS filed suit against Massey and Capitol, alleging professional negligence, negligent misrepresentation, and breach of contract based on Massey's conduct in preparing the appraisal. A central point of dispute between the parties was how Icon obtained the appraisal. CUMIS alleged that the Hruzas included the appraisal with their loan application, thus prompting Icon to pay Capitol for the appraisal. Massey suggested that Icon improperly obtained the appraisal, pointing to Icon's admission that it did not know how it obtained it and that Icon did not request a letter of assignment from Clearwater to use or rely on the appraisal. The district court concluded that CUMIS could not establish that Massey owed a legal duty to Icon, that Idaho does not recognize a cause of action for negligent misrepresentation against appraisers, and that CUMIS had no breach of contract claim. Therefore, the district court granted Massey’s motion for summary judgment and dismissed all claims asserted by CUMIS, with prejudice. Finding that there remained issues of material fact, the Supreme Court vacated the district court's judgment dismissing CUMIS's complaint. The case was remanded for further proceedings. View "CUMIS Insurance Society, Inc. v. Massey" on Justia Law