Justia Insurance Law Opinion SummariesArticles Posted in Georgia Supreme Court
Lloyd’s Syndicate No. 5820 v. AGCO Corporation
Appellee AGCO Corporation (AGCO) manufactured and sold a self-propelled, agricultural spray applicator called the "RoGator." In 2005, AGCO began offering an Extended Protection Plan (EPP) to its RoGator customers. Appellant Lloyd’s Syndicate No. 5820 d/b/a Cassidy Davis provided the master policy of insurance for the EPP program, which covered AGCO for certain liability to customers who purchased the RoGator EPP. Glynn General Corporation administered the plans. Between 2005 and 2008, AGCO enrolled about 2,050 RoGator machines in the EPP program. In 2008, a number of customers presented claims under the EPP based on the failure of wheel motors on the RoGator. After it paid about 25 claims related to this failure, Cassidy Davis invoked the "Epidemic Failure Clause" of the master insurance policy and refused to pay for any more claims. AGCO then sued Cassidy Davis asserting various claims, namely claims for breach of contract and bad faith denial of insurance coverage. The trial court granted partial summary judgment to AGCO and denied partial summary judgment to Cassidy Davis on a breach of contract issue, holding that the EPP covered failures caused by design and engineering defects in the RoGators. The trial court also denied Cassidy Davis’s motion for summary judgment on the bad faith claim, rejecting the insurer’s argument that it was not obligated to indemnify AGCO until a court entered a judgment establishing AGCO’s legal liability to its customers. The Court of Appeals affirmed the trial court on both issues. Cassidy Davis appealed, arguing: (1) that the Court of Appeals erred in its interpretation of the coverage provision of the extended protection plan; and (2) the Court of Appeals erred in its interpretation of the indemnity provision of the master policy of liability insurance. Upon review of the matter, the Supreme Court concluded the Court of Appeals misinterpreted the relevant language of both contracts. Therefore the Court reversed on both issues. View "Lloyd's Syndicate No. 5820 v. AGCO Corporation" on Justia Law
Hospital Authority of Clarke County v. GEICO General Insurance Co.
In March 2010, Justyna Kunz was involved in a car accident with GEICO's insureds, Crystal, Joseph, and Elizabeth Kalish. Kunz received medical treatment at Athens Regional Medical Center; the Hospital Authority of Clarke County and Athens Regional Medical Center (collectively, "the Hospitals") filed three hospital liens. Kunz subsequently filed suit against the Kalishes. Kunz's attorney wrote a letter to the Kalishes' attorney accepting their $100,000 policy limit settlement offer. The settlement documents, signed in Fall 2010, expressly required Kunz to satisfy the hospital liens out of the settlement fund and constituted a "general[ ] release ... from all legal and equitable claims of every kind and nature." The liens were never satisfied. The Court of Appeals held that, under OCGA 44–14–473 (a), the Hospitals were barred by a one-year statute of limitations from filing suit against GEICO to collect on the hospital liens. The Hospitals appealed the appellate court's decision. Finding that the appellate court erred in arriving at its conclusion, the Supreme Court reversed. View "Hospital Authority of Clarke County v. GEICO General Insurance Co." on Justia Law
Georgia Insurer’s Insolvency Pool v. Hulsey Environmental Services, Inc.
The Georgia Insurance Insolvency Pool (GIIP) brought a declaratory judgment action against two insureds who purchased workers compensation insurance from the Southern United States Insurance Company (SEUS) before SEUS became a member of GIIP. SEUS insureds whose claims predated June, 2006 were not covered by GIIP, and those insureds faced exposure when SEUS was liquidated in October, 2009. In 2010, the Georgia Legislature enacted a law to expand GIIP's "covered claims" to include certain insureds who obtained insurance from a captive insurer that later became insolvent. The effect of the 2010 amendment was to retroactively cover the previously excluded claims of SEUS insureds. GIIP claimed that extension of coverage would decrease GIIP's reserves and increase the assessments levied on member insurance companies. The defendants, whose claims would be covered only because of the 2010 amendment, filed a motion to dismiss, asserting GIIP lacked standing to bring suit. The trial court granted the motion and the appellate court affirmed. Upon review, the Supreme Court concluded the legislature gave GIIP the power to sue and be sued, and as such, had no standing to challenge the 2010 statutory amendment. View "Georgia Insurer's Insolvency Pool v. Hulsey Environmental Services, Inc." on Justia Law
Taylor Morrison Services, Inc. v. HDI-Gerling America Insurance Co.
In a commercial general liability policy (GCL) coverage case, the United States Court of Appeals for the Eleventh Circuit certified two questions to the Georgia Supreme Court: (1) whether, for an "occurrence" to exist under a standard CGL policy, Georgia law requires there to be damage to "other property;" and (2) if "no" to the first question, whether for an "occurrence" to exist under a standard CGL policy, Georgia law requires that the claims being defended not be for breach of contract, fraud, or breach of warranty from the failure to disclose material information. The Supreme Court answered the first question in the negative, and the second in the affirmative to fraud, but negative as to breach of warranty. View "Taylor Morrison Services, Inc. v. HDI-Gerling America Insurance Co. " on Justia Law
Wilson v. Automobile Insurance Co. of Hartford, Connecticut
The United States District Court for the Northern District of Georgia certified two questions to the Georgia Supreme Court. The questions related to the Automobile Insurance Company of Hartford Connecticut's umbrella policy issued to Louis and Betty Wilson. At the time, Georgia law required policies to have uninsured motorist coverage unless the insured rejected that coverage in writing. The Wilsons did not reject uninsured motorist coverage; their policy excluded such coverage despite being required by law. Because it was not written into the policy but required, it was implied by operation of law. In 2010, Louis Wilson was seriously injured in an accident, and gave notice of a claim for uninsured motorist benefits. The insurance company denied the claim, contending that a 2008 amendment to the Georgia law specifically excluded umbrella policies from mandatory uninsured motorist coverage. The questions from the federal court centered on whether the amendment to the applicable Georgia law applied to the Wilson's umbrella policy after 2009, and whether the notice requirements of the amended law applied to umbrella policies. After review, the Georgia Court concluded that the amendment in question here did not apply to the Wilson's umbrella policy, nor did the notice requirement. View "Wilson v. Automobile Insurance Co. of Hartford, Connecticut" on Justia Law
Woodcraft by MacDonald, Inc. v. Georgia Casualty & Surety Co.
Following the fracture of an underground gas pipeline owned and operated by Atmos Energy Corporation, a subsequent fire and explosion damaged a building owned by Woodcraft by Macdonald, Inc. d/b/a Coachcraft. Coachcraft's insurer, Georgia Casualty and Surety Co., paid Coachcraft $1,675,169 under two policies and then pursued its own subrogation rights against Atmos in federal court where Coachcraft and its owner, intervened as plaintiffs. After more than two years of discovery and preparation for trial, Georgia Casualty decided to settle its claims against Atmos for $950,000. Coachcraft filed an objection to the settlement, arguing Georgia Casualty was prohibited from settling its subrogation claims until Coachcraft was "made whole." The federal court denied the objection. In lieu of continuing its own federal case, Coachcraft also settled its claims against Atmos for $125,000. Following the settlements, Coachcraft demanded Georgia Casualty pay, from its settlement, the remaining amount it claimed was necessary to make it whole from the damage to its building ($179,130.59). Georgia Casualty refused the demand, and Coachcraft brought a breach of contract action. The trial court denied Georgia Casualty's motion for summary judgment on the breach of contract claim, but granted summary judgment on the bad faith claim. On interlocutory appeal, the Court of Appeals found that summary judgment for Georgia Casualty was warranted on both the breach of contract and bad faith claims. The Supreme Court granted Coachcraft's petition for certiorari to determine whether the Court of Appeals erred when it reversed the trial court's denial of summary judgment to Georgia Casualty on the breach of contract claim. Upon review, the Court upheld the Court of Appeals' ultimate conclusion that the "made whole" doctrine did not require Georgia Casualty to demonstrate that Coachcraft had been fully compensated prior to exercising its subrogation rights under the insurance policy. View "Woodcraft by MacDonald, Inc. v. Georgia Casualty & Surety Co." on Justia Law
Lumpkin Co. v. Georgia Insurers Insolvency Pool
Following the trial court's grant of summary judgment to the Georgia Insurers Insolvency Pool (GIIP), Lumpkin County appealed, contending that following the insolvency of the County's regular insurer, GIIP was required to step in and cover the pending workers' compensation claims against the County. Specifically, the County argued that the trial court erred in finding that it was not entitled to coverage under the GIIP because the County's net worth exceeded $25 million. Alternatively, the County argued OCGA 33-36-3 unconstitutionally violated the County's due process rights. Upon review, the Supreme Court affirmed: "The County contend[ed] that this ruling was erroneous because the term 'net worth' is inapplicable to government entities, and, instead, the applicability of the twenty-five million dollar exemption under the Act should be assessed based on the County's 'net assets.' The County argue[d] that the bulk of its assets, including land, roads, bridges, and government buildings are restricted from use and are thus unavailable to meet its obligations or satisfy liabilities. Based on the County's calculation of its own net assets, it only has $5.6 million dollars with which to meet these obligations. As a result, the County maintain[ed] that it should receive coverage for its claims from the GIIP. This argument is misplaced." Therefore, the Court held that the trial court did not err in excluding the County from GIIP protection based on the net worth exemption. Furthermore, the County does not possess due process rights by which to challenge the constitutionality of the Act, and its argument premised on any such right necessarily failed. View "Lumpkin Co. v. Georgia Insurers Insolvency Pool" on Justia Law
Posted in: Constitutional Law, Georgia Supreme Court, Government & Administrative Law, Insurance Law
Arby’s Restaurant Group, Inc. v. McRae
The Supreme Court granted certiorari in this appeal to consider whether OCGA section 34-9-207 required an employee who files a claim under the Georgia Workers' Compensation Act (OCGA 34-9-1 et seq.), to authorize her treating physician to engage in ex parte communications with her employer or an employer representative in exchange for receiving benefits for a compensable injury. Because the Court of Appeals erroneously held an employee is not required to authorize such communications, the Supreme Court reversed. View "Arby's Restaurant Group, Inc. v. McRae" on Justia Law
Smith v. Ellis
The issue before the Supreme Court was whether an employee who filed an injury claim against his employer under the State Workers' Compensation Act and receives compensation in exchange for a "no liability" settlement with his employer that is approved by the State Board of Workers' Compensation may then turn around and sue the co-employee who caused the injury in a tort action. Ten years ago, the Court of Appeals answered this question no, holding that the Act's exclusive remedy provision bars such a lawsuit based on the same injury for which the employee has already received a remedy. In this appeal, however, the Court of Appeals was equally divided as to whether the underlying case law should be overruled, and the case was sent to the Supreme Court for resolution. Upon review, the Supreme Court held that "Ridley" was correctly decided. Thus, appellant Joseph Smith, having previously entered a Board-approved settlement with his employer in exchange for compensation, would be barred from suing appellee John Ellis for the same injury in tort if Ellis qualified as an "employee of the same employer" as Smith, rather than a "third-party tort-feasor," as those phrases are used in the applicable statutory authority. However, the evidence did not establish that Ellis was acting as "an employee of the same employer" in the course of his employment, at the time he injured Smith. The trial court therefore erred in granting summary judgment to Ellis, and that judgment was reversed. View "Smith v. Ellis" on Justia Law
Posted in: Georgia Supreme Court, Government & Administrative Law, Injury Law, Insurance Law, Labor & Employment Law
Gates v. Glass
The Supreme Court granted certiorari to the Court of Appeals in "Glass v. Gates" to answer whether the definition of "any motor vehicle" in OCGA 33-24-51(a) continued to be the broader definition of the term provided for in prior case law, notwithstanding the 2002 passage of OCGA 36-92-1. As inmates at the Troup County Correctional facility, Jonathan Glass and Tony Smith were operating tractors when Smith's tractor got stuck in a ditch. Donrell Gates, Glass' detail supervisor, instructed the men to attach a chain to the tractors so Glass could use his tractor to pull Smith's from the ditch. As Glass did so, Smith engaged his tractor's bush hog, causing a rock to take flight and pierce Glass' throat. Glass bled profusely and died later that day. Plaintiffs, Glass' minor son and the executor of his estate, brought a wrongful death and survivor action against Troup County and Gates. The county sought summary judgment, claiming plaintiffs' claims were barred by sovereign immunity. The County asserted that by revising OCGA 33-24-51 (b) in 2002 (effective 2005), the legislature demonstrated its intent to apply the more narrow definition of "motor vehicle" found in OCGA 36-92-1 (6) in determining whether a local government waived sovereign immunity by purchasing liability insurance on a motor vehicle. The trial court agreed and granted summary judgment in favor of the County, concluding that the county did not waive sovereign immunity because neither a tractor nor a bush hog could be deemed a "motor vehicle" under OCGA 36-92-1. The Court of Appeals reversed, holding that the broader definition of "motor vehicle" should have been applied under 33-24-51, and that therefore, the County waived its sovereign immunity as long as it purchased insurance for the tractor and bush hog used by Smith. The Supreme Court agreed with the Court of Appeals' reasoning, and affirmed by answering the appellate court's original question in the affirmative. View "Gates v. Glass" on Justia Law
Posted in: Constitutional Law, Criminal Law, Georgia Supreme Court, Government & Administrative Law, Injury Law, Insurance Law, Trusts & Estates