Justia Insurance Law Opinion Summaries

The United States Court of Appeals for the Eleventh Circuit certified two questions to the Georgia Supreme Court: "(1) Did the Georgia Insurance Commissioner act within his legal authority when he promulgated Ga. Comp. R. & Regs. 120-2-20-.02, such that a multiple-line insurance policy providing first-party insurance coverage for theft-related property damage must be reformed to conform with the two-year limitation period provided for in Georgia's Standard Fire Policy, Ga. Comp. R. & Regs. 120-2-19-.01?; and, (2) is this action barred by the Policy's one-year limitation period?" These questions arose from a dispute over Petitioner Ricardo White's purchase of a homeowner's insurance policy from Respondent State Farm Fire and Casualty Company. The insurance policy was a first-party insurance contract that provided multiple-line coverage, including coverage for loss or damage caused by both fire and theft. The policy contained a limitation provision stating that a lawsuit against State Farm must be brought "within one year of the date of loss or damage." After his home was burglarized in January 2008 (within the period of coverage), Petitioner filed a claim for the loss of more than $135,000 in personal property. State Farm denied the claim based on its determination that Petitioner misrepresented material information in filing his claim. Waiting more than one year after his date of loss, Petitioner filed a June 2009 complaint against State Farm in state court alleging claims for breach of contract, bad faith, and fraud. Upon review of the facts of this case, the Supreme Court found that: (1) the Georgia Insurance Commissioner did not act within his legal authority and (2) this action was barred by the one-year limitation period in his insurance policy. View "White v. State Farm Fire & Casualty Co." on Justia Law

Plaintiff sustained a serious brain injury when he fell while climbing down from the roof of a residence while working for EWES. At the time of the accident, EWES held a commercial liability insurance policy issued by Maxum. Maxum denied coverage and refused to defend, citing the policy's Employer Liability Exclusion. After plaintiff obtained a negligence judgment against EWES, he filed suit against Maxum pursuant to an assignment of claims from EWES, asserting breach of the duty to defend and seeking indemnification. The court reversed as to the notice issue, finding that Maxum waived its right to assert a defense based on untimely notice because it did not properly alert EWES that the lack of timely notice would be a potential bar to coverage. The court also reversed the Court of Appeals' decision regarding Maxum's duty to defend, finding that since Maxum waived its right to assert a defense related to EWES' failure to give timely notice of the occurrence, timely notice of the occurrence was not a prerequisite to Maxum's duty to defend. View "Hoover v. Maxum Indemnity Co." on Justia Law

The United States Court of appeals asked the court to answer a question that stemmed from a dispute over the proper interpretation under Georgia law of a contract insuring real property. The primary issue presented was whether the court's ruling in State Farm Mut. Auto. Ins. Co. v. Mabry, a case involving an automobile insurance policy wherein the court held that a provision requiring the insurer to pay for loss to the insured's car required the insurer to also pay for any diminution in value of the repaired vehicle, was applicable. The court held that its ruling in Mabry was not limited by the type of property insured, but rather spoke generally to the measure of damages an insurer was obligated to pay.

Appellee, as executrix of the estate of her father, and her sister, brought a breach of contract action in which they asserted that their father's second wife, appellant, contractually waived her right to retain the proceeds of their deceased father's employer-provided 401K plan and life insurance policy by entering a settlement agreement incorporated into an order of separate maintenance executed approximately a year prior to the father's death. At issue was whether the court of appeals erred in finding that decedent's children could maintain a state law action against the decedent's surviving spouse to recover proceeds distributed to the spouse as the beneficiary of the decedent's ERISA-governed benefits plans, 29 U.S.C. 1001 et seq., where the state law claims were based on a contention that the spouse waived her rights to such proceeds. The court answered in the negative, concluding that, in this case, since the proceeds of the ERISA-covered plans were paid out to appellant and were no longer in the control of the plan administrator, the trial court erred when it dismissed appellees' breach of contract claim against appellant.

Lisa Krebs sued Carmen McReynolds and GM for serious injuries she received when McReynold's car struck the GM vehicle in which Krebs was a passenger. McReynolds subsequently appealed the trial court's rulings. The court granted certiorari to consider two questions: (1) Did the Court of Appeals correctly construe OCGA 51-12-33 to require a trier of fact to apportion an award of damages among multiple defendants when the plaintiff was not at fault?; and (2) Did the Court of Appeals correctly find that McReynolds's insurer made a counteroffer in response to Krebs's settlement demand? The court answered both questions affirmatively. The court held that in applying section 51-12-33, the trier of fact must "apportion its award of damages among the persons who were liable according to the percentage of fault of each person" even if the plaintiff was not at fault for the injury or damages claimed. In light of this holding, there was no error in the dismissal of McReynolds's cross-claims for contribution and set-off against GM. The court construed the response by McReynolds's insurer to Krebs's settlement offer, proposing to resolve the hospital and other liens "as part of this settlement," as a counteroffer rather than an unconditional and unequivocal acceptance. Accordingly, no binding settlement was formed.

This case arose from an automobile collision in which a police officer employed by the City of Newman was driving a City police car when it was struck by a motor vehicle owned and operated by the insured, who had $25,000 of motor vehicle liability coverage. The City had a Member Coverage Agreement (Agreement) with the Georgia Interlocal Risk Management Agency (GIRMA), established under OCGA 36-85-1 et seq. The officer subsequently sued the insured in tort and served a copy of the complaint on GIRMA to notify GIRMA that it might be held responsible as an uninsured motorist carrier pursuant to OCGA 33-7-11. The court subsequently granted a writ of certiorari to the court of appeals to consider whether that court properly determined that a municipality's motor vehicle liability coverage secured through an interlocal risk management agency was not statutorily obligated to satisfy the requirements for uninsured and underinsured motorist coverage that were applied to commercial insurance policies and private self-insurance plans. The court held that the district court reached the correct conclusion when it determined that there was no authority for the conclusion that an interlocal risk management program such as that offered by GIRMA must include uninsured motorist coverage pursuant to OCGA 33-7-11. Therefore, the Agreement was limited to its express terms and did not include the underinsured motorist protection that the police officer sought. Accordingly, the judgment was affirmed.