Justia Insurance Law Opinion Summaries

Plaintiff-Appellant Cynthia Pfeifer filed suit against Defendant-Appellee Federal Express Corporation in the District of Kansas, alleging that the company fired her in retaliation for receiving workers' compensation benefits. Plaintiff filed suit fifteen months following the termination within the applicable state statute of limitations, but outside the limit of six months enumerated in her employment agreement. The district court granted Defendant's motion for summary judgment, concluding that the contract clause was reasonable and was not a violation of public policy. Because no Kansas law appeared to control the outcome of the case, the Tenth Circuit certified two questions to the Kansas Supreme Court regarding the ability of parties to shorten the applicable statute of limitations by contract, and if not, then was the six-month limitation unreasonable in this case? The Kansas Court responded that the contract clause in question here did violate public policy. Because of that answer, the Court did not respond to the Tenth Circuit's second question. In light of these answers, the federal district court was reversed and the case remanded for further proceedings. View "Pfeifer v. Federal Express Corporation" on Justia Law

A staffing services company (Company) furnished workers for the City, including Respondent. During the course of his employment, Employee lost an arm working on a garbage truck driven by an employee of the City. Respondent sued the City and its employee (collectively, Petitioners). Petitioners filed a motion for summary judgment, asserting governmental immunity based in part on the exclusive remedy under the Texas Labor Code, which provides that recovery of workers' compensation benefits is the exclusive remedy of an employee covered by workers' compensation insurance. The trial court dismissed the case. The court of appeals reversed, holding that a fact question remained whether Respondent, who was paid by Company, was within the specific terms of the City's workers' compensation coverage. The Supreme Court reversed and dismissed the case, holding that, as a matter of law, the City provided Respondent's workers' compensation coverage, and therefore, Respondent's exclusive remedy was the compensation benefits to which he was entitled. View "City of Bellaire v. Johnson" on Justia Law

Employee was employer at Employer's aluminum-processing plant from 1957 to 1989. In 2009, Employee filed an occupational-disease claim for benefits with the Arkansas Workers' Compensation Commission, alleging that he suffered from cancer caused by his exposure to asbestos while working for Employer. A law judge found Employee's complaint was time barred. Rather than appeal the decision to the full Commission, Employee filed suit against Employer in circuit court. Employer filed a motion to dismiss based on the exclusive remedy afforded by the Workers' Compensation Act. The circuit court denied the motion, concluding that, where a plaintiff's disease manifests after the statute of limitations has expired, a circuit court has authority to exercise jurisdiction over the plaintiff's claims. The Supreme Court granted Employer's requested writ of prohibition, holding that the Commission had exclusive jurisdiction to decide the issue in the first instance, and because Employee's claim was not submitted to the Commission, the circuit court lacked jurisdiction to decide the case. View "Reynolds Metal Co. v. Circuit Court" on Justia Law

Employee-claimant Cathy Bone filed a workman's compensation claim for a work-related injury. The employer, U.S. Food Service, and its carrier Indemnity Insurance Co. of North America disputed the claim. The single commissioner and an Appellate Panel of the South Carolina Workers' Compensation Commission issued orders denying the claim. Under the procedure then in place, Bone appealed to the circuit court, which concluded the injury was compensable and remanded the matter to the Commission for further proceedings. The employer appealed the circuit court's order, and the Court of Appeals dismissed the appeal on the basis the order was not a "final judgment" and thus not immediately appealable because further proceedings were ordered before the administrative agency. The Supreme Court granted Petitioners' petition for a writ of certiorari to review the decision of the Court of Appeals, and the Supreme Court affirmed. The high court subsequently granted a petition for rehearing filed by the employer, and it additionally granted the following two motions: (1) Bone's motion to argue against precedent, and (2) the motion of the South Carolina Defense Trial Attorneys' Association to accept its Amicus Curiae Brief in support of Petitioners. After considering the record in this matter, as well as the briefs and arguments, the Court adhered to its original decision to affirm. View "Bone v. U.S. Food Service" on Justia Law

Paul Dyer held licenses as an insurance producer and consultant. Because of Dyer's alleged misconduct, the Bureau of Insurance filed a petition for enforcement against Dyer alleging that Dyer violated the Maine Insurance Code and seeking the revocation of his licenses and requesting civil penalties and restitution. After a hearing, the Superintendent of Insurance concluded that Dyer violated the identified provisions of the Insurance Code, revoked Dyer's licenses, and ordered him to pay civil penalties and restitution. Dyer appealed the judgment entered in the business and consumer docket affirming the Superintendent's decision. The Supreme Court affirmed, holding that the Superintendent did not err in interpreting the Insurance Code or in making factual findings and did not abuse his discretion by imposing penalties permitted in the statute. View "Dyer v. Superintendent of Ins." on Justia Law

Petitioner Robert Smitter applied for workers' compensation benefits after being injured on the job working as a firefighter for Thornapple Township. At the time of his injury, Petitioner also worked for General Motors. He earned eleven percent of his income from the township and 89 from GM. The township did not reduce its workers’ compensation obligation by coordinating Petitioner's benefits with his disability benefits under MCL 418.354(1)(b). The township sought reimbursement from the Second Injury Fund under the dual-employment provisions for the entirety of Petitioner's wage-loss benefits. The fund agreed to pay the amount it would have owed if the township had coordinated Petitioner's benefits. The township filed an application for a hearing with the Worker’s Compensation Board of Magistrates, seeking reimbursement from the fund for the uncoordinated amount. The magistrate ordered the fund to reimburse the township for 89 percent of Petitioner's uncoordinated benefits. The Workers’ Compensation Appellate Commission (WCAC) affirmed. The Court of Appeals denied the fund’s application for leave to appeal. After its review, the Supreme Court concluded that when the injury employment provided less than 80 percent of the employee’s wages, the fund is required to reimburse its portion of the coordinated amount of benefits. Because the Township did not coordinate in this case, the appellate court erred in its analysis. Accordingly the appellate court was reversed and the case remanded to the magistrate for further proceedings. View "Smitter v. Thornapple Township" on Justia Law

The Providence School Board (Board) provided health insurance to active employees and retirees. In 2006, the Providence Teachers Union (Union) filed a grievance protesting a difference in the increase of premium costs for retirees compared with a more modest increase in premium costs for active employees. The Union argued that the Board's action violated three provisions of the collective bargaining agreement (CBA) between the board and the union. An arbitrator ruled in the Union's favor, concluding that the Board violated the CBA by failing to include retirees and active employees in a single group when it calculated the healthcare premium rates. The trial justice vacated the arbitration award, concluding (1) the Union did not have standing to pursue a grievance on behalf of retirees, and (2) the issue of the calculation of the group premium rate was not arbitrable. The Supreme Court affirmed, holding (1) pursuant to Arena v. City of Providence and City of Newport v. Local 1080, the Union could not pursue this grievance on behalf of the retirees; and (2) because the Union had no standing to pursue this particular grievance, the grievance was not arbitrable. View "Providence Sch. Bd. v. Providence Teachers Union, Local 958" on Justia Law

Workforce Safety & Insurance (WSI) appealed a district court's judgment reversing its denial of worker's compensation benefits to claimant Brenda Albright. Albright submitted her claim to WSI for a work-related back injury. Albright had a history of back problems; an independent medical records review of Albright's case showed she had "well-documented multilevel degenerative disk pathology" which contributed to the claim at issue here. The ALJ hearing Albright's case concluded her injury was not the result of a single incident, and denied her application for benefits. Finding that the evidence in the record supported the ALJ's decision to deny Albright's application for benefits, the Supreme Court reversed the district court, affirmed the ALJ and reinstated WSI's order denying benefits. View "Albright v. ND Workforce Safety & Ins" on Justia Law

Appellant was employed as a laborer by County Saw & Knife. Appellant successfully sought workers' compensation after he developed respiratory problems from his exposure to metal dust. One year later, Appellant applied for an additional award, alleging that Country Saw violated specific safety requirements (VSSRs). The Industrial Commission denied Appellant's application, concluding that County Saw had not violated the VSSRs. The court of appeals denied Appellant's request for a writ of mandamus that would require the Commission to vacate its order denying Appellant's application. The Supreme Court affirmed, holding that Appellant did not present sufficient evidence to establish that he was entitled to an award for a VSSR in addition to his extant workers' compensation benefits. View "State ex rel. Scott v. Indus. Comm'n" on Justia Law

Appellee Young's Sales & Service submitted a claim with Appellant Underground Storage Indemnification Fund for reimbursement of remediation costs it incurred following the release of certain regulated chemicals stored in underground tanks on its property. The claim was denied, and Appellee appealed. The issue before the Supreme Court in this case was whether the Commonwealth Court correctly held that section 706(2) of the Storage Tank Spill Prevention Act applied on a per tank basis. Upon review, the Supreme Court concluded it did not. Accordingly, the Court reversed the Commonwealth Court and reinstated the Board's order denying Appellee's claim. View "Young's Sales & Service v. Underground Storage Tank Indemnification Board" on Justia Law