Justia Insurance Law Opinion Summaries

Claimant Barbara Kelly was an employee of Blue Ribbon Linen Supply, Inc. when a cart rolled over her left foot. She filed for workers’ compensation benefits. Kelly sustained additional injuries in an automobile accident when returning home from an Independent Medical Evaluation (IME) scheduled by the Idaho State Insurance Fund (Surety) in connection with the cart incident. The Industrial Commission concluded that Kelly’s injuries from the automobile accident were not compensable because they did not arise out of and in the course of her employment with Blue Ribbon. The Supreme Court concluded after review that the causal connection between Kelly’s employment and the injuries she sustained as a result of the accident was sufficiently compelling that it held that the injuries arose out of and in the course of her employment. Accordingly, the Court reversed the Commission’s decision and remanded for further proceedings. View "Kelly v. Blue Ribbon Linen Supply, Inc." on Justia Law

In 2009, plaintiff Craig Mulford filed a complaint against his employer Union Pacific Railroad (UP) seeking relief under the Federal Employer’s Liability Act (FELA). Plaintiff alleged he sustained injury to his knees as a result of UP's negligence. The case went to trial in 2012. The jury reached its verdict, unanimously concluding that UP was not negligent. The district court issued its final judgment and dismissed plaintiff's claims. In this appeal, plaintiff claimed that the district court erred on two separate grounds: (1) failing to disqualify a juror for cause; and (2) admitting evidence that he received disability benefits from the Railroad Retirement Board (RRB) to impeach statements made by plaintiff on direct examination. Finding no reversible error, the Supreme Court affirmed. View "Mulford v. Union Pacific Railroad" 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

This appeal stemmed from a worker’s compensation case in which Michael Vawter sought compensation from his employer, United Parcel Service (UPS), for a back injury he claimed he suffered as a result of his employment. UPS attempted to establish that Vawter did not suffer a compensable injury, but if he did the State's Industrial Special Indemnity Fund (ISIF) was liable for a portion of his benefits. Ultimately, the Idaho Industrial Commission found that Vawter was totally and permanently disabled and that UPS was solely responsible for Vawter’s disability benefits because it was estopped from arguing Vawter had a preexisting condition, a necessary element of ISIF liability. UPS appealed, arguing: (1) the accident causing Vawter’s injury did not arise out of his employment; (2) the Commission improperly applied the doctrine of quasi-estoppel to prevent it from asserting a preexisting condition; and (3) the Commission improperly awarded Vawter attorney fees. Vawter and ISIF both cross-appealed. Upon review, the Supreme Court reversed the Industrial Commission’s determination that Vawter was not entitled to recover all medical expenses incurred between the date of the accident and September 27, 2010. The Court affirmed the Industrial Commission in all other respects. View "Vawter v. United Parcel Service, Inc." on Justia Law

Claimant-Appellant Dallas Clark appealed an Industrial Commission order that denied her workers' compensation benefits. Claimant worked for Shari's Management Corporation as an experienced server. During a graveyard shift, she suffered a herniated disc in her back while lifting a heavy tray onto a high shelf. She would later be diagnosed with sciatica attributed to the lifting injury from work. Shari's completed a Report of Injury, interviewing Claimant in the process. The investigator testified that Claimant attributed the injury as "standing wrong" at a salad bar, which left her unable to lift the tray. The Commission concluded after a hearing that Claimant was unable to prove an industrial accident had occurred. The Supreme Court agreed with the Commission and affirmed its order. View "Clark v. Shari's Management Corp" on Justia Law

Liberty Northwest Insurance filed a product liability action against Spudnik Equipment Company to recover workers' compensation benefits paid to an employee of its insured, Grand 4-D Farms, who was injured while working on a potato conveyor. The district court granted Spudnik summary judgment, finding Liberty failed to adequately identify the equipment involved in the accident. Liberty appealed to the Supreme Court. Finding no reversible error, the Supreme Court affirmed. View "Liberty Northwest Ins. Co., v. Spudnik Equip Co.," on Justia Law

Claimant Rubio Izaguirre settled with a third-party tortfeasor following a work-related automobile accident. His employer and surety asserted a right of subrogation against the entirety of that settlement. On appeal, claimant argued that subrogation rights should have extended only to damages that workers’ compensation typically insures and not to pain and suffering. The Commission found in favor of the employer and surety, holding that all of the settlement proceeds were subject to subrogation. Finding no error, the Supreme Court affirmed. View "Izaguirre v. R&L Carriers" on Justia Law

At issue in this case was a worker’s compensation claim stemming from an accident at an onion processing plant. Petitioner James Clark was injured when his right forearm was caught in a roller machine which resulted in significant soft-tissue damage. The Industrial Commission determined that Clark suffered a compensable injury and that he was entitled to medical treatment for approximately one year. The Commission also found that Clark had a permanent partial impairment (PPI) of 10% of the whole person and a permanent partial disability rated at 25% of the whole person. Clark appealed that determination pro se, arguing the Commission relied on fraudulent evidence because his medical records were fraudulently obtained. Finding no error, the Supreme Court affirmed. View "Clark v. State Ins Fund" on Justia Law

The issue on appeal to the Supreme Court in this case stemmed from district court decisions regarding an uninsured motorist claim between Plaintiffs-Appellants Sam and Deva Ferrell and Defendant-Respondent United Financial Casualty Company (United Financial, d.b.a. Progressive Insurance Company). The parties underwent arbitration, and the Ferrells subsequently filed a petition that sought confirmation of the arbitration award and an award of costs and attorney fees. The district court ordered confirmation of the arbitration award and interest based upon an agreement of the parties. On the issue of attorney fees, the district court found that arbitration began five months prior to the amendment of I.C. 41-1839 which explicitly allowed attorney fees in arbitration, and therefore the statute as it existed did not provide for attorney fees in this case. The Supreme Court reversed in part and remanded the case back to the district court. View "Ferrell v. United Financial Casualty Co." on Justia Law

William Shapley appealed the district court’s dismissal of his breach of contract and negligence claims against Centurion Life Insurance Company and Wells Fargo Financial. Shapley and his wife applied for credit life insurance with Centurion on the same day they closed on a real estate loan with Wells Fargo. The Shapleys were provided with a notice of insurance underwriting practices. The application papers stated that the Shapleys would receive insurance coverage only if Centurion approved their application. Centurion never had a chance to have a phone interview with Mrs. Shapley (a requirement for the policy). The day after the Shapleys closed on their loan, Mrs. Shapley suffered a brain hemorrhage from which she died four days later. Mr. Shapley contacted Centurion the same day to claim benefits in connection with Mrs. Shapley’s passing. Centurion denied the claim because it never issued an insurance policy on Mrs. Shapley. Because the interview never took place, Centurion issued insurance solely to Mr. Shapley. Mr. Shapley argued on appeal that the district court's dismissal was in error. Upon review, the Supreme Court affirmed the district court’s decisions, finding that while the district court incorrectly concluded that there must be a contract for estoppel to apply, the denial of Mr. Shapley’s motion to amend was appropriate because his estoppel claim was futile. View "Shapley v. Centurion Life Ins Co" on Justia Law