Justia Insurance Law Opinion Summaries

Plaintiffs, David Miller and Miller’s Auto Body, alleged that they were subject to a malicious investigation into suspected insurance fraud that Defendants, three insurance companies, believed was taking place at Plaintiffs’ auto-body shop. Miller was charged with, among other charges, four counts of insurance fraud. The criminal information was dismissed by the Attorney General, but the dismissal was conditioned on an agreement between Miller and the Attorney General requiring Miller to execute a general liability release in favor of Defendants. More than one year after executing the release, Plaintiffs filed a complaint against Defendants. The trial court granted pretrial summary judgment for Defendants on the majority of Plaintiffs’ claims. Only Plaintiffs’ abuse-of-process claim went to trial. The jury returned verdicts in favor of Plaintiff against the two remaining defendants. The trial court subsequently granted judgment as a matter of law in favor of one defendant but denied the other defendant’s motion for judgment as a matter of law. The Supreme Court affirmed in part and reversed in part, holding that the release executed by Miller before he initiated suit barred all his claims against the defendants. View "Miller v. Metro. Prop. & Cas. Ins. Co." on Justia Law

In 2007, while operating a truck, Yelder, an employee of Yelder-N-Son Trucking, collided with a Tri-National truck, causing extensive property damage. Tri-National filed a claim with its insurer, Harco, which paid $91,100 and retained a subrogation interest. Yelder was insured by Canal with an MCS-90 endorsement, mandated by the Motor Carrier Act of 1980, 94 Stat. 793. In 2010, Canal sought a declaratory judgment against the Yelder defendants and Harco. An Alabama court entered default judgment against the Yelder defendants only, stating Canal had no duty to defend or indemnify them under the Canal policy. The court made no declaration about whether the MCS-90 endorsement requires a tortfeasor’s insurer to compensate an injured party when the injured party has already been compensated by its own insurer. Tri-National then sued the Yelders in Missouri and obtained a $91,100 default judgment. Tri-National sought equitable garnishment against Canal, apparently on behalf of Harco. Canal removed the action to the federal district court, which granted Tri-National’s motion. The Eighth Circuit affirmed, holding that the MCS-90 does require such compensation. The circumstance of Tri-National carrying its own insurance did not absolve Canal of its obligations under the endorsement View "Tri-National, Inc. v. Canal Ins. Co." on Justia Law

In 2006, Sletten, an orthodontist practicing in Minnesota and Wisconsin, bought general liability and personal injury liability insurance from Continental through Wells Fargo. The next year, Sletten formed S&B, which opened an office in Hudson, Wisconsin and employed Brettin to practice orthodontics there. Sletten notified Wells Fargo that he had opened the Hudson office and requested coverage for the location. Wells Fargo added the Hudson office as an additional insured location but never added S&B as a named insured. In 2012, St. Croix Dental and Wolff sued, that Brettin, acting “on behalf of and with the knowledge and consent of” S&B, used his neighbor’s wireless network to post defamatory comments about St. Croix to the Internet. Brettin allegedly posed as a patient of St. Croix and criticized Wolff’s orthodontia. St. Croix alleged defamation and libel, civil conspiracy, and unfair competition. Continental refused to defend because the policy did not identify S&B as a named insured. S&B and Sletten then sued Continental and Wells Fargo. The Eighth Circuit affirmed dismissal, holding that the policy excluded coverage for acts done with the intent to injure; every claim pleaded that S&B and Brettin acted with the intent to injure. View "Sletten & Brettin Orthodontics, LLC v. Cont'l Cas. Co." on Justia Law

Country Casualty's agent Lessaris, issued an automobile insurance policy to Skaperdas. Skaperdas’s fiancée, Day, was subsequently involved in an accident while driving his vehicle. Country Casualty covered the loss but required Skaperdas to change his policy to include Day. Lessaris prepared the policy, but identified only Skaperdas, not Day, as a named insured. The policy's declarations page identified the driver as a “female, 30-64.” Following issuance of the policy, Day’s minor son, Jackson, was struck by a vehicle while riding his bicycle and seriously injured. The driver’s insurance was insufficient to cover Jackson’s medical expenses. Plaintiffs made a demand for underinsured motorist coverage under the Country Casualty policy. Country Casualty denied the claim on the ground that neither Day nor Jackson was listed as a named insured. Plaintiffs filed suit, alleging that Lessaris breached his duty to exercise ordinary care and skill in renewing, procuring, binding, and placing insurance coverage as required by 735 ILCS 5/2-2201, and that Country Casualty was responsible for the acts of its agent under the doctrine of respondeat superior. They also sought reformation of contract to include Day as an additional named insured and a declaration of coverage. The trial court dismissed the negligence and respondeat superior counts. The appellate court reversed. The Illinois Supreme Court affirmed, holding that the Code does impose a duty of ordinary care. View "Skaperdas v. Country Cas. Ins. Co." on Justia Law

Plaintiff, a Montana corporation, sells workers’ compensation insurance to employers without the use of insurance agencies. Defendant Montana State Fund sells workers’ compensation insurance through in-house and out-of-house agents. The remaining defendants also sell workers’ compensation insurance, including State Fund policies. In 2011, Plaintiff brought this of action against Defendants, alleging violations of the Unfair Trade Practices Act (UTPA) and intentional interference with prospective economic advantage. The district court (1) dismissed Plaintiff’s UTPA claim on the grounds that the UTPA does not create a private right of action by one insurance company against another; and (2) granted Defendants’ motions for summary judgment with respect to interference with prospective economic advantage. The Supreme Court affirmed, holding that Plaintiff’s inability to establish damages was fatal to its intentional interference claim and would be fatal as well to any UTPA-related claim. View "Victory Ins. Co. v. Mont. State Fund" on Justia Law

When Mark Chartier and Lisa Heward were married, Chartier purchased an annuity policy from Farm Family Life Insurance Co. for which he named Heward as primary beneficiary. Heward later requested the cash value of the annuity to Farm Family by signing Chartier’s name on the form. Farm Family issued a check payable to Chartier in the requested amount, Heward deposited the check into her and Chartier’s joint account with Gorham Savings Bank, and then withdrew $40,000 from the joint account. That same day, Heward informed Chartier that she wanted a divorce. Chartier filed a complaint against Farm Family, Gorham Savings Bank, and Farm Family’s sales agent, alleging breach of fiduciary duty, breach of the implied covenant of good faith and fair dealing, and negligence. The superior court granted summary judgment in favor of the defendants as to all counts. The Supreme Judicial Court affirmed, holding that summary judgment was properly entered in the defendants’ favor as to all counts. View "Chartier v. Farm Family Life Ins. Co." on Justia Law

Argonaut sued Audrain County Joint Communications (ACJC) alleging ACJC's negligence in monitoring a security alarm panel caused or contributed to damages arising out of the burglary and fire of a grocery store insured by Argonaut. Public employees at the ACJC call center monitored a private security company's alarm panels. The panels were defective. ACJC argued that it was entitled to sovereign immunity as a Missouri state entity, and to statutory immunity as a 911 call center. The district court denied summary judgment after finding ACJC had waived its sovereign and statutory immunity by purchasing insurance. The Eighth Circuit dismissed part of an interlocutory appeal for lack of jurisdiction, but otherwise affirmed. Missouri Revised Statutes Section 537.600 generally preserves "sovereign or governmental tort immunity as existed at common law" and specifically refers to "the immunity of [a] public entity from liability and suit." Section 190.307, however, does not create a substantive right to be free from the burdens of litigation. There was no clear error in the district court's determination under section 537.600 that ACJC did not prove the existence of a pre-existing agreement between itself and the insurer to include the sovereign immunity endorsement with the original policy. View "Argonaut Great Cent. Ins. Co. v. Audrain Cnty. Joint Commc'ns." on Justia Law

Appellee was injured when he fell from a ladder-jack scaffold while working as a carpenter on a construction project for his Employers. Appellee sued his Employers, alleging claims of employer intentional tort. The Cincinnati Insurance Company (“CIC”), which insured the Employers under a commercial general liability policy, intervened and filed a complaint seeking a declaration that it had no obligation to indemnify the Employers should Appellee prevail on his employer-intentional-tort claims. The policy contained a provision that excluded coverage for acts committed with the deliberate intent to injure an employee. The trial court granted summary judgment for CIC. The Court of Appeals reversed, concluding that liability may be imposed without a finding of deliberate intent under the policy. The Supreme Court reversed the Court of Appeals, holding that an insurance provision that excludes from coverage liability for an insured’s act committed with the deliberate intent to injure an employee precludes coverage for employer intentional torts. View "Hoyle v. DTJ Enters., Inc." on Justia Law

Claimant worked at the Vermont State Hospital as a psychiatric technician and ward aide. His duties involved lifting and dealing with patients who could be combative. Claimant suffered work-related injuries on three separate occasions in 1987, 1992, and 1997. All of these claims related to low back pain. Claimant underwent surgery after each of these injuries and returned to work. After the 1992 injury, claimant's surgeon rated him with a 10% permanent impairment to his spine, and the State began paying permanent partial disability benefits. There was no new rating for the 1997 injury. This appeal came after a dispute over an order based on a worker's compensation agreement. Claimant injured his back again in 2002. Claimant received an 8% whole-person impairment rating, with 6% of that rating referable to a previous injury. Based on this rating, claimant executed an Agreement for Permanent Partial Disability Compensation (Form 22) with the State, which the Commissioner of the Department of Labor then approved. Six years after the commissioner ordered the award, claimant underwent two more permanency evaluations with different doctors who both used a method that the first doctor had not used. Each of the subsequent evaluations resulted in higher whole-person impairment ratings before consideration of the portion attributable to any pre-existing impairment. Based on the higher ratings, claimant made a claim for additional benefits related to the 2002 injury. Claimant asserted that the award should be modified because his medical condition had worsened, or, alternatively, that the parties had based their Form 22 agreement upon a material mistake of fact. The commissioner ruled in the State's favor. Claimant then appealed to the superior court, which reversed the decision of the commissioner and awarded claimant additional benefits after a bench trial. After review, the Supreme Court concluded that the differences between the doctors' impairment ratings in 2010 and an impairment rating from 2003 were insufficient to serve as grounds for reopening the original order for compensation. The Court therefore concluded as a matter of law that failed to meet his burden of demonstrating a mistake of fact sufficient to require reformation of the approved Form 22. The Court vacated the decision of the superior court as to the issues on appeal. View "Marshall v. Vermont State Hospital" on Justia Law

In 2007, Jessica Gonzalez alleged she was sexually assaulted by Rebagliati and nine other members of the De Anza College baseball team. A year later, Gonzalez filed a civil lawsuit against her purported assailants. Rebagliati sought insurance coverage for his defense through his parents’ homeowner’s and personal umbrella policies, issued by Fire and Truck. Both companies denied coverage. Eventually, Rebagliati settled with Gonzalez, assigning Gonzalez his rights against Fire and Truck. Gonzalez sued the insurers for breach of the duty of good faith and fair dealing and breach of contract and sought recovery of judgment pursuant to Insurance Code section 11580. Her underlying allegations included accidental bodily injury, false imprisonment, invasion of privacy, and slander. Fire and Truck argued they had not owed Rebagliati a duty to defend. The trial court granted the insurers summary judgment. The court of appeal reversed in part. While none of Gonzalez’s claims can be construed to allege an accidental occurrence triggering coverage under the Fire policy, Truck’s umbrella policy is broadly worded and does not require an “accident” for personal injury coverage. View "Gonzalez v. Fire Ins. Exchange" on Justia Law