Justia Insurance Law Opinion Summaries

Jennifer Lockwood was injured in a car accident caused by an uninsured drunk driver. Lockwood had car insurance through Geico General Insurance Company. After exhausting her policy's medical payments coverage, Lockwood sought payment under her uninsured motorist coverage. Geico offered $750 to settle the uninsured motorist claim, and Lockwood declined. Geico questioned Lockwood's "high" medical bills and refused to make additional medical payments outside of a total settlement of Lockwood's uninsured motorist claim. The parties eventually settled Lockwood's uninsured motorist claim for $25,000. Lockwood brought a tort claim against Geico for alleged breach of the duty of good faith and fair dealing implied in her insurance contract, arguing that Geico unreasonably delayed payment of Lockwood's uninsured motorist claim. The superior court granted summary judgment in favor of Geico on the bad-faith tort claim and awarded attorney's fees. Upon review of the matter, the Supreme Court reversed the superior court: because there was a genuine issue of material fact regarding whether Geico lacked a reasonable basis for delaying payment on Lockwood's uninsured motorist claim. The case was remanded for further proceedings. View "Lockwood v. Geico General Insurance Company" on Justia Law

Dennis Whedbee appealed a district court judgment affirming Workforce Safety and Insurance's ("WSI") binding dispute resolution denying Whedbee's request for a myoelectric prosthesis and approving a body-powered prosthesis. Whedbee argued the binding dispute resolution was an abuse of discretion and violated his due process rights. He argued that WSI should have selected an independent medical examiner located closer to his residence and that his treating physician's opinion should have been given controlling weight. Finding no reversible error, the Supreme Court affirmed. View "Whedbee v. WSI" on Justia Law

Respondent-claimant, Ben Snell was employed by petitioner-employer Kentucky Fried Chicken of McAlester. He alleged that while at work he slipped and fell while carrying a tray of chicken weighing approximately 40 to 50 pounds. The trial court awarded claimant temporary total disability (TTD) and reasonable and necessary medical treatment for injuries to his neck, the second finger of his right hand, and aggravation of pre-existing conditions to his left knee and low back. All other issues were reserved. On appeal, the Court of Civil Appeals (COCA) sustained the award. In its opinion, COCA ruled the standard of review in this case was the "any competent evidence" standard because of a holding in a previous opinion by the same division, "Westoak Industries, Inc. v. DeLeon," which held 85 O.S. 2011 sec. 340(D)(4), setting out "against the clear weight of the evidence" as the appellate standard of review in workers' compensation cases, constituted a violation of the separation of powers provision of the Oklahoma Constitution. Westoak was completely at odds with another COCA opinion, "Harvey v. Auto Plus of Woodward." "Harvey" held section 340(D)(4) was not unconstitutional as a separation of powers violation. The Supreme Court granted certiorari to consider the issue as one of first impression since certiorari was not sought in either of the previous cases. The Court concluded that there was no constitutional separation of powers prohibition in in the Okla.Const., art IV, section 1 against the Legislature's adoption of the "against the clear weight of the evidence" standard of review in 85 O.S. 2011 sec. 340(D)(4). COCA's opinion was therefore vacated. Because "Westoak" and "Harvey" were totally inconsistent with the views expressed in this opinion, they were both specifically overruled. View "Kentucky Fried Chicken of McAlester v. Snell" on Justia Law

After Charles Eugene Becker died from falling from a two-story home after the ladder he was climbing detached from the house, his estate filed a wrongful death suit. This appeal stems from plaintiff's claims against Anchorage Homes LLC, another contractor working on the home construction project. At the time, Anchorage held a commercial general liability insurance policy with Mid-Continent. The district court reasoned that the state court pleadings and the record evidence established that Becker was exempted from Anchorage's insurance policy with Mid-Continent under the policy's employee exclusion clause. The court concluded that the district court correctly concluded that Florida's law requires that the employee exclusion clause in Anchorage's insurance policy be construed as applying both to actual and statutory employees of Anchorage. Because Anchorage was the statutory employer of Becker, Team Fritz's employee, Anchorage was not entitled to indemnification under its general liability insurance policy for damages arising from Becker's death on the job. Therefore, plaintiff could not establish that Mid-Continent had a duty to indemnify Anchorage in the underlying suit in order to enforce the settlement agreement against Mid-Continent. There were no genuine issues of material fact and Mid-Continent was entitled to judgment as a matter of law. The court affirmed the judgment of the district court and affirmed the district court's fee and cost order. View "Stephens v. Mid-Continent Casualty Co." on Justia Law

Claimant was injured at work as she walked out a door used by employees to exit Employer's school building. A rug outside the door slipped out from under her, causing her to fall. At the time of this accident, claimant was leaving work early due to a family medical emergency. The Workers' Compensation Court found this injury to be compensable, but the Court of Civil Appeals ruled it was not. The Court of Civil Appeals held that claimant was on a personal mission at the time of the injury and vacated the award of benefits. The dispositive question for the Supreme Court's review was whether Claimant's injury while leaving work in response to a family medical emergency arose out of her employment. The Workers' Compensation Court answered this question in the affirmative. Upon review, the Supreme Court agreed, and reversed the Court of Appeals. View "Graham Public Schools v. Priddy" on Justia Law

Levon Flowers made a workers' compensation claim against his former employer Crown Cork & Seal USA. The Supreme Court granted Crown’s petition for certiorari to review the compensability of a foot injury Flowers sustained in 2007. The Workers’ Compensation Commission denied Flowers’s request for permanent disability benefits for this injury and awarded temporary total disability benefits for the period between the injury and the date Flowers was cleared by his doctor to return to work. The Court of Appeals reversed, finding that Flowers was entitled to receive temporary total disability benefits until he reached maximum medical improvement (MMI) for his foot injury, which had not yet been determined by his doctors. Upon review, the Supreme Court found that the Court of Appeals reached the correct result in this case, but the Supreme Court reached that conclusion based on different precedent. The record in this case reflected that Crown refused to reinstate or rehire Flowers after his doctors released him to return to work. There was also evidence that Flowers underwent an unsuccessful search for alternative employment after Crown refused to rehire him. However, the ALJ and the Commission did not determine when Flowers reached MMI for his foot injury. From the testimony of Flowers' doctor, Flowers had not yet reached MMI as of January 14, 2008. Therefore, this case was not controlled by the Court's holding in "Jordan:" "[the Court] reiterate[d] that it is a primary duty of the Commission to analyze the evidence and determine whether and when a claimant has reached MMI. [. . .] After determining when Flowers reached MMI for his foot injury, the Commission must decide from the evidence presented whether Flowers is entitled to permanent disability benefits." View "Flowers v. Crown Cork & Seal USA, Inc." on Justia Law

Steven Thomas & Sons (T&S), LLC did excavation and soil compaction work for an addition to a school building in the Kimball School District. The School District was later informed that problems in the building caused by settling issues were due to negligently performed work by T&S. The School District brought suit against T&S and other defendants. T&S’s commercial general liability insurer, Employers Mutual Casualty Company (EMC) withdrew from contributing to T&S's defense, asserting that the policy excluded coverage for continuous or progressive property damage that occurred before the effective date of the policy, and the problems to the building were observed before the 2007 policy date. In 2005 and 2006, T&S was insured by AMCO Insurance Company. Ultimately, AMCO paid defense costs and indemnified T&S for its share of the arbitration award in favor of the School District. AMCO subsequently brought a declaratory judgment action against EMC seeking a ruling that EMC had a joint duty to defend T&S and a declaration that EMC’s policy exclusion was void as against public policy. The circuit court granted summary judgment in favor of EMC. The Supreme Court affirmed, holding that EMC’s exclusion did not violate public policy. View "AMCO Ins. Co. v. Employers Mut. Cas. Co." on Justia Law

Plaintiff filed a complaint against Metropolitan Property and Casualty Insurance Company and other defendants, alleging multiple counts. A jury found Defendants liable for abuse of process and awarded compensatory and punitive damages against each defendant. On May 31, 2012, judgments were entered against Defendants. On August 31, 2012, Metropolitan filed an appeal from the May 31, 2012 judgment, and on September 18, 2012, Plaintiff filed a notice of cross-appeal from the May 31, 2012 judgment. Metropolitan moved to dismiss Plaintiff’s cross-appeal, arguing that it was untimely because it was not filed within the initial twenty-day appeal period that began to run after entry of the August 20, 2012 orders. The trial justice denied Metropolitan’s motion to dismiss, concluding that Plaintiff’s cross-appeal was timely because it was filed within twenty days of Metropolitan’s August 31, 2012 notice of appeal. The Supreme Court affirmed, holding that Plaintiff’s September 18, 2012 notice of cross-appeal was timely because it was filed within the twenty-day period triggered by Metropolitan’s August 31, 2012 notice of appeal. View "Miller v. Metro. Prop. & Cas. Ins. Co." on Justia Law

This case had its origins in a property damage action brought by Jason and Gina Corrick against B&B Transit, Inc. B&B Transit filed a notice and coverage claim with its insurer, Montpelier US Insurance Company. Montpelier eventually settled the case against B&B Transit. While the Corricks’ complaint was still pending, Respondents, including B&B Transit, filed a first-party bad faith claim against Petitioners, including Montpelier and its national coverage counsel, Charlston, Revich & Wollitz (“CRW”). Respondents subsequently served discovery requests on Petitioners. After CRW opposed disclosure of certain requested documents, Respondents filed a motion to compel disclosure of the documents. The circuit court entered an order requiring CRW to disclose certain documents. Petitioners sought a writ of prohibition to prevent enforcement of the circuit court’s discovery order. The Supreme Court granted the writ of prohibition as moulded, concluding that part of the circuit court’s order permitting discovery of documents sought by Respondents was prohibited from enforcement because the documents were protected under the attorney-client privilege. View "State ex rel. Montpelier US Ins. Co. v. Hon. Bloom" on Justia Law

Petitioner was injured in a car accident while riding as a passenger in a vehicle driven by a co-employee. The liability limits of the at-fault driver were tendered, and there was no underinsured motorist (UIM) coverage on the vehicle in which he was riding. Therefore, Petitioner submitted a claim for UIM benefits under a Progressive insurance policy, issued to Sarah Severn. At the time of the accident, Petitioner resided with Severn and their child. He described Severn as "his on again off again fiancé." Both Petitioner's and Severn's names appear on the Declarations Page of the Policy under the heading "Drivers and household residents." Under the heading "Additional information," Severn is listed as the "Named insured." Progressive denied UIM coverage to Petitioner under Part III of the Policy. According to the affidavit filed by Progressive's Claims Injury Operations Manager, "[t]he claim was denied because [Petitioner] did not fall within the terms, provisions and conditions of [the Policy] to qualify for benefits under the [UIM] provisions," as Petitioner "was only listed as a 'driver' on the policy and not a named insured, nor was he a resident relative of the named insured." The Supreme Court granted Bell's petition for review of the court of appeals' decision affirming the circuit court's grant of summary judgment in favor of Progressive Direct Insurance Company. Finding no reversible error, the Supreme Court affirmed. View "Bell v. Progressive Direct Insurance" on Justia Law