Justia Insurance Law Opinion Summaries

A driver caused injury to the passenger of another car in a two-car accident. The passenger brought suit for damages, including her insurer's subrogated claim for medical expenses. The driver made an early offer of judgment, which the passenger did not accept. The driver's insurer then made a direct payment to the subrogated insurer, thereby removing that amount from the passenger's potential recovery. The driver then made a second offer of judgment, which the passenger did not accept. After trial both parties claimed prevailing party status; the driver sought attorney's fees. The superior court ruled that the first offer of judgment did not entitle the driver to fees, but the second offer did. Both parties appealed, arguing the superior court improperly considered the subrogation claim payment in its rulings. Upon review, the Supreme Court concluded that the subrogation claim payment had to be taken into account when evaluating the first offer of judgment and affirmed the decision that the driver was not the prevailing party based on the first offer of judgment. But because the nature of the payment on the subrogation claim was not clear, the Court vacated the decision that the second offer of judgment entitled the driver to attorney fees and remanded the case for further proceedings on this issue. View "Dearlove v. Campbell" on Justia Law

Plaintiff Charles Honeycutt was injured in an automobile accident involving a Mississippi state trooper. He sued the state trooper and two automobile-insurance providers, Atlanta Casualty Company and American Premier Insurance Company. The trial court granted the defendants' motions for summary judgment. On appeal, the Court of Appeals affirmed the trial court's grant of summary judgment. Plaintiff filed a writ of certiorari, seeking to appeal the grant of summary judgment for American Premier: (1) whether the trial court and the Court of Appeals erred by finding an insurance agent does not have a duty to explain uninsured-motorist coverage; (2) whether summary judgment was granted improperly. The Supreme Court found that, in order to obtain a knowing and voluntary waiver of uninsured-motorist coverage (UM coverage), an insurance agent does have a duty to explain UM coverage to the insured. The Court also found that summary judgment was not proper in this case. Thus, the Court reversed both lower courts' judgments and remanded the case back to the trial court for further proceedings. View "Honeycutt v. Coleman" on Justia Law

Plaintiff was injured in a motor-vehicle collision with an underinsured driver (Tortfeasor). Tortfeasor was insured by Progressive Insurance Company (Progressive). Progressive paid Plaintiff its policy limits of $25,000. Plaintiff then sought recovery for personal injuries pursuant to the uninsured/underinsured motorist provisions (UM/UIM coverage) of her policy with Encompass Insurance Company (Encompass). Arbitrators issued a total award of $172,750. Plaintiff sought confirmation of the arbitration award. Encompass objected, arguing that Plaintiff's UM/UIM policy provided $100,000 maximum coverage, that Encompass had paid the policy limits in accordance with the insurance contract, and that, under Rhode Island law, Plaintiff was not entitled to recover from Encompass in excess of her policy limits. The trial justice vacated the portion of the award in excess of the $100,000 policy limit and confirmed the remainder of the arbitration award. The Supreme Court vacated the order of the superior court and directed that the arbitration award be reinstated in its entirety, holding that the superior court was incorrect in its interpretation of the law, and no grounds for modification or vacation of the award existed. View "Wheeler v. Encompass Ins. Co." on Justia Law

Kenneth Crum, who was horseback riding at the time, was struck and severely injured by a vehicle driven by Raymond Ousley. At the time, Ousley was test-driving the vehicle, an uninsured car titled to Rhonda Ward. Crum sued Ousley for personal injuries and later joined Ousley's auto liability insurer, Kentucky Farm Bureau, for no-fault benefits. Kentucky Farm and Crum settled the negligence claims against Ousley for $25,000. Later, the trial court declared by final order that Kentucky Farm was also required to pay basic reparation benefits (BRBs) to Crum for the motor vehicle accident. The trial court then entered a final order declaring coverage for Crum and ordering Kentucky Farm also to pay Crum the no-fault benefits. The court of appeals reversed, holding that Kentucky law did not allow Crum to recover and Ousley's policy excluded Crum. The Supreme Court reversed, holding (1) a pedestrian struck by an uninsured vehicle being driven by an ininsured driver can recover no-fault benefits from the driver's insurance company; and (2) therefore, Crum was entitled to receive BRBs from Kentucky Farm. View "Samons v. Ky. Farm Bureau Mut. Ins. Co." on Justia Law

Plaintiff Kenneth Admire was seriously injured when the motorcycle he was riding collided with a car being operated by an insured of Defendant Auto-Owners Insurance Company. Following the accident, Kenneth required wheelchair-accessible transportation. Through his guardian Russ Admire, brought an action against Auto-Owners Insurance Company, seeking payment of personal protection insurance (PIP) benefits under the no-fault act. Auto-Owners had agreed to pay the full cost of purchasing a van modified to accommodate Kenneth’s wheelchair. Kenneth’s guardian gave Auto-Owners notice of his intent to purchase a new van. In response, Auto-Owners stated that it was not obligated to pay the base purchase price of a new van, but that it would pay for the necessary modifications if Kenneth’s guardian purchased a new vehicle for him. Kenneth’s guardian purchased the new van for Kenneth, and after the cost of the modifications was reimbursed and the trade-in value was applied, Kenneth was left with $18,388.50 in out-of-pocket expenses for the modified van. Kenneth brought suit seeking reimbursement for the out-of-pocket expenses. The Court of Appeals ruled in favor of Kenneth, but the Supreme Court reversed: Auto-Owners met its statutory obligation to pay for the transportation expenses recoverable under the statute, by paying for the van’s modifications and reimbursing him for mileage to and from his medical appointments. The Court of Appeals erred by concluding that the base price of the van was compensable. View "Admire v. Auto-Owners Ins. Co. " on Justia Law

Benjamin Morris appealed an order of the Idaho Industrial Commission that denied his motion to set aside a lump sum settlement agreement he made with his employer's surety, Liberty Northwest Insurance. Morris initiated his workers' compensation action after he suffered injuries while working construction for his employer, Hap Taylor & Sons, Inc. Morris sustained a serious head injury on when a twenty-five pound rock thrown by a piece of heavy machinery struck him in the head. Morris initiated settlement discussions with Liberty Northwest Insurance, Hap Taylor & Sons' insurer. Liberty responded with a counter-offer—a single lump sum payment which Morris accepted "with the clear understanding this is a partial settlement and does not resolve the medical side." The parties executed a Stipulation and Agreement of Partial Lump Sum Discharge (LSSA) and submitted it to the Commission for approval. Approximately eighteen months later, on July 8, 2011, a Notice of Appearance was filed with the Commission whereby Morris substituted attorney Michael Walker with his then present counsel, attorney Starr Kelso. On the same day, Morris filed a motion to review the LSSA, accompanied by an affidavit signed by Kelso. Kelso's affidavit expressed concern that Morris may not have been "competent to testify" due to his injury—though, no credible evidence of incompetence was ever offered. Liberty filed an objection to Morris' motion to review. Ultimately, the Commission denied Morris' motion. Following the Commission's refusal to review the LSSA, Morris filed a Motion to Set Aside Lump Sum Settlement Agreement, seeking to void the LSSA on grounds of illegality and constructive fraud. The Commission issued an order denying Morris' motion to set the LSSA. Morris filed a timely appeal to the Supreme Court. After its review, the Supreme Court concluded that the Commission did not err in denying Morris' request for a hearing on his fraud claim. Furthermore, the Court affirmed the Commission's decision to deny Morris' motion to set the LSSA. View "Morris v. Hap Taylor & Sons" on Justia Law

Morris died after a 2004 collision in Indiana; he was a passenger in Sampson’s vehicle. Sampson was insured by Mid-Century. The Estate made a claim for $50,000, the highest allowable amount. Nuzzo, a citizen of Ohio, was the assigned claims adjustor. The Estate ultimately filed a wrongful death suit. An Indiana state court awarded $1.2 million. Sampson assigned his rights against Mid-Century for an agreement that the Estate would not pursue collection against Sampson personally. In 2011, the Estate sued Mid-Century in California state court, alleging that its bad faith failure to pay the claim resulted in the excess jury verdict against Sampson. The court dismissed on forum non conveniens grounds. The Estate then sued Mid-Century and Nuzzo in Ohio state court, alleging tortious bad faith failure to pay the claim and breach of contract. The case was removed to an Ohio federal district court, then transferred to the district court in Indianapolis, which found that claims against Nuzzo were potentially viable under Ohio law, but that Indiana law governed both claims, so that Nuzzo was fraudulently joined. The court dismissed claims against Nuzzo and denied the Estate’s motion to remand. The Seventh Circuit vacated with instructions to remand, finding that Nuzzo was not fraudulently joined. View "Morris v. Nuzzo" on Justia Law

Palmetto Hardwood, Inc., employed Petitioner Clifton Sparks as a saw operator. Petitioner suffered three work-related injuries during this employment, the first two of which injured Petitioner's lower back. In the third incident, Petitioner was required to remove a piece of metal from under a gang saw. In the process, the metal exploded and a three- to four-inch cubic piece struck him in the head. Petitioner subsequently sought workers' compensation for his injuries. At the hearing, Petitioner testified to substantial head pain, loss of cognitive ability, and other brain-function-related symptoms, including inability to read without severe headache, loss of his mathematical abilities, inability to balance while standing or to walk without a cane, hand tremors, anxiety, and more. Petitioner argued on appeal to the Supreme Court that the Court of Appeals erred when it applied an improper definition of "physical brain damage" within the meaning of section 42-9-10(C). The Supreme Court disagreed. Because "physical brain damage" as contemplated in S.C. Code Ann. 42-9-10 required "severe and permanent physical brain damage as a result of a compensable injury" and the Workers' Compensation Commission's finding that Petitioner did not suffer such brain damage was supported by substantial evidence in the record, the Court affirmed the Court of Appeals. View "Sparks v. Palmetto Hardwood" on Justia Law

This case arose from the water loss claims Appellant Roger Daniel Rizzo made under Respondent State Farm Fire and Casualty Company's homeowners insurance policy. All of Appellant's claims were for water damage to his home's basement. The district court granted summary judgment in favor of the insurance company, effectively dismissing all of Appellant's causes of action because his homeowner's policy did not cover his water damage claims. Appellant also appealed the district court's denial of his motion to amend his complaint to include various new causes of action and the district court's grant of State Farm's motion for protective order against certain overbroad discovery requests. Finding no error in the district court's grant of summary judgment in favor of State Farm, the Supreme Court affirmed the district court's decisions. View "Rizzo v. State Farm Insurance" on Justia Law

William Piper was killed in a motor vehicle accident in which he was driving. His passenger, Kyle Hoffman, was also killed. The Estate of Hoffman subsequently filed suit against the Estate of Piper. The case was bifurcated into two parts for trial. Relevant to this appeal was the declaratory judgment action of insurance coverage involving State Farm Fire & Casualty Company. The declaratory judgment coverage action involved the question of whether Piper was a resident of the home of his grandparents at the time of his death. If he was, there would be coverage under a State Farm personal liability umbrella policy issued to Piper's grandfather. The jury returned a verdict finding Piper lived with his grandparents, thus finding in favor of Hoffman's Estate on the coverage issue. At issue on appeal was whether the circuit court erroneously applied the Dead Man's Statute in prohibiting the testimony of Piper's family members and the introduction of documentary evidence regarding where Piper was residing on the date of his death. The Supreme Court reversed and remanded for a new trial, holding that the Dead Man's Statute is invalid, as it conflicts with the paramount authority of the West Virginia Rules of Evidence. View "State Farm Fire & Cas. Co. v. Prinz" on Justia Law