Justia Insurance Law Opinion Summaries

Town & Country Property, L.L.C., and Town & Country Ford, ("T&C"), appealed a summary judgment in favor of Amerisure Insurance Company and Amerisure Mutual Insurance Company which held that Amerisure was not obligated to pay a $650,100 judgment entered on a jury verdict in favor of T&C and against Amerisure's insured, Jones-Williams Construction Company, because, the trial court reasoned, the faulty construction of the T&C facility upon which the judgment was based was not an "occurrence" covered under the commercial general-liability ("CGL") insurance policy Amerisure had issued Jones-Williams. In October 2011, the Supreme Court affirmed in part the judgment entered by the trial court, agreeing that faulty construction did not in and of itself constitute an occurrence for CGL-policy purposes and that, accordingly, "Amerisure was not required to indemnify Jones-Williams for the judgment entered against it insofar as the damages represented the costs of repairing or replacing the faulty work." However, the Court further recognized that if damages had been awarded T&C to compensate it for damage the faulty construction later caused to personal property or some otherwise nondefective portion of the T&C property, then "[t]hose damages would constitute 'property damage' resulting from an 'occurrence,' and they would be covered under the terms of the Amerisure policy ...." Upon a review of the record, the Supreme Court concluded that on remand, a $392,600 judgment entered by the trial court was not supported by the evidence. The order ultimately entered by the trial court failed to specifically identify any personal property or nondefective portions of the T&C facility that were damaged as a result of the faulty construction. The Supreme Court reversed the judgment entered by the trial court on remand, and remanded the case once again to the trial court so that it could enter a final judgment in favor of T&C for $600. View "Town & Country Property, L.L.C. v. Amerisure Insurance Company" on Justia Law

Employee was severely injured while working for Employer. Employer and its Insurer began paying lifetime workers' compensation benefits. Employee brought a separate negligence action against Employer's parent company (Ridgetop) and joined Employer and Insurer for workers' compensation subrogation purposes. Employee reached a settlement agreement with Ridgetop, after which the trial court granted Employer and Insurer's motion, pursuant to Neb. Rev. Stat. 48-118, for a future credit in the amount of Employee's settlement with Ridgetop against its continuing workers' compensation obligations. The Supreme Court affirmed in part and reversed in part the order granting the future credit, holding (1) the trial court did not err in granting the motion for credit against the settlement proceeds Employee received from Employer; (2) Insurer did not waive its right to a future credit through a waiver clause in the policy or statements during settlement negotiations; but (3) the trial court erred in granting the credit for the entire amount of the settlement. Remanded for the limited purpose of deducting $437,500 - the amount paid to Insurer and an indemnity company - out of the settlement and for determining the amount of attorney fees to additionally be deducted from the amount of the credit. View "Bacon v. DBI/SALA" on Justia Law

Respondent injured his back while working, and his employer's workers' compensation insurer, Texas Mutual Insurance Company (TMIC), accepted the injury as compensable. Three years later when it was discovered that Respondent had herniated lumbar intervertebral discs, TMIC disputed whether they were causally related to the original injury. The Texas Department of Insurance Division of Workers' Compensation determined that the disc herniations were related to the original injury and ordered TMIC to pay medical benefits, which it did. Respondent later sued TMIC for damages caused by its delay in paying benefits. The trial court rendered judgment for Respondent, and the court of appeals affirmed. Based on the Court's recent decision in Texas Mutual Insurance Co. v. Ruttiger, the Supreme Court reversed and rendered judgment for TMIC. View "Tex. Mut. Ins. Co. v. Morris" on Justia Law

The issue before the Supreme Court in this case centered on whether a workers' compensation insurer was entitled to reimbursement of death benefits it paid when a claimant's beneficiary also received proceeds from a life-insurance policy. Upon review, the Court held that under 21 V.S.A. 624(e) a workers' compensation carrier cannot seek reimbursement from life-insurance payments because such proceeds are not "damages," as contemplated by the statute and paid because of a third party's tortious actions. The Court therefore affirmed the Commissioner of Labor's grant of summary judgment to the estate of the claimant. View "Estate of Dunn v. Windham Northeast Supervisory Union" on Justia Law

This appeal arose from a motor vehicle collision involving Roger Linton and James Carey that resulted in Carey's death. At the time of the collision, Linton was driving a truck owned by Jonathan Jennings, for whom Linton worked as an independent contractor. Jennings's insurer, State Farm, filed a declaratory judgment action against Carey's Estate and Linton to determine whether it was responsible for liability coverage and obligated to defend and indemnify Linton for claims arising from the collision. The superior court entered a judgment in favor of State Farm, concluding that Linton was not an insured covered by Jennings's policy because his use of the truck was not within the scope of Jennings's consent. At issue on appeal was whether the superior court erred in its application of the minor deviation rule in determining that Linton's use of the truck exceeded the scope of Jennings's consent. The Supreme Court vacated the judgment, clarified the applicable burdens associated with the minor deviation rule, and remanded for the superior court to apply the minor deviation rule as clarified. View "State Farm Mut. Auto. Ins. Co. v. Estate of Carey" on Justia Law

Freeport and Brand Energy were named defendants in a personal injury suit in Texas state court. Freeport sought defense and indemnity from ACE, its insured, in the state court proceedings under Brand Energy's insurance policy with ACE. The court affirmed the district court's summary judgment in favor of ACE, holding that it had no duty to defend Freeport in the state court proceedings because Freeport was not covered as an additional insurer under Brand Energy's insurance policy with respect to the underlying state court claims. The court remanded for a determination of whether ACE had a duty to indemnify Freeport for the cost of its settlement in the state court proceedings. View "ACE American Ins. Co. v. Freeport Welding & Fabricating" on Justia Law

Blue, a bus driver insured under Hartford group disability plans, stopped working because of chronic headaches in 1998; Hartford approved short-term disability (STD) benefits. Blue was diagnosed with sphenopalatine ganglion neuralgia. Hartford approved long-term (LTD) benefits in 2001. To qualify for STD benefits, Blue needed to show inability to perform his own occupation; for LTD benefits, he needed to show that he could not do “any occupation or work for which he was or could become qualified by training, education or experience.” In 2002, Hartford amended its LTD policy, retroactive to 1993, adopting the more lenient “own occupation” standard. Hartford received annual physician’s reports, and by 2008, his provider indicated that Blue was capable of full-time light or sedentary work. Hartford notified Blue that he was no longer eligible for LTD benefits, quoting the “any occupation” language; it apparently did not send the 2002 retroactive amendment. In 2011, Hartford acknowledged its mistake to the district court, reinstated benefits, and issued a check for retroactive benefits. After granting one, but denying a second, extension of time, the district court ruled without Blue’s response, finding the contract claim was moot and granting Hartford summary judgment on the bad faith claim. The Seventh Circuit affirmed. View "Blue v. Hartford Life & Accident Ins. Co." on Justia Law

An Illinois driver alleged that she was injured in an accident with an uninsured motorist in Wisconsin in 2007. In Illinois proceedings her insurer, Country Preferred, sought a declaration of noncoverage and she unsuccessfully moved to compel arbitration. Uninsured motorist coverage was part of the policy, but the policy also provided that “any suit, action or arbitration will be barred unless commenced within two years from the date of the accident.” The insurer contended that the driver had not met this requirement, and the circuit court agreed. The appellate court reversed, persuaded by the driver’s theory that public policy was violated by virtue of the fact that the applicable statute of limitations in Wisconsin is three years, unlike Illinois (and the policy), where it is two years. The Illinois Supreme Court reversed, noting that the insured never initiated any type of legal action to settle her claim within the policy’s applicable time frame. There is no public policy violation in requiring the insured driver to bring her suit, action, or arbitration request within two years, the same time period as the Illinois statute of limitations, even though the limitation period in Wisconsin, the state where the accident occurred, is longer.View "Country Preferred Ins. Co. v. Whitehead" on Justia Law

The issue on appeal before the Supreme Court in this case concerned whether a written settlement agreement compromising a contested property insurance claim constituted a "proof of loss" under La. Rev. Stat. 22:1892(A)(1) sufficient to trigger the penalties set forth in La. Rev. Stat. 22:1892(B) for the insurer's arbitrary and capricious failure to timely pay the settlement funds. Plaintiff, Katie Realty, Ltd., filed suit against defendant, Louisiana Citizens Property Insurance Corporation (Citizens), for its untimely handling of plaintiff's Hurricane Gustav property damage claim. The matter was settled through mediation. When Citizens failed to timely pay the settlement funds, plaintiff filed a motion to enforce settlement and assess penalties pursuant to La. Rev. Stat. 22:1892 and 1973. In accordance with La. Rev. Stat. 22:1892(B)(1), the District Court awarded plaintiff $125,000 in penalties. The court of appeal affirmed, finding the settlement agreement constituted sufficient "proof of loss" under the provisions of La. Rev. Stat. 22:1892(A)(1) and Citizens' misconduct warranted the imposition of penalties under La. Rev. Stat. 22:1892(B)(1). Upon review, the Supreme Court concluded that the written settlement agreement did not constitute satisfactory proof of loss under the provisions of La. Rev. Stat. 22:1892(A)(1) sufficient to trigger the penalties set forth in La. Rev. Stat. 22:1892(B)(1). Accordingly, the Court reversed the judgment of the court of appeal and rendered judgment awarding plaintiff $5,000 in statutory penalties for Citizens' failure to timely pay the settlement funds in accordance with the provisions of La. Rev. Stat. 22:1973(B)(2) and (C). View "Katie Realty, Ltd. v. Louisiana Citizens Property Ins. Corp." on Justia Law

At issue in this case was whether plaintiffs' dismissal with prejudice of a lawsuit filed in federal court after the defendant has made a general appearance of record was a "voluntary dismissal" for purposes of La. C.C. art. 3463, which provides "[i]nterruption [of prescription] is considered never to have occurred if the plaintiff abandons, voluntarily dismisses the action at any time either before the defendant has made any appearance of record or thereafter . . ." After reviewing the record and the applicable law, the Supreme Court reversed the court of appeal and the reinstated the trial court's dismissing plaintiffs' suit. View "Sims v. American Insurance Co." on Justia Law