Justia Insurance Law Opinion Summaries

After Mississippi Farm Bureau Casualty Insurance Co. (Farm Bureau) delayed payment of Robert Fulton's uninsured-motorist benefits, Fulton sued. The jury found Farm Bureau negligent for failing to timely investigate and pay Fulton's claim, awarding Fulton $10,000 in extracontractual damages. The jury did not find that Farm Bureau acted grossly negligent, reckless, or in bad faith and awarded no punitive damages. Following the jury's verdict, Fulton filed a post-judgment motion to amend, seeking $120,773 in attorney’s fees and expenses. The circuit court denied the motion, analyzing it under Mississippi Rule of Civil Procedure 59(e) and finding that Fulton had not shown reason to amend. Fulton appealed the denial of his motion, arguing that attorney's fees were collateral to the final judgment and outside the scope of Rule 59(e). The Court of Appeals agreed and reversed the circuit court, holding that the court at least should have considered awarding them. Upon review, the Supreme Court found that the Court of Appeals erred in classifying attorney’s fees as "collateral." Fulton had no post-judgment right to attorney's fees because the jury did not award punitive damages, and neither a statutory nor a contractual provision authorizes such fees. The circuit court, by properly applying a Rule 59(e) analysis, did not abuse its discretion in denying Fulton’s motion. Therefore, the Court reversed the Court of Appeals and reinstated and affirmed the circuit court's decision. View "Fulton v. Mississippi Farm Bureau Casualty Ins. Co. " on Justia Law

In July 2001, Kaye Hankins entered into a home-construction contract with Elite Homes, Inc. ("Elite"). An August 2001 soil-test report on the subject property recommended that "a stabilizing blanket of natural silty clays . . . and/or compacted fill soils having a maximum 7-foot thickness" was required "to minimize the Yazoo Clay . . . swell or heave potential to within limits tolerable to a strong slab foundation . . . ." Hankins received assurances from Elite that the Yazoo clay "was nothing to be concerned about." She moved into the new home in April 2002. During Hankins's first year in the home, she reported to Elite numerous cracks, leaks, and difficulties in closing doors and windows. In September 2009, Hankins filed a complaint against Elite averring "that the damage which has occurred to said house . . . would not have occurred except for the negligence" of Elite. Thereafter, a "Default Judgment" of was entered against Elite. In August 2010, Hankins filed a "Suggestion for Writ of Garnishment" against Elite's commercial general liability ("CGL") insurer, Maryland Casualty Company/Zurich American Insurance Company ("Maryland Casualty"). In October 2010, a default judgment was entered against Maryland Casualty. Subsequently, Maryland Casualty filed a "Motion to Suspend Execution of Default Judgment against Maryland Casualty and For Leave to File Answer to Writ of Garnishment," which argued, inter alia, that because its CGL policy "exclud[ed] coverage for property damage caused by earth movement," then it "has no property or effects in its possession belonging to" Elite. Maryland Casualty then filed a "Motion for Summary Judgment" on the same basis. The circuit court concluded that the "earth movement" endorsement "excludes the damages suffered by [Hankins] from coverage under the policy." Based thereon, the circuit court granted summary judgment in favor of the insurance company, and set aside the default judgment. Upon review, the Supreme Court found Maryland Casualty's "earth movement" endorsement was unambiguous and operated to exclude the property damage Hankins suffered from coverage under the CGL policy. Accordingly, the Court affirmed the circuit court's order granting summary judgment to the insurance company, and the setting aside of the default judgment. View "Hankins v. Maryland Casualty Company" on Justia Law

In 1994, while en route to the scene of a fire, volunteer fireman James Hingle collided with a vehicle occupied by Sam and Ruby Anderson. Hingle was driving his personal vehicle at the time of the accident. The Andersons filed suit against Hingle, Marshall County, the volunteer fire department, and the Marshall County Board of Supervisors. The Andersons claimed that their injuries and damages amounted to $4,150,000. At the time of the accident, Hingle had two insurance policies with Guidant: personal automobile liability policy with limits of $250,000 per person and $500,000 per accident, and an umbrella protection policy with a $1,000,000 limit. Marshall County had a business automobile liability policy with a $300,000 limit through INA, which covered non-owned automobiles and provided coverage to the volunteer fire department. A dispute arose regarding which insurance company should defend the litigation and which provided primary coverage. INA filed a declaratory-judgment action against Guidant in the Circuit Court of Marshall County. INA asked for a judgment declaring, inter alia, that Guidant had a duty to defend all the defendants and INA did not have any duty to defend, and that Guidant's policies afforded primary coverage for all defendants, while INA provided excess coverage only. INA moved for summary judgment in the declaratory-judgment action, but the trial court held the motion in abeyance pending a final determination on the merits of the underlying lawsuit. Following that ruling, INA provided defense counsel to Marshall County and the fire department in the Anderson lawsuit. Guidant defended Hingle. INA appealed the trial court's decision on remand. Upon review, the Supreme Court affirmed in part, reversed in part, and remanded the case back to the trial court. The Court affirmed the trial court's denial of INA's Rule 56(f) motion for continuance and the denial of INA's request for prejudgment interest. The Court found that INA's claims of procedural errors warranting reversal were without merit. While the Court agreed with the trial court's finding that INA was required to contribute to the settlement, the Court reversed the trial court's determination that INA was required to contribute its policy limit. The Court held that Guidant was required to exhaust its $500,000 per-accident limit before INA's insurance was to be applied. View "Indemnity Insurance Company of North America v. Guidant Mutual Insurance Company" on Justia Law

Merwin Carlson appealed a judgment affirming a Workforce Safety and Insurance ("WSI") decision that denied his claim for workers' compensation benefits after remand. Under the law of the underlying case, the Supreme Court held that the administrative law judge ("ALJ") erred in concluding WSI properly exercised its continuing jurisdiction under N.D.C.C.65-05-04 to deny Carlson benefits on remand. The Court reversed and remanded for WSI to award Carlson benefits based on the ALJ's calculation that Carlson's average weekly wage was $722. View "Carlson v. Workforce Safety & Ins." on Justia Law

The Supreme Court granted allowance of appeal in this case to determine whether the immunity provisions of Section 23 of the Workers' Compensation Act (Act 44) applied to "subrogation and/or reimbursement claims sought against an employee who has entered into a third[-]party settlement with a Commonwealth [p]arty such as Southeastern Pennsylvania Transportation Authority ('SEPTA')." Upon review of this matter, the Supreme Court held that the portion of Act 44 at issue in this case barred any claim made by the employer for the recoupment of workers' compensation benefits it paid. View "Fraizer v. W.C.A.B." on Justia Law

In 2007, an explosion occurred at a metal processing plant in Manchester, Georgia owned by GSMC, which had obtained insurance through Continental, covering damage to the plant. Continental made some payments to GSMC, but GSMC subsequently sued, alleging that the payments were inadequate. GSMC is now in bankruptcy. Plaintiffs, claiming that the failure of Continental to timely pay adequate damages to GSMC caused them damages, brought suit against Continental and Hylant, their former insurance broker. Three of the plaintiffs are businesses affiliated with GSMC, and are additional named insureds under the policy that covered the Manchester plant. The other plaintiffs are owners and operators of GSMC, and allege that they are third-party beneficiaries of the policy. The district court dismissed the claims of: breach of contract; promissory estoppel; bad faith; negligence; tortious interference with contract; negligent infliction of emotional distress; and breach of fiduciary duties. The Seventh Circuit affirmed, applying Indiana law. View "G & S Holdings LLC v. Cont'l Cas. Co." on Justia Law

This appeal came before the Supreme Court from a declaratory judgment action brought by Farm Bureau Mutual Insurance Company of Idaho (Farm Bureau). Farm Bureau brought suit in response to a claim for insurance benefits filed by the personal representatives of the estate of a deceased policyholder (the Estate). Farm Bureau requested a judgment declaring that the Estate was not an "insured" under the decedent's insurance policy and was therefore not entitled to payment of wrongful death damages under the Policy's underinsured motorist coverage. The district court granted the Estate's motion for summary judgment, determining that Idaho's wrongful death statute, entitled the insured's Estate to recover damages for wrongful death and that the Policy provided coverage for those damages. Farm Bureau appealed. Upon review, the Supreme Court reversed: as to the Estate, the Court determined that under the plain language of the wrongful death statute, the Estate was not legally entitled to recover damages for itself, but only to bring an action on behalf of the heirs to recover their damages. "The Estate stepped into [the decedent's] shoes for those claims, and Farm Bureau made those payments to the Estate. Farm Bureau's payment of these legitimate claims under the insurance contract does not constitute a change of position or an admission that coverage exists for other claims. We hold that these payments do not prevent Farm Bureau from arguing that it is not required to pay the Estate for damages that [the decedent] was not legally entitled to recover." View "Farm Bureau v. Estate of Eisenman" on Justia Law

Frank Hutson was working as a crane operator for the State Ports Authority when he suffered an injury to his lower back and legs while attempting to remove a container from a ship. He was diagnosed with a disc bulge for which he was treated with steroid injections, physical therapy, and used a back brace. After reaching maximum medical improvement, he filed a Form 50 with the workers' compensation commission for continued benefits alleging permanent and total disability pursuant to Sections 42-9-10 and 42-9-30 South Carolina Code (1976 & Supp. 2011) or, alternatively, a wage loss under Section 42-9-20. He also asked to receive the award in lump sum. Although the Ports Authority and its insurance carrier, the State Accident Fund (collectively, Respondents), admitted the accident and the back injury, they disputed the claims to his legs and argued he should receive only permanent partial disability benefits. They also objected to Hutson's request that his benefits be paid in a lump sum. The issue before the Supreme Court centered on whether speculative testimony by the claimant concerning his possible future work as a restaurateur qualified as substantial evidence to establish he did not sustain a wage loss pursuant to Section 42-9-20 of the South Carolina Code (1976). The Court held it did not, and therefore reversed and remanded the case for further proceedings. View "Hutson v. SC State Ports Authority" on Justia Law

In 2000 an “incident” occurred on the ice of a professional hockey game in Switzerland between Miller and McKim. McKim was injured. Swiss courts filed criminal charges against Miller. McKim’s insurer and hockey club filed suit against Miller, and two civil judgments were entered against Miller. Miller left Switzerland before the judgments were finalized and informed his hockey team and its insurer (Winterthur) that he no longer had the financial means to defend the litigation. In 2005, a document was submitted to Miller in Michigan from Winterthur that acknowledged its responsibility for the costs of criminal and civil judgments and proceedings pending in Zurich and previous attorneys’ fees. In 2010, McKim’s team and insurer submitted demands for payment to Miller from the Swiss judgment. Miller, claiming reliance, submitted the demands to Winterthur, which declined to pay the judgments in full. Miller brought suit in Michigan, seeking contractual damages and enforcement of the terms of the 2005 document. The district court granted Winterthur’s motion to dismiss for lack of personal jurisdiction. The Sixth Circuit affirmed. Miller had established a basis for personal jurisdiction under Michigan’s long-arm statute, but the requirements of constitutional due process were not met. View "Miller v. AXA Winterthur Ins. Co." on Justia Law

Plaintiff Wade Stancil was injured in 1995 while employed by Orient Originals. He received workers' compensation benefits from his employer's compensation carrier, defendant ACE USA (ACE). In 2006, following a trial, the court of compensation determined that Stancil was totally disabled. In 2007, Stancil filed a motion in the compensation court seeking an order compelling ACE to pay outstanding medical bills. During a hearing on the motion, the compensation judge commented that ACE had a history of failing to make payments when ordered to do so. The compensation judge granted Stancil's motion, warned ACE against any further violation of the order to pay, and awarded Stancil counsel fees. The parties returned to the compensation court for a further proceeding relating to the disputed bills. After finding that the bills identified in the earlier order remained unpaid and that ACE's failure to make payment was a willful and intentional violation of the order, the court issued another order compelling ACE to make immediate payment and again awarding counsel fees. In 2008, Stancil underwent additional surgery and psychiatric treatment. Stancil's physician attributed the need for additional treatment to an earlier treatment delay caused by the carrier's delay in paying medical providers. N.J.S.A. 34:15-1 to -142 (the Act), is the exclusive remedy for the claims pled in the complaint and therefore no damages could be awarded. The trial court granted ACE's motion effectively denying payments for Stancil's 2008 treatment. The Appellate Division affirmed. The issue on appeal to the Supreme Court was whether the employee could sue the carrier for pain and suffering caused by the carrier's delay in paying for medical treatment, prescriptions, and other services. Upon review, the Court concluded that an injured employee does not have a common law right of action against a workers' compensation carrier for pain and suffering caused by the carrier's delay because: (1) the workers' compensation system was designed to provide injured workers with a remedy outside of the ordinary tort or contract remedies cognizable in the Superior Court; (2) in amending the Workers' Compensation Act in 2008, the Legislature rejected a provision that would have given the compensation courts broader permission to authorize a resort to the Superior Court and adopted a remedy that permits compensation courts to act through a contempt power; and (3) allowing a direct common-law cause of action against a carrier would undermine the workers' compensation system by substituting a cause of action that would become the preferred manner of securing relief. View "Stancil v. ACE USA" on Justia Law