Justia Insurance Law Opinion Summaries

National Union appealed from the district court's award of consequential damages to plaintiffs, following a jury trial, for National Union's breach of its duty to defendant plaintiffs in a securities arbitration. At issue was whether consequential damages, which were traditionally available for breach of contract claims, were also available for a claim of breach of a duty to defend an insured under Connecticut law, and if so, whether they could include damages for harm to reputation and loss of income. Absent a precedential decision from the Connecticut courts, the court certified the two issues. View "Ryan v. Nat'l Union Fire Ins." on Justia Law

The United States District Court for the Northern District of Alabama, Eastern Division certified two questions of first impression to the Alabama Supreme Court: whether a coverage exclusion clause in an automobile insurance policy applied to the use of the vehicle used for transporting people or delivering newspapers (as part of the insured's job) was enforceable. A secondary issue was whether that exclusion applied when an accident takes place after the delivery of the last paper, "but while the insured is driving back to his point of origin or some other location." Scott and Lori Touart Thomas were injured as the result of an automobile accident; Lori had been driving. The Thomases recovered a judgment in state court against defendant Kenneth Gooden, Jr., the driver of the other vehicle. The dispute involved whether the Thomases were entitled to recover from Nationwide under the provisions of a Nationwide automobile liability insurance policy naming Gooden as an insured. Upon review, the Supreme Court concluded that the answer to the first certified question is "yes:" a clause in an automobile liability-insurance policy excluding coverage for the "use of any motor vehicle to carry persons or property for a fee" could be enforced as to an insured if the finder of fact concludes that the insured delivers newspapers for a fee and that the insured was using the covered vehicle for that purpose at the time of the accident. With regard to the second question, the Court concluded that the answer to the second certified question is "no:" a clause in an automobile liability-insurance policy excluding coverage for the "use of any motor vehicle to carry persons or property for a fee" cannot be enforced as to an insured after the delivery of the "property," i.e., newspapers in this case, is complete. View "Nationwide Mutual Ins. Co. v. Thomas" on Justia Law

Respondent sustained six injuries while playing for the Washington Redskins on four separate occasions. Consequently, Respondent filed with the Maryland Workers Compensation Commission six separate claims against his employer, the Washington Redskins (Petitioner). The Commission denied five of Respondent's claims on the ground that he was not a "covered employee" because he was working for the Redskins outside of the State when he sustained the injuries underlying the claims. The circuit court affirmed. The court of special appeals reversed. The Court of Appeals affirmed, holding that a football player employed by the Washington Redskins is a "covered employee," and therefore entitled to avail himself of Maryland's workers' compensation laws, when injured while practicing and playing football outside of Maryland. View "Pro-Football, Inc. v. McCants" on Justia Law

This appeal concerned the method for excluding impairment from a non-compensable disability when calculating a worker's permanent disability benefit under the post-1996 version of Kan. Rev. Stat. 342.730(1)(b). The ALJ calculated a benefit based on the claimant's entire post-injury permanent impairment rating and then subtracted an amount equal to a benefit based on his pre-existing active impairment rating. The workers' compensation board reversed, determining that the present version of section 342.730(1)(b) requires the calculation of income benefits to be based only on the permanent impairment rating caused by the injury being compensated. The court of appeals affirmed. The Supreme Court affirmed, holding that pre-existing impairment must be excluded when calculating a total disability award under section 342.730(1)(b). View "Tudor v. Indus. Mold & Mach. Co." on Justia Law

Claimant sustained a work-related injury in 2003, for which he was awarded temporary total disability (TTD) benefits followed by 425 weeks of permanent partial disability benefits. In 2007 Claimant sustained another injury. After finding the effects of the 2003 injury caused Claimant's 2007 injury, an ALJ increased Claimant's partial disability benefit at reopening and tripled the entire income benefit awarded for his injury. The workers' compensation board and court of appeals affirmed. The Supreme Court affirmed, holding (1) substantial evidence supported the finding of increased impairment as well as the finding that Claimant lacked the physical capacity at reopening to perform the type of work performed at the time of his injury; and (2) the combined effects of the impairment present at the time of the initial award and the additional impairment present at reopening entitled Claimant to triple benefits based on the whole of his disability for the balance of the compensable period. View "James T. English Trucking v. Beeler" on Justia Law

An ALJ determined that Claimant sustained a work-related hearing loss and that Kan. Rev. Stat. 342.7305(4) placed the entire liability for income and medical benefits with Appellant, the last employer with whom Claimant was last injuriously exposed to hazardous noise. The workers' compensation board and court of appeals affirmed. The Supreme Court affirmed, holding (1) the record contained substantial evidence that testing revealed a pattern of hearing loss compatible with that caused by hazardous noise exposure and contained substantial evidence that Claimant sustained repetitive exposure to hazardous noise in the workplace, including his final employment with Appellant; and (2) Kan. Stat. Rev. 342.7305(4) does not permit apportioning liability among employers in such cases. View "Greg's Constr. v. Keeton" on Justia Law

This appeal concerned an ALJ's decision to award the claimant temporary total disability (TTD) benefits for his work-related shoulder injury from the date he left work, May 10, 2007, until May 8, 2009. The ALJ also awarded permanent income and medical benefits for the injury but denied claims for cervical and lumbar spine injuries. A court of appeals majority reversed, concluding that the opinion and award failed to contain findings adequate to make clear whether the ALJ considered and understood all of the evidence relevant to the date when TTD began. The Supreme Court (1) reversed to the extent that the ALJ made the finding of fact required by Kan. Rev. Stat. 342.0011(11)(a); but (2) affirmed to the extent the Court was unable to determine whether the ALJ simply misstated May 10, 2007 as being the date the claimant testified he stopped working due to the effects of his injury, misunderstood the evidence concerning his reason for missing work on May 10, 2007, or chose May 10, 2007 based on other evidence. Remanded to the ALJ to clarify that portion of the decision. View "Arnold v. Toyota Motor Mfg." on Justia Law

Jerry and Martha Garrison witnessed their son's injuries after he was struck by a car. The son died afterwards. The Garrisons filed a claim for negligent infliction of emotional distress against the owner and driver of the car. The Garrisons also served a copy of the complaint upon their insurance company, State Farm, pursuant to the uninsured motorist provisions of their policy. The policy covered damages for "bodily injury," and "bodily injury" was defined in the policy as "bodily injury to a person and sickness, disease, or death that results from it." The trial court determined that the "bodily injury" provision of the uninsured motorist statute covered mental injuries, and therefore, the policy provided, by operation of law, coverage for the Garrisons' emotional distress claim. The court of appeals reversed. The Supreme Court affirmed, holding (1) as applied to this case, "bodily injury" did not include damages for emotional harm alone; and (2) the definition of "bodily injury" in the policy did not conflict with the uninsured motorist statute. View "Garrison v. Bickford " on Justia Law

This case involved a claim by a former professional football player (the athlete) for benefits under the Maryland Workers' Compensation Act based on an injury during pre-game warm-up at the employer's stadium in Maryland. The employment agreement contained a forum selection clause providing, inter alia, that claims for workers' compensation benefits should be governed by Virginia law and that the Virginia Workers' Compensation Commission should have exclusive jurisdiction to resolve such claims. The Maryland Workers' Compensation Commission decided that it could properly exercise jurisdiction over the athlete's claim, that the athlete had sustained an accidental injury arising out of the course of his employment, and that the athlete's disability was causally related to his accidental injury. The circuit court upheld the decision. The court of special appeals affirmed. The Court of Appeals affirmed, holding (1) the forum selection clause in the employment contract was ineffective to divest the Commission of the ability to exercise jurisdiction; and (2) injuries occurring while playing and practicing professional football are accidental injuries and thus compensable under the Act. View "Pro-Football, Inc. v. Tupa" on Justia Law

Candice Brilz filed an action in Montana state court purportedly asserting statutory and common law bad-faith claims against Metropolitan General Insurance Company (Metropolitan). Metropolitan removed the action to federal court and filed a motion for summary judgment, which the federal court granted. Thereafter, Brilz commenced this suit district court seeking a determination that she may pursue her common law bad-faith claim against Metropolitan. Because the statute of limitations on that claim had since expired, Brilz requested a ruling that she may pursue the claim pursuant to 27-2-407, MCA, or the Supreme Court's doctrine of equitable tolling. The District Court dismissed the action, and Brilz appealed. The Supreme Court concluded that principles of claim preclusion barred her from filing a second action against Metropolitan arising out of the same underlying facts. Accordingly the Court affirmed the District Court's judgment. View "Brilz v. Metropolitan General Ins." on Justia Law