Justia Insurance Law Opinion Summaries

TAMS, a medical device manufacturer, hired Comtrans to coordinate shipment of equipment to a trade show in Chicago. Comtrans is not a carrier. It used its affiliate, ACS, which retained Atlas to perform the actual shipment. The Atlas truck was involved in a serious accident, leaving TAMS with more than $1 million in losses. TAMS’s insurance company sued on behalf of TAMS. Atlas is an interstate motor carrier authorized by the Federal Motor Carrier Safety Administration to transport goods in interstate commerce. Claims are subject to the Carmack Amendment, 49 U.S.C. 14706, which provides that a carrier of property in interstate commerce is liable for the actual loss or injury to the property caused b” the carrier, which may be limited “to a value established by written or electronic declaration of the shipper or by written agreement between the carrier and shipper if that value would be reasonable under the circumstances.” Atlas relied on the contract it had in place with ACS and the bill of lading delivered signed by a Comtrans warehouse manager when Atlas picked up TAMS’s shipment, as limiting liability to $0.60 per pound. The district court entered summary judgment for Atlas. The Seventh Circuit remanded for further development of the facts. View "Nipponkoa Ins. Co., L v. Atlas Van Lines, Inc." on Justia Law

Plaintiffs Memorial Properties, LLC (Memorial) and Mount Hebron Cemetery Association (Mt. Hebron) are respectively the manager and owner of Liberty Grove Memorial Gardens. Mt. Hebron was sued in 2007 and 2008 in seven lawsuits in the Superior Court of New Jersey and the Supreme Court of New York by family members of decedents whose remains were sent by funeral directors to Liberty Grove for cremation in 2003, 2004 and 2005. The New Jersey and New York plaintiffs alleged that prior to being sent to Liberty Grove, the decedents’ bodies were unlawfully dissected, and that tissue, bone and organs were removed for commercial sale. The families contended that they did not discover the illegal harvesting scheme until 2006, when law enforcement officials who investigated and prosecuted the perpetrators advised them that their relatives’ body parts had been illegally harvested. Memorial and Mt. Hebron contended that they received the decedents’ remains in closed containers and were unaware that the remains had been tampered with before being turned over to the crematory. Memorial and Mt. Hebron were not prosecuted as a result of the criminal investigation of the illegal harvesting. This appeal arose from Memorial’s and Mt. Hebron’s pursuit of a defense and indemnification with respect to the New Jersey and New York litigation, under two insurance policies. The first policy, issued by Assurance Company of America (Assurance), provided coverage for the year 2003 for claims arising from damage to human remains and bodily injury, including mental anguish. The second, issued by Maryland Casualty Company (Maryland), provided analogous coverage for the year 2006, but contained an "improper handling" exclusionary clause, barring coverage for bodily injury or property damage arising from specified acts and omissions including "[f]ailure to bury, cremate or properly dispose of a 'deceased body.'" In 2008, Memorial and Mt. Hebron demanded that Assurance and Maryland defend and indemnify them. Assurance declined coverage on the ground that the occurrences were outside of the policy period, invoking plaintiffs' claims that they learned of the harvesting scheme in 2006. Maryland declined coverage, citing the "improper handling" exclusionary clause in its 2006 policy. Memorial and Mt. Hebron filed a declaratory judgment action on May 14, 2008, naming as defendants Assurance, Maryland and Zurich North American Insurance Company (Zurich), and demanding defense and indemnification. Assurance and Maryland cross-moved for summary judgment. The trial court denied the summary judgment motion filed by Memorial and Mt. Hebron, but granted defendant insurers' cross-motion for summary judgment, identifying the year 2006 as the time frame of the "occurrence" in the two cases for which the insureds sought coverage. The Appellate Division affirmed both of the trial court’s orders granting the summary judgment motions filed by Assurance and Maryland. After its review, the New Jersey Supreme Court concluded that neither the Assurance policy nor the Maryland policy required the insurer to defend or indemnify Memorial and Mt. Hebron for claims asserted in the New Jersey and New York litigation. The Court affirmed the Appellate Division's ruling. View "Memorial Properties, LLC v. Zurich American Insurance Co." on Justia Law

Claimant Henry Marange filed a disputed claim for compensation against his employer, Custom Metal Fabricators, Inc. asserting he injured his back in a work-related accident. Custom Metal answered the petition, and denied Claimant's allegation. The issue before the Supreme Court was whether the court of appeal erred in reversing of the Office of Workers' Compensation (OWC), which held that Claimant failed to establish by a preponderance of the evidence that a workplace accident occurred. Upon review of the facts in record, the Court concluded that the court of appeal erred in reversing the OWC's judgment. View "Marange v. Custom Metal Fabricators, Inc." on Justia Law

Jason McCann was involved in an automobile accident with Jeffrey Kreml. McCann's insurer, Auto Club Insurance Association, defended McCann against Kreml's personal injury action. After Kreml and McCann settled, Auto Club sought contribution from Sentry Insurance, the insurer for McCann's employer, claiming Sentry was obligated to provide co-primary coverage for McCann. The court granted summary judgment to Sentry, finding the Sentry policy only obligated Sentry to provide excess liability coverage, and McCann had no excess exposure because he settled within the limits of the Auto Club policy. The Eighth Circuit Court of Appeals affirmed, holding that the district court's interpretation of the policy was reasonable. View "Auto Club Ins. Ass'n v. Sentry Ins." on Justia Law

The Supreme Court granted certiorari to the Court of Appeals in "Glass v. Gates" to answer whether the definition of "any motor vehicle" in OCGA 33-24-51(a) continued to be the broader definition of the term provided for in prior case law, notwithstanding the 2002 passage of OCGA 36-92-1. As inmates at the Troup County Correctional facility, Jonathan Glass and Tony Smith were operating tractors when Smith's tractor got stuck in a ditch. Donrell Gates, Glass' detail supervisor, instructed the men to attach a chain to the tractors so Glass could use his tractor to pull Smith's from the ditch. As Glass did so, Smith engaged his tractor's bush hog, causing a rock to take flight and pierce Glass' throat. Glass bled profusely and died later that day. Plaintiffs, Glass' minor son and the executor of his estate, brought a wrongful death and survivor action against Troup County and Gates. The county sought summary judgment, claiming plaintiffs' claims were barred by sovereign immunity. The County asserted that by revising OCGA 33-24-51 (b) in 2002 (effective 2005), the legislature demonstrated its intent to apply the more narrow definition of "motor vehicle" found in OCGA 36-92-1 (6) in determining whether a local government waived sovereign immunity by purchasing liability insurance on a motor vehicle. The trial court agreed and granted summary judgment in favor of the County, concluding that the county did not waive sovereign immunity because neither a tractor nor a bush hog could be deemed a "motor vehicle" under OCGA 36-92-1. The Court of Appeals reversed, holding that the broader definition of "motor vehicle" should have been applied under 33-24-51, and that therefore, the County waived its sovereign immunity as long as it purchased insurance for the tractor and bush hog used by Smith. The Supreme Court agreed with the Court of Appeals' reasoning, and affirmed by answering the appellate court's original question in the affirmative. View "Gates v. Glass" on Justia Law

The Wyoming Workers' Safety and Compensation Division awarded benefits to Appellant Gary Mitcheson after he fell at work and injured his tailbone in July of 2007. Approximately two years later, the Division issued a final determination denying payment for medical care that Appellant claimed was related to his workplace injury. Appellant requested a contested case hearing, and the Office of Administrative Hearings (OAH) upheld the Division's determination. Appellant appealed to the district court, which upheld the OAH's order. On appeal, Appellant challenged the OAH order contending: (1) the order was arbitrary and unsupported by substantial evidence; (2) the OAH's denial of payment for treating Appellant's tailbone was arbitrary; and (3) the OAH order denying payment for medical care contrary to the "Rule Out" rule was contrary to law. Finding the issues Appellant raised on appeal to be without merit, the Supreme Court affirmed the OAH's decision. View "Mitcheson v. Wyoming" on Justia Law

This appeal involved the interpretation of a claims-made professional liability insurance policy that Appellant Physicians Insurance Company of Wisconsin, Inc., d.b.a. PIC Wisconsin (PIC), issued to nonparty dentist Hamid Ahmadi, D.D.S. The policy covered dental malpractice claims made against Dr. Ahmadi and reported to PIC during the policy period. On cross-motions for summary judgment, the district court determined that PIC received constructive notice of Respondent Glenn Williams’s malpractice claim against Dr. Ahmadi while the policy was in force and held that this was enough to trigger coverage. Upon review, the Supreme Court reversed, finding that a "report" of a potential demand for damages to qualify as a "claim" required sufficient specificity to alert the insurer’s claim department to the existence of a potential demand for damages arising out of an identifiable incident, involving an identified or identifiable claimant or claimants, with actual or anticipated injuries. The Court did not find an ambiguity that would permit the PIC policy to have been triggered by the report of a default judgment against the doctor filed in public records. As such, the Court remanded the case with instructions to enter summary judgment in favor of PIC. View "Physicians Insurance Co. v. Williams" on Justia Law

Claimant Crystal DeLeon sought workers' compensation benefits for a work-related injury to her back, neck and one shoulder. SAIF Corporation, her insurer, accepted the claim but awarded only temporary partial disability; the insurer did not award Claimant permanent partial disability. Claimant sought reconsideration, and the Department of Consumer and Business Services awarded her an eleven percent permanent partial disability for her shoulder. The insurer appealed the Department's award; the ALJ agreed with the insurer and reduced the permanent partial disability award to zero. Claimant appealed the ALJ's decision to the Workers' Compensation Board. The board reversed the ALJ and reinstated the eleven percent disability determination, and awarded attorney's fees. The issue on appeal concerned the authority of the Workers' Compensation Board to award attorney fees. Upon review, the Supreme Court found that the Board indeed has statutory authority to award attorneys' fees. View "SAIF Corp. v. DeLeon" on Justia Law

At issue in this appeal was whether to judicially invalidate an insurance contract requirement that the insured file her lawsuit for underinsured motorist coverage (UIM) within two years of her auto accident. Plaintiff argued the deadline was unenforceable because, although she was still experiencing pain two years after the accident, only later did she discover the full extent of her injuries and realize her claim exceeded the other driver's liability limits. Plaintiff filed this UIM action against her insurer (Defendant) nearly six years after the accident. The district court granted Defendant's motion for summary judgment enforcing the contractual deadline as reasonable. The court of appeals reversed, holding the two-year limitation period was unreasonable under the circumstances. The Supreme Court vacated the court of appeals and affirmed the district court, holding that the two-year UIM insurance policy deadline was enforceable as a matter of law because it matched the two-year statute of limitations in Iowa Code 614.1(2) for personal injury actions. View "Robinson v. Allied Prop. & Cas. Ins. Co." on Justia Law

An employee of a tribal enterprise sought to invoke the jurisdiction of the Oklahoma Workers' Compensation Court. Petitioner John A. Waltrip fell on a patch of ice while working as a surveillance supervisor at a casino and injured primarily his right shoulder. Petitioner initially obtained treatment from his personal physician but Tribal First, the employer Osage Million Dollar Elm Casino's claim administrator, sent him to an orthopedic specialist who recommended surgery in 2009. Petitioner filed a claim in the Oklahoma Workers' Compensation Court on July 17, 2009, seeking medical treatment and temporary total disability. The Casino and Insurer Hudson Insurance Company asserted that court lacked jurisdiction based on the tribe's sovereign immunity. A hearing was held solely on the jurisdictional issue; the Workers' Compensation Court denied jurisdiction and dismissed the claim holding that the tribe enjoyed sovereign immunity and that the provisions of the tribe's workers' compensation policy did not subject the insurance company to liability for claims in state court. The Court of Civil Appeals affirmed and the Supreme Court granted certiorari review. Upon review, the Supreme Court held that: (1) the tribe enjoyed sovereign immunity and was not therefore subject to the jurisdiction of the Oklahoma Workers' Compensation Court; and (2) the workers' compensation insurer did not enjoy the tribe's immunity and was estopped to deny coverage under a policy for which it accepted premiums computed in part on the employee's earnings. View "Waltrip v. Osage Million Dollar Elm Casino" on Justia Law