Justia Insurance Law Opinion Summaries

James Bennett, the father of Brooke Bennett and the administrator of her estate, appealed a trial court's declaration of no coverage for the claims made in the lawsuit filed against homeowner Denise Woodward for negligent supervision and damages arising out of the abduction, assault, and death of his daughter, Brooke. Woodward was formerly married to Brooke’s uncle, Michael Jacques, who was alleged to have kidnapped, sexually assaulted, and murdered Brooke. Woodward's insurer brought a declaratory judgment action asking the trial court to hold that its policy does not cover these claims. The trial court decided the case on summary judgment, holding that the insurance policy excluded coverage and Bennett appealed. The trial court granted summary judgment for the insurer, concluding that insurer owed no duty of defense or indemnification in the underlying suit in part because the policy barred coverage for intentional acts by "an insured" that are not "occurrences." The court rejected Bennett's argument that the separate insureds, or severability clause provided coverage for homeowner because the complaint alleged that the uncle committed intentional acts. On appeal, father reiterated his argument that Jacques' alleged intentional acts did not preclude coverage for homeowner because the policy contained a severability clause. Upon review, the Supreme Court found that the plain meaning of the terms in the insurance policy at issue did not include intentional tortious acts nor allowed for severability under the facts of this case.

Plaintiff, a maintenance director, had a stroke and began leave under the Family and Medical Leave Act, 29 U.S.C. 612(a)(1) in January 2008. He received disability benefits from Unum. The doctor cleared him to return to work starting on May 1, with conditions that he not work more than four hours per day or lift loads in excess of 20 pounds. The administrator notified plaintiff that part-time work was not available. The doctor cleared him to work full-time, but did not change the lifting restriction. On April 20, the employer terminated plaintiff's employment and notified him that he would not be rehired with lifting restrictions. Until July 2008, when the restrictions were lifted, he received benefits from Unum. The district court rejected claims under the Americans with Disabilities Act, the Pennsylvania Human Relations Act, and the FMLA. The Third Circuit affirmed. The FMLA does not require an employer to provide reasonable accommodation to facilitate return to an equivalent position following leave. Entitlement to restoration requires that the employee be able to perform essential job functions without accommodation. Having represented to Unum that he was disabled, plaintiff was estopped from claiming that he was able to perform all essential functions.

Appellant was injured when she was involved in a motor vehicle accident. The other vehicle involved in the accident, a truck, was listed on two different insurance policies: an Allstate policy issued to Jeremy Lucas and a Mountain West policy issued to Wyoming Electric Company. Appellee, Mountain West, filed a complaint for declaratory judgment, requesting that the district court find Mountain West did not have to cover the truck under the policy. The district court granted summary judgment in favor of Mountain West, finding that the owner of Wyoming Electric had given the truck to Lucas and, therefore, the truck was no longer covered under the company's insurance policy. The Supreme Court affirmed, holding that although the truck was titled and registered in the name of Wyoming Electric and was still listed as a specific vehicle on the Mountain West Policy, Mountain West was not required to pay under the policy because, on the date of the accident, Wyoming electric no longer owned the truck and the truck was no longer covered under the Mountain West insurance policy.

After Employer and Employee settled a suit Employee brought against Employer, Employer's Insurer paid the policy's maximum of $2 million pursuant to an oral funding agreement. Insurer then filed an action against Employer, seeking a declaration that its policies provided no coverage for Employee's claim and reimbursement of the $2 million. The circuit court granted summary judgment in favor of Employer on March 26, but the parties agreed to delay entry of a final judgment. On July 8, the circuit court entered a final judgment. Insurer appealed on August 12. The court of appeals dismissed the appeal as untimely, concluding that the circuit court's March 26 decision and order was the final order for purposes of appeal. The Supreme Court reversed, holding (1) Insurer's appeal was timely because although the March 26 order arguably disposed of the entire matter in litigation between the parties, it did not unambiguously do so, and therefore, the July 8 judgment was final for purposes of appeal; (2) the funding agreement was an enforceable contract; (3) under these circumstances, an insurer cannot recover payments based on an unjust enrichment theory; and (4) Insurer's asserted mistake of fact did not provide grounds for voiding the contract.

Lowell Burris and his wife commenced a product liability action against Menard, Versa, and Versa's affiliate in Minnesota state court. After Menard removed the action to federal court, which had diversity jurisdiction, Gulf commenced this action seeking a judgment declaring "that the policy issued by Gulf to [the named insureds] does not afford coverage to them or Menard, Inc. for any claim made by [Burris] under the terms of the Gulf Policy." The district court granted Gulf's motion for a summary declaratory judgment on the ground that Versa' dissolution after expiration of the policy meant that the insured "cannot meet its obligations under the SIR" (Self-Insured Retention endorsement), a material breach that terminated Gulf's obligations under the policy. Burris appealed. The court concluded that summary judgment for Gulf was factually unwarranted and the declaratory judgment action was dismissed with prejudice.

Lisa Krebs sued Carmen McReynolds and GM for serious injuries she received when McReynold's car struck the GM vehicle in which Krebs was a passenger. McReynolds subsequently appealed the trial court's rulings. The court granted certiorari to consider two questions: (1) Did the Court of Appeals correctly construe OCGA 51-12-33 to require a trier of fact to apportion an award of damages among multiple defendants when the plaintiff was not at fault?; and (2) Did the Court of Appeals correctly find that McReynolds's insurer made a counteroffer in response to Krebs's settlement demand? The court answered both questions affirmatively. The court held that in applying section 51-12-33, the trier of fact must "apportion its award of damages among the persons who were liable according to the percentage of fault of each person" even if the plaintiff was not at fault for the injury or damages claimed. In light of this holding, there was no error in the dismissal of McReynolds's cross-claims for contribution and set-off against GM. The court construed the response by McReynolds's insurer to Krebs's settlement offer, proposing to resolve the hospital and other liens "as part of this settlement," as a counteroffer rather than an unconditional and unequivocal acceptance. Accordingly, no binding settlement was formed.

Kyle Hoffman was a passenger in an automobile driven by William Piper (William) when an accident resulted in the deaths of Hoffman and William. Robin Prinz, administratrix of the estate of Kyle Hoffman, filed a complaint asserting a wrongful death claim against Julie Piper (Petitioner), administratrix of the estate of William, and a declaratory judgment claim against State Farm. The complaint alleged that William's grandfather maintained a personal liability policy through State Farm that provided coverage to William. The circuit court bifurcated the two claims and stayed the wrongful death action pending resolution of the declaratory judgment action. The circuit court found the State Farm policy provided liability coverage for the allegedly negligent actions of William. State Farm appealed. Petitioner filed a motion to stay the wrongful death action pending the Court's resolution of State Farm's appeal, which the circuit court denied. Petitioner subsequently filed a petition for writ of prohibition to prevent the circuit court from enforcing its order denying the stay. The Supreme Court denied the writ, holding (1) the court did not abuse its discretion by refusing to further stay the wrongful death proceedings; and (2) a writ of prohibition is not available to correct discretionary rulings.

Michael Bryant, an owner and employee of Prime Cut Meat Market, assaulted another motorist, Francis Latanowich, in an apparent incident of road rage. Prime Cut and its employees were insured by a policy issued by The Travelers Indemnity Company. Latanowich and his wife sued Bryant and Prime Cut. Prime Cut successfully moved for summary judgment, and Bryant and the Latanowiches agreed to a settlement that included Bryant assigning all of his rights related to potential insurance coverage to the Latanowiches. Travelers later filed a complaint against Bryant and the Latanowiches seeking a declaratory judgment that it had no duty to indemnify Bryant for claims arising from the altercation because Bryant was not an insured under its policy issued to Prime Cut for purposes of that conduct. The superior court concluded that the policy language did not cover the incident, and it granted Travelers's motion for summary judgment. The Latanowiches appealed. The Supreme Court affirmed, holding that, pursuant to the unambiguous language of the policy, the court correctly concluded that Bryant's assault of Latanowich was not covered by the policy and properly entered summary judgment.

Plaintiff sued her employer and its workers' compensation insurer for intentional obstruction of workers' compensation in violation of Minnesota statute 176.82. The employer and insurer moved for summary judgment, which the district court granted. The court held that there were genuine issues of material fact as to whether the employer intentionally obstructed her receipt of workers' compensation benefits through her manager's fabrications and its 17-month delay in payment. The court also held that genuine issues of material fact remained as to whether the insurer intentionally obstructed her receipt of workers' compensation benefits by concealing the manager's first statement about the purpose of the meeting at issue, filing a factually-inaccurate claim denial, and continuing to deny the claim through trial. Accordingly, the court reversed the judgment of the district court and remanded for further proceedings.

Employee, a truck driver, resigned from his employment with Employer after he developed arthritis. Employee later filed an occupational disease claim, which the Montana State Fund (MSF) denied. The Workers' Compensation Court (WCC) concluded that Employee's job duties were the major contributing cause of his arthritic condition, and therefore, Employee was suffering from an occupational disease. The Supreme Court affirmed, holding that the WCC did not err in concluding that Grande was suffering from a compensable occupational disease arising out of and in the course and scope of his employment, as the WCC's findings of fact were supported by substantial, credible evidence, and its conclusions of law were correct.