Justia Insurance Law Opinion Summaries

The company issued the family auto insurance when they lived in New Jersey. The family moved to Pennsylvania, and made the company aware of the permanent relocation, before being involved in a traffic accident in Pennsylvania that killed one member of the family and injured others. The policy of the other driver has paid its limit. New Jersey law limits personal injury protection claims to $250,000 per person; under Pennsylvania law the family would be entitled to "stacked" underinsured motorist benefits. The district court granted the company declaratory relief, finding that New Jersey law applied to the contract. The Third Circuit remanded holding that Pennsylvaniaâs choice-of-law rules do not apply, but that New Jersey choice-of-law rules point to Pennsylvania law as governing the dispute. The court affirmed the grant of summary judgment to the company on a counterclaim alleging that it engaged in a bad faith denial of insurance coverage.

This case arose because the settlement of a personal-injury suit brought by a recipient of workers' compensation benefits against a third-party tortfeasor did not make any provision to repay the statutory subrogee, the Ohio Bureau of Workers' Compensation. The Bureau brought suit against both the recipient of the workers' compensation benefits and third-party tortfeasor under Ohio Rev. Code 4123.931(G) to recover the full amount of its subrogation interest. The trial court held that a two-year limitations period applied and that it had expired. The court of appeals reversed, holding that a six-year limitations period applied and that it had not yet run out. At issue on appeal was whether a claim under section 4123.931(G) brought by a statutory subrogee to recover its subrogation interest is subject to a two-year statute of limitations, the same period applicable to the injured worker's personal-injury suit against the third party, or to a six-year statute of limitations for an action on a liability created by statute. The Supreme Court affirmed the court of appeals, holding that the claim in this case was an action upon a liability created by statute and that the statute of limitations was six years.

In this appeal, accounting firm Bryan Brothers sought coverage under a professional liability insurance policy issued by Continental Casualty Company for liability arising from illegal acts of a former Bryan Brother's employee. Under the policy, it was a condition precedent to coverage that no insured had knowledge, prior to the inception of the policy, of an act that was reasonably likely to become the basis for a claim. The court held that because Bryan Brothers had such knowledge, the claims at issue were not covered. Therefore, the court affirmed the district court's grant of summary judgment to Continental Casualty Company.

A father and his sixteen-year-old son were sued after the son was involved in an accident while driving a vehicle owned, insured, and provided to him by his father. The basis for the suit against the father was the family purpose doctrine, which imposes vicarious liability on the owner of a vehicle for the negligent operation of the vehicle by a family member. The trial court granted summary judgment to the father, finding that the family purpose doctrine did not apply. The court of appeals reversed and granted partial summary judgment in favor of the plaintiff, ruling that the family purpose doctrine applied as a matter of law. The Supreme Court vacated the decision of the court of appeals, holding that while two of the essential elements of the family purpose doctrine were met in this case, a genuine issue of material fact remained as to the last element. Remanded for trial.

Gregory Latterell, on behalf of his stepson Jared Boom's estate, sued Progressive Northern Insurance and AIG Insurance to recover underinsured motorist (UIM) benefits following Boom's death from a motor vehicle accident. Progressive, the insurer of Boom's vehicle, denied Latterell's claim for UIM benefits because of a business-use exclusion in Boom's insurance policy. AIG, Lattrell's insurer, also denied Latterell's claim. Latterell sued, and the district court granted summary judgment to Progressive and AIG. The court of appeals affirmed, holding (1) the business-use exclusion in the Progressive policy was enforceable under the Minnesota No-Fault Automobile Insurance Act and unambiguously excluded UIM coverage under the specific circumstances of this case, and (2) Latterell could not recover UIM benefits under the AIG policy. The Supreme Court reversed the denial of Latterell's summary judgment as to Progressive, holding that Progressive's business-use exclusion was unenforceable under the No-Fault Act. Remanded with instructions to enter judgment in favor of Latterell against Progressive.

After Homeowners' house burned down, Homeowners' insurer denied coverage, stating that payment was not timely delivered, the money order was not signed, and the damaged house was the secondary house and Insurer's underwriting policies required insurance on the primary house also to be purchased through Insurer in order to have coverage in place for the secondary residence. Homeowners filed suit, asserting that no reasonable basis in fact or law existed for denial of the claim and seeking damages and a declaratory judgment that the loss was covered. The district court granted Insurer's motion for summary judgment and denied Homeowners' motion for partial summary judgment with respect to their declaratory judgment action. The Supreme Court reversed in part and affirmed in part, holding (1) the district court erred in granting summary judgment to Insurer as genuine issues of material fact remained, and (2) the district court did not abuse its discretion in denying Homeowners' motion for partial summary judgment.

Employee was diagnosed with silicosis, a condition caused by work with Employer, and filed a claim for workers' compensation benefits. During the course of Employee's employment, Employer's workers' compensation liability was covered by two insurers, first Liberty Mutual and, later, American Mutual. After Employee terminated his employment, American Mutual was declared insolvent. The Connecticut Guarantee Association subsequently became liable for certain American Mutual obligations. The workers' compensation commissioner held the association initially liable for payment of benefits as the last insurer on the risk. The workers' compensation review board affirmed. The association appealed, contending that deeming the association liable conflicted with the requirement under the Connecticut Insurance Guaranty Association Act that other insurance policies covering the same claim must be exhausted before recovery is permitted from the association. The Supreme Court affirmed, concluding that holding the association liable for an insolvent insurer's obligation as the last insurer on the risk does not conflict with the Guaranty Act.

Virginia King was injured in an automobile accident and was treated for her injuries at Toledo Hospital. Although King informed the hospital staff that she was covered by a health-insuring corporation, the hospital billed King's automobile insurer for the services rendered. King sued the hospital and ProMedica Health System (Appellants). Each of King's causes of action was based on the claim that Appellants violated Ohio Rev. Code. 1751.60(A) by billing the automobile insurer instead of the health-insuring corporation. Section 1751.60(A) stated that every provider that contracts with a health-insuring corporation to provide health-care services to an insured shall seek payment solely from the corporation. The trial court granted Appellants' motion to dismiss, and the court of appeals reversed. At issue on appeal was whether section 1751.60(A) prohibited a provider from seeking payment for medical treatment rendered to an insured injured in an automobile accident from the insured's automobile insurance medical benefits. The Supreme Court reversed the court of appeals, holding (1) section 1751.60(A) applies only when a health-care provider seeks payment from an insured, and (2) section 1751.60(A) does not conflict with Ohio's law on the coordination of insurance benefits.

Following an automobile crash for which United Tool Rental (UTR) and DeLyle Paulsen admitted negligence, UTR and Paulsen sought contribution from the state DOT and several construction entities (construction parties), alleging their negligent design, construction, and maintenance of the highway contributed to the crash. After a jury trial, the district court determined UTR and Paulsen were entirely at fault for the crash and rejected their contribution claim. On appeal, the Supreme Court affirmed, holding (1) the district court did not abuse its discretion in excluding evidence the DOT erected a "no left turn" sign after the crash and a post-crash memorandum prepared by the highway patrol; (2) the district court did not deprive UTR and Paulsen a fair trial by allowing the construction parties' counsel to inquire what caused Paulsen to drive inattentively; and (3) the jury's verdict was not defective.

Stephen and Dawn Steadele contracted with Montana Component Housing Corporation (MCHC) to construct a home. MCHC did not complete the home by the deadline and eventually abandoned the project without completing the home. The Steadeles filed suit against MCHC. The district court entered a default judgment against MCHC when it failed to respond to the suit. The Steadeles then requested payment from Colony Insurance Company, MCHC's insurer. Colony denied coverage and refused to pay because MCHC never notified it of the Steadeles' claim. The Steadeles then filed this action, arguing that Colony's refusal to issue payment on the underlying judgment was a violation of Mont. Code Ann. 33-18-201, which prohibits unfair claim settlement practices. The district court granted summary judgment to Colony. The Supreme Court affirmed, holding that the district court did not err in granting summary judgment to Colony because MCHC's failure to notify Colony of the Steadeles' claim was a material breach of MCHC's obligations under the policy.