Justia Insurance Law Opinion Summaries
Articles Posted in Injury Law
Phoenix Insurance Company v. Rosen
Phoenix Insurance Company ("Phoenix") filed a complaint in circuit court rejecting the arbitration award given to appellee when she requested coverage under the underinsured-motorist provisions of her policy with Phoenix after she was injured in a car accident and the other driver's vehicle was underinsured. At issue was whether a provision allowing either party to an insurance contract to demand a trial de novo following arbitration was unenforceable when it appeared in an underinsured-motorist policy. The court held that the provision in appellee's underinsured-motorist policy allowing either party to reject an award over the statutory minimum for liability coverage did not violate public policy and was not unconscionable.
Westfield Insurance Co. v. Hunter
In this appeal, the Supreme Court interpreted an exclusion in a homeowner's insurance policy that denied coverage for claims "arising out of" premises that are owned by the insured, but are not an insured location under the policy. Appellee Westfield Insurance provided Appellants Michael and Marilyn Hunter's insurance on their Ohio home; the Hunters hold an additional policy for any personal liability that arises from bodily injury or property damages. The Hunters also own a farm in Indiana that is not a named insured location under the Westfield policy. The Hunters purchased liability insurance for the Indiana property from co-appellant Grinell Mutual Reinsurance Company. Children playing on the Indiana property suffered bodily injuries on the property, and brought suit against the Hunters for negligence. The Hunters applied to Westfield seeking indemnification under their personal liability policy. Westfield brought a declaratory judgment action against the Hunters and Grinell seeking a declaration that it had no duty to defend or indemnify the Hunters for claims asserted in the Indiana lawsuit. At trial, the court reasoned that the claims raised by the injured children "arose out of" premises that were not insured by Westfield, therefore Westfield had no duty to indemnify the Hunters for personal liability claims. Grinnell appealed to the Supreme Court for discretionary review, and secured an order from the appellate court certifying that its decision in this case was in conflict with that of another state appellate court. On review of the lower courts' holdings, the Supreme Court found that the Westfield policy does exclude coverage for claims arising from the Indiana property, or any claims based solely on the insured's ownership of the property on which the injury occurred.
Lawson v. Hanson Brick America, Inc.
Appellants Hanson Brick America, Inc and Zurich North America appeal the circuit court's order reversing the appellate panel of the South Carolina Workers' Compensation Commission's finding that Respondent Lawson's knee problems were not causally related to his back injury sustained on the job, and the awarding Respondent temporary total disability benefits. Respondent, a fork lift operator, was injured while moving a bag of motor. Diagnosed with degenerative disk disease, Respondent underwent surgery and had bones fused and screws inserted in his spine. Following surgery, Respondent still suffered from back pain; several months later, he developed pain in both knees that affected his ability to walk. Respondent filed a Form 50 with the Commission to report his injuries, and seeking temporary total disability benefits. Appellants challenged Respondent's claim. The Commission's hearing officer ruled that Respondent was entitled to receive temporary total disability benefits, but that the pains in his knees were not a compensible injury. Prior to the Commission's final order, Respondent sought to have newly discovered evidence admitted for the Commission's consideration; Appellants objected, but the commissioner determined that Respondent, in addition to benefits for his back injury, should also receive compensation for his knee pain. On review of the records, the Supreme Court reversed the circuit court's determination that Lawson was entitled to temporary total disability benefits and further evaluation of his knees, and remand the case back to the appellate panel for reconsideration of all evidence.
Lawson v. Hanson Brick America, Inc.
Appellants Hanson Brick America, Inc and Zurich North America appeal the circuit court's order reversing the appellate panel of the South Carolina Workers' Compensation Commission's finding that Respondent Lawson's knee problems were not causally related to his back injury sustained on the job, and the awarding Respondent temporary total disability benefits. Respondent, a fork lift operator, was injured while moving a bag of motor. Diagnosed with degenerative disk disease, Respondent underwent surgery and had bones fused and screws inserted in his spine. Following surgery, Respondent still suffered from back pain; several months later, he developed pain in both knees that affected his ability to walk. Respondent filed a Form 50 with the Commission to report his injuries, and seeking temporary total disability benefits. Appellants challenged Respondent's claim. The Commission's hearing officer ruled that Respondent was entitled to receive temporary total disability benefits, but that the pains in his knees were not a compensible injury. Prior to the Commission's final order, Respondent sought to have newly discovered evidence admitted for the Commission's consideration; Appellants objected, but the commissioner determined that Respondent, in addition to benefits for his back injury, should also receive compensation for his knee pain. On review of the records, the Supreme Court reversed the circuit court's determination that Lawson was entitled to temporary total disability benefits and further evaluation of his knees, and remand the case back to the appellate panel for reconsideration of all evidence.
Posted in:
Injury Law, Insurance Law