Justia Insurance Law Opinion Summaries

Christa Taylor purchased an automobile insurance policy from Root Insurance Company. After her vehicle was damaged in a hailstorm, Root determined it to be a total loss and paid Taylor the vehicle's actual cash value of $22,750. However, Root did not include an amount representing the sales tax in this payment. Taylor argued that the policy required Root to pay the applicable sales tax in addition to the actual cash value and filed a putative class action for breach of contract and violation of the Texas Prompt Payment of Claims Act (TPPCA).The United States District Court for the Western District of Texas reviewed the case. Root moved to dismiss Taylor's claims under Federal Rule of Civil Procedure 12(b)(6). The magistrate judge recommended granting Root's motion and denying Taylor's request for leave to amend her complaint. The district court conducted a de novo review, agreed with the magistrate judge, and dismissed the suit. Taylor then appealed the decision.The United States Court of Appeals for the Fifth Circuit reviewed the case de novo. The court held that the insurance policy's language required Root to pay only the "applicable sales tax," and since a total-loss settlement is not considered a sale under Texas law, no sales tax was applicable. The court also noted that actual cash value does not include taxes and fees payable to purchase a replacement vehicle under Texas law. Consequently, Root did not breach the policy, nor did it violate the TPPCA. The court affirmed the district court's dismissal of Taylor's claims. View "Taylor v. Root Insurance" on Justia Law

Covil Corporation, through its receiver, sued Pennsylvania National Mutual Insurance Company for breaching their insurance contract by not contributing to a settlement in an asbestos case. David Rollins had sued Covil and others, alleging negligent asbestos exposure caused his mesothelioma. Penn National insured Covil during part of the exposure period. Covil settled the case and sought $50,000 from Penn National, which the insurer refused to pay.The circuit court granted summary judgment for Covil, requiring Penn National to indemnify Covil for the settlement. The court rejected Penn National's arguments about untimely notice, premature summary judgment, and policy exclusions. The court of appeals affirmed the decision.The South Carolina Supreme Court reviewed the case and affirmed the court of appeals' decision with modifications. The court held that the notice-prejudice rule did not apply because the underlying plaintiff, Rollins, had already been fully compensated. The court also found that Covil's untimely notice was not a material breach of the insurance contract, as Covil's interests were adequately protected by other insurers' counsel. Additionally, the court ruled that Penn National did not waive its right to timely notice by attending mediation.The court further held that the policy's "Products Hazard" and "Completed Operations Hazard" exclusions did not apply. The Products Hazard exclusion was inapplicable because Covil's liability was based on installation, not supplying asbestos. The Completed Operations Hazard exclusion did not apply because Rollins's exposure occurred before Covil's work was completed. Thus, the court affirmed the lower court's summary judgment in favor of Covil. View "Covil Corporation v. Pennsylvania National Mutual Casualty Insurance Company" on Justia Law

A severe thunderstorm caused significant damage to Norwood Hospital, owned by Medical Properties Trust, Inc. (MPT) and leased to Steward Health Care System LLC (Steward). The storm led to extensive flooding in the hospital's basements and rainwater accumulation on the rooftop courtyard and parapet roofs, which then seeped into the building, causing further damage. MPT and Steward sought coverage from their insurers, Zurich American Insurance Company (Zurich) and American Guarantee and Liability Insurance Company (AGLIC), respectively. Both policies had high overall coverage limits but lower sublimits for flood damage. The insurers argued that all the damage was due to "Flood" as defined in the policies, which included "surface waters," and thus subject to the lower sublimits.The United States District Court for the District of Massachusetts granted partial summary judgment to the insurers, interpreting "surface waters" to include rainwater accumulated on the roofs. The court allowed an interlocutory appeal, recognizing the substantial ground for difference of opinion on this legal issue. The United States Court of Appeals for the First Circuit then certified the question to the Supreme Judicial Court of Massachusetts, asking whether rainwater accumulating on a building's rooftop courtyard or parapet roof constitutes "surface waters" under Massachusetts law.The Supreme Judicial Court of Massachusetts concluded that the term "surface waters" is ambiguous in this context. The court noted the lack of a clear definition in the policies and the divided case law on the issue. Given this ambiguity, the court ruled in favor of the insureds, determining that rainwater accumulating on the rooftop courtyard and parapet roofs does not unambiguously constitute "surface waters" under the policies. Therefore, the damage from such water infiltration is not subject to the flood sublimits. View "Zurich American Insurance Company v. Medical Properties Trust, Inc." on Justia Law

Plaintiff Katherine Rosenberg-Wohl procured a homeowners insurance policy from State Farm Fire and Casualty Company, which covered various risks including fire. After her neighbor fell on her staircase, she discovered the stairs needed replacement and filed a claim with State Farm. The insurer denied her claim, citing policy exclusions. Rosenberg-Wohl then filed two lawsuits: one for breach of contract and another under the Unfair Competition Law (UCL), seeking declaratory and injunctive relief regarding State Farm’s general claims-handling practices.The San Francisco City and County Superior Court sustained State Farm’s demurrer, concluding that the one-year limitations period in the insurance policy applied to all of Rosenberg-Wohl’s claims, including her UCL claim. The court reasoned that her claims were essentially “on the policy” because they were grounded in the denial of her insurance claim. The Court of Appeal affirmed this decision, with a majority agreeing that the one-year limitations period applied, while a dissenting justice argued that the UCL’s four-year limitations period should govern.The Supreme Court of California reviewed the case and concluded that the one-year limitations period in section 2071 of the Insurance Code and the insurance policy did not apply to Rosenberg-Wohl’s UCL cause of action. The court determined that her lawsuit was not a “suit or action on [the] policy for the recovery of any claim” because she sought only declaratory and injunctive relief, not a financial recovery under the policy. The court emphasized that the UCL’s four-year statute of limitations governed her claim. Consequently, the Supreme Court reversed the judgment of the Court of Appeal and remanded the matter for further proceedings consistent with its opinion. View "Rosenberg-Wohl v. State Farm Fire & Casualty Co." on Justia Law

Kalvin Earl Richardson purchased a house in St. Louis County, Missouri, through a Post Third Sale Offering, a process for selling tax-delinquent properties that have not been sold in three consecutive annual tax-collection auctions. Richardson then applied for homeowner insurance from Nationwide Mutual Insurance Company, stating on the application that the property was not purchased at a public auction. After a fire damaged the house, Nationwide refused to pay the claim, asserting that Richardson had misrepresented the purchase method. Nationwide sued, claiming the policy was void due to this misrepresentation.The United States District Court for the Eastern District of Missouri granted summary judgment in favor of Nationwide. The court ruled that the Post Third Sale Offering constituted a public auction and that Richardson's contrary statement on the insurance application was a material misrepresentation, rendering the insurance policy void ab initio.The United States Court of Appeals for the Eighth Circuit reviewed the case de novo. The appellate court found that the term "public auction" was not clearly defined in Nationwide's insurance application and that the Post Third Sale Offering did not meet the ordinary understanding of a public auction, which typically involves competitive bidding. The court noted that Missouri statutes and case law emphasize competition among bidders as a key element of a public auction, which was absent in the Post Third Sale Offering. Consequently, the court held that Nationwide did not meet its burden to prove that Richardson's representation was false in fact. The Eighth Circuit reversed the district court's summary judgment and remanded the case for further proceedings. View "Nationwide Mutual Insurance Company v. Richardson" on Justia Law

A commercial tenant and landlord entered into a contract for the construction and lease of a warehouse, with the landlord also acting as the general contractor. The contract included a waiver of subrogation, where both parties waived subrogation against each other for certain losses, including those caused by their subcontractors. After the warehouse sustained weather damage, the tenant’s insurer sought to recoup insurance payments by suing the subcontractors.The Circuit Court for Baltimore City granted summary judgment in favor of the subcontractors, concluding that they were intended beneficiaries of the waiver of subrogation in the contract between the tenant and landlord. The court did not consider any extrinsic evidence regarding the parties' intent. The Appellate Court of Maryland reversed this decision, finding that the waiver of subrogation in the contract did not unambiguously benefit the subcontractors and that the subcontractors were not intended third-party beneficiaries.The Supreme Court of Maryland reviewed the case and held that the waiver of subrogation in the contract between the tenant and landlord did not extend to the subcontractors. The court found that the language of the waiver was unambiguous and did not show an intent to benefit the subcontractors. However, the court found that the waiver of subrogation included in the subcontracts was ambiguous regarding whether it applied to the tenant’s insurer’s claims against the subcontractors. Therefore, the court held that extrinsic evidence was needed to determine the parties' intent regarding the scope of the subrogation waiver in the subcontracts.The Supreme Court of Maryland affirmed the Appellate Court's decision, reversing the Circuit Court's summary judgment in favor of the subcontractors, and remanded the case for further proceedings to consider extrinsic evidence. View "Lithko Contracting v. XL Insurance America, Inc." on Justia Law

A commercial automobile liability insurance policy dispute arose from an accident at the Ina Pit Mine in Pima, Arizona, operated by Staker & Parson Companies ("Staker"). Staker had a Haul and Materials Agreement with BDR Transport ("BDR"), which required BDR to name Staker as an additional insured on its insurance policy. William Baughn, a BDR employee, was injured while attempting to dislodge a rock from his trailer's tires. Baughn sued Staker, BDR, and others, alleging negligence by Staker in loading the trailer, maintaining the road, and providing safety training.The United States District Court for the District of Utah reviewed the case and certified four questions to the Arizona Supreme Court regarding the interpretation of "use" under Arizona law in the context of the insurance policy. The district court had previously ruled that the policy's "Movement of Property by Mechanical Device" clause excluded coverage for Baughn's claims related to the loading of the truck.The Arizona Supreme Court answered the certified questions as follows: First, it held that "use" of a vehicle includes loading and unloading cargo, even if the additionally named insured does not have active control over the vehicle. Second, it determined that merely driving on private roads owned by the additionally named insured does not constitute "use" of the vehicle. Third, it concluded that managerial functions, such as establishing safety training procedures, do not constitute "use" of a vehicle. Finally, the court provided guidance on causation, stating that there must be a causal relationship between the injury and the use of the vehicle, but left the determination of a sufficient causal link to the trier of fact.The Arizona Supreme Court's main holdings clarified the scope of "use" under Arizona law, emphasizing that it includes loading and unloading but does not extend to managerial functions or the mere use of private roads. The court also outlined the causation standard for determining an insurer's duty to defend. View "Staker & Parson Companies v Scottsdale Insurance Co." on Justia Law

The case revolves around James "Tim" Norman, who was convicted of conspiring to commit murder for hire and murder for hire, as well as conspiring to commit mail and wire fraud. Norman had orchestrated the murder of his nephew, Andre Montgomery, and attempted to cash in on a fraudulent life insurance policy on his life. The insurance policy was set up without Montgomery's knowledge and would have resulted in a $450,000 payout upon Montgomery's death.The case was initially heard in the United States District Court for the Eastern District of Missouri. Norman appealed the decision, challenging several of the district court's trial rulings. He argued that two potential witnesses, Carroll and Yaghnam, had waived their Fifth Amendment privilege against self-incrimination and should have been compelled to testify. The district court found that their claims of privilege were valid.The case was then reviewed by the United States Court of Appeals for the Eighth Circuit. The court affirmed the district court's decision, finding no abuse of discretion in the lower court's rulings. The court held that Carroll and Yaghnam's claims of privilege were valid and that they faced real danger by testifying. The court also found that the district court did not abuse its discretion by refusing to compel Yaghnam to appear and assert his Fifth Amendment privilege in person, as Norman had failed to serve a subpoena. The court further held that the district court did not abuse its discretion by admitting hearsay texts from Montgomery and an out-of-court statement from Carroll. Finally, the court found no abuse of discretion in the district court's use of demonstrative exhibits to summarize evidence. View "United States v. Norman" on Justia Law

This case revolves around a dispute over an insurance claim following a house fire. The plaintiff, William Werner, owned a home in Springfield, Illinois, which was in foreclosure when it burned down in 2017. Werner's home insurance policy was with Auto-Owners Insurance Company. After the fire, Werner filed a claim seeking to recover his policy limit on the home itself and two smaller coverages, totaling just over $190,000. Auto-Owners denied Werner’s claim for the full replacement value of the home, arguing that Werner had lost any insurable interest in the full value of the property after the judicial sale occurred and all of Werner’s rights of redemption had expired.The case was first heard in the United States District Court for the Central District of Illinois. The district court ruled in favor of Auto-Owners, holding that at the time of the fire, Werner’s only remaining insurable interest in the property was based on his narrow right under Illinois law to occupy the home until 30 days after the judicial sale was confirmed. The court awarded Werner the rental value of that temporary right, which amounted to just under $4,000.Werner appealed the decision to the United States Court of Appeals for the Seventh Circuit. The appellate court affirmed the district court's ruling. The court agreed with the lower court's interpretation of Illinois insurance law, stating that Werner's insurable interest at the time of the fire was limited to the value of his temporary right of possession. The court noted that Werner still held legal title to the property when the fire occurred, but he had no legal right to redeem it from foreclosure or otherwise retain it. The court concluded that Werner's insurable interest did not extend to the full value of the property. View "Werner v. Auto-Owners Insurance Company" on Justia Law

In early 2020, Josephson, LLC, doing business as The Moinian Group (Moinian), filed a lawsuit against its insurance company, Affiliated FM Insurance Company (AFM), seeking coverage for losses sustained due to the COVID-19 pandemic. Moinian argued that the presence of COVID-19 at its insured properties constituted "physical loss or damage" under its insurance policy. The trial justice, however, determined that the presence of COVID-19 alone did not constitute "physical loss or damage" sufficient to implicate the coverage provisions. The trial justice also concluded that the Contamination Exclusion in the insurance policy unambiguously barred coverage because contamination, such as COVID-19, was expressly excluded under the terms of the policy.The Superior Court granted AFM's motion for partial summary judgment and denied Moinian's motion for partial summary judgment. The court determined that the presence of COVID-19 at Moinian's insured properties did not constitute "physical loss or damage" under the terms of the policy. The court also found that the Contamination Exclusion in the policy unambiguously applied to bar Moinian's claim. Moinian appealed the decision.The Supreme Court of Rhode Island affirmed the trial justice's determination. The court agreed with the lower court's interpretation of the Contamination Exclusion in the insurance policy. The court concluded that the exclusion for "contamination" was intended to limit coverage for a "type of risk," not a "type of loss." Therefore, the court held that Moinian's losses due to the COVID-19 pandemic were not covered under the insurance policy. View "Josephson v. Affiliated FM Insurance Company" on Justia Law