Justia Insurance Law Opinion Summaries

The Supreme Court reversed the judgment of the district court granting summary judgment in favor of State Farm Mutual Automobile Insurance Company in this insurance dispute, holding that the coverage for damage to Plaintiffs' RV was mandated under the plain language of the insurance policy.After Plaintiffs purchased an RV, they purchased a recreational vehicle policy through State Farm. Later, the roof and wall of the RV were damaged. State Farm paid for the roof repair but denied coverage for the wall repair, finding it was not a "covered loss" under the terms of the policy. Plaintiffs then filed this complaint. The Supreme Court granted State Farm's motion for summary judgment and dismissed the issue. The Supreme Court reversed, holding that the coverage for the wall repair was a covered expense under the plain language of the policy. View "Kaul v. State Farm Mutual Automobile Insurance Co." on Justia Law

The Seventh Circuit affirmed the district court's judgment declaring that Zurich had no duty to defend Ocwen in the underlying litigation brought by a consumer. In the underlying case, the consumer's complaint relied on the Fair Debt Collection Practices Act (FDCPA) and the Telephone Consumer Protection Act (TCPA), as well as common law claims of defamation and invasion of privacy. Zurich insured Ocwen under a series of commercial general liability policies, but two provisions in the policies expressly excluded injuries resulting from conduct that violates certain laws.Setting aside the live-operator calls to the consumer's home and the manually dialed calls to her cell phone, and assuming that neither violated the TCPA, the court concluded that it remains true that if Ocwen caused "a telephone to ring … repeatedly or continuously with the intent to annoy, abuse, or harass any person at that called number," which the district court concluded Ocwen did, then it violated the FDCPA. Because the policy exclusion's catch-all clause swept in the FDCPA as an "other statute" that regulates the communication of information, Zurich had not duty to defend based on the factual allegations of the consumer's complaint. View "Zurich American Insurance Co. v. Ocwen Financial Corp." on Justia Law

In 2011, Appellants Eric Monzo and Dana Spring Monzo purchased a homeowners insurance policy issued by Appellee Nationwide Property & Casualty Co. (“Nationwide”). The policy contained standard exclusions for water damage and earth movement, along with optional water backup coverage. In July 2017, a heavy thunderstorm destroyed a pedestrian bridge and retaining wall located at the Monzos’ residence. A pair of engineering reports prepared after the storm indicated that a combination of water backups from drainage systems, scouring of supporting earth embankments, heavy rain, and tree debris caused the damage. The Monzos filed a claim with Nationwide, seeking coverage under the homeowners insurance policy. Nationwide denied coverage, and the Monzos sued. The court granted summary judgment for Nationwide, holding that the policy’s earth movement and water damage exclusions applied. The Monzos appealed, arguing the Superior Court erred by granting summary judgment too early in the discovery process, misinterpreting the policy, and denying a motion for post-judgment relief. Having reviewed the briefs and record on appeal, the Delaware Supreme Court: (1) affirmed the Superior Court’s holding that Nationwide was entitled to summary judgment regarding the collapsed bridge; (2) reversed the Superior Court’s holding that Nationwide was entitled to summary judgment regarding the retaining wall; and (3) affirmed the Superior Court’s denial of the Monzos’ post-judgment motion. View "Monzo v. Nationwide Property & Casualty Insurance Co." on Justia Law

The Supreme Court answered a certified question under Nev. R. App. P. 5 concerning an insurer's right to reimbursement, holding that when a party to a contract performs a challenged obligation under protest and a court subsequently determines that the contract did not require performance, the party may generally recover in restitution, thus giving effect to the terms of the parties' bargain.Insurer filed this declaratory judgment action seeking reimbursement of expenses it had occurred in defending Insured against a suit by a third party. The district court concluded that Insurer was not entitled to reimbursement. The Ninth Circuit Court of Appeals affirmed, concluding that the suit did not trigger a duty to defend. The Supreme Court accepted a certified question from the Ninth Circuit regarding the issue. The Supreme Court then held (1) no contract governed the right to reimbursement in this case; and (2) under the principle of unjust enrichment, a party that performs a disputed obligation under protest and does not in fact have a duty to perform is entitled to reimbursement. View "Nautilus Insurance Co. v. Access Medical, LLC" on Justia Law

The Supreme Court affirmed the judgment of the trial court denying Insureds' motion for attorney fees after they prevailed in their claims against Insurer, holding that the circuit court properly declined to award Insureds' requested attorney fees.A jury returned a verdict in favor of Insureds on their claims of breach of contract and tortious breach of good faith and fair dealing arising out of Insurer's failure to pay for property damage sustained after a hail and wind storm. Insureds filed a motion for attorney fees, arguing that Insurer's disallowance of their claim was vexatious and unreasonable and in violation of the Unfair Trade Practices Act. The trial court denied Insureds' request, concluding that the circuit court could not award attorney fees without a jury determination that Insurer had engaged in an unfair trade practice. The Supreme Court affirmed, holding that the circuit court did not err in declining to award attorney fees. View "Sentell v. Farm Mutual Insurance Co." on Justia Law

Hall filed various contract, statutory, and common-law claims against Old Republic in federal district court for failing to indemnify Hall under its title insurance policies. The district court concluded that, although the unpaid Penta pre-policy-date work is a defect under Covered Risk 2 and an encumbrance under Covered Risk 10, coverage is precluded by Exclusions 3(a) and 3(d), which bar claims for liens and work performed after the policy date. The district court found that Hall had not raised a genuine dispute of material fact that Penta's liens were for unpaid work before the policy date, and granted Old Republic's motion for summary judgment and denied Hall's motion for partial summary judgment.The Fifth Circuit concluded that the insuring clauses do not cover Hall's Penta lien losses. The court explained that any doubt about whether Covered Risks 2 and 10 could possibly be read to cover the Penta lien losses at issue here is removed by the fact that the parties also signed standard ALTA Form 32-06. In so doing, the parties specifically contracted to eliminate one coverage provision of the standard-form insurance policy—Covered Risk 11(a). Even assuming arguendo that the 32-06 endorsements and the Covered Risks conflict or result in an ambiguity about whether the Penta lien losses are covered, the court explained that it is the more general provisions that suggest that there may be coverage (under Hall's theory), while the more specific provisions instruct that there is no such coverage. Under basic principles of contract interpretation, the specific controls the general. Therefore, the court need not review the district court's conclusions regarding Exclusions 3(a) and 3(d) to affirm the judgment.The court also affirmed the district court's grant of Old Republic's motion for summary judgment on Hall's bad-faith and Texas Insurance Code claims. The court explained that, because Hall is not entitled to indemnification for the Penta lien losses, Hall cannot show that Old Republic acted in bad faith in denying its claim. Furthermore, because Hall alleges no other harm apart from the Penta lien losses, Hall cannot demonstrate that Old Republic caused it any harm in violating the Texas Insurance Code—assuming arguendo that the Texas Insurance Code applies, and that Old Republic ran afoul of its provisions. Finally, the court affirmed the district court's grant of Old Republic's motion for summary judgment on Hall's independent-counsel (or duty-to-defend) claim. View "Hall CA-NV, LLC v. Old Republic National Title Insurance Co." on Justia Law

Nationwide Mutual Insurance Company ("Nationwide") relied on flight-from-law enforcement and felony step-down provisions in an automobile liability insurance policy to limit its coverage to the statutory mandatory minimum. Following a bench trial and after issuance of the South Carolina Supreme Court's opinion in Williams v. Government Employees Insurance Co. (GEICO), 409 S.C. 586 (2014), the circuit court held the step-down provisions were void pursuant to Section 38-77-142(C) of the South Carolina Code (2015). The court of appeals reversed. Three individuals, Sharmin Walls, Randi Harper, and Christopher Timms, were passengers in a vehicle driven by Korey Mayfield that crashed in 2008 following a high-speed chase by law enforcement. Mayfield refused to pull over, and during the chase, the trooper's vehicle reached speeds of 109 miles per hour. All the passengers begged Mayfield to stop the car, but Mayfield refused. Eventually, the trooper received instructions to terminate the pursuit, which he did. Nevertheless, Mayfield continued speeding and lost control of the vehicle. Timms died in the single-car accident, and Walls, Harper, and Mayfield sustained serious injuries. After being charged with reckless homicide, Mayfield entered an Alford plea. At the time of the accident, Walls' automobile was insured through her Nationwide policy, which included bodily injury and property damage liability coverage with limits of $100,000 per person and $300,000 per occurrence. Walls also maintained uninsured motorist (UM) coverage for the same limits, but she did not have underinsured motorist (UIM) coverage. In reliance on the aforementioned provisions, Nationwide paid only $50,000 in total to the injured passengers (the statutory minimum as provided by law) rather than the liability limits stated in the policy. Safe Auto, Mayfield's insurance company, also paid a total of $50,000 to the passengers. Nationwide brought this declaratory judgment action requesting the court declare that the passengers were not entitled to combined coverage of more than $50,000 for any claims arising from the accident. Walls answered, denying there was any evidence that the flight-from-law enforcement and felony provisions applied. The South Carolina Supreme Court reversed the court of appeals, holding that section 38-77-142(C) rendered Nationwide's attempt to limit the contracted-for liability insurance to the mandatory minimum void. View "Nationwide Mutual Ins. Co. v. Walls" on Justia Law

Defendant Factory Mutual Insurance Company (Factory Mutual) appealed a superior court order denying its motion for summary judgment and granting plaintiffs' Daniel Ro and Sebastian Lim motion. Plaintiffs sought a declaration they were implied co-insureds under a fire insurance policy issued by Factory Mutual to the Trustees of Dartmouth College. Plaintiffs were students in 2016 living in campus dormitories. Prior to being assigned a dormitory room, each plaintiff was required to sign a form acknowledging receipt and understanding of the college’s student handbook, which included prohibitions on: (1) possessing charcoal grills in student housing; (2) lighting and burning of any item with an open flame in residence halls; and (3) placing items on, and the use of, “the roof, portico, fire escape, or any other architectural feature not designed for recreational or functional use, except in cases of emergency.” Plaintiffs set up a charcoal grill on a platform outside a fourth floor window in Lim’s dormitory. The grill started a fire on the platform, which then spread to the roof. Firefighters used a substantial quantity of water to extinguish the fire, and all four floors of the dormitory sustained water damage. Factory Mutual, which insured the building, paid the Trustees $4,544,313.55 and then brought a subrogation claim against plaintiffs to recover that amount. The trial court concluded that Factory Mutual could not maintain its counterclaims against either plaintiff, specifically noting, “To the extent Mr. Lim’s possessory interest in Morton Hall is insurable, so is Mr. Ro’s. Mr. Ro’s possessory interest in Morton Hall is analogous to that of a tenant who rents one unit in a residential complex but causes fire damage to another unit in the complex.” In affirming the superior court, the New Hampshire Supreme Court concluded that, even if plaintiffs lacked a possessory interest in their dormitories, and even if their relationship with the college was not strictly that of landlord and tenant, they had a contractual relationship with the college in which they paid for the right, subject to the noted limitations, among others, to occupy a college dormitory for a certain period of time. "This contractual relationship gave rise to the reasonable expectation that Dartmouth College carried fire insurance on its dormitories, that the plaintiffs’ room and board fees contributed, in some way, to the premium for that insurance, and, therefore, that the insurance inured to their benefit." View "Ro v. Factory Mutual Insurance Company, as Subrogee of Trustees of Dartmouth College" on Justia Law

In 2002, Dr. Phillips performed a hysterectomy on Bramlett; she died from complications days later. Bramlett’s family sued Phillips, his clinic, and the hospital. Phillips and his clinic held a $200,000 MedPro professional liability insurance policy. The hospital settled for about $2.3 million. Under Texas law, an insurer who rejects a settlement demand (Stowers demand) within policy limits that a reasonably prudent insurer would accept will later be liable for any amount awarded in excess of the policy limit. MedPro refused two $200,000 Stowers demands. A jury returned a $14 million verdict. In 2009, the Supreme Court of Texas capped Phillips’s liability at $1.6 million. The Bramletts sued MedPro. The parties settled for a confidential amount.MedPro asked its insurer, AISLIC, to cover the settlement. AISLIC refused. The district court rejected MedPro's claims under an exclusion, finding that MedPro’s rejections of the two Stowers demands were Wrongful Acts that MedPro could have reasonably foreseen would lead to a claim.On remand, the district court held that MedPro could invoke coverage without having to prove that it actually committed a “Wrongful Act,” and found that a claim was not first asserted against MedPro for its failure to settle for policy limits before the 2006 AISLIC Policy incepted. A jury found that MedPro did not commit a “Wrongful Act.” The Seventh Circuit affirmed. The district court properly held that MedPro was covered by the 2006 Policy before the jury decided the issue of exclusion. The earlier interpretation of the policy did not require a holding that MedPro never committed a “Wrongful Act” necessary to invoke coverage. MedPro can invoke coverage because the claim that it settled was not brought before the policy period began. View "Medical Protective Company of Fort Wayne v. American International Specialty Lines Insurance Co" on Justia Law

The Court of Appeals held that a change in life insurance beneficiary constitutes a conveyance under the Maryland Uniform Fraudulent Conveyance Act (MUFCA), Md. Code Comm. Law 15-201(c), and that a guardian of property is not granted the authority to change a life insurance beneficiary on a policy of the ward under section 15-102(t) of the Estates and Trusts Article (ET).In a case arising from a decade-long dispute between the adult children of the Buckingham family and United Bank, the United States District Court for the District of Maryland certified two questions of law to the Court of Appeals regarding whether the children intentionally defrauded the Bank when they successfully diverted significant amounts of life insurance proceeds away from the declining family business and to their personal use. The Court of Appeals answered the questions as follows: (1) a change of the beneficiary designation of a life insurance policy constitutes a conveyance under MUFCA; and (2) the guardian of property does not have the authority to change the beneficiary on a life insurance policy of a ward under ET 15-102(t). View "United Bank v. Buckingham" on Justia Law