Justia Insurance Law Opinion Summaries

Appellants Ryan and Kathryn McFarland owned real property in Garden Valley, Idaho, which feathred three structures insured through Liberty Mutual Insurance Group: a main cabin; a detached garage with an upstairs “bonus room”; and a pump house containing a geothermal well. The policy provided two types of coverage for structures. Coverage A (“Dwelling Coverage”) provided up to $188,500 in coverage for “the dwelling on the ‘residence premises’. . . including structures attached to the dwelling . . .” and Coverage B (“Other Structures Coverage”) provided up to $22,350 for “other structures on the ‘residence premises’ set apart from the dwelling by clear space.” In February 2017, a radiant heater burst in the bonus room and damaged the garage and its contents. After the McFarlands filed a claim, Liberty stated that the damage was covered under the policy. Believing the damage to fall under the Dwelling Coverage, the McFarlands hired contractors to repair the damage. However, after Liberty paid out a total of $23,467.50 in March 2017, Liberty stated that the coverage was exhausted because the damage fell under the Other Structures Coverage. This led the McFarlands to sue, alleging among other claims, breach of contract based on Liberty’s interpretation of the policy. The parties filed cross motions for summary judgment on the issue of whether the damage fell under the Dwelling Coverage or the Other Structures Coverage. Ruling that the policy unambiguously provided coverage for the garage under the Other Structures Coverage, the district court denied the McFarlands’ motion and granted Liberty’s. The McFarlands appealed. Finding that the policy at issue here failed to define the term "dwelling", and the term was reasonably subject to differing interpretations, the Idaho Supreme Court reversed the award of summary judgment and remanded for further proceedings. View "McFarland v. Liberty Insurance Corp" on Justia Law

In this case involving the proper method of applying a personal injury protection (PIP) insurance policy deductible to a medical provider’s bill for hospital emergency services and care, the Supreme Court approved the Fifth District Court of Appeal’s decision, holding that the deductible should be subtracted from the total charges prior to application of the reimbursement limitation in Fla. Stat. 627.736(5)(a)1.b.While this case was pending in the Court, the Fourth District Court of Appeal issued an opinion in State Farm Mutual Automobile Insurance Co. v. Care Wellness Center, LLC (Care Wellness), 240 So. 3d 22 (Fla. 4th DCA 2018), holding that the deductible should be applied after charges are reduced under any fee schedule found in section 627.736. The Supreme Court approved the Fifth District’s decision in the instant case and disapproved the Fourth District’s decision in Care Wellness, holding that, under Fla. Stat. 627.739(2), the deductible should be applied to the total medical charges prior to reduction under the reimbursement limitation. View "Progressive Select Insurance Co. v. Florida Hospital Medical Center" on Justia Law

This case stemmed from Truck Insurance’s refusal to defend its insured, Scout, LLC, in a trademark infringement action brought over Scout’s use of the trademark ROGUE in the advertisement of its restaurant, Gone Rogue Pub. Scout claimed its use of ROGUE constituted an advertising injury that was covered by the insurance it purchased from Truck Insurance. Truck Insurance did not dispute that ordinarily Scout’s advertising injury would be covered and it would accordingly have a duty to defend, but coverage was properly declined in this instance based on a prior publication exclusion found in the policy. The district court granted summary judgment to Truck Insurance after determining that a Facebook post of Scout’s Gone Rogue Pub logo before insurance coverage began triggered the prior publication exclusion, thereby relieving Truck Insurance of the duty to defend Scout. Scout appealed. Finding no reversible error, the Idaho Supreme Court affirmed the district court. View "Scout, LLC v. Truck Insurance" on Justia Law

Plaintiff Oklahoma Schools Risk Management Trust (OSRMT) brought a declaratory judgment action seeking a declaration it was not liable for losses sustained by McAlester Public Schools resulting from a ruptured water pipe in one of its schools. McAlester Public Schools answered, alleged breach of contract by plaintiff, and sought indemnification for its losses. A trial court granted summary judgment for Oklahoma Schools Risk Management Trust on its request for declaratory relief and against McAlester Public Schools on its indemnity claim. McAlester Public Schools appealed the judgment. The Oklahoma Supreme Court agreed with McAlester Schools that OSMRT failed to show a policy-based exclusion to coverage, reversed summary judgment and remanded for further proceedings. View "Okla. Schools Risk Management Trust v. McAlester Pub. Schools" on Justia Law

The Eighth Circuit affirmed the district court's grant of summary judgment for American Family, in an action brought by Clarke, alleging that the insurer wrongfully denied coverage for defense and indemnity of a lawsuit against Clarke in state court. The court held that the claims as pled in the underlying state court action did not give rise to a duty to defend under Iowa law, and no duty to indemnify could exist. In this case, the claims for damages caused by ice dams during the 2009-2010 winter did not rationally involve property damage that occurred before the policy expired in 2006. View "Clarke Co., Ltd. v. American Family Mutual Insurance Co." on Justia Law

In 2002, Charles Herron, who was under the influence of alcohol and not old enough to legally possess or consume it, was involved in a single-vehicle accident in Bethel, Alaska A 15-year-old passenger in Herron’s vehicle, Angelina Trailov, was injured. Herron was insured by Allstate Insurance Company. Allstate filed a complaint for declaratory relief in the U.S. District Court in anticipation of Herron confessing judgment in the accident-related personal injury suit. Allstate requested a declaration that “its good faith attempt to settle Trailov and Mary Kenick's (Trailov's mother) claims satisfied its obligation to its insured, and a further declaration that Allstate [wa]s not obligated to pay any portion of the confessed judgment that exceed[ed] the limit of the bodily injury coverage afforded Herron under the [p]olicy.” Due to Herron’s April confession of judgment and assignment of claims, Allstate amended its federal complaint for declaratory relief. The only material addition was the statement that Herron had confessed judgment and assigned his rights against Allstate. The issue this case presented for the Alaska Supreme Court's review centered on the preclusive effect of that declaratory judgment in favor of the insurance company against its insured in federal court in a subsequent state court proceeding. The superior court concluded that the declaratory judgment had no preclusive effect on a negligent adjustment action brought in state court by the insured’s assignees against the insurance company and its claims adjuster. The state action proceeded to an 11-day jury trial ending with a multi-million dollar verdict against the insurance company and its claims adjuster. The declaratory judgment determined that the insurance company and the adjuster acted reasonably when they offered policy limits to settle the underlying claim against the insured. Because the insurance company’s and adjustor’s reasonableness in adjusting the insurance claim was a necessary element of a negligent adjustment tort, the Supreme Court held that the assignees of the insured were precluded from relitigating this issue. The superior court therefore erred in denying the insurance company’s and claims adjuster’s motions for summary judgment. View "Allstate Insurance Company v. Kenick" on Justia Law

At issue in this appeal were commercial general liability policy exclusions that barred coverage for damage to “that particular part” of the property on which an insured is performing operations, or which must be repaired or replaced due to the insured’s incorrect work. The Tenth Circuit concluded the phrase “that particular part” was susceptible to more than one reasonable construction: it could refer to the distinct component upon which an insured works or to all parts ultimately impacted by that work. The Court surmised the contract had to then be interpreted consistent with the mutual intent of the parties, with the ambiguity resolved most favorably to the insured and against the insurance carrier. The Court adopted the narrower interpretation of the phrase “that particular part,” under which the exclusion extends only to the distinct components upon which work was performed. This conclusion was contrary to the district court's interpretation, and therefore reversed and remanded for further proceedings. View "MTI v. Employers Insurance Co." on Justia Law

The Supreme Court reversed the judgment of the court of appeals reversing the trial court’s judgment in favor of Anadarko Petroleum Corp. and Anadarko E&P Co., L.P. (collectively, Anadarko), minority-interest owners in the Deepwater Horizon operation, on Anadarko’s claim that it was entitled to insurance coverage for the legal fees and related expenses Anadarko incurred defending against liability and enforcement claims, holding that a negotiated policy provision did not limit the excess coverage for defense expenses.In this appeal, Anadarko argued that the insurance policy covered all of its defense expenses, up to the policy’s $150 million excess-coverage limit. The policy’s underwriters (the Underwriters), however, argued that the negotiated policy provision capped the excess coverage, including coverage for defense costs, at twenty-five percent of the policy’s excess-coverage limit. The trial court granted Anadarko’s summary judgment motion in part. The court of appeals reversed and rendered judgment for the Underwriters. The Supreme Court reversed, holding that the provision at issue did not limit coverage for Anadarko’s defense expenses. View "Anadarko Petroleum Corp. v. Houston Casualty Co." on Justia Law

The Supreme Court affirmed in part and reversed in part the decision of the court of appeals affirming the circuit court’s grant of summary judgment to Steadfast Insurance Company giving Steadfast the right to recover from Greenwich Insurance Company, holding, among other things, that Greenwich breached its duty to defend.Steadfast’s right to recover from Greenwich was based on the two insurer’s relationships with Milwaukee Metropolitan Sewerage District (MMSD), which was sued for alleged negligent maintenance and operation of Milwaukee’s sewerage system. After MMSD tendered its defense to the insurers, Steadfast accepted the tender but Greenwich did not. Steadfast then sued Greenwich to recover the defense costs it paid to MMSD. The Supreme Court held (1) both Greenwich and Steadfast were primary and successive insurers in regard to MMSD; (2) Greenwich breached its contractual duty to defend MMSD; (3) Steadfast had a contractual duty to defend MMSD that was not abrogated by Greenwich’s breach of its contractual duty to defend MMSD, and therefore, defense costs are allocated between Steadfast and Greenwich; and (4) Steadfast is entitled to recover attorney fees from Greenwich. View "Steadfast Insurance Co. v. Greenwich Insurance Co." on Justia Law

This appeal required the Pennsylvania Supreme Court to determine whether a “household vehicle exclusion” contained in a motor vehicle insurance policy violated Section 1738 of the Motor Vehicle Financial Responsibility Law (“MVFRL”), 75 Pa.C.S. 1738, because the exclusion impermissibly acted as a de facto waiver of stacked uninsured and underinsured motorist (“UM” and “UIM,” respectively) coverages. In 2012, Appellant Brian Gallagher was riding his motorcycle when William Stouffer ran a stop sign in his pickup truck, colliding with Gallagher’s motorcycle, causing Gallagher to suffer severe injuries. At the time of the accident, Gallagher had two insurance policies with GEICO; one included $50,000 of UIM coverage, insured only Gallagher’s motorcycle; the second insured Gallagher’s two automobiles and provided for $100,000 of UIM coverage for each vehicle. Gallagher opted and paid for stacked UM and UIM coverage when purchasing both policies. Stouffer’s insurance coverage was insufficient to compensate Gallagher in full. Consequently, Gallagher filed claims with GEICO seeking stacked UIM benefits under both of his GEICO policies. GEICO paid Gallagher the $50,000 policy limits of UIM coverage available under the Motorcycle Policy, it denied his claim for stacked UIM benefits under the Automobile Policy. GEICO based its decision on a household vehicle exclusion found in an amendment to the Automobile Policy. The exclusion states as follows: “This coverage does not apply to bodily injury while occupying or from being struck by a vehicle owned or leased by you or a relative that is not insured for Underinsured Motorists Coverage under this policy.” According to Gallagher, by denying him stacked UIM coverage based upon the household vehicle exclusion, GEICO was depriving him of the stacked UIM coverage for which he paid. The Pennsylvania Supreme Court held the household vehicle exclusion violated the MVFRL, and vacated the Superior Court’s judgment, reversed the trial court’s order granting summary judgment in favor of GEICO, and remanded to the trial court for further proceedings. View "Gallagher v. GEICO" on Justia Law