Justia Insurance Law Opinion Summaries

Exercising jurisdiction over Defendant-insurer under the circumstances of this case was permitted by Connectictut’s corporate long arm statute, Conn. Gen. Stat. 33-929(f)(1), and comported with the due process clause of the Fourteenth Amendment.Defendant issued an automobile insurance policy covering a vehicle driven by Insured. The policy was written in New York at Defendant’s principal place of business, and Defendant did not direct or participate in any business transactions in Connecticut at the time. The coverage territory of the policy included Connecticut. Insured’s vehicle later collided with a vehicle occupied by Plaintiffs. A judgment was rendered against Insured in favor of Plaintiffs. Defendant failed to defend Insured or to indemnify him for the judgment rendered against him. Plaintiffs then brought this action against Defendant. Defendant moved to dismiss the action for lack of personal jurisdiction. The trial court granted the motion to dismiss. The Supreme Court reversed, holding that Defendant’s agreement to defend and indemnify Insured established personal jurisdiction under the long arm statute and that subjecting Defendant to the jurisdiction of this state comported with the due process clause of the Fourteenth Amendment. View "Samelko v. Kingstone Insurance Co." on Justia Law

AEI filed a declaratory judgment action alleging that Lincoln was barred from challenging the validity of a life insurance policy because the two‐year contestability period had lapsed. The district court granted AEI's motion for summary judgment. The Second Circuit held that the contract did not contain a choice-of-law provision and thus New York conflict-of-law rules governed the dispute. The court held that, because those rules instructed the courts to look to the "center of gravity" of the events at issue to determine which state's substantive law applied, and the center of gravity in this case was New York, New York's substantive law applied. In this case, applying New York's substantive incontestability law barred Lincolnʹs challenges to the policy. View "AEI Life, LLC v. Lincoln Benefit Life Co." on Justia Law

In this insurance dispute, the Supreme Court held that the issue of whether the trial court properly disregarded some of the jury’s findings should be remanded to the court of appeals for reconsideration in light of this Court’s decision in USAA Texas Lloyds Co. v. Menchaca, __ S.W.3d __ (Tex. 2018).Plaintiffs sued their insurer, State Farm, for breach of contract and Insurance Code violations. The jury found that both parties breached the insurance contract but that Plaintiffs breached first. The jury then awarded damages for State Farm’s breach of the policy and for Plaintiffs’ extra-contractual claims. The trial court disregarded two of the jury’s findings about Plaintiffs’ breach of the insurance contract and rendered judgment for Plaintiffs. The court of appeals affirmed. While State Farm's appeal was pending, the Supreme Court issued its final opinion and judgment in Menchaca, which clarified whether an insured can recover policy benefits based on an insurer’s violation of the Texas Insurance Code even though the jury failed to find that the insurer failed to comply with its obligations under the policy. On appeal, the Supreme Court held (1) State Farm’s first issue should be remanded for reconsideration in light of Menchaca; and (2) as to the remaining issues, the court of appeals’ judgment is affirmed. View "State Farm Lloyds v. Fuentes" on Justia Law

The United States District Court for the Western District of Washington certified a question of Washington law to the Washington Supreme Court. This case concerned a class action insurance claim suit pending in federal court. Plaintiff Brett Durant was a State Farm Mutual Automobile Insurance Company insured, and carried a $35,000 personal injury protection (PIP) rider. In 2012, Durant was injured in a motor vehicle accident; he opened a PIP claim with State Farm. The "coverage letter" advised Durant that "Medical services must also be essential in achieving maximum medical improvement for the injury you sustained in the accident." Durant sought treatment with chiropractor Harold Rasmussen, DC, who diagnosed injuries including sprains to the neck, back, pelvis, and right shoulder. After a shoulder MRI showed a ligament sprain and "a possible small type I SLAP [(superior labral anteroposterior)] tear,"Durant was referred to an orthopedic surgeon who diagnosed"mild bursitis/tendinitis,"which was treated with physical therapy and cortisone injections. Durant's injuries were not resolved by a date set by his physicians; his providers billed his PIP claims, but State Farm denied them on grounds that Durant had "previously reached maximum medical improvement." The federal district court asked the Washington Supreme Court (1) whether an insurer violates WAC 284-30-395(1)(a) or (b) if that insurer denied or terminated an insured's medical benefits based on a finding of "maximum medical improvement;" and (2) whether the term "maximum medical improvement" was consistent with the definition of "reasonable" or "necessary" as those terms appeared in WAC 284-30-395(1). The Washington Court answered the first certified question "yes." With regard to the second question, the Court found that under the circumstances of this case, the term "maximum medical improvement" was not consistent with the terms "reasonable" or "necessary" as those terms appeared in WAC 284-30-395(1). View "Durant v. State Farm Mut. Auto. Ins. Co." on Justia Law

The Fifth Circuit affirmed the district court's grant of summary judgment for an insurer, in an action seeking a declaratory judgment that the insurer owed no coverage under a commercial property insurance policy. The insured then counterclaimed for declaratory judgment, breach of the insurance contract, and violations of the Texas Insurance Code. The court held that the insured failed to meet its burden to offer evidence that would allow a trier of fact to segregate covered losses from non-covered losses. Therefore, because the insured failed to meet its burden to show what portion, if any, of the claimed damage occurred during the coverage period, the insurer was entitled to summary judgment on its claim seeking declaratory judgment. The insured's counterclaims failed for the same reason. View "Certain Underwriters at Lloyd's of London v. Lowen Valley View, LLC" on Justia Law

The circuit court did not err when it ruled that Plaintiff, a retired firefighter, was not a disabled person entitled to receive health insurance benefits under the Virginia Line of Duty Death and Disability Act, Va. Code 9.1-400 et seq.Plaintiff was diagnosed with throat cancer after he retired from the fire department but did not experience any health problems while he worked as a firefighter. The circuit court concluded (1) under the plain reading of the Act, Plaintiff’s duties as a firefighter ceased as of his retirement; and (2) because Plaintiff became disabled after he retired, his claim for insurance coverage under the Act was not viable. The Supreme Court affirmed, holding that Plaintiff was not a “disabled person” under the Act because his incapacity did not prevent the “further performance” of his duties as a firefighter. Therefore, Plaintiff was not entitled to continued health insurance coverage under the Act. View "Jones v. Von Moll" on Justia Law

This case concerned a discovery dispute arising out of an automobile accident in which Gary Griggs, a driver insured by State Farm, injured Susan Goddard and several others. State Farm sought a declaratory judgment that Griggs breached the contractual duties set forth in his insurance policy by executing a settlement agreement pursuant to Nunn v. Mid-Century Insurance Co., 244 P.3d 116 (Colo. 2010), in which he waived a jury trial, consented to arbitration, and assigned to Goddard any rights that he had against State Farm. Goddard counterclaimed, asserting, among other things, that State Farm acted in bad faith by refusing both to settle her claims against Griggs and to indemnify Griggs for the judgment entered against him after the arbitration to which Griggs had consented. The district court determined State Farm impliedly waived the attorney-client privilege protecting communications between it and its former counsel when it submitted an affidavit from that former counsel to rebut allegations of discovery misconduct. The Colorado Supreme Court concluded after review that the attorney affidavit submitted in this case did not place any privileged communications at issue. Accordingly, the district court erred in finding that State Farm impliedly waived its attorney-client privilege. View "State Farm v. Griggs" on Justia Law

The United States District Court for the District of Colorado certified a question of law to the Colorado Supreme Court. The question asked for an interpretation of the meaning of the words “suicide, sane or insane,” when used in life insurance policies. The Colorado Supreme Court concluded that, under Colorado law, a life insurance policy exclusion for “suicide, sane or insane” excluded coverage only if the insured, whether sane or insane at the time, committed an act of self-destruction with the intent to kill himself. View "Renfandt v. New York Life Insurance Company" on Justia Law

Appraisers may determine the factual cause of damage to insured property to ascertain the amount of the loss, but coverage questions are to be resolved by the court.In the instant case, the district court rejected an insurance appraisal award for hail damage to roofing shingles. The property insurer denied coverage for hail caused damage to the asphalt shingles based on a preexisting manufacturing defect. The insured townhome association sued the insurer for breach of contract and invoked the appraisal provision of the property insurance policy to ascertain the amount of the loss from the hailstorm. The appraisal panel valued the hail damage loss at $1.4 million. The district court found no shingle damage from hail, applied an exclusion for defective materials, and rejected the appraisal award. The Supreme Court remanded the case, holding (1) the district court erred by disregarding the appraisal award’s determination of the amount of the loss for shingles damaged by the hailstorm; and (2) the issue of the extent of preexisting shingle damage excluded from coverage must be decided by the court on remand. View "Walnut Creek Townhome Ass’n v. Depositors Insurance Co." on Justia Law

By interlocutory appeal, Central Insurers of Grenada, Inc., challenges the Warren County Circuit Court’s denial of its motion to dismiss William Greenwood’s complaint against it for insufficient service of process. Greenwood, the owner of Antique Wood Company of Mississippi, filed a complaint against Central and three other defendants, alleging breach of contract, conspiracy, and bad faith due to the defendants’ refusal to provide coverage under a commercial liability insurance policy Greenwood had purchased from them. Greenwood’s complaint acknowledged that Central was a Mississippi corporation, identified Lynn Simmons Grim as Central’s registered agent for service of process, and listed an address in Grenada County, Mississippi, where Grim could be served. However, Greenwood did not personally serve process on an officer or registered agent of Central, nor did he mail a copy of the complaint and summons directly to Central or its registered agent. Instead, Greenwood’s process server served a copy of the complaint and summons on an employee of the Mississippi Commissioner of Insurance. The Commissioner’s legal process clerk then forwarded a copy of the complaint and summons, along with a notification letter, to Central via certified mail. The Mississippi Supreme Court determined the trial court erred in finding the Mississippi Commissioner of Insurance was authorized to accept service of process on Central's behalf, so it reversed that judgment and remanded this case for further proceedings. View "Central Insurers of Grenada, Inc. v. William Greenwood d/b/a Antique Wood Company of Mississippi" on Justia Law