Justia Insurance Law Opinion Summaries

In this case, the plaintiff, William Loomis, a truck driver who was injured in a car accident in New York, sought recovery from his employer's insurance company, ACE American Insurance Company, for his remaining damages after the underinsured driver's insurer paid out their policy limit. Loomis claimed that ACE failed to comply with both New York and Indiana laws requiring an insurer to provide underinsured motorist coverage.The United States Court of Appeals for the Second Circuit had to determine whether New York's laws requiring insurers to offer optional supplemental uninsured/underinsured motorist coverage could make an insurer liable when it fails to offer this coverage, and whether Indiana law requires an insurer to provide underinsured motorist coverage when the insured suffers damages in excess of the tortfeasor’s policy limit and has no other underinsured motorist coverage to cover damages up to a certain limit.The court concluded that under New York law, Loomis was not entitled to relief. While insurers are required to offer supplemental uninsured/underinsured motorist coverage in New York, this coverage is optional. Even if ACE violated New York law by failing to offer this coverage, Loomis's claim seeking to reform the insurance contract to include this coverage was not supported by New York law. Therefore, the court affirmed the lower court's grant of summary judgment on this claim.In terms of the claim under Indiana law, the court could not confidently predict how the Indiana Supreme Court would interpret the relevant statute, and therefore, certified questions to the Indiana Supreme Court. View "Loomis v. ACE American Insurance Company" on Justia Law

A dispute arose between The Pep Boys — Manny, Moe & Jack and The Pep Boys Manny Moe & Jack of California LLC (collectively, Pep Boys) and their insurers, Old Republic Insurance Company (Old Republic); Executive Risk Indemnity Company, formerly known as American Excess Insurance Company (American Excess); and Fireman’s Fund Insurance Company (Fireman’s Fund). Pep Boys had been sued by hundreds of people claiming harm from exposure to asbestos in products sold by Pep Boys. Following these claims, Pep Boys sought coverage from their insurers who had sold them a "tower" of commercial general liability policies providing coverage between February 1, 1981, and July 1, 1982.The insurers claimed that their respective policies provided only a single aggregate annual limit, while Pep Boys filed a declaratory judgment action against them, arguing that each policy provided two aggregate annual limits, one for the first 12 months and one for the remaining period. The trial court ruled in favor of the insurers, holding that the policies each provided only a single aggregate limit.In the appeal, the Court of Appeal of the State of California First Appellate District Division Four held that Old Republic's and Fireman’s Fund's policies, which were for terms longer than 12 months, contained two separate annual periods for the purposes of the annual aggregate limits of liability. However, it agreed with the trial court that the American Excess policy, which had different language, had only one period for purposes of that policy’s annual aggregate limits. Therefore, the appellate court reversed the trial court’s judgment in part. View "The Pep Boys v. Old Republic Insurance Company" on Justia Law

In this case before the Supreme Court of the State of Washington, a consortium of over 130 institutions of higher education sued a group of 16 insurance carriers for denying their COVID-19 related claims. The insurance carriers had issued identical “all risk” property insurance policies to the institutions via the Educational & Institutional Insurance Administrators Inc. (EIIA). The colleges, including three in Washington, filed the suit in Pierce County Superior Court, Washington, seeking a declaratory judgment that their COVID-19 related losses were covered under the insurance policies. However, two of the defendant insurers filed a similar suit in Illinois, seeking a declaratory judgment that the losses were not covered by the policies.The insurers argued that the Washington court should dismiss the case based on forum non conveniens, asserting that Illinois was a more convenient forum due to the geographical distribution of the colleges. They also argued that the Illinois action should be allowed to proceed. The colleges, on the other hand, argued that the insurance policies' "suit against the company" clause allowed them to choose the forum and prohibited the insurers from seeking to alter that choice.The Supreme Court of the State of Washington affirmed the lower court's decision, denying the motion to dismiss on forum non conveniens grounds and issuing an injunction against further proceedings in the Illinois action. The court held that the insurers had contractually agreed to submit to the jurisdiction of any court chosen by the insured and could not seek to transfer, change venue, or remove any lawsuit filed by the insured in such a court. The court also found that an injunction was appropriate under the circumstances to protect the colleges' contractual rights and prevent a manifest wrong and injustice. View "Pacific Lutheran Univ. v. Certain Underwriters at Lloyd's London" on Justia Law

In this case, Southwest Airlines filed a suit against Liberty Insurance Underwriters for denial of a claim for reimbursement under its cyber risk insurance policy after a massive computer failure. This computer failure resulted in flight delays and cancellations, causing Southwest to incur over $77 million in losses. Southwest claimed these losses under their insurance policy, but Liberty denied the claim, arguing that the costs incurred by Southwest were discretionary and either not covered under the policy or excluded by certain policy clauses.The United States Court of Appeals for the Fifth Circuit disagreed with the lower court's decision to grant summary judgment for Liberty. The court concluded that the costs incurred by Southwest due to the system failure were not categorically barred from coverage as a matter of law. The court found that Southwest's five categories of costs satisfied the policy's causation standard and were thus "losses" that it "incurred."The court also concluded that the district court erred in finding that the claimed costs were consequential damages excluded from coverage and that the term "third parties" did not apply to Southwest’s customers and did not preclude costs related to Southwest’s payments to its customers.The court reversed the district court's decision and remanded the case back to the lower court for further proceedings consistent with its opinion. View "Southwest Airlines v. Liberty Insurance" on Justia Law

After being involved in a car accident, Kenan Watkins filed a diminished value claim with his insurer, Allstate Property and Casualty Insurance Company ("Allstate"), which was denied. Watkins then filed an action in the United States District Court for the Southern District of Mississippi, alleging that the denial of his claim violated Mississippi law. However, the district court ruled in favor of Allstate, holding that Allstate's policy did not violate Mississippi law and that Watkins failed to state a plausible claim, which led to Watkins' appeal to the United States Court of Appeals for the Fifth Circuit.In the background of the case, Watkins had an insurance policy with Allstate for his 2021 Chevrolet Tahoe. After the accident, Watkins' vehicle sustained substantial damages, and Watkins alleged that his car sustained an additional diminished value. Allstate denied Watkins' diminished value claim, relying upon a provision in its policy that excludes any decrease in the property's value resulting from the loss and/or repair or replacement. Watkins did not dispute this policy exclusion, but argued that Allstate's exclusion provision violates the Mississippi Uninsured Motorist Statute. Allstate moved to dismiss the case under Rule 12(b)(6), arguing that Watkins did not plausibly allege that the other driver's vehicle was an "uninsured motor vehicle" under Mississippi law, and that even if it was, Allstate's provision excluding diminished value is valid under Mississippi law.Upon review, the United States Court of Appeals for the Fifth Circuit affirmed the district court's decision. The court held that Watkins failed to make a plausible claim for relief under Rule 12(b)(6) due to insufficient factual content in the complaint. The court also held that Allstate’s diminished value exclusion is valid under Mississippi law and does not violate public policy. The court reasoned that Watkins had not pointed to any legislative or judicial pronouncement requiring that diminished value be a part of all automobile insurance policies. Therefore, in this instance, the plain meaning of Allstate’s policy controlled, and Allstate’s diminished value exclusion was upheld as valid under Mississippi law. View "Watkins v. Allstate Property & Casualty Insurance Co." on Justia Law

The plaintiff, Kathryn Tornai, filed a lawsuit against her insurance company, CSAA Insurance Exchange, alleging breach of contract and bad faith for not paying her underinsured motorist claim. In response, CSAA filed a motion to compel arbitration, in line with a provision in Tornai's automobile policy. The trial court denied the motion, leading to CSAA's appeal. The Court of Appeal of the State of California First Appellate District Division Two reversed the trial court's decision. It concluded that the parties disagreed over the amount of underinsured motorist damages owed to Tornai, leading to the requirement for arbitration under section 11580.2, subdivision (f) and the terms of the policy. The appellate court found that the trial court erred in denying CSAA's motion to compel arbitration. Therefore, it instructed the lower court to grant CSAA's motion to compel arbitration of the underinsured motorist damages. View "Tournai v. CSAA Insurance Exchange" on Justia Law

In this case heard by the Supreme Court of the State of Wyoming, the plaintiff, Scherri Hacker, made a conversion claim against Hacker Oil, Inc., which had paid premiums on a whole life insurance policy on her husband, James Hacker. The policy was executed as a split-dollar arrangement, with the intention that upon Mr. Hacker's death, Hacker Oil would be reimbursed for the paid premiums, and the remaining death benefits would be distributed to Mrs. Hacker. After Mr. Hacker's death, Hacker Oil received $125,000 and half the interest accrued under the policy, which exceeded the $55,048 it had remitted in premium payments.The defendant, Hacker Oil, appealed the district court's decision, arguing that Mrs. Hacker had failed to mitigate her damages by withholding her signature from a letter agreement and by asserting a conversion claim against Hacker Oil. The court, however, upheld the district court's ruling, finding that Mrs. Hacker did not have a duty to mitigate her damages. The court determined that Mrs. Hacker's failure to sign the letter agreement prior to Hacker Oil's signing and submission of a claim to the insurance company did not constitute a failure to mitigate damages. The court further concluded that once Hacker Oil committed the conversion, Mrs. Hacker rightfully brought a claim and asserted her rights. Thus, the Supreme Court of the State of Wyoming affirmed the district court's decision, holding that Hacker Oil had wrongfully converted $70,372.68, the difference between the amount it received and the amount it was entitled to receive. View "Hacker Oil, Inc. v. Hacker" on Justia Law

The United States Court of Appeals for the First Circuit considered a case where Lawrence General Hospital (LGH) sued Continental Casualty Company for denying coverage for losses LGH alleges it suffered during the COVID-19 pandemic. LGH argued that its insurance policy with Continental covered the losses under two types of coverage: coverage for "direct physical loss of or damage to property" and a Health Care Endorsement covering losses and costs incurred due to compliance with government decontamination orders.Applying Massachusetts state law, the court ruled that LGH failed to state a claim that the SARS-CoV-2 virus caused "direct physical loss of or damage to its property," affirming the lower court's dismissal of this claim. However, the court found that LGH was subject to decontamination orders due to COVID-19 and thus had a valid claim for coverage under the Health Care Endorsement. As such, the court reversed the lower court's dismissal of this claim and remanded the case for further proceedings. View "Lawrence General Hospital v. Continental Casualty Co." on Justia Law

In this case heard in the United States Court of Appeals for the Seventh Circuit, an accident occurred at a construction site which resulted in bodily injuries to Gaylon Cruse and Mark Duckworth. During the installation of roof trusses, a power crane operated by Douglas Forrest was prematurely released, causing a truss to fall and collapse onto other trusses, injuring Cruse and Duckworth. Southern Truss, the owner of the truck to which the crane was attached, had two insurance policies - a commercial auto policy from Artisan and Truckers Casualty Company (Artisan) and a commercial general liability policy from The Burlington Insurance Company (Burlington). Both insurance companies denied a duty to defend in the underlying lawsuit initiated by Cruse and Duckworth.Artisan filed a suit in federal court seeking a declaration that it owed no duty to defend under its auto policy due to an operations exclusion clause and that Burlington owed a duty to defend. The district court denied both companies' motions for judgment, finding an ambiguity in Artisan's policy that should be construed in favor of the insured and that Burlington had a duty to defend some claims not covered by Artisan's policy. Both Artisan and Burlington appealed.The appeals court, applying Illinois law and conducting a de novo review, found no ambiguity in Artisan's policy. The court concluded that the operations exclusion applied because the injuries arose from the operation of the crane attached to the truck, whose primary purpose was to provide mobility to the crane. As such, Artisan had no duty to defend. Since Artisan had no duty to defend, the court determined that Burlington did have a duty to defend under its policy. Thus, the court affirmed in part and reversed in part the decision of the district court. View "Artisan and Truckers Casualty Company v. Burlington Insurance Company" on Justia Law

In this case before the Supreme Court of the State of Delaware, the plaintiff, First State Orthopaedics, P.A., sought a declaration that a billing code used by the defendants (a group of insurance companies operating under the Liberty Mutual Group) to deny insurance coverage violated Delaware's workers' compensation law. The defendant companies had stopped using the challenged code six months before the plaintiff filed its complaint and none of the codes in their new billing system contained the same challenged language. The Superior Court held that the discontinuation of the code did not remove the plaintiff's standing to bring the case because the defendants might resume using the code in the future and because they had not "corrected" their response to 19 invoices for which they had previously denied coverage using the challenged code. On appeal, the Supreme Court of Delaware overturned the lower court's decision, ruling that the plaintiff lacked standing to bring the case because the defendants had stopped using the challenged code before the plaintiff filed its complaint, and therefore, the plaintiff's request for a declaration that the code violated workers' compensation law did not seek to address an actual or imminent injury. The court also ruled that the defendants' alleged failure to correct their responses to 19 invoices could not confer standing because the prospective relief that a declaratory judgment affords would not redress the injury caused by the statements already issued to the plaintiff's patients. View "Employers Insurance Company of Wasau v. First State Orthopaedics, P.A." on Justia Law