Justia Insurance Law Opinion Summaries

After Wynndalco Enterprises, LLC was sued in two putative class actions for violating Illinois’ Biometric Information Privacy Act (“BIPA”), its business liability insurer, Citizens Insurance Company of America, filed an action seeking a declaration that it has no obligation under the terms of the insurance contract to indemnify Wynndalco for the BIPA violations or to supply Wynndalco with a defense. Citizens’ theory is that alleged violations of BIPA are expressly excluded from the policy coverage. Wynndalco counterclaimed, seeking a declaration to the contrary that Citizens is obligated to provide it with defense in both actions. The district court entered judgment on the pleadings for Wynndalco.   The Seventh Circuit affirmed. The court explained that the narrowing construction that Citizens proposes to resolve that ambiguity is not supported by the language of the provision and does not resolve the ambiguity. Given what the district court described as the “intractable ambiguity” of the provision, the court held Citizens must defend Wynndalco in the two class actions. This duty extends to the common law claims asserted against Wynndalco in the other litigation, which, as Citizens itself argued, arise out of the same acts or omissions as the BIPA claim asserted in that suit. View "Citizens Insurance Company of America v. Wynndalco Enterprises, LLC" on Justia Law

The Supreme Court affirmed the judgment of the court of appeals denying State Farm Mutual Automobile Insurance Company's petition for a writ of prohibition to prevent Judge Brian Edwards of the Jefferson Circuit Court from enforcing certain discovery orders, holding that State Farm was not entitled to the writ.Betty Irvin was involved in an automobile collision with Deborah Combs, who was insured by State Farm. Irvin brought suit, alleging a negligence claim against Combs and a third-party statutory bad faith claim under Kentucky's Unfair Claims Settlement Practices Act, Ky. Rev. Stat. 304.12-230, against State Farm. The trial court bifurcated the bad faith claim against State Farm from the other claims. Later, State Farm filed this petition seeking to prevent Judge Edwards from enforcing his discovery orders on the grounds that Irvin's bad faith claim against it was not yet ripe. The court of appeals denied the writ petition. The Supreme Court affirmed, holding that the court of appeals did not err. View "State Farm Mutual Automobile Insurance Co. v. Honorable Edwards" on Justia Law

The Supreme Court reversed the opinion of the court of appeals that because an insurance company's coverage under its policy had never been finally adjudicated, a third-party claimant's bad faith claim was premature, holding that the court of appeals erred.Relying on Pryor v. Colony Insurance Co., 414 S.W.3d 424 (Ky. App. 2013), the court of appeals held that the circuit court improperly allowed Plaintiffs to pursue their bad faith claims because coverage had not been established when they filed their third-party bad faith complaint. The Supreme Court reversed, holding (1) Pryor should not be construed as requiring a final judicial determination of coverage prior to filing a third-party tort claim against an insurer, and instead, this Court continues to apply the requirements of Wittmer v. Jones; and (2) the court of appeals erred concluding that the circuit court improperly permitted Plaintiffs to pursue their bad faith claims in violation of Pryor because coverage had not been established when they filed their third-party bad faith complaint. View "Estate of Bramble v. Greenwich Insurance Co." on Justia Law

The Supreme Court reversed the judgment of the court of appeals affirming the decision of the trial court to utilize Ky. R. Civ. P. 37.02(3) to assess attorney's fees against a non-party after the non-party failed to obey an order to comply with a subpoena duces tecum, holding that the plain language of CR 34.07(3) applies only to parties to an action.Plaintiffs brought two actions related to an automobile collision against their insurer, Allstate Property & Casualty Insurance Company, among others. Allstate disputed the charges assessed by Dr. David Megronigle for his chiropractic treatment to Plaintiffs, alleging that they were not properly compensable. Plaintiffs later filed a notice of voluntary dismissal as to Megronigle. Thereafter, Allstate filed a motion for attorney's fees under CR 37.02(3). The court granted the motion and ordered Megronigle to pay Allstate the amount of $816. The court of appeals affirmed. The Supreme Court reversed, holding (1) the plain language of CR 37.07(3) applies only to parties to an action; and (2) Megronigle was not a party to the underlying action because he was involved solely by virtue of the subpoenas served upon him by Allstate. View "Megronigle v. Allstate Property & Casualty Insurance Co." on Justia Law

The Supreme Court affirmed in part and reversed in part the judgment of the circuit court in favor of Secura Supreme Insurance Company as the underinsured motorists' (UIM) carrier for Viviane Renot, holding that the trial court erroneously permitted Dr. David Porta to testify about medical questions beyond his qualifications.Renot was allegedly injured in a vehicle collision and brought this action against Secura as her UIM carrier. During trial, Secura called Porta, a biomechanics expert, to testify regarding his biomechanics and anatomical opinions relative to the mechanism of injury in the collision. The jury returned a verdict in favor of Secura, finding that the collision had not been a substantial factor in Renot's injuries. The court of appeals affirmed. The Supreme Court reversed in part, holding that the trial court erroneously permitted Dr. Porta to invade the exclusive province of medical doctors in determining medical causation, and the error required a new trial. View "Renot v. Secura Supreme Insurance Co." on Justia Law

The Supreme Court reversed the judgment of the court of appeals affirming the decision of the trial court to utilize Ky. R. Civ. P. 37.02(3) to assess attorney's fees against a non-party after the non-party failed to obey an order to comply with a subpoena duces tecum, holding that the plain language of CR 34.07(3) applies only to parties to an action.Plaintiffs brought two actions related to an automobile collision against their insurer, Allstate Property & Casualty Insurance Company, among others. Allstate disputed the charges assessed by Dr. David Megronigle for his chiropractic treatment to Plaintiffs, alleging that they were not properly compensable. Plaintiffs later filed a notice of voluntary dismissal as to Megronigle. Thereafter, Allstate filed a motion for attorney's fees under CR 37.02(3). The court granted the motion and ordered Megronigle to pay Allstate the amount of $816. The court of appeals affirmed. The Supreme Court reversed, holding (1) the plain language of CR 37.07(3) applies only to parties to an action; and (2) Megronigle was not a party to the underlying action because he was involved solely by virtue of the subpoenas served upon him by Allstate. View "Megronigle v. Allstate Property & Casualty Insurance Co." on Justia Law

Dr. Robert P. Rothenberg (Rob) tragically suffered a fatal heart attack prior to paying the initial premium on his term life insurance policy issued by Principal National Life Insurance Company (Principal). Principal filed this action in the district court, seeking a declaratory judgment that Appellant— the policy’s intended beneficiary—was not owed death benefits in light of the nonpayment. Appellant filed a counterclaim, asserting claims against Principal for breach of contract, vexatious denial of proceeds, and negligence, as well as claims against Appellee, the couple’s insurance broker and financial planner, for negligence. After the parties filed cross-motions for summary judgment, the district court granted summary judgment in favor of Principal and Appellee, finding, in part, that the policy was not in effect at the time of Rob’s death. Appellant appealed, arguing that the district court erred in concluding (1) that the Policy was not in effect at the time of Rob’s death and (2) that, assuming the Policy was not in effect, neither Principal nor Appellee were negligent because neither owed a duty to Appellant.   The Eighth Circuit affirmed. The court explained that Appellant did not pay the initial premium until after Rob’s death, at which time he was not in a similar state of health as when he applied for the policy. Moreover, any “privileges and rights” Rob (or Appellant) had to retroactively effectuate the Policy were terminated at Rob’s death pursuant to the Policy’s termination provision. Second, Rob’s signature on the EFT Form alone did not render the Policy effective on April 26, 2019, or earlier. View "Principal National Life Insurance Company v. Donna Rothenberg" on Justia Law

Plaintiff underwent bariatric surgery to lose weight. A few months later, Plaintiff began working for Zimmerman Transfer, Inc. and became a participant in its self-insured employee benefit plan. Zimmerman is the plan administrator, and Benefit Plan Administrators of Eau Claire, LLC (“BPA”) served as the third-party administrator until January 2020. After exhausting his administrative appeals, Plaintiff sued BPA and Zimmerman for benefits under Section 1132(a)(1)(B). He then moved for summary judgment against BPA and Zimmerman. Both Defendants filed cross-motions for summary judgment, which the district court granted.   The Eighth Circuit affirmed. The court explained that because Plaintiff’s plan specifically excludes coverage of treatment for complications of weight-reduction surgery, neither Iowa law nor the ACA requires that his treatment be covered. It is undisputed that Plaintiff’s treatment was due to a complication of his prior bariatric surgery. Thus, Iowa law and the ACA do not require that his treatment be covered. Further, the court wrote that imposing and enforcing coverage limitations, even if it results in a plan participant paying large medical bills, is not inconsistent with the plan’s goal because the plan must allocate limited resources among all plan participants. Accordingly, the court concluded that there was no abuse of discretion in denying Plaintiff’s claim for benefits because the interpretation of the plan was reasonable, and the decision to deny benefits was supported by substantial evidence. View "Darrin Shafer v. Zimmerman Transfer, Inc." on Justia Law

The Supreme Court affirmed the rulings of the Workers' Compensation Court (WCC) determining that Johnny Lee Sheldon's claim was compensable, that Contessa Bryer, Sheldon's guardian and conservator, was entitled to her attorney fees, and that a statutory penalty should be imposed against Accident Fund General Insurance Company, holding that the WCC did not err.Sheldon was rendered incapacitated and mentally incompetent after a workplace accident. Because Accident Fund General Insurance Company refused to accept liability for Sheldon's workers' compensation claim Bryer, Sheldon's guardian and conservator, petitioned the WCC for a hearing. The WCC ruled that Accident Fund was liable for Sheldon's injuries and that Bryer was entitled to attorney fees and a statutory penalty. The Supreme Court affirmed, holding that the WCC did not err when it (1) ruled that the statute of limitations was tolled during the time that Sheldon had no appointed guardian; (2) found that substantial credible evidence supported the WCC's finding that Sheldon was working with argon when the pressure relief valve burst; and (3) awarded attorney fees under Mont. Code Ann. 39-71-611 and by imposing a penalty against Accident Fund under Mont. Code Ann. 39-71-2907. View "Bryer v. Accident Fund General Insurance Co." on Justia Law

Two individuals were involved in a car accident in St. Louis, Missouri. One of the cars crashed into White Knight Diner, resulting in property damage to the restaurant. At the time, White Knight was insured by Owners Insurance Company (Owners)pursuant to a policy that provided coverage for property damage and loss of business income (the Policy). After the insurers brought several motions to dismiss, the district court dismissed all parties except for Owners and White Knight. White Knight then filed an amended complaint against Owners only, adding new causes of action, including breach of contract and breach of the implied covenant of good faith and fair dealing. Owners filed a motion for summary judgment on all claims. The district court granted Owners’ motion. White Knight appealed, arguing that disputed material facts remain as to whether Owners’ subrogation efforts were conducted in breach of the Policy.   The Eighth Circuit affirmed. The court explained that even assuming Owners’ actions were taken pursuant to the Policy, White Knight’s claim still fails because it does not establish that it suffered any damages as a result of Owners’ failure to abide by the contracted-for procedures. White Knight, as an insured party under the Policy, contracted for and paid premiums to receive insurance. And Owners settled White Knight’s claim under the Policy when Owners paid White Knight a total of $66,366.27 for property damage and business income loss. White Knight has not shown that it suffered any damages beyond the compensation it received from Owners. Without evidence of damages, a breach of contract claim fails. View "White Knight Diner, LLC v. Owners Insurance Company" on Justia Law