Justia Insurance Law Opinion Summaries
Articles Posted in Insurance Law
M.O. v. GEICO General Insurance Co.
The Supreme Court vacated the judgment of the circuit court confirming M.O.'s arbitration award in this personal injury action, holding that the circuit court erred in confirming the arbitration award because GEICO General Insurance Company was statutorily entitled to intervene in the pending lawsuit between M.O. and M.B. pursuant to Mo. Rev. Stat. 537.065.2.M.O. sued M.B. alleging that she had contracted HPV from M.B. while having sexual relations in M.B.'s vehicle, which was insured by GEICO. had sexual relations in M.B.'s vehicle, which was insured by GEICO. M.B. and M.O., without informing GEICO, entered into an agreement providing that M.O.'s claims were be submitted to arbitration but that M.O. would seek recovery of any judgment from M.B.'s insurers. The arbitrator awarded M.O. $5.2 million. M.O. then sued M.B. without informing GEICO. After GEICO filed its motion to intervene the circuit court confirmed the arbitration award. Thereafter, the circuit court sustained GEICO's motion to intervene. The Supreme Court vacated the circuit court's judgment, holding that GEICO was statutorily entitled to intervene in the underlying lawsuit before judgment was entered. View "M.O. v. GEICO General Insurance Co." on Justia Law
Principal Growth Strategies, LLC v. AGH Parent LLC
In this case involving a Pennsylvania-domiciled insurance company in rehabilitation under the jurisdiction of a Pennsylvania court and a management company that was a wholly-owned subsidiary of the Pennsylvania-domiciled insurance company that was not a part of the rehabilitation proceeding the Court of Chancery granted in part and denied in part Plaintiffs' motion to stay, holding that a stay was warranted in part.In In re Liquidation of Freestone Insurance Co., 143 A.3d 1234 (Del. Ch. 2016), the Court of Chancery was presiding over an insurance delinquency proceeding, and at issue was whether to lift a broad anti-suit injunction to permit litigation to proceed in another state against the delinquent insurer. The Court of Chancery held that the factors set forth in Freestone to consider in deciding whether to depart from the presumption against permitting collateral proceedings to go forward against the delinquent insurer supported a stay in the instant case as to the delinquent insurer but did not support a stay as to the management company. View "Principal Growth Strategies, LLC v. AGH Parent LLC" on Justia Law
Ken’s Foods, Inc. v. Steadfast Insurance Co.
The Supreme Judicial Court held that there is no common-law duty for insurers to cover costs incurred by an insured to prevent imminent covered loss when the plain, unambiguous terms of the insurance policy speak directly to the question of mitigation and reimbursement and do not provide coverage and the costs are otherwise excluded by other policy provisions.Insured sought recovery from Insurer for various costs it incurred after a wastewater treatment system at its manufacturing facility malfunctioned, claiming coverage under its pollution liability policy. In dispute were costs incurred that were not cleanup costs or costs necessary to avoid imminent endangerment to public health or welfare but necessary to avoid a business interruption. The district court held that the costs at issue were not recoverable and that there was no basis to impose a common-law duty that was inconsistent with the policy's coverages and exclusions. View "Ken's Foods, Inc. v. Steadfast Insurance Co." on Justia Law
Bradley v. Viking Insurance
In a case involving the denial of coverage for an automobile accident, the Fifth Circuit addressed whether uninsured motorist coverage can be denied simply because the driver, who was the son of the insured, was not listed on the policy? The court answered that question “no.” The other is whether the policy can be voided because the insured committed a material misrepresentation by failing in her application for insurance to name, as required, those of driving age who lived in her household? The court answered that question, “yes.”
The Fifth Circuit affirmed the district court’s ruling granting Viking Insurance’s motion for summary judgment in Plaintiffs’ suit seeking damages for a wrongful denial of benefits. The court concluded that if an insurer declines to exercise the greater power to void a policy, it still retains the lesser power to exercise a contractual right to deny coverage. The court explained that here, a knowing misstatement in the application about the drivers in the household was material if it would have caused Viking either not to issue the policy or to increase the premium. The court accepted that materiality is not affected by the relationship between the false statement and the specific coverage being sought in litigation. It is enough that the falsity was material to the decision of the company to issue the policy at the agreed price. Consequently, Viking could have voided the policy. By not voiding, Viking’s policy remained in effect. Accordingly, Viking had the right to deny Plaintiffs’ claim. View "Bradley v. Viking Insurance" on Justia Law
Wilson v. USI Insurance Services LLC
The plaintiffs are food service, medical, health and wellness, art, music, and legal businesses in Pennsylvania, New Jersey, New York, Maryland, and Delaware. In March 2020, to curb the spread of COVID-19, the governors of those states issued executive orders closing or restricting the activities of nonessential businesses and urging people to stay home whenever possible. The businesses were forced to close or significantly limit their operations.The businesses filed claims under their commercial property insurance policies. Their insurers universally denied coverage, reasoning that the businesses did not suffer a “physical loss of or damage to” property necessary to trigger coverage or that a “virus exclusion” barred coverage. The businesses argued that their loss of the ability to use their properties for their intended business purposes was a “physical loss of” property and that either the exclusions did not apply or the insurers were estopped from arguing that they do. The district courts all ruled in favor of the insurers. The Third Circuit affirmed, concluding that the loss of use of a property’s intended business purpose is not a physical loss of property covered by the businesses’ insurance policies. The court did not reach the issue of whether the virus exclusions or any other exclusions apply. View "Wilson v. USI Insurance Services LLC" on Justia Law
Admiral Ins. Co. v. Niagara Transformer Corp.
Admiral Insurance Co. (“Admiral”) sought a declaration that it need not defend or indemnify its historical insured, Niagara Transformer Corp. (“Niagara”), in potential litigation between Niagara and nonparties Monsanto Co., Pharmacia LLC, and Solutia Inc. (collectively, “Monsanto”) over harms caused by polychlorinated biphenyls that Monsanto had sold to Niagara in the 1960s and 1970s. Admiral appealed from the order of the district court dismissing its action for lack of a justiciable “case of actual controversy” within the meaning of the Declaratory Judgment Act (the “DJA”). The district court principally relied on (1) the fact that Monsanto has not commenced or explicitly threatened formal litigation against Niagara, and (2) its assessment that Monsanto would not be likely to prevail in such litigation.
The Second Circuit affirmed the district court’s order dismissing Admiral’s action to the extent that it sought a declaration of Admiral’s duty to indemnify Niagara, and remanded for the district court to determine whether there exists a practical likelihood that Monsanto will file suit against Niagara. The court explained that while the district court properly concluded that it lacked jurisdiction to declare Admiral’s duty to indemnify Niagara, it did not adequately distinguish between that duty and the insurer’s separate duty to defend its insured. Because a declaratory-judgment action concerning either duty becomes justiciable upon a “practical likelihood” that the duty will be triggered, the justiciability of Admiral’s duty-to-defend claim turns on the practical likelihood that Monsanto will file suit against Niagara – not on whether Monsanto has already in fact done so. View "Admiral Ins. Co. v. Niagara Transformer Corp." on Justia Law
Shusha, Inc. v. Century-National Ins. Co.
Shusha, Inc., dba La Cava (La Cava) appeals from the judgment of dismissal entered after the trial court sustained without leave to amend the demurrer filed by Century-National Insurance Company (Century-National) to La Cava’s first amended complaint. La Cava sued Century-National for breach of an insurance contract and related claims after Century-National denied coverage for La Cava’s lost business income as a result of its suspension of restaurant operations in March 2020 due to the COVID-191 pandemic and associated government shutdowns.
On appeal, La Cava contended the trial court erred in concluding the alleged presence of the COVID-19 virus in its restaurant did not constitute “direct physical loss of or damage to” the restaurant necessary for coverage under the terms of the policy at issue. La Cava also argued Century-National acted in bad faith by summarily denying coverage without investigating La Cava’s claim.
The Second Appellate District reversed the trial court’s order and remanded for the trial court to vacate its order sustaining the demurrer without leave to amend and to enter a new order overruling the demurrer. The court held that La Cava’s allegations that contamination by the COVID-19 virus physically altered its restaurant premises were sufficient to withstand demurrer. The court explained that Century-National’s denial of coverage just three weeks after La Cava tendered its claim and in the earliest days of our understanding of the novel COVID-19 virus, cannot be deemed as a matter of law to have been made in good faith with reasonable grounds. View "Shusha, Inc. v. Century-National Ins. Co." on Justia Law
Planned Parenthood South Atlantic, et al. v. South Carolina, et al.
In 2021, the South Carolina General Assembly passed the Fetal Heartbeat and Protection from Abortion Act ("the Act"), which prohibited an abortion after around six weeks gestation. This was before many women—excluding those who were trying to become pregnant and were therefore closely monitoring their menstrual cycles—even know they were pregnant. The Supreme Court held that the decision to terminate a pregnancy rested upon the "utmost personal and private considerations imaginable," and implicates a woman's right to privacy. "While this right is not absolute, and must be balanced against the State's interest in protecting unborn life, this Act, which severely limits—and in many instances completely forecloses—abortion, is an unreasonable restriction upon a woman's right to privacy and is therefore unconstitutional." View "Planned Parenthood South Atlantic, et al. v. South Carolina, et al." on Justia Law
American Builders Insurance Company v. Southern-Owners Insurance Company
An insured fell from a roof and became paralyzed from the waist down, never to walk again. Within months, his medical bills climbed past $400,000, and future costs were projected into the millions. Three insurance companies potentially provided coverage for the insured. This appeal is a battle between the two of them. The primary insurer was Southern Owners Insurance Company. At the time of the accident, the insured was performing subcontracting work for Beck Construction, which had a policy with American Builders Insurance Company and an excess policy with Evanston Insurance Company. American Builders investigated the accident, assessed Beck Construction’s liability, and evaluated the claim. Southern-Owners did little to nothing for months. American Builders then sued Southern-Owners for common law bad faith under Florida’s doctrine of equitable subrogation. Southern-Owners moved for summary judgment, but the district court denied the motion. A federal trial jury heard the case and found in favor of American Builders. After the entry of final judgment, Southern-Owners sought judgment matter of law or, in the alternative, a new trial. On appeal, Southern-Owners challenges the denials of its summary judgment and post-trial motions.
The Eleventh Circuit affirmed. The court held that taking the evidence in the light most favorable to American Builders, a reasonable jury could have found (as it did) both that Southern-Owners acted in bad faith and that its bad faith caused American Builders to pay its policy. Moreover, American Builders did not breach Southern-Owners’ contract and relieve Southern-Owners of its good-faith duties. The district court did not err in denying Southern-Owners’ Rule 50(b) motion. View "American Builders Insurance Company v. Southern-Owners Insurance Company" on Justia Law
Serendipity at Sea, LLC v. Underwriters at Lloyd’s of London Subscribing to Policy Number 187581
This appeal arises out of an insurance dispute involving a yacht, the Serendipity, that was destroyed by Hurricane Dorian, a Category 5 storm, that slammed into Great Abaco Island in the Bahamas. Serendipity at Sea, LLC (“Serendipity, LLC”), a holding company created by M.S. and J.E. (“the Managers”) to manage the Serendipity, sued Underwriters at Lloyd’s of London Subscribing to Policy Number 187581 (“Lloyd’s”) for breach of contract after Lloyd’s denied the the Managers insurance claim for the damage Hurricane Dorian caused to the Serendipity. In denying that it had breached the contract, Lloyd’s argued that it was not liable because Serendipity, LLC did not employ a full-time licensed captain in violation of the policy’s Captain Warranty, and that the breach increased the hazard to the yacht because a licensed captain would have operated the vessel back to Florida when Hurricane Dorian formed and was forecast to hit the Bahamas.
The district court granted summary judgment in favor of Lloyd’s. It found that the Captain Warranty was unambiguous; that Serendipity, LLC breached the agreement by failing to hire a full-time licensed captain; and that the breach increased the hazard posed to the Serendipity based on the purportedly undisputed testimony of an expert hired by Lloyd’s. The Eleventh Circuit reversed the district court’s grant of summary judgment in favor of Lloyd’s and remanded. The court explained that while it agreed with the district court’s conclusion that Serendipity, LLC breached the Captain Warranty, a disputed question of material fact remains about whether the breach increased the hazard posed to the vessel. View "Serendipity at Sea, LLC v. Underwriters at Lloyd's of London Subscribing to Policy Number 187581" on Justia Law