Justia Insurance Law Opinion Summaries

The Supreme Court held that the language in the insurance policy at issue in this case provided liability coverage for right-of-seclusion violations litigated under the Telephone Consumer Protection Act of 1991 (TCPA), 47 U.S.C. 227, assuming such coverage is consistent with the insured's reasonable expectations.Privacy injuries involving the right of seclusion are sometimes actionable under the TCPA provided that the violation involves the use of telephonic equipment. The insurance policy in this case provided liability coverage for injuries "arising out of...[o]ral or written publication...of material that violates a person's right of privacy." At issue before the Supreme Court was whether this language provided liability coverage for right-of-seclusion violations brought under the TCPA. The Court held that a commercial general liability insurance policy that provides coverage for "personal injury" defined in part as injury arising out of oral or written publication of material that violates a person's right of privacy can cover liability for violations of the right of seclusion if that coverage is consistent with the insured's reasonable expectations. View "Yahoo Inc. v. National Union Fire Insurance Co. of Pittsburgh, PA" on Justia Law

After Defendant’s Arkansas home burned to the ground, her insurer, Hiscox Dedicated Corporate Member Limited (a "capital provider" to an underwriting syndicate doing business within the Lloyd's of London insurance marketplace), declined to pay her for her loss and instead rescinded the insurance policy because she had made material misrepresentations in her insurance application. Hiscox then sued Defendant in federal court, seeking a declaratory judgment that it had properly rescinded the policy and had no obligation to Defendant. The district court agreed with Hiscox and granted it summary judgment.   The relevant question is whether Defendant "had a foreclosure, repossession, bankruptcy or filed for bankruptcy during the past five (5) years." Defendant maintains that the district court erred in concluding that the phrase "had a foreclosure" meant the initiation of foreclosure proceedings.   The Eighth Circuit reversed and remanded. The court agreed with Defendant that the question is ambiguous. Under Arkansas law, the court read the question in its "plain, ordinary, and popular sense," as "the common usage of terms should prevail". Further, the court wrote it sees no indication in any case that the parties meant to adopt Arkansas statutes as the standard to determine the meaning of the words in the application question. View "Hiscox Dedicated Corp Member v. Suzan Taylor" on Justia Law

Plaintiff Keene Auto Body, Inc. appealed a circuit court order that dismissed its complaint against defendant State Farm Mutual Automobile Insurance Company. Keene Auto Body, acting as an assignee of Caleb Meagher, who insured his vehicle through State Farm, sued State Farm for breach of contract for failing to cover the full cost of repairs to the insured’s vehicle. State Farm moved to dismiss the suit on grounds that, because of an anti-assignment clause in the insured’s policy, the insured’s assignment of his breach of contract claim to Keene Auto Body was not valid, and that, even if it was, Keene Auto Body did not sufficiently state a claim for breach of contract. The trial court granted the motion. The New Hampshire Supreme Court found the anti-assignment clause at issue here was ambiguous, and construed it against the insurer. Therefore, the clause did not prohibit the insured from assigning his post-loss claim to Keene Auto Body. Given this holding, the Supreme Court determined Keene Auto Body's factual allegations were sufficient to survive State Farm's motion to dismiss. Judgment was reversed and the matter remanded for further proceedings. View "Keene Auto Body, Inc. v. State Farm Mutual Automobile Insurance Company" on Justia Law

In this dispute between an Insurer and pension holders, the Second Circuit granted in part and denied in part Insurer's motion to dismiss. Plaintiffs did not timely appeal from the district court’s orders addressing the methodology for computing individual relief, so the court lacked jurisdiction over that portion of Plaintiffs’ appeal. However, the court found that it had jurisdiction over the portion of Plaintiffs’ appeal challenging the district court’s order denying sanctions. Considering that order on the merits, the court concluded that it was not an abuse of discretion and affirmed. View "Amara v. Cigna Corporation" on Justia Law

Plaintiffs filed a civil suit against an insurer based on allegations that the insurer negligently advised them that they did not need to purchase a builder's risk policy for a hotel project. The district court granted the insurer's motion for summary judgment, finding that the insurer had no duty to give advice about different coverages or to ensure that adequate coverage existed and that plaintiffs failed to show the existence of a special relationship between the agent and the insureds that would give rise to additional duties on the agent's part to ensure the insured had adequate coverage.The Eighth Circuit affirmed, finding that the trial court did not err in its resolution of the motion for summary judgment. View "I Square Management, LLC v. McGriff Insurance Services, Inc." on Justia Law

Plaintiff sued Farmers New World Life Insurance Company (Defendant or Farmers) for breach of contract, breach of the covenant of good faith and fair dealing, and punitive damages in connection with a policy insuring the life of her ex-husband. The trial court granted summary judgment for Defendant on those claims, concluding it was undisputed that the ex-husband remained the owner of the policy until he died, and that he had changed the beneficiaries on the policy, reducing his ex-wife’s interest from 100 percent to 25 percent.   The Second Appellate District reversed, finding that the trial court failed to consider the terms of a divorce decree affecting ownership of the policy, and because Defendant’s agent repeatedly assured Plaintiff, up to and after the ex-husband’s death, that Plaintiff remained the sole beneficiary. Therefore, the court concluded disputed issues of material fact prevent summary judgment. View "Randle v. Farmers New World Life Insurance Co." on Justia Law

Blue Cross Blue Shield of Vermont (Blue Cross) appealed the Green Mountain Care Board’s (GMCB) decision modifying its proposed health-insurance rates for 2022. The GMCB approved Blue Cross’s proposed rates with several exceptions, one of which was relevant here: its contribution to reserves (CTR). Blue Cross had sought a base CTR rate of 1.5%, but the GMCB ordered Blue Cross to lower it to 1.0%, thereby diminishing overall insurance rates by 0.5% and reducing health-insurance premiums. The GMCB found that a 1.5% base CTR was “excessive” because Blue Cross was expected to be above its target Risk Based Capital (RBC) range by the end of 2021, “individuals and small businesses are still struggling financially after a year-long economic slowdown,” and a 1.0% CTR would allow its “reserves to sit comfortably within the company’s RBC target range.” Blue Cross moved for reconsideration, arguing that the term “excessive” was strictly actuarial in nature, and that the GMCB misconstrued it by weighing non-actuarial evidence— testimony concerning affordability—as part of its examination of whether the proposed rate was excessive. On appeal to the Vermont Supreme Court, Blue Cross raised essentially the same issue. Because none of the actuarial experts who testified concluded that Blue Cross’s proposed CTR was excessive, Blue Cross argued, the GMCB could not properly conclude that it was. Blue Cross conceded that health-insurance rates for 2022 could not now be changed, but it urged the Supreme Court to rule on the merits, arguing that this matter was not moot because the CTR rate for this year will disadvantage Blue Cross in future rate-review proceedings. The Supreme Court determined Blue Cross did not demonstrate that this kind of case was capable of repetition yet evading review or subjected it to continuing negative collateral consequences. Therefore, Blue Cross failed to meet the exceptional thresholds necessary for the Court to reach the merits in a moot case. View "In re Blue Cross and Blue Shield 2022 Individual & Small Group Market Filing" on Justia Law

The Travelers Indemnity Company appeals the judgment entered after the superior court denied Travelers’ petition for a writ of administrative mandate challenging the Insurance Commissioner’s decision that certain agreements relating to workers’ compensation insurance policies issued to Adir International, LLC were unenforceable. Travelers contended that Adir’s lawsuit in the trial court, which included a request for a declaratory judgment the agreements were void, barred the Commissioner, under the doctrine of exclusive concurrent jurisdiction, from exercising jurisdiction while that lawsuit was pending. Travelers also appealed the post-judgment order granting Adir’s motion for attorney fees, contending attorney fees were not authorized.   The Second Appellate Division affirmed the order and judgment denying Travelers’s petition. The court explained that the exclusive concurrent jurisdiction doctrine does not apply in this context to proceedings pending before the trial court and an administrative agency; and, in any event, it was reasonable and consistent with the primary jurisdiction doctrine for the trial court to defer to the Commissioner’s determination of the validity of the agreement at issue. In addition, because Adir’s administrative claim fell within the agreement’s attorney fee provision, the court affirmed the post-judgment order awarding Adir attorney fees. View "The Travelers Indemnity Co. v. Lara" on Justia Law

Respondent Myra Windham was seriously injured while driving a rental car that was considered a temporary substitute vehicle under her State Farm policy. In this declaratory judgment action instituted by Petitioner State Farm, the issue this case presented for the South Carolina Supreme Court's determination was whether Windham could stack her underinsured motorist ("UIM") coverage pursuant to section 38-77-160 of the South Carolina Code. The circuit court agreed with State Farm that stacking was prohibited, and the court of appeals reversed. Because both parties offered reasonable interpretations of the policy language, the Supreme Court found an ambiguity existed, which it construed against the drafter. Accordingly, the Court agreed with the court of appeals that Windham could stack, and affirmed as modified. View "State Farm v. Windham" on Justia Law

The Multiemployer Pension Plan Amendments Act of 1980 imposes liability on employers who withdraw—partially or completely—from multiemployer pension funds. After a complete withdrawal, GCIU-Employer Retirement Fund’s (GCIU) actuary calculated MNG Enterprise’s (MNG) withdrawal liability using an interest rate published by the Pension Benefit Guaranty Corporation. On MNG’s challenge, an arbitrator found (1) that MNG could not be assessed partial withdrawal liability following a complete withdrawal, (2) that it had shown the interest rate used was not the best estimate of the plan’s experience, and (3) that GCIU properly included the newspapers’ contribution histories. The district court affirmed the arbitrator’s award, vacating and correcting only a typographical error on the interest rate.   The Ninth Circuit affirmed in part and vacated in part the district court’s order affirming, except for a typographical error, an arbitrator’s award regarding the withdrawal liability. The panel held that the MPPAA directs the plan actuary to determine withdrawal liability based on “actuarial assumptions and methods which, in the aggregate, are reasonable (taking into account the experience of the plan and reasonable expectations) and which, in combination, offer the actuary’s best estimate of anticipated experience under the plan.” The panel held that the GCIU actuary’s use of the PBGC rate, without considering the “experience of the plan and reasonable expectations,” did not satisfy the “best estimate” standard. View "GCIU-EMPLOYER RETIREMENT FUND, ET AL V. MNG ENTERPRISES, INC." on Justia Law