Justia Insurance Law Opinion Summaries

Cathy L. Stroud sued Ozark National Life Insurance Company and its agent, Stephen Guinn, for negligent misrepresentation and breach of fiduciary duty after her husband, Alan Stroud, converted his term life insurance policy to a whole life policy, reducing the death benefit. Cathy claimed that Guinn's advice led to the conversion, which was against their best interests. Alan had a 20-year term life insurance policy with a $60,000 death benefit, which he converted to a whole life policy with a $30,000 death benefit shortly before his death.The Sedgwick District Court granted summary judgment in favor of Ozark and Guinn, concluding that Cathy failed to establish a fiduciary duty and that Guinn did not supply false information. Cathy appealed, and the Kansas Court of Appeals affirmed the district court's judgment, agreeing that Cathy did not present sufficient evidence to establish a fiduciary duty or negligent misrepresentation.The Kansas Supreme Court reviewed the case and affirmed the lower courts' decisions. The court held that Cathy failed to establish a fiduciary relationship because there was no evidence that Guinn consciously assumed fiduciary duties. The court also held that Cathy did not present evidence of an affirmative misrepresentation by Guinn, as required for a negligent misrepresentation claim under Restatement (Second) of Torts § 552. The court noted that Cathy's claim was more akin to fraud by silence, which was not pleaded or argued.The Kansas Supreme Court concluded that summary judgment was appropriate because Cathy did not establish genuine issues of material fact for trial on her claims of breach of fiduciary duty and negligent misrepresentation. Consequently, the court affirmed the district court's denial of Cathy's motion to amend her petition to add a claim for punitive damages. View "Stroud v. Ozark Nat'l Life Ins. Co. " on Justia Law

Patricia Nicholson filed a garnishment action after her husband was killed in an accident involving Ava Mercer, who was insured by Key Insurance Company. Key provided Mercer with an attorney but did not actively defend her. Nicholson attempted to settle for the policy limit, but Key delayed. Nicholson then filed a wrongful death suit, and Key offered to settle for the policy limit, which Nicholson rejected. Instead, Nicholson and Mercer agreed that Mercer would assign her rights to sue Key for bad faith to Nicholson, and Nicholson would not execute any judgment against Mercer. Mercer waived her right to a jury trial and did not present a defense. Nicholson won a $3 million verdict.The Leavenworth District Court ruled against Key on the merits, finding that Key acted in bad faith and ordered garnishment for the $3 million judgment. Key did not argue that garnishment was statutorily unavailable due to the assignment of rights at the district court level. On appeal, Key raised the issue of subject-matter jurisdiction for the first time, arguing that garnishment was impossible following an assignment of rights, thus the district court lacked jurisdiction.The Kansas Supreme Court reviewed the case and affirmed the lower courts' decisions. The court clarified that subject-matter jurisdiction is the constitutional power of courts to decide disputes and does not disappear due to a flawed claim. The court held that the district court had jurisdiction to hear Nicholson's garnishment action on the merits. The court emphasized that Key's statutory arguments should have been presented as a motion to dismiss at the district court level and could not be raised for the first time on appeal under the guise of a jurisdictional argument. The judgment of the Court of Appeals and the district court was affirmed. View "Nicholson v. Mercer" on Justia Law

In a dispute between Timothy Towne and the Unified School District No. 259, the Supreme Court of the State of Kansas reversed the lower courts' rulings, finding that self-insured school districts are not exempt from regulation under the Kansas Insurance Code. Towne, an employee of the school district, was injured in a car accident and received benefits from the school district's self-funded medical benefit plan. After Towne recovered funds from a third party, the school district required him to reimburse the plan. Towne claimed that the plan's subrogation clause, which allowed for this reimbursement, was unenforceable under Kansas regulations. The district court and Court of Appeals held that the school district's plan was exempt from the Kansas Insurance Code, thereby making the subrogation clause enforceable. However, the Supreme Court reversed, holding that the medical benefit plan offered by the school district is a "health benefit plan" and the school district is a "health insurer" under Kansas law, making the school district subject to the anti-subrogation regulation. The case was remanded for further proceedings. View "Towne v. U.S.D. 259" on Justia Law

The Supreme Court affirmed the decision of the court of appeals panel reversing the judgment of the district court against Key Insurance Company in this garnishment action brought by Nancy Granados seeking pay under the liability insurance policy Key had issued to John Wilson, holding the court of appeals made the correct conclusion.John Wilson struck a car while he was driving under the influence and killed the driver. The driver's wife, Granados, brought a wrongful death lawsuit against Wilson. The district court entered a judgment against Wilson for nearly $3.5 million. Granados then filed this garnishment action seeking payment from Key under the automobile liability insurance policy it had issued to Wilson and under which Key limited tis coverage for bodily injuries caused by Wilson to $50,000 in the aggregate. Granados argued that, despite the policy limits, Key's negligent and bad-faith handling of Wilson's claim rendered it liable for the entire judgment. The trial court agreed and entered judgment against Key. The court of appeals reversed. The Supreme Court affirmed, holding that Granados failed to meet her burden to prove that Key's handling of the claim caused the judgment exceeding policy limits. View "Granados v. Wilson " on Justia Law

The Supreme Court reinstated the district court's award granting Plaintiff substitution benefits after a court of appeals panel held that married persons cannot be a provider or recipient of substitution services to each other, holding that Plaintiff was entitled to substitution benefits for the amount he promised to pay his wife for what she did resulting from Plaintiff's automobile accident.Insurer insured Plaintiff when he was injured in an automobile accident. When Plaintiff returned from the rehabilitation hospital, he and his wife agreed she would provide caregiver services for $25 a day. Plaintiff sought payment for personal injury protection (PIP) substitution benefits available to him under his policy, but Insurer refused. Litigation ensued, and the district court granted judgment for Plaintiff. The court of appeals reversed, concluding that an injured person's spouse is excluded from providing substitution services. The Supreme Court reversed, holding (1) Kan. Stat. Ann. 40-3103(w) does not expressly preclude Plaintiff's wife from providing substitution services simply because of her marital relationship with Plaintiff; (2) Plaintiff incurred an obligation to pay his wife by entering into a contract with her to perform specific services for him that she would not otherwise have performed while Plaintiff convalesced; and (3) Plaintiff was entitled to PIP substitution benefits. View "Williams v. Geico General Insurance Co." on Justia Law

The Supreme Court reversed the decision of the court of appeals affirming the district court’s garnishment order in favor of a judgment creditor and her insurer, holding that the insurer demonstrated prejudice as a matter of law from its lack of notice of suit.The policy in this case contained a requirement that the insured inform the insurer of a lawsuit arising out of an otherwise covered automobile accident. After the judgment creditor and her insurer obtained the garnishment order, the court of appeals affirmed. The Supreme Court reversed, holding that the stipulated facts established that the insured breached his notice-of-suit duty under the insurance policy and that the insurer was prejudiced by that breach. View "Geer v. Eby" on Justia Law

The Supreme Court reversed the decision of the Court of Appeals affirming the decision of the district court granting summary judgment to The Bar Plan Mutual Insurance Company on Daniel Becker’s insurance coverage dispute with the company, holding that the lower courts erroneously relied upon certain caselaw in granting summary judgment and that, under the correct caselaw, questions of fact remained that were inappropriate for summary judgment.Specifically, the Court held (1) the lower courts erred in relying on the “expansion of coverage” rule in concluding that Becker was asking for the coverage to be expanded beyond the insurance contract’s terms and that that courts should instead have continued their analysis to see if estoppel was appropriate to apply to the facts under the “reservation of rights” rule; and (2) because several genuine issues of material fact remained on the issue of estoppel, this case must be remanded for further proceedings. View "Becker v. Bar Plan Mutual Insurance Co." on Justia Law

The Supreme Court affirmed the decision of the court of appeals affirming the judgment of the district court ordering Devin Wilson to pay Kenneth Risley a jury award in favor of Risley, holding that the district court did not err in determining that the assignment provision in Kan. Stat. Ann. 40-3113a(c) did not divest Risley of the right to recover his medical expenses from the tortfeasor.A jury found Wilson liable in tort for injuring Risley in an automobile accident and awarded Risley the cost of his medical expenses in addition to other compensation. Risley had previously been paid for his medical expenses under the personal injury protection (PIP) coverage of his automobile insurance policy. The jury entered judgment on the entire amount of damages as awarded by the jury. On appeal, Wilson argued that Risley had no right to sue for the medical expenses because the cause of action for those medical expenses had been statutorily assigned pursuant to section 40-3113a(c) to Risley’s PIP insurance carrier. The court of appeals affirmed. The Supreme Court affirmed, holding that Risley was entitled to the full damages as awarded by the jury, including any medical expenses that were duplicative of the PIP benefits Risley received from his PIP insurance carrier. View "McCullough v. Wilson" on Justia Law

Nationwide Mutual Insurance Company issued an automobile insurance policy, which included uninsured motorist coverage, to Melvin Briggs. After Nationwide sent Briggs a notice of nonrenewal of the policy, Briggs was involved in a collision with an uninsured motorist. Briggs's children filed a claim under the Nationwide policy for uninsured motorist benefits, which Nationwide denied. Nationwide subsequently sued Briggs’s children, seeking a declaratory judgment that it had nonrenewed Briggs’s policy before the automobile accident. The U.S. district court granted summary judgment for Nationwide, concluding that it had complied with statutory and policy requirements for notice of nonrenewal. On appeal, the Tenth Circuit Court of Appeals certified a question of law to the Kansas Supreme Court, which answered the certified question as follows: Notice to nonrenew an insurance policy that complies with the procedure set out in Kan. Stat. Ann. 40-3118(b) and a consistent provision in the policy itself is sufficient to force a lapse of coverage, regardless of whether a proper substantive basis for nonrenewal exists under Kan. Stat. Ann. 40-276a(a) and consistent policy language. View "Nationwide Mut. Ins. Co. v. Briggs" on Justia Law

While driving a vehicle owned by her employer (Employer), Appellant was injured in an accident caused by an underinsured motorist. Appellant claimed underinsured motorist (UIM) benefits under Employer’s commercial insurance package policy, which Appellant believed had been insured by Insurer, the same carrier that insured the tortfeasor. Insurer denied Appellant’s claim. A jury awarded Appellant damages, finding the tortfeasor at fault. The district court denied Insurer’s posttrial motion for judgment based upon its claim that it did not issue Employer’s insurance policy and granted Insurer’s motion for credit against the verdict in part, declining, however, to give Insurer credit for future medical expenses. The Supreme Court (1) affirmed the trial court’s denial of Insurer’s motion for judgment as a matter of law on Insurer’s claim that Appellant named the wrong insurance company as the defendant; (2) reversed the district court’s decision on Insurer’s motion for partial summary judgment on future medical expenses and vacated the jury’s award of future medical expenses; and (3) reversed the district court’s denial of Appellant’s motion for attorney fees. Remanded. View "Bussman v. Safeco Ins. Co. of Am. " on Justia Law