Justia Insurance Law Opinion Summaries

In 2009 Universal demanded payment from Allstate for medical services that Universal allegedly rendered to 36 persons claiming coverage under Allstate insurance policies. Allstate denied payment, contending that Universal had not, in fact, rendered any services to those persons. Universal filed suit asserting claims for reimbursement, for defamation, and for tortious interference with business relationships. In November 2009, Allstate served Universal with interrogatories and document requests. Universal failed to respond for more than two months, so Allstate filed a motion to compel. In May 2010, the magistrate judge granted Allstate’s motion and ordered Universal to “provide full and complete responses” no later than June 7, 2010. Again Universal did not respond by the deadline or by an extended deadline. Universal finally responded on October 6, but its responses were incomplete. After Universal failed to supplement or to Allstate’s efforts to depose employees, Allstate filed a second motion to dismiss, which was granted. The Sixth Circuit affirmed, noting that Allstate’s repeated motions, and the court’s own orders, were not enough to compel Universal to do what the Rules required. “Universal’s conduct violated the rules of civil procedure and common courtesy alike” View "Universal Health Grp. v. Allstate Ins. Co." on Justia Law

Defendants Robert Christy, Christy & Tessier, P.A., Debra Johnson, and Kathy Tremblay, appealed a superior court decision that rescinded a professional liability policy issued by Plaintiff Great American Insurance Company (GAIC), to the law firm of Christy & Tessier, P.A. Robert Christy (Christy) and Thomas Tessier (Tessier) were partners in the firm, practicing together for over forty-five years. In 1987, Frederick Jakobiec, M.D. (Jakobiec) retained Tessier to draft a will for him. In 2001, Jakobiec's mother, Beatrice Jakobiec (Beatrice), died intestate. Her two heirs were Jakobiec and his brother, Thaddeus Jakobiec (Thaddeus). Jakobiec asked Tessier, who was Beatrice's nephew, to handle the probate administration for his mother's estate. From 2002 through 2005, Tessier created false affidavits and powers of attorney, which he used to gain unauthorized access to estate accounts and assets belonging to Jakobiec and Thaddeus. Litigation ensued; two months after Tessier and Jakobiec entered into the settlement agreement, Christy executed a renewal application for professional liability coverage on behalf of the law firm. Question 6(a) on the renewal application asked: "After inquiry, is any lawyer aware of any claim, incident, act, error or omission in the last year that could result in a professional liability claim against any attorney of the Firm or a predecessor firm?" Christy's answer on behalf of the firm was "No." The trial court found that Christy's negative answer to the question in the renewal application was false "since Tessier at least knew of Dr. Jakobiec's claim against him in 2006." On appeal, the defendants argued that rescission was improper because: (1) Christy's answer to question 6(a) on the renewal application was objectively true; (2) rescission of the policy or denial of coverage would be substantially unfair to Christy and the other innocent insureds who neither knew nor could have known of Tessier's fraud; and (3) the alleged misrepresentation was made on a renewal application as opposed to an initial policy application. GAIC argued that rescission as to all insureds is the sole appropriate remedy given the material misrepresentations in the law firm's renewal application. Upon review, the Supreme Court held that the trial court erred as a matter of law in ruling that Tessier's knowledge is imputed to Christy and the other defendants thereby voiding the policy ab initio. The Court made no ruling, however, as to whether any of the defendants' conduct would result in non-coverage under the policy and remanded for further proceedings. View "Great American Insurance Company v. Christy" on Justia Law

Miller, a Fund beneficiary, fell from a ladder and was injured. He hired attorney Darr on a contingent fee basis to sue the person who was supposed to hold the ladder. The Fund advanced $86,709.73 in medical and disability benefits on the condition that Miller repay from any recovery, without deducting attorneys’ fees. Miller and Darr, signed a subrogation agreement. The lawsuit settled for $500,000. Calculating his fee based on $413,290.27, Darr submitted $57,806.48 to the Fund, stating that he was withholding $28,903.25 as a fee. To avoid jeopardizing Miller’s benefits Darr later submitted the $28,903.25. The Fund indicated that if Darr pursued his claim, it would consider Darr and Miller in breach of Plan terms and in repudiation of the subrogation agreement and would consider terminating coverage and seeking relief under ERISA. Darr sued the Fund in Illinois state court under the common fund doctrine, which permits a party who creates a fund in which others have an interest to obtain reimbursement for litigation expenses incurred in creating that fund. The district court enjoined Darr’s lawsuit. The Seventh Circuit vacated. A federal court may not enjoin “proceedings in a State court except as expressly authorized by Act of Congress, or where necessary in aid of its jurisdiction, or to protect or effectuate its judgments,” 28 U.S.C. 2283.View "Trs. of the Carptenters' Health & Welfare Trust v. Darr" on Justia Law

Attorneys Post and Reid were retained to defend a medical malpractice action. At trial, plaintiffs introduced evidence suggesting that Post and Reid had engaged in discovery misconduct. Fearing that the jury believed that there had been a “cover-up” involving its lawyers, and concerned with the “substantial potential of uninsured punitive exposure,” the hospital, represented by new counsel, settled the case for $11 million, which represented the full extent of its medical malpractice policy limits. The settlement did not release Post, Reid, the law firm where they began representation of the hospital, or their new firm from liability. The hospital threatened Post with a malpractice suit and sought sanctions. Post eventually brought claims of bad faith and breach of contract against his legal malpractice insurer. The district court awarded $921,862.38 for breach of contract. The Third Circuit affirmed summary judgment in favor of the insurer on the bad faith claim and remanded for recalculation of the award, holding that, under the policy, the insurer is responsible for all costs incurred by Post in connection with the hospital’s malpractice claim from October 12, 2005 forward and for all costs incurred by Post to defend the sanctions proceedings from February 8, 2006 forward. View "Post v. St. Paul Travelers Ins. Co." on Justia Law

After an attorney filed a settlement offer under Rule 68, opposing counsel accepted the offer. Before either attorney filed the offer and acceptance with the Superior Court, the accepting attorney realized he had made a mistake, and revoked his acceptance. The attorney who had extended the offer responded to his revocation by filing the written acceptance, thereby securing a final judgment in the form of the settlement order by means of Super. Ct. Civ. R. 68’s instruction to the Prothonotary. The attorney did not mention that the written acceptance had been revoked before it was filed. Upon review, the Supreme Court reversed the Superior Court judge’s order denying the Motion to Vacate the Judgment, and remanded the case for further proceedings. View "Ceccola v. State Farm Mutual Automobile Insurance Co." on Justia Law

Employee filed a workers' compensation claim against Employer. Employer's Insurer accepted liability for Employee's claim. Insurer contracted with third-party Adjuster to provide services for Employee's claim. Employee and Insurer disagreed over elements of the claim, and Attorney advised Insurer on various legal matters. The claim was eventually resolved. Employee then filed the present action for unfair claims settlement practices, naming Insurer and an employee of Adjuster as defendants. Employee served Employer with a subpoena requesting, inter alia, a letter Attorney wrote to Adjuster's employee concerning the underlying case. Employer and Insurer objected to the subpoena, citing attorney-client privilege and the work-product doctrine. The court denied the motions. Insurer then petitioned the Supreme Court for a writ of supervisory control. The Court dismissed the petition, holding that the district court correctly applied the law of attorney-client privilege but incorrectly analyzed the work product doctrine. However, because the court reached the proper conclusion, supervisory control was unnecessary.

Tracy Stanfield was injured in 1992. A settlement relating to his injuries resulted in an annuity providing periodic payments to Stanfield from Metropolitan Life Insurance Company (MetLife). Stanfield assigned certain annuity payments, and the assignee in turn assigned them to J. G. Wentworth S.S.C. Limited Partnership (Wentworth). Stanfield later caused MetLife to ignore the assignments to Wentworth. Wentworth filed an action in a Pennsylvania state court and obtained a judgment against Stanfield. Wentworth then filed a motion for a judgment against MetLife for the same amount. A Pennsylvania court granted the motion. Soon thereafter, Stanfield's mother Mildred filed a petition in an Oklahoma district court to be appointed guardian of her son's estate. MetLife filed an interpleader action in a Pennsylvania federal district court and named Wentworth and Mildred in her capacity as guardian of her son's estate as defendants. Mildred asked attorney Loyde Warren to accept service of process on her behalf, and he agreed. Stanfield signed Warren's contingency fee agreement; Warren then engaged local counsel in Pennsylvania. At the settlement conference the parties agreed that Wentworth's judgment would be withdrawn; payments would be paid from Stanfield's annuity payments to Wentworth; the annuity assignment was rescinded; and future annuity payments from MetLife to Stanfield, as guardian, would be made payable in care of Warren. In 2009, Warren filed a motion in the open and continuing guardianship case before the Oklahoma district court for approval of both the 2001 contract for legal representation and the payment of legal fees made pursuant to that contract. Mildred objected and among her arguments, she maintained that a contingency fee for successfully defending a client from a judgment was improper, and that the fee agreement was unenforceable because it had not been approved by the guardianship court. The district court denied Warren's motion, "[b]ecause the application was not filed prior to payment of the fee and was not filed until nearly eight years after the contract was executed." The Court of Civil Appeals affirmed, and Warren appealed. Upon review, the Supreme Court held that (1) the district court possessed jurisdiction to adjudicate a guardianship proceeding a motion seeking court approval of a lawyer's contingent fee contract; (2) the guardian's failure to obtain court approval of a contingent fee agreement prior to payment pursuant to that agreement is not, by itself, a legally sufficient reason for a court to deny a motion to approve the agreement; and (3) the mere passage of time between creation of a contingent fee agreement and when it is presented to a court for approval in an open and continuing guardianship proceeding is not a legally sufficient reason to deny approval of that agreement.

This case involved a legal malpractice claim brought by Plaintiff MB Industries, LLC (MBI) against attorneys Steven Durio and John Weinstein. The attorneys represented MBI in an ultimately unsuccessful lawsuit against former MBI employees. Rather than appeal the unfavorable judgment, MBI chose to sue its former attorneys. The issues before the Supreme Court were: (1) whether a party's failure to appeal an underlying judgment waived any right to bring a legal malpractice claim based on that judgment; and (2) whether summary judgment was properly granted in light of MBI's failure to introduce expert testimony to establish the applicable standard of care which would have demonstrated the attorneys' actions fell below that standard. After careful review, the Court found that Louisiana law does not impose a "per se" rule requiring an appeal before a client can sue his former attorney. Furthermore, the Court found that a party alleging legal malpractice must introduce expert testimony to establish a standard of care "except in those rare cases involving malpractice so egregious that a lay jury could infer the defendant's actions fell below any reasonable standard." The Court found that under the particular facts of this case, there were no genuine issues of material fact, and that MBI failed to establish it could satisfy its evidentiary burden of proof at trial. The attorneys were entitled to judgment as a matter of law. Accordingly, the Court reversed the appellate court and reinstated the trial court's original judgment in favor of the attorneys.

Appellants appealed an order revoking their pro hac vice admissions in connection with a putative class action suit where the suit alleged that appellants' clients breached supplemental cancer insurance policies that they had issued. At issue was whether the district court erred in revoking appellants' pro hac vice status where the revocation was based on motions appellants filed in response to plaintiffs' request for class certification, chiefly a motion to recuse the district judge based on his comments during an earlier hearing. The court vacated the revocation order and held that, even though the recusal motion had little merit, the district court erred in revoking appellants' pro hac vice admissions where it did not afford them even rudimentary process.