Justia Insurance Law Opinion SummariesArticles Posted in Missouri Supreme Court
Nevils v. Group Health Plan, Inc.
Plaintiff was injured in an automobile accident. Group Health Plan, Inc. (GHP) paid Plaintiff’s medical bills. Plaintiff subsequently recovered a personal injury settlement from the tortfeasor. GHP, through its agent, ACS Recovery Services, Inc. (ACS), asserted a lien against Plaintiff’s settlement, seeking reimbursement or subrogation for its payment of Plaintiff’s medical bills. Plaintiff filed a class action petition against GHP asserting several claims based on the premise that Missouri law does not permit the subrogation of tort claims. ACS intervened. The trial court entered summary judgment for GHP and ACS, concluding that the Federal Employee Health Benefits Act (FEHBA) preempts Missouri’s anti-subrogation law. The Supreme Court reversed, holding that FEHBA does not preempt Missouri law barring subrogation of personal injury claims. Remanded. View "Nevils v. Group Health Plan, Inc." on Justia Law
Posted in: Class Action, Injury Law, Insurance Law, Missouri Supreme Court
Columbia Cas. Co. v. HIAR Holding, LLC
A class of Plaintiffs brought suit against Insured, a hotel proprietor, alleging that Insured violated the Telephone Consumer Protection Act (TCPA). The class and Insured subsequently reached a settlement. The class then filed a garnishment action against Insurer. Insurer sought a declaratory judgment that its policy with Insured did not provide coverage because the policy did not cover damages awarded related to the TCPA. The trial found (1) Insurer owed Insured a duty to defend in the class actions because the class's claims were covered under the policy; and (2) Insurer had a duty to indemnify Insured for the full settlement plus interest. The Supreme Court affirmed, holding (1) the trial court correctly determined that Insurer wrongly refused to defend Insured under its policy coverage; (2) Insurer was not entitled to a reassessment of the reasonableness of the settlement; and (3) policy limits did not bar Insurer's indemnification of the settlement. View "Columbia Cas. Co. v. HIAR Holding, LLC" on Justia Law
Posted in: Class Action, Consumer Law, Contracts, Insurance Law, Missouri Supreme Court
Steele v. Shelter Mut. Ins. Co.
Plaintiff's young son was injured by an uninsured motorist while he was a passenger in his daycare provider's van. Plaintiff filed a petition on behalf of her son against the daycare provider's insurance company, Shelter Mutual, alleging that her child was an "insured" under the uninsured motorist provisions of the policy. The policy defined "insured" to include owners, operators, and other users who exercise physical control of the right of control of the vehicle. The trial court granted summary judgment to Shelter. Plaintiff appealed, arguing that the uninsured motorist statute requires coverage of all passengers within the definition of "user." The Supreme Court affirmed, holding that Plaintiff's child was not an insured because (1) Plaintiff's child was not included in the definition of "insured" under the policy itself; (2) the financial responsibility law implies coverage as a matter of law in a policy for owners, operators and users to the extent that liability may be imposed on them under Missouri law for damages arising out of such ownership, operation, or use; and (3) Plaintiff's child did not come within this scope of coverage. View "Steele v. Shelter Mut. Ins. Co." on Justia Law
Posted in: Contracts, Insurance Law, Missouri Supreme Court
U.S. Dep’t of Veterans Affairs v. Boresi
Veteran filed a claim for workers' compensation benefits alleging that he sustained an injury during the course of his employment with Employer. Veteran received care and treatment for that injury at a United States Department of Veterans Affairs (VA) medical facility, which Employer did not authorize. The VA petitioned for a writ to compel the chief ALJ to allow the VA's intervention in the proceeding, claiming entitlement to intervene as a matter of right under 38 U.S.C. 1729 and the U.S. Constitution's supremacy clause. The circuit court denied the VA's petition. The Supreme Court reversed and issued a permanent writ of mandamus, holding that section 1729 and the supremacy clause gave the VA the right to intervene in Veteran's workers' compensation claim to assert its claim for recovery of health care provided to him. View "U.S. Dep't of Veterans Affairs v. Boresi" on Justia Law
Travelers Prop. Cas. Co. of Am. v. Manitowoc Co., Inc.
A construction crane owned and operated by a construction company (Jacobsmeyer) fell on a building. Jacobsmeyer's insurer (Travelers) reached a settlement agreement with the designer and manufacturer of the crane (Grove) wherein Grove agreed to pay Jacobsmeyer and Travelers (hereinafter referred to collectively as Jacobsmeyer) for a majority of their remaining losses associated with the accident. Jacobsmeyer subsequently sued Grove and its parent company (hereinafter referred to jointly as Manitowoc) for breach of the settlement agreement. Manitowoc filed third-party petition claims for contribution and/or indemnity against U.S. Steel, alleging that U.S. Steel's predecessor-in-interest provided the faulty steel for the crane. The trial court dismissed Manitowoc's third-party petition with prejudice because Manitowoc failed to satisfy pleading requirements where it did not admit its own liability as a joint tortfeasor in its third-party petition. The Supreme Court reversed, holding that a party seeking contribution or indemnity need not admit its own fault in its third-party petition but rather can deny liability in its answer to the plaintiff's petition and assert in its third-party petition that if it is liable to the plaintiff, then the third-party defendant is liable to it. Remanded. View "Travelers Prop. Cas. Co. of Am. v. Manitowoc Co., Inc." on Justia Law
Posted in: Contracts, Injury Law, Insurance Law, Missouri Supreme Court
Manner v. Schiermeier
Appellant suffered extensive injuries while riding a motorcycle that was hit by a vehicle driven by Tortfeasor. Appellanat recovered $100,000 from Tortfeasor's insurance company, which left Appellant with $1.4 million in unpaid damages. Appellant sought additional recovery under the underinsured motorist coverage endorsement of the American Family policy he had purchased for the motorcycle and under the underinsured motorist coverage endorsements of each of the additional American Family insurance policies he had purchased for his two trucks. He also sought recovery as an additional insured on the American Standard policy his father maintained for a motorcycle. Both insurers denied coverage under all of these four policies. Appellant then joined both insurers as additional defendants, claiming he was entitled to $400,000 in underinsured motorist coverage under the four policies. The trial court granted summary judgment in favor of the insurers, holding that the policies' owned-vehicle exclusions unambiguously applied to the motorcycle he was riding at the time of the accident. The Supreme Court reversed, holding (1) Tortfeasor's vehicle was an underinsured motor vehicle; (2) the insurers failed to show that the owned-vehicle exclusion applied; and (3) the "other insurance" clause permitted stacking of the underinsured motorist coverage, and offset was not permitted. View "Manner v. Schiermeier" on Justia Law
Posted in: Injury Law, Insurance Law, Missouri Supreme Court
Mendenhall v. Prop. & Cas. Ins. Co. of Hartford
Ruth Mendenhall appealed a summary judgment in favor of Property and Casualty Insurance Company of Hartford on her equitable garnishment claim seeking insurance coverage for the death of her husband, Len Mendenhall. The trial court's judgment was premised on the conclusion that Len was an "employee" under the terms of the Hartford policy and, therefore, was excluded from coverage. The Supreme Court reversed the judgment of the trial court, holding that, given the facts of this case and the policy language, Len was not an "employee" but was instead a "temporary worker" subject to coverage under the terms of the Hartford policy. View "Mendenhall v. Prop. & Cas. Ins. Co. of Hartford" on Justia Law
Posted in: Contracts, Insurance Law, Labor & Employment Law, Missouri Supreme Court
Emerson Elec. Co. v. Marsh & McLennan Cos.
Insured appealed the circuit court's grant of judgment on the pleadings to Broker on Insured's claims that Broker violated a fiduciary duty of loyalty to Insured by not disclosing that Broker received contingent commissions from Insurers for directing Insured's business to them and that Broker kept all interest earned on the premiums Insured sent it between the time Broker received them and the time they were forwarded to the Insurers. In addition, Insured argued that Broker breached a duty to find it the least costly policy possible. The Supreme Court reversed, holding (1) brokers do not have a duty to find insureds the lowest possible cost insurance available to meet their needs; (2) Missouri law specifically authorizes a broker to receive commissions from the insurer and to deposit premiums in an account pending their payment to the insurer or refund to the insured; but (3) the trial court erred by dismissing the petition because it could not be said as a matter of law that Emerson could not recover on one or more of its claims. Remanded.
Posted in: Business Law, Commercial Law, Consumer Law, Insurance Law, Missouri Supreme Court
Schmitz v. Great American Assurance Co.
A young woman died from injuries she sustained after falling from a portable rock climbing wall at a minor league baseball game. Her parents sued the team's owner, who had an excess insurance policy with Respondent Great American Assurance Company (Great American). To protect himself from additional liability, the team owner entered into an agreement with the parents that limited collection of any judgment to the limits of both primary and excess insurance policies. The trial court entered judgment against the team owner, finding him liable, and awarded $4 million in damages. The parents then brought an equitable garnishment suit to collect against the primary and excess policies. The primary insurers settled for less than their policy limit. However, the parents entered a release of judgment for the full policy limit. The excess insurer, Great American, disputed its obligation to pay under its policy because the primary insurance limit had not been exhausted. The appellate court agreed with Great American, and denied the parents equitable garnishment. The parents appealed, arguing that the excess insurance policy did not require exhaustion before it was obligated to pay. The Supreme Court reviewed the policy and found it had no provisions requiring exhaustion. The Court reversed the appellate court on the exhaustion issue, and affirmed the lower court's decision on all other matters brought on appeal.
Posted in: Injury Law, Insurance Law, Missouri Supreme Court