Justia Insurance Law Opinion SummariesArticles Posted in Montana Supreme Court
Cramer v. Farmers Insurance Exchange
In this insurance dispute, the Supreme Court reversed in part the entry of summary judgment in Plaintiff’s declaratory action regarding underinsured motorist coverage (UIM) in favor of Farmers Insurance Exchange, holding that the district court erred by holding that Farmers could offset its underinsured motorist coverage (UIM) obligation to Plaintiff dollar-for-dollar with GEICO’s entire UIM payment.Plaintiff was one of five passengers injured in an accident. The tortfeasor was underinsured by $48,686 as to Plaintiff’s damages. The vehicle in which Plaintiff was a passenger was insured by GEICO, and Plaintiff carried personal vehicle coverage with Farmers, including medical payment (MedPay) coverage and UIM coverage. GEICO paid Plaintiff its individual UIM coverage limit and Farmers paid Plaintiff under her MedPay coverage. In total, Plaintiff received payments of $2,500 less than her total stipulated damages. Disputes Plaintiff had with Farmers led Plaintiff to file this declaratory action. The district court held in Farmers’ favor on the two contested issues. The Supreme Court held (1) the policy language did not permit Farmers to offset its UIM obligation dollar-for-dollar with the entire GEICO UIM payment; (2) Farmers was entitled to offset its UIM obligation with its MedPay payments to Plaintiff; and (3) Plaintiff was entitled to recover attorney fees. View "Cramer v. Farmers Insurance Exchange" on Justia Law
ALPS Property & Casualty Insurance Co. v. McLean & McLean
The Supreme Court affirmed in part and reversed and remanded in part the district court’s grant of summary judgment in favor of ALPS Property & Casualty Insurance Company (ALPS) in this declaratory action, holding that the district court erred when it determined that ALPS properly rescinded an insurance policy, which the court rendered void from the inception of the coverage period for Michael McLean and McLean & McLean, PLLP (M&M), but the court did not err in concluding that no coverage existed as to third-party claimants Miantae McConnell and Joseph and Marilyn Micheletti.Specifically, the Court held (1) the district court erred in concluding that Mont. Code Ann. 33-15-403 provided for a right to rescind the policy; and (2) the district court did not err when it concluded that the third-party claims were barred because they were lodged after ALPS had cancelled the policy or were excluded from coverage under other policy provisions. View "ALPS Property & Casualty Insurance Co. v. McLean & McLean" on Justia Law
Reservation Operations Center LLC v. Scottsdale Insurance Co.
The Supreme Court reversed the district court’s deemed denial of Scottsdale Insurance Company’s motion to set aside the default judgment entered against it, holding that Scottsdale satisfied its burden of establishing that doubt existed concerning whether service was properly effectuated.National Parks Reservations (NPR) filed a complaint and demand for jury trial, naming Scottsdale. Because Scottsdale was a foreign insurer, NPR was statutorily required to serve Scottsdale through the Office of the Montana State Auditor, Commissioner of Securities and Insurance (the Commissioner). The Commissioner, in turn, was statutorily required to forward the complaint and summons to Scottsdale. After Scottsdale failed to appear the district court entered a partial default judgment against Scottsdale. Scottsdale moved to set aside the default judgment, arguing that both NPR and the Commissioner had failed strictly to comply with foreign insurer service requirements under Mont. Code Ann. 33-1-603(1), and, thus, the default judgment was void. Scottsdale’s motion was deemed denied. The Supreme Court reversed, holding that Scottsdale established that doubt existed regarding whether service was properly completed by the Commissioner. View "Reservation Operations Center LLC v. Scottsdale Insurance Co." on Justia Law
Marshall v. Safeco Insurance Co. of Illinois
In this insurance coverage dispute, the district court erred in concluding that Plaintiff’s claim under the Unfair Trade Practices Act (UTPA) and the Declaratory Judgment Act should be dismissed.Plaintiff was involved in an accident while she was a passenger in a car driven by Kevin Gallivan. Peter Kirwan owned the vehicle, and Safeco Insurance Company insured Kirwan. Mid-Century Insurance Company insured Gallivan. Plaintiff sued Safeco and Mid-Century (collectively, Defendants), and the parties entered into a settlement agreement. Plaintiff subsequently brought this lawsuit against Defendants bringing claims seeking declaratory judgment and violations under the UTPA and alleging that Defendants used the collateral source statute to justify reduction in her damages notwithstanding that the collateral source statute was inapplicable. The district court granted Defendants’ motion to dismiss. The Supreme Court reversed, holding (1) even if Defendants had a reasonable basis to apply the collateral source statute, the court failed to consider the plain language of the statute and whether it was applicable in Plaintiff’s case; and (2) Plaintiff sufficiently pled an independent cause of action under the UTPA to overcome Defendants’ joint motion to dismiss. View "Marshall v. Safeco Insurance Co. of Illinois" on Justia Law
Moreau v. Transportation Ins.
Christita Moreau appealed a Workers’ Compensation Court (WCC) order denying her motion for summary judgment and granting summary judgment to Transportation Insurance Company. Moreau’s husband Edwin worked at the W.R. Grace mine near Libby. In 2009, he died from asbestos-related lung cancer. In 2010 Moreau, as personal representative of Edwin’s estate, filed a workers’ compensation claim for occupational disease benefits. Transportation Insurance Company (Transportation) was W.R. Grace’s workers’ compensation insurer, and it denied liability for the claim. Edwin’s employer, W.R. Grace, established and funded the Libby Medical Plan (LMP) to pay the medical expenses of its employees who were injured by exposure to asbestos. LMP paid approximately $95,000 of Edwin’s medical expenses. In 2012, as part of Grace’s bankruptcy, “certain rights and duties of the LMP” were transferred to the Libby Medical Plan Trust. Grace remained responsible for LMP’s “ongoing payment obligations” incurred before that time. In 2013, Transportation accepted liability for the workers’ compensation claim and entered a settlement with Moreau. Transportation agreed to reimburse Medicaid, other providers, and Moreau personally for medical expenses each had paid for Edwin’s care. The parties stipulated that Transportation paid all of Edwin’s medical bills or reimbursed the other persons or entities that had paid them. Transportation did not reimburse the LMP for the $95,846 of Edwin’s medical bills it had previously paid because the LMP refused to accept it. After the LMP refused to accept reimbursement from Transportation, Moreau demanded that Transportation pay the $95,000 either to Edwin’s Estate, to the LMP or its successor, or to a charity selected by the Estate. Transportation refused and Moreau filed a second petition with the WCC to resolve the issue. The WCC determined that all of Edwin’s medical care costs had been paid; that Edwin had no liability to any health care provider; and that he had no right to claim any further payment from Transportation. The WCC determined that if the Estate were to receive the $95,000 from Transportation it would represent a double recovery because Edwin had already received the medical benefits themselves. The Court concluded that Moreau therefore lacked standing to proceed Moreau’s petition. The WCC also found that Moreau’s attorneys also represented the LMP Trust “for purposes of recovering the disputed $95,846” for the LMP Trust. At the time of the WCC order, the LMP Trust was not a party to this action and had not advanced a claim in the WCC for reimbursement of the amount paid by its predecessor LMP. The WCC therefore granted summary judgment to Transportation. Finding no reversible error in that WCC decision, the Montana Supreme Court affirmed. View "Moreau v. Transportation Ins." on Justia Law
Teeter v. Mid-Century Insurance Co.
The Supreme Court reversed the order of the district court granting Jennifer Teeter’s motion for summary judgment in this declaratory action filed by Teeter against Mid-Century Insurance Company, Teeter's insurer, seeking payment of medical expenses and lost wages after an accident. The district court concluded that Teeter made a prima facie showing that it was reasonably clear that her medical expenses and wage losses were causally related to the accident and that the opinions of certain doctors did not create a disputed issue of material fact as to medical causation and damages. The Supreme Court disagreed and remanded the case for further proceedings, holding that there was a clear dispute of material fact regarding causation because it was not reasonably clear if Teeter’s expenses were causally related to the accident. View "Teeter v. Mid-Century Insurance Co." on Justia Law
Mlekush v. Farmers Insurance Exchange
An injured first party insured who is compelled to sue for underinsured motorist (UIM) benefits and recovers more at trial than the last insurance company offer, the insurer must pay the first party insured’s attorney fees in an amount determined by the district court to be reasonable.Plaintiff in this case filed suit against Farmers Insurance Exchange, demanding her UIM policy limits. After Farmers extended its final offer of $77,500 to settle the claim, the jury returned a verdict in the amount of $450,000 in favor of Plaintiff. Judgment was entered for the policy limit amount of $200,000. The district court denied Plaintiff’s motion for attorney fees. The Supreme Court reversed, holding that Farmers was required to pay Plaintiff’s attorney fees because Plaintiff was compelled to sue and the jury returned a verdict higher than the amount of the last offer made by Farmers to settle her UIM claim. View "Mlekush v. Farmers Insurance Exchange" on Justia Law
Mlekush v. Farmers Insurance Exchange
An injured first-party insured who is compelled to sue for underinsured motorist (UIM) benefits and recovers more at trial than the last insurance company offer is entitled to recover his or her attorney fees in an amount subsequently determined by the district court to be reasonable.In this case, Plaintiff was compelled to sue Insurer. The jury returned a verdict higher than the amount of the last offer made by Insurer to settle her UIM claim. The Supreme Court held that Insurer was required to pay Plaintiff’s attorney fees. The court thus reversed the district court order denying fees and remanded the case for further proceedings. View "Mlekush v. Farmers Insurance Exchange" on Justia Law
Kilby Butte Colony, Inc. v. State Farm Mutual Automobile Insurance Co.
The Supreme Court affirmed the order of the district court granting summary judgment to State Farm Mutual Automobile Insurance Company on Kilby Butte Colony, Inc.’s complaint filed after State Farm declined the Colony’s underinsured motorist (UIM) claim submitted on behalf of Mary Ann and Ivan Stahl. The Stahls, members of the Kilby Butte Hutterite Colony, were injured in an automobile accident. Hutterite colony members own assets of the community collectively, and therefore, the Stahls could not own a vehicle in their individual capacities. All of the Colony’s auto insurance policies were purchased through State Farm, and no individual Colony members were listed as named insureds on any vehicle owned by the Colony. The district court determined the the Stahls did not qualify for UIM coverage because they did not satisfy the definition of an “insured” within the terms of the policy. The Supreme Court affirmed, holding that the district court did not err in finding that the Stahls did not satisfy the unambiguous definition of “insured” under UIM coverage in the policy and that they were therefore not entitled to those benefits. View "Kilby Butte Colony, Inc. v. State Farm Mutual Automobile Insurance Co." on Justia Law
Huckins v. United Services Automobile Ass’n
Jessica Huckins filed a complaint against Barry Van Sickle and his real estate agent alleging several causes of action related to Van Sickle’s failure to disclose previous basement flooding problems in the sale of his home. At all relevant times, Van Sickle held three insurance policies through United Services Automobile Association (USAA). USAA denied coverage for the claims stated in the underlying complaint. Van Sickle settled the underlying litigation with Huckins by way of a consent judgment and Van Sickle’s assignment of all claims under his insurance policies to Huckins in exchange for a covenant not to execute. Huckins then brought this case against USAA, alleging, inter alia, breach of duty to defend Van Sickle. The district court concluded that USAA had not breached its duty to defend under any of the policies because the claim did not constitute an “occurrence” as defined by the policies. The Supreme Court reversed, holding (1) USAA had a duty to defend Van Sickle, at least until a ruling was obtained declaring there was no coverage; and (2) by failing to defend Van Sickle, USAA breached its duty to defend. View "Huckins v. United Services Automobile Ass’n" on Justia Law