Justia Insurance Law Opinion Summaries

Plaintiff was involved in a vehicle collision with another driver, who admitted fault. At the time of the accident, Plaintiff’s vehicle was insured with Farmers Insurance Exchange under a policy that included underinsured motorist (UIM) coverage. After Plaintiff received medical treatment, Plaintiff filed a complaint requesting “all sums due and owing” under her insurance policy with Farmers. During the course of the litigation, Farmers extended settlement offers to Plaintiff, but the case did not settle. The jury returned a verdict in favor of Plaintiff. Thereafter, Plaintiff moved for attorney fees and nontaxable costs under the insurance exception to the American Rule. The district court denied Plaintiff’s motion, concluding that the insurance exception did not apply to Plaintiff’s attorney fees and related costs. The Supreme Court reversed, holding that the district court incorrectly interpreted Montana law when it relied on only the circumstances surrounding the filing of Plaintiff’s complaint to conclude that Plaintiff did not meet the insurance exception. Remanded for further proceedings to determine whether Farmers forced Plaintiff to assume the burden of legal action to obtain the full benefit of her UIM policy, thus entitling her to attorney fees under the insurance exception. View "Mlekush v. Farmers Inc." on Justia Law

In 2009, Plaintiff’s floral shop was destroyed by a fire. State Farm Casualty Insurance Company, with whom Plaintiff had an insurance policy for her business, paid Plaintiff the maximum amount available under her policy, which was approximately $21,105. Plaintiff filed suit against State Farm and insurance agent Shawn Ori, alleging that Ori, acting as State Farm’s agent, had a professional duty to ascertain or advise her of the adequate amount of coverage for her business and that his failure to do so constituted professional negligence. State Farm and Ori jointly moved for summary judgment on the ground that Plaintiff failed to name an expert witness to establish the standard of care applicable to an insurance agent. The district court granted summary judgment in favor of Defendants, concluding that expert testimony was required to establish the standard of care to which Ori was required to conform. The Supreme Court affirmed, holding that Plaintiff’s failure to obtain an expert witness resulted in an insufficiency of proof regarding duty and thus prevented Plaintiff from establishing a prima facie claim of negligence. View "Dulaney v. State Farm Fire & Cas. Ins. Co." on Justia Law

Plaintiff was injured in an accident while driving a business vehicle owned by Mattress King, Inc. and insured by Mountain West Farm Bureau. Plaintiff, whose personal vehicles were insured by Safeco Insurance Company of Illinois, filed a claim with Safeco for medical payment benefits. Plaintiff received medical payment benefits from Safeco and an undisclosed amount of underinsured motorist benefits from Mountain West. Believing Safeco wrongfully refused to pay additional claimed benefits, Plaintiff brought a class action suit against Safeco. The district court ultimately ruled in favor of Safeco. The Supreme Court affirmed, holding that the “other insurance” clauses in Plaintiff’s automobile liability policy were valid and, as applied in this case, did not constitute de facto subrogation. View "Scheafer v. Safeco Ins. Co. of Ill." on Justia Law

Plaintiff was involved in a motor vehicle accident caused by another driver. As a result of the accident, Plaintiff sustained both bodily injury and property damage. Plaintiff carried an automobile insurance policy through United Services Automobile Association General Indemnity Company (USAA). USAA paid vehicle repair and car rental costs, after which it sought subrogation for the property damage expenses from the tortfeasor’s automobile liability insurer. Plaintiff subsequently filed an action on behalf of himself and a putative class of plaintiffs, alleging that USAA violated Montana law by seeking subrogation for property damage loss before its insured had been made whole with respect to related personal injuries. The U.S. district court certified a question to the Montana Supreme Court, which answered by holding that Montana law does not prohibit an insurer from exercising its right of subrogation under the limited, specific circumstances presented in the certified question. View "Orden v. United Servs. Auto. Ass'n" on Justia Law

Mid-Continent Casualty Company provided comprehensive general liability insurance to Scentry Biologicals, the manufacturer of NoMate, a pest control product designed to protect agricultural crops from destructive insects. Applewood Orchards purchased NoMate from Wilbur-Ellis (W-E), a distributor of NoMate, and used the product on its apple crop to protect against moths. After Applewood discovered significant moth damage, it filed a tort action against Scentry and W-E. Scentry and W-E requested that Mid-Continent defend them under Scentry’s policy. Mid-Continent agreed to defend Scentry, reserving its right to determine its coverage obligations later, but refused to defend W-E. Applewood settled with W-E, and a court ruled against Scentry and in favor of Applewood. Meanwhile, Scentry filed a declaratory judgment against against Mid-Continent seeking declaratory relief on coverage issues. W-E and Applewood intervened. The district court granted summary judgment for and awarded damages to Scentry, Applewood, and W-E. The Supreme Court affirmed, holding that the district court did not err in granting the summary judgment motions filed by Scentry, Applewood, and W-E. View "Scentry Biologicals, Inc. v. Mid-Continent Cas. Co." on Justia Law

Steve Sangwin, a State employee, was a qualified subscriber and beneficiary of the State of Montana Employee Benefits Plan (Plan), which was administered by Blue Cross and Blue Shield of Montana (BCBS). Steve's daughter, McKinley, was also a beneficiary under the Plan. This case arose after BCBS denied a preauthorization request for a medical procedure for McKinley on the grounds that the procedure was "experimental for research." Steve and his wife (collectively, the Sangwins) initiated this action by filing an amended complaint setting forth five counts, including a request for certification of a class action. The Sangwins defined class members as other beneficiaries of the Plan who had their employee benefits denied by the State based on the experimental exclusion for research in the past eight years. The district court granted the Sangwins' motion for class certification. The State appealed. The Supreme Court (1) affirmed the district court's order defining the class; but (2) reversed and remanded with respect to the question certified for class treatment, holding that the district court abused its discretion in specifying for class treatment the question of whether the State breached its contract of insurance with the plaintiffs. View "Sangwin v. State" on Justia Law

The Montana Association of Counties Joint Powers Insurance Authority (MACo/JPIA) obtained catastrophic property insurance from Allianz Global Risks US Insurance Company to cover damages over $100,000. The Lincoln County Port Authority (Port) insured a building in its industrial facility through the MACo/JPIA self-insured risk pool. After the building's roof collapsed, MACo/JPIA informed the Port that it would no longer insure the building. The building was subsequently destroyed by a fire, and MACo/JPIA and Allianz refused to cover the loss. The Port filed this suit against Allianz. The district court concluded that the Allianz policy insured the Port and awarded $6,060,980 based on the findings of an appraisal panel. The Supreme Court (1) affirmed the district court's determination that Allianz's policy provided coverage for the building; (2) affirmed the district court's refusal to reform the Allianz policy; (3) reversed the district court's award of "replacement cost" for those portions of the building that the Port had slated for demolition; and (4) remanded to allow the district court to calculate post-judgment interest owed to the Port for the damages owed under the policy. View "Lincoln County Port Auth. v. Allianz Global Risks US Ins. Co." on Justia Law

Appellant was involved in a car accident with Kent Blough. Appellant's insurer, USAA Casualty Insurance Company, concluded that Appellant was the majority at fault for the accident and refused to honor Appellant's $300,000 UM/UIM coverage. Appellant filed suit against Blough, and in an apparent attempt to prevent Appellant from prevailing, USAA unsuccessfully tried to intervene in the lawsuit. Blough's insurer paid Appellant the limit of Blough's insurance policy. USAA's expert eventually determined that Blough, whom USAA had already paid under Appellant's policy, had been the majority at fault. USAA then tendered to Appellant its $300,000 UM/UIM policy limit. Appellant filed a complaint against USAA for, among other claims, violations of the Montana Unfair Trade Practices Act and emotional distress as a result of the mishandling of her claim. The district court entered summary judgment for USAA. The Supreme Court reversed, holding that the district court (1) erred in determining that Appellant may not pursue a claim based upon USAA's alleged failure to reasonably investigate her claim as required under Mont. Code Ann. 33-13-201(4); and (2) erred when it granted summary judgment in favor of USAA regarding Appellant's claim for damages arising from emotional distress. View " McVey v. USAA Cas. Ins. Co." on Justia Law

Johnathon Alfson was injured when Jack McCoy rear-ended Alfson's truck. Because Alfson was unable to return to work he demanded that Allstate Property and Casualty Insurance Company, McCoy's insurer, pay his lost wages in advance of any settlement. Alfson then filed an action seeking a declaration requiring Allstate to issue advance payments for lost wages in the amount of $24,117. The district court granted summary judgment in Alfson's favor and issued a declaratory judgment requiring Allstate to advance pay Alfson's lost wages. The Supreme Court reversed, holding that because the district court considered and relied upon informal letters not supported by sworn affidavits or discovery responses, the court's grant of summary judgment in Alfson's favor and declaratory judgment based on that summary judgment grant were legally infirm. View "Alfson v. Allstate" on Justia Law

Thomas Warner filed a complaint against Robert and Rebecca Hanke for conversion and negligence after Robert Hanke asserted ownership over some personal property Warner was storing on the Hanke's property. At the time the action was filed, Robert and Rebecca Hankes maintained home insurance coverage from a subsidiary of Horace Mann Insurance Company. The Hankes filed a claim with Horace Mann to request a defense against Warner's suit. Horace Mann filed a declaratory judgment action requesting a determination whether the insurance policy required Horace Mann to defend the Hankes. The district court concluded that Horace Mann did not owe coverage to the Hankes for the Warner dispute. The Supreme Court affirmed in part, reversed in part, and remanded, holding that the district court (1) properly determined that the Hankes' insurance policy failed to cover the Warner dispute; (2) correctly determined that Horace Mann's decisions to provide a defense and to pay the settlement of Warner's claims nevertheless allowed Horace Mann to pursue reimbursement for the Hankes' share of the settlement; and (3) abused its discretion in awarding attorney's fees to Horace Mann. View "Horace Mann Ins. Co. v. Hanke" on Justia Law