Justia Insurance Law Opinion Summaries
Articles Posted in New Hampshire Supreme Court
Appeal of Andrew Panaggio
Petitioner Andrew Panaggio appealed a New Hampshire Compensation Appeals Board (Board) determination that respondent, CNA Insurance Company (the insurer), could not be ordered to reimburse him for his purchase of medical marijuana because such reimbursement would have constituted aiding and abetting his commission of a federal crime under the federal Controlled Substances Act (CSA). When Panaggio appealed the insurer’s denial to the New Hampshire Department of Labor, a hearing officer agreed with the insurer. Panaggio appealed the hearing officer’s decision to the Board, which unanimously found that his use of medical marijuana was reasonable and medically necessary. Nonetheless, the Board upheld the insurer’s refusal to reimburse Panaggio, concluding that “the carrier is not able to provide medical marijuana because such reimbursement is not legal under state or federal law.” The New Hampshire Supreme Court surmised the issue on appeal raised a question of federal preemption, "which is essentially a matter of statutory interpretation and construction." Although it was an issue of first impression for the New Hampshire Court, other courts considered whether the CSA preempted a state order requiring reimbursement of an employee’s purchase of medical marijuana. Panaggio reasoned that “[b]ecause New Hampshire law unambiguously requires the insurer to pay for the claimant’s medically related treatment,” an insurer that reimburses a claimant for the purchase of medical marijuana acts without the volition required by the federal aiding and abetting statute. The insurer asserted Panaggio’s argument leads to an absurd result, observing that “[c]onflict preemption applies because state law requires what federal law forbids.” The New Hampshire Supreme Court ultimately concluded the CSA did not make it illegal for an insurer to reimburse an employee for his or her purchase of medical marijuana. "[A] Board order to reimburse Panaggio does not interfere with the federal government’s ability to enforce the CSA. Regardless of whether the insurer is ordered to reimburse Panaggio for his medical marijuana purchase, the federal government is free to prosecute him for simple possession of marijuana under the CSA." Under these circumstances, the Court concluded the “high threshold” for preemption “is not met here.” The Board's decision was reversed and the matter remanded for further proceedings. View "Appeal of Andrew Panaggio" on Justia Law
Genworth Life Ins. Co. v. New Hampshire Dep’t of Ins.
Plaintiff Genworth Life Insurance Company challenged amended regulations promulgated by the New Hampshire Department of Insurance (Department) retroactively limiting rate increases for long-term care insurance (LTCI) policies. Plaintiff provided LTCI to over 6,000 New Hampshire residents. It appealed superior court orders dismissing its claim that the regulations violate the contract clauses of the State and Federal Constitutions, and entering summary judgment for the Department with respect to plaintiff’s claims that the regulations were ultra vires and violated the takings clauses of the State and Federal Constitutions. Because the New Hampshire Supreme Court concluded that the regulations were ultra vires, and, therefore, invalid, the Court reversed and remanded. View "Genworth Life Ins. Co. v. New Hampshire Dep't of Ins." on Justia Law
O’Donnell v. Allstate Indemnity Company
Plaintiff John O’Donnell appealed a superior court order granting summary judgment to defendant Allstate Indemnity Company. Following a November 2015 motor vehicle accident, O’Donnell filed an underinsured motorist claim under a personal umbrella insurance policy that he had purchased from Allstate. Allstate denied the claim. O’Donnell then filed this declaratory judgment action to determine whether his policy provided uninsured motorist coverage. The trial court concluded that O’Donnell’s policy did not provide uninsured motorist coverage, finding that a written waiver of uninsured motorist coverage that O’Donnell had executed in September 2011 remained in effect at the time of the accident. Finding no reversible error in that judgment, the New Hampshire Supreme Court affirmed. View "O'Donnell v. Allstate Indemnity Company" on Justia Law
Zannini v. Phenix Mutual Fire Insurance Company
Plaintiffs Steve and Pamela Zannini, appealed a superior court order granting summary judgment to defendant Phenix Mutual Fire Insurance Company, on plaintiffs’ breach of contract and declaratory judgment claims. In March 2016, the plaintiffs’ Ashland, New Hampshire residence sustained “significant flooding” as the result of burst pipes. The house was insured by defendant, and plaintiffs filed a claim for water damage. Defendant sent an adjuster to investigate, who instructed plaintiffs to remove the floor of the house so that he could investigate the area underneath. After they did so, the house began to collapse, and plaintiffs repaired its framing to prevent it from collapsing completely. As a result of removing the floor, plaintiffs “suffered a complete loss [of the house] and direct physical loss of [their] personal property and use of the [house] for a substantial amount of time.” On May 3, 2016, defendant sent the plaintiffs a letter denying coverage of the damage caused by the collapse. Plaintiffs argued on appeal to the New Hampshire Supreme Court that: (1) a provision in the insurance policy at issue requiring that suits be brought within one year of the date of loss was unenforceable because it violated public policy; and (2) genuine issues of material fact existed as to whether defendant’s communications tolled the one-year period, and defendant was estopped from asserting or waived it as a defense. The Supreme Court affirmed, finding the one-year limitation period did not violate the public policy underlying statutes of limitations. Further, the communications between the parties did not create issues of material fact as to whether the one- year period was tolled or whether the defendant waived or was otherwise estopped from asserting the provision as a defense. View "Zannini v. Phenix Mutual Fire Insurance Company" on Justia Law
Santos v. Metropolitan Property & Casualty Ins. Co.
Defendant Metropolitan Property and Casualty Insurance Company (Metropolitan), appealed a superior court order partially granting and partially denying its summary judgment motion as well as a cross-motion filed by plaintiff Joseph Santos. Santos held a personal excess liability policy with Metropolitan that included excess underinsured motorist (UIM) coverage. After Metropolitan denied a claim made by Santos for excess UIM benefits after Santos was hurt in a motorcycle accident, he brought this declaratory judgment action. The trial court ruled that Metropolitan was liable to Santos for excess UIM benefits. Metropolitan argued the trial court erred in so holding because Santos’s policy required, as a precondition to receiving excess UIM benefits, that he carry a certain amount of underlying insurance coverage, and Santos did not do so. Santos argued his lack of sufficient underlying coverage allowed Metropolitan to reduce its excess UIM liability but not escape it altogether. Finding no error in the superior court's judgment, the New Hampshire Supreme Court affirmed partial summary judgment. View "Santos v. Metropolitan Property & Casualty Ins. Co." on Justia Law
Rizzo v. Allstate Insurance Company
Defendant Allstate Insurance Company appealed a superior court order granting the motion for partial summary judgment filed by plaintiff Joseph Rizzo, and denying the cross-motion for partial summary judgment filed by Allstate. Rizzo alleged he was injured in an automobile accident while a passenger in a car insured by Allstate. Rizzo sought uninsured motorist coverage under the Allstate policy, and, after Allstate denied his claim, the claim went to arbitration. The uninsured motorist provision in the Allstate policy provided that if the arbitration award exceeded $25,000, the financial responsibility limit in New Hampshire, the insured and Allstate had the right to elect a trial de novo following arbitration. Allstate rejected the arbitration award, which exceeded the financial responsibility limits, and requested a trial de novo. The trial court ruled that the trial de novo provision in the policy was not enforceable because it was unconscionable, ambiguous, and violated public policy, and confirmed the arbitration award. The New Hampshire Supreme Court concluded the trial de novo provision did not contravene New Hampshire public policy regarding arbitration. Nor did the Supreme Court find the trial de novo provision unconscionable. Accordingly, the Court reversed and remanded for further proceedings. View "Rizzo v. Allstate Insurance Company" on Justia Law
Langevin v. Travco Insurance Company
Plaintiffs Brian and Nancy Langevin appealed a superior court order denying their motion for summary judgment and granting summary judgment to defendant, Travco Insurance Company (Travco). The trial court ruled that plaintiffs were not entitled to payment from Travco under their medical payments coverage to pay a lien asserted by the plaintiffs’ health insurer because such payment would constitute a “duplicate payment” contrary to the language of both RSA 264:16, IV (2014) and plaintiffs’ automobile insurance policy with Travco. The New Hampshire Supreme Court reversed and remanded. "Although our interpretation does not allow the plaintiffs to retain the benefit of payment from both a health insurer and an automobile insurer for the same medical expense, we recognize that it does leave open the possibility that the plaintiffs will receive a double benefit in a different sense — they may receive and retain the benefit of medical payments coverage, and a recovery from the third-party tortfeasor. This type of double benefit is not prohibited by RSA 264:16, IV." The Court found the plain language of RSA 264:16, IV prohibited duplicate payments for the same medical expense from only two sources: “medical payments coverage and a health insurance policy.” It does not address payments, duplicate or otherwise, from a tortfeasor or a tortfeasor’s liability insurer. Because the statute expressly prohibited “duplicate payment” only from medical payments coverage and a health insurance policy, with no reference to payments from the tortfeasor or the tortfeasor’s liability policy, the Court construed the prohibition on “duplicate payment” as applying only to medical payments from health insurers and automobile insurers. View "Langevin v. Travco Insurance Company" on Justia Law
Russell NGM Insurance Co.
Homeowner-plaintiffs Michelle and Robert Russell appealed a superior court order denying their summary judgment motion and granting that of insurer-defendant NGM Insurance Company. On appeal, the homeowners argued the trial court erred when it determined that their homeowners’ insurance policy provided no coverage for the additional living expenses they incurred when they were unable to live in their home because of mold contamination. Finding no reversible error, the New Hampshire Supreme Court affirmed. View "Russell NGM Insurance Co." on Justia Law
Massachusetts Bay Insurance Company v. American Healthcare Services Association
Defendant Arch Specialty Insurance Company (Arch) appealed multiple superior court orders granting summary judgment to defendants Triage Staffing, Inc. (Triage), Exeter Hospital, Inc. (Exeter), and American Healthcare Services Association (AHSA) on their petitions for declaratory judgment, and denying Arch’s cross-motion for summary judgment. The court ruled that Arch was required to defend and indemnify Triage, Exeter, and AHSA, pursuant to two insurance policies that Arch issued to Triage, for claims asserted against the defendants by patients of Exeter who contracted Hepatitis C (Exeter Patients). On appeal, Arch argued the trial court erred in finding inapplicable certain exclusions found in the insurance policies and in determining that the claims involved multiple occurrences under the policies. After review, the New Hampshire Supreme Court reversed the superior court’s grant of summary judgment in favor of Triage and Exeter regarding Arch’s duty to defend and indemnify them pursuant to the general liability coverage forms; the Court reversed the trial court’s grant of summary judgment in favor of Exeter regarding Arch’s duty to defend and indemnify it pursuant to the umbrella coverage forms; reversed in part and vacated in part the trial court’s grant of summary judgment in favor of Triage regarding Arch’s duty to defend and indemnify it pursuant to the umbrella coverage forms, and remanded all matters to the trial court for further proceedings. View "Massachusetts Bay Insurance Company v. American Healthcare Services Association" on Justia Law
Exeter Hospital, Inc. v. Steadfast Insurance Company
In this declaratory judgment proceeding, petitioner Exeter Hospital, Inc. (Exeter) appealed a superior court order denying its motion for partial summary judgment as to the amount at which coverage was triggered under an umbrella policy (the policy) issued to Exeter by respondent Steadfast Insurance Company (Steadfast). In the spring of 2012, an outbreak of Hepatitis C infections among patients serviced by Exeter’s cardiac catheterization lab led investigators to discover that a technician had spread the virus to patients “through a clandestine drug diversion scheme.” The technician allegedly injected certain drugs into his body by way of intravenous needles, then reused the needles on patients, thereby infecting them with the virus. Numerous lawsuits were lodged against Exeter by affected patients. Exeter was primarily insured through a Self-Insurance Trust Agreement (SIT), which provided professional liability coverage in the amount of $1 million per medical incident, with a $4 million annual aggregate cap. Exeter also maintained the policy with Steadfast, which provided excess health care professional liability coverage. Steadfast maintained that it would pay damages only in excess of the $100,000 retained limit for each medical incident. Exeter filed this proceeding, seeking a declaration that it was not required to pay $100,000 retained limit per claim. The trial court interpreted the term “applicable underlying limit” as being a variable amount “dependent on the actual coverage remaining under [the] other [limits of] insurance,” here, the limits of the SIT. Because Exeter had paid out the limits of the SIT, the court found that the “applicable underlying limit” was zero, thereby rendering the $100,000 retained limit greater than the “applicable underlying limit.” Thus, the court determined that, pursuant to “Coverage A,” Steadfast was required “to pay damages in excess of $100,000 for each medical incident.” Exeter sought reconsideration of the court’s order, which the court denied. Although the New Hampshire Supreme Court did not agree with every underlying argument pressed by Exeter, it concluded that its overall argument regarding the interpretation of Coverage A was reasonable, and the trial court therefore erred in granting partial summary judgment as to the terms of Coverage A. View "Exeter Hospital, Inc. v. Steadfast Insurance Company" on Justia Law