Justia Insurance Law Opinion Summaries

Goodwill Industries of Central Oklahoma, Inc., suspended operations of its retail stores and donations centers on March 25, 2020, to comply with state and local orders regarding the COVID-19 pandemic. After suffering losses due to the shutdown, Goodwill sued its insurer, Philadelphia Indemnity Insurance Company (“Philadelphia”), under its commercial lines policy. The policy provided coverage for “loss of Business Income” when the insured must suspend its operations due to “direct physical loss of or damage to” covered property. The district court granted Philadelphia’s motion to dismiss, concluding the policy did not cover Goodwill’s loss and that the policy’s Virus Exclusion barred coverage. Finding no reversible error in that judgment, the Tenth Circuit affirmed. View "Goodwill Industries Central v. Philadelphia Indemnity" on Justia Law

An employee of a nonprofit serving disabled adult clients used her position to embezzle more than half a million dollars held by the nonprofit for its clients. After the embezzlement was discovered, Travelers Casualty & Surety Company, the nonprofit's insurance company, made the nonprofit whole. Travelers then sought contribution from the bank in federal court. By submitting certified questions of Washington law, that court has asked the Washington Supreme Court to decide, among other things, whether a nonpayee's signature on the back of a check was an indorsement. Furthermore, the Court was also asked whether claims based on unauthorized indorsements that are not discovered and reported to a bank within one year of being made available to the customer are time barred. The Supreme Court answered yes to both questions. View "Travelers Cas. & Sur. Co. v. Wash. Trust Bank" on Justia Law

Petitioner Thomas Todd, a Massachusetts resident, is a member of the New Hampshire Chapter of the Appalachian Mountain Club (AMC). He was a member of the AMC’s paddling committee since 1989 and was the committee’s co-chair in 2009 and 2010. Sally Leonard was also a member of the AMC’s paddling committee. In January 2014, Leonard filed a stalking petition against Todd, alleging Todd "hacked" her computer and broke her vehicle’s window after she had voiced her opinion at an AMC meeting that Todd should not be allowed to participate in a paddling committee event "due to his history of aggressive behavior toward females." Todd was insured under a homeowner’s insurance policy and an umbrella liability policy issued to him by Vermont Mutual Insurance Company. After the stalking petition was filed, Todd notified Vermont Mutual of the action and requested that it provide a defense under one or both of the policies. Vermont Mutual declined. The AMC was insured by Hanover Mutual Insurance Company under an employment practices liability (EPL) policy and a nonprofit directors, officers and organizations liability (D & O) policy. Todd informed the AMC of the stalking petition and requested that it notify Hanover to provide him with a defense. Hanover declined too. In March 2014, the Circuit Court ultimately found that Leonard “failed to sustain [her] burden of proof,” and, therefore, the court did not issue a restraining order against Todd. Todd incurred approximately $18,000 in attorney’s fees and costs in defending against the stalking petition. In June 2014, Todd filed this declaratory judgment proceeding, seeking a declaration that Vermont Mutual and Hanover owed a duty to defend him against the stalking petition and to reimburse him for the attorney’s fees and costs incurred in defending against the stalking petition. In addition, he sought attorney’s fees and costs for bringing the declaratory judgment proceeding. Todd appealed when cross-motions for summary judgment and summary judgment were granted favor of the insurance companies. Finding no reversible error, the Supreme Court affirmed the circuit court. View "Todd v. Vermont Mutual Insurance Co." on Justia Law

Appellees in these consolidated appeals challenged under the Religious Freedom Restoration Act (RFRA) the requirement under the Patient Protection and Affordable Care Act (ACA) that contraceptive coverage be provided to their plan participants and beneficiaries. Appellees included a nonprofit institution of higher learning established by the Reformed Presbyterian Church and certain Catholic Dioceses and nonprofit organizations affiliated with the Catholic Church. Because they provided coverage to the Catholic nonprofits, the Dioceses, which were otherwise exempt, were required to comply with the contraceptive coverage requirement as to the nonprofits. The nonprofit appellees were eligible for an accommodation to the contraceptive coverage requirement, under which the contraceptive services will be independently provided by an insurance issuer or third-party administrator once the appellees advise that they will not pay for those services. Appellees argued that the accommodation places a substantial burden on their religious exercise because it forces them to facilitate the provision of insurance coverage for contraceptive services and has the impermissible effect of dividing the Catholic Church. The district courts granted Appellees’ motions for a preliminary injunction. The Third Circuit reversed, concluding that the accommodation places no substantial burden on Appellees, and therefore, Appellees did not show a likelihood of success on the merits of their RFRA claim. View "Geneva College v. Sec’y U.S. Dep’t of Health & Human Servs." on Justia Law

Appellant Greg Bell requested that County Risk Sharing Authority (CORSA), a joint self-insurance pool whose members included the majority of Ohio's counties, provide him with certain CORSA records pursuant to Ohio Rev. Code 149.43 and Ohio Rev. Code 149.431. David Brooks, the managing director of property and casualty insurance for CORSA, refused to provide copies of the records, asserting that they were not public records and that CORSA was a private corporation and not a public office subject to section 149.43. Bell filed for writs of mandamus to compel Brooks to provide copies of the requested CORSA records. The court of appeals denied the requested writs. The Supreme Court (1) affirmed the judgment of the court of appeals insofar as it denied the writs relating to Bell's claim for CORSA's board meeting minutes on grounds that CORSA was not the functional equivalent of a public office for purposes of section 149.43, but (2) reversed to the extent that the court of appeals failed to consider Bell's records requests for CORSA's financial and compensation records as CORSA's status as a private, nonprofit corporation was not dispositive in regard to these claims. Remanded.

This case involved the construction and application of a combined professional and general liability insurance policy issued by appellant to appellee where appellee requested a defense from appellant under the policy for a civil lawsuit. In that underlying suit, plaintiff alleged that while her mother was terminally ill, she consented to appellee's harvesting of some of her mother's organs and tissues after her mother's death and consented to the harvesting because appellee was a non-profit corporation. Appellee, instead, transferred the tissues to a for-profit company, which sold the tissues to hospitals at a profit. Appellee subsequently sought coverage under its general liability insurance with appellant and appellant denied coverage because the conduct alleged was outside the scope of the insurance policy's coverage. The court certified the following questions to the Supreme Court of Texas: (1) "Does the insurance policy provision for coverage of 'personal injury,' defined therein as 'bodily injury, sickness, or disease including death resulting therefrom sustained by any person,' include coverage for mental anguish, unrelated to physical damage to or disease of the plaintiff's body?" (2) "Does the insurance policy provision for coverage of 'property damage,' defined therein as 'physical injury to or destruction of tangible property, including consequential loss of use thereof, or loss of use of tangible property which has not been physically injured or destroyed,' include coverage for the underlying plaintiff's loss of use of her deceased mother's tissues, organs, bones, and body parts?"

In 2009, a car collided with a bus driven by Angela Austin, causing several passengers' deaths and serious injuries to others. Austin drove the bus as a transport vehicle for a nonprofit called Focus. Focus was insured by appellant Philadelphia Indemnity Insurance Company, who filed a complaint for interpleader indicating its willingness to pay insurance-policy proceeds in the total amount of $1 million as per its policy and requesting to be discharged from further liability. The circuit court entered an order interpleading appellant's funds. Appellees, the injured passengers and administrators of the deceased passengers' estates, filed counterclaims against appellant, alleging that Focus negligently failed to restrict Austin from using her cell phone while driving and arguing they were entitled to a judgment against appellant for a share of the interpleaded funds. Appellant filed a motion for declaratory judgment and a motion to dismiss, stating it had paid the full amount as stated in the insurance policy. The circuit court denied appellants' motions. The Supreme Court affirmed, holding that the circuit court correctly concluded that the language of the policy was ambiguous.

Appellant Robert Petty is sole owner of Co-Appellant R.G. Petty Masonry. Appellants contracted with Respondent Blue Cross of Northeastern Pennsylvania (Blue Cross), a nonprofit hospital corporation that provides health insurance coverage for its employees. Appellants are covered under the group policy as subscribers. Appellants filed a four-count class action suit against Blue Cross, alleging that it violated the state Nonprofit Law by accumulating excessive profits and surplus well beyond the "incidental profit" permitted by statute. The second count alleged Blue Cross breached its contract with Appellants by violating the Nonprofit Law. The third count alleged Blue Cross owed appellants a fiduciary duty by virtue of their status as subscribers, and that duty was breached when it accrued the excess surplus. The fourth count requested an inspection of Blue Cross' business records. The trial court found Appellants lacked standing to challenge Blue Cross' alleged violations of the Nonprofit Law and dismissed the suit. The Commonwealth Court affirmed the trial court. Upon careful consideration of the briefs submitted by the parties in addition to the applicable legal authorities, the Supreme Court found that Appellants indeed lacked standing under the Nonprofit Law to challenge Blue Cross by their four-count complaint. Accordingly, the Court affirmed the lower courts' decisions and dismissed Appellants' case.