Justia Insurance Law Opinion Summaries

APM, a property management company, sought a builders risk insurance policy from TCI Insurance Agency, Inc. to cover an apartment building under construction in Fargo. Jay Alsop, APM's president, discussed insurance policies with TCI's agent Devin Gaard. One policy in particular, from Philadelphia Insurance Company, covered lost rent and other "soft costs," such as interest. Alsop also received a quote from a different insurance agency for another policy from Travelers Insurance Company, which was cheaper than the Philadelphia policy. The Travelers policy did not have coverage for lost rent and soft costs. Alsop informed Gaard about the Travelers policy and requested Gaard to procure the policy as it was quoted by the other agency, without change. A fire at the construction site delayed the opening of the apartment building for five months. APM filed a claim under the insurance policy for damages caused by the fire, including lost rent and interest charges. Travelers paid part of the claim, but denied the claim for lost rent and interest because the policy did not provide coverage for those costs. APM sued TCI, alleging TCI and Gaard were negligent for failing to offer APM a policy endorsement that provided additional coverage for lost rent and soft costs. TCI denied liability and moved for summary judgment, claiming that APM did not request the additional coverage for lost rent and soft costs and that TCI and Gaard were not required to offer the additional coverage to APM. The district court granted TCI's motion, concluding APM failed to raise a genuine issue of material fact as to whether Gaard breached his duty to APM. The court also concluded Gaard's duty was not enhanced because APM failed to establish a genuine issue of material fact indicating a special relationship existed between APM and TCI. On appeal, APM argued the district court erred in deciding there were no genuine issues of material fact as to whether: (1) Gaard breached his duty to APM; and (2) a special relationship existed between APM and TCI. Finding no reversible error, the Supreme Court affirmed the grant of summary judgment to TCI. View "APM, LLP v. TCI Insurance Agency, Inc." on Justia Law

In 2010, Amy Hiltner was seriously injured when she fell off the trunk of a moving vehicle driven by Samantha Denault. Denault's insurer paid Hiltner its liability limit under a policy covering the vehicle. Owners Insurance Company provided underinsured coverage to Hiltner in an automobile policy issued to her father. In 2012, Hiltner sued Owners in state court for underinsured motorist coverage benefits under North Dakota law, alleging she was injured as a result of driver Denault's negligent operation of the motor vehicle. Owners removed the action from state court to the United States District Court in North Dakota. The United States District Court for the District of North Dakota certified then certified a question of North Dakota law to the North Dakota Supreme Court regarding the proper calculation of an offset provision to underinsured motorist coverage. The questions was "[w]hether the court should deduct no-fault benefits from the award of past economic damages before reduction for the percentage of fault attributable to plaintiff and other parties for whose conduct the defendant is not responsible." The Supreme Court answered the certified question, "No." View "Hiltner v. Owners Ins. Co." on Justia Law

In 2011, Chase Koller and his girlfriend Stephanie Nelson were killed when Koller allegedly lost control of an all-terrain vehicle. Nelson was the mother of G.K., a child from a previous relationship. Becky Anderson, Koller's mother, was the registered owner of the vehicle. The vehicle was insured under a policy issued by Nodak Mutual Insurance Company. Todd Anderson, Koller's stepfather, was the named insured. The policy provided coverage for any "family member" of the named insured, up to $100,000 per incident. The policy defined a "family member" as "a person related to you by blood, marriage or adoption, including a ward or foster child, who is a resident of your household." The policy included a "step-down" endorsement that reduced the policy limits to $25,000 per incident if the vehicle was being driven by an insured who was not a "family member" of the named insured. After the fatal accident, Nodak retained an attorney to represent Anderson to prepare probate documents. Nodak then sued Anderson in her capacity as Personal Representative to the Estate of Chase Koller, and Chris Kemp, as guardian of G.K., and the heirs of Stephanie Nelson, seeking a declaration that it was only liable to pay the reduced step-down policy limits because Koller was not a resident of Todd Anderson's household and, therefore, was not a "family member" under the policy. Kemp filed an answer, cross-claim, and third-party complaint asserting wrongful death against Anderson in her capacity as Personal Representative, and asserting negligent entrustment against Todd and Anderson individually, claiming the family car doctrine applied. The district court severed Kemp's wrongful death claim from Nodak's declaratory judgment action. In the declaratory judgment action, Kemp moved for summary judgment. Nodak responded to Kemp's motion for summary judgment arguing that the district court should deny Kemp's motion and grant summary judgment in its favor. After a hearing, the district court entered an order granting Kemp's motion for summary judgment determining that Koller was a resident of the Andersons' household under Nodak's policy. Before the district court entered judgment, the North Dakota Supreme Court decided "Nodak Mutual Ins. Co. v. Bahr-Renner," (842 N.W.2d 912), interpreting an identical "step-down" provision. After reviewing "Bahr-Renner," the district court vacated its order granting Kemp's motion for summary judgment applied the "Bahr-Renner" factors, and found that Koller was not a resident of Todd Anderson's household and, Nodak was only required to pay the "step-down" policy limits. Kemp appealed from the district court's declaratory judgment in favor of Nodak. Finding no error with the district court's judgment, the Supreme Court affirmed. View "Nodak Mutual Ins. Co. v. Koller" on Justia Law

In January 2010, Kory Clark received a telephone call around 3 a.m. from his brother asking for assistance with his pickup, which was stuck in a snowdrift. According to Clark's deposition, after the brothers were unable to pull the pickup out of the snowdrift, he drove to their grandfather's nearby farm to get a tractor to pull it out. Clark stated that after proceeding a short way down the road, the tractor broke down and he was unable to get over to the shoulder of the road or restart it. He then walked back to the farm to get his pickup and pick up his brother, who took him home and said he would take care of the tractor. Before the tractor was removed from the road, Rita Fred collided with it while driving to work. Fred sued Clark and his grandfather to recover for her injuries. At the time of the accident, Clark's grandfather had a farm liability policy with Farmers Union Mutual Insurance. Farmers Union defended the grandfather in the action brought by Fred, but declined to defend Clark, claiming he was not insured under the policy. Clark sought a declaratory judgment that Farmers Union had a duty to defend or indemnify him. He also sought damages for bad-faith refusal to defend. QBE Americas, Inc., joined as the third-party claims administrator for Farmers Union. Both Farmers Union and QBE moved for summary judgment, which the district court granted. Clark appealed, arguing the district court erred in granting summary judgment and holding he was not entitled to coverage under a farm liability policy. He also argued the district court should not have dismissed his claim for breach of duty to defend. Because the Supreme Court concluded the district court correctly held Clark failed to present evidence sufficient to raise genuine issues of material fact in regard to his claims, it affirmed the judgment. View "Clark v. Farmers Union Mutual Ins." on Justia Law

Plaintiff-appellant Timothy Huether contracted with Nodak Mutual to provide insurance coverage for his house, buildings and structures on his farm. The coverage was under Nodak Mutual's Farm and Ranch Policy. The Farm and Ranch Policy did not provide insurance coverage for grain dryers. Huether added an equipment endorsement insuring his agricultural equipment, which included a grain handler dryer. A fire destroyed the grain handler dryer, fans and parts. Nodak Mutual's agricultural endorsement provided coverage for "direct physical loss or damage caused by perils 1 through 10." Huether's Farm and Ranch Policy listed fire as Peril 1. Damage from fire was a "direct physical loss or damage" and Nodak Mutual paid Huether $278,187.44 for damage to the grain dryer, control room and grain handling equipment. Huether did not contest the coverage or payment for those items, but claimed an additional $82,954.77 in expenses for transporting to and drying his crops at other grain drying facilities. Nodak Mutual denied Huether's claim because the agricultural equipment endorsement covered "direct physical loss or damage" and did not cover loss-of-use. Huether sued Nodak Mutual seeking damages for the denied claim. The district court found Huether's claim was not covered under the policy and granted summary judgment in favor of Nodak Mutual. Huether appealed, arguing the district court erred in granting summary judgment for Nodak Mutual because it misinterpreted the terms of the insurance policy. Finding no error, the Supreme Court affirmed. View "Huether v. Nodak Mutual Ins. Co." on Justia Law

Workforce Safety and Insurance appealed a district court judgment affirming an administrative law judge's order finding William Snook and other similarly situated welders were independent contractors. The Supreme Court affirmed, concluding the ALJ's findings of fact were supported by a preponderance of the evidence and the conclusions of law were supported by those facts. View "WSI v. Larry's On Site Welding" on Justia Law

Dennis Whedbee appealed a district court judgment affirming Workforce Safety and Insurance's ("WSI") binding dispute resolution denying Whedbee's request for a myoelectric prosthesis and approving a body-powered prosthesis. Whedbee argued the binding dispute resolution was an abuse of discretion and violated his due process rights. He argued that WSI should have selected an independent medical examiner located closer to his residence and that his treating physician's opinion should have been given controlling weight. Finding no reversible error, the Supreme Court affirmed. View "Whedbee v. WSI" on Justia Law

Workforce Safety and Insurance ("WSI") denied Rick Brockel medical benefits and terminated his disability benefits. Upon review of Brockel's arguments on appeal, the Supreme Court concluded WSI's finding that Brockel's condition was not causally related to his work injury was supported by a preponderance of the evidence. Furthermore, the Court concluded Brockel was denied a fair hearing because he was not provided notice that one of the grounds for terminating his disability benefits would be the failure to submit medical verification of his disability. In addition, the Court concluded WSI's finding that Brockel failed to show his wage loss was the result of his compensable injury was not in accordance with the law. Therefore, the Court affirmed in part, reversed in part, and remanded the case for retroactive reinstatement of Brockel's disability benefits and for further proceedings. View "Brockel v. WSI" on Justia Law

Warren Parsons appealed a judgment affirming a Workforce Safety and Insurance Fund ("WSI") decision that denied his claim for workers' compensation benefits. Parsons applied for workers' compensation benefits from WSI, alleging he sustained an injury to his left shoulder and neck while working for Ames Construction. He claimed he developed pain at the base of his neck and into his left shoulder from hitting the seat belt repeatedly while driving the dump truck on rough roads. Parsons argued his cervical spine and left shoulder injuries were "compensable injuries" by law. Upon review, the Supreme Court concluded WSI erred in determining Parsons' injury was not a compensable injury and in denying his claim for benefits. View "Parsons v. WSI" on Justia Law

Michelle and Tony Tweten brought an action against COUNTRY Preferred Insurance Company and American National Property and Casualty Company ("ANPAC"), seeking the full amount of underinsured motorist coverage from both insurance companies. The United States District Court for the District of North Dakota certified a question to the North Dakota Supreme Court that called for an interpretation of the Twetens' policies under North Dakota law. The federal court asked whether the Twetens as a divorced couple with separate insurance policies, were foreclosed from recovering up to the full amount of underinsured motorist benefits from their respective policies under the 'other insurance' clause contained in each policy and the statutory anti-stacking provisions of NDCC Ch. 26.1-40 following the death of their son in a car accident. The North Dakota Supreme Court answered the question "Yes." View "Tweten v. COUNTRY Preferred Insurance Company" on Justia Law