Justia Insurance Law Opinion Summaries

In this case, the plaintiff, David Yaffee, was awarded $3,299,455 in damages by a jury for past and future economic earnings and noneconomic loss due to injuries sustained when his vehicle was rear-ended by a truck driven by Joseph Skeen, who was employed by KLS Transportation, Inc. The accident occurred in 2015, and Yaffee experienced significant medical issues, including back pain and leg tingling, leading to multiple medical treatments and surgeries.The Superior Court of Sacramento County entered a judgment on the jury's verdict, which included awards for past and future medical expenses, lost earnings, and noneconomic damages. Defendants, including National Liability & Fire Insurance Company, challenged the awards on several grounds, including the reasonableness of past medical expenses, the speculative nature of future medical expenses, and the sufficiency of evidence supporting lost earnings.The Court of Appeal of the State of California, Third Appellate District, reviewed the case. The court found that the trial court had erred in its interpretation of the Hospital Lien Act (HLA) regarding the measure of past medical damages, leading to the improper admission of evidence on the reasonable value of services. The court concluded that the HLA only applies to services provided while the patient remains in the hospital or affiliated facility following emergency services. Consequently, the award for past medical expenses was reversed.The court also found that the award for future medical expenses was not supported by substantial evidence, particularly regarding the speculative nature of the need for a dorsal root ganglion stimulator. The court reversed the award for future medical expenses and remanded for a new trial on this issue.The awards for past and future lost earnings were upheld, as the court found sufficient evidence supporting the jury's findings. The award for future noneconomic damages was also upheld, as the evidence established a reasonable certainty of future pain and suffering.The court vacated the award for costs and prejudgment interest, as these were based on the reversed portions of the judgment. The case was remanded for a new trial on the issues of past and future medical expenses. View "Yaffee v. Skeen" on Justia Law

Dionicio Rodriguez, an employee of SIR Electric LLC (SIR), was injured while working and filed for workers' compensation benefits under SIR's policy with Hartford Underwriters Insurance Company (Hartford). After receiving benefits, Rodriguez filed a personal injury lawsuit against SIR, alleging negligence, gross negligence, recklessness, and intentional wrongdoing. SIR requested Hartford to defend against the lawsuit, but Hartford refused, citing policy exclusions. SIR then filed a third-party complaint against Hartford, claiming wrongful disclaimer of defense coverage.The trial court granted Hartford's motion to dismiss SIR's complaint, ruling that the policy excluded intent-based claims. SIR's motion for reconsideration and to amend its complaint, arguing that the policy's enhanced intentional injury exclusion (EII exclusion) violated public policy, was denied. The Appellate Division affirmed the trial court's decision.The Supreme Court of New Jersey reviewed the case and held that Hartford has no duty to defend SIR. The court determined that Rodriguez's claims of negligence, gross negligence, and recklessness are subject to the workers' compensation exclusivity bar and are not covered under Part One of the policy. These claims are also excluded from coverage under Part Two of the policy. Additionally, Rodriguez's claims of intentional wrongdoing are excluded under the policy's EII exclusion.The court concluded that the trial judge properly denied SIR's motion to amend its third-party complaint, as the EII exclusion does not violate public policy. The court affirmed the Appellate Division's judgment, upholding the dismissal of SIR's third-party complaint against Hartford. View "Rodriguez v. Shelbourne Spring, LLC" on Justia Law

Hurricane Katrina destroyed Paul and Sylvia Minor’s home in 2005. The Minors had a homeowner’s insurance policy with United Services Automobile Association (USAA) that covered wind damage but excluded storm surge or flood damage. USAA issued payments for wind damage but not for storm surge or flood damage, leading to a dispute. The Minors claimed a total loss due to wind and demanded policy limits. In 2013, a jury awarded the Minors $1,547,293.37 in compensatory damages.The Minor Estate appealed a pretrial order granting partial summary judgment to USAA on the Minors’ bad faith claim. The Mississippi Court of Appeals reversed the trial court’s decision, finding a genuine issue of material fact regarding USAA’s denial and delay of payment. The case was remanded for further proceedings on the bad faith claim. On remand, a jury awarded the Minors $10,000,000 in punitive damages and $457,858.89 in extra-contractual damages (attorneys’ fees). USAA appealed, and the Minor Estate cross-appealed the denial of its post-trial motion for additional attorneys’ fees.The Supreme Court of Mississippi reviewed the case and found no reversible error, affirming the jury’s award of $10,457,858.89 in damages. The court also reversed and rendered attorneys’ fees on behalf of the Estate in the amount of $4,500,000, plus post-judgment interest. The court held that the trial judge did not err in submitting the issue of punitive damages to the jury and that the $10 million punitive damages award was not unconstitutionally disproportionate. The court also found no error in the jury’s award of extra-contractual damages and no errors warranting a new trial. View "United Services Automobile Association v. Estate of Minor" on Justia Law

Following heavy snowfall in Pine Bluff, Arkansas, the roofs of several chicken houses at ten poultry farms collapsed. Norfolk & Dedham Mutual Fire Insurance Company, which insured the farms, sued Rogers Manufacturing Corporation, the manufacturer of the roof trusses used in the chicken houses, claiming strict product liability, negligence, and breach of warranties. Rogers moved to dismiss the complaint under Federal Rule of Civil Procedure 12(b)(6), arguing that Norfolk’s claims were barred by the Arkansas statute of repose.The United States District Court for the Eastern District of Arkansas agreed with Rogers and dismissed the complaint. Norfolk appealed the dismissal, arguing that the statute of repose did not apply to Rogers because the roof trusses were standardized goods, not custom-designed for the farms.The United States Court of Appeals for the Eighth Circuit reviewed the district court’s dismissal de novo, accepting the allegations in the complaint as true and drawing all reasonable inferences in Norfolk’s favor. The court found that Norfolk’s complaint plausibly supported an inference that the roof trusses were standardized goods, which would not be covered by the Arkansas statute of repose. The court emphasized that at this early stage, the complaint should not be dismissed if it allows for a reasonable inference of liability.The Eighth Circuit reversed the district court’s dismissal of the complaint and remanded the case for further proceedings, noting that the facts and legal arguments could be further developed as the case progresses. View "Norfolk & Dedham Mutual Fire Insurance Company v. Rogers Manufacturing Corporation" on Justia Law

Torrey Kath brought a personal injury lawsuit against Michael Prochnow and Prochnow Farms, alleging that Prochnow moved a semi-truck while Kath was underneath, causing significant injury. Kath and Prochnow entered into a Miller-Shugart agreement, where Prochnow accepted damages, and Kath agreed to collect solely from Prochnow’s insurers. The case was dismissed with prejudice after a stipulation of dismissal was filed.Kath then filed a declaratory judgment action against Farmers Union Mutual Insurance Company (FUMIC), which insured Prochnow under a farm liability policy. Kath sought declarations that the policy covered his injuries and that the Miller-Shugart agreement was reasonable and binding on FUMIC. The District Court of Stutsman County granted Kath summary judgment on the coverage issue, interpreting the policy’s motor vehicle exclusion as not applying to the coverage added by a farm employer liability endorsement.FUMIC moved for summary judgment, arguing it had no duty to indemnify Prochnow because the personal injury action had been dismissed with prejudice. While this motion was pending, Kath and Prochnow successfully moved to vacate the dismissal and entered a $2 million judgment against Prochnow, to be paid solely by FUMIC. The district court then denied FUMIC’s motion for summary judgment, holding that the judgment in the personal injury action rendered FUMIC’s motion moot and granted summary judgment in favor of Kath on the second count of his complaint.The North Dakota Supreme Court reviewed the case and reversed the district court’s judgment. The Supreme Court held that the policy’s motor vehicle exclusion applied to Kath’s injuries, and thus, the policy did not provide coverage. The court concluded that the endorsement did not supersede the motor vehicle exclusion and that the policy, when read as a whole, excluded coverage for injuries related to the use of motor vehicles. View "Kath v. Farmers Union Mutual Ins. Co." on Justia Law

In October 2020, Elliot Fama, employed by Sanford Contracting, was working on a project in Scarborough, Maine. After work, he and his co-worker, Robert Clarke, consumed alcohol at a hotel and a tavern. Later, in the hotel parking lot, Clarke struck Mr. Fama, causing him to fall and sustain fatal injuries. Laureen Fama, Mr. Fama’s widow, settled a workers’ compensation claim in Massachusetts for $400,000.Laureen Fama then filed a lawsuit in Cumberland County Superior Court against Bob’s LLC, which operated the tavern, and Clarke. She alleged liquor liability, wrongful death, loss of consortium, and battery. The defendants moved for summary judgment, arguing that the workers’ compensation settlement precluded the lawsuit. The Superior Court denied these motions, leading to the current appeal.The Maine Supreme Judicial Court reviewed the case. It held that under Maine’s Workers’ Compensation Act (MWCA), Ms. Fama’s settlement barred her from suing Clarke, as the Act’s immunity provisions extend to co-employees. Consequently, Clarke was exempt from the lawsuit. The court further held that because Clarke could not be retained as a defendant, the claims against Bob’s LLC failed under the “named and retained” provisions of Maine’s Liquor Liability Act (MLLA).The court vacated the Superior Court’s order denying summary judgment and remanded the case for entry of judgment in favor of Bob’s LLC and Clarke. View "Fama v. Bob's LLC" on Justia Law

The case revolves around a car accident that occurred on November 4, 2015, involving Donna Powers and Fendol Carruthers, Jr. Carruthers was charged and pleaded guilty to operating a motor vehicle under the influence of alcohol or drugs. Powers claimed to have sustained serious, permanent injuries from the crash. Carruthers was insured by State Farm Mutual Automobile Insurance Company (State Farm) with a policy limit of $50,000. Powers began receiving Personal Injury Protection (PIP) benefits from her own insurance carrier, Kentucky Farm Bureau (KFB). The Kentucky Motor Vehicle Reparations Act (MVRA) imposes a two-year statute of limitations for tort actions arising from motor vehicle accidents. Powers received her last PIP payment on August 4, 2016, meaning any tort claim she wished to assert arising from her accident with Carruthers must have been filed by August 4, 2018.Powers filed a complaint in McCracken Circuit Court on April 3, 2018, asserting a negligence claim against Carruthers and an underinsured motorist (UIM) claim against KFB. However, Carruthers had died two years earlier in March 2016, unbeknownst to Powers or her attorneys. The case remained stagnant for the next year, with Powers failing to take any action to rectify the portion of her complaint that was a nullity against Carruthers. It wasn't until August 2019 that Powers successfully moved the district court to appoint the Public Administrator to act as Administrator of Carruthers’s Estate.The Supreme Court of Kentucky affirmed the decisions of the lower courts, which had dismissed Powers’s negligence claim against Carruthers, denied Powers’s motions for substitution and revival, denied Powers’s motion for leave to amend her complaint to raise a new claim, and granted summary judgment in favor of KFB. The court held that Powers’s claim against Carruthers was null, and her attempted claim against the Estate was untimely. Furthermore, Powers’s inability to recover from Carruthers or the Estate foreclosed her underinsured motorist claim against KFB. View "Powers v. Kentucky Farm Bureau Mutual Insurance Co." on Justia Law

The case involves Continental Indemnity Company (Continental) and its attempt to collect a default judgment against BII, Inc. (BII) from Starr Indemnity & Liability Company (Starr), BII's insurer. Continental had paid a workers' compensation claim for an employee injured at a construction site where BII was a subcontractor. Continental then sought reimbursement from BII, which had failed to maintain its own workers' compensation insurance. When BII did not pay, Continental secured a default judgment against BII and sought to collect from Starr under Illinois garnishment procedures.The district court in the Northern District of Illinois dismissed the garnishment proceeding against Starr, finding that it lacked subject matter jurisdiction. The court reasoned that the dispute over the scope of coverage under the Starr-BII insurance policy was too distinct from the underlying suit between Continental and BII. Continental appealed this decision to the United States Court of Appeals for the Seventh Circuit.The Seventh Circuit affirmed the district court's decision. The court found that the garnishment proceeding introduced new factual and legal issues, making it essentially a new lawsuit. The court explained that while federal courts have ancillary enforcement jurisdiction to consider proceedings related to an underlying suit, the subject of those proceedings must still be sufficiently related to the facts and legal issues of the original action. In this case, the court found that the garnishment proceeding fell outside the scope of ancillary enforcement jurisdiction. The court suggested that Continental could file a new civil action against Starr to litigate the dispute over the insurance policy's coverage. View "Continental Indemnity Company v. BII, Inc." on Justia Law

The case revolves around a dispute over who should pay for the personal injury protection (PIP) benefits of Justin Childers, who was severely injured in a car accident. Initially, Childers' PIP benefits were covered by American Fellowship Mutual Insurance Company, but the company was declared insolvent in 2013. The Michigan Property and Casualty Guaranty Association (MPCGA) then assumed responsibility for Childers' PIP benefits. The MPCGA, after an investigation, concluded that Progressive Marathon Insurance Company was next in line to provide Childers' PIP benefits. However, Progressive denied Childers' claim.The trial court granted summary disposition to Progressive, ruling that while the actions were not time-barred, Progressive was not within statutory priority for Childers' benefits. The Court of Appeals reversed this decision, concluding that the one-year limitations period did not apply because the MPCGA is not generally subject to the no-fault act, and the MPCGA did not bring the action under the no-fault act. Instead, the Court of Appeals reasoned that the MPCGA’s right to proceed against Progressive came from the guaranty act, which allows the MPCGA to claim reimbursement from another insurer in the chain of designated priority insurers.The Michigan Supreme Court, however, disagreed with the Court of Appeals. It held that the one-year limitations period in MCL 500.3145(1) applies where either an insured or the MPCGA brings an action for PIP benefits against a lower priority no-fault insurer after the higher priority insurer becomes insolvent. The court concluded that both the action brought by Childers' conservator and the MPCGA's action were time-barred. The court reversed part of the Court of Appeals' opinion, vacated the remainder, and remanded the case to the trial court for further proceedings. View "Childers v. Progressive Marathon Insurance Company" on Justia Law

The case involves a personal injury action initiated by Torrey Kath against Michael Prochnow and Prochnow Farms. After the parties filed a "Stipulation of Dismissal with Prejudice," the district court dismissed the case. Kath then filed a separate declaratory judgment action against Agraria Insurance Company, doing business as Farmers Union Mutual Insurance Company (FUMIC), seeking an order that FUMIC had a duty to indemnify Prochnow under an insurance policy. While FUMIC's motion in the declaratory judgment action was pending, Kath and Prochnow filed a "Joint Rule 60 Motion to Vacate Dismissal with Prejudice" in the original case, seeking an amended judgment.The district court had previously dismissed the case with prejudice. However, Kath and Prochnow filed a motion to vacate the dismissal, which the court granted. FUMIC then filed a motion to intervene, arguing that Kath and Prochnow were seeking to impair its rights. The district court ruled that it lacked jurisdiction to decide on FUMIC's intervention motion because the case had been dismissed.The Supreme Court of North Dakota disagreed with the district court's decision. The court noted that Kath and Prochnow's motion to vacate the dismissal re-invoked the district court's jurisdiction. Furthermore, FUMIC's intervention motion initiated a special proceeding, which also invoked the court's jurisdiction. Therefore, the Supreme Court held that the district court erred in ruling that it lacked jurisdiction to consider FUMIC's motion to intervene. The case was remanded for the district court to decide on FUMIC's motion to intervene and, if necessary, to conduct additional proceedings consistent with its disposition of the motion. View "Kath v. Prochnow" on Justia Law