Justia Insurance Law Opinion Summaries

Lanclos was born in 1982 at the Keesler Air Force Base Medical Center. During childbirth, she was seriously injured and as a result, suffers from Athetoid cerebral palsy. The settlement agreement for Lanclos’s medical malpractice suit required the government to make lump sum payments to Lanclos’s parents and their attorney; Lanclos would receive a single lump sum payment followed by specific monthly payments for the longer of 30 years or the remainder of her life. The government would purchase an annuity policy to provide the monthly payments. The government selected Executive Insurance to provide the monthly annuity payments. Executive encountered financial difficulties and, in 2014, reduced the amount of the monthly payments by 42%. Lanclos estimates that the reduction will result in a shortfall of $731,288.81 from the amount described in the settlement agreement.The Court of Federal Claims reasoned that the “guarantee” language in the Lanclos agreement applies to the scheduled monthly structure of the payments but not the actual payment of the listed amounts and that the government was not liable for the shortfall. The Federal Circuit reversed. Under the ordinary meaning of the term “guarantee” and consistent with the agreement as a whole, the government agreed to assure fulfillment of the listed monthly payments; there is no reasonable basis to conclude that the parties sought to define “guarantee” or to give the term an alternative meaning. View "Lanclos v. United States" on Justia Law

While working at Dura-Bond’s Duquesne, Pennsylvania plant, Marshall stepped out of his truck, while others were loading metal pipes onto it. A worker accidentally ran a forklift into the pipes, causing one to roll off the truck and crash into Marshall. Doctors had to amputate both of Marshall’s legs, leaving him totally disabled.Russell Trucking had contracted with Express to use its license. Express would ensure that drivers met federal requirements, but Russell could otherwise retain the drivers they wanted. Marshall had completed an Express application, passed a background check, and completed training with Russell. Marshall leased a truck from Russell and drove it under Express’s license. Although he signed a contract stating that he was an independent contractor, Marshall believed that he was an employee of both Express and Russell.Marshall filed a workers’ compensation claim. Russell, Express, and Dura-Bond all disclaimed an employment relationship with Marshall. Marshall conceded that he had agreed to obtain his own workers’ compensation insurance and had failed to do so. An ALJ found that Russell was Marshall’s “immediate employer” and that Express and Dura-Bond were Marshall’s “statutory employers” under Pennsylvania’s workers’ compensation statute. Neither Express nor Russell had insurance for Marshall. The judge ordered Dura-Bond (which had insurance) to pay Marshall’s benefits and allowed it to seek indemnity. Express reimbursed Dura-Bond for the benefits.Marshall subsequently brought tort claims against Express and Russell. RLI, which had issued Express a commercial general liability policy, refused to reimburse for a $2.4 million settlement, citing policy exclusions for “[a]ny obligation” “under a workers’ compensation” “law” and for injuries to an “employee.” The Sixth Circuit affirmed a jury finding that Marshall was a “temporary worker,” leaving the tort-suit settlement covered by the policy. View "P.I. & I. Motor Express, Inc. v. RLI Insurance Co." on Justia Law

Lia Kazan (“Lia”) visited an Alexandria, Louisiana motel to meet some friends. During the course of her visit, she went went to the motel parking lot to retrieve something from her vehicle. Anthony Murray, another motel guest, exited his room and approached the vehicle with Lia inside. Audio from the camera footage recorded Lia screaming “stop,” “no,” and calling for help accompanied by repeated honking of the vehicle’s horn. Murray then started the ignition and, with Lia in the passenger seat, reversed out of the parking lot onto the service road. The vehicle was later found submerged in Lake Dubuisson – the bodies of Murray and Lia were recovered in the water. Lia’s death was classified as a homicidal drowning. Ali Kazan and Ebony Medlin filed suit, individually, and on behalf of their daughter, Lia (collectively “Plaintiffs”) against several parties, including the motel’s owner, Vitthal, LLC, and its insurer, Great Lakes Insurance Company SE (“Great Lakes”), seeking damages for Lia’s kidnapping and death. In response, Great Lakes filed a petition for declaratory judgment averring it had no obligation under the operable commercial general liability policy (“the CGL Policy”) to defend or indemnify the other defendants. Great Lakes moved for summary judgment on its petition arguing the CGL Policy contained an exclusion – specifically defining “assault,” “battery,” and “physical altercation” – which barred coverage for Lia’s kidnapping and death. The Louisiana Supreme Court granted review in this case to determine whether an insurance policy, by its own terms, excluded coverage for damages arising from a kidnapping resulting in death. The Court found the clear and unambiguous language of the relevant policy exclusion barred coverage. View "Kazan et al. v. Red Lion Hotels Corporation, et al." on Justia Law

The Supreme Court held that the circuit court did not err when it granted Nationwide's motion for summary judgment on its complaint seeking a declaratory judgment regarding its duty to indemnify and defend Defendants against a personal injury lawsuit stemming from an accident on their farm.Nationwide issued a farm liability insurance policy for Defendants' farm and cattle ranch operation. After an accident resulted in permanent injuries to a relative, the relative filed a personal injury action against Defendants and their business entities. Nationwide then commenced this declaratory judgment action to determine the extent of its obligation to defend or indemnify Defendants. The circuit court granted summary judgment for Nationwide, concluding that a "Recreational Vehicle Liability Coverage Endorsement" in the policy operated to exclude coverage for the accident. The Supreme Court affirmed, holding that the circuit court properly granted summary judgment based on the language in the Recreational Vehicle Endorsement. View "Nationwide Agribusiness v. Fitch" on Justia Law

The Supreme Court vacated the decision of the court of appeals affirming the summary judgment and fees ordered by the trial court in favor of Defendants' right to direct payment of basic reparation benefits within an element of loss under Kentucky's Motor Vehicle Reparations Act, holding that this Court lacked subject matter jurisdiction over this appeal.Defendants were involved in a collision while in a vehicle insured by Erie Insurance Exchange. Erie filed a declaratory judgment action to determine whether it was required to pay bills within an element of loss in an order directed by secured persons. Defendants filed a counterclaim seeking attorney's fees and excess interest for the unreasonable delay of the payment of their bills caused by Erie. The trial court granted Defendants' motion for an attorney's fee and denied Erie's second summary judgment motion, but did not indicate in its order that it granted Defendants' motion for summary judgment. The court of appeals affirmed. The Supreme Court vacated the order below, holding that no final and appealable orders were before the Court, and therefore, this Court lacked jurisdiction over the appeal. View "Erie Insurance Exchange v. Johnson" on Justia Law

Mecosta County Medical Center, d/b/a Spectrum Health Big Rapids (and others) sued Metropolitan Group Property and Casualty Insurance Company and State Farm Mutual Automobile Insurance Company at the Kent Circuit Court, seeking personal protection insurance (PIP) benefits related to a single-car crash involving Jacob Myers. Myers co-owned the vehicle involved in the crash with his girlfriend; his girlfriend’s grandmother had purchased a no-fault insurance policy on the vehicle through Metropolitan Group. Myers assigned plaintiffs his right to collect PIP benefits in the amount of his treatment bills. After the assignment, Myers sued Metropolitan Group and State Farm at the Wayne Circuit Court for PIP benefits related to other costs arising from the crash. Plaintiffs sued defendants at the Kent Court to recover on the assigned claim. Defendants moved for summary judgment against Myers at the Wayne Court. State Farm argued that because Myers did not live with the State Farm policyholders he was not covered by their policy. Metropolitan Group asserted that Myers was not entitled to coverage because he did not personally maintain coverage on the vehicle. The Wayne Court granted both motions and dismissed Myers’s PIP claim with prejudice. Myers did not appeal. While defendants’ motions were pending with the Wayne Court, Metropolitan Group also moved for summary judgment at the Kent Court on the same basis as its motion in the Wayne Court. However, the Wayne Court granted defendants’ motions before the Kent Court considered Metropolitan Group’s motion. After the Wayne Court granted summary judgment for defendants, defendants filed additional motions for summary judgment at the Kent Court, arguing plaintiffs’ claims were barred under the doctrines of res judicata and collateral estoppel because the Wayne Court had concluded that Myers was ineligible for PIP benefits. The Kent Court granted the motion, holding that plaintiffs’ claims were barred by res judicata and collateral estoppel. Plaintiffs appealed, and the Court of Appeals reversed in a split, unpublished opinion. The appellate majority held that an assignee was not bound by a judgment against an assignor in an action commenced after the assignment occurred. The Michigan Supreme Court affirmed, finding that plaintiffs were not in privity with Myers with respect to the judgment entered subsequently to the assignment, and therefore, plaintiffs could not be bound by that judgment under the doctrines of res judicata and collateral estoppel. View "Mecosta County Medical Center v. Metropolitan Group Property, et al." on Justia Law

Appellants alleged that Respondents, Berkshire Hathaway Homestate Insurance Company (Berkshire), Cypress Insurance Company (Cypress), Zenith Insurance Company (Zenith), and others conspired to “hack” a third-party computer system. At the direction of the insurance-company Respondents, allegedly copied thousands of electronic litigation files, which had been uploaded to the system by workers’ compensation and personal injury attorneys and their clients (including Appellants), and transmitted the copies to insurers and insurance defense law firms. Appellants first sued respondents in federal district court on various causes of action, including invasion of privacy.   The Second Appellate District, affirmed and agreed with the trial court that Appellants failed to state a claim. The court concluded that Appellants failed to allege any actionable injury because: (1) they did not allege damage or disruption to the computer system, as required by Intel; and (2) they did not allege injury to the copied files or their asserted property interests therein. The trial court properly sustained Respondents’ demurrers to Appellants’ trespass-to-chattels claim, because Appellants failed to allege any actionable injury to a property interest, whether in the HQSU system or in the files copied from it. In response to Appellants’ unfounded warnings that affirmance will leave future victims of hacking without any effective remedy. Having abandoned a privacy claim during their federal litigation, Appellants effectively attempted, both in the trial court and on appeal, to repackage an alleged invasion of privacy as a trespass to chattels. Because Appellants failed to plead facts satisfying the latter tort’s element of injury to a property interest, the trial court properly sustained respondents’ demurrers. View "Casillas v. Berkshire Hathaway Homestate Insurance Co." on Justia Law

Tymoc died in a single-car accident. At the time of the accident, Tymoc was traveling between 80-100 miles per hour; the speed limit was 60 miles per hour speed. As Tymoc attempted to pass multiple cars, the gap between a car in the right lane and a box truck in the left lane closed. Tymoc veered to the right, causing his vehicle to drive off the road, roll down an embankment, striking multiple trees, and flip over several times.Through his employer, Tymoc was covered by Unum life insurance; the policy provided both basic life insurance coverage and an additional accidental death benefit. Unum approved a $100,000 payment of group life insurance benefits but withheld $100,000 in accidental death benefits, explaining that Tymoc’s conduct—speeding and reckless driving—caused his death, thereby triggering the policy’s crime exclusion. In a suit under the Employee Retirement Income Security Act, 29 U.S.C. 1001– 1191d, the district court entered in Fulkerson’s favor as to the accidental death benefits. The Sixth Circuit reversed. Reckless driving falls within the unambiguous plain meaning of crime. View "Fulkerson v. Unum Life Insurance Co. of America" on Justia Law

Plaintiff appealed the district court’s summary judgment dismissal of the breach of contract claims that he has asserted, as a third-party beneficiary, against Defendant. The district court determined that the insurer’s duty to defend its insured, on which Plaintiff’s claims were based, was never triggered, relative to Plaintiff’s underlying personal injury suit, because the insured, N.F. Painting, Inc., never requested a defense or sought coverage.   The Fifth Circuit affirmed finding no error in the district court’s assessment under Texas law. The court explained that it is well-established, that under Texas law, despite having knowledge and opportunity, an insurer is not required to simply interject itself into a proceeding on its insured’s behalf.   Here, as stated, N.F. Painting did not seek defense or coverage from Defendant when it was served with Plaintiff’s original state court petition. The undisputed facts show that N.F. Painting chose, with the assistance of counsel, to handle Plaintiff’s personal injury claims in its own way, without involving Defendantin its defense, as it was entitled to do. And Plaintiff has put forth no evidence suggesting that Defendant was not entitled to rely on that decision. Having made that decision, it is N.F. Painting, and thus Plaintiff, as third-party beneficiary, not Defendant who must bear responsibility for any resulting adverse consequences. In other words, the law will not permit a third-party beneficiary to simply disregard an insured’s litigation decisions, i.e., essentially re-write history, merely because he has no other means of satisfying his judgment against the insured. View "Moreno v. Sentinel Ins" on Justia Law

The question presented for the Mississippi Supreme Court in this case “boils down to one of statutory interpretation:” whether plaintiff Crystal Bufkin was “legally entitled to recover” damages from her employer under the uninsured motorist statute, Mississippi Code Section 83-11-101(1) (Supp. 2021). The Supreme Court previously held that employees are not legally entitled to recover from their employers and thus could not make a claim under uninsured motorist coverages. Bufkin acknowledged that precedent precluded her claim, but she argued Medders v. U.S. Fid. & Guar. Co., 623 So. 2d 979 (Miss. 1993 )and its progeny were wrongly decided because the uninsured motorist law should be liberally construed in her favor. The Supreme Court concluded it already rejected the arguments Bufkin presented here, and declined to overrule Medders. View "Bufkin v. Geico Insurance Agency, Inc." on Justia Law