Justia Insurance Law Opinion Summaries

Taleetha Fuentes filed a worker's compensation complaint against her employer Cavco Industries and Cavco’s surety, Sentry Casualty Company (collectively, Defendants). Fuentes filed her complaint in July 2019, and the Defendants denied the claim. During discovery, the Defendants filed a motion to compel in October 2019, which was granted. Following no response from Fuentes, the Defendants filed a motion for sanctions, and Fuentes again did not respond. On December 19, 2019, the full Idaho Industrial Commission issued an Order Dismissing Complaint, citing Industrial Commission Judicial Rule of Procedure (JRP) 12(B). Five months later, in May 2020, Fuentes responded to the initial discovery requests and moved to retain the case on the active calendar, but her filing and motion were returned “unfiled” as explained in an email from the assigned Referee. Fuentes also moved for reconsideration of the dismissal and filed a petition to vacate the order of dismissal under JRP 15. The Commission denied both motions. The Idaho Supreme Court determined the Commission acted in excess of its powers when it misapplied JRP12(B) in the initial dismissal order, and in applying JRP 16 to Fuentes' case. Accordingly, the Court reversed the Commission’s decision to dismiss Fuentes’ case, and vacated the order. The case was remanded for further proceedings. View "Fuentes v. Cavco Industries, Inc." on Justia Law

In this insurance dispute, the Supreme Court reversed in part and affirmed in part the judgment of the district court granting the cross-motion for partial summary judgment in favor of Plaintiffs and New West Health Services and denying Allied World Assurance Company's motion for partial summary judgment, holding that the district court erred in part.Dana Rolan, who serious injuries in an automobile accident, had health insurance through New West. New West denied coverage because the tortfeasor's liability insurance paid $100,000 of Rolan's medical expenses. Rolan filed a class action complaint alleging that New West violated its made-whole obligations. New West tendered the defense to its insurer, Allied. The district court certified the class and held New West liable for monetary losses. Plaintiffs and New West subsequently entered into a settlement. Allied opposed the district court's ensuing motion for final judgment, arguing that the proposed settlement amount was not covered by Allied. The district court approved the settlement between New West and Plaintiffs. The Supreme Court held that the district court (1) erred in holding that Allied was estopped from asserting a $1 million "each Claim" limit of liability under the policy; and (2) correctly concluded that Allied's "Loss" provision did not preclude Allied's indemnity obligation of the class's damages. View "Rolan v. New West Health Services" on Justia Law

In August 2016, Plaintiff Maribel Ronquillo was in an automobile collision. According to her complaint, Ronquillo was rear-ended by defendant Jesse Williams, who was operating a vehicle owned by an EcoClean employee and towing an EcoClean trailer. Ronquillo suffered serious physical injuries and incurred around $250,000 in medical expenses. At the time of the accident, Ronquillo did not have health insurance, so she entered into a medical finance lien agreement with Injury Finance. Under the terms of that agreement, Injury Finance purchased Ronquillo’s accounts receivable from her healthcare providers at a predetermined, discounted contractual rate, which allowed Ronquillo to receive prompt medical care. Ronquillo remained contractually obligated to repay Injury Finance for “all charges billed by the [medical] [p]roviders” regardless of the result of any litigation. Ronquillo and her husband filed suit alleging negligence and loss of consortium against Williams and asserting a respondeat superior claim against EcoClean. As part of discovery, Defendants subpoenaed Injury Finance, seeking information and documents pertaining to Injury Finance’s accounts receivable purchase rates, provider contracts, and business operations and methodologies. When Injury Finance did not respond to the subpoena, Defendants filed a motion to compel production, which the district court granted. Defendants also filed a “motion for determination of a question of law pursuant to C.R.C.P. 56(h) that Injury Finance . . . is not a collateral source[]” subject to the pre-verdict evidentiary component of the collateral source rule. This interlocutory appeal to the Colorado Supreme Court raised the narrow question of whether a medical finance company was a collateral source for purposes of the pre-verdict evidentiary component of Colorado’s collateral source rule. The Supreme Court agreed with the district court that Injury Finance was not a collateral source, "Collateral sources must confer a 'benefit,' as defined in section 10-1-135(2)(a), C.R.S. (2021), onto the injured party. ... Ronquillo has not received a benefit from Injury Finance for purposes of the collateral source rule because her arrangement with Injury Finance does not reduce her financial obligations." The Court expressed no opinion on whether the disputed evidence could be excluded under other evidentiary rules such as CRE 401 and 403. View "Ronquillo v. EcoClean" on Justia Law

The Supreme Court held that the term "civil action" in Mass. Gen. Laws 27-7-2.2 refers to a judicial proceeding that is commenced by the filing in court of a complaint and all other required documents together with fees.This case involved an accident in which Horace Johnson and Carlton Johnson were seriously injured when Horace was driving. Before any party filed suit, Carlton's counsel sent a letter to Arbella Mutual Insurance Company, which had issued an automobile insurance policy to Horace, demanding a settlement in the amount of the $100,000 policy limit. After Arbella indicated its acceptance of the settlement offer Carlton and his mother (together, Plaintiffs) filed suit. The case was removed to federal district court, which granted summary judgment to Defendants, rejecting Carlton's argument that section 27-7-2.2 applied to the case and rendered Arbella's acceptance of the settlement offer ineffective. On appeal, the First Circuit Court of Appeals certified the instant question to the Supreme Court. The Supreme Court answered that "civil action" in section 27-7-2.2 refers to a judicial proceeding which is commenced by the filing of a complaint and all other required documents together with the fees prescribed by law. View "Johnson v. Johnson" on Justia Law

The Supreme Court reversed the decision of the court of appeals affirming an order of the trial court granting summary judgment in favor of Insureds and against Insurer in reliance upon its prior decision in N.C. Farm Bureau Mutual Insurance Co. v. Gurley, 139 N.C. App. 178 (2000), holding that the lower courts erred.Matthew Bronson, who was intoxicated, collided with a vehicle owned by Pamela Dana, resulting in serious injuries to Pamela and William Dana, who was riding in the passenger seat. Pamela died from her injuries. At the time of the accident, Pamela was insured under a policy of automobile liability insurance issued by Insurer. William, individually and as administrator of Pamela's estate, claimed to be entitled to an additional $74,750 in underinsured motorist coverage over the amount that Insurer had already tendered to them. Insurer filed a complaint seeking a declaratory judgment regarding the amount of underinsured motorist coverage it was required to provide to the Danas. The trial court entered summary judgment in favor of the Danas, and the court of appeals affirmed. The Supreme Court affirmed, holding that the application of Gurley in this case was error. View "N.C. Farm Bureau Mutual Insurance Co. v. Dana" on Justia Law

The Supreme Court affirmed the rulings of the district court that the State was covered by an insurance policy it had with National Indemnity Company (National) for claims made against the State for injury and death resulting from asbestos exposure but reversed the district court's rulings regarding qualifying "occurrences" under the policy, holding that remand was required for further consideration of these issues.This insurance dispute followed litigation between the State and claimants who alleged that they were harmed by the State's failure to warn them of the hazards of asbestos exposure over years of mining and milling operations in Libby, Montana. National insured the State against general liability from 1973-1975. National filed this action seeking determinations that it had no obligation to defend the State or to cover the claims. The State concluded that National breached its duty to defend the State but disagreed with the district court's determination of the number of "occurrences" eligible for coverage under the policy, holding that remand was required for further factual findings. View "National Indemnity Co. v. State" on Justia Law

The Supreme Judicial Court affirmed the judgment of the superior court in this insurance dispute, holding that the superior court properly entered summary judgment in favor of 21st Century Centennial Insurance Company and 21st Century Insurance and Financial Services, Inc. (collectively, 21st Century).Collette Boure and Alexander Meyers took the car of Nancy Snow, Meyers's great aunt, and fled Maine to begin a drive across the country. While the teenage couple was in Oklahoma, they crashed in a chase with police, resulting in Boure's death. Boure's Estate sought uninsured motorist coverage from Concord General Mutual Insurance Company (Concord) on a personal auto policy issued to him and from 21st Century on a personal auto policy issued to Meyers's great aunt. After both insurers denied coverage Concord brought a declaratory judgment action against the Estate. The Estate counterclaimed against Concord and brought a separate action against 21 Century. The court granted summary judgments in favor of Concord and 21st Century. The Supreme Judicial Court affirmed, holding (1) the Estate's appeal of the summary judgment in favor of Concord was untimely; and (2) the court properly entered summary judgment in favor of 21st Century. View "Concord General Mutual Insurance Co. v. Estate of Collette J. Boure" on Justia Law

The Supreme Court reversed the decision of the circuit court granting judgment as a matter of law in favor of Mutual Benefit Group and against Eric Parks in this action brought by Mutual Benefit as a result of an automobile accident, holding that the circuit court erred.Mutual Benefit brought this action to recover monies it paid in another action stemming from an automobile accident involving Parks. The magistrate court found in favor of Mutual Benefit. After a trial de novo, the circuit court granted judgment as a matter of law to Mutual Benefit on the grounds that Parks had failed to respond to requests for admissions that Mutual Benefit had served upon him in the magistrate court. The Supreme Court reversed and remanded the case for further proceedings, holding that the West Virginia Rules of Civil Procedure for Magistrate Courts provide the exclusive means of discovery in magistrate courts and do not provide for parties to serve requests for admission. View "Parks v. Mutual Benefit Group" on Justia Law

Petitioner AmGUARD Insurance Group (Carrier), insurer of Pelmac Industries, Inc. (Pelmac), appealed a New Hampshire Compensation Appeals Board (CAB) decision awarding workers’ compensation death benefits to the respondent, the decedent-employee’s estate. The Carrier argued that the decedent’s original June 5, 2018 injury was not a work-related injury, and, in the alternative, that his subsequent death by suicide did not result from the original injury. The Carrier also argued that the CAB violated its due process rights. Finding no reversible error, the New Hampshire Supreme Court affirmed. View "Appeal of Pelmac Industries, Inc." on Justia Law

Plaintiff-appellant Kevin McGrath challenged a superior court’s decision granting summary judgment to appellee Progressive Northern Insurance Company. Specifically, he argued the court erred in concluding that he was not “occupying” a vehicle, as that term is defined in the insurance policy at issue, when he was struck and injured by an underinsured motorist. Plaintiff was driving the vehicle’s owner in the owner’s vehicle to the airport. Plaintiff stopped at a gas station/convenience store on the way; he got out to pump gas and paid for it at the pump. The owner went inside the store for coffee. As the two returned to the car, but before they got inside, a pickup truck struck both plaintiff and the owner. Plaintiff filed for underinsured motorist benefits with the owner’s insurance company, Progressive, asserting he qualified for coverage under the terms of the policy. Progressive denied the claim, contending Plaintiff was not operating or occupying the car at the time of the accident. Plaintiff sued for a declaratory judgment on stipulated facts and no discovery. Summary judgment was entered in favor of the insurer. The Vermont Supreme Court affirmed, finding that while Plaintiff intended to enter the car, he did not, thus he did not occupy it under the terms of the policy at issue. View "Progressive Northern Insurance Company v. McGrath" on Justia Law