Justia Insurance Law Opinion Summaries

The Supreme Court affirmed the order of the district court granting summary judgment in favor of Depositors Insurance Company in its declaratory judgment action to determine any obligation it had relative to Patrick Sandidge pursuant to Ridley v. Guaranty National Insurance Co., 951 P.2d 987 (Mont. 1997), holding that the district court did not err.Specifically, the Supreme Court held that the district court (1) did not err by holding a hearing on the parties' cross-motions for summary judgment; (2) did not err by holding that Depositors had standing to bring a declaratory action pursuant to Ridley; (3) did not err by granting Depositors' motion for summary judgment; and (4) did not abuse its discretion by denying Sandidge attorney fees and costs. View "Depositors Insurance Co. v. Sandidge" on Justia Law

The Supreme Court reversed the decision of the court of appeals reversing the circuit court's grant of summary judgment in favor of State Farm Mutual Automobile Insurance Company and instead granting summary judgment in favor of Elliot Brey, holding that Wis. Stat. 632.32(2)(d) does not bar an insurer from requiring that an insured sustain bodily injury or death in order to trigger underinsured (UIM) coverage under an automobile liability insurance policy.The circuit court determined (1) the State Farm automobile liability insurance policy issued to Brey's mother and her husband did not provide uninsured motorist (UIM) coverage to Brey for the death of his father in an automobile accident because Brey was an insured under the policy but his father was not; and (2) Brey could not recover under the policy because he did not sustain bodily injury. The court of appeals reversed, concluding that sections 632.32(1) and (2)(d) bar an insurer from limiting UIM coverage to only those insureds who sustain bodily injury or death. The Supreme Court reversed, holding that section 632.32(2)(d) does not require insurers to extend UIM coverage to an insured for bodily injury or death suffered by a person who was not insured under the policy. View "Brey v. State Farm Mutual Automobile Insurance Co." on Justia Law

Dorothy Wright and her grandchildren (collectively, the “Decedents”) were killed when their vehicle was struck by a stolen vehicle that was being chased by College Park Police Department officers. At the time of the accident, the City of College Park had an insurance policy provided by Atlantic Specialty Insurance Company (“Atlantic”), which provided coverage for negligent acts involving the City’s motor vehicles up to $5,000,000 but also included immunity endorsements which said that Atlantic had no duty to pay damages “unless the defenses of sovereign and governmental immunity are inapplicable.” Plaintiffs filed suit against the City, raising claims of negligence and recklessness resulting in the wrongful deaths of the three Decedents, to which the City raised sovereign immunity as a defense. Plaintiffs claimed the insurance policy limit was $5,000,000 for the three deaths, while Atlantic contended the policy limit was capped at $700,000 under the relevant statutory scheme and the terms of the City’s policy. As the parties agreed, pursuant to OCGA 36-92-2 (a)(3), the sovereign immunity of local government entities was automatically waived up to $700,000 in this instance, regardless of whether the City had a liability insurance policy. Atlantic intervened in the case to litigate the limit of the insurance policy. The trial court ruled that the policy limit is $5,000,000, and the Court of Appeals affirmed. The Georgia Supreme Court then granted Atlantic’s petition for certiorari to decide whether the City’s insurance policy waived the City’s sovereign immunity under OCGA 36-92-2 (d)(3). The Supreme Court concluded the Court of Appeals incorrectly ruled that the City’s insurance policy increased the sovereign immunity waiver notwithstanding the immunity endorsements, which expressly precluded coverage when a sovereign immunity defense applies. Judgment was therefore reversed. View "Atlantic Specialty Insurance Co. v. City of College Park, et al." on Justia Law

In 2013, Vercellino was injured in an accident while riding on an ATV operated by his friend, Kenney. Both were minors. Vercellino was a covered dependent on his mother’s insurance plan. The plan is self-funded, so ERISA, 29 U.S.C. 1001, preempted state law. The Insurer paid nearly $600,000 in medical expenses and did not exercise its right to seek recovery in subrogation from Kenney or Kenney’s parents during the applicable statutory period, nor did Vercellino’s mother ever file suit to recover medical expenses from the Kenneys. In 2019, Vercellino, then an adult, filed suit against the Kenneys seeking general damages and sought declaratory judgment that the Insurer would have no right of reimbursement from any proceeds recovered in that litigation. The Insurer counterclaimed, seeking declaratory judgment that it would be entitled to recover up to the full amount it paid for Vercellino’s medical expenses from any judgment or settlement Vercellino obtained.The Eighth Circuit affirmed summary judgment for the Insurer. The plain language of the plan at issue here is unambiguous: the Insurer is entitled to seek reimbursement for medical expenses arising out of the ATV accident paid on Vercellino’s behalf from any judgment or settlement he receives in his litigation with Kenney. View "Vercellino v. Optum Insight, Inc." on Justia Law

The Supreme Court affirmed the judgment of the superior court entered in favor of Plaintiff that granted Plaintiff's motion for additur, holding that there was no error.In 2013, Plaintiff was involved in an automobile accident. Because she believed she was not fully compensated for the injuries she sustained from the accident, Plaintiff brought this complaint against Allstate Insurance Company, her insurer, seeking underinsured motorist benefits. The jury reached a verdict in favor of Plaintiff, awarding damages in the amount of $22,890. Plaintiff filed a motion for an additur, which the trial justice granted in the amount of $6,000. The Supreme Court affirmed, holding that the trial justice did not abuse his discretion in granting an additur of $6,000. View "Mowry v. Allstate Insurance Co." on Justia Law

Appellant Dameron Hospital Association (Dameron) required patients or their family members to sign Conditions of Admissions (COAs) when Dameron provided the patients’ medical care. The COAs at issue in this case contained language that assigned to Dameron direct payment of uninsured and underinsured motorist (UM) benefits and medical payment (MP) benefits that would otherwise be payable to those patients under their automobile insurance policies. Dameron treated five of California State Automobile Association Inter-Insurance Bureau's ("CSAA") insureds for injuries following automobile accidents. Those patients had UM and/or MP coverage as part of their CSAA coverage, and Dameron sought to collect payment for those services from the patients’ UM and/or MP benefits at Dameron’s full rates. Instead of paying to Dameron the lesser of either all benefits due to the patients under their UM and MP coverage, or Dameron’s full charges, CSAA paid portions of those benefits directly to the patients which left balances owing on some of Dameron’s bills. Dameron sued CSAA to collect UM and MP benefits it contended CSAA owed Dameron under the assignments contained in the COAs. The trial court concluded that Dameron could not enforce any of the assignments contained in the COAs and entered judgment in CSAA’s favor following CSAA’s successful motion for summary judgment. The Court of Appeal held Dameron could not collect payment for emergency services from the UM or MP benefits due to patients that were covered under health insurance policies. Further, the Court held: (1) the COA forms were contracts of adhesion; (2) it was not within the reasonable possible expectations of patients that a hospital would collect payments for emergency care directly out of their UM benefits; and (3) a trier of fact might find it was within the reasonable expectations of patients that a hospital would collect payments for emergency care directly out of their MP benefits. Accordingly, the Court concluded Dameron could not maintain causes of action to collect MP or UM benefits due to four of the five patients directly from CSAA. However, consistent with this opinion, the trial court could consider whether an enforceable assignment of MP benefits was made by one adult patient. View "Dameron Hospital Assn. v. AAA Northern Cal. etc." on Justia Law

Plaintiffs Calvin and Mary Landry filed a petition for damages, alleging they suffered injuries arising out of an automobile collision. Plaintiffs brought the action against defendant-driver Riyad Shaibi, his insurer Financial Indemnity Company (“Financial”), and Progressive Security Insurance Company (“Progressive”), as the insurer of the 2008 Toyota Sienna that Shaibi was driving at the time of the collision. Shaibi was bringing the 2008 Toyota Sienna to a tire shop to repair a flat tire as a favor to its owner, Aziz Ali. The Louisiana Supreme Court granted review of this matter to address whether the court of appeal erred in finding public policy mandated liability coverage by a defendant driver’s automobile insurance policy for an accident occurring while operating a non-owned automobile. Under the narrow facts presented, the Court found neither statutory law nor public policy considerations required automobile insurance liability coverage related to a defendant driver’s negligent operation of a non-owned vehicle. Accordingly, the Court reversed the court of appeal and reinstated the ruling of the district court granting summary judgment in favor of the defendant insurer. View "Landry v. Progressive Security Ins. Co., et al." on Justia Law

An explosion at the Omega Protein Plant in Moss Point, Mississippi killed one man and seriously injured several others. Multiple lawsuits were filed against Omega in federal district court. Colony Insurance Company filed a declaratory judgment action in state circuit court seeking a declaration that it did not cover bodily injuries arising out of the Moss Point facility explosion. Evanston Insurance Company intervened also seeking a declaration of no coverage for the same injuries: Evanston provided a $5 million excess liability policy, which provided coverage after Colony’s $1 million policy was exhausted. Because Colony settled one of the underlying personal injury cases for $1 million (the limits under its policy), Omega sought excess coverage from Evanston for the injuries that occurred at its plant. A special master was appointed, and the trial court granted Evanston’s motion for summary judgment, finding that the pollution exclusion in the insurance contract barred coverage. Omega appealed that grant of summary judgment. The Mississippi Supreme Court found that a pollution exclusion in the insurance contract was ambiguous, and should have been construed in favor of the insured, allowing coverage. Further, the Court found the question of whether coverage was triggered was governed by the language of the contract, and that Evanston failed to prove there could be no coverage under the excess liability policy. Therefore, the Supreme Court reversed the trial court’s grant of summary judgment as to all issues and remanded the case for further proceedings. View "Omega Protein, Inc. v. Evanston Insurance Company" on Justia Law

The Supreme Court affirmed the judgment of the circuit court denying Plaintiffs' declaratory judgment action against State Farm seeking payment of $2 million under Florida's uninsured motorist (UM) statute, holding that Florida law did not require State Farm to provide UM coverage.State Farm denied Plaintiffs UM coverage under their personal liability umbrella insurance policy after a motorcycle accident with an uninsured vehicle in South Dakota because the policy did not include UM coverage. Thereafter, Plaintiffs, who resided in Florida at the time of the accident, filed this declaratory action. The circuit court concluded that Florida law applied to the dispute, that State Farm did not violate Florida's UM statute, and that Plaintiffs were not entitled to UM coverage. The Supreme Court affirmed, holding that Florida law did not require State Farm to provide UM coverage. View "Payne v. State Farm Fire & Casualty Co." on Justia Law

The First Circuit affirmed the decision of the district court granting summary judgment for Defendants in this personal injury action, holding that the district court properly granted summary judgment as to all claims.This case arose from a car accident in Rhode Island involving Horace Johnson, the driver, and Carlton Johnson, a passenger. Carlton and his mother sued to recover damages for Carlton's injuries. The district court granted summary judgment for Defendants - Horace, his insurer, and the company from which Horace had leased the vehicle. The First Circuit ultimately certified to the Rhode Island Supreme Court a question regarding the definition of "civil action" in Rhode Island's Rejected Settlement Offer Interest Statute, R.I. Gen. Laws 27-7-2.2. After the Rhode Island Supreme Court supplied its answer, this Court affirmed the district court's judgment in its entirety, holding that the district court (1) correctly concluded that section 27-7-2.2 was inapplicable; (2) properly concluded that an enforceable settlement agreement existed; and (3) was right to grant summary judgment as to Carlton's insurer bad faith claims. View "Johnson v. Johnson" on Justia Law