Justia Insurance Law Opinion Summaries

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

Ben E. Keith Company, Inc. ("BEK"), appealed a circuit court order entering summary judgment in favor of Lyndon Southern Insurance Company ("Lyndon") on Lyndon's complaint for a declaratory judgment. On December 14, 2018, Felicia Edwards and Robert Allen Marak were involved in a motor-vehicle accident in Dadeville. Felicia was driving a 2009 Toyota Camry automobile that was owned by Annette Edwards and insured by Lyndon. Marak was driving a tractor-trailer that was owned by BEK. As a result of the accident, BEK incurred damage to its tractor-trailer. BEK sued Felicia and Annette claiming negligence and wantonness against both Felicia and Annette and a claim of negligent entrustment against Annette. BEK later amended the complaint to add a negligent-maintenance claim against Annette. Lyndon filed a complaint for a declaratory judgment against Felicia, Annette, and BEK, asserting the policy it issued to Annette excluded coverage for "[a]ny operator of a vehicle who is not listed as a driver on the Policy Applications, Declarations, and/or added by Endorsement who is under the age of twenty-five and is either a Family Member or resides in the same household as the Named Insured" and for "[a]n operator of a vehicle who is an unlicensed driver or whose driving privileges have been terminated or suspended." BEK argued the trial court erroneously granted Lyndon's motion for a summary judgment because Lyndon did not produce substantial admissible evidence to establish that Felicia was a noncovered person under the policy that insured Annette's vehicle at the time of the accident. Specifically, it contended Lyndon did not produce substantial admissible evidence to establish that Felicia did not have a valid driver's license at the time of the accident or to establish Felicia's age and residence at the time of the accident. After review, the Alabama Supreme Court concurred Lyndon did not produce substantial evidence to establish that Felicia did not have a valid driver's license at the time of the accident and did not produce substantial evidence to establish that Felicia was under the age of 25 and resided in Annette's household at the time of the accident. Therefore, Lyndon did not shift the burden of proof to BEK. Accordingly, the trial court erred in granting Lyndon's motion for a summary judgment. Judgment was therefore reversed. View "Ben E. Keith Company, Inc. v. Lyndon Southern Insurance Company" on Justia Law

In each of two automobile personal injury actions, plaintiffs moved for entry of a qualified protective order (QPO) pursuant to the Health Insurance Portability and Accountability Act (HIPAA), 110 Stat. 1936, and its implementing regulations (45 C.F.R. 160, 164) (Privacy Rule). Plaintiffs’ proposed QPOs would allow protected health information (PHI) to be released, subject to restrictions that nonlitigation use or disclosure of PHI is prohibited and PHI must be returned or destroyed at the conclusion of the litigation. State Farm, the liability insurer for the named defendants, intervened in each lawsuit and sought entry of its own protective order, which expressly allowed insurance companies to use, disclose, and maintain PHI for purposes beyond the litigation and expressly exempted insurers from the “return or destroy” requirement.In both cases the circuit court granted the plaintiffs’ motions. The appellate court and Illinois Supreme Court affirmed, rejecting State Farm’s argument that property and casualty insurers fall outside HIPAA. Rejecting arguments concerning the requirements of the Illinois Insurance Code, the court stated that no Illinois law requires State Farm to use or disclose plaintiffs’ PHI after the conclusion of the litigation. The Cook County standard protective order is preempted by the Privacy Rule and the McCarran-Ferguson Act, 15 U.S.C. 1011, does not apply to shield that order from traditional preemption. View "Haage v. Zavala" on Justia Law

Consolidated cases presented a certified question from the United States District Court for the District of Oregon. The Oregon Supreme Court was asked to determine whether Oregon law precluded an insurer from limiting its liability for uninsured/underinsured motorist (UM/UIM) benefits on the basis that another policy also covered the insured’s losses. Each plaintiff suffered injuries caused by an uninsured or underinsured motorist, and each plaintiff incurred resulting damages that qualify as covered losses under multiple motor vehicle insurance policies issued by defendant State Farm Mutual Automobile Insurance Company (State Farm). Each plaintiff alleged a loss that exceeded the declared liability limits of any single applicable policy and sought to recover the excess under additional applicable policies, up to the combined total of the limits of liability. In each case, however, State Farm refused to cover the excess loss, citing a term in the policies that allowed State Farm to limit its liability to the amount that it agreed to pay under the single policy with the highest applicable limit of liability. The Oregon Supreme Court concluded that that term made State Farm’s uninsured motorist coverage less favorable to its insureds than the model coverage that the legislature has required and, thus, was unenforceable. View "Batten v. State Farm Mutual Automobile Ins. Co." on Justia Law

A minor was severely injured in an all-terrain vehicle collision in which the other driver was at fault. The minor had medical benefits coverage through a health care plan provided by her father’s employer, the Fairbanks North Star Borough. As allowed by the terms of the plan, the Borough refused to pay the minor’s medical bills until she signed an agreement that included a waiver of certain defenses to the Borough’s subrogation rights, such as the common fund and made-whole doctrines. The minor refused to sign the agreement without reservation and filed suit, seeking a declaration that the Borough could not condition payment of her medical bills on her signature. The superior court decided on summary judgment that the Borough’s health care plan was not a true insurance plan and that, regardless of whether it was interpreted as an insurance policy or an ordinary contract, the parties could lawfully reject subrogation defenses. The minor appealed. The Alaska Supreme Court held that the health care plan was a bargained-for employee benefit rather than a true insurance policy, and that the superior court’s interpretation of it was correct. The Court therefore affirmed the superior court's judgment. View "Best v. Fairbanks North Star Borough" on Justia Law

Dwayne Harris appealed a circuit court order dismissing his counterclaim against Dubai Truck Lines, Inc., pursuant to Rule 12(b)(6), Ala. R. Civ. P. On February 18, 2018, three vehicles were involved in an accident in Jefferson County, Alabama: a vehicle owned by Dubai and driven by Jose Martinez, one of Dubai's employees; a vehicle driven by Harris; and a vehicle driven by Annika Schaefer. Schaefer's vehicle was insured by State Farm Mutual Automobile Insurance Company. On February 28, 2019, Schaefer and State Farm, as subrogee of Schaefer sued Dubai and Martinez. According to Dubai, it was not served with the complaint until June 2020, after the expiration of the applicable two-year statute-of- limitations period. On August 7, 2020, Dubai filed an answer denying all liability for the accident and adding Harris as a third-party defendant pursuant to Rule 14, Ala. R. Civ. P. Dubai specifically impleaded Harris to allege that Harris's negligence was the proximate cause of the accident. On November 13, 2020, Harris filed a counterclaim against Dubai, alleging that Martinez, Dubai's employee, had been negligent and/or wanton in causing the accident, that Harris had suffered injuries as a result of the accident and that Dubai was vicariously liable for those injuries. Dubai then moved to dismiss the counterclaim, alleging Harris' counterclaim was barred by the applicable statute of limitations. The Alabama Supreme Court found Harris's counterclaim was compulsory, and not subject to a statute-of-limitations defense. Thus, there was no basis for the circuit court to dismiss Harris's counterclaim pursuant to Rule 12(b)(6). View "Harris v. Dubai Truck Lines, Inc." on Justia Law

Melvin James appealed a circuit court's grant of summary judgment in favor of Assurance America Insurance Company ("Assurance") on its complaint for a declaratory judgment. In February 2019, Bernardino Mejia and James were involved in a motor-vehicle accident in Montgomery, Alabama. Mejia was driving a 2003 Chrysler Town and Country minivan, and James was driving a 2004 Toyota Camry automobile. As a result of the accident, Mejia's three children were ejected from the Town and Country. One of Mejia's children died, and the other two were seriously injured. James was also injured as a result of the accident. Mejia was arrested, and, on September 23, 2019, he was indicted for one count of reckless murder and four counts of first- degree assault as a result of the accident. He was incarcerated on those charges. In April 2019, James sued Mejia, ALFA Insurance Corporation, USAA Casualty Insurance Company, and various fictitiously named defendants for negligence, negligence per se, wantonness, and breach of contract. Mejia moved to stay the civil proceeding until the accident-related criminal proceedings against him were concluded; this motion was granted. Assurance sought the summary judgment motion at issue here, against Mejia and James. Assurance contended Mejia was not the named insured under the Assurance policy that covered the Town & Country he was driving, and that policy excluded coverage for injury or damage caused by an insured vehicle when driven by a person who was not listed as a driver on the declarations page of the policy and who did not have a valid driver's license. The Alabama Supreme Court reversed and remanded, finding Assurance did not produce substantial, admissible evidence to establish Mejia did not have a valid driver's license at the time of the accident and therefore did not shift the burden of proof to James. Accordingly, the trial court erred in granting Assurance's motion for a summary judgment. View "James v. Assurance America Insurance Company" on Justia Law