Justia Insurance Law Opinion Summaries
Articles Posted in Personal Injury
Anaya-Smith v. Federated Mutual Insurance Co.
The case involves Nancy Anaya-Smith, the next of kin of Michael Brian Smith, who was killed in a single-car accident while he was a passenger in a company vehicle owned by Fixtures & Drywall Company of Oklahoma (FADCO). The vehicle was being driven by Smith's coworker, Duane Clark. Anaya-Smith alleges that Clark's negligence caused the fatal accident. At the time of the accident, FADCO maintained an insurance policy with Federated Mutual Insurance Company (Federated). The policy provided up to $1,000,000 of liability coverage per accident and an additional $6,000,000 of liability coverage per accident under an umbrella policy. However, FADCO had rejected uninsured motorist (UM) coverage for all employees, except for its directors, officers, partners, owners, and their family members.The United States District Court for the Western District of Oklahoma granted summary judgment in favor of Federated, concluding that the vehicle was an uninsured vehicle at the time of the accident because Clark is immune from tort liability under the workers' compensation exclusive remedy provision, and that FADCO's policy providing UM coverage for some individuals who qualify as insureds but rejecting UM coverage for other insureds does not violate Oklahoma law. Anaya-Smith appealed from the summary judgment order.The Supreme Court of the State of Oklahoma answered the first certified question in the affirmative, holding that the vehicle qualifies as an uninsured motor vehicle within the meaning of Oklahoma law. The court answered the second certified question in the negative, concluding that the plain language of Oklahoma law requires a named insured to either elect or reject uninsured/underinsured motorist coverage for all insureds under the policy, treating every insured in the same manner. The court declined to answer the third certified question as the record was undeveloped and the parties did not submit legal arguments pertaining to it. View "Anaya-Smith v. Federated Mutual Insurance Co." on Justia Law
EASTMAN VS. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
This case involves a three-car consecutive rear-end collision. The plaintiffs, Scott Eastman and his wife, filed a lawsuit against Jillian Peterson and her insurer, State Farm Mutual Automobile Insurance Company, alleging that Peterson was solely liable for the accident because she negligently rear-ended Eastman's vehicle. Peterson and State Farm denied the allegations, contending that Eastman was comparatively at fault for the accident because he impacted the vehicle in front of him prior to being rear-ended by Peterson. They also disputed the severity of Eastman's injuries caused by the accident and argued that a majority of his alleged injuries and damages were due to a pre-existing condition.The case was tried before a jury, which found both Peterson and Eastman comparatively liable for the accident, assigning fifty-percent fault to each. The jury also found that Eastman had been injured in the accident and awarded him damages. Eastman then filed a motion for judgment notwithstanding the verdict (JNOV), arguing that the jury erred as the evidence strongly and overwhelmingly favored a finding of sole liability on the part of Peterson. The trial court granted the JNOV, finding Peterson solely liable for the accident and increasing the damages awarded to Eastman. The court of appeal affirmed the trial court's judgment.The Supreme Court of Louisiana granted certiorari to review the lower courts' judgments. The court found that the trial court erred in granting the JNOV as to both liability and damages. The court noted that there was conflicting, credible testimony as to whether Eastman collided with the vehicle ahead of him prior to being impacted from behind by Peterson. The court also found that the evidence did not so strongly and overwhelmingly favor Eastman that reasonable jurors could not reach different conclusions. Therefore, the court reversed the court of appeal, vacated the judgment of the trial court, and reinstated the jury's verdict. View "EASTMAN VS. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY" on Justia Law
Kramer v. Nationwide Insurance
The case involves a dispute between Stewart Kramer and Valerie Concinello (Parents) and Nationwide Property and Casualty Insurance Company (Nationwide) over the interpretation of their homeowners insurance policy. The dispute arose after the fatal drug overdose of Michael T. Murray, Jr. (Decedent) at Parents' home. The administrator of Decedent's estate sued Parents and their son, Adam Kramer, for wrongful death and survival actions. Parents sought coverage under their insurance policy with Nationwide, but Nationwide denied coverage based on a controlled substance exclusion in the policy. Parents then filed a declaratory judgment action, and the trial court ordered Nationwide to defend Parents.The Superior Court affirmed the trial court's decision but based its ruling on a different interpretation of the policy. The Superior Court concluded that the policy's controlled substance exclusion applied to the bodily injury claims in the underlying lawsuit but did not apply to emotional distress damages claimed in the wrongful death action.The Supreme Court of Pennsylvania reversed the Superior Court's decision. The Supreme Court held that the Superior Court's interpretation that Nationwide was potentially required to pay out for emotional and mental distress damages was contrary to the unambiguous provisions of the policy and erroneous as a matter of law. The Supreme Court concluded that Nationwide had no duty to defend the underlying lawsuit because emotional and mental distress damages in the wrongful death claims were not bodily injuries under the policy. View "Kramer v. Nationwide Insurance" on Justia Law
Mitchell v. Durham Enterprises, Inc.
The case revolves around a patient, Tommy Harris, who contracted bacterial sepsis due to repeated infections from his dialysis treatment at a clinic in Belleville, Illinois. Harris filed a malpractice lawsuit against the operators of the clinic and later included a claim against Durham Enterprises, Inc., the janitorial company responsible for cleaning the facility. The case primarily concerns Durham’s insurance coverage. Durham submitted the lawsuit to Ohio Security Insurance Company, its insurer, which denied coverage based on the insurance policy’s exclusion for injuries caused by fungi or bacteria. Harris and Durham then negotiated an agreement in which Durham promised not to mount a defense and Harris promised to seek recovery only from the insurer. The state trial judge granted a motion to sever Harris's claim against Durham and set it for a bench trial. The judge held a short, uncontested bench trial and entered judgment against Durham for more than $2 million.Ohio Security was not a party to the state court proceedings and the insurance policy was not in the record. However, the consent judgment includes findings on insurance issues, notably, that the insurer breached its duty to defend and is estopped from asserting any policy defenses. After the judgment became final, Harris filed an amended complaint purporting to add Ohio Security as a defendant. Ohio Security removed the action to federal court and sought a declaration of its coverage obligations. The district court held that the bacteria exclusion precludes coverage.In the United States Court of Appeals for the Seventh Circuit, Harris and Durham jointly appealed, challenging the no-coverage ruling but also raising a belated challenge to subject-matter jurisdiction under the Rooker–Feldman doctrine. The court found the jurisdictional argument meritless, as the Rooker–Feldman doctrine does not block federal jurisdiction over claims by nonparties to state-court judgments. The court also affirmed the district court's ruling that the policy’s bacteria exclusion precludes coverage for this loss. View "Mitchell v. Durham Enterprises, Inc." on Justia Law
Hartford Accident and Indemnity Company v. Lin
This case involves a dispute between Zhen Feng Lin, a food delivery driver who was severely injured in a car accident, and his employer's insurance company, Hartford Accident and Indemnity Company. After the accident, Lin received a settlement from the at-fault driver's insurance company, and workers' compensation benefits from his employer's insurance carrier, Hartford Fire Insurance Company. Lin later sought additional recovery under his employer's underinsured motorist policy with Hartford Accident.The United States Court of Appeals for the Seventh Circuit affirmed the district court's decision that Lin and Hartford Accident had not entered into a "settlement agreement" as defined by the insurance policy. As a result, the court ruled that the policy limits should be reduced by the amount Lin received in workers' compensation benefits. The court also agreed with the district court that Lin should be credited for the amount he paid to settle the workers' compensation lien.Additionally, the court affirmed the district court's dismissal of Lin's counterclaims for bad faith and breach of contract. The court found no plausible claim supporting the argument that Hartford Accident unreasonably delayed settling Lin's claim. Lin's request for statutory penalties for Hartford Accident's purported delay in handling his claim was also denied.Finally, the court denied both parties' motions for sanctions. Lin's appeal was deemed frivolous in part, but the court exercised its discretion not to impose sanctions. View "Hartford Accident and Indemnity Company v. Lin" on Justia Law
Virgo v. Roberts
In this case, an automobile repair technician, Donijah Virgo, was injured when his stalled vehicle was hit by a car driven by Heather Michelle Roberts while he was attempting to push it across a road. Virgo sued Roberts for negligence, but the Mobile Circuit Court granted Roberts a partial summary judgment, dismissing Virgo's counterclaim. The Supreme Court of Alabama affirmed the lower court's decision.In October 2020, Virgo was diagnosing a mechanical problem in a Crown Victoria automobile. The car stalled on a road, and he moved it into a median left-turn lane. After waiting for about 10 minutes for traffic to clear, Virgo attempted to push the car across the road, during which Roberts's vehicle collided with it, resulting in major damage and serious injuries to Virgo.Roberts sued Virgo for negligence and wantonness and sought uninsured motorist benefits from GEICO Casualty Company. Virgo filed a counterclaim alleging negligence on Roberts's part. After settling the claim against GEICO, Roberts moved for a summary judgment on Virgo's counterclaim, which the circuit court granted.The Supreme Court of Alabama affirmed the circuit court's decision. The court concluded that Virgo failed to present substantial evidence to raise a genuine issue of material fact regarding his counterclaim, and thus, the circuit court did not err in granting a summary judgment in favor of Roberts. View "Virgo v. Roberts" on Justia Law
Dodds v. Tierney
The Supreme Court of the State of Montana affirmed a lower court decision that granted Dr. Gregory S. Tierney's motion to dismiss a medical malpractice lawsuit filed by Janice M. Dodds for insufficient service of process. Dodds initially filed the suit against Dr. Tierney and Benefis Health System in 2013, alleging medical malpractice related to a knee replacement surgery. She failed to serve the defendants in time. Dr. Tierney later filed for bankruptcy, which invoked an automatic stay, halting the lawsuit. After his bankruptcy discharge, Dodds attempted to serve Dr. Tierney but failed to do so within the required 30-day timeframe following the discharge.Dodds further sought to join Dr. Tierney's malpractice insurance company as the real party in interest, but the court denied the motion. Upon review, the Supreme Court found that Dodds had not proven Dr. Tierney's liability, thus the insurer had no duty to indemnify him. The court also rejected Dodds' argument that Dr. Tierney lacked standing after his Chapter 7 discharge. The court held that Dr. Tierney maintained a personal stake in demonstrating he was not liable for medical malpractice and that his insurer would only have a duty to indemnify him once Dodds proved her malpractice claims. View "Dodds v. Tierney" on Justia Law
Axis Surplus Insurance Company v. TriStar Companies, LLC
In 2021, a warehouse developed by TriStar Companies, LLC but possessed by Amazon collapsed during a tornado, causing injuries and deaths. Several personal injury and wrongful death lawsuits were filed against TriStar, claiming negligence in the warehouse's construction. TriStar, insured by AXIS Surplus Insurance Company, sought coverage under their policy, but AXIS denied coverage and filed a complaint for a declaratory judgment that it had no duty to defend or indemnify TriStar for the resulting lawsuits. The district court granted AXIS's motion for summary judgment, ruling that the insurance policy did not cover the warehouse due to certain exclusions and limitations.Upon appeal, the United States Court of Appeals for the Eighth Circuit affirmed the lower court's decision. The Court of Appeals applied Missouri law, giving the insurance policy terms "the meaning which would be attached by an ordinary person of average understanding if purchasing insurance." The court found that the policy's language was clear and unambiguous. It limited coverage to premises owned, rented, or occupied by TriStar per a schedule of locations on file with AXIS. As the warehouse's location was not listed in the schedule, and TriStar did not own, rent, or occupy the warehouse when the incident occurred, the court concluded that the policy did not cover the incident.The court rejected TriStar's interpretation of the schedule of locations, which would have resulted in coverage extending to an entire city, as untenable and against common sense. Therefore, AXIS had no duty to defend or indemnify TriStar for the lawsuits arising from the warehouse collapse. View "Axis Surplus Insurance Company v. TriStar Companies, LLC" on Justia Law
NBIS Construction & Transport Insurance Services, v. Liebherr-America, Inc.
In this case, the United States Court of Appeals for the Eleventh Circuit had to apply Florida tort law to a dispute concerning the collapse of a crane boom. The plaintiff, NBIS Construction & Transport Insurance Services, Inc., an insurer of the crane's owner, sued the defendants, Liebherr-America, Inc., a distributor and servicer of the type of crane in question, for over $1.7 million in damages resulting from the collapse. The defendants argued that they were shielded from liability by Florida’s economic loss rule. The magistrate judge, after a five-day bench trial, rejected this argument. The court of appeals found Florida law unclear on this issue and certified a question to the Florida Supreme Court.The facts of the case involved a crane purchased by Sims Crane & Equipment Company from a non-party broker, which was manufactured by Liebherr Werk Ehingen GMbH. Two Sims crane operators received training from a Liebherr-America employee, which involved swapping out different configurations of the crane boom. However, the training was inadequate and did not provide sufficient information about the proper placement of specific pins which, if misadjusted, could cause the crane boom to collapse. When the crane boom did collapse during a construction project, causing a fatality and damage to the crane, NBIS filed a negligence suit against Liebherr-America.The key issue in the case was whether Florida’s economic loss rule, which generally limits recovery in tort cases to situations where there is damage to other property or personal injury, and not just economic loss, applied in this case. The defendants argued that the rule should apply because the plaintiff’s negligence claims were akin to failure to warn theories found in products liability law, which fall within the scope of the rule. The plaintiff argued that the rule should not apply because this was not a product liability case asserting a product defect, but rather a case alleging negligent services provided by the defendants. Because the court found Florida law unclear on this issue, it certified the question to the Florida Supreme Court. View "NBIS Construction & Transport Insurance Services, v. Liebherr-America, Inc." on Justia Law
COMBS V. SPICER
In this case heard before the Supreme Court of Kentucky, the primary issue was whether the Breathitt Circuit Court correctly dismissed Teresa Spicer's lawsuit against James Combs for intentional infliction of emotional distress (IIED). Spicer's suit arose from damages linked to Combs' actions, following a fatal ATV accident which resulted in the death of Tiara Combs, James Combs’ wife and Spicer's daughter. Prior to the lawsuit, Combs and Spicer, as co-administrators of Tiara's estate, had signed a release settlement with Progressive Casualty Insurance Company, effectively absolving both Combs and Progressive of any further liability relating to the accident.After learning that Combs was intoxicated at the time of the accident, a fact he allegedly hid from her, Spicer sought to sue Combs personally for IIED. Combs moved to dismiss Spicer's complaint on the grounds that the previous release signed by Spicer barred her claim, and that her complaint did not meet the standard for an IIED claim. The circuit court dismissed the action, holding that the release was intentionally broad and included all potential claims, including IIED.On appeal, the Court of Appeals reversed the dismissal, ruling that the release did not prevent Spicer from asserting a personal cause of action against Combs. The Supreme Court of Kentucky affirmed the Court of Appeals' decision. The court ruled that the language of the release only covered claims possessed by the estate and not Spicer's individual claims. Furthermore, the Court held that Spicer's complaint was sufficient to proceed under a motion to dismiss for failure to state a claim, leaving it to the circuit court to resolve whether Spicer can sufficiently establish her claim at a later time. View "COMBS V. SPICER" on Justia Law