Justia Insurance Law Opinion Summaries

John Buckley started working for Labor Ready, Inc., a temporary employment service, in 2009. He was injured on assignment for a shipping company. At the time of injury he was performing a task prohibited by the contract between the temporary employment service and the shipping company. The injury resulted in loss of the worker’s hand and part of his arm. After getting workers’ compensation benefits from the temporary employment service, the worker brought a negligence action against the shipping company and one shipping company employee. The superior court decided on cross-motions for summary judgment that the exclusive liability provision of the Alaska Workers’ Compensation Act (Act) barred the action. The Alaska Supreme Court reverse, finding material issues of fact precluded disposition by summary judgment. View "Buckley v. American Fast Freight, Inc." on Justia Law

Keith Steffes, Kelly Steffes and Tasha (Rohrbach) Steffes appealed a district court order granting Nodak Mutual Insurance Company’s motion for a new trial. The Steffeses argued the district court abused its discretion in vacating the judgment and granting Nodak’s motion for a new trial. The North Dakota Supreme Court dismissed the appeal because the order granting a new trial was not then reviewable. View "Nodak Mutual Insurance Company v. Steffes, et al." on Justia Law

This case involved an appeal brought by Aerocet, Inc., and its surety, the State Insurance Fund, in which they appealed an Idaho Industrial Commission decision involving two worker’s compensation claims brought by George McGivney. The Commission awarded McGivney benefits for injuries he sustained to his left knee while working for both Aerocet and Quest Aircraft (Quest). The Referee consolidated the two cases and issued a recommendation that attributed the vast majority of liability to Quest. The Commission rejected the bulk of the Referee’s recommendations and apportioned liability equally between Aerocet and Quest. Aerocet appealed, alleging the Commission inappropriately consolidated McGivney’s two injury claims. Aerocet also argued the Commission failed to determine McGivney’s disability in excess of impairment from his 2011 accident at Aerocet prior to his 2014 accident at Quest, and that the Commission erred in its application of Brown v. Home Depot, 272 P.3d 577 (2012). Aerocet also contended the Commission’s decision was not supported by substantial and competent evidence. After review, the Idaho Supreme Court affirmed the Commission’s decisions. The matter was remanded back to the Commission to enable it to calculate the amount due Quest’s surety from Aerocet’s surety for any amounts overpaid by Quest’s surety. View "McGivney v. Aerocet, Inc" on Justia Law

Two cases consolidated for review by the Delaware Supreme Court involved automobile accidents. John Henry and Charles Fritz sustained injuries in accidents while operating employer-owned vehicles during the course of their employment. In both cases, the accidents were allegedly caused by a third-party tortfeasor. Both employees received workers’ compensation from their respective employers’ insurance carriers. In each case, the vehicle was covered by an automobile liability insurance policy issued to the employer by Cincinnati Insurance Company. The superior court issued an order in Henry’s case first, finding the exclusive-remedy provision in the Delaware Workers’ Compensation Act in effect at the time of his accident precluded Henry from receiving underinsured motorist benefits under the Cincinnati policy. Following that decision, the Fritz court granted Cincinnati’s motion for summary judgment on the same ground. Henry and Fritz argued on appeal to the Delaware Supreme Court that the superior court erred in finding the Act’s exclusivity provision precluded them from receiving underinsured motorist benefits through the automobile liability policies their respective employers purchased from Cincinnati. The Supreme Court agreed both trial courts erred in finding the Act’s exclusivity provision prevented underinsured motorist benefits. The Court reversed and remanded for further proceedings. View "Henry v. Cincinnati Insurance Co." on Justia Law

The Supreme Court reversed the judgment of the circuit court entering summary judgment in favor Insured in this insurance coverage dispute, holding that the circuit court erred in finding that Insured was entitled to underinsured motorist (UIM) coverage under three insurance policies Insured maintained with Insurer after the death of her daughter (Decedent).When Driver crashed the vehicle she was driving, Decedent, the passenger, sustained fatal injuries. Insured asserted a wrongful death claim against Driver, and Driver settled the claim for her insurance policy's limits. Thereafter, Insured sought UIM coverage from Insurer. Insurer provided UIM coverage pursuant to one of the insurance policies, but Insurer denied UIM coverage under the other two insurance policies. Insured then brought this suit seeking a declaration that UIM coverage existed for Decedent and alleging breach of contract. The circuit court granted summary judgment for Insured. The Supreme Court reversed, holding that under the plain language of two of the policies at issue, Decedent was not an insured entitled to UIM coverage. View "Seaton v. Shelter Mutual Insurance Co." on Justia Law

The Supreme Court affirmed the judgment of the superior court granting summary judgment in favor of Insurer and Plaintiff's claims alleging that Insurer was contractually obligated to provide insurance coverage to Plaintiff, which was listed as an additional issued on the relevant insurance policy, holding that Insurer had no duty to defend Plaintiff.Plaintiff, the general contractor for a construction project, subcontracted with Insured for structural work on the project. Insured purchased a commercial general liability insurance policy from Insurer, which named Plaintiff as an additional insured. The policy provided for defense and indemnification costs to Insured for its work on the project. Insured's employee (Employee), who sustained injuries while working on the construction project site, filed a complaint against Plaintiff, alleging that Plaintiff's negligent acts were the proximate cause of his injuries. Plaintiff sought a declaratory judgment that Insurer was contractually obligated to indemnify and defend Plaintiff as an additional insured relative to the Employee action. The superior court justice granted summary judgment for Insurer. The Supreme Court affirmed, holding that Employee's complaint was devoid of any allegations that brought the underlying case within the coverage of the policy, and therefore, Insurer had no duty to defend Plaintiff. View "Bacon Construction Co. v. Arbella Protection Insurance Co." on Justia Law

The Supreme Court affirmed in part and reversed in part the decision of the court of appeals reversing the circuit court's order that determined that Plaintiffs' claims against Defendant-insurance company were barred by the doctrine of claim preclusion, holding that claim preclusion barred the claims of certain plaintiffs, but the Court was evenly divided as to whether claim preclusion barred the claims brought by a fourth plaintiff.This case arose from a car accident in which a mother and her three daughters were seriously injured. The father was not in the car. The accident resulted in two separate lawsuits. In the first action, the mother brought a negligence claim against the driver of the other vehicle and her insurer, State Farm. The children were also named as plaintiffs. The action settled. The second lawsuit brought by the family, including the father, alleging that the driver of the car in which they were passengers was negligent. Plaintiffs sued the driver's insurer directly. The circuit court granted summary judgment for Defendant, concluding that the action was barred by claim preclusion. The court of appeals reversed. The Supreme Court held (1) claim preclusion barred the claims brought by the mother and daughters in the second action; but (2) the court of appeals properly allowed the father's claims to proceed. View "Teske v. Wilson Mutual Insurance Co." on Justia Law

Claimant Elvia Garcia-Solis was injured in a work-related accident. Farmers Insurance Company and Yeaun Corporation (collectively, “Insurer”) accepted a workers’ compensation claim and certain specified medical conditions associated with the accident. Because claimant also showed psychological symptoms, her doctor recommended a psychological referral to diagnose her for possible post-traumatic stress disorder (PTSD). Insurer argued, and the Court of Appeals agreed, that the cost of the psychological referral was not covered by workers’ compensation because claimant had failed to prove that it was related to any of the medical conditions that insurer had accepted. The Oregon Supreme Court reversed both the Court of Appeals and the Workers’ Compensation Board: “’injury’ means work accident is context-specific to exactly two uses in the first and second sentences of ORS 656.245(1)(a). It does not apply to the second use in the first sentence of ORS 656.245(1)(a). We do not decide or suggest that it applies to any other statute in the workers’ compensation system.” View "Garcia-Solis v. Farmers Ins. Co." on Justia Law

In this declaratory relief proceeding, the Supreme Court affirmed the circuit court's denial of State Farm's motion for summary judgment and entered a judgment in favor of LeRoy James on his complaint alleging that State Farm had no right to reimbursement or subrogation for paying James's medical expenses under his policy, holding that State Farm had no contractual right to reimbursement for the $5,000 paid to James for medical expenses under the policy.State Farm insured both James and Melissa Rivers, who rear-ended James and caused him personal injury. State Farm paid a portion of James's medical expenses under his policy and then, acting on behalf of Rivers, settled with James. Once James released Rivers from liability, State Farm demanded that James use his settlement proceeds to reimburse State Farm for paying his medical expenses. James then brought this action. The circuit court entered a judgment in favor of James. The Supreme Court affirmed, holding that the text of the reimbursement provision of the policy was ambiguous, and therefore, State Farm had no contractual right to reimbursement from James. View "James v. State Farm Mutual Automobile Insurance Co." on Justia Law

On October 30, 2013, Consuelo Prieto Mariscal was driving her minivan in Pasco, Washington, with her daughter. There were vehicles, including an orange, pickup truck and a van, on the right side of the road. As Prieto passed the orange pickup truck, she heard a noise, felt her van jump a little, and saw a boy, Brayan, lying on the ground. Realizing Brayan was seriously hurt, her daughter called 911. Brayan was taken to a nearby hospital. Prieto and her daughter both told the police they did not see how the accident happened. There were no other eyewitnesses, and though the officer only spoke to Prieto and her daughter, he noted in his report the "bicyclist pulled into the roadway [and] was stuck on the left side and fell to the ground. The passenger side front tire drove over the child['s] right front leg." Brayan gave a number of statements, the most detailed of which related his right shoelace got stuck in the spokes of his bicycle and his right leg was run over when he leaned over to untangle the lace. Monica Diaz Barriga Figueroa, Brayan's mother, retained counsel, and signed a blank personal injury protection (PIP) application form. The English-speaking legal assistant completed the form for the Spanish-speaking Diaz, pulling language of the accident from the police report. The significant difference between the PIP form and Brayan's testimony became a central issue at trial. Prieto's counsel stressed the differences between Diaz's and Brayan's testimony and the PIP form; Diaz's counsel stress the PIP form was based on accounts from people who did not see the accident. At trial, and over Diaz's counsel's objection, Prieto's counsel referenced the PIP form as a statement against interest. Diaz's counsel moved to exclude the PIP form as privileged. The issue before the Washington Supreme Court was whether the form could be considered work product entitled to protection from disclosure. The Court determined that in this instance, where the insured gained the status of insured by statute, rather than contract, the form at issue was privileged. The Court affirmed the Court of Appeals and remanded this matter back to the trial court for a new trial. View "Figueroa v. Mariscal" on Justia Law