Justia Insurance Law Opinion Summaries
Articles Posted in Personal Injury
Menard, Inc. v. Farm Bureau P&C Ins. Co.
Cynthia Bowen purchased an insurance policy from Farm Bureau Property & Casualty Insurance Company ("Farm Bureau") for her pick-up truck. She was injured when an employee of Menard, Inc. ("Menards") accidentally dropped a large board on her while helping load her truck at a store. Bowen sued Menards for damages, alleging negligence. Menards then filed an action against Farm Bureau seeking a declaratory judgment that it was entitled to a defense and indemnification from Farm Bureau under Bowen's insurance policy. The district court ruled in favor of Menards, finding that Menards and its employee were covered insureds under the policy and that no policy exclusion applied.On appeal, the United States Court of Appeals for the Eighth Circuit reversed the district court's decision. The court concluded that the policy's "Intrafamily Immunity" exclusion applied to the case. This exclusion stated that there was no coverage for any bodily injury to any "insured," which, in this case, included both Bowen and Menards. Therefore, the policy provided no liability coverage for Bowen's claim against Menards, another insured party. The court rejected the district court's reasoning that the term "intrafamily" limited the application of the exclusion, finding that the plain meaning of the operative policy provision prevailed. The court also rejected Menards' argument that Farm Bureau was estopped from asserting this defense to coverage. Consequently, the court reversed the district court's judgment, ruling that Farm Bureau was not obligated to provide defense and indemnification for Menards in connection with the lawsuit brought by Bowen.
View "Menard, Inc. v. Farm Bureau P&C Ins. Co." on Justia Law
Rice v. Doe
In this case, the South Carolina Supreme Court was asked to decide whether the requirement for a witness affidavit under subsection 38-77-170(2) of the South Carolina Code should be considered a condition precedent to filing a "John Doe" civil action. The case arose from a car accident where the plaintiff, Peter Rice, filed a lawsuit against an unidentified driver, referred to as "John Doe." Rice alleged that Doe's vehicle crossed into his friend's lane, causing his friend to swerve and hit a tree. Under South Carolina law, it's possible to recover damages under an uninsured motorist policy for accidents caused by unidentified drivers. However, the law requires that the accident must have been witnessed by someone other than the owner or operator of the insured vehicle and that the witness must sign an affidavit attesting to the truth of the facts of the accident. Doe moved to dismiss the case on the grounds that Rice had failed to comply with the requirement for a witness affidavit at the time of filing his complaint. The lower court initially denied Doe's motion, but later another judge ruled that the affidavit was a condition precedent to the right to bring an action and dismissed the case. The court of appeals reversed this decision, finding that the second judge did not have the authority to overrule the first judge's decision. On review, the South Carolina Supreme Court held that compliance with the witness affidavit requirement is not a condition precedent to filing a "John Doe" civil action. Rather, the court found that the witness affidavit may be produced after the commencement of the lawsuit. However, the court noted that the affidavit should be produced promptly upon request and if it is not, the action could be dismissed pursuant to Rule 56(c) of the South Carolina Rules of Civil Procedure. The Supreme Court therefore affirmed the decision of the court of appeals, albeit on different grounds, and remanded the case for trial. View "Rice v. Doe" on Justia Law
Moody v. Oregon Community Credit Union
In the State of Oregon, a woman whose husband was accidentally shot and killed during a camping trip filed a lawsuit against her husband's life insurance company. The woman claimed that the insurance company negligently failed to investigate and pay her claim for policy benefits, causing her economic harm and emotional distress. The trial court granted the insurance company's motions to dismiss the woman's negligence claim and to strike her claim for emotional distress damages. The Court of Appeals reversed the trial court's decision, and the insurance company appealed the case to the Supreme Court of Oregon.The Supreme Court of Oregon affirmed the decision of the Court of Appeals. The court held that the woman had pleaded facts sufficient to give rise to a legally cognizable common-law negligence claim for emotional distress damages. The court reasoned that the woman, as the surviving spouse of a deceased breadwinner, had a legally protected interest sufficient to support a common-law negligence claim for emotional distress damages against her husband's life insurance company for failure to reasonably investigate and promptly pay her claim for insurance benefits. The court concluded that the insurance claim practices that Oregon law requires and the emotional harm that foreseeably may occur if that law is violated are sufficiently weighty to merit imposition of liability for common-law negligence and recovery of emotional distress damages. Therefore, the Supreme Court of Oregon reversed the judgment of the trial court and remanded the case back to the trial court for further proceedings. View "Moody v. Oregon Community Credit Union" on Justia Law
Franco v. Reinhardt
The Supreme Court vacated the judgment of the intermediate court of appeals (ICA) reinstating the jury's verdict and judgment for Tiare Franco's family (the Francos) after granting Sabio Reinhardt's motion to set aside the jury verdict and judgment, holding that the ICA erred.The Francos brought a wrongful death lawsuit against Reinhardt for negligently crashing a truck and killing Tiare. National Interstate Insurance Company (NIIC), the truck's insurer, filed a declaratory judgment action claiming it had no duty to defend and indemnify Reinhardt under the policy. The circuit court granted summary judgment for NIIC, and the Francos successfully appealed. Before the ICA resolved the declaratory action appeal, the circuit court held a jury trial, and the jury returned a verdict in favor of the Francos. Counsel for Reinhardt moved to set aside the jury's verdict. The trial court granted the Francos' ensuing motion to disqualify counsel and Reinhardt's motion to set aside the jury verdict and judgment. The ICA reinstated the jury's verdict and judgment, holding that Reinhardt's counsel lacked authority to act as his lawyer. The Supreme Court vacated the ICA's judgment and affirmed the circuit court's orders, holding that the circuit court correctly denied the Francos' motion to disqualify counsel and did not abuse its discretion by granting Reinhardt's motion to set aside. View "Franco v. Reinhardt" on Justia Law
Galarza v. Direct Auto Insurance Co.
Guiracocha and his son, Cristopher, filed an uninsured motorist (UM) claim against Direct Auto, stemming from a hit-and-run incident where 14-year-old Cristopher was struck by a vehicle while riding his bicycle. They asserted Fredy was the named insured under an automobile insurance policy issued by Direct Auto and that UM coverage applied to Cristopher based on his status as a “relative” under the policy. Direct Auto denied coverage because Cristopher was not an occupant of a covered vehicle at the time of the accident and sought a declaratory judgment. The circuit court granted Direct Auto summary judgment.The appellate court reversed, holding that a provision in an automobile insurance policy that limits UM coverage to insureds occupying an insured automobile violates the Illinois Insurance Code (215 ILCS 5/143a). The Illinois Supreme Court affirmed. Section 143a states that an insurance policy cannot be “renewed, delivered, or issued for delivery” in Illinois unless it provides coverage to “any person” for injuries “arising out of the ownership, maintenance or use of a motor vehicle.” A bicyclist injured by an uninsured motorist vehicle is a “person” who suffered injuries arising out of the ownership, maintenance, or use of “a motor vehicle.” The injured person’s status as an occupant of a vehicle is irrelevant. View "Galarza v. Direct Auto Insurance Co." on Justia Law
Team Industrial Services v. Zurich American Insurance Company, et al.
Plaintiff Team Industrial Services, Inc. (Team) suffered a $222 million judgment against it in a wrongful-death lawsuit arising out of a steam-turbine failure in June 2018 at a Westar Energy, Inc. (Westar) power plant. Team sought liability coverage from Westar, Zurich American Insurance Company (Zurich), and two other insurance companies, arguing that it was, or should have been, provided protection by Westar’s Owner-Controlled Insurance Program (OCIP) through insurance policies issued by Zurich and the two other insurers. Team’s claims derived from the fact that its liability for the failure at the Westar power plant arose from work that had previously been performed by Furmanite America, Inc. (Furmanite), which had coverage under Westar’s OCIP. The district court granted summary judgment to Defendants, and Team appealed. Not persuaded by Team's arguments for reversal, the Tenth Circuit affirmed the district court. View "Team Industrial Services v. Zurich American Insurance Company, et al." on Justia Law
Westfield Insurance Co. v. Sistersville Tank Works, Inc.
The Supreme Court concluded that under the continuous-trigger theory, when an insurance claim is made by alleging a progressive injury caused by chemical exposure or other analogous toxic, injurious substance, damages that are caused, continuous, or progressively deteriorating throughout successive policy periods are covered by all the occurrence-based policies in effect during those periods.This case involved claims against a standardized commercial general liability (CGL) policy alleging that long-term exposure to chemicals caused a disease to develop over a number of years before being diagnosed. The exposure to the chemicals and the development of the disease, however, happened across numerous CGL policy periods. Insurer denied coverage under its CGL policies and filed a complaint for declaratory relief. The district court granted a judgment in favor of Insured, finding that Insurer owed Insured a duty to defend and indemnify under all of its policies. The Supreme Court answered a certified question that, under the continuous-trigger theory, when a claim is made alleging a progressive injury caused by chemical exposure or other analogous harm, every occurrence-based policy in effect from the initial exposure, through the latency and development period and up to the manifestation of the bodily illness, is triggered and must cover the claim. View "Westfield Insurance Co. v. Sistersville Tank Works, Inc." on Justia Law
Scott Fetzer Co. v. American Home Assurance Co.
The Supreme Court affirmed the judgment of the court of appeals in this dispute arising out of environmental-cleanup and remediation work at two Superfund sites in Bronson, Michigan, holding that Restatement (Second) 193 does not govern the choice-of-law analysis for bad faith claims.Scott Fetzer Company filed this action asserting a breach of contract claim against certain insurance companies, including Travelers Casualty and Surety Company, alleging breaches of certain insurance contracts. Fetzer also asserted a tort claim against each company, arguing that they had acted in bad faith when handling his claims. As to Travelers, an administrative judge concluded that Ohio law applied to a discovery dispute concerning Scott Fetzer's bad faith claim. The court of appeals affirmed, determining that Ohio law governed the bad-faith discovery dispute because the cause of action was a tort. In affirming, the court applied the choice-of-law rules set forth in section 145 of the Restatement. Travelers appealed, arguing that section 193 governs the choice-of-law analysis for bad faith claims because they arise out of insurance contracts. The Supreme Court affirmed, holding that the court of appeals correctly ruled that the choice-of-law analysis applicable to a bad-faith claim as provided by section 145. View "Scott Fetzer Co. v. American Home Assurance Co." on Justia Law
State Farm Mutual Automobile Ins. Co. v. Wood
State Farm Mutual Automobile Insurance Company ("State Farm") appealed a judgment entered against it on a jury verdict in an automobile-accident case. Brian Wood ("Brian") was driving through an intersection in Auburn when his vehicle was T-boned by a vehicle being driven by Mark Stafford. Brian and his wife Jennifer sued Stafford, an uninsured motorist, alleging claims of negligence, wantonness, and loss of consortium. Because Stafford was uninsured, the Woods also sued State Farm, their automobile-insurance company, seeking uninsured-motorist benefits under their policy. The jury returned a verdict in the Woods' favor, awarding them $700,000 in compensatory damages, and the trial court entered a judgment on that verdict. The jury did not award any punitive damages. State Farm filed a postjudgment motion challenging the judgment on various grounds, including whether the wantonness claim should have gone to the jury. The postjudgment motion was denied by operation of law, and State Farm appealed. After review, the Alabama Supreme Court concluded State Farm failed to establish the trial court erred by not setting aside its judgment entered on the jury's verdict, therefore the judgment was affirmed. View "State Farm Mutual Automobile Ins. Co. v. Wood" on Justia Law
Hee Lowery, et al v. AmGuard Insurance Company
After Plaintiff sustained serious injuries from a hot-soup spill at Noodle College Park, an Atlanta-area restaurant, she and her spouse sued Shou & Shou, Inc., which owned and operated the restaurant. Shou & Shou tendered the defense to and sought coverage from AmGuard Insurance Company. But AmGuard denied coverage on the ground that the policy named “Noodle, Inc.”—an entity that did not exist—as insured. Shou & Shou settled the suit and assigned the Lowerys its rights under the policy. Plaintiffs, as assignees, then sued AmGuard for equitable reformation of the policy. The district court granted partial summary judgment in favor of Plaintiffs and later entered a final judgment.
The Eleventh Circuit affirmed, holding that reformation of the policy was proper under Georgia law. The court explained that the district court correctly equitably reformed the 2016–17 policy to insure the true owner of the restaurant. The court explained that AmGuard insists that it could not have shared Shou & Shou’s mistake because it did not know the “identity” of the intended insured and could not have intended to “name” Shou & Shou as an insured. But Georgia law does not demand that degree of specificity in defining a mutual mistake. Further, the court held that Plaintiffs claim of breach of contract merges with reformation of the policy. View "Hee Lowery, et al v. AmGuard Insurance Company" on Justia Law