Justia Insurance Law Opinion Summaries

The Eighth Circuit reversed the district court's award of damages to plaintiff for injuries that she sustained in a vehicle-related accident. The court held that the district court improperly applied a heightened duty to the sober designated driver for a group of intoxicated passengers. In this case, the findings of fact were insufficient to support apportioning greater fault to the driver based on her duty to exercise reasonable care in driving the vehicle. Accordingly, the court remanded for new findings and conclusions on the allocation of fault. View "Hiltner v. Owners Insurance Co." on Justia Law

An employee continued to work for over ten years after a job-related knee injury but had multiple surgeries on her injured knee. Over time, her employer made several permanent partial impairment payments, and she was eventually determined to be permanently and totally disabled because of the work injury. She began to receive Social Security disability at about the same time she was classified as permanently and totally disabled for workers’ compensation. Her employer asked the Alaska Workers’ Compensation Board to allow two offsets to its payment of permanent total disability (PTD) compensation: one related to Social Security disability benefits and one related to the earlier permanent partial impairment (PPI) payments. The Board established a Social Security offset and permitted the employer to deduct the amount of previously paid PPI. The employee appealed to the Alaska Workers’ Compensation Appeals Commission, arguing that the Board had improperly applied one of its regulations in allowing the PPI offset and had incorrectly calculated the amount of the Social Security offset. She also brought a civil suit against the State challenging the validity of the regulation. The State intervened in the Commission appeal; the lawsuit was dismissed. The Commission reversed the Board’s calculation of the Social Security offset and affirmed the Board’s order permitting the PPI offset. The employer appealed the Commission’s Social Security offset decision to the Alaska Supreme Court, and the employee cross- appealed the PPI offset. The Court affirmed that part of the Commission’s decision reversing the Board’s calculation of the Social Security disability offset and reversed that part of the Commission’s decision permitting an offset for permanent partial impairment benefits. The case was remanded back to the Commission for further proceedings. View "Alaska Airlines, Inc. v. Darrow" on Justia Law

While employed by Zing LLC, Josue Barrios (“Claimant”) was totally and permanently disabled as a result of an industrial accident when he fell about twelve feet from a ladder and hit his head face first on a concrete floor. He suffered multiple facial fractures, a frontal bone fracture, the loss of sight in his left eye, and a severe traumatic brain injury that caused a major neurocognitive disorder and speech language deficits. This case was an appeal of an Industrial Commission order requiring an employer and its surety to pay the cost of a guardian and a conservator for Barrios. Finding no reversible error in the Commission's order, the Idaho Supreme Court affirmed. View "Barrios v. Zing, LLC" on Justia Law

Roniesha Adams, her son, and her son’s father, Barry Adams (Barry), were passengers in Milton Mitchell’s car when the car was rear ended. Mitchell and his three passengers asserted claims against State Farm, seeking personal injury protection and uninsured motorist benefits. Because they allegedly gave inconsistent statements to State Farm regarding “substantive issues,” State Farm advised Mitchell, Adams, and Barry that they were required to submit to questioning under oath. Adams and Barry refused to submit to questioning under oath, and State Farm refused to pay additional benefits. Adams and Barry filed suit, and State Farm filed a counterclaim seeking a declaratory judgment that it did not have to provide coverage because Adams and Barry failed to cooperate with its investigation. The circuit court granted summary judgment for State Farm. Adams appealed. The court of appeals reversed, ruling that State Farm was required to obtain a court order before it could require Adams to submit to questioning under oath. The Supreme Court reversed, holding that the circuit court correctly found that Adams was required to submit to questioning under oath regarding issues as a condition precedent to coverage. View "State Farm Mutual Automobile Insurance Co. v. Adams" on Justia Law

A tree fell on Kaitlyn and Joshua. Kaitlyn died. She was pregnant. Doctors delivered the baby, but he died an hour later. Joshua survived with serious injuries. A state jury found the Somerset Housing Authority liable and awarded $3,736,278. The Authority belonged to the Kentucky Housing Authorities Self-Insurance Fund, which provided a policy with Evanston. Evanston sought a declaratory judgment limiting its liability under the Fund’s policy to $1 million. Meanwhile, through mediation of the state court case, Evanston agreed to pay the “policy limits” in return for an agreement to dismiss the state court action and release the Authority from further liability. Evanston claimed that $1 million was the coverage cap; the defendants claimed it was $2 to $4 million. The district court determined that there was complete diversity and ruled for Evanston on the merits. The Sixth Circuit affirmed. The district court properly aligned the parties given their respective interests in the primary dispute at the time of filing, so that diversity jurisdiction was not destroyed. The policy obligates Evanston to provide a maximum of $1 million of coverage per “occurrence,” with an aggregate limit of $2 million for more than one occurrence. The contract defines “occurrence” as “an accident, including continuous or repeated exposure to substantially the same general harmful conditions.” When one tree falls at one time, that is one occurrence and one accident. View "Evanston Insurance Co. v. Housing Authority of Somerset" on Justia Law

Defendant-appellant Christopher Klick was seriously injured after suffering carbon monoxide poisoning while aboard a friend’s fishing boat. An exhaust pipe had broken off at the spot where it connected with the engine. As a result, the engine had been expelling carbon monoxide gas into the engine compartment rather than through the exhaust pipe and out behind the boat. When the engine compartment hatch from within the wheelhouse was opened, carbon monoxide flowed up into the wheelhouse. Klick quickly lost consciousness and fell into the engine compartment. He awoke there several hours later, severely burned from lying on the engine. He also suffered brain damage from the carbon monoxide. The gas killed the boat’s two other occupants, but Klick survived. Klick sued the boat dealer in state court. The dealer had an insurance policy from Travelers Property Casualty Company of America that required Travelers to pay for liabilities resulting from bodily injury. The policy, however, had a pollution exclusion providing that the policy did not cover liability for injuries arising out of the release, dispersal, or migration of certain pollutants. Travelers sued in federal court, seeking a declaration that the policy did not cover liability for Klick’s injuries. The district court granted summary judgment for Travelers. We conclude that the pollution exclusion applies, and we therefore affirm. View "Travelers Property Casualty v. Klick" on Justia Law

The Court of Appeals affirmed the finding of the Workers’ Compensation Commission (WCC) that Employer and Insurer (collectively, Respondents) were entitled to offset the ordinary disability benefits already paid to Petitioner against the temporary total disability benefits paid to him by Respondents.Petitioner suffered injuries primarily to his back and neck while working for Employer. Employer received two different sets of disability benefits from Employer and Insurer, each awarded by a different state agency. Specifically, Petitioner was granted temporary total disability benefits by the WCC and ordinary disability benefits by the State Retirement Agency. The WCC found that Respondents were entitled to a credit for the ordinary disability benefits already paid to Petitioner. On judicial review, the circuit court granted summary judgment in favor of the WCC. The Court of Appeals affirmed, holding that because both sets of benefits compensated Petitioner for the same injury, pursuant to Md. Code Ann. Lab. & Empl. 9-610, the statutory offset properly applied to prevent a double recovery for the same injury. View "Reger v. Washington County Board of Education" on Justia Law

Lori Greenwood was injured while working for J.J. Hooligans, LLC. Greenwood was informed that because of nonpayment, FirstComp Insurance Company (FirstComp) was not the workers’ compensation insurance carrier on the date of the accident. Greenwood filed a petition against J.J. Hooligan’s and FirstComp seeking workers’ compensation benefits. FirstComp filed a motion to dismiss, arguing that it was not a proper party because it had timely notified J.J. Hooligan’s that it had terminated its insurance coverage for nonpayment of its premium and therefore did not provide workers’ compensation insurance on the date of the accident. The Nebraska Workers’ Compensation Court sustained the motion to dismiss. The Supreme Court reversed, holding that FirstComp failed to present sufficient competent evidence as to whether it complied with the employer notice of cancellation requirement in Neb. Rev. Stat. 48-144.03 to warrant an order of dismissal. View "Greenwood v. J.J. Hooligan’s, LLC" on Justia Law

The Supreme Court affirmed the district court’s summary judgment for the County of Lancaster in this complaint filed by the City of Lincoln seeking reimbursement of expenses paid on its employee’s behalf after a deputy sheriff with the County made contact with the employee, injuring the employee’s shoulder. The district court concluded (1) the County’s procurement of liability insurance did not constitute a waiver of its sovereign immunity for claims less than the policy’s retained insurance limit; and (2) because the amount in controversy was $63,418, the County did not waive its sovereign immunity by obtaining insurance for claims exceeding $250,000. The Supreme Court affirmed for reasons different from those stated by the district court, holding (1) the County’s procurement of insurance did not constitute a waiver of immunity as to a claim arising out of a battery; and (2) therefore, the County’s policy did not cover the underlying event, and there was no waiver of immunity regardless of the retained insurance limit. View "City of Lincoln v. County of Lancaster" on Justia Law

Ashley Palmer (Palmer) and Stephen Palmer appealed a district court’s order granting Lisa Ellefson’s motion for a new trial under Idaho Rule of Civil Procedure 59(a)(6). Ellefson was involved in an automobile accident caused by Palmer. A jury found that Ellefson was not injured in the accident. However, the district court determined that the jury verdict of “no injury” was against the clear weight of evidence and granted a new trial subject to an additur in the amount of $50,000. On appeal, Palmer argued that the district court abused its discretion in granting the new trial and in setting additur at $50,000. Finding no such error, the Idaho Supreme Court affirmed. View "Ellefson v. Palmer" on Justia Law