Justia Insurance Law Opinion Summaries

After suffering a fall at work, Linda Mitchell returned to the same position she had before her injury, and continued to work for more than seven months until she was terminated for a cause unrelated to the injury. She then sought and was awarded disability benefits from the Mississippi Workers’ Compensation Commission. But because the Administrative Law Judge (ALJ) and Commission both failed to recognize that Mitchell’s return to work created a rebuttable presumption that she suffered no loss of earning capacity, the Supreme Court reversed the award of disability benefits and remanded this case to the Commission to apply the correct legal standard. View "Hudspeth Regional Center v. Mitchell" on Justia Law

In 2014, Lend Lease, the construction manager of the Chicago River Point Tower Project, hired Cives as a subcontractor. Cives hired Midwest Steel. Midwest had, years before, hired AES to supply Midwest with additional workers, who were co‐employed by Midwest and AES. Lend Lease entered into a “contractor-controlled insurance program” with Starr Liability with a $500,000 deductible. All subcontractors were to join in the policy. AES had, several years earlier, obtained workers’ compensation for its workers from TIC, so that injured AES‐Midwest workers could obtain workers’ compensation from either Starr (or Lend Lease under the deductible) or TIC. Four ironworkers, jointly employed by Midwest and AES and performing work for Midwest were injured on the job and sought workers’ compensation. The claims exceeded $500,000, so Lend Lease had to pay its full deductible. Starr paid the remaining claims. Lend Lease filed suit against TIC, AES’s insurer, and AES, seeking reimbursement of the $500,000. The district court dismissed. The Seventh Circuit affirmed. Lend Lease made a deal with Starr and is bound by it. The court rejected an argument that AES has been unjustly enriched; AES was not obligated to purchase an insurance policy that would cover Lend Lease's deductible. View "Lend Lease (US) Construction, Inc. v. Administrative Employer Services, Inc." on Justia Law

The United States District Court for the District of New Mexico certified a question of New Mexico law to the state Supreme Court. The question centered on whether a worker injured in the course of employment by a co-worker operating an employer owned motor vehicle was a person “legally entitled to recover damages” under his employer’s uninsured/underinsured motorist coverage. Andrew Vasquez was killed at the workplace after being struck by a steel beam that fell off of a forklift during the course of his employment at Coronado Wrecking and Salvage. A coworker operating the forklift had jumped off to check whether the steel beam being lifted was secure, leaving the forklift unattended as the steel beam slid off of the forks, striking and killing Vasquez. Plaintiff, Vasquez’s estate, subsequently collected workers’ compensation benefits from Coronado’s workers’ compensation carrier. Related to the forklift accident, Plaintiff also collected uninsured motorist benefits under Vasquez’s own automobile insurance policy.The certified question from the district court arose from an alleged discontinuity among the plain language of New Mexico’s Workers’ Compensation Act (WCA), the Uninsured Motorist statute, and the New Mexico Court’s case law. Because the WCA provided the exclusive remedy for an employee injured in a workplace accident by an employer or its representative, the employee was not legally entitled to recover damages from the uninsured employer tortfeasor under the Uninsured Motorist statute. The Court therefore answered the certified question in the negative. View "Vasquez v. American Cas. Co. of Reading" on Justia Law

Samantha Gillespie and her mother, Tina Taylor, appealed the grant of summary judgment dismissing their lawsuit against Taylor's motor vehicle insurer, National Farmers Union, for underinsured motor vehicle coverage. Gillespie and Taylor sued Farmers Union for underinsured motor vehicle coverage, alleging Gillespie was insured under her mother's motor vehicle policy with Farmers Union and was driving a motor vehicle owned by another person when Gillespie lost control of the vehicle and it overturned, resulting in significant injuries to her. According to Gillespie and Taylor, the motor vehicle was owned by Angela Ayers, Gillespie's aunt, and insured by GEICO. Ayers died as a result of the accident and another passenger in the motor vehicle sustained significant injuries. Gillespie and Taylor asserted GEICO paid Gillespie $25,000 in no-fault benefits, but denied her request for liability coverage based on a claim that Ayers negligently entrusted the vehicle to Gillespie, an alleged inexperienced driver who received her learner's permit two days before the accident. After review, the Supreme Court concluded Gillespie and Taylor failed to raise a genuine issue of material fact about whether Gillespie was legally entitled to collect for bodily injury from the owner or operator of an underinsured motor vehicle, and affirmed. View "Gillespie v. National Farmers Union Property & Casualty Co." on Justia Law

An insurer refused to defend its insured against a third party’s tort claims. The third party, standing in the insureds’ shoes, brought a declaratory judgment action against the insurer for indemnification and failure to defend. Prior to the instant suit, an Arizona state court entered default judgment against the insureds that was entered pursuant to a Damron agreement that stipulated facts determinative of both liability and coverage. In the instant case, a federal district court granted summary judgment for the insurer. Applying Arizona law, the district court concluded that the default judgment did not preclude the insurer from litigating the question of whether coverage existed under the policy and that, as a matter of law, the insured did not own the vehicle involved in the accident at the time of the accident. The Supreme Court accepted certification and held (1) insurers are generally not precluded from litigating pure coverage issues in a default judgment action; (2) an insurer in a coverage action may not, in the guise of a coverage defense, litigate what are essentially and solely liability issues resolved by the default judgment; and (3) the insurer here was not precluded from litigating, for coverage purposes, who owned the vehicle at issue at the time of the accident.View "Quihuis v. State Farm Mut. Auto. Ins. Co." on Justia Law

Pennsylvania National Mutual Casualty Insurance Company ("Penn National") was sued by Jacob Walker, an employee of its named insured, seeking underinsured-motorist ("UIM") benefits following an automobile accident. After settling the claims against it, Penn National filed a cross-claim against Michael Bradford, the alleged tortfeasor, asserting a subrogation theory of recovery. The trial court dismissed the cross-claim on the ground that it was barred by the statute of limitations, and Penn National appealed. Finding no reversible error, the Supreme Court affirmed the trial court's judgment. View "Pennsylvania National Mutual Casualty Insurance Company v. Bradford " on Justia Law

Mercury Casualty Company filed an action seeking declaratory relief regarding its obligation to students Hung Chu and his roommate Tu Pham. Mercury issued an automobile policy to Chu insuring his 1995 Honda Accord. Chu was driving, and Pham was a passenger, when Chu collided with a vehicle driven by Krystal Nguyen Hoang. Pham filed a personal injury action against Chu and Hoang and obtained a $333,300 judgment against Chu. Mercury sought a judicial determination confirming Mercury’s decision Chu’s policy excluded coverage for Pham’s judgment under a “resident exclusion.” Mercury also sought an order requiring Chu to reimburse Mercury the fees and costs it incurred in defending him against Pham’s lawsuit. Chu cross-complained against Mercury for breach of contract, bad faith, and general negligence. Mercury prevailed on the issue of whether the policy provided coverage for Pham’s judgment. The court determined Mercury had no duty to indemnify Chu with respect to the judgment. It granted Mercury’s motion for judgment on the pleadings (JOP) on Chu’s cross-complaint but determined Mercury could not seek reimbursement of its attorney fees and costs in defending Chu because such damages were not sought in the JOP. Both parties appealed. Chu and Pham appealed the determination that Mercury’s policy excluded coverage for Pham’s personal injury lawsuit against Chu. Mercury appealed the court’s ruling Chu was not required to reimburse Mercury for the defense fees and costs. After its review of the record, the Court of Appeal reversed, concluding the policy provision excluding Pham from coverage was an overbroad expansion of the statutorily permitted exclusion and was also contrary to public policy. Based on this ruling, the Court did not address the issue raised in Mercury’s cross-appeal regarding its entitlement to defense costs and fees.View "Mercury Casualty v. Chu" on Justia Law

In this case, Gary Walston was exposed to asbestos while working at The Boeing Company and was later diagnosed with mesothelioma. The Court of Appeals held that pursuant to the Industrial Insurance Act (IIA), Boeing was immune from suit because Walston had not raised a material question of fact as to whether Boeing had actual knowledge that injury was certain to occur. The Supreme Court agreed after its review of the matter: Walston has not made such a showing, and therefore, he was limited to the recovery provided by the IIA' s workers' compensation system.View "Walston v. Boeing Co." on Justia Law

Manuel Lainez had been independently driving commercial vehicles for eight and a half years. He owned his own truck and his own business, Lainez Trucking. He purchased a trucker’s liability policy from Scottsdale Indemnity Company with a $1 million liability limit. Lainez entered into a motor carrier agreement with Western Transportation Services. Western did not own tractors or trailers, but contracted with owner/operators or drivers. The agreement provided that Lainez was an independent contractor and was responsible for all costs and expenses incidental to the performance of transportation services. He agreed to maintain liability insurance and to name Western Transport as an additional insured. Western Transport, through the California Automobile Assigned Risk Plan (CAARP), purchased a commercial assigned risk policy from National Continental Insurance Company (NCI), which stated "'Named Insured’s Business: 1 Trucker for Hire-Excess'" and named Lainez as a driver. It did not list, describe, or rate any vehicle. It was rated on an excess cost of hire basis at a premium that was 4 to 10 percent of the cost of a policy rated on a primary cost of hire basis. The issue this case presented for the Court of Appeal's review was whether the two insurance companies were coprimary insurers or whether NCI was an excess insurer for an underlying fatality involving Lainez. The trial court granted NCI’s motion for a summary judgment, concluding that Scottsdale was the primary insurer pursuant to California Insurance Code section 11580.9, subdivisions (d) and (h). The Court of Appeal agreed that Scottsdale was the primary insurer and NCI was the excess insurer and affirmed the judgment. View "Scottsdale Indemnity v. National Continental Insurance Co." on Justia Law

State farm Fire & Casualty Company issued a rental dwelling policy to Jerry Dantzler. The tenants of Dantzler’s rental property sued Dantzler for personal injuries allegedly sustained by a Dantzler’s tenant as a result of exposure to lead-based paint. Dantzler tendered the claim to State Farm. State Farm subsequently filed an action for declaratory judgment against Dantzler and the tenants asking for a determination of whether its policy precluded coverage for the tenants’ personal injury claim. The district court granted summary judgment for State Farm, concluding as a matter of law that the pollution exclusion barred coverage under State Farm’s policy. The court of appeals reversed, concluding that a genuine issue of material fact existed as to whether the tenant’s injuries were the result of a “discharge, dispersal, spill, release or escape of pollutants” as described in the pollution exclusion. The Supreme Court reversed, holding that all manners of exposure to lead-based paint involve discharge, dispersal, spill, release, or escape, and therefore, the manner of exposure was not a material fact that prevented summary judgment. Remanded.View "State Farm Fire & Cas. Co. v. Dantzler" on Justia Law