Justia Insurance Law Opinion Summaries

Plaintiff Thomas P. Whelan, Jr.'s decedent father, Thomas P. Whelan, Sr., was in Plaintiff's parked truck when it was hit by a moving vehicle. The collision allegedly resulted in severe injuries and medical costs in excess of $100,000 and ultimately in the decedent's death a few years later. At the time of the accident, occupants of Plaintiff's truck were insureds under the terms of a $50,000 liability policy issued by State Farm, facially providing no UM/UIM coverage. In the Supreme Court's decision in "Jordan v. Allstate Ins. Co.," the effective rejection of an insured's statutory rights to UM/UIM coverage equal to liability limits had to be made in writing and as part of the insurance policy delivered to the insured. Because the result in "Jordan" was foreshadowed by other precedents, the Supreme Court declined to make Jordan applicable only to cases arising in the future, and held that policies that failed to comply with Jordan's rejection requirements would be judicially reformed to provide full statutory coverage. In 2011, following the 2010 issuance of Jordan, Plaintiff made a demand on his insurer State Farm for reformation of his policy that was in effect at the time of the accident. Relying on a clause in the policy that purported to bar UM/UIM claims made more than six years after the date of the underlying accident, State Farm rejected the claim. Plaintiff then instituted a declaratory judgment action against State Farm for reformation of the policy. Upon review of this matter, the Supreme Court held that a limitations clause based solely on the date of the accident without consideration of the actual accrual of the right to make a UM/UIM claim was unreasonable and unenforceable as a matter of law. But addressing the merits of Plaintiff's action, the Court also held that judicial reformation under Jordan did not extend to historical insurance contracts formed before another precedential opinion was issued in 2004. Because the policy in this case was issued before that date, it was not subject to retroactive reformation of its facial lack of UM/UIM coverage. View "Whelan v. State Farm Mutual Auto Ins. Co." on Justia Law

A highly paid worker suffered a debilitating stroke while traveling for his employer. The employer did not think the stroke was work related, but it later accepted the claim and paid workers' compensation benefits. The statutory maximum compensation rate at the time of the injury was $700 a week. A little more than five months after the employee's stroke, an amended version of the Alaska Workers' Compensation Act took effect. Instead of an absolute maximum compensation rate, the amended statute set a variable rate indexed to the statewide average weekly wage. The employee asked for an increased rate of compensation, arguing that the law in effect at the time he was recognized as being permanently and totally disabled should govern his benefit amount. The Alaska Workers' Compensation Board, with one panel member dissenting, decided that the version of the statute in effect at the time of the injury was the applicable statute and consequently capped the employee's benefits at $700 a week for life. The dissenting panel member would have construed the statute as permitting increased benefits. The Alaska Workers' Compensation Appeals Commission affirmed the Board's decision. The employee appealed, arguing that the amount of his benefits did not fairly compensate him for lost wages during the period of his disability so that the date of his disability, rather than the date of his injury, should have been used to determine the version of the statute governing his claim. Finding no reversible error, the Supreme Court affirmed the Commission's decision.View "Louie v. BP Exploration (Alaska), Inc." on Justia Law

Hartford Casualty Insurance Company issued a commercial general liability policy to Ultimate Support Systems, a company that sold the Ulti-Cart. The policy covered “personal and advertising injury,” which included claims arising out of publication of material that "disparages a person’s or organization’s goods, products or services.” Gary-Michael Dahl, the manufacturer of the Multi-Cart, sued Ultimate for patent and trademark infringement, false designation of origin, and damage to business, reputation, and goodwill. Hartford denied coverage on the ground that the suit did not allege that Ultimate had disparaged the Multi-Cart or Dahl. The Supreme Court affirmed, holding (1) a claim of disparagement requires a plaintiff to show a false or misleading statement that specifically refers to the plaintiff’s product or business and clearly derogates that product or business; and (2) because Dahl’s suit did not allege that Ultimate clearly derogated the Multi-Cart, there was no claim of disparagement triggering Harford’s duty to defend.View "Hartford Cas. Ins. v. Swift Distrib., Inc." on Justia Law

While working for Vista Care (Employer), appellant Sherrie Fowler suffered a back injury. Appellant began receiving TTD and subsequently underwent back surgery. Several years later, a physician determined that appellant reached maximum medical improvement (MMI). This case began when appellant filed a complaint with the Workers' Compensation Act (WCA) in 2010, for reinstatement of her TTD benefits and for an increase in her PPD rating. The Court of Appeals held that the Act limited appellant's eligibility for TTD benefits to 700 weeks of benefits and reversed a contrary decision of the Workers’ Compensation Administration judge. Upon review of the matter, the Supreme Court concluded that the Act imposed no such limitation; TTD benefits are payable during any period of total disability for the remainder of a worker’s life. View "Fowler v. Vista Care" on Justia Law

In 2011, defendant S.G.'s vehicle collided with a motorcycle driven by John Allmer. S.G. was fifteen years old at the time. The parties stipulated Allmer suffered significant injuries, had medical expenses in excess of $1 million and continued to incur medical expenses for his care and treatment. Defendant Sandy Goetz and S.G.'s father were divorced, and S.G.'s father owned and insured the vehicle S.G. was driving. S.G. had exclusive possession of the car for six months prior to the accident. Her father's policy had an underlying liability limit of $250,000 and an umbrella policy of $1 million, which her father's insurance company offered in settlement of the claims against him. Goetz had an insurance policy with State Farm that listed Goetz and her vehicle as covered under the policy. Goetz signed S.G.'s driver's license application sponsorship form for drivers under the age of eighteen, assuming financial liability for S.G.'s negligent acts arising from operation of a motor vehicle under sections 39-06-08 (2011) and 39-06-09 (2011), N.D.C.C. State Farm filed a motion for summary judgment, arguing no dispute existed that S.G.'s vehicle was not covered under Goetz's policy. Goetz and S.G. filed a motion for summary judgment and Allmer filed a motion for summary judgment, arguing the language in Goetz's State Farm's insurance policy should be construed to provide coverage for the accident. State Farm did not dispute Goetz was liable for S.G.'s negligent acts; therefore, the district court addressed only whether State Farm's policy provided coverage for the claim. The district court found for the purposes of Goetz's policy that S.G. was considered a "resident relative" and S.G.'s Oldsmobile was a "non-owned" vehicle. The district court also determined State Farm was not required to cover S.G.'s vehicle because the vehicle was not designated on the policy. The district court granted State Farm's motion for summary judgment, and denied Goetz and S.G.'s motion for summary judgment and Allmer's motion for summary judgment. Allmer appealed, arguing that Goetz's signature on S.G.'s sponsorship form for her driver's license application imputed S.G.'s negligence to Goetz and created coverage for S.G.'s accident under Goetz's insurance policy. Finding no reversible error, the Supreme Court affirmed. View "State Farm Mutual Automobile Insurance Co. v. Gruebele" on Justia Law