Justia Insurance Law Opinion Summaries

Plaintiff's multi-unit apartment building in Staten Island was damaged by fire on August 4, 2014. At the time, she had an insurance policy with Tower Insurance Company of New York, which required any legal action to be brought within two years of the damage and stipulated that replacement costs would only be paid if repairs were made as soon as reasonably possible. Restoration was completed in July 2020, and her claim was denied on September 1, 2020. Plaintiff filed a lawsuit on August 4, 2020, seeking full replacement value and coverage for lost business income, alleging that Tower/AmTrust's bad faith conduct delayed the restoration process.The Supreme Court granted the Tower/AmTrust defendants' motion to dismiss the complaint, citing the policy's two-year suit limitation provision. The court found that the plaintiff failed to demonstrate that she attempted to repair the property within the two-year period or took any action to protect her rights as the limitation period expired. The Appellate Division affirmed the dismissal, holding that the plaintiff did not allege that she reasonably attempted to repair the property within the two-year period but was unable to do so. Consequently, the claims against the broker defendants were also dismissed as the plaintiff's failure to recover was due to her own actions.The New York Court of Appeals affirmed the Appellate Division's order. The court held that the plaintiff did not raise an issue as to whether the suit limitation provision was unreasonable under the circumstances. The plaintiff's allegations were deemed conclusory and lacked specific details about the extent of the damage or efforts to complete repairs within the two-year period. The court concluded that the Tower/AmTrust defendants' motion to dismiss was properly granted, and the claims against the broker defendants were also correctly dismissed. View "Farage v Associated Insurance Management Corp." on Justia Law

A general contractor, Tocci Building Corporation, and its affiliates were involved in a dispute with their insurers, including Admiral Insurance Company, over coverage under a commercial general liability (CGL) insurance policy. The issue was whether the CGL policy covered damage to non-defective parts of a construction project caused by a subcontractor's defective work on another part of the project. Tocci sought defense and indemnity coverage under the Admiral policy for a lawsuit filed by Toll JM EB Residential Urban Renewal LLC, which alleged various issues with Tocci's work on a residential construction project.The United States District Court for the District of Massachusetts concluded that Admiral had no duty to defend Tocci. The court found that the lawsuit did not allege "property damage" caused by an "occurrence" as required for coverage under the policy. The court reasoned that the damage alleged was within the scope of the project Tocci was hired to complete and thus did not qualify as "property damage." Additionally, the court held that faulty workmanship did not constitute an "accident" and therefore was not an "occurrence" under the policy.The United States Court of Appeals for the First Circuit reviewed the case and affirmed the district court's decision, but for different reasons. The appellate court focused on the policy's exclusions, particularly the "Damage to Property" exclusion (j)(6), which excludes coverage for property that must be restored, repaired, or replaced because the insured's work was incorrectly performed on it. The court concluded that this exclusion applied to the entire project since Tocci was the general contractor responsible for the entire construction. The court also noted that Tocci did not meet its burden of showing that any exceptions to the exclusion applied, such as the "products-completed operations hazard," because Tocci's work was not completed or abandoned. Thus, the appellate court held that Admiral had no duty to defend Tocci in the underlying lawsuit. View "Admiral Insurance Company v. Tocci Building Corporation" on Justia Law

In March 2013, Woodsboro Farmers Cooperative contracted with E.F. Erwin, Inc. to construct two grain silos. Erwin subcontracted AJ Constructors, Inc. (AJC) for the assembly. AJC completed its work by July 2013, and Erwin finished the project in November 2013. However, Woodsboro noticed defects causing leaks and signed an addendum with Erwin for repairs. Erwin's attempts to fix the silos failed, leading Woodsboro to hire Pitcock Supply, Inc. for repairs. Pitcock found numerous faults attributed to AJC's poor workmanship, necessitating complete deconstruction and reconstruction of the silos, costing Woodsboro $805,642.74.Woodsboro sued Erwin in Texas state court for breach of contract, and the case went to arbitration in 2017. The arbitration panel found AJC's construction was negligent, resulting in defective silos, and awarded Woodsboro $988,073.25 in damages. The Texas state court confirmed the award in September 2022. In December 2018, TIG Insurance Company, Erwin's insurer, sought declaratory relief in the United States District Court for the Southern District of Texas, questioning its duty to defend and indemnify Erwin. The district court granted TIG's motion for summary judgment on the duty to defend, finding no "property damage" under the policy, and later ruled there was no duty to indemnify, as the damage was due to defective construction.The United States Court of Appeals for the Fifth Circuit reviewed the case. The court found that there were factual questions regarding whether the damage constituted "property damage" under the insurance policy, as the silos' metal parts were damaged by wind and weather due to AJC's poor workmanship. The court determined that the district court erred in granting summary judgment for TIG and concluded that additional factual development was needed. The Fifth Circuit reversed the district court's decision and remanded the case for further proceedings. View "TIG Insurance Company v. Woodsboro Farmers Coop" on Justia Law

American Building Innovation LP (ABI) was hired by Balfour Beatty Construction, LLC (Balfour Beatty) as a subcontractor for a school construction project. ABI had a workers’ compensation insurance policy when it began work, but the policy was canceled due to ABI’s refusal to pay outstanding premiums from a previous policy. This cancellation led to the automatic suspension of ABI’s contractor’s license. Despite knowing it was unlicensed and uninsured, ABI continued working on the project.The Superior Court of Orange County found that ABI was not duly licensed at all times during the performance of its work, as required by California law. ABI’s license was suspended because it failed to maintain workers’ compensation insurance. ABI later settled its premium dispute and had the policy retroactively reinstated, but the court found this retroactive reinstatement meaningless because it occurred long after the statute of limitations for any workers’ compensation claims had expired. The court ruled that ABI could not maintain its action to recover compensation for its work due to its lack of proper licensure.The California Court of Appeal, Fourth Appellate District, Division Three, affirmed the lower court’s judgment. The court held that ABI was not entitled to retroactive reinstatement of its license because the failure to maintain workers’ compensation insurance was not due to circumstances beyond ABI’s control. ABI’s decision not to pay the premiums and its false representations to the Contractors’ State License Board were within its control. Consequently, ABI was barred from bringing or maintaining the action under section 7031 of the Business and Professions Code. The court also affirmed the award of attorney fees to Balfour Beatty under the subcontract’s prevailing party attorney fee provision. View "American Building Innovations v. Balfour Beatty Construction" on Justia Law

B.R.S. Real Estate, Inc. owned a commercial property in West Warwick, Rhode Island, which suffered extensive water damage in 2018 due to frozen and burst pipes. B.R.S. filed an insurance claim under a policy issued by Certain Underwriters at Lloyd's, London. Disagreements arose over the amount of the loss, leading to an appraisal process involving party-appointed appraisers and a neutral umpire. The appraisal panel issued an award, which B.R.S. contested, arguing that the appraiser appointed by the insurers was biased and that the district court erred in granting summary judgment on its claim for withheld depreciation.The United States District Court for the District of Rhode Island initially denied the defendants' motion to confirm the appraisal award, citing the need for discovery. After discovery, the court granted summary judgment for the defendants, concluding that no reasonable jury could find the appraiser biased or the umpire incompetent. The court also found that B.R.S. had not met the policy conditions for receiving the withheld depreciation, as the property had not been repaired or replaced for the same use.The United States Court of Appeals for the First Circuit reviewed the case and affirmed the district court's judgment. The appellate court held that the district court correctly applied the summary judgment standard and that B.R.S. could not challenge the appraiser's impartiality post-decision based on information known before the appraisal. The court also found that the umpire was competent and that B.R.S. failed to provide evidence that the property was repaired or replaced for the same use, as required by the policy. Consequently, the court upheld the denial of the withheld depreciation and confirmed the appraisal award. View "B.R.S. Real Estate, Inc. v. Certain Underwriters at Lloyd's, London" on Justia Law

A severe thunderstorm caused significant damage to Norwood Hospital, owned by Medical Properties Trust, Inc. (MPT) and leased to Steward Health Care System LLC (Steward). The storm led to extensive flooding in the hospital's basements and rainwater accumulation on the rooftop courtyard and parapet roofs, which then seeped into the building, causing further damage. MPT and Steward sought coverage from their insurers, Zurich American Insurance Company (Zurich) and American Guarantee and Liability Insurance Company (AGLIC), respectively. Both policies had high overall coverage limits but lower sublimits for flood damage. The insurers argued that all the damage was due to "Flood" as defined in the policies, which included "surface waters," and thus subject to the lower sublimits.The United States District Court for the District of Massachusetts granted partial summary judgment to the insurers, interpreting "surface waters" to include rainwater accumulated on the roofs. The court allowed an interlocutory appeal, recognizing the substantial ground for difference of opinion on this legal issue. The United States Court of Appeals for the First Circuit then certified the question to the Supreme Judicial Court of Massachusetts, asking whether rainwater accumulating on a building's rooftop courtyard or parapet roof constitutes "surface waters" under Massachusetts law.The Supreme Judicial Court of Massachusetts concluded that the term "surface waters" is ambiguous in this context. The court noted the lack of a clear definition in the policies and the divided case law on the issue. Given this ambiguity, the court ruled in favor of the insureds, determining that rainwater accumulating on the rooftop courtyard and parapet roofs does not unambiguously constitute "surface waters" under the policies. Therefore, the damage from such water infiltration is not subject to the flood sublimits. View "Zurich American Insurance Company v. Medical Properties Trust, Inc." on Justia Law

A commercial tenant and landlord entered into a contract for the construction and lease of a warehouse, with the landlord also acting as the general contractor. The contract included a waiver of subrogation, where both parties waived subrogation against each other for certain losses, including those caused by their subcontractors. After the warehouse sustained weather damage, the tenant’s insurer sought to recoup insurance payments by suing the subcontractors.The Circuit Court for Baltimore City granted summary judgment in favor of the subcontractors, concluding that they were intended beneficiaries of the waiver of subrogation in the contract between the tenant and landlord. The court did not consider any extrinsic evidence regarding the parties' intent. The Appellate Court of Maryland reversed this decision, finding that the waiver of subrogation in the contract did not unambiguously benefit the subcontractors and that the subcontractors were not intended third-party beneficiaries.The Supreme Court of Maryland reviewed the case and held that the waiver of subrogation in the contract between the tenant and landlord did not extend to the subcontractors. The court found that the language of the waiver was unambiguous and did not show an intent to benefit the subcontractors. However, the court found that the waiver of subrogation included in the subcontracts was ambiguous regarding whether it applied to the tenant’s insurer’s claims against the subcontractors. Therefore, the court held that extrinsic evidence was needed to determine the parties' intent regarding the scope of the subrogation waiver in the subcontracts.The Supreme Court of Maryland affirmed the Appellate Court's decision, reversing the Circuit Court's summary judgment in favor of the subcontractors, and remanded the case for further proceedings to consider extrinsic evidence. View "Lithko Contracting v. XL Insurance America, Inc." on Justia Law

This case revolves around a dispute over an insurance claim following a house fire. The plaintiff, William Werner, owned a home in Springfield, Illinois, which was in foreclosure when it burned down in 2017. Werner's home insurance policy was with Auto-Owners Insurance Company. After the fire, Werner filed a claim seeking to recover his policy limit on the home itself and two smaller coverages, totaling just over $190,000. Auto-Owners denied Werner’s claim for the full replacement value of the home, arguing that Werner had lost any insurable interest in the full value of the property after the judicial sale occurred and all of Werner’s rights of redemption had expired.The case was first heard in the United States District Court for the Central District of Illinois. The district court ruled in favor of Auto-Owners, holding that at the time of the fire, Werner’s only remaining insurable interest in the property was based on his narrow right under Illinois law to occupy the home until 30 days after the judicial sale was confirmed. The court awarded Werner the rental value of that temporary right, which amounted to just under $4,000.Werner appealed the decision to the United States Court of Appeals for the Seventh Circuit. The appellate court affirmed the district court's ruling. The court agreed with the lower court's interpretation of Illinois insurance law, stating that Werner's insurable interest at the time of the fire was limited to the value of his temporary right of possession. The court noted that Werner still held legal title to the property when the fire occurred, but he had no legal right to redeem it from foreclosure or otherwise retain it. The court concluded that Werner's insurable interest did not extend to the full value of the property. View "Werner v. Auto-Owners Insurance Company" on Justia Law

The case involves plaintiffs Martin Tait, Jane Tait, and Bry-Mart, LLC (collectively, the Taits) who sued Commonwealth Land Title Insurance Company (Commonwealth) for breach of a title insurance policy. The Taits alleged that Commonwealth failed to pay the full amount by which their property’s value was diminished due to an undisclosed easement. The Taits had purchased a residential property in Danville for $1.25 million and had plans to subdivide the property into two lots. However, they discovered a separate 1988 maintenance easement that they believed would impact the marketability and value of the property and interfere with its potential development.The trial court granted Commonwealth’s motion for summary judgment, ruling that the policy required Commonwealth to compensate the Taits only for the value of their actual use of the property as a vacant residential lot suitable for only one home rather than its highest and best use as a subdividable lot. The court reasoned that the legal standard for title insurance losses did not permit consideration of a property’s highest and best use, only its actual use as vacant residential land.The Court of Appeal of the State of California First Appellate District Division Four disagreed with the trial court's interpretation. The appellate court held that the Taits’ policy entitles them to reimbursement for the diminution in value of their property based on its highest and best use. The court found that the Taits’ evidence of the likelihood of subdivision and the value of a subdividable lot created a triable issue of fact regarding the amount of the Taits’ loss under the policy, thereby precluding summary judgment. Therefore, the court reversed the trial court's decision. View "Tait v. Commonwealth Land Title Insurance Co." on Justia Law

A real estate developer, 3534 East Cap Venture, LLC, and a construction company, McCullough Construction, LLC, were involved in a dispute with their insurers, Westchester Fire Insurance Company and Endurance American Insurance Company. The dispute centered around the coverage of two identical builders’ risk insurance policies for a residential and retail complex under construction in the District of Columbia. During construction, the absence of a vapor barrier in the architect's plans led to the condensation of vapor into water during cold weather, causing nearly $1.5 million in damages. The insurers denied the claims, arguing that the policies excluded losses caused by atmospheric dampness or temperature changes.The case was initially brought to the Superior Court of the District of Columbia, but was moved to federal district court due to diversity of citizenship. The district court ruled in favor of the insurers, holding that the exclusions for losses caused by "dampness of atmosphere" or "changes in temperature" applied. The court also held that the ensuing-loss exception to the exclusions did not apply because losses from "water damage" to the building were "inextricably intertwined" with—and indeed were "one and the same" as—losses covered by the dampness and temperature exclusions.The United States Court of Appeals for the District of Columbia Circuit reversed the district court's decision. The appellate court held that the ensuing-loss clause in the insurance policies applied to losses from water damage caused by the excluded perils of dampness and temperature changes. Therefore, the policies covered the losses at issue. The court remanded the case with instructions to enter summary judgment for the insureds on the question of liability. View "3534 East Cap Venture, LLC v. Westchester Fire Insurance Company" on Justia Law