Justia Insurance Law Opinion Summaries

A carpenter who managed his own construction business was involved in a multi-vehicle accident in September 2013, while driving a car owned by another individual. The accident, caused by another driver, resulted in significant injuries and financial losses for the plaintiff, who claimed over $75,000 in medical expenses and more than $250,000 in lost income. The plaintiff had a business insurance policy with Main Street America Assurance Company (MSAA) during the relevant period. The driver and owner of the vehicle that struck the plaintiff were insured by GEICO General Insurance Company.Previously, the plaintiff sued the at-fault driver and owner (the Mathieus) in Kent County Superior Court and later settled that case. In the present suit, the plaintiff brought claims against both GEICO and MSAA for breach of contract, breach of the implied covenant of good faith and fair dealing, and statutory bad faith refusal to settle. Both defendants moved to sever the bad faith and implied covenant claims and to stay discovery on those claims, which the Superior Court granted. The court also denied the plaintiff’s motion to compel additional document production from GEICO, pending resolution of summary judgment motions. Ultimately, the Superior Court granted summary judgment for both defendants.On appeal, the Supreme Court of Rhode Island affirmed the Superior Court’s judgments. The Court held that MSAA’s business insurance policy expressly excluded coverage for injuries arising from automobile use, so the plaintiff’s contract and related claims failed as a matter of law. As to GEICO, the Court found that Rhode Island law prohibits direct actions against an insurer under these circumstances, and the plaintiff had no contractual or third-party rights under the GEICO policy. The Court also concluded that the issues related to severance and discovery were moot given the disposition of the contract claims. View "Menge v. GEICO General Insurance Company" on Justia Law

The plaintiff, an employee of Verizon, was involved in a motor vehicle accident while driving a company-assigned bucket truck during work hours. He typically drove his personal vehicle to work, then operated the Verizon truck exclusively for his work assignments, including commuting between the central work location and job sites. The Verizon truck was not for personal use, but was used daily for work, and the plaintiff kept work-related items in it. After the accident, the plaintiff sought uninsured motorist benefits under his personal auto insurance policy with the defendant, Nationwide, but his claim was denied under the policy's exclusion for injuries suffered while occupying a vehicle furnished for his “regular use.”The plaintiff filed suit in Providence County Superior Court, seeking a declaratory judgment that he was entitled to coverage. The defendant moved for summary judgment, arguing the facts were undisputed and the regular use exclusion applied. The hearing justice denied the motion, finding factual questions remained about whether the Verizon truck was furnished for the plaintiff’s regular use. At trial, after both parties stipulated to undisputed facts and the plaintiff rested, the defendant moved to discharge the jury, arguing that only a question of contract interpretation remained. The trial justice agreed, discharged the jury, and indicated that the regular use question was legal, not factual.The Supreme Court of Rhode Island granted review and held that, under its prior decision in Ricci v. United States Fidelity and Guaranty Company, whether a “non-owned” vehicle is furnished for “regular use” within the meaning of an insurance policy is a question of fact for the jury. The Court concluded that the trial justice erred by removing the question from the jury and quashed the Superior Court’s order, remanding the case for a new trial. View "O'Rourke v. Nationwide Mutual Insurance Company" on Justia Law

In March 2010, a motor vehicle accident occurred on Interstate 95 South in Cranston, Rhode Island, involving Julie DeOliveira, her daughter Maxine, and a truck driven by Greg Trecaso, who was insured by Star Insurance Company. Julie and Maxine claimed that Mr. Trecaso negligently operated his truck, causing their injuries. After Mr. Trecaso and his business were dismissed from the case due to lack of service, Star Insurance remained as defendant. The case proceeded to a jury trial where the key dispute was whether Mr. Trecaso’s actions caused the accident, as described by conflicting accounts from Julie, Maxine, Mr. Trecaso (via deposition), and a police officer.The Providence County Superior Court admitted contested evidence, including Mr. Trecaso’s deposition and a police report, over plaintiffs’ objections. During trial, the jury heard testimony from the plaintiffs, Mr. Trecaso’s deposition, and Trooper Hanley, who investigated the accident. The jury found that neither Julie nor Maxine proved by a preponderance of evidence that Star Insurance’s insured was negligent. Plaintiffs’ motion for a new trial was denied by the Superior Court, as was Star’s motion for judgment as a matter of law.On appeal, the Supreme Court of Rhode Island reviewed several alleged errors, including evidentiary rulings, jury instructions, statements by defense counsel, and the verdict sheet. The Court applied an abuse of discretion standard to evidentiary and procedural rulings and found no error by the trial justice. The Court concluded that the jury instructions were proper, the verdict sheet was not misleading, and the empty chair doctrine was not violated. The Supreme Court affirmed the denial of the plaintiffs’ motion for a new trial and the judgment in favor of Star Insurance Company, declining to address the defendant’s cross-appeal. View "DeOliveira v. Trecaso" on Justia Law

An employee who worked for a state agency in Rhode Island and regularly used her own personal vehicle for job-related travel was injured in a car accident caused by an underinsured driver. On the day of the incident, no state-owned vehicle was available, so she drove her own car. Her employer, the State of Rhode Island, carried a commercial auto insurance policy with Travelers Property Casualty Company of America, which provided liability coverage for employees using any vehicle within the scope of employment but only provided uninsured/underinsured motorist (UM/UIM) coverage when employees were occupying state-owned vehicles.After the accident, the employee sought UM/UIM benefits from Travelers, but her claim was denied because she was not occupying a covered auto under the policy. She brought suit in Providence County Superior Court, alleging breach of contract, seeking declaratory judgments on coverage, and pursuing bad faith and punitive damages. Travelers removed the case to federal court. The United States District Court for the District of Rhode Island granted summary judgment to Travelers, finding the policy language unambiguously did not provide the coverage she sought, and that Rhode Island law did not otherwise require it.On appeal, the United States Court of Appeals for the First Circuit certified two questions to the Supreme Court of Rhode Island: whether, under Rhode Island law and the precedent of Martinelli v. Travelers Insurance Companies, an employee using her own car within the scope of employment must be considered a named insured for UM/UIM coverage despite contrary policy terms; and whether it violates the Rhode Island Uninsured Motorist Statute or public policy for an employer’s policy to provide liability but not UM/UIM coverage in these circumstances.The Supreme Court of Rhode Island answered both questions in the negative, holding that neither the Martinelli precedent nor Rhode Island law required the employee to be treated as a named insured, and that the statutory and public policy requirements were not violated by the policy’s terms. View "Roberge v. Travelers Property Casualty Company of America" on Justia Law

A fatal car accident occurred in January 2023, resulting in the death of Papa Ndoye, who was struck by a vehicle driven by a minor covered under an auto insurance policy issued by GEICO to the driver’s mother. Following Mr. Ndoye’s death, his wife, Fama Diop, sent a settlement demand to GEICO and then brought a wrongful death action against the driver and the policyholder. That wrongful death suit remained pending.Subsequently, GEICO initiated a declaratory judgment action in the Providence County Superior Court to determine its obligations under the policy, specifically whether the “each person” limit of $50,000 or the “each occurrence” limit of $100,000 applied to Ms. Diop’s claims. Ms. Diop counterclaimed, seeking a declaration that she was entitled to the statutory $250,000 minimum under Rhode Island’s Death by Wrongful Act statute. Both parties moved for summary judgment. The Superior Court granted summary judgment for GEICO, holding that under Rhode Island Supreme Court precedent, including Allstate Insurance Company v. Pogorilich, loss-of-consortium and wrongful death claims that derive from bodily injury to a single person are subject to the “each person” policy limit. The court found the policy language unambiguous and declined to interpret the wrongful death statute as entitling Ms. Diop to a higher amount under the policy.On appeal, the Supreme Court of Rhode Island reviewed the matter de novo and affirmed the Superior Court’s judgment. The Court held that the “each person” limit of $50,000 applied to all claims arising from Mr. Ndoye’s death, including derivative claims for loss of consortium. The holding was based on the clear language of the policy and controlling precedent. The judgment for GEICO was affirmed. View "GEICO General Insurance Company v. Diop" on Justia Law

Vermont Mutual Insurance Company issued a homeowners insurance policy to Joanne St. Vil for property in Rumford, Rhode Island. St. Vil filed a claim for windstorm damage, which Vermont Mutual paid after an inspection. St. Vil later engaged New England Property Services Group, LLC (NEPSG) for additional repairs, leading to a dispute over the scope of damages. St. Vil assigned her insurance claim to NEPSG, which demanded an appraisal. Vermont Mutual objected to NEPSG's appraiser, Steven Ceceri, due to his financial interest but proceeded with the appraisal, reserving the right to dispute the award. The appraisal resulted in a final award of $144,855.37, which Vermont Mutual contested.The Superior Court denied Vermont Mutual's petition to vacate the appraisal award and granted NEPSG's cross-petition to confirm it. The court ruled that the policy did not require the appraiser to be disinterested, referencing a similar case it had previously decided.The Rhode Island Supreme Court reviewed the case and held that the appraisal process in Vermont Mutual's policy constituted arbitration under the Arbitration Act. The Court found that Steven Ceceri had a direct financial interest in the award, establishing evident partiality. The Court also determined a causal nexus between Ceceri's conduct and the final award, as the award was not unanimous and significantly higher than Vermont Mutual's appraiser's estimate. Consequently, the Supreme Court vacated the Superior Court's order and remanded the case for a new appraisal. View "Vermont Mutual Insurance Company v. New England Property Services Group, LLC" on Justia Law

The plaintiff, Alexandria Kazarian, filed a negligence lawsuit against New London County Mutual Insurance Company after a trip-and-fall accident near property owned by the defendant’s insured, Irene Swiney. Kazarian alleged that Swiney allowed a vehicle to be parked in a manner that obstructed the sidewalk, causing her to walk into the street and trip over an unsecured gas cap, resulting in injury. After Swiney passed away, New London was substituted as the defendant.In the Superior Court, a jury trial resulted in a verdict in favor of New London. Kazarian’s motion for a new trial was denied. She argued that Swiney was negligent for allowing the vehicle to obstruct the sidewalk and that a master-servant relationship existed between Swiney and the vehicle owner, making Swiney liable. The trial justice denied the motion, stating it was within the jury’s purview to evaluate the evidence and witness credibility.The Rhode Island Supreme Court reviewed the case. Kazarian contended that the trial justice erred in denying her motions for judgment as a matter of law and a new trial. She also argued that the trial justice’s use of the word “redacted” in response to a jury question was prejudicial. The Supreme Court found that reasonable minds could differ on whether the vehicle obstructed the sidewalk and whether it was a reasonable and necessary use of the sidewalk. The Court also noted that Kazarian failed to object contemporaneously to the alleged golden rule violation and the grass-growth argument during the trial, thus waiving those issues.The Supreme Court affirmed the Superior Court’s judgment, concluding that the trial justice conducted an appropriate analysis and did not err in his decisions. The case was remanded to the Superior Court. View "Kazarian v. New London County Mutual Insurance Co." on Justia Law

The plaintiff, New England Property Services Group, LLC, filed a claim under a homeowners’ insurance policy for wind damage to a property in Greenville, Rhode Island. The insurance company, Vermont Mutual Insurance Company, provided an estimate for the loss, which the plaintiff disputed. The plaintiff invoked the appraisal process outlined in the insurance agreement. Each party appointed an appraiser, but they could not agree on an umpire, so the Superior Court appointed one. The appraisal concluded with an award signed by the plaintiff’s appraiser and the umpire, but not the defendant’s appraiser.The plaintiff filed a petition in the Superior Court to confirm the appraisal award under Rhode Island’s Arbitration Act. The defendant filed a cross-petition to vacate the award, arguing that the plaintiff’s appraiser was ineligible due to a financial interest in the award. The Superior Court granted the defendant’s cross-petition to vacate the award and denied the plaintiff’s petition to confirm it. The plaintiff did not appeal this order but instead filed a motion to reconsider, arguing that the appraisal process was not arbitration because the insurance contract did not require appraisers to be disinterested. The Superior Court denied this motion.The Rhode Island Supreme Court reviewed the case and affirmed the Superior Court’s order. The Court held that the appraisal process was akin to arbitration, despite the absence of the word “disinterested” in the insurance contract. The Court noted that the plaintiff had initially sought to confirm the award under the Arbitration Act and only challenged the nature of the proceedings after the award was vacated. The Court concluded that the Superior Court had subject-matter jurisdiction and that the appraisal clause in the insurance policy constituted arbitration under the Arbitration Act. View "New England Property Services Group, LLC v. Vermont Mutual Insurance Company" on Justia Law

The plaintiff, New England Property Services Group, LLC (NEPSG), appealed from a summary judgment in favor of the defendant, NGM Insurance Company (NGM). NEPSG had been assigned the insurance claim benefits by the policyholders, Stephen and Betty Callahan, for storm-related damage to their residence. NGM initially covered some damages but denied others, leading to a series of inspections and disagreements over the loss amount. Eventually, an appraisal process was conducted, resulting in an award that NEPSG found unsatisfactory due to updated labor costs published after the award was signed.The Superior Court granted summary judgment to NGM, finding that NEPSG was not entitled to a modification of the appraisal award or a second appraisal. The court also found that NEPSG failed to establish its claims for breach of contract, bad faith, unjust enrichment, and tortious interference with contractual relations. NEPSG argued that the award should be modified due to a miscalculation of labor costs and that NGM acted in bad faith by using unlicensed appraisers, among other claims.The Rhode Island Supreme Court reviewed the case de novo and affirmed the Superior Court's judgment. The court held that the appraisal award was akin to an arbitration award and thus subject to limited judicial review. NEPSG's request for modification based on post-award labor cost updates was not supported by admissible evidence. The court also found no basis for a second appraisal or for NEPSG's claims of breach of contract and bad faith, as NGM had fulfilled its contractual obligations and there was no evidence of bad faith. Additionally, the court rejected NEPSG's claims of unjust enrichment and tortious interference, finding no inequitable benefit retained by NGM and no evidence of intentional harm to NEPSG's contract with the policyholders. View "New England Property Services Group, LLC v. NGM Insurance Company" on Justia Law

In early 2020, Josephson, LLC, doing business as The Moinian Group (Moinian), filed a lawsuit against its insurance company, Affiliated FM Insurance Company (AFM), seeking coverage for losses sustained due to the COVID-19 pandemic. Moinian argued that the presence of COVID-19 at its insured properties constituted "physical loss or damage" under its insurance policy. The trial justice, however, determined that the presence of COVID-19 alone did not constitute "physical loss or damage" sufficient to implicate the coverage provisions. The trial justice also concluded that the Contamination Exclusion in the insurance policy unambiguously barred coverage because contamination, such as COVID-19, was expressly excluded under the terms of the policy.The Superior Court granted AFM's motion for partial summary judgment and denied Moinian's motion for partial summary judgment. The court determined that the presence of COVID-19 at Moinian's insured properties did not constitute "physical loss or damage" under the terms of the policy. The court also found that the Contamination Exclusion in the policy unambiguously applied to bar Moinian's claim. Moinian appealed the decision.The Supreme Court of Rhode Island affirmed the trial justice's determination. The court agreed with the lower court's interpretation of the Contamination Exclusion in the insurance policy. The court concluded that the exclusion for "contamination" was intended to limit coverage for a "type of risk," not a "type of loss." Therefore, the court held that Moinian's losses due to the COVID-19 pandemic were not covered under the insurance policy. View "Josephson v. Affiliated FM Insurance Company" on Justia Law