Justia Insurance Law Opinion Summaries

The Providence School Board (Board) provided health insurance to active employees and retirees. In 2006, the Providence Teachers Union (Union) filed a grievance protesting a difference in the increase of premium costs for retirees compared with a more modest increase in premium costs for active employees. The Union argued that the Board's action violated three provisions of the collective bargaining agreement (CBA) between the board and the union. An arbitrator ruled in the Union's favor, concluding that the Board violated the CBA by failing to include retirees and active employees in a single group when it calculated the healthcare premium rates. The trial justice vacated the arbitration award, concluding (1) the Union did not have standing to pursue a grievance on behalf of retirees, and (2) the issue of the calculation of the group premium rate was not arbitrable. The Supreme Court affirmed, holding (1) pursuant to Arena v. City of Providence and City of Newport v. Local 1080, the Union could not pursue this grievance on behalf of the retirees; and (2) because the Union had no standing to pursue this particular grievance, the grievance was not arbitrable. View "Providence Sch. Bd. v. Providence Teachers Union, Local 958" on Justia Law

Plaintiff was injured in a motor-vehicle collision with an underinsured driver (Tortfeasor). Tortfeasor was insured by Progressive Insurance Company (Progressive). Progressive paid Plaintiff its policy limits of $25,000. Plaintiff then sought recovery for personal injuries pursuant to the uninsured/underinsured motorist provisions (UM/UIM coverage) of her policy with Encompass Insurance Company (Encompass). Arbitrators issued a total award of $172,750. Plaintiff sought confirmation of the arbitration award. Encompass objected, arguing that Plaintiff's UM/UIM policy provided $100,000 maximum coverage, that Encompass had paid the policy limits in accordance with the insurance contract, and that, under Rhode Island law, Plaintiff was not entitled to recover from Encompass in excess of her policy limits. The trial justice vacated the portion of the award in excess of the $100,000 policy limit and confirmed the remainder of the arbitration award. The Supreme Court vacated the order of the superior court and directed that the arbitration award be reinstated in its entirety, holding that the superior court was incorrect in its interpretation of the law, and no grounds for modification or vacation of the award existed. View "Wheeler v. Encompass Ins. Co." on Justia Law

Petitioner was severely injured when he was assaulted by a stranger in the West End of the City of Providence. Petitioner had been sent to that location by his employer, Verizon New England. Petitioner subsequently filed a claim for workers' compensation benefits. The trial judge denied Petitioner's request, concluding that Petitioner's injuries were noncompensable under Rhode Island's actual-risk test, which requires that there be some causal connection between the injury suffered by the employee and the employment or the conditions of employment. The appellate division affirmed. The Supreme Court quashed the decree of the appellate division and remanded, holding that Petitioner's injuries were compensable under the street-peril doctrine. View "Ellis v. Verizon New England, Inc." on Justia Law

Pearl Archambault died while in the care of Haven Health Center of Greenville (Haven Health) after a nurse mistakenly administered a lethal overdose of morphine. The administratrix of her estate, Plaintiff, filed a medical malpractice action against Haven Health. Health Haven subsequently filed for Chapter 11 bankruptcy. Thereafter, Plaintiff amended her complaint to add Columbia Casualty Company, the professional liability insurer of Health Haven, as a defendant and asserted two counts against Columbia directly based on R.I. Gen. Laws 27-7-2.4, which permits an injured party to proceed against an insurer when the insured has filed for bankruptcy. The superior court entered default judgment against Haven Health. The court then granted summary judgment in favor of Columbia. The Supreme Court reversed and remanded with instructions to enter judgment against Columbia, holding that the superior court erred in interpreting Rhode Island law and that the insurance contract between Columbia and Health Haven should be construed in Plaintiff's favor. View "Peloquin v. Haven Health Ctr. of Greenville, LLC" on Justia Law

Dean Pepper, the owner and sole shareholder of D.F. Pepper Construction (DFP) was driving one of his trucks home in the early winter morning. An icy road caused the truck to slide into Pepper's house and crash through the foundation and west wall. The house was later condemned and demolished as a result of the damage. The house was insured by Nationwide Casualty Insurance Company. Nationwide paid the loss. As subrogee of Pepper, Nationwide then sued DFP, the registered owner of the truck, alleging vicarious liability for the negligence of its employee, Pepper. The superior court issued judgment in favor of Nationwide, finding that Pepper had been negligent and that the antisubrogation rule did not apply in this case. The Supreme Court affirmed, holding that the trial court did not err in its judgment. View "Nationwide Prop. & Cas. Ins. Co. v. D.F. Pepper Constr., Inc." on Justia Law

DWS Properties (DWS) owned rental property. The sole member of DWS was Dustin Shore. After a pipe burst at the property causing substantial damage, Shore executed contracts with Performance Adjusting Public Insurance Adjusters (Performance) and Multi-State Restoration (Multi-State), in which Performance agreed to provide public adjusting service relative to the loss, and Multi-State agreed to perform emergency clean-up work at the property. Performance and Multi-State (Plaintiffs) were never paid for the services they provided, and after Shore filed for personal bankruptcy, Shore's debts to Plaintiffs were discharged. Plaintiffs subsequently filed suit against DWS, seeking damages for book account, breach of contract, quasi-contract, and unjust enrichment. DWS filed a motion to dismiss, which the hearing justice converted into a motion for summary judgment and granted, reasoning that Shore had signed the contracts in an individual capacity without making any reference to DWS. The Supreme Court vacated the judgment of the superior court and remanded, holding (1) summary judgment was inappropriate on Plaintiffs' contract claims; and (2) the fact that DWS was not explicitly named on the contracts did not entitle it to judgment as a matter of law on Plaintiffs' equitable claims. View "Multi-State Restoration, Inc. v. DWS Props., LLC" on Justia Law

Jared Crook was driving a Cadillac leased for him by his father, Calvin Crook, when he collided with Jessica Ahlquist's vehicle. Ahlquist sustained severe personal injuries as a result of the accident. The Cadillac was insured by Calvin through a policy issued by Allstate Insurance Company. Allstate paid the policy limits, and Ahlquist sought to recover additional compensation through another Allstate policy issued to Cheryl, Calvin's former wife. The policy was issued for Cheryl's vehicle. Allstate filed a declaratory judgment action arguing that Cheryl's insurance policy did not apply to the accident. The trial justice granted summary judgment in Allstate's favor. Ahlquist appealed, contending that the trial justice erred in granting summary judgment because Calvin, who was a named driver under Cheryl's insurance policy, provided the Cadillac to Jared. Ahlquist also argued that there was an ambiguity as to whether the policy covered the accident. The Supreme Court affirmed, holding that the trial court did not err in its judgment. View "Allstate Ins. Co. v. Ahlquist" on Justia Law

Under the terms of a collective-bargaining agreement, the City of Newport provided health insurance benefits to its retired firefighters. After the City decided to modify those benefits, Local 1080, International Association of Firefighters, ALF-CIO (Union) filed grievances and sought arbitration. The City responded by seeking relief in the superior court to determine the arbitrability of disputes over changes to these benefits. The superior court determined that this dispute was not arbitrable. The Union disagreed and petitioned the Supreme Court for a writ of certiorari. The Court affirmed the judgment of the superior court, holding that the parties did not intend to arbitrate disputes regarding retiree healthcare, and therefore, such disputes must be resolved, if at all, judicially rather than through arbitration. View "City of Newport v. Local 1080, Int'l Ass'n of Firefighters, AFL-CIO" on Justia Law

Plaintiffs Joseph and Josephine Iozzi owned a home located in Cranston. On October 15, 2005, excessive rainfall overwhelmed the sewer system servicing the Iozzis's home, causing water and sewage to back up and enter their basement, resulting in extensive damage to their home and personal property. Plaintiffs filed suit seeking declaratory relief and compensatory damages from Triton Ocean State, LLC (Triton); U.S. Filter Operating Services, Inc. (Veolia); and Peerless Insurance Company (Peerless). The complaint alleged that Triton and Veolia were jointly and severally liable for negligently "operating, maintaining and repairing the sewer disposal system" in the city. As to Peerless, the complaint alleged that it was liable for breach of contract for rejecting plaintiffs' claim for damages under their homeowner's insurance policy. Peerless moved for summary judgment arguing that the language in the homeowner's policy was clear and unambiguous and excluded coverage for the claims Plaintiffs made. Triton and Veolia filed a joint motion for summary judgment arguing that neither of them had a contractual or common-law responsibility to Plaintiffs for the damage to their property because a lease service agreement with the City of Cranston relieved them of responsibility for the damage and because the flooding that caused Plaintiffs' damages was caused by an "Act of God." Agreeing with the superior court's reasoning for granting defendants' motions for summary judgment, the Supreme Court affirmed dismissal of Plaintiffs' case. View "Iozzi v. City of Cranston" on Justia Law

In this case, the Supreme Court was asked to decide whether the decedent Robert Daniel George, who was struck and killed by an uninsured motorist in 2006, qualified as an insured under an insurance policy provided by Harleysville Worcester Insurance Company, which policy was procured by The Cormack-Routhier Agency, Inc. Plaintiffs Pamela A. Riel and Glenn N. George, as co-administrators of the decedent’s estate, and Pamela A. Riel, on behalf of her and the decedent’s minor daughter, Kara George, brought a complaint against Defendants Harleysville and Cormack for declaratory and other relief, but a Superior Court justice granted summary judgment in favor of the defendants. Plaintiffs appealed, arguing that the trial justice erred in dismissing their claims against Harleysville because a genuine issue of material fact existed with respect to whether the decedent should be considered a named insured under the policy. Plaintiffs further asserted that the trial justice erred in dismissing their claims against Cormack because, even if they failed to establish that the decedent was a named insured, they still were entitled to pursue their claims against Cormack for failing to procure adequate coverage. After considering the parties' written and oral submissions and reviewing the record, the Court affirmed the judgment of the Superior Court. View "Riel v. Harleysville Worcester Ins. Co." on Justia Law