Justia Insurance Law Opinion Summaries

Articles Posted in South Carolina Supreme Court
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Jimi Redman shot and killed Lynn Harrison with a rifle while both were in their vehicles at a stoplight. Immediately before the shooting, Redman, who was driving a Ford Escape, approached Harrison's GMC in the lane to her right. A witness, who was directly behind Harrison in the left lane, saw Redman make hand gestures and blow kisses toward Harrison. There is no evidence that Harrison attempted to evade Redman or that she even saw his gestures. Instead, as the two vehicles stopped at the red light, Redman pulled out a rifle and fired one shot which traveled through Harrison's passenger side window, killing her. Redman subsequently sped away, while Harrison's vehicle, which was still in drive, crept forward until coming to rest in the median. Redman was arrested a few blocks away. The issue this case presented for the South Carolina Supreme Court's review was whether uninsured or underinsured benefits could be recovered when an individual was shot and killed by another motorist as both cars were stopped at a traffic light. In deciding this question, the Court revisited and attempted to clarify conflicting jurisprudence as to whether such injuries arise out of the "ownership, maintenance, or use" of an automobile. To this, the Court held that gunshot injuries do not arise out of the use of an automobile. Therefore, it reversed the court of appeals and reinstated the judgment of the circuit court. View "Progressive Direct v. Groves" on Justia Law

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The United States District Court for the District of South Carolina certified a question of law to the South Carolina Supreme Court. Sullivan Management, LLC operated restaurants in South Carolina and filed suit to recover for business interruption losses during COVID-19 under a commercial property insurance policy issued by Fireman's Fund and Allianz Global Risks US Insurance Company (Fireman's). Specifically, the questions was whether the presence of COVID-19 in or near Sullivan's properties, and/or related governmental orders, which allegedly hinder or destroy the fitness, habitability or functionality of property, constituted "direct physical loss or damage" or did "direct physical loss or damage" require some permanent dispossession of the property or physical alteration to the property. The Supreme Court held that the presence of COVID-19 and the corresponding government orders prohibiting indoor dining did not fall within the policy’s trigger language of “direct physical loss or damage.” View "Sullivan Mgmt v. Fireman's Fund" on Justia Law

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PCS Nitrogen sought insurance coverage for liability arising from contamination of a fertilizer manufacturing site in Charleston, South Carolina, claiming its right to coverage stemmed from an assignment of insurance benefits executed by Columbia Nitrogen Corporation in 1986. Respondents, the insurance carriers who issued the policies at issue, claimed they owed no coverage because Columbia Nitrogen Corporation executed the assignment without their consent. The circuit court granted summary judgment to Respondents, and the court of appeals affirmed. The South Carolina Supreme Court granted PCS's petition for a writ of certiorari, finding Columbia Nitrogen Corporation executed a valid post-loss assignment of insurance rights in 1986. "PCS cannot be denied coverage on the basis that Respondents did not consent to the assignment." The case was remanded to the trial court for further proceedings. View "PCS Nitrogen, Inc. v Continental Casualty Company, et al." on Justia Law

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Before the South Carolina Supreme Court in this appeal was the trial court's dismissal of respondent Jeanne Beverly's claims pursuant to Rule 12(b)(6) of the South Carolina Rules of Civil Procedure. Beverly brought claims against Grand Strand Regional Medical Center, LLC. Blue Cross Blue Shield of South Carolina (BCBS) was a mutual insurance company that provided health insurance coverage through Member Benefits Contracts to its Members. Beverly was a BCBS Member. In 2005, Grand Strand and BCBS entered into a contract labeled "Institutional Agreement." The Institutional Agreement contained a clause entitled, "No Third Party Beneficiaries," that provided in part, "This Agreement is not intended to, and shall not be construed to, make any person or entity a third party beneficiary." Grand Strand and BCBS were the only parties to the Institutional Agreement. Grand Strand made two promises to BCBS in the Institutional Agreement that Beverly contended created rights she and other BCBS Members could enforce. Beverly was injured in an automobile accident on September 6, 2012. The same day, she received health care services at a Grand Strand emergency room for injuries she sustained in the accident. Beverly alleges she provided Grand Strand proof of her status as a BCBS Member. Some time later, Beverly received a bill directly from Grand Strand for $8,000. Beverly alleges the $8,000 bill does not reflect the discount Grand Strand promised in the Institutional Agreement. Beverly filed this action on behalf of herself and a class of similarly situated BCBS Members who were denied the right to have their bills processed and discounted according to Grand Strand's promises in the Institutional Agreement. The primary question before the Supreme Court was whether the "no beneficiary" clause in the Institutional Agreement overrode an otherwise manifestly clear purpose of the contracting parties to provide a direct benefit to non-contracting parties. "Mindful that we are reviewing a Rule 12(b)(6) dismissal order—not an order on the merits—we hold it does not." The Supreme Court affirmed the court of appeals' opinion reversing the 12(b)(6) dismissal. The case was remanded to circuit court for discovery and trial. View "Beverly v. Grand Strand Regional Medical Center, LLC" on Justia Law

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After sustaining injuries in a vehicle driven by her son, Kevin Simms, Petitioner Belinda Pickens sought UM coverage through her policy with Respondent United Services Automobile Association (USAA). At the time of the accident, Pickens's policy covered five vehicles, including the 1997 Chevrolet involved in the accident. The policy included liability, personal injury protection (PIP), UM, and underinsured motorist (UIM) coverage. Pickens also executed a named driver exclusion. Pickens's declarations page also contained a provision that stated, "***COVERAGES EXCLUDED WHEN ANY VEHICLE OPERATED BY KEVIN SIMMS***." USAA denied Pickens's claim and initiated a declaratory judgment action asserting she was not entitled to UM coverage because Simms, the excluded driver, was operating the vehicle at the time of the accident. Pickens sued USAA and lost. The issue this case presented for the South Carolina Supreme Court's review centered on whether Section 38-77-340 of the South Carolina Code (2015) permitted a named driver exclusion that precluded uninsured motorist (UM) coverage to a passenger injured in an accident involving an unknown driver. The Court held that it did. "As the circuit court noted, no liability coverage would have been afforded to a third party had Simms been at fault, and thus, it would violate public policy to allow Pickens to recover UM when she was the person who executed the exclusion yet knowingly allowed Simms to drive her vehicle." View "United Services Automobile Association v. Pickens" on Justia Law

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A Town of Cottageville police officer shot and killed the former town Mayor Bert Reeves. A federal jury awarded Reeves' estate $97,500,000 in damages. The South Carolina Municipal Insurance and Risk Financing Fund, which insured the town, paid $10,000,000 to settle the federal lawsuit and two other lawsuits. The Settlement Agreement provided for two questions to be submitted to the state courts: (1) whether the amount of indemnity coverage available under the policy was more than $1,000,000; and (2) whether the South Carolina Tort Claims Act applied to a bad faith action against the Fund. The South Carolina Supreme Court answered the first question "yes"; it declined to answer the second. View "Reeves v. South Carolina Municipal Insurance" on Justia Law

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Kristina Knight agreed to an endorsement to her Nationwide automobile insurance policy providing the coverage in the policy would not apply to her husband. During the policy period, Danny Knight was tragically killed in a motorcycle accident. Knight, as personal representative of Danny's estate, recovered $25,000 in UIM coverage under Danny's motorcycle insurance policy with Progressive Casualty Insurance Company and $25,000 in UIM coverage under a policy with ACCC Insurance Company insuring a different vehicle Danny owned. Knight made a claim with Nationwide to recover an additional $25,000 in UIM coverage under her insurance policy. Nationwide denied the claim and filed this lawsuit asking the trial court to declare Nationwide did not have to pay the $25,000 because Danny was excluded from all coverages under the policy. On appeal, Knight claimed the endorsement excluding coverage for her husband violated public policy and Nationwide could not enforce it. The South Carolina Supreme Court found the exclusion was clear and unambiguous and was not in violation of any statute. Therefore, the Court held the exclusion was enforceable. View "Nationwide Insurance Company of America v. Knight" on Justia Law

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The United States District Court for the District of South Carolina certified a question to the South Carolina Supreme Court on whether a homeowner's insurance policy that did not define the term "actual cash value," an insurer could depreciate the cost of labor in determining the "actual cash value" of a covered loss when the estimated cost to repair or replace the damaged property includes both materials and embedded labor components. This issue arose in two cases in which the homes of Miriam Butler and Joseph Stewart were damaged in separate fires. Butler and Stewart each purchased a homeowner's insurance policy from one of the defendants, both of whom were subsidiaries of The Travelers Companies, Inc. Butler and Stewart elected not to immediately repair or replace their damaged property. Each thus elected not to receive replacement cost but instead to receive a cash payment for the ACV of the damaged property. The certified question addressed whether Travelers properly calculated the ACV payments Travelers offered to Butler and Stewart to settle their property damage claims. The Supreme Court responded affirmatively: “the fact the labor cost is embedded makes it impractical, if not impossible, to include depreciation for materials and not for labor to determine ACV of the damaged property. Rather, the value of the damaged property is reasonably calculated as a unit. Therefore, we answer the certified question "yes," because it makes no sense for an insurer to include depreciation for materials and not for embedded labor.” View "Butler v. The Travelers Home" on Justia Law

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Nationwide Mutual Insurance Company ("Nationwide") relied on flight-from-law enforcement and felony step-down provisions in an automobile liability insurance policy to limit its coverage to the statutory mandatory minimum. Following a bench trial and after issuance of the South Carolina Supreme Court's opinion in Williams v. Government Employees Insurance Co. (GEICO), 409 S.C. 586 (2014), the circuit court held the step-down provisions were void pursuant to Section 38-77-142(C) of the South Carolina Code (2015). The court of appeals reversed. Three individuals, Sharmin Walls, Randi Harper, and Christopher Timms, were passengers in a vehicle driven by Korey Mayfield that crashed in 2008 following a high-speed chase by law enforcement. Mayfield refused to pull over, and during the chase, the trooper's vehicle reached speeds of 109 miles per hour. All the passengers begged Mayfield to stop the car, but Mayfield refused. Eventually, the trooper received instructions to terminate the pursuit, which he did. Nevertheless, Mayfield continued speeding and lost control of the vehicle. Timms died in the single-car accident, and Walls, Harper, and Mayfield sustained serious injuries. After being charged with reckless homicide, Mayfield entered an Alford plea. At the time of the accident, Walls' automobile was insured through her Nationwide policy, which included bodily injury and property damage liability coverage with limits of $100,000 per person and $300,000 per occurrence. Walls also maintained uninsured motorist (UM) coverage for the same limits, but she did not have underinsured motorist (UIM) coverage. In reliance on the aforementioned provisions, Nationwide paid only $50,000 in total to the injured passengers (the statutory minimum as provided by law) rather than the liability limits stated in the policy. Safe Auto, Mayfield's insurance company, also paid a total of $50,000 to the passengers. Nationwide brought this declaratory judgment action requesting the court declare that the passengers were not entitled to combined coverage of more than $50,000 for any claims arising from the accident. Walls answered, denying there was any evidence that the flight-from-law enforcement and felony provisions applied. The South Carolina Supreme Court reversed the court of appeals, holding that section 38-77-142(C) rendered Nationwide's attempt to limit the contracted-for liability insurance to the mandatory minimum void. View "Nationwide Mutual Ins. Co. v. Walls" on Justia Law

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Several insurance companies (the Insurers) appealed the denial of their motions to intervene in a construction defect action between a property owners' association (the Association) and a number of construction contractors and subcontractors (the Insureds). The underlying construction defect action proceeded to trial, resulting in a verdict for the Association. After review, the South Carolina Supreme Court determined the Insurers were not entitled to intervene as a matter of right, and the trial court did not abuse its discretion in denying them permissive intervention. However, the Court held the Insurers had a right to a determination of which portions of the Association's damages are covered under the commercial general liability (CGL) policies between the Insurers and the Insureds. The Court also recognized that the Insurers had the right and ability to contest coverage of the jury verdict in a subsequent declaratory judgment action. "In that action, the Insurers and the Insureds will be bound by the existence and extent of any jury verdict in favor of the Association in the construction defect action. However, they will not be bound as to any factual matters for which a conflict of interest existed, such as determining what portion of the total damages are covered by any applicable CGL policies." View "Builders Mutual Insurance Company" on Justia Law