Justia Insurance Law Opinion Summaries

Articles Posted in Supreme Court of Appeals of West Virginia
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In this original jurisdiction proceeding, the Supreme Court granted a writ of prohibition sought by Petitioners, out-of-state Blue Cross Blue Shield Plans, to prevent the enforcement of the circuit court's order concluding that it had jurisdiction over Petitioners in this action, holding that jurisdiction over Petitioners was clearly not appropriate in this case.Respondent alleged that the circuit court had jurisdiction over Petitioners for several reasons. Petitioners filed a motion to dismiss for lack of jurisdiction, asserting that they had no relevant jurisdictional contacts with West Virginia. The circuit court denied the motion, concluding that Petitioners purposefully availed themselves of the privilege of conducting business in West Virginia. Petitioners then filed the instant writ, arguing that any attempt to exercise specific jurisdiction over them violated due process because there was no allegation or evidence showing that they developed or maintained a substantial relationship with West Virginia or purposefully engaged in forum-related conduct that gave rise to Respondent's claims. The Supreme Court granted the writ, holding that Petitioners were entitled to the writ of prohibition. View "State ex rel. Blue Cross & Blue Shield of Kansas, Inc. v. Honorable Shawn D. Nines" on Justia Law

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The Supreme Court reversed the circuit court's order granting summary judgment for Respondents on their declaratory judgment action against Petitioner, their insurer, to determine the rights and responsibilities of the parties under the insurance policy, holding that an exclusion in the policy was applicable so that the policy did not cover Respondents' loss.The building housing Respondents' business was inundated with sewage, causing damage. Respondents were insured by Petitioner under a general commercial liability policy. Petitioner denied coverage for the loss as falling under an exclusion for "water that backs up or overflows from a sewer, drain or sump." Respondents brought a declaratory judgment action to determine the rights of the parties under the insurance contract. The trial court found that the policy exclusion was inapplicable. The Supreme Court reversed, holding that the circuit court erred when it found the exclusion to be inapplicable. View "Motorists Mutual Insurance Co. v. Zukoff" on Justia Law

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The Supreme Court affirmed the circuit court's dismissal of West Virginia Counties Group Self-Insurance Risk Pool, Inc.'s (WVCoRP) claims against Great Cacapon Volunteer Fire Department, Inc. (VFD), holding that the circuit court did not err.When a fire destroyed the building where VFD was housed, the owner of the building, the Morgan County Commission, was reimbursed for the loss by WVCoRP. Seeking to recover the funds it expended, WVCoRP sued the VFD and other parties for negligence. In the process, WVCoRP invoked a contractual right to subrogation. The circuit court determined that the claims against VFD were barred by W. Va. Code 29-12A-13(c), which prohibits claims against political subdivisions made under a right of subrogation. The Supreme Court affirmed, holding (1) WVCoRP's claims spring from its coverage contract with the Commission and fall within any plain meaning of subrogation; and (2) section 29-12A-13(c) is not an insurance law of the State from which WVCoRP is exempt. View "West Virginia Counties Group v. Great Cacapon Volunteer Fire Department, Inc." on Justia Law

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The Supreme Court granted a writ of prohibition prohibiting the circuit court from enforcing its sua sponte order dismissing count three of Respondents' complaint and finding that West Virginia law applied to all of Respondents' bad faith claims but declined to extend the writ to find that Georgia law applies to the entire dispute, holding that a writ of prohibition was not the proper avenue for such relief.After Petitioners denied insurance coverage for certain damages Petitioners filed a declaratory judgment action in the State of Delaware to determine their rights and responsibilities under the relevant insurance policies. Respondents subsequently filed the underlying complaint asserting five separate counts, including breach of contract and bad faith under Georgia law (count three). Petitioners sought to dismiss the West Virginia proceeding. The circuit court denied the motion but, sua sponte, dismissed count three. Petitioners then filed the instant petition. The Supreme Court granted the writ as moulded, holding (1) the circuit court exceeded its lawful authority when it sua sponte dismissed count three of the complaint and held that West Virginia law applied to Respondents' bad faith claims; and (2) this Court declines Petitioners' invitation to find that the Georgia choice-of-law provisions in the policies govern this action. View "State ex rel. National Union Fire Insurance Co. of Pittsburg, Pennsylvania v. Hummel" on Justia Law

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The Supreme Court granted this petition for a writ of prohibition brought by insurers (collectively, Petitioners) seeking to have the Court prohibit enforcement of a ruling by the circuit court that denied Petitioners’ motion for summary judgment against Respondent, holding that the circuit court erred as a matter of law in denying Petitioners’ motion for summary judgment.David Ralph Allen died from injuries he sustained in a motorcycle collision with a car. The car was owned by an auto dealership, and Petitioners provided an insurance policy for the dealership. The garage operations and auto hazard provision of the policy provided a limit of $300,000 in liability coverage. The commercial umbrella provision provided up to $5 million in liability coverage. Respondent, administratrix of Allen’s estate, asserted a declaratory judgment action against Petitioners to determine the amount of insurance coverage available. Petitioners asserted that the umbrella coverage part of the policy did not cover Respondent’s claims against the driver. The circuit court denied Petitioners’ motion for summary judgment on the coverage issue. The Supreme Court disagreed, holding that the circuit court erred in denying summary judgment for Petitioners on the umbrella coverage issue. View "State ex rel. Universal Underwriters Insurance Co. v. Honorable Patrick Wilson" on Justia Law

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The Supreme Court answered two certified questions from the United States Court of Appeals for the Fourth Circuit in this dispute between two insurance companies as follows: (1) The Workers’ Compensation Office of Judges does not have jurisdiction over a declaratory judgment action involving a dispute between insurance carriers regarding whether one or both carriers are responsible for contributing toward payment of an employee’s workers’ compensation benefits; and (2) Pursuant to W. Va. Code 33-46A-7(a), parties to a professional employer agreement must designate either the professional employer organization (PEO) or the client-employer as the responsible party for obtaining workers’ compensation insurance coverage for covered employees. Further, when parties to a professional employer agreement designate the PEO as the responsible party for obtaining workers’ compensation insurance coverage for covered employees, the policy obtained by the PEO is primary over a policy obtained by a client-employer. Thus, coverage under a workers’ compensation policy purchased by the client-employer is triggered only if the PEO or its carrier default on their obligation to provide workers’ compensation coverage. View "Brickstreet Mutual Insurance Co. v. Zurich American Insurance Co." on Justia Law

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The Supreme Court affirmed the order of the circuit court granting Plaintiff’s petition for declaratory judgment. In the order, the circuit court ruled that Erie Insurance Property and Casualty Company was required to provide Plaintiff, Erie’s insured, with the statutory minimum amount of uninsured motorist coverage for an ATV that Plaintiff was towing when he was struck by an at-fault, uninsured motorist. The Supreme Court held (1) the circuit court correctly granted declaratory judgment in favor of Plaintiff on the coverage issue; and (2) Erie’s challenge to the circuit court’s order denying its motion to dismiss Plaintiff’s separate claims for common law bad faith and violation of the Unfair Trade Practices Act was an interlocutory matter and not subject to appeal at this time. View "Erie Insurance Co. v. Dolly" on Justia Law

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The Supreme Court affirmed the order of the circuit court granting Plaintiff’s petition for declaratory judgment. In the order, the circuit court ruled that Erie Insurance Property and Casualty Company was required to provide Plaintiff, Erie’s insured, with the statutory minimum amount of uninsured motorist coverage for an ATV that Plaintiff was towing when he was struck by an at-fault, uninsured motorist. The Supreme Court held (1) the circuit court correctly granted declaratory judgment in favor of Plaintiff on the coverage issue; and (2) Erie’s challenge to the circuit court’s order denying its motion to dismiss Plaintiff’s separate claims for common law bad faith and violation of the Unfair Trade Practices Act was an interlocutory matter and not subject to appeal at this time. View "Erie Insurance Co. v. Dolly" on Justia Law

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The commercial general liability policy at issue in this case is internally inconsistent and therefore ambiguous, and therefore, the policy is interpreted in favor of the insured.An employer’s commercial general liability policy was amended by an endorsement that included a “Stop Gap - Employers Liability Coverage Endorsement - West Virginia” that expressly provided coverage for bodily injury to employees, as well as an exclusion for statutory deliberate intent claims. At issue was whether coverage existed for a statutory deliberate intent action under the circumstances of this case. Insurer brought this appeal from an order of the circuit court that granted partial summary judgment for Employer/Insured and Employees. The Supreme Court affirmed, holding that ambiguous policy language must be construed in favor of Insured and that the Stop Gap endorsement operated to provide coverage for the deliberate intent claims of Employees against Employer/Insured, and the conflicting exclusion may not be enforced. View "First Mercury Insurance Co., Inc. v. Russell" on Justia Law

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In this dispute concerning a liability insurance policy, the Supreme Court granted relief in prohibition to State Auto Property Insurance Companies, holding that State Auto was entitled to a dismissal of CMD Plus, Inc.’s third-party complaint as a matter of law.When Plaintiffs filed an action against CMD, a residential construction company, seeking recovery for damages to their house and property, CMD filed a third-party complaint against State Auto, its insurer, alleging that State Auto delayed investigating Plaintiffs’ claim, settling Plaintiffs’ lawsuit, and indemnifying CMD. In this petition for a writ of prohibition, State Auto challenged the circuit court’s denial of its motion for summary judgment. The Supreme Court held that relief in prohibition was warranted because the record showed that State Auto defended and indemnified CMD throughout the lawsuit as required by the commercial general liability policy, and the terms of the policy provided no coverage to CMD for damage to its own property. View "State ex rel. State Auto Property Insurance Cos. v. Honorable James C. Stucky" on Justia Law