Justia Insurance Law Opinion Summaries

Zurich American Insurance Company issued a builder’s risk insurance policy for the construction of an academic building for City Colleges of Chicago. Infrastructure Engineering, Inc. (IEI), a subcontractor, designed a rainwater collection system for the project. During construction, a rainstorm caused significant flooding and damage to the building. Zurich paid the claim to CMO, the general contractor, and then sued IEI for breach of contract, alleging that IEI’s design caused the damage.The Cook County circuit court granted summary judgment in favor of IEI, agreeing with IEI’s argument that Zurich was not entitled to subrogation because the payment was made to CMO, not City Colleges, and CMO repaired the damage. Zurich appealed, and the appellate court reversed the circuit court’s decision, holding that Zurich was entitled to subrogation under the policy’s provisions, which allowed Zurich to step into City Colleges’ shoes.The Supreme Court of Illinois reviewed the case and affirmed the appellate court’s judgment. The court held that City Colleges, as the owner of the damaged property, had an insurable interest and sustained a loss when the building was damaged. The court found that Zurich, having paid for the repairs through CMO, was entitled to subrogation rights under the clear terms of the builder’s risk policy. The court rejected IEI’s argument that City Colleges did not sustain a loss or receive payment, emphasizing that CMO acted as City Colleges’ agent in handling the claim and repairs. The case was remanded for further proceedings consistent with this opinion. View "Zurich American Insurance Co. v. Infrastructure Engineering, Inc." on Justia Law

The case involves a dispute over the interpretation of a multi-vehicle insurance policy. The appellants, Mark and Karen Kuhn, were involved in a fatal accident with a semi-truck insured by the appellee, Owners Insurance Company. The Kuhns sought a declaration that the $1 million liability limits for each of the seven vehicles covered under the policy could be aggregated or "stacked" for a total of $7 million in coverage for the accident, despite an "anti-stacking" provision in the policy.The trial court ruled in favor of the Kuhns, finding the policy ambiguous and thus allowing for the stacking of the liability limits. However, the appellate court reversed this decision, holding that the policy's anti-stacking clause was unambiguous and should be enforced as written.The Supreme Court of the State of Illinois affirmed the appellate court's judgment. The court found that the insurance policy, when read as a whole, unambiguously provided a $1 million per accident liability limit and prohibited stacking the liability limits of each insured vehicle. The court rejected the Kuhns' argument that the policy was ambiguous due to the separate listing of liability limits for each vehicle insured. The court held that the policy's anti-stacking provision, in conjunction with the declarations pages, clearly indicated that the limits could not be aggregated. View "Kuhn v. Owners Insurance Co." on Justia Law

The Homeowners Association alleged that M/I’s subcontractors caused construction defects in a Hanover Park development by using defective materials, conducting faulty workmanship, and failing to comply with building codes. The Association alleged that it would be required to repair the defects and “damage to other property caused by the [d]efects.” M/I demanded a defense from Acuity as the additional insured on a commercial general liability policy that Acuity issued to one of its subcontractors on which M/I was an additional insured. Acuity sought a declaratory judgment, arguing that the complaint failed to allege any “property damage” caused by an “occurrence” as those terms are defined by the policy and interpreted by Illinois law. The circuit court granted Acuity summary judgment.The Illinois Supreme Court held that the allegations sufficiently fall within the initial grant of coverage requirement that there be “property damage” caused by an “occurrence.” The court remanded for further consideration of whether policy exclusion bar coverage. To hold that all construction defects that result in property damage to the completed project are always excluded would mean that the exclusions in the policy related to business risk become meaningless. The business risk exclusions contemplate that some construction defects that result in property damage are covered and some are not, depending on various factors. View "Acuity v. M/I Homes of Chicago, LLC" on Justia Law

Guiracocha and his son, Cristopher, filed an uninsured motorist (UM) claim against Direct Auto, stemming from a hit-and-run incident where 14-year-old Cristopher was struck by a vehicle while riding his bicycle. They asserted Fredy was the named insured under an automobile insurance policy issued by Direct Auto and that UM coverage applied to Cristopher based on his status as a “relative” under the policy. Direct Auto denied coverage because Cristopher was not an occupant of a covered vehicle at the time of the accident and sought a declaratory judgment. The circuit court granted Direct Auto summary judgment.The appellate court reversed, holding that a provision in an automobile insurance policy that limits UM coverage to insureds occupying an insured automobile violates the Illinois Insurance Code (215 ILCS 5/143a). The Illinois Supreme Court affirmed. Section 143a states that an insurance policy cannot be “renewed, delivered, or issued for delivery” in Illinois unless it provides coverage to “any person” for injuries “arising out of the ownership, maintenance or use of a motor vehicle.” A bicyclist injured by an uninsured motorist vehicle is a “person” who suffered injuries arising out of the ownership, maintenance, or use of “a motor vehicle.” The injured person’s status as an occupant of a vehicle is irrelevant. View "Galarza v. Direct Auto Insurance Co." on Justia Law

Sheckler rented residential property from McIntosh. The lease provided McIntosh “shall maintain fire and other hazard insurance on the premises only” and that Sheckler was responsible for insurance on possessions contained in the premises. The lease's indemnification clause exculpated McIntosh from any damages or injury occurring on the premises. McIntosh obtained insurance from Auto-Owners; first-party dwelling coverage provided coverage for fire damage and third-party landlord liability coverage provided coverage for claims brought by third parties that the insured “becomes legally obligated to pay as damages because of or arising out of bodily injury or property damage.” The third-party coverage provided a duty to defend any claim covered by the policy, excluding “property damage to property occupied or used by an insured or rented to or in the care of, any insured.” The policy listed McIntosh as the only named insured. McIntosh claims no money received from Sheckler was used to pay the annual premium.Sheckler notified McIntosh that the gas stove was not working. McIntosh placed a service call. The technician’s efforts resulted in a fire that caused substantial property damage. Auto-Owners paid McIntosh for damages incurred due to the fire and lost rental income and filed a subrogation action against the technician (Workman), who filed a third-party contribution complaint against Sheckler. Sheckler tendered the defense to Auto-Owners, which rejected the claim. The Illinois Supreme Court reinstated the rejection of Sheckler’s claim. An insurer’s duty to defend or indemnify does not extend to the tenant of an insured property against a third-party negligence contribution claim when the tenant is not identified as a person insured under the policy. View "Sheckler v. Auto-Owners Insurance Co." on Justia Law

Prate, a construction contractor, sought coverage through the Illinois Assigned Risk Plan, which provides workers’ compensation insurance coverage through a risk pool administered by the National Council on Compensation Insurance (NCCI). Liberty was assigned as Prate’s carrier. After determining that Prate’s subcontractor, ARW, did not have workers’ compensation insurance, Liberty assessed Prate an additional premium of $127,305. The Illinois Workers’ Compensation Appeals Board, which provides dispute resolution services for NCCI, declined to rule on the dispute, citing insufficient information. Prate appealed to the Department of Insurance (DOI) under Insurance Code section 462. One of Prate’s arguments was that ARW had no employees and that all work on Prate projects was performed by RTS, which had workers’ compensation insurance. The DOI’s hearing officer agreed with Liberty on all issues. The circuit court affirmed. While an appeal was pending, the appellate court issued its ruling in a dispute between Liberty and a trucking company, finding that DOI did not have the authority to resolve a dispute concerning employment status.The Illinois Supreme Court reinstated the trial court decision. The DOI had the authority to resolve the dispute under 215 ILCS 5/462. While section 462 does not apply to all insurance premium disputes but only to those involving the application of a rating system to a party’s insurance, the existence of a single factual dispute does not preclude review under section 462. View "Prate Roofing and Installations, LLC v. Liberty Mutual Insurance Corp." on Justia Law

Munoz sued general contractor, Bulley & Andrews, for injuries he sustained while an employee of its subcontractor, Bulley Concrete. Bulley & Andrews had paid workers’ compensation insurance premiums and benefits for the subcontractor and its employees. Each company has its own distinct federal tax identification number and files separate federal and state income tax returns. The companies have different presidents and employ different workers.The circuit court dismissed, finding that the genderal contractor was immune from the lawsuit under the exclusive remedy provisions of the Workers’ Compensation Act (820 ILCS 305/5(a). The appellate court affirmed.The Illinois Supreme Court reversed. The exclusive remedy provisions do not extend to a general contractor who is not the employee’s immediate employer. Immunity does not hinge on the payment of benefits. Bulley & Andrews had no legal obligation to provide workers’ compensation insurance for Bulley Concrete employees. The fact that Bulley Concrete was a subsidiary of Bulley & Andrews is of no import. If a parent company and its subsidiary are operated as separate entities, only the entity that was the immediate employer of the injured worker is entitled to immunity. The Act bars an employee from bringing a civil suit directly against his employer but does not limit the employee’s recovery from a third-party general contractor. View "Munoz v. Bulley & Andrews, LLC" on Justia Law

In each of two automobile personal injury actions, plaintiffs moved for entry of a qualified protective order (QPO) pursuant to the Health Insurance Portability and Accountability Act (HIPAA), 110 Stat. 1936, and its implementing regulations (45 C.F.R. 160, 164) (Privacy Rule). Plaintiffs’ proposed QPOs would allow protected health information (PHI) to be released, subject to restrictions that nonlitigation use or disclosure of PHI is prohibited and PHI must be returned or destroyed at the conclusion of the litigation. State Farm, the liability insurer for the named defendants, intervened in each lawsuit and sought entry of its own protective order, which expressly allowed insurance companies to use, disclose, and maintain PHI for purposes beyond the litigation and expressly exempted insurers from the “return or destroy” requirement.In both cases the circuit court granted the plaintiffs’ motions. The appellate court and Illinois Supreme Court affirmed, rejecting State Farm’s argument that property and casualty insurers fall outside HIPAA. Rejecting arguments concerning the requirements of the Illinois Insurance Code, the court stated that no Illinois law requires State Farm to use or disclose plaintiffs’ PHI after the conclusion of the litigation. The Cook County standard protective order is preempted by the Privacy Rule and the McCarran-Ferguson Act, 15 U.S.C. 1011, does not apply to shield that order from traditional preemption. View "Haage v. Zavala" on Justia Law

Sproull filed a putative class action against State Farm, alleging breach of contract. State Farm allegedly depreciated labor costs in determining “actual cash value” (ACV) of a covered loss and concealed this practice from its policyholders. The policy does not define ACV. State Farm agreed to certify a question for interlocutory review: “Where Illinois’ insurance regulations provide that the ‘actual cash value’ or ‘ACV’ of an insured, damaged structure is determined as ‘replacement cost of property at time of loss less depreciation if any,’ and the policy does not itself define actual cash value, may the insurer depreciate all components of replacement cost (including labor) in calculating ACV?”The Appellate Court reformulated the question to address solely labor costs, rather than all components of replacement cost and answered the question in the negative. The Illinois Supreme Court affirmed, finding the policy ambiguous and construing it against the insurer. Illinois’s insurance regulations provide that the ACV of an insured, damaged structure is determined as the replacement cost of the property at time of loss less depreciation if any; only the property structure and materials are subject to a reasonable deduction for depreciation, and depreciation may not be applied to the intangible labor component. View "Sproull v. State Farm Fire and Casualty Co." on Justia Law

Sekura purchased a membership from Krishna that gave her access to L.A. Tan’s salons. Her membership required Sekura to provide Krishna with her fingerprints. Sekura filed a class-action lawsuit against Krishna, alleging that Krishna violated the Biometric Information Privacy Act: because it “systematically and automatically collected, used, stored, and disclosed their [customers’] biometric identifiers or biometric information without first obtaining the written release required by 740 ILCS 14/15(b)(3) … systematically disclosed ... biometric identifiers and biometric information to SunLync, an out-of-state … vendor and … does not provide a publicly available retention schedule or guidelines for permanently destroying its customers’ biometric identifiers and biometric information as specified by the [Act].” The complaint also alleged negligence and unjust enrichment. Krishna tendered Sekura’s lawsuit to West Bend, its insurer.West Bend sought a declaratory judgment that it did not owe a duty to defend Krishna against Sekura’s lawsuit. The trial court entered a judgment for Krishna. The appellate court and Illinois Supreme Court affirmed after construing the policy terms “personal injury or advertising injury,” “publication” of material, and violation of Sekura’s “right of privacy” to conclude that the allegations in Sekura’s complaint fall within or potentially within West Bend’s policies’ coverage for personal injury or advertising injury. A “violation of statutes” exclusion in the policies does not apply to the Act. View "West Bend Mutual Insurance Co. v. Krishna Schaumburg Tan, Inc." on Justia Law