Justia Insurance Law Opinion Summaries

Kent backed up a grain truck that was owned by his father, Sheldon, to an auger that was being used to move grain to a transport truck. A tractor powered the auger by means of a power take-off shaft. Kent, attempting to open the truck’s gate, wanted to get extra leverage and stepped onto the auger. The auger’s protective shield had been removed. Kent’s foot was exposed to the turning shaft. In the ensuing accident, Kent lost his leg below the knee. Kent settled a negligence action against Sheldon and received $1.9 million from insurers.Kent reserved his right to pursue additional coverage under the auto policy that covered the truck. State Farm sought a declaratory judgment that no coverage was provided because an auger is neither a “car” nor a “trailer,” as defined in the policy but fell under the policy’s “mechanical device” exclusion for damages resulting from "THE MOVEMENT OF PROPERTY BY MEANS OF A MECHANICAL DEVICE, OTHER THAN A HAND TRUCK, THAT IS NOT ATTACHED TO THE VEHICLE.” The circuit court granted State Farm summary judgment. The appellate court construed the exclusion against State Farm.The Illinois Supreme Court reversed. The exclusion was not ambiguous. The auger is a machine or tool designed to move grain from one place to another and is a device that was “operated by a machine or tool” (a tractor) that is not a small hand-propelled truck or wheelbarrow, and was not attached to the insured vehicle. Exclusions are permissible if they do not differentiate between named insureds and permissive users. View "State Farm Mutual Automobile Insurance Co. v. Elmore" on Justia Law

Cahill was the office administrator for the Family Vision optometry practice and handled insurance billings. She left her employment and filed for bankruptcy protection. About 90% of Family’s revenue came from claims submitted to VSP, which covers claims from optometrists only if they have “majority ownership and complete control” of their medical practices. VSP disburses payments after the provider signs an agreement certifying itself as “fully controlled and majority-owned” by an optometrist. At the time Cahill was submitting Family’s claims, the practice was actually owned by a practice management company with more than 150 surgery centers and other medical practices.About a year after Cahill left Family, the trustee of Cahill’s bankruptcy estate sued under the Insurance Claims Fraud Prevention Act, 740 ILCS 92/1, which added civil penalties to existing criminal remedies for fraud against private insurance companies and allows a claim to be raised on the state’s behalf by a private person (relator), in a qui tam action. The relator becomes entitled to remuneration if the lawsuit succeeds. A relator must be an “interested person” but the Act does not define that term.The Illinois Supreme Court affirmed the reinstatement of the case. A former employee-whistleblower with personal, nonpublic information of possible wrongdoing qualifies as an “interested person” under the Act and need not allege a personal claim, status, or right related to the proceeding. The state need not suffer money damages to partially assign its claim to a relator. The Act is intended to remedy fraud against private insurers, where the only injury to the state is to its sovereignty, based on a violation of criminal law. View "Leibowitz v. Family Vision Care, LLC" on Justia Law

Kiselewski was driving with his two granddaughters in the backseat. Klamm's vehicle crossed the center line and struck Kiselewski’s vehicle. Kiselewski, one granddaughter, and Klamm were killed. Klamm was insured under a Meridian policy issued to his mother that provides coverage for four vehicles. The policy contains an “antistacking clause” with respect to bodily injury liability limits of $100,000 per person and $300,000 per accident. In a declaratory judgment action, the circuit court found that the policy, taken as a whole, was ambiguous and declared that Meridian had a duty under the policy to aggregate the bodily injury coverage limits for all four vehicles covered by the policy, resulting in coverage in the amount of $400,000 per person and $1.2 million per accident.The Illinois Supreme Court reversed. When the declarations are read together with the antistacking clause, there is no ambiguity. The policy provides bodily injury liability coverage of $100,000 per person and $300,000 per accident, regardless of the number of claims, insureds, covered vehicles, premiums, or vehicles involved in the accident. The policy does not list liability limits separately for each covered vehicle. It lists the limits once on the first page of the declarations, next to Autos 1, 2, and 3, and once on the second page, next to Auto 4. View "Hess v. Estate of TJay Klamm" on Justia Law

In 1994, based on doctored evidence from the City of Chicago Heights Police Department, Sanders was charged with murder, attempted murder, and armed robbery. Sanders was wrongfully convicted and imprisoned for approximately 20 years before being exonerated in 2014. From November 2011 to November 2014, Chicago Heights obtained primary liability insurance from Illinois Union and excess liability insurance from Starr. The primary insurance policy covered damages arising out of the “offense” of “malicious prosecution.” The Illinois Supreme Court held that, although the cause of action for malicious prosecution did not arise until the exoneration, the underlying event that triggered the obligation to provide coverage occurred in 1994, not during the policy period. The court noted that a typical occurrence-based policy, containing multiple references to coverage for occurrences or offenses happening during the term of the policy, reflects the intent to insure only for the insured’s acts or omissions that happen during a policy period. If exoneration were deemed to trigger for coverage of a malicious prosecution insurance claim, liability could be shifted to a policy period in which none of the acts or omissions giving rise to the claim occurred, which would violate the intent of the parties to an occurrence-based policy. View "Sanders v. Illinois Union Insurance Co." on Justia Law

In 2010, the Foundations and their insurance broker, Gallagher, discussed the renewal of the Foundations’ $25 million directors and officers (D&O) insurance coverage. The Foundations wanted to obtain the same coverage with a reduced premium. Gallagher offered renewal of the existing Chubb policy or the purchase of a $25 million Chartis policy, stating that the Chartis policy provided the same coverage with a premium that was $3400 lower. Unbeknownst to the Foundations, the Chartis policy contained a broad exclusion of claims related to securities transactions; the Chubb policy contained a narrower exclusion. In 2007, the Foundations sold their Tribune stock for $2 billion during a leveraged buyout. A year later, the Tribune filed for bankruptcy. The Foundations were named in suits filed by aggrieved shareholders, alleging fraud. The Foundations tendered the litigation to Chartis, which denied coverage. The Foundations, asserting that Chubb would have defended and indemnified them, sued Gallagher for breach of contract and professional negligence. Gallagher’s defenses asserted that the Foundations’ conduct was fraudulent and uninsurable and that the Foundations knew of “an ongoing, progressive loss” before changing insurers. Gallagher subpoenaed the Foundations and their attorneys, seeking communications related to the Tribune bankruptcy and the litigation. The Foundations asserted attorney-client privilege. The circuit court applied an exception, finding that Gallagher had a “common interest” with the Foundations because it was “standing in the insurer’s shoes for the purposes of this malpractice issue and may bear the ultimate burden of payment of the underlying claims and defense costs.”The Illinois Supreme Court reversed. The common-interest exception to the attorney-client privilege does not extend to these circumstances, where there is no insured-insurer relationship between the parties and the party claiming the privilege is bringing suit based on the defendant’s negligence in failing to procure appropriate insurance as a broker. View "Robert R. McCormick Foundation v. Arthur J. Gallagher Risk Management Services, Inc." on Justia Law

American Family filed a declaratory judgment action against Walter and Lisa Krop, contending their homeowner's insurance policy did not cover a tort action pending against their son. The Krops filed a counterclaim against American Family and a third-party claim against Andrew Varga, an insurance agent for American Family. The appellate court reversed the circuit court's dismissal of the Krops' claims as untimely.The Supreme Court of Illinois held that when customers have the opportunity to read their insurance policy and can reasonably be expected to understand its terms, the cause of action for negligent failure to procure insurance accrues as soon as the customers receive the policy. In this case, the complaint was filed over two years after the Krops received their policy and the complaint failed to plead facts that would support any recognized exception to the expectation that customers will read the policy and understand its terms. Therefore, their claim was untimely and the court reversed the appellate court's decision. View "American Family Mutual Insurance Co. v. Krop" on Justia Law

State Farm issued two policies of motor vehicle insurance to plaintiff, covering a Pontiac Grand Am and a Pontiac GTO. Each policy provided liability, uninsured motorist, and underinsured motorist coverage in the amounts of $100,000 per person and $300,000 per accident. Each contained a “Driver Exclusion Endorsement” that excluded Evans. Plaintiff was a passenger in a Hyundai automobile that was owned and operated by Evans when Evans’s vehicle was involved in an accident with another automobile. Evans was at fault. Plaintiff was injured and had more than $30,000 in medical bills. Evans’s insurer paid plaintiff $20,000, the policy limit. State Farm denied plaintiff's claim for underinsured motorist coverage. The circuit court granted plaintiff summary judgment. The appellate court and the Illinois Supreme Court affirmed, citing the Illinois Safety and Family Financial Responsibility Law (625 ILCS 5/7-601(a)), under which no one may operate a motor vehicle or allow a vehicle to be operated without obtaining sufficient insurance, and the Insurance Code (215 ILCS 5/143a, 143a-2), requiring automobile liability insurance policies to include uninsured and underinsured motorist coverage. The court reasoned that the named driver exclusion violated Illinois mandatory insurance requirements and public policy where the exclusion barred coverage for the named insured. View "Thounsavath v. State Farm Mutual Automobile Insurance Co." on Justia Law

State Farm issued two policies of motor vehicle insurance to plaintiff, covering a Pontiac Grand Am and a Pontiac GTO. Each policy provided liability, uninsured motorist, and underinsured motorist coverage in the amounts of $100,000 per person and $300,000 per accident. Each contained a “Driver Exclusion Endorsement” that excluded Evans. Plaintiff was a passenger in a Hyundai automobile that was owned and operated by Evans when Evans’s vehicle was involved in an accident with another automobile. Evans was at fault. Plaintiff was injured and had more than $30,000 in medical bills. Evans’s insurer paid plaintiff $20,000, the policy limit. State Farm denied plaintiff's claim for underinsured motorist coverage. The circuit court granted plaintiff summary judgment. The appellate court and the Illinois Supreme Court affirmed, citing the Illinois Safety and Family Financial Responsibility Law (625 ILCS 5/7-601(a)), under which no one may operate a motor vehicle or allow a vehicle to be operated without obtaining sufficient insurance, and the Insurance Code (215 ILCS 5/143a, 143a-2), requiring automobile liability insurance policies to include uninsured and underinsured motorist coverage. The court reasoned that the named driver exclusion violated Illinois mandatory insurance requirements and public policy where the exclusion barred coverage for the named insured. View "Thounsavath v. State Farm Mutual Automobile Insurance Co." on Justia Law

Antonicelli, was a passenger in a vehicle traveling on I-88. Three lanes were closed for construction. Browder was operating a semi-tractor and trailer, traveling behind Antonicelli’s vehicle. Rodriguez, under the influence of cocaine, made an improper U-turn through the median and collided with Antonicelli’s vehicle, causing it to rotate. Browder was unable to stop his semi and slammed into Antonicelli’s vehicle. Antonicelli suffered severe permanent injuries. Rodriguez pled guilty to aggravated driving under the influence of drugs and acknowledged fault. Antonicelli sued and entered ­ into a settlement with Rodriguez for $20,000, the limit of his insurance coverage. Rodriguez sought a finding of a good-faith settlement, informing the court that the insurance policy was his only material asset. The nonsettling Browder defendants counterclaimed for contribution against Rodriguez, alleging that Rodriguez’s conduct was intentional rather than negligent under the Contribution Act (740 ILCS 100/2). The court granted Rodriguez a finding of good faith and dismissal, allowing the Browder defendants to credit $20,000 against any future judgment. The Illinois Supreme Court affirmed, finding no basis for the allegation of intentional conduct. The Browder counterclaims alleging intentional conduct are separate and independent causes of action that do not change the nature of Antonicelli’s complaint, which alleged only negligent conduct. Requiring a court to make a determination as to each defendant’s fault before finding that a settlement agreement was in good faith would be impracticable and would defeat the Act's purpose of encouraging settlement in the absence of bad faith, fraud, or collusion. View "Antonicelli v. Rodriguez" on Justia Law

Plaintiffs brought a purported class action to recover damages resulting from an alleged scheme to inflate the interest rate delinquent property taxpayers in Madison County, Illinois, were compelled to pay to those who purchased delinquent taxpayer debt. Former Madison County Treasurer and Collector (Bathon) had purportedly agreed with certain defendants to manipulate the delinquent tax purchasing system, so that delinquent taxpayers were required to pay the maximum allowable interest to the purchasers of their tax debt to discharge the liens and redeem their properties. The purchasers of the tax debt allegedly provided financial support to Bathon. Plaintiffs brought suit against those involved in the scheme, Madison County, and RLI, the entity acting as surety on Bathon’s statutory public official bond under 55 ILCS 5/3-10003 and 35 ILCS 200/19-40. The bond identified “Madison County Government” as the named obligee. The court dismissed, finding that plaintiffs were not proper claimants under the terms of the public official bond or under the statutes. The appellate court affirmed. The Illinois Supreme Court affirmed. Private citizens are precluded from making claims on the statutorily mandated public official bond at issue. View "Bueker v. Madison County" on Justia Law