Justia Insurance Law Opinion SummariesArticles Posted in Supreme Court of Missouri
Macke v. Patton
In this appeal from the circuit court's distribution of proceeds from Nicklaus Macke's wrongful death settlement the Supreme Court affirmed the judgment of the circuit court overruling Appellant's motion for a second continuance and in apportioning only a small percent of the wrongful death settlement to Appellant, holding that the circuit court did not err or abuse its discretion. Nicklaus, the son of Pamela Eden and Loren Macke (Macke), suffered fatal injuries in a motor vehicle collision with Austin Patton. Macke negotiated a settlement with Patton's insurance company, which offered to pay its policy limit in satisfaction of Macke's wrongful death claim against Patton. The circuit court apportioned ninety-eight percent of the settlement to Nicklaus' father and two percent to Eden, who played little to no role in Nicklaus' childhood and upbringing. The Supreme Court affirmed, holding (1) the circuit court did not err in overruling Appellant's motion for continuance; and (2) the circuit court did not erroneously apply the law in making its apportionment judgment, and the apportionment was not against the weight of the evidence. View "Macke v. Patton" on Justia Law
Seaton v. Shelter Mutual Insurance Co.
The Supreme Court reversed the judgment of the circuit court entering summary judgment in favor Insured in this insurance coverage dispute, holding that the circuit court erred in finding that Insured was entitled to underinsured motorist (UIM) coverage under three insurance policies Insured maintained with Insurer after the death of her daughter (Decedent). When Driver crashed the vehicle she was driving, Decedent, the passenger, sustained fatal injuries. Insured asserted a wrongful death claim against Driver, and Driver settled the claim for her insurance policy's limits. Thereafter, Insured sought UIM coverage from Insurer. Insurer provided UIM coverage pursuant to one of the insurance policies, but Insurer denied UIM coverage under the other two insurance policies. Insured then brought this suit seeking a declaration that UIM coverage existed for Decedent and alleging breach of contract. The circuit court granted summary judgment for Insured. The Supreme Court reversed, holding that under the plain language of two of the policies at issue, Decedent was not an insured entitled to UIM coverage. View "Seaton v. Shelter Mutual Insurance Co." on Justia Law
Griffitts v. Old Republic Insurance Co.
The circuit court erroneously declared the law when it concluded that an employee’s violation of employer’s rules regarding vehicle operation were sufficient to preclude coverage under the omnibus clause of the employer’s insurance policy. James Campbell, an employee of BNSF Railway Company, rear-ended Ricky Lee Griffitts while driving a BNSF company vehicle. Campbell was intoxicated at the time of the collision. Numerous lawsuits ensued. This appeal was from an equitable garnishment action that Griffitts filed against BNSF and its insurer, Old Republic (collectively, Respondents), to collect on an unsatisfied judgment entered against Campbell in an earlier action. In this action, Griffitts claimed that Campbell was a permissive user under the omnibus clause of the insurance policy Old Republic issued to BNSF. The circuit court concluded that Campbell did not have permission to use the company vehicle at the time of the accident due to his violation of BNSF’s policy on the use of alcohol and drugs, and therefore, Campbell was not a permissive user under the omnibus clause. The Supreme Court reversed, holding that Campbell had permission to use the company vehicle at the time of the accident and that it did not matter, for purposes of insurance coverage, that Campbell was drunk. View "Griffitts v. Old Republic Insurance Co." on Justia Law
Doe Run Resources Corp. v. American Guarantee & Liability Insurance
The Supreme Court reversed the judgment of the circuit court entering summary judgment in favor of the Doe Run Resources Corporation in this insurance coverage dispute. Doe Run was sued by several minor plaintiffs allegedly injured by toxic pollution released from Doe Run’s smelting facility in Peru. Doe Run sued St. Paul Fire and Marine Insurance Company, its insurer, for reimbursement of defense costs incurred during the litigation of these claims. St. Paul alleged that coverage was barred under the insurance policy’s pollution exclusion. The circuit court found the pollution exclusion ambiguous and unenforceable. The Supreme Court reversed, holding that the pollution exclusion unambiguously barred coverage and that St. Paul had no duty to defend Doe Run from the lawsuits. View "Doe Run Resources Corp. v. American Guarantee & Liability Insurance" on Justia Law
Nevils v. Group Health Plan, Inc.
Nevils was a federal employee insured through a plan governed by the Federal Employee Health Benefits Act (FEHBA) when she was injured in an automobile accident. Coventry paid her medical expenses and asserted a subrogation lien against a settlement Nevils received from the party responsible for the accident. Nevils filed a class action, arguing Missouri law does not permit subrogation of personal injury claims. Coventry obtained summary judgment, based on FEHBA’s preemption clause: The terms of any contract under this chapter which relate to the nature, provision, or extent of coverage or benefits (including payments with respect to benefits) shall supersede and preempt any State or local law, ... which relates to health insurance, 5 U.S.C. 8902(m)(1). Initially, the Missouri Supreme Court concluded Congress did not manifest a clear intent to preempt state anti-subrogation laws. The Office of Personnel Management subsequently promulgated a rule providing that an insurer’s rights to subrogation and reimbursement under federal employee health benefits contracts “relate to the nature, provision, and extent of coverage or benefits” under FEHBA. On remand, the Missouri Supreme Court held the rule did not alter its analysis. The U.S. Supreme Court then held an insurer’s subrogation rights “relate to . . . payments with respect to benefits” and that FEHBA “manifests the same intent to preempt state law” as other federal preemption statutes despite the different “linguistic formulation” of section 8902(m)(1). In light of that holding, the Missouri Supreme Court affirmed the trial court’s judgment. View "Nevils v. Group Health Plan, Inc." on Justia Law
Owners Insurance Co. v. Craig
Owners Insurance Company issued Vicki and Chris Craig a policy with underinsured motorist (UIM) coverage. Vicki was injured in an accident when her vehicle was struck by a vehicle driven by another motorist. Vicki incurred damages exceeding $300,000. Shelter Insurance, which insured the at-fault motorist, paid the Craigs $50,000. The Craigs then sought from Owners $250,000, the declarations listed UIM limit amount. Owners paid the Craigs $200,000, citing the off-set provisions that allowed them to deduct the amount paid by Shelter. Thereafter, Owners sought a declaratory judgment over the disputed $50,000. The circuit court ruled that the policy was ambiguous and entered summary judgment in favor of the Craigs. The Supreme Court reversed, holding that the policy unambiguously provides for the $50,000 set-off, that the policy never promised to pay up to the full amount listed in the declarations, and that the declarations did not promise coverage. Remanded. View "Owners Insurance Co. v. Craig" on Justia Law
Swadley v. Shelter Mutual Insurance Co.
Shelter Mutual Insurance Company issued the Swadley family a policy with underinsured motorist (UIM) coverage. The policy’s declarations page listed “100,000 Per Person” as the UIM limit. After Angela Swadley was killed in a collision, the Swadleys made a claim to Shelter pursuant to their policy’s UIM coverage. When Shelter denied the claim, the Swadleys filed a petition against Shelter. The circuit court ruled that the policy was ambiguous, entered partial summary judgment in favor of the Swadleys and awarded the Swadleys $100,000. The Supreme Court reversed, holding that the policy unambiguously precluded UIM coverage from applying to the Swadleys’ claim. View "Swadley v. Shelter Mutual Insurance Co." on Justia Law
Allen v. Bryers
Franklin Allen obtained a $16 million personal injury award against Wayne Bryers after Bryers’ handgun discharged, seriously injuring Allen. Thereafter, Allan filed a Mo. R. Civ. P. 90 garnishment action seeking proceeds from an insurance policy issued by Atain Specialty Insurance Company (Insurer), which insured the premises where the shooting occurred. Allen alleged that Insurer wrongfully refused to defend Bryers and acted in bad faith when it refused to defend Bryers. The garnishment court ordered Insurer to pay Allen $16 million. Insurer appealed, arguing, inter alia, that the circuit court erred in denying its motions to intervene and to set aside the underlying tort judgment on the basis of fraud. The Supreme Court dismissed the appeal in part and affirmed as modified the remainder of the garnishment court’s judgment, holding (1) the garnishment court’s rulings on Insurer’s motions to intervene and to set aside the judgment were void; (2) Insurer wrongfully refused to defend Bryers and was bound by the result of the underlying tort action, including the findings related to coverage; but (3) the garnishment court exceeded its authority in awarding Allen the full amount of the underlying tort judgment because Allen was only entitled to receive the $1 million policy limit from Insurer. View "Allen v. Bryers" on Justia Law