Justia Insurance Law Opinion Summaries

In 2016, Daniel Zeljkovich, driving a tractor trailer, collided with Donald Matthews, who was insured by Protective Insurance Company. Zeljkovich was insured by Spirit Commercial Auto Risk Retention Group. Matthews sued Zeljkovich for negligence in Virginia, and Spirit negotiated a $700,000 settlement. Before finalizing the settlement, Spirit became insolvent and was placed into receivership and liquidation. Matthews then sought uninsured/underinsured motorist (UM/UIM) benefits from Protective, which paid him $700,000 and claimed subrogation rights against Spirit’s estate.The Special Deputy Receiver categorized Protective’s claim under the residual priority category, NRS 696B.420(1)(g), due to insufficient funds. Protective objected, arguing its claim should fall under the higher-priority classification, NRS 696B.420(1)(b). The Eighth Judicial District Court in Clark County, Nevada, affirmed the Special Deputy Receiver’s decision, leading Protective to appeal.The Supreme Court of Nevada reviewed the case and held that NRS 696B.420(1)(b) excludes a private insurance company’s subrogation claim. The court reasoned that subrogation law, the statute’s text, and public policy all support this exclusion. The court emphasized that the statute prioritizes claims by policyholders and statutory insurance guaranty associations, not private insurers. The court also found that including private insurers’ subrogation claims would undermine the statute’s purpose of protecting vulnerable insurance consumers. Consequently, the court affirmed the district court’s decision, relegating Protective’s claim to the residual category, NRS 696B.420(1)(g). View "Protective Insurance Company v. State" on Justia Law

Ramon Vasquez, Jr., sustained injuries while working in a restaurant and subsequently filed a workers' compensation claim, which was accepted by AmTrust North America, Inc. AmTrust paid $177,335.59 in benefits. Vasquez then initiated third-party litigation against several defendants, resulting in a $400,000 settlement. AmTrust, having intervened as subrogee, sought to recover its lien from the settlement proceeds. Vasquez argued that AmTrust was not entitled to any of the settlement proceeds based on prior case law.The Eighth Judicial District Court of Clark County held that AmTrust did not meaningfully participate in the third-party litigation and thus had to bear a portion of the litigation costs and fees under the Breen formula. The court also ruled that AmTrust could not recover from the portion of the settlement allocated to noneconomic damages, as per Poremba. Consequently, the district court adjudicated AmTrust’s lien at $0 and dismissed its complaint.The Supreme Court of Nevada reviewed the case and found that the Breen formula, which required insurers to bear a portion of litigation costs, conflicted with NRS 616C.215(5). The court held that there is no requirement for an insurer to intervene or participate in the third-party claim to recover on its lien. The court also overruled the Breen formula and Poremba to the extent they conflicted with the statute, stating that an insurer's lien applies to the total proceeds of any recovery, including noneconomic damages. The Supreme Court of Nevada reversed the district court’s order and remanded the case for further proceedings consistent with this opinion. View "Amtrust North America, Inc. v. Vasquez" on Justia Law

The appellant, Demitri Gee, was convicted for driving under the influence resulting in substantial bodily harm. He appealed the judgment of conviction, challenging the restitution amount of $9,940 that was awarded to the State of Nevada Victims of Crime Program. On appeal, the Supreme Court of the State of Nevada found two main issues: whether an order of restitution must be based on competent evidence and whether a defendant’s restitution obligation should be offset by the amount the defendant’s insurance provider paid to the victim for the same losses.Gee had been driving while intoxicated when he lost control of his vehicle and collided with another car, severely injuring the occupants. He subsequently fled the scene. As a result of the collision, Gee was charged with two counts of driving under the influence resulting in substantial bodily harm among other charges. A civil settlement agreement was reached with the victims, and they received compensation through Gee's insurance.The court found that the restitution amount of $9,940 was not supported by competent evidence as the state failed to present evidence to support it. The court also found that the district court had not evaluated whether the restitution should be offset by the insurance payment made by Gee to the victims. Therefore, the Supreme Court of Nevada concluded that the district court had abused its discretion by ordering restitution not supported by competent evidence and by failing to evaluate whether the award needed to be offset by the compensation provided to the victim through Gee’s insurance. The court then vacated the $9,940 in restitution, affirmed the rest of the conviction, and remanded the case for further proceedings regarding the restitution amount. View "Gee v. State" on Justia Law

The Supreme Court affirmed the judgment of the district court dismissing the complaint brought by a first deed of trust holder against its title insurance company for breach of contract and related claims, holding that there was no error.The insurer in this case denied coverage to a first deed of trust holder for its loss of interest in property following a foreclosed upon a "superpriority piece." At issue was whether the first deed of trust holder could recover for its loss of interest in the subject property by making a claim on its title insurance policy. The district court granted the title insurance company's motion to dismiss as to all claims, concluding that no coverage existed under the policy. The Supreme Court affirmed, holding (1) the claims for declaratory judgment, breach of contract, and breach of the covenant of good faith and fair dealing were properly dismissed; and (2) the first deed of trust holder was not entitled to relief on its remaining allegations of error. View "Deutsche Bank National Trust v. Fidelity National Title Insurance Co." on Justia Law

The Supreme Court held that a commercial property insurance policy did not provide coverage for the economic losses JGB Vegas Retail Lessee, LLC suffered when COVID-19 forced JGB to shut down abruptly.JGB was insured under a policy with Starr Surplus Lines Insurance Co. amidst the closures and accompanying financial troubles of the COVID-19 pandemic, JGB filed a claim with Starr seeking coverage for lost business income, extra expenses, and other applicable coverage. When Starr did not respond JGB brought suit, claiming that the presence of COVID-19 on the property created the requisite "direct physical loss or damage" covered under the policy. Starr moved for summary judgment, which the district court granted in part. Thereafter, Starr filed the instant petition seeking a writ of mandamus challenging the denial of summary judgment on the remaining claims. The Supreme Court affirmed, holding that the district court erred in denying summary judgment because JGB's claims for losses resulting from COVID-19 were excluded from coverage. View "Starr Surplus Lines Insurance Co. v. District Court" on Justia Law

The Supreme Court reversed the judgment of the appeals officer denying Claimant's request to reopen his industrial claim, holding that the appeals officer misapplied Nev. Rev. Stat. 616C.065(7) and failed to properly consider whether Claimant satisfied the requirements of Nev. Rev. Stat. 616C.390.Claimant, a high school teacher, was injured while diverting a student altercation and requested workers' compensation from the school district's industrial insurer (Insurer). Insurer's acceptance of coverage was restricted to Claimant's cervical strain and thoracic sprain. Insurer, however, did not expressly deny coverage for treatment to Claimant's lumber spine. Claimant later sought the reopening of his industrial claim under Nev. Rev. Stat. 616C.390 for treatment to his lumbar spine. Insurer denied the request, and a hearing officer affirmed. The appeals officer also affirmed. The Supreme Court reversed, holding (1) the appeals officer misapplied section 616C.065(7) to find that the lumbar spine was not within the scope of Claimant's accepted industrial claim; and (2) Claimant's failure to appeal after receiving Insurer's determination of claim acceptance or closure did not preclude him from subsequently seeking to reopen his claim under section 616.390. View "Gilman v. Clark County School District" on Justia Law

The Supreme Court affirmed the judgment of the district court enjoining a regulation to the extent it required insurers to give retroactive premium refunds but otherwise rejecting the lawsuit brought by National Association of Mutual Insurance Companies (NAMIC), holding that the Nevada Division of Insurance (Division) had the statutory and constitutional authority to promulgate R087-20.While the Nevada Insurance Code permits insurers to use customer credit information when underwriting and rating personal property and casualty insurance, the Division promulgated a regulation, R087-20, after the governor's COVID-19 declaration of emergency led to mass unemployment across the state. R087-20 prohibited insurers from adversely using consumer credit information changes that occurred during the emergency declaration, plus two years. On behalf of itself and its members, NAMIC sued to invalidate the regulation. The district court largely rejected NAMIC's claims. The Supreme Court affirmed, holding that the Division did not exceed its authority in promulgating R087-20. View "Nat'l Ass'n of Mutual Insurance Cos." on Justia Law

The Supreme Court answered certified questions brought to it by the Ninth Circuit Court of Appeals as to whether, in Nevada, the insured or the insurer has the burden of proving that an exception to an exclusion of coverage provision applies.The Ninth Circuit asked whether, under Nevada law, the burden of proving the applicability of an exception to an exclusion of coverage in an insurance policy falls on the insurer or the insured and whether the party that bears that burden may rely on extrinsic evidence to carry its burden. The Supreme Court answered (1) the burden of proving the applicability of an exception to an exclusion for coverage in an insurance policy falls on the insured; and (2) the insured may rely on any extrinsic evidence that was available to the insurer at the time the insured tendered the defense to the insurer. View "Zurich American Insurance Co. v. Ironshore Specialty Insurance Co." on Justia Law

The Supreme Court affirmed the order of the district court finding that an exclusion in a personal umbrella liability insurance policy expressly excluding coverage for damages that are "payable to any insured" was valid and precluded coverage, holding that the district court did not err.Plaintiff sought coverage for injuries he incurred as the passenger on a motorcycle that crashed. At the time of the crash, Plaintiff's wife was the named insured on a personal umbrella policy directly underwritten by Farmers Insurance Exchange. Farmers denied coverage under the umbrella policy under the exclusion at issue. Because Plaintiff was an insured under the umbrella policy, argued Farmers, he was not entitled to payment under the policy. The district court granted summary judgment for Farmers. The Supreme Court affirmed, holding (1) Nev. Rev. Stat. 687B.147 does not apply to umbrella policies; (2) an insured who alleges that an exclusion was not disclosed must make that allegation in an affidavit rather than rely solely on the arguments of counsel; and (3) there was no other error on the part of the district court. View "Sciarratta v. Foremost Insurance Co. Grand Rapids Michigan" on Justia Law

The Supreme Court answered a certified question under Nev. R. App. P. 5 concerning an insurer's right to reimbursement, holding that when a party to a contract performs a challenged obligation under protest and a court subsequently determines that the contract did not require performance, the party may generally recover in restitution, thus giving effect to the terms of the parties' bargain.Insurer filed this declaratory judgment action seeking reimbursement of expenses it had occurred in defending Insured against a suit by a third party. The district court concluded that Insurer was not entitled to reimbursement. The Ninth Circuit Court of Appeals affirmed, concluding that the suit did not trigger a duty to defend. The Supreme Court accepted a certified question from the Ninth Circuit regarding the issue. The Supreme Court then held (1) no contract governed the right to reimbursement in this case; and (2) under the principle of unjust enrichment, a party that performs a disputed obligation under protest and does not in fact have a duty to perform is entitled to reimbursement. View "Nautilus Insurance Co. v. Access Medical, LLC" on Justia Law