Justia Insurance Law Opinion Summaries

In this insurance policy cancellation dispute, the Supreme Court (1) reversed the district court’s grant of summary judgment for the insurance company and remanded the case so that the insured may pursue its claims against the insurer, and (2) affirmed summary judgment in favor of the broker against the insured. The court held (1) Nev. Rev. Stat. 687B.360 requires strict compliance, and therefore, without an express statement of a policyholder’s right to request additional information about the reasons for a policy’s cancellation, the cancellation notice is ineffective; and (2) the relationship between an insurance broker who obtained an insurance policy for a client and the insured client in this case did not give rise to a duty to monitor the client’s premium payments and to alert the client when the policy is about to be canceled for nonpayment of premiums. View "O.P.H. of Las Vegas, Inc. v. Oregon Mutual Insurance Co." on Justia Law

William Poremba (Appellant) was injured in an accident during the course of his employment with Southern Nevada Paving. Southern Nevada Paving, through S&C Claims (collectively, Respondents), accepted Appellant’s workers’ compensation claim and eventually closed the claim. Approximately four years later, Appellant sought to reopen his claim. Respondents denied the request. Appellant administratively appealed. The appeals officer denied Appellant’s attempt to reopen his claim. The district court denied Appellant’s petition for judicial review. The appeals officer and the district court apparently resolved the petition to reopen based on whether Appellant exhausted his funds from a settlement with third-parties involved in the accident on medical expenses. Appellant appealed, arguing, inter alia, that the appeals officer erred in granting summary judgment because he was not required to prove that he spent his excess recovery on medical expenses. The Supreme Court reversed, holding (1) Nev. Rev. Stat. 616C.390 does not require exhaustion or reimbursement as a condition precedent to reopening a workers’ compensation claim; and (2) insurers are only entitled to reimbursement from the portions of third-party recovery allocated to expenses within the scope of workers’ compensation. View "Poremba v. Southern Nevada Paving" on Justia Law

In Employers Insurance Co. of Nevada v. Chandler, the Supreme Court held that an insurer may refuse to pay additional funds when a claimant reopens a workers’ compensation claim until the claimant demonstrates that he or she has exhausted any third-party settlement funds. In the instant case, Appellant, a construction driver, was injured by another driver during the course of his employment. Appellant filed a workers’ compensation claim, which his employer, through a workers’ compensation administrator (collectively, Employer), accepted. Employer eventually closed the claim. When Appellant was unable to return to work, he sought to reopen his claim, but Employer denied it. Appellant filed an administrative appeal. An appeals officer granted Employer summary judgment. At issue on appeal was whether Chandler precluded Appellant from reopening his claim because he spent settlement funds on expenses other than medical costs. The Supreme Court reversed, holding (1) a claimant may reopen his workers’ compensation claim after exhausting his settlement funds on nonmedical expenses; and (2) the appeals officer erred when issuing a decision without detailed findings of fact and conclusions of law. View "Poremba v. Southern Nevada Paving" on Justia Law