Justia Insurance Law Opinion Summaries

This case arose from a land development project dispute where the Retreat took out a short-term purchase loan from a Georgia bank to finance the acquisition of the land. At issue was the district court's interpretation of an exclusion in a title insurance policy issued by First American to the bank and the district court's decision that First American was entitled to summary judgment based on that exclusion. The court held that the district court correctly interpreted the terms of the title insurance contract; the district court's conclusion that the affidavit at issue would be admissible at trial was not an abuse of discretion; and the evidence demonstrated that the bank was fully aware of the Retreat property's lack of dedicated access when it extended the purchase loan and took out the insurance policy from First American. Because there were no genuine issues of material fact in dispute and because First American was entitled to judgment as a matter of law, summary judgment was appropriate. View "Cynergy, LLC v. First American Title Ins. Co." on Justia Law

Plaintiff appealed the district court's grant of summary judgment in a class action suit alleging that Broward County's employee wellness program violated the Americans with Disabilities Act of 1990 (ADA), 42 U.S.C. 12101 et seq. Plaintiff alleged that the wellness program's biometric screening and online Health Risk Assessment questionnaire violated the ADA's prohibition on non-voluntary medical examinations and disability-related inquiries. The court held that the district court did not err in finding as a matter of law that the wellness program was a "term" of Broward County's group health insurance plan, such that the wellness program fell within the ADA's safe harbor provision. View "Seff v. Broward County, Florida" on Justia Law

The Eleventh Circuit consolidated two criminal cases involving sophisticated financial structuring arrangements between related corporate subsidiaries. Appellants, William Allen Broughton and Richard William Peterson were convicted of conducting a "modern-day financial shell game" in which they falsified financial statements, exchanged paper ownership over non-extant fraudulent assets, and collected insurance premiums and monthly payments from unwitting innocents. Collectively, they stated two bases for reversal: (1) Broughton contended that the Government's purported failure to file charges within the relevant statutes of limitations "demand[ed]" reversal; and (2) both Appellants claimed that the district court erred in denying their motions for judgment of acquittal due to an insufficiency of evidence. Finding no error, the Eleventh Circuit affirmed Appellants' convictions. View "United States v. Peterson" on Justia Law

IWC appealed the district court's judgment as a matter of law in favor of IDH. Hawaiian, a Florida condominium, contracted with IDH for roof repair. While IDH was conducting the repairs, a large stone veneer wall fell, causing damage to the condominium. Hawaiian's insurer, ICW, sued IDH for negligence. IDH alleged that the wall fell because it was structurally unsound. During trial, at the close of ICW's case, the district court granted IDH's motion for judgment as a matter of law, holding that no reasonable jury could find that IDH was negligent because ICW failed to present any evidence on the standard of care in the roofing industry. Without reaching the issue of whether roofers were "professionals" under Florida law, the court held that ICW was required to put forth some evidence of the standard of care in the roofing industry in order to meet its burden. Because ICW failed to do so, judgment as a matter of law was appropriate. Further, the specificity requirement in Rule 50(a)(2) did not bar the granting of judgment as a matter of law. Accordingly, the court affirmed the judgment.

This action arose when Vestavia Hills won a judgment in state court against Cameron and based on that judgment, Vestavia Hills was entitled to collect from Cameron. Cameron submitted a claim for coverage on the judgment to its insurer, General Fidelity, and General Fidelity denied Cameron's claim, whereupon Vestavia Hills filed a one-count complaint in state court, suing Cameron and General Fidelity pursuant to Alabama Code 27-23-2. General Fidelity removed the case to the Northern District of Alabama. On appeal, Vestavia Hills challenged the district court's motion to remand the matter back to state court. In denying Vestavia Hill's motion to remand, the district court realigned Cameron as a plaintiff because Vestavia Hill's and Cameron's interests converged against General Fidelity in that both Vestavia Hills and Cameron wanted to force General Fidelity to provide coverage. The court concluded that realignment of the parties did not result in converting the case into a direct action under 28 U.S.C. 1332(c). Accordingly, the court affirmed the judgment of the district court.

Plaintiff, a class representative, appealed the district court's dismissal of her complaint for failure to state a claim and its order denying her motion for reconsideration. Plaintiff argued that examinations under oath (EUOs) were impermissible conditions precedent to personal injury protection (PIP) coverage under Florida law and the Florida No-Fault automobile insurance statute based on the Florida Supreme Court's decision in Custer Med. Ctr. v. United Auto. Ins. Co. As a result of varying interpretations of Custer in the lower Florida state courts, the court concluded that Florida law was unclear in the context of statutorily mandated insurance and the Florida No-Fault Statute and certified this question to the Florida Supreme Court.

In an insurance coverage dispute, the court was required to determine, under Florida law, what constituted "property damage" under a post-1986 standard form commercial general liability (CGL) policy with products-completed operations hazard (PCOH) coverage. Specifically, whether such a policy issued to a general contractor for damage to the part of the completed project performed by a subcontractor, but not to any other project component, caused by a subcontractor's defective work. In light of Florida precedent addressing the scope of similar CGL policies, the court concluded that the policy provided no coverage in this case. Therefore, the court affirmed the judgment of the district court, holding that the damage at issue was not covered under the policy.

This case arose when plaintiff sought review of the denial of her long-term disability insurance benefits from Prudential. Upon the parties' cross motions for summary judgment, the district court entered partial summary judgment for plaintiff on some issues and remanded the case to Prudential to decide in the first instance whether plaintiff was disabled. Prudential subsequently appealed, asserting jurisdiction under 28 U.S.C. 1291. After Prudential initiated the appeal, it acted on the district court's remand order and determined that plaintiff was disabled. The court invited the parties to submit supplemental briefs and after reviewing these submissions, the court concluded that the district court's order granting plaintiff partial summary judgment and remanding the case to the plan administrator, Prudential, for further proceedings, was not a final decision under section 1291. Nor was that order appealable under the collateral order doctrine. Therefore, the court lacked jurisdiction to hear the appeal.

This case involved a dispute between plaintiff and other class members (insureds) and Pioneer, which was succeeded in this action by Washington National. The controversy was over the proper interpretation of certain similar insurance contracts under Florida law. Washington National appealed the district court's grant of summary judgment for the insureds. The court agreed with the district court and held that the policies in question were ambiguous, but concluded that Florida law was unsettled on the proper way to resolve the ambiguity. To establish the proper approach to take under Florida law in interpreting ambiguity, the court certified the following question to the Supreme Court of Florida: In this case, does the Policy's "Automatic Benefit Increase Percentage" apply to the dollar values of the "Lifetime Maximum Benefit Amount" and the "Per Occurrence Maximum Benefit"?

Plaintiff, suing on behalf of her husband, obtained a judgment against defendant for benefits payable under a home health care insurance policy. Defendant appealed and following a judgment, the district court awarded plaintiff attorney's fees and costs. Defendant again appealed. The court held that the district court properly granted summary judgment to plaintiff, rejecting defendant's contention that the custodial care expenses claimed were not covered expenses under the policy. Case No. 10-15115 was affirmed. Because defendant challenged the award of attorneys' fees and costs in Case No. 10-15878 on the sole ground that summary judgment was improperly granted in Case No. 10-15115, the award of attorneys' fees and costs in Case No. 10-15878 was affirmed.