Justia Insurance Law Opinion Summaries

Olympus appealed the district court's dismissal of its complaint for failure to state a claim. Olympus argued that the district court erred in determining that its contract with Benfield clearly and unambiguously provided that Benfield did not owe Olympus an annual fee after Benfield was notified of Olympus's decision to replace Benfield with another reinsurance broker. The court agreed with the district court's sound reasoning that the proper reading of the contract was to define "Subject Business" as the placement and servicing of all of Olympus's reinsurance contracts and therefore, this part of the contract was not ambiguous. The court also agreed with the district court, which determined that "intent not to renew" encompassed both termination and replacement and therefore, no ambiguity existed as to that matter. When Guy Carpenter informed Benfield that it would be taking over as Olympus's reinsurance broker, this activated the forfeiture provision of the contract and released Benfield from the obligation to pay the Annual Fee to Olympus, regardless of whether it was viewed as termination, replacement, or intent not to renew. Because the court found the contract to be clear and unambiguous, Olympus's claims for equitable relief must be rejected. Accordingly, the court affirmed the judgment. View "Olympus Ins. Co. v. AON Benfield, Inc., et al" on Justia Law

Gear Automotive appealed from the district court's grant of summary judgment in favor of its insurer. Gear Automotive's sole owner suffered an injury that resulted in substantial medical and disability loss. Gear Automotive subsequently sought coverage from its insurer for the owner's injuries. The court concluded that the owner was an employee for purposes of employing the Employee exclusion and that the owner's injury arose out of and in the course of his employment with Gear Automotive. Because the undisputed facts established both elements of the Employee exclusion, Gear Automotive was not entitled to coverage. Ultimately, the owner, as an employee, attempted to recover under a policy of insurance that was not intended to cover Gear Automotive's liability to its employees. Accordingly, the court affirmed the district court's grant of summary judgment. View "Gear Automotive v. Wilshire Ins. Co." on Justia Law

Plaintiff sued American General, alleging that American General breached the terms of a life insurance policy plaintiff purchased. The policy at issue was a ten-year term life insurance policy on the life of her father. The district court denied plaintiff's motion for partial summary judgment and granted judgment to American General. Because the policy was not in force when plaintiff's father died because plaintiff failed to make the first payment, the district court did not err in concluding that no benefits were due under the terms of the policy. Plaintiff also failed to present a submissible case of estoppel or waiver under Missouri law. Accordingly, the court affirmed the judgment. View "Dallas v. American General Life and Accident Ins. Co." on Justia Law

In this insurance coverage dispute, BSI brought suit against Hartford alleging breach of contract and vexatious refusal to pay claims under Missouri law. The district court granted Hartford's motion for summary judgment, determining that Hartford's policy excluded coverage under the present circumstances. The court concluded that the faulty workmanship exclusion excluded coverage for the damaged roof at issue; there was no conflict between the exclusion and the ensuing loss exception because the property for which coverage was excluded was not the same property for which coverage was maintained pursuant to the exception; and the district court properly granted Hartford's motion for summary judgment on BSI's vexatious refusal to pay claim. Accordingly, the court affirmed the judgment. View "BSI Constructors v. Hartford Fire Ins. Co." on Justia Law

Heubel and Raymond appealed the district court's grant of summary judgment in favor of Universal on Heubal's claim for coverage under a Universal insurance policy. The district court held that Heubel's breach of a cooperation clause in the Universal policy absolved Universal of the duty to defend or provide coverage for a products liability lawsuit against Heubel. Because no reservation of rights or conflict of interest entitled Heubel to select its own counsel while continuing to enjoy the coverage benefits of the Universal policy, Heubel breached the policy by refusing to allow Universal to control the defense. Because nothing in the Universal policy or the Raymond indemnification program precluded a third-party indemnification claim by Universal against Raymond in the Harris suit, Universal suffered substantial prejudice from Heubel's refusal to allow Universal to control the defense. As a result, Universal was justified in denying coverage based on Heubel's breach of the cooperation clause. Accordingly, the court affirmed the judgment. View "Heubel Materials Handling Co. v. Universal Underwriters Ins. Co." on Justia Law

Oakdale and Cincinnati disputed whether the commercial property insurance policy Oakdale purchased from Cincinnati covered a loss suffered by Oakdale in August 2009. The court affirmed the district court's grant of summary judgment to Cincinnati, concluding that the policy excluded Oakdale's damages where the district court accepted Oakdale's specific calculations of common area and decided that they were insufficient to allow a reasonable jury to find the vacancy provision of the policy was met. View "Oakdale Mall Assoc. v. Cincinnati Ins. Co." on Justia Law

This appeal arose from a dispute between Unum and the late Kevin Sullivan over long-term disability benefit payments. Sullivan sued Unum, arguing that the termination of his benefits violated the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1001 et seq., and Unum counterclaimed for overpayment of benefits. The court concluded that it was not an abuse of discretion for the administrator to determine that the large payments that Sullivan received in 2004 were payments for the sale of a business for the purpose of calculating his benefits. Unum asserted that the payments were salary, not income. The court reversed the district court's grant of summary judgment and award of attorney's fees, remanding for consideration of Unum's counterclaims. View "Sullivan v. Unum Life Ins. Co., et al" on Justia Law

A railroad employee sued his employer, DM&E, after he was injured while working as the employee-in-charge of a construction site. DM&E then brought a third-party complaint against Corman, contending that Corman was required to indemnify and defend it against the employee's Federal Employers' Liability Act (FELA), 45 U.S.C. 51-60, claim pursuant to a contract between the parties. Nothing in the Contract Work Agreement (CWA) indicated that it extended to claims which were unrelated to Corman's common-law negligence. The indemnity clause in the CWA did not mention the FELA. Therefore, the court held that DM&E had not shown any issues of material fact existed and therefore no negligence could be attributed to Corman. The court also held that the indemnification provision in the CWA did not trigger the insured contract exception to the general exclusion provision contained in the Lexington Insurance policy, and, as a result, no obligation existed based on the terms of the policy. View "Dakota, MN & Eastern R. R. v. R. J. Corman R. R. Construction" on Justia Law

Plaintiff, a former software developer for Lockheed Martin Corporation, brought this action for judicial review after Connecticut General terminated his disability benefits in 2007. The court held that the district court properly applied an abuse of discretion standard; on the record, it was not an abuse of discretion to terminate plaintiff's benefits; and the district court did not err in denying plaintiff an opportunity to depose the expert at issue. Accordingly, the court affirmed the judgment. View "Siegel v. Connecticut General Life Ins., et al" on Justia Law

This case principally involved challenges to the application, in Missouri, of the provision of the Plan administered by BCBS-KC that required a Plan enrollee who received benefits in connection with any injury in addition to compensation from a third party must reimburse BCBS-KC the amount of benefits paid. Given the state's antisubrogration laws, plaintiff contended that BCBS-KC was unable to recover its reimbursement liens in Missouri. BCBS-KC removed the action to federal district court and plaintiff then moved to remand the matter to state court. BCBS-KC subsequently appealed the district court's remand based upon the local controversy exception to the Class Action Fairness Act (CAFA), 28 U.S.C. 1332(d); its determination that federal common law was not contemplated in this action; and its decision that BCBS-KC could not remove this matter under the federal officer removal statute. Because the court determined that this matter was properly in federal court under the federal officer removal statute, the court need not address plaintiff's remaining claims. That said, the court did not delve into the CAFA claim, but rather reversed the district court's judgment and remanded this matter for further consideration, directing that this action remain in federal court. View "Jacks v. Meridian Resource Co., et al" on Justia Law