Justia Insurance Law Opinion Summaries

Aetna Life Insurance Company, as the plan administrator, determined Sharon Wade was no longer disabled and stopped paying long-term disability benefits from Wade's former employer's welfare benefit plan. Wade sought judicial review of Aetna's decision by filing a civil action under ERISA. The district court granted summary judgment in favor of Aetna, concluding that Aetna did not abuse its discretion in terminating Wade's benefits because substantial evidence supported the decision. The Eighth Circuit Court of Appeals affirmed, holding that the district court (1) applied the appropriate standard of review; (2) gave appropriate weight to the Social Security Administration's grant of long-term disability benefits to Wade; and (3) did not abuse its discretion by determining substantial evidence supported Aetna's termination of benefits. View "Wade v. Aetna Life Ins. Co." on Justia Law

Flowers Bakeries Brands, Inc. brought suit against Interstate Bakeries Corporation (IBC) for trademark infringement, among other claims, alleging that IBC'S NATURE'S PRIDE and NATURE'S CHOICE trademarks in connection with packaged breads were confusingly similar to Flowers' NATURE'S OWN trademark. When OneBeacon Insurance Company, IBC's insurer, refused to defend IBC in the underlying lawsuit, IBC initiated this action seeking a declaration that OneBeacon had a duty to defend IBC. At issue was whether the trademarked phrase NATURE'S OWN was a title or slogan under IBC's advertising insurance policy with OneBecaon. The district court entered judgment in favor of OneBeacon. The Eighth Circuit Court of Appeals affirmed, holding that OneBeacon did not have a duty to defend IBC in the underlying litigation, as Flowers failed to allege facts that would indicate the phrase NATURE'S OWN was potentially a title or slogan under the policy. View "Interstate Bakeries Corp. v. OneBeacon Ins. Co." on Justia Law

This declaratory judgment action concerned a controversy over the limits of an insurance policy issued by Insurer to Insured. A livestock company (Company) brought suit in Minnesota state court against Insured after Company's cattle in Insured's care died in unusually high numbers. Insured submitted the complaint in the underlying action to Insurer. Insurer refused to defend or indemnify Insured in the case brought by Company, basing its denial of coverage on an exclusion in the liability insurance policy for damage to property in the "care, custody, or control" of the insured. The Minnesota district court entered judgment against Insured. Insurer then commenced this action against Company and Insured in federal district court, seeking a declaratory judgment that the claims alleged in the underlying action were not covered under Insured's policy with Insurer and that Insurer therefore had no obligation to defend or indemnify Insured. The district court concluded that the claims were covered by the policy and granted Company and Insured's motion for summary judgment. The Eighth Circuit Court of Appeals reversed, holding that because Company's cattle were under Insured's care, custody, and control when they were damaged, the policy did not provide coverage for Company's claimed loss. Remanded. View "Grinnell Mut. Reinsurance v. Schwieger" on Justia Law

Jason McCann was involved in an automobile accident with Jeffrey Kreml. McCann's insurer, Auto Club Insurance Association, defended McCann against Kreml's personal injury action. After Kreml and McCann settled, Auto Club sought contribution from Sentry Insurance, the insurer for McCann's employer, claiming Sentry was obligated to provide co-primary coverage for McCann. The court granted summary judgment to Sentry, finding the Sentry policy only obligated Sentry to provide excess liability coverage, and McCann had no excess exposure because he settled within the limits of the Auto Club policy. The Eighth Circuit Court of Appeals affirmed, holding that the district court's interpretation of the policy was reasonable. View "Auto Club Ins. Ass'n v. Sentry Ins." on Justia Law

Sandra Emas owned a life insurance policy issued by ReliaStar. The policy named her estate as the beneficiary. When Emas died intestate, she left her son, Jaysen McCleary, as her only heir. McCleary was appointed the administrator of his mother's estate. McCleary later filed for personal bankruptcy. McCleary, as the administrator of the estate, subsequently filed suit against ReliaStar, alleging that ReliaStar had wrongfully refused to pay the estate benefits under Emas's insurance policy. ReliaStar moved for summary judgment, arguing that Emas's interest in any cause of action against ReliaStar passed immediately to McCleary upon her death. The district court granted summary judgment in favor of ReliaStar. The Eighth Circuit Court of Appeals affirmed, holding (1) the estate was functionally closed, and McCleary could not bring a suit on behalf of a closed estate; and (2) there was not an issue of fact as to whether McCleary sold the estate's interest in his bankruptcy proceedings, as McCleary had the authority to sell the estate's interest in its claims against ReliaStar. View "McCleary v. Reliastar Life Ins. Co." on Justia Law

Appellants appealed from the district court's grant of summary judgment in favor of American Standard. The district court concluded that appellants were not entitled to recover underinsured motorist (UIM) coverage benefits under four American Standard policies because the tortfeasor's vehicle was not an "underinsured motor vehicle" under the policies' plain language. The court held that the district court correctly concluded that appellants were not entitled to recover under the UIM policies because stacking them did not result in an amount exceeding the tortfeasor's liability. Accordingly, the court affirmed the judgment.

LINA appealed the district court's ruling that LINA abused its discretion in denying death benefits to Dawn McClelland based upon her husband's life insurance policy. LINA also appealed the district court's award of attorney's fees. The court found that LINA committed an abuse of discretion in denying benefits because its interpretation was contrary to the language of the plan that it would cover "loss of life" based upon an "accident" and because substantial evidence did not support its decision. The court also found that the total fee awarded should be $85,000 and remanded to the district court to enter an award in that amount. The prejudgment interest award was affirmed.

After plaintiff was denied long-term disability benefits by Standard, he sought review of Standard's determination under the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1001 et seq. The court affirmed the district court's grant of summary judgment in favor of Standard and held that there was substantial evidence supporting Standard's denial of benefits. The court also held that a conflict of interest alone was not determinative where there existed substantial evidence on the record supporting the denial of benefits.

Plaintiff sued Hartford seeking coverage under his life insurance policy for accidental dismemberment benefits after he suffered serious injuries to his eyes when a can of oven cleaner exploded in his face. The district court dismissed plaintiff's suit, concluding it was untimely because it was brought three years after the loss, outside the policy's time limitations for bringing legal actions against Hartford. Plaintiff appealed, arguing that he brought suit within Arkansas's five-year statute of limitations for breach of contract actions, Ark. Code Ann. 23-79-202(b). The court agreed with plaintiff and held that prior case law was inconsistent with Hartford's contention that the "period prescribed by law" referred to in section 23-79-202 meant something other than the full five-year period set forth in Ark. Code Ann. 16-56-111. Accordingly, the court reversed and remanded.

This appeal arose from an insurance coverage dispute where the City sought coverage from Genesis for 42 U.S.C. 1983 claims in the nature of malicious prosecution. Genesis filed suit against the City, seeking a declaratory judgment that its policies provided no coverage for the underlying actions. The district court granted summary judgment to Genesis and the City appealed, arguing that the district court erred in ruling as a matter of law that the policies did not provide the City insurance coverage for the claims. Because Genesis did not have an insurance contract with the City in 1977, when the underlying charges were filed, it did not have a duty to defendant and indemnify the city in the suits. Accordingly, the court affirmed the judgment.