Justia Insurance Law Opinion Summaries

Plaintiff filed a subrogation suit against defendants for recovery of insurance payments to its insured, Taube-Koret, for environmental response costs Taube-Koret incurred in cleaning up pollutants released on its property. The court concluded that plaintiff had no standing to bring suit under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), 42 U.S.C. 9601-9675, section 107(a) because it did not incur any "costs of response" related to the removal or remediation of a polluted site, and because the common law principle of subrogation did not apply to section 107(a); plaintiff could not bring a subrogation claim under section 112(c) because it did not allege that Taube-Koret was a "claimant"; and plaintiff's state law claims were time-barred. Accordingly, the court affirmed the district court's dismissal of plaintiff's third amended complaint with prejudice under Rule 12(b)(6). View "Chubb Custom Ins. Co. v. Space Systems/ Loral, Inc., et al" on Justia Law

Plaintiffs purchased variable universal life insurance policies from defendant. Plaintiffs subsequently filed a class action suit against defendant under the Securities Litigation Uniform Standards Act (SLUSA), 15 U.S.C. 78bb(f)(1), for levying excessive cost of insurance charges. The court concluded that claims of breach of contract and breach of the duty of good faith and fair dealing were not precluded by SLUSA, even if such claims related to the purchase or sale of a covered security. The court reversed the district court's dismissal of the two contract claims, on the condition that plaintiffs amend their complaint to remove any reference to deliberate concealment or fraudulent omission. The court affirmed the dismissal of the class claim for unfair competition in violation of California law. View "Freeman Investments, L.P., et al v. Pacific Life Ins. Co." on Justia Law

Petitioner petitioned for review of the Board's denial of an application for benefits under the Railroad Retirement Act (RRA), 45 U.S.C. 231 et seq. The court held that short periods of temporary employment, inadequately performed, did not constitute substantial gainful employment that would disqualify a claimant for benefits. The court further held that when considering the RRA's requirement of continuous disability, the court must look to the history of the claimant's disability and the claimant's success or lack thereof in sustaining meaningful employment. Accordingly, the court concluded that petitioner was entitled to benefits. View "Stephens, Jr. v. U.S Railroad Retirement Board" on Justia Law

Debtors filed for bankruptcy protection under Chapter 13. At issue was whether debtors could exclude an annuity debtor received under the Railroad Retirement Act of 1974 (RRA), 45 U.S.C. 451m(a), when calculating their "projected disposable income," which determined the amount they must repay creditors to qualify for Chapter 13 relief. The court concluded that the Bankruptcy Appellate Panel's decision was reviewable. Applying a trust law understanding of the statute pursuant to Hisquierdo v. Hisquierdo, the court held that the RRA's anti-anticipation clause, which provided that the payment of an annuity shall not be "anticipated," referred to premature receipt of payment, and thus did not preclude the inclusion of the RRA annuity payments in Chapter 13 debtors' projected disposable income. View "In re: Robert Scholz & Carolyn Scholz" on Justia Law

Plaintiff, injured in a bicycling accident, disputed Unum Life Insurance Company's calculation of his pre-disability earnings upon which his disability benefits were based. The court agreed with the district court that the applicable standard of review was abuse of discretion. The district court also correctly held that Unum was responsible both for evaluating benefits claims and paying them, it operated under a conflict of interest, which must be weighed as a factor in determining whether there was an abuse of discretion. However, in determining what weight ought to be given the conflict, the district court erred in three ways: First, it failed to apply the traditional rules of summary judgment to its analysis of whether and to what extent a conflict of interest impacted Unum's benefits determination. Second, it incorrectly held that certain internal memoranda between Unum's claims analyst and its in-house counsel were not discoverable. Finally, it did not take into account substantial evidence that Unum's conflict of interest infiltrated the entire decision-making process and therefore ought to be accorded significant weight. Accordingly, the court remanded for further proceedings. View "Stephan v. Unum Life Ins. Co." on Justia Law

This case involved a dispute over the proceeds of a life insurance policy. At issue was whether the federal interpleader remedy shields a negligent stakeholder from tort liability for its creation of a conflict over entitlement to the interpleaded funds. After analyzing the Supreme Court's reasoning in State Farm Fire & Cas. Co. v. Tashire, the Ninth Circuit Court of Appeals held that it did not, and that a claimant may seek to recover all damages directly and proximately caused by the negligent stakeholder's conduct. In so holding, the Court reversed the district court and remanded for further proceedings. View "Lee v. W. Coast Life Ins. Co." on Justia Law

At issue before the Ninth Circuit Court of Appeals in this case was whether an adverse claim to a stake may be so lacking in substance that a neutral stakeholder cannot interplead in good faith. Interpleader is proper when a stakeholder has at least a good faith belief that there are conflicting colorable claims. Appellee in this case was an insurance company that sought to interplead disputed insurance proceeds. Seeking to interplead the insurance funds, Appellee filed a counterclaim against Appellant and a third party complaint against Appellant's former husband. The district court found that interpleader was appropriate. The Ninth Circuit affirmed, holding that Appellee interpleaded in good faith, and consequently, the district court's judgment in interpleader was proper. View "Michelman v. Lincoln Nat'l Life Ins. Co." on Justia Law

Plaintiff appealed the district court's dismissal of her claim challenging the termination of her long-term disability benefits under the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1132. Plaintiff challenged the district court's grant of summary judgment in favor of Unum on it's counterclaim for restitution of overpaid benefits. The court held that the district court abused its discretion by dismissing the claim for denial of benefits for failure to exhaust administrative remedies. The exhaustion requirement should have been excused because plaintiff acted reasonably in light of Unum's ambiguous communications and failure to engage in a meaningful dialogue. Accordingly, the court vacated the judgment in favor of Unum on plaintiff's claim for denial of benefits. View "Bilyeu v. Morgan Stanley Long Term Disability Plan, et al." on Justia Law

Defendant appealed the district court's grant of partial summary judgment in favor of CGI in its action seeking "appropriate equitable relief" under section 502(a)(3) of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1001 et seq. CGI appealed the district court's grant of partial summary judgment in favor of defendant's counsel and codefendant, dismissing the codefendant from the action. CGI also appealed the district court's grant of proportional fees and costs to the codefendant, deducted from CGI's recovery from defendant. The court affirmed the district court's grant of summary judgment in favor of the codefendant, dismissing it from the action. However, because the court saw no indication that in fashioning "appropriate equitable relief" for CGI, the district court did more than interpret the plain terms of the reimbursement provision, and no indication that the district court considered traditional equitable principles in assigning responsibility to CGI for attorneys' fees and costs, the court vacated the judgment in favor of CGI, vacated the judgment that the codefendant deducted fees and costs from CGI's entitlement, and remanded to the district court for further proceedings. View "CGI Technologies and Solutions v. Rose, et al." on Justia Law

Sierra filed a motion under FRCP 60 in the district court that had issued default judgments against defendant, an officer of a French corporation that bought assets from an insolvent California insurance company pursuant to a rehabilitation plan, asking that court to correct judgments to add an explanation sufficient to permit its enforcement in France. The district court granted the motion and entered two corrected judgments. Defendant appealed. The court affirmed because the operative, substantive terms of the corrected judgments were identical to the terms of the original judgments. Therefore, the amendments only clarified the original intent of the judgments, and the district court did not abuse its discretion in making those changes under Rule 60(a). The court also held that, by failing to challenge the original judgments, defendant waived his arguments as to setoff, release, and the nature and amount of his liability. Finally, the court concluded that the district court did not abuse its discretion by refusing to stay entry of the amended or corrected judgments. View "Garamendi v. Hennin" on Justia Law