Justia Insurance Law Opinion Summaries

Century appeals the district court's final judgment determining that Hipner does have coverage under an umbrella policy entered between the parties. Because Wyoming law had not definitively addressed whether an insurer must be prejudiced before being entitled to deny coverage when the insured has failed to give notice “as soon as practicable,” the court certified the question to the Supreme Court of Wyoming. On certification, the Supreme Court of Wyoming adopted the notice-prejudice rule, holding that “prejudice to the insurer [is required] before coverage may be denied based upon a violation of a notice provision contained in the policy.” Additionally, that court held that “an insurance clause is [not] enforceable where it excludes coverage unless the insured notifies the insurer ‘as soon as practicable . . . whether [the insurer] [is] prejudiced or not.’” In this case, although Hipner did not provide timely notice to Century, the court concluded that Century failed to show how the four-month delay in receiving notice actually prevented it from taking any meaningful investigatory steps that it would have done had there been no delay. Because Century suffered no prejudice from the delay in notice, the court affirmed the judgment. View "Century Surety Co. v. Jim Hipner LLC" on Justia Law

Plaintiffs contend that their insurance policy from Amica covered damage caused by a fire to their house and personal property. On appeal, plaintiffs challenge the district court's grant of summary judgment for Amica. The district court concluded that no reasonable jury would be able to reconcile the difference between the value of the personal property plaintiffs reported as lost in the fire and the value of personal property they reported in their bankruptcy petition a year earlier. Therefore, the district court determined that the insurance policy was void as a matter of law, and granted summary judgment to Amica on plaintiffs' claims. The court affirmed, concluding, as a matter of law, that because plaintiffs intentionally made material misrepresentations on the Proof of Loss, their entire insurance policy is void under the Concealment of Fraud provision. View "Neidenbach v. Amica Mutual Insurance Co." on Justia Law

After Steve Walker died in a motorcycle accident, his wife, Ronda, filed a wrongful death action against the driver of the other vehicle. The parties settled for the driver's liability policy limit and then Ronda filed suit against the couple's insurer, Progressive, to recover underinsured motorist insurance (UMI) under two policies. The district court granted Progressive's motion for summary judgment. The court agreed with the district court's conclusion that the policies' "owned vehicle" exclusion simply and unambiguously precludes coverage for damages sustained while the insured is occupying a vehicle he owns that is not included on the policies' declaration page. Accordingly, the court affirmed the judgment. View "Walker v. Progressive Direct Insurance Co." on Justia Law

American Family and Liberty Mutual (Appellants) filed suit against the City after a water-main break in the City flooded the basement condominiums and street-level window wells in the the nearby Sexton building. On appeal, Appellants challenge the district court’s decision on their Equal Protection Clause claim, federal takings claim, and state takings claim. The court concluded that the insurance companies are not similarly situated to the uninsured property owners for purposes of an Equal Protection Clause claim. Even if Appellants could demonstrate that they are similarly situated to the uninsured claimants, the court is satisfied that the reasons proffered by the City, including protecting the welfare of its citizens by minimizing the time claimants were without housing and suffering uncompensated damages, as well as minimizing its own costs and litigation risks, demonstrate that its settlement decisions were rationally related to legitimate, government interests. The court also concluded that because Appellants failed to pursue the available mandamus action in state court, both the state and federal takings claims are not ripe for review by the federal district court. Accordingly, the court affirmed the judgment. View "American Family Ins. v. City of Minneapolis" on Justia Law

After he was diagnosed with multiple sclerosis, plaintiff applied for long term disability benefits under his Sun Life policy. The policy required plaintiff to provide written notice of his claim within 30 days of the end of a set period of time (referred to as the elimination period), and to provide proof of his claim no later than 90 days after the end of the elimination period. The policy also included a limitations period requiring any lawsuit regarding benefits to be brought within 3 years of the date that proof of claim was required. In this case, plaintiff did not file his lawsuit until March 2013, well after the contractual limitations period had expired. Therefore, the court concluded that plaintiff's suit is untimely and affirmed the district court's grant of summary judgment in favor of Sun Life. View "Schmitz v. Sun Life Assurance Co." on Justia Law

A1's, packages and sells landscaping materials, filed suit against Decker to recover losses after Decker sold defective plastic bags to A1's. Because Decker failed to manufacture the bags with an ultraviolet inhibitor (UVI), the bags deteriorated in the sunlight, causing small shreds of plastic to commingle with A1’s landscaping materials, sometimes while still in A1’s inventory and sometimes after delivery to its customers. Decker filed a claim with its comprehensive general liability (CGL) insurer, West Bend. After West Bend denied coverage, Decker filed suit and West Bend removed to federal court. The district court granted summary judgment to West Bend. Determining that Iowa law governs the court's interpretation of the West Bend policy, the court concluded that there was an "occurrence" triggering coverage under the terms of West Bend's policy. Accordingly, the court reversed and remanded. View "Decker Plastics Inc. v. West Bend Mut. Ins. Co." on Justia Law

Plaintiff was insured under a group long-term disability policy the county obtained from Hartford. After Hartford denied plaintiff's claim for disability benefits, she filed suit in Minnesota state court for breach of contract. Hartford timely removed to federal court based on diversity jurisdiction. The district court then granted Hartford summary judgment. Under the plain meaning of the statute, the court concluded that plaintiff's suit was time-barred. The court also concluded that the legislative distinction between individual and group policies does not violate the principles of equal protection under the United States and Minnesota constitutions. Accordingly, the court affirmed the district court's conclusion that plaintiff's suit was untimely. View "Walker v. Hartford Life and Accident Ins." on Justia Law

Capson filed suit against MMIC seeking a declaration that MMIC was the primary professional liability insurer for Karl J. Hasik, M.D., and that Capson was the excess insurer. MMIC counterclaimed and filed a third-party complaint against Dr. Hasik and others, seeking rescission of its insurance policy or, in the alternative, a declaration that MMIC had no obligation to defend or indemnify Dr. Hasik for two medical negligence cases that had been filed against him. The district court granted MMIC’s motion for summary judgment. The court concluded that Dr. Hasik’s and the hospital’s nondisclosure of the Wilson lawsuit (a medical malpractice suit filed by a patient against Dr. Hasik) was the equivalent of a false assertion. Therefore, the court held that the elements of equitable rescission were satisfied in this case. Dr. Hasik’s and the hospital’s nondisclosure of the Wilson lawsuit was the equivalent of a material representation that was false. MMIC was entitled to rescind the prior-acts coverage it had agreed to provide. The court further held that Iowa law does not preclude a judgment of rescission in this case. Accordingly, the court affirmed the judgment and dismissed the cross-appeal as moot. View "Capson Physicians Ins. Co. v. MMIC Ins. Inc." on Justia Law

Plaintiffs filed suit against Midwest, alleging that an insurance agent carelessly and negligently failed to designate plaintiffs as owners of the insurance policy at issue. The district court concluded that the complaint failed to state a viable claim and dismissed the case. The court concluded that, under the policy, control over the policy during the lifetime of the insured - including the power to name a new owner - belonged solely to the insured in this case. Therefore, Midwest cannot be liable for negligence for failing to do something it had no power to do. Accordingly, the court affirmed the judgment. View "Carlson v. Midwest Prof'l Planners" on Justia Law

Plaintiff filed suit seeking interest and attorney's fees after General American notified plaintiff that the treasury warrant in the amount of his annuity transfer had never cleared. General American reversed the transaction. The court found that, under the terms of plaintiff's annuity, General American promised to make periodic payments to plaintiff at agreed upon dates; plaintiff does not allege that General American failed to make payments or otherwise failed to fulfill an obligation under the terms of the annuity; nor does this action arise from a declaratory judgment action or an effort by General American to cancel or lapse the policy. Accordingly, the court concluded that plaintiff did not suffer a “loss” covered by Ark. Code Ann. Sections 23-79-208 and 23-79-209, and the district court was correct that neither a 12% penalty nor attorney’s fees are owing by American General under these sections. The court also concluded that the district court did not err in finding plaintiff was not entitled to an award of attorney’s fees under section 16-22-308. Finally, the court concluded that the district court did not abuse its discretion in denying attorney’s fees in this case. The court affirmed the judgment. View "Cooper v. General American Life Ins. Co." on Justia Law