Justia Insurance Law Opinion Summaries

Plaintiff filed suit against the company for interest she claimed it owed her on a payout it made on a policy. The company counterclaimed, asking for its money back because it had paid plaintiff by mistake and so plaintiff was not entitled to the payout in the first place, let alone interest. The district court granted the company summary judgment on plaintiff's claims and granted her summary judgment on the company's counterclaim. The court rejected plaintiff's argument that fraudulent concealment tolled the limitations period and held that the district court correctly found that plaintiff's claims were untimely. In regard to the cross-appeal, the court concluded that the district court erred in holding that the company's counterclaim failed because it neglected to discover all of the relevant facts, where the company has a perfectly straightforward claim for restitution in this case. Accordingly, the court affirmed in part, reversed in part, and remanded for further proceedings. View "DeCoursey v. American General Life Ins." on Justia Law

Plaintiff filed suit against her insurer, Allied, after Allied refused to pay a claim she submitted under her policy's underinsured motorist (UIM) endorsement. In this case, Allied only owed coverage when the tortfeasor met the definition of a UIM by having a policy with a limit of liability that is less than $50,000. The driver who caused the accident that injured plaintiff had a $100,000 limit of liability, the sum for which plaintiff settled her claim. Therefore, under the plain terms of the policy, the other driver did not qualify as underinsured. The court rejected plaintiff's claims to the contrary and affirmed the district court's grant of summary judgment to Allied. View "Burger v. Allied Property & Casualty Ins." on Justia Law

After a Bamford employee caused a car accident resulting in third party injuries, Bamford requested that its insurer, Regent, settle the claims within Bamford's policy limits. Regent did not settle the claims, the case proceeded to trial, and a jury returned a verdict in excess of Bamford’s policy limits. Bamford filed suit against Regent, alleging that Regent acted in bad faith in not settling the claims. The jury returned a verdict for Bamford. In this appeal, Regent challenged the district court's denial of its post-verdict motion for judgment as a matter of law or for a new trial. The court affirmed, holding that Bamford presented sufficient evidence from which a reasonable jury could conclude that Regent acted in bad faith in failing to settle the third party claims within the policy limits. Based on the same record of evidence, the court held that the district court did not abuse its discretion in denying Regent’s motion for a new trial predicated on the sufficiency of the evidence. Finally, the court held that the district court did not abuse its discretion in giving the challenged jury instructions, which were nearly identical to instructions approved by the Nebraska Supreme Court, and must be read as a whole with all of the instructions. View "Bamford, Inc. v. Regent Ins. Co." on Justia Law

Federated Mutual, the insurer, filed an interpleader suit to determine the rights of Moody Station and the Big Store to insurance proceeds. The district court found Moody Station was not entitled to the full amount and awarded attorney fees to Federated. The court concluded that Moody Station is correct that there is no jurisdiction under 28 U.S.C. 1335’s interpleader because the two adverse claimants are both citizens of Missouri. The court determined that diversity jurisdiction exists in this case because there is diversity of citizenship and the amount in controversy is met. Although the district court did not explicitly find a partial loss, the district court implicitly rejected that a total loss occurred. In this case, the district court did not clearly err in determining the actual cash value of the destroyed property. The court concluded, however, that the district court clearly abused its discretion in ordering Moody Station to pay attorney fees to Federated where Federated has consistently opposed Moody Station’s attempts to collect on its policy and is not a disinterested stakeholder deserving attorney fees. Accordingly, the court affirmed in part, reversed in part, and remanded. View "Federated Mutual Ins. Co. v. Moody Station and Grocery" on Justia Law

NSC, a wholly owned subsidiary of Fireman's Fund, filed a declaratory judgment action against Dustex seeking a judicial determination that it did not have a duty to defend or indemnify Dustex in an arbitration proceeding, which, at the time, was pending before the American Arbitration Association (AAA). The district court subsequently concluded that Dustex failed to establish the affirmative defense of estoppel. The court concluded that, under either Georgia or Iowa law, the district court did not clearly err in finding that Dustex knew or should have known that Fireman's Fund was proceeding under a reservation of rights. The court's review of the district court's findings does not indicate that Fireman's Fund failed to provide Dustex with an effective reservation of rights that included a specific basis for Fireman's Fund's reservations about coverage. Accordingly, the court affirmed the judgment. View "National Surety Corporation. v. Dustex Corp." on Justia Law

32nd Street filed suit against the insurers for quantum meruit, unjust enrichment, and vexatious refusal to pay an insurance claim, as well as injunctive relief arising out of medical services provided to the insurers' insureds. The district court granted summary judgment for the insurers and denied 32nd Street's motion to compel discovery. The court concluded that the plain language of the provisions at issue support the district court's conclusion that, in the ancillary-provider agreement, 32nd Street agreed to accept the Blue Traditional rate for services rendered to insureds belonging to all of the insurers’ networks; the district court did not err by finding that the equitable claims were barred by the contracts governing the reimbursement rates paid by the insurers; the district court did not err in granting summary judgment to the insurers on the vexatious-refusal claim where 32nd Street fails to establish any genuine issue of material fact that the insurers refused to pay an amount due under an insurance policy; and the district court did not abuse its discretion by denying 32nd Street's motion to compel. Accordingly, the court affirmed the judgment. View "32nd St. Surgery Ctr. v. Right Choice Managed Care" on Justia Law

American Family filed suit seeking a declaratory judgment as to whether an umbrella insurance policy issued to Todd Patton provided any coverage for an automobile accident in which a passenger in a vehicle driven by Todd's son, Jacob Patton, was seriously injured. The district court granted summary judgment for American Family. The court concluded that the Pattons breached the umbrella policy's cooperation clause by entering into a Miller-Shugart agreement after already being protected from personal liability in the Drake-Ryan settlement, and that such breach was material and prejudicial. Accordingly, the court affirmed the judgment. View "American Family Mutual Ins. v. Donaldson" on Justia Law

After Eric Orloske shot his brother, Brian, to death after Eric tripped and fell down the stairs in his home while holding a loaded shotgun, the trustee for Brian's next of kin filed a wrongful death suit against Eric. At issue in this appeal is whether Country Mutual's homeowner's policy, which covered Eric's home, provided coverage for Brian's death. The court concluded that the district court correctly determined that Minnesota's reasonable-expectations doctrine is inapplicable in this case and correctly granted summary judgment to Country Mutual.The doctrine forces insurers to communicate the coverage and exclusions of their policies clearly; it is not a means of avoiding unambiguous policy language. Here, the policy expressly listed the criminal-acts exclusion - Eric had pleaded guilty to manslaughter for Brian's death - in the exclusion section of the policy between exclusions related to controlled substances and pollution. Accordingly, the court affirmed the judgment. View "Country Mutual Ins. Co. v. Orloske" on Justia Law

Before floodwaters destroyed plaintiffs' property, FEMA issued a flood-in-progress designation. Plaintiffs believed that the FEMA designation rendered their two Standard Flood Insurance Policies (SFIPs) worthless for the pending flood and elected to cancel them. Congress then passed the Biggert-Waters Flood Insurance Reform Act of 2012 (FIRA), Pub. L. No. 112-141, 100227(b), 126 Stat. 405, 943–44, a remedial amendment that would have extended coverage for plaintiffs but for the fact that they had canceled the SFIPs. Plaintiffs filed suit against American Bankers, the issuer of the SFIPs, seeking reinstatement of the SFIPs and payment for their flood loss. The court affirmed the district court's conclusion that plaintiffs were chargeable with knowledge of the terms of the SFIPs and that the FIRA does not reinstate the canceled SFIPs. View "Hodde v. American Bankers Ins. Co." on Justia Law

Plaintiff filed suit against Standard, asserting various claims after Standard determined that plaintiff was no longer disabled and discontinued benefits. The district court granted summary judgment to plaintiff, concluding that Standard abused its discretion in discontinuing long-term disability (LTD) benefits. In this case, Standard's decision was based on its determination that the disabling cognitive impairments suffered by plaintiff in a 2011 car accident had improved to the point that she could return full-time to her Own Occupation. The court concluded that the administrative record more than adequately supports the manner in which Standard addressed the Own Occupation issue in its final decision. The court also concluded that substantial evidence supported Standard's decision to discontinue benefits. Accordingly, the court reversed and remanded. View "Whitley v. Standard Ins. Co." on Justia Law