Justia Insurance Law Opinion Summaries

Kepali Group procured insurance for its fleet of vehicles through an agent at Brown & Brown of Florida, with Prime Property & Casualty Insurance Company issuing a commercial automobile policy for the period from January 23, 2019, to January 23, 2020. The policy included a provision for after-acquired vehicles, requiring notification within 30 days of acquisition for coverage. On December 6, 2019, a 2009 Toyota Sienna owned by Kepali was involved in an accident. Kepali had acquired the vehicle on September 30, 2019, and notified Brown to add it to the Prime policy. Prime issued a quote for the additional premium, but Kepali did not pay it, and Prime did not issue an endorsement for the vehicle.The United States District Court for the Southern District of Florida ruled that Brown was acting as Kepali’s agent, not Prime’s, when attempting to procure insurance for the 3985 Toyota. However, the court concluded that the vehicle was covered under the policy’s after-acquired auto provision because Kepali met the two conditions: Prime covered all of Kepali’s vehicles, and Kepali notified Prime within 30 days of acquiring the vehicle. The court ruled that Prime had a duty to defend Kepali and Mr. Rodriguez but deferred ruling on the duty to indemnify until the underlying suit was resolved. The court granted summary judgment against Kepali and Mr. Rodriguez on their reformation and promissory estoppel claims and dismissed the remaining claims as moot.The United States Court of Appeals for the Eleventh Circuit affirmed the district court’s ruling. The court held that the after-acquired auto provision did not require payment of an additional premium within 30 days for coverage to continue. The court also found that the premium audit provision allowed Prime to compute the final premium and bill Kepali, and that Prime failed to perform this audit or send a bill. Therefore, Prime could not terminate coverage for non-payment without following the policy’s cancellation procedures. The court concluded that Prime had a duty to defend Kepali and Mr. Rodriguez in the underlying state court action. View "Prime Property and Casualty Insurance Company v. Kepali Group, Inc." on Justia Law

State Farm Mutual Automobile Insurance Company and others filed a lawsuit against Michael LaRocca and his associated chiropractic clinics, alleging that the clinics submitted fraudulent insurance claims for services that were not medically necessary. The clinics, owned by LaRocca, were operating under an exemption from Florida's Health Care Clinic Act, which requires clinics to be licensed unless they are wholly owned by licensed health care practitioners who are legally responsible for compliance with all federal and state laws.The United States District Court for the Middle District of Florida denied State Farm's motion for partial summary judgment, rejecting the argument that LaRocca's failure to ensure compliance with all laws invalidated the clinics' exemption and rendered their charges noncompensable. The court found that the term "legally responsible" did not impose an affirmative duty on LaRocca to ensure compliance with all laws but rather indicated accountability for violations.The United States Court of Appeals for the Eleventh Circuit reviewed the case and determined that the interpretation of "legally responsible" within the context of Florida's Health Care Clinic Act was a matter best decided by the Florida Supreme Court. The Eleventh Circuit certified the question to the Florida Supreme Court, seeking clarification on whether the term imposes an affirmative duty on clinic owners to ensure compliance with all federal and state laws to maintain their exemption status. The Eleventh Circuit deferred its decision pending the Florida Supreme Court's interpretation. View "State Farm Mutual Automobile Insurance Company v. LaRocca" on Justia Law

The case involves a shooting incident at the Pride of St. Lucie Lodge 1189, Inc. (the "Lodge") on March 2, 2015, where Tanya Oliver was shot in the forehead and later died from her injuries. The Lodge was insured by Kinsale Insurance Company ("Kinsale"), which had a $50,000 policy sublimit for claims arising out of assault and battery. The Estate of Tanya Oliver sued the Lodge for negligent security, and a jury awarded damages exceeding $3.348 million.The Lodge and the Estate then sued Kinsale for common law bad faith under Florida law, claiming Kinsale breached its duty of good faith by failing to make a settlement offer within the policy limits before the Estate’s claim was filed. The United States District Court for the Southern District of Florida granted summary judgment to Kinsale, concluding that Kinsale had no duty to initiate settlement negotiations because no reasonable jury could find that this was a case of "clear liability."The United States Court of Appeals for the Eleventh Circuit reviewed the case and found that, viewing the evidence in the light most favorable to the Lodge and the Estate, a jury could reasonably find that Kinsale knew or should have known that liability was clear. The court noted that the Lodge's security guards had failed to prevent a second fight in the parking lot, which led to the shooting, and that Kinsale was aware of the severity of Oliver's injuries and the potential for damages far exceeding the policy limit.The Eleventh Circuit reversed the district court's grant of summary judgment and remanded the case for trial by jury, holding that a jury could reasonably find that Kinsale acted in bad faith by failing to tender its policy limit before the Estate filed suit. View "Kinsale Insurance Company v. Pride of St. Lucie Lodge 1189, Inc." on Justia Law

Kaufman Lynn Construction was hired to build a corporate campus for JM Family Enterprises in South Florida. Kaufman obtained a commercial general liability policy from Liberty Surplus Insurance to cover itself and its subcontractors. After completing several buildings, Tropical Storm Eta caused significant water damage to the completed structures. Kaufman sought indemnification from Liberty, which denied the claim based on the policy's Course of Construction Exclusion (COCE), stating that coverage did not apply until the entire project was completed. Kaufman disputed this and filed a lawsuit against its subcontractors and initiated a claims process with Liberty.The United States District Court for the Southern District of Florida granted Liberty's motion for summary judgment, concluding that the COCE excluded coverage for the water damage because the entire project was not completed. The court also dismissed Kaufman's counterclaim for declaratory relief as duplicative and ruled that Kaufman's breach of contract counterclaim was moot. Additionally, the court dismissed Kaufman's reformation counterclaim for lack of standing, reasoning that Kaufman had not demonstrated a cognizable injury.The United States Court of Appeals for the Eleventh Circuit reviewed the case and determined that Kaufman had Article III standing to seek reformation of the policy, as it suffered a cognizable injury by receiving a policy different from what was bargained for. The court affirmed the district court's ruling that the COCE precluded coverage for the water damage, as the entire project was not completed. The court also affirmed the district court's denial of Liberty's motion for attorney's fees, as Liberty's settlement proposal did not comply with the requirements of Florida's offer of judgment statute and Rule 1.442(c)(2)(B). The case was remanded for further proceedings on the reformation counterclaim. View "Liberty Surplus Insurance Corp. v. Kaufman Lynn Construction, Inc." on Justia Law

Plaintiff filed suit against U.S. Specialty for breach of contract, based on its denial of coverage of fraudulent transfer claims in an underlying suit. The district court entered summary judgment for U.S. Specialty and entered judgment against plaintiff. The Eleventh Circuit affirmed, holding that, in light of Florida law, plaintiff's fraudulent conveyance claims "arose from" wrongful acts that predate November 10, 2008, and thus fell within the scope of the Prior Acts Exclusion of the U.S. Specialty policy. Furthermore, the policy's terms were unambiguous and its coverage was not illusory. Therefore, U.S. Specialty did not breach the insurance contract. View "Zucker v. U.S. Specialty Insurance" on Justia Law

After Ulysses Anderson was involved in a car accident with an intoxicated driver who was driving a company vehicle with his employer's permission, a jury found the driver liable and awarded Anderson one million dollars. Great American, the employer's insurance company, filed suit for a declaration that the driver was not a permissive user – and thus not covered under the applicable insurance policies – because he broke internal company policies. The district court found that the driver was not an insured at the time of the accident, and that Great American owed no duty to cover the damages awarded at the trial of the underlying action. After the Georgia Supreme Court held that inquires into permissive use should extend only to whether a vehicle is used for an approved purpose in Strickland v. Georgia Cas. & Sur. Co., the Georgia Court of Appeals held that a company's internal rules can govern the scope of permissive use, and that violations thereof can negate an individual's status as an insured. In this case, the court found that the district court erred because it followed Barfield, and thus narrowed the scope of permissive use beyond what was permitted by Strickland. Accordingly, the court reversed and remanded. View "Anderson v. Great American Alliance Insurance Co." on Justia Law

After Darcia Dominguez died in an automobile accident with a Hillsborough County employee, her personal representative, Jorge Dominguez, filed a wrongful death suit against the County in state court, which is still pending. This instant action involves an insurance dispute between the County, Mr. Dominguez, and the County's excess carrier, Star Insurance. The court addressed an issue of first impression under Florida law - the interplay between the limited waiver of sovereign immunity set forth in Fla. Stat. 768.28(5) and the language of the self-insured retention limit (SIRL) contained in an endorsement to the excess liability policy issued to the County by Star. The district court granted Mr. Dominguez's motion for entry of judgment. The court affirmed the portions of the summary judgment order and final judgment which (a) declared that the County cannot unilaterally settle Mr. Dominguez's claim within policy limits without Star’s consent, and (b) explained that other issues related to the proposed settlement are unripe for resolution on the current record; vacated the portion of the summary judgment order and the final judgment which declares that the $350,000 SIRL can be satisfied without the passage of a special claims bill; concluded that, on this record, the district court's reliance on the frustration of purpose doctrine was misplaced, and the court has no basis to address the interplay between section 768.28(5) and the policy's SIRL because the proposed settlement between the County and Mr. Dominguez anticipates the need for, and passage of, a special claims bill; and affirmed the district court's denial of Star's belated motion for discovery. View "Hillsborough County v. Star Insurance Co." on Justia Law

In the underlying lawsuit EmbroidMe was sued for alleged copyright infringement. EmbroidMe was insured by Travelers but failed to notify Travelers of the claim filed against it or to request that Travelers provide EmbroidMe with a defense on the suit. Travelers subsequently refused to reimburse EmbroidMe for legal expenses. EmbroidMe argued that because Travelers’ notification refusing to pay pre-tender legal expenses was made after the thirty-day statutory deadline had elapsed, it must now pay the pre-tender legal expenses. The court affirmed the district court's conclusion that Travelers’ refusal to reimburse expenses of EmbroidMe to which it had not consented did not constitute a coverage defense, meaning that the statutory time period for an insurer to notify its insured of its defense to coverage did not apply. Accordingly, the court affirmed the district court's grant of summary judgment to Travelers. View "Embroidme.com, Inc. v. Travelers Property Casualty Company of America" on Justia Law

Plaintiff filed a bad-faith diversity case against GEICO for failure to settle her claim when it could and should have done so. GEICO moved for partial summary judgment and sought a determination that the jury's $900,000 verdict in the underlying state uninsured motorist (UM) case was not binding as a measure of the damages in the federal bad-faith case. The district court denied GEICO's motion, but subsequently granted GEICO’s renewed motion for judgment as a matter of law. At issue on appeal is whether judgment as a matter of law correctly was entered for GEICO, when plaintiff failed to establish permanent injury under Fla. Stat. 627.727(7) for noneconomic damages within the cure period. Under the clear language of Florida law regarding noneconomic damages in an insurance bad-faith case, the court concluded that the district judge was correct to conclude that the jury had no evidence from which it reasonably could have found GEICO had acted in bad faith. In this case, there was no evidence of permanency during the cure period, which is required under Florida law. Accordingly, the court affirmed the district court's judgment. View "Cadle v. GEICO General Ins. Co." on Justia Law

In 2003, the Florida Legislature enacted Chapter 558 of the Florida Statutes, establishing a notice and repair process to resolve construction disputes between property owners and contractors, subcontractors, suppliers, or design professionals. At issue is whether Chapter 558’s statutorily prescribed notice and repair process constitutes a “suit” under a commercial general liability (CGL) insurance policy, so as to trigger the insurer’s duty to defend. The court concluded that it would be greatly benefited from the guidance of the Florida Supreme Court on the meaning of the policy language at issue here and its relationship to Chapter 558. Accordingly, the court certified the following question of law to that court: Is the notice and repair process set forth in Chapter 558 of the Florida Statutes a “suit” within the meaning of the CGL policies issued by C&F to ACI? View "Altman Contractors, Inc. v. Crum & Forster Specialty Ins. Co." on Justia Law