Justia Insurance Law Opinion SummariesArticles Posted in U.S. Court of Appeals for the Eleventh Circuit
Zucker v. U.S. Specialty Insurance
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
Anderson v. Great American Alliance Insurance Co.
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
Hillsborough County v. Star Insurance Co.
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
Embroidme.com, Inc. v. Travelers Property Casualty Company of America
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
Cadle v. GEICO General Ins. Co.
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
Altman Contractors, Inc. v. Crum & Forster Specialty Ins. Co.
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
Grange Mut. Cas. Co. v. Woodard
O.C.G.A. 9-11-67.1 is a new Georgia statute governing settlement offers for personal injury and death claims arising from motor vehicle accidents. This case arises from an automobile accident involving the Dempseys and the Woodards, in which Thomas Dempsey was at fault. The court found it necessary to certify questions of Georgia law to the Georgia Supreme Court concerning the interpretation of section 9-11-67.1. The court certified the following questions: 1) Under Georgia law and the facts of this case, did the parties enter a binding settlement agreement when Insurer Grange accepted the Woodards' offer in writing? 2) Under Georgia law, does O.C.G.A. 9-11-67.1 permit unilateral contracts whereby offererors may demand acceptance in the form of performance before there is a binding, enforceable settlement contract? 3) Under Georgia law and the facts of the case, did O.C.G.A. 9-11-67.1 permit the Woodards to demand timely payment as a condition of accepting their offer? 4) Under Georgia law and the facts of this case, if there was a binding settlement agreement, did Insurer Grange breach that agreement as to payment, and what is the remedy under Georgia law? View "Grange Mut. Cas. Co. v. Woodard" on Justia Law
Coker v. American Guarantee and Liability Ins. Co.
Defendants, three excess liability insurers, appealed the district court's grant of summary judgment to plaintiffs on their breach of contract claims. The district court concluded that Georgia's uninsured/underinsured motorist (UM) statute imposed upon defendants an unconditional obligation to provide UM coverage to the insured as if they were primary insurers, and that defendants' failure to tender payment amounted to a breach of contract. The court held that Georgia's UM statute, Ga. Code Ann. 33-7-11, applies to defendants' excess liability policies; defendants' excess liability policies contain vertical exhaustion requirements; and section 33-7-11 does not supersede the vertical exhaustion requirements in defendants' excess liability policies. Accordingly, the court reversed and remanded. View "Coker v. American Guarantee and Liability Ins. Co." on Justia Law
Payroll Mgmt., Inc. v. Lexington Ins. Co.
The court originally remanded this case to the district court for additional fact-finding to establish complete diversity of citizenship between all plaintiffs and all defendants with instructions to reenter summary judgment if federal subject-matter jurisdiction could be properly established. After dismissing a nondiverse plaintiff it found was not a real party in interest to this case, the district court reentered its earlier grant of summary judgment in favor of the insurer on all claims. The court affirmed the district court's dismissal of PMI Delaware and its grant of summary judgment to Lexington. The court concluded that the district court's dismissal of PMI Delaware pursuant to FRCP 21 as a "nominal or formal party" was proper because the district court found that though PMI Delaware was a named insured on the Insurance Policy, PMI Delaware would not be entitled to any portion of a successful judgment against Lexington because PMI Florida, not PMI Delaware, was the party against whom Blue Cross had filed suit and PMI Florida, not PMI Delaware, was the only party that made a claim for coverage to Lexington. Further, PMI Delaware was not even a party to the underlying Blue Cross contract, which provided healthcare coverage only to PMI Florida’s leased employees. Further, the court affirmed the district court's holding that Lexington owed no coverage to PMI Florida. Here, the court saw no contractual ambiguity; the Insurance Policy issued by Lexington explicitly excludes the coverage sought by PMI Florida. Therefore, the district court properly granted summary judgment to Lexington on PMI Florida’s claims for breach of contract and declaratory judgment. Finally, the district court properly granted summary judgment to Lexington on its claim of negligent misrepresentation where no jury could reasonably find that Yoohoo justifiably relied on the statement at issue as an indication that there would be coverage under the policy. View "Payroll Mgmt., Inc. v. Lexington Ins. Co." on Justia Law
Robbins v. Garrison Prop. & Cas. Ins. Co.
Plaintiffs filed a purported class action challenging their insurer's interpretation of Fla. Stat. 627.736(1)(a)(3)–(4). In consolidated appeals, plaintiffs presented the issue of what the Florida Motor Vehicle No-Fault Law, Fla. Stat. 627.730–627.7405, places on an insured’s personal injury protection (PIP) benefits where no medical provider has made any determination about whether the insured’s injury was an emergency medical condition. The legislative history clearly shows that the Florida legislature sought to reduce fraudulent claims by making the full $10,000 amount of benefits available only to those insureds who suffered severe injuries, a restriction defined into the term “emergency medical condition.” The court held that Fla. Stat. 627.736, as amended, limits an insurer’s obligation to provide personal injury protection benefits to $2,500, unless one of the medical providers listed in subparagraph (1)(a)(3) has determined that the injured person had an emergency medical condition. Because neither plaintiffs' claim was supported by such a determination, neither insurer violated Fla. Stat. 627.736 by limiting benefits to $2,500. Accordingly, the court affirmed the dismissal of the suits. View "Robbins v. Garrison Prop. & Cas. Ins. Co." on Justia Law