Justia Insurance Law Opinion Summaries

After the EPA accused LaGen of violating the Clean Air Act, 42 U.S.C. 7401, LaGen promised, among other things, to upgrade parts of its power plant pursuant to a consent decree. LaGen then asked its insurer, ILU, to pay the costs of these measures, but ILU refused. The district court entered summary judgment for LaGen. The court upheld the district court’s ruling that the Consent Decree Measures indirectly mitigate BCII’s (a coal-fired electric steam generating plant owned by LaGen) past pollution; there is no genuine issue of material fact on this point, nor would further discovery create one; it is unclear, however, whether indirect mitigation and abatement efforts qualify in the first place as “remediation,” and their costs as “remediation costs,” under the Policy; and therefore, a genuine dispute of material fact exists as to whether LaGen is entitled to indemnification for any of the costs of the Consent Decree Measures. Moreover, the court concluded that, even if indirect mitigation efforts can give rise to covered “remediation costs,” genuine disputes of material fact exist as to whether LaGen’s claimed costs are unreasonable. Specifically, it is unclear whether LaGen’s claimed costs include costs that Entergy paid; design and elevator costs properly attributable to Units 1 and 2; and unreasonable delay-related cost overruns. Accordingly, the court vacated and remanded for further proceedings. View "Louisiana Generating v. Illinois Union Ins. Co." on Justia Law

This case arises out of personal injuries sustained by Raylin Richard, an Offshore employee, while working on a drillship in the Gulf of Mexico. At issue is whether Valiant, as an excess insurer on a marine insurance policy, is required to reimburse Offshore, the insured, for payments in Richard's personal injury settlement. The district court granted summary judgment for Valiant, holding that an exclusion in the insurance policy precludes coverage. The court agreed with the district court that the facts as alleged by Offshore do not show conduct which would induce a reasonable person to conclude that Valiant waived its coverage defenses under the policy at issue. Accordingly, the court affirmed the judgment and denied Valiant's motion to strike portions of the record. View "Richard v. Anadarko Petroleum Corp." on Justia Law

Plaintiffs filed suit against Scottsdale, seeking additional pay for wind-related damages to their property from Hurricane Isaac. Two months later, plaintiffs added Underwriters as defendants and alleged that they were entitled to additional payment for flood damages. At issue in this appeal is plaintiffs' mortgage lender's, First American’s, breach of contract claim against Underwriters. Underwriters sought summary judgment on the merits of that claim, arguing that First American failed to timely submit a formal proof-of-loss statement and could not prove that the approximately $232,000 Underwriters already paid was insufficient to repair the properties’ damage. Determining that the district court has jurisdiction to allow the filing of the complaint adding First American’s claim that was tried against Underwriters, the court held that First American's claim was timely; there was adequate evidence to support the jury's findings that Underwriters received satisfactory proof of loss to support First American’s claim for additional recovery; and there was sufficient evidence from which to conclude that Underwriters’ presuit payments were inadequate to repair the properties to their pre-Hurricane Isaac condition. Accordingly, the court affirmed the district court's denial of Underwriter's motion for judgment as a matter of law. View "Cotton v. Scottsdale Ins. Co." on Justia Law

Tesoro filed suit against National Union, seeking insurance coverage under a commercial crime policy for alleged acts of forgery committed by a Tesoro employee. The district court granted summary judgment for National Union because the policy did not cover Tesoro’s losses.The court concluded that Texas caselaw addressing theft by deception makes clear that the decision-maker must be aware of the false statement and induced by it. In this case, Tesoro has failed to connect any of the evidence of the employee mentioning these forged security documents to Tesoro’s decision-making process in selling fuel to Enmex, let alone show that the forged documents induced the sale. Therefore, even if the court were to accept Tesoro’s meaning of “unlawful taking,” Tesoro cannot survive summary judgment because it has failed to show a genuine dispute of material fact as to whether a theft by deception occurred. Accordingly, the court affirmed the judgment. View "Tesoro Ref. & Mktg. Co. v. National Union Fire Ins." on Justia Law

Southern and Affiliated provide insurance coverage for the Ogletree House, an on-campus building at the University, located in Hattiesburg, Mississippi. In February 2013, the house was one of several university buildings damaged by a tornado. Southern contends, inter alia, it is not liable because, under its policy’s valuation provision, the loss by its insured, the University of Southern Mississippi Alumni Association (association), is “nothing” for coverage purposes. Affiliated, the insurer for the University, contends Southern is fully responsible for the loss, and, in the alternative, contests the district court’s pro rata allocation of liability. The district court denied summary judgment for Southern, and granted it in part for the association and Affiliated. The court concluded that Southern is not entitled to summary judgment where its valuation condition can be construed as ambiguous; and, in the alternative, its construction of its policy engenders an unfair or absurd result. Accordingly, the court affirmed the district court's judgment. View "Southern Ins. Co. v. Affiliated FM Ins." on Justia Law

In the underlying lawsuits, individuals filed suit against DP and its employee after the individuals were injured in an industrial accident at an Entergy nuclear power plant. In this case, DP's insurers, Hartford Casualty Insurance Company and Hartford Lloyds Insurance Company, seek a declaratory judgment that they have no duty to defend or to indemnify DP in the underlying suits. The district court granted summary judgment to the insurers. The court concluded that the underlying lawsuits fall within the professional services exclusion because the factual allegations in the underlying complaints describe injuries that “arise out of” DP’s and the employee’s allegedly negligent engineering services. Therefore, the district court correctly entered summary judgment for Hartford that there was no duty to defend. Likewise, the court affirmed the district court's resolution of DP's counterclaims related to the duty to defend. The court concluded, however, that the district court should not have determined the duty to indemnify based solely on the pleadings in the underlying lawsuit. Therefore, the court reversed the district court’s grant of summary judgment to Hartford on the duty to indemnify and remanded for further proceedings. View "Hartford Cas. Ins. Co. v. DP Engine" on Justia Law

Plaintiff filed suit against Humana, alleging claims for breach of contract and unfair insurance practices. The district court granted summary judgment to Humana. Plaintiff submitted a claim with Humana to cover the cost of her husband's medical services after he overdosed on ecstasy. At issue is the application of an exclusion under the policy that excluded loss due to being intoxicated or under the influence of any narcotic unless administered on the advice of a health care practitioner. The court concluded that the term "narcotic" includes ecstasy and the husband's stroke was due to being under the influence of ecstasy. Accordingly, the court affirmed the judgment. View "Crose v. Humana Ins. Co." on Justia Law

In the underlying lawsuit, Larry Naquin was using an EBI land-based crane to relocate a test block when the pedestal of the crane snapped, causing the crane to topple over and sustaining injuries as result. Naquin subsequently filed suit against EBI and the jury awarded a verdict in Naquin's favor. EBI appealed. EBI then filed a third-party complaint against its insurance companies, SNIC and Certain London Insurers, alleging that the insurers breached their insurance contracts by denying EBI's insurance claims arising from Naquin's accident and by failing to provide EBI with defense and indemnity. In this appeal, EBI challenged the district court's grant of summary judgment for SNIC. The court agreed with SNIC that the terms of the policy does not provide coverage for the land-based incident due to EBI's negligence. Consequently, EBI has no valid underlying claim on which to stand and the district court did not err in dismissing EBI's claim for bad faith. The court affirmed the judgment. View "Naquin, Sr. v. Elevating Boats, LLC" on Justia Law

This dispute arose from injuries sustained by a platform worker employed by Vertex. Continental appealed the district court's final judgment in favor of Tetra and Maritech, requiring Continental and its codefendant insured, Vertex, to indemnify them. The court concluded that the summary judgment record is inadequate to determine whether the Outer Continental Shelf Lands Act (OCSLA), 43 U.S.C. 1333(a)(1), (a)(2)(A), requires the adoption of Louisiana law as surrogate federal law where the court cannot determine whether there is an OCSLA situs, the court cannot determine whether federal maritime law applies, and the Louisiana Oilfield Indemnity Act (LOIA), La. Rev. Stat. Ann. 9:2780, is consistent with federal law. Accordingly, the court concluded that neither party is entitled to summary judgment as to whether LOIA must be adopted as surrogate federal law under OCSLA. The court remanded to the district court to determine the dispositive issue of whether Louisiana law must be adopted as surrogate federal law. View "Tetra Tech. v. Vertex Servs." on Justia Law

Chapter 1301 of the Texas Insurance Code requires healthcare insurers to make coverage determinations and pay claims made by preferred healthcare providers within a specified time or face penalties. HCSC filed suit seeking a declaratory judgment against Methodist, seeking a declaration that Chapter 1301 does not apply to HCSC as the administrator of particular health plans, and the Federal Employee Health Benefits Act of 1959 (FEHBA), 5 U.S.C. 8901, et seq., preempts application of the statute to its administration of claims under the Federal Employees Health Benefits Program (FEHBP). The district court granted summary judgment to HCSC. The court held that Chapter 1301 is not applicable to BCBSTX’s activities as administrator of the self-funded plans or state government plans, nor to those activities that it performs as administrator of claims under the BlueCard program. The court also held that FEHBA preempts Chapter 1301’s application to the claims processed by BCBSTX under FEHBP plans. Accordingly, the court affirmed the judgment. View "Health Care Serv. Corp. v. Methodist Hospitals" on Justia Law