Justia Insurance Law Opinion Summaries
Articles Posted in U.S. Court of Appeals for the Seventh Circuit
Sterigenics U.S., LLC v National Union Fire Insurance Company of Pittsburg
Griffith Foods International Inc. and Sterigenics U.S. operated a medical supply sterilization plant in Willowbrook, Illinois, emitting ethylene oxide (EtO) over 35 years. In 2018, a report linked these emissions to high cancer rates in the area, leading to over 800 lawsuits against the companies. The plaintiffs alleged that the companies knowingly emitted dangerous levels of EtO, causing various illnesses, including cancer.The United States District Court for the Northern District of Illinois handled the insurance dispute between Griffith, Sterigenics, and National Union Fire Insurance Company. Griffith and Sterigenics sought a declaration that National Union had a duty to defend them under their commercial general liability (CGL) policies. The district court ruled in favor of Griffith and Sterigenics, determining that the pollution exclusion in the CGL policies did not apply because the emissions were authorized by a permit from the Illinois Environmental Protection Agency (IEPA).The United States Court of Appeals for the Seventh Circuit reviewed the case. The court focused on whether the pollution exclusion in the CGL policies applied to the emissions of EtO. The court noted that the Illinois Supreme Court's decision in American States Insurance Co. v. Koloms interpreted the pollution exclusion to apply to traditional environmental pollution. However, an Illinois appellate court decision in Erie Insurance Exchange v. Imperial Marble Corp. suggested that emissions authorized by a regulatory permit might not constitute traditional environmental pollution.Given the conflicting interpretations and the significant implications for the insurance industry, the Seventh Circuit decided to certify the question to the Illinois Supreme Court. The court sought clarification on the relevance of a permit or regulation authorizing emissions in assessing the application of a pollution exclusion within a standard-form CGL policy. View "Sterigenics U.S., LLC v National Union Fire Insurance Company of Pittsburg" on Justia Law
Griffith Foods International Inc. v National Union Fire Insurance Company of Pittsburg
Griffith Foods International and Sterigenics U.S. operated a medical supply sterilization plant in Willowbrook, Illinois, emitting ethylene oxide (EtO) over a 35-year period. In 2018, a report revealed high cancer rates in Willowbrook, allegedly due to these emissions. Griffith and Sterigenics faced over 800 lawsuits from residents claiming bodily injuries, including cancer, caused by the emissions. Griffith had obtained permits from the Illinois Environmental Protection Agency (IEPA) for the plant's operation, which included EtO emissions.The United States District Court for the Northern District of Illinois reviewed the case. Griffith and Sterigenics sought declarations that National Union Fire Insurance Company had a duty to defend them under their commercial general liability (CGL) policies. The district court ruled in favor of Griffith and Sterigenics, determining that the pollution exclusion in the CGL policies did not apply because the emissions were authorized by IEPA permits. The court relied on the Illinois appellate decision in Erie Insurance Exchange v. Imperial Marble Corp., which found ambiguity in the pollution exclusion when emissions were permitted by regulatory authorities.The United States Court of Appeals for the Seventh Circuit reviewed the case. The court acknowledged the importance of the pollution exclusion in CGL policies and the precedent set by the Illinois Supreme Court in American States Insurance Co. v. Koloms. The Seventh Circuit noted the conflicting interpretations between Koloms and Imperial Marble regarding the scope of the pollution exclusion. Given the significant implications for Illinois law and the insurance industry, the Seventh Circuit decided to certify the question to the Illinois Supreme Court to determine the relevance of regulatory permits in applying the pollution exclusion in CGL policies. View "Griffith Foods International Inc. v National Union Fire Insurance Company of Pittsburg" on Justia Law
Starstone Insurance SE v City of Chicago
Jacques Rivera, after being released from over 20 years in prison for a wrongful murder conviction, sued the City of Chicago and several police officers under 42 U.S.C. §1983 for civil rights violations. A jury awarded him over $17 million, and his attorneys sought more than $6 million in fees and costs. The case was settled for $18.75 million, including at least $3.75 million for attorneys' fees and costs. Chicago, which had an insurance policy with Starstone Insurance SE covering liabilities between $15 and $20 million, sought indemnity for the $3.75 million. Starstone refused, claiming their policy only covered damages, not attorneys' fees and costs, and filed for a declaratory judgment.The United States District Court for the Northern District of Illinois ruled in favor of Chicago, determining that the insurance policy covered the entire $18.75 million settlement as an "ultimate net loss" that Chicago was legally obligated to pay. Starstone appealed this decision.The United States Court of Appeals for the Seventh Circuit reviewed the case. The court first addressed whether Starstone, a Societas Europaea (SE) based in Liechtenstein, qualified as a "corporation" under 28 U.S.C. §1332 for diversity jurisdiction purposes and concluded that it did. On the merits, the court found that the insurance policy's language covered the entire settlement amount, including attorneys' fees and costs, as part of the "ultimate net loss" Chicago was legally obligated to pay. The court affirmed the district court's decision, holding that the policy's terms included indemnity for attorneys' fees and costs awarded under statutory provisions. View "Starstone Insurance SE v City of Chicago" on Justia Law
Wolf v. Riverport Insurance Company
Suzanne Wolf suffered multiple pelvic fractures in a car accident caused by an underinsured motorist. After receiving $100,000 from the at-fault driver’s insurance, she filed claims for underinsured motorist benefits with her personal automobile insurer and her employer’s general commercial liability insurer, Riverport Insurance Company. Wolf settled with her personal insurer for $150,000 and eventually settled with Riverport after four years of negotiations and arbitration, which awarded her $905,000. Riverport paid the award, less the amounts received from the other insurers.Wolf filed a lawsuit against Riverport in the Circuit Court of Cook County, alleging unreasonable delay in payment under section 155 of the Illinois Insurance Code. Riverport removed the case to the United States District Court for the Northern District of Illinois, invoking diversity jurisdiction. The district court granted Riverport’s motion for judgment on the pleadings under Rule 12(c) of the Federal Rules of Civil Procedure, finding that Wolf lacked a viable legal theory to support her claim. The court also denied Wolf’s discovery request.The United States Court of Appeals for the Seventh Circuit reviewed the case. The court held that the insurance policy did not impose a duty on Riverport to investigate and settle Wolf’s claim in good faith. The court found that the policy’s provision granting Riverport discretion to investigate and settle claims applied only to defending insureds against third-party claims, not to first-party claims by insureds against Riverport. Consequently, Wolf’s breach-of-contract theory failed, and the district court’s judgment was affirmed. The appellate court also upheld the district court’s discovery decision, as Wolf could not show actual and substantial prejudice from the denial of additional discovery. View "Wolf v. Riverport Insurance Company" on Justia Law
Philadelphia Indemnity Insurance Co. v Kinsey & Kinsey, Inc.
Bellin Memorial Hospital hired Kinsey & Kinsey, Inc. to upgrade its computer software. Kinsey failed to implement the agreed-upon software, leading Bellin to sue Kinsey in Wisconsin state court for breach of contract and other claims. Bellin also sued Kinsey’s president and a senior product consultant. Kinsey’s insurer, Philadelphia Indemnity Insurance Company, provided a defense under a professional liability insurance policy. During the trial, Bellin and Philadelphia Indemnity entered into a partial settlement, resolving some claims and specifying the conditions under which Bellin could collect damages from Kinsey. Bellin prevailed at trial and was awarded damages.The Wisconsin circuit court ruled that the limited liability provision in the Agreement did not apply due to Kinsey’s material breach. The court granted a directed verdict on the breach of contract claim against Kinsey, leaving the question of damages to the jury. The jury awarded Bellin $1.39 million, later reduced to $750,000 plus costs. The jury found Kinsey and its president not liable for intentional misrepresentation and misleading representation.Philadelphia Indemnity filed a declaratory judgment action in the United States District Court for the Northern District of Illinois, seeking a declaration that the state court’s judgment was covered by the insurance policy and that the $1 million settlement offset the $750,000 judgment. The district court ruled for Bellin, concluding that the state court judgment was not covered by the insurance policy.The United States Court of Appeals for the Seventh Circuit affirmed the district court’s decision. The court held that the insurance policy covered only negligent acts, errors, or omissions, and the state court’s judgment was based on a breach of contract, not negligence. Therefore, the $1 million set-off provision did not apply, and Bellin could recover the full amount of the judgment. View "Philadelphia Indemnity Insurance Co. v Kinsey & Kinsey, Inc." on Justia Law
Kennedy v. Lilly Extended Disability Plan
Seventh Circuit affirms award of permanent disability benefits for fibromyalgia.Kennedy was hired by Lilly in 1982 and became an executive director in Lilly’s human resources division, with a monthly salary of $25,011. In 2008, she quit work because of disabling symptoms of fibromyalgia. She was approved for monthly benefits of $18,972 under the company’s Extended Disability Benefits plan. Three and a half years later her benefits were terminated. Kennedy sued under the Employee Retirement Income Security Act (ERISA), 29 U.S.C. 1001. The Seventh Circuit affirmed summary judgment in favor of Kennedy, with an award of $537,843.81 in past benefits and prejudgment interest and reinstatement of benefits. The court characterized Lilly’s evidence as “a hodgepodge” and noted that Lilly did not indicate what kind of work Kennedy would be able to perform. Kennedy’s general internist testified that she is permanently disabled, basing this opinion on his diagnoses of her nonarticular rheumatism (musculoskeletal aches and pains not traceable to joints), fibromyalgia, sleep disorder, depression, irritable bowel syndrome, restless leg syndrome, and her symptoms of pain and fatigue. Her rheumatologist concurred. The court noted the company’s conflict of interest, being both the initial adjudicator of an employee’s benefits claim and the payor of those benefits. View "Kennedy v. Lilly Extended Disability Plan" on Justia Law
Title Industry Assurance Co., R.R.G. v. First American Title Insurance Co.
In 2008, Chicago Abstract was sued in state court by a title insurance company and financial firms. Chicago Abstract tendered these lawsuits to its “errors and omissions” liability insurer, TIAC. TIAC could defend without reservation; defend while reserving its rights; seek a declaratory judgment concerning the scope of coverage; or decline to defend. Under Illinois law, when a liability insurer unjustifiably refuses to defend, the insurer is estopped from later asserting policy defenses to coverage. TIAC declined to defend. Years passed without further communications between TIAC and its insured. In 2014, a state court plaintiff filed an amended complaint. An attorney appointed by TIAC made an appearance in that case. TIAC then sought a declaration that coverage was unavailable based on policy exclusions. Chicago Abstract did not defend; the company had been involuntarily dissolved. Plaintiffs from the state-court litigation against Chicago Abstract appeared in the federal case as defendants. The Seventh Circuit affirmed judgment in favor of those defendants. The undisputed facts show that TIAC breached its duty to defend in the underlying litigation and is estopped from asserting “at this very late stage” any policy defenses to coverage that might have been available if TIAC had made a different choice when the complaints were first tendered. View "Title Industry Assurance Co., R.R.G. v. First American Title Insurance Co." on Justia Law
Prather v. Sun Life Financial Insurance Co.
Prather, age 31, tore his Achilles tendon. His surgery to repair the injury was uneventful. He returned to work. Four days later he collapsed, went into cardiopulmonary arrest, and died as a result of a blood clot in the injured leg that had traveled to a lung. Prather’s widow applied for benefits under his Sun Life group insurance policy (29 U.S.C. 1132(a)(1)), which limited coverage to “bodily injuries ... that result directly from an accident and independently of all other causes.” Sun Life refused to pay. The Seventh Circuit ruled in favor of Prather’s widow, noting that deep vein thrombosis and pulmonary embolism are risks of surgery, but that even with conservative treatment, such as immobilization of the affected limb, the insured had an enhanced risk of a blood clot. The forensic pathologist who conducted a post-mortem examination of Prather did not attribute his death to the surgery. Prather’s widow then sought attorneys’ fees of $37,170 under ERISA, 29 U.S.C. 1132(g)(1). The Seventh Circuit awarded $30,380, stating that there is no doubt of Sun Life’s culpability or of its ability to pay without jeopardizing its existence; the award of attorneys’ fees is likely to give other insurance companies in comparable cases pause; and a comparison of the relative merits of the contending parties clearly favors the plaintiff. View "Prather v. Sun Life Financial Insurance Co." on Justia Law
Madison Mutual Insurance Co. v. Diamond State Insurance Co.
In 1999, the Dribbens purchased a home from the Favres on 42 acres in a four‐parcel development near Saint Louis, Missouri. Davidson represented the Favres in that purchase. Davidson was also one of the developers and owned one parcel. The development has a 30‐acre artificial lake; the dam creating that lake is located on the Dribbens parcel. In a 2006 lawsuit, the Dribbens alleged that Davidson failed to disclose that the original owners/developers had never obtained a permit from the Illinois Department of Natural Resources, which amounted to fraudulent concealment and consumer fraud. Davidson tendered the suit to Diamond State, which had issued her professional liability errors and omissions policy. In 2011, the Dribbens filed a second suit, alleging a pattern of harassment, intimidation, and interference with the Dribbens’ property rights by the Davidsons. Davidson tendered the 2011 lawsuit to Madison Mutual, which had provided her homeowner’s insurance and umbrella coverage. Diamond State refused to supply a defense to the 2011 litigation. Madison Mutual sought a declaratory judgment that Diamond State has breached its duty to defend in the 2011 suit and had a duty to reimburse Madison Mutual. The Seventh Circuit affirmed summary judgment in favor of Diamond State. The 2011 suit does not potentially assert a claim that is plausibly within the Diamond State professional liability coverage. View "Madison Mutual Insurance Co. v. Diamond State Insurance Co." on Justia Law
Telamon Corporation v. Charter Oak Fire Insurance Co
Berry worked for Telamon from 2005-2011, under Consulting Agreements between Telamon and Berry’s one-woman company. Berry’s responsibilities expanded beyond those described in the Agreements. She became Telamon’s senior regional manager. She oversaw Telamon’s AT&T Asset Recovery Program, to remove old telecommunications equipment from AT&T sites and sell it to salvagers. Berry removed the equipment and sold it, but kept the profits. The company discovered the scheme in 2011; it had suffered $5.2 million in losses. Berry was convicted of wire fraud and tax evasion; she was sentenced to 60 months’ imprisonment and ordered to pay $3,440,885 in restitution. Telamon sought compensation under its Travelers crime insurance policy and its Charter Oak general commercial insurance policy. Travelers denied coverage because Berry was not, legally, an employee; Charter denied coverage because she was, functionally, an employee. Telamon sued, alleging bad faith, then unsuccessfully sought permission to add claims based on older policies. The request came a year after the deadline for amending pleadings. Telamon filed suit in state court, raising essentially the same claims. The insurers again removed; the district court dismissed the suit as an impermissible attempt to split claims. The Seventh Circuit affirmed both decisions, noting that none of the four ways of establishing bad faith under Indiana law exist in this case. View "Telamon Corporation v. Charter Oak Fire Insurance Co" on Justia Law