Justia Insurance Law Opinion Summaries

Plaintiff insured a nightclub under a general liability policy, which covered “bodily injury and property damage liability.” The policy contained several restrictions on that coverage. A nightclub employee and guest were both shot during a shooting at the club.   After the shooting, Plaintiff filed a federal declaratory judgment to determine the full extent of its liability. Plaintiff claimed that because the nightclub shooting was an assault and battery, the policy limited recovery for any and all injuries to $50,000. Second, it argued that the worker’s compensation and employee-injury exclusions barred the employee’s recovery. To get around the bar, the employee’s estate argued that the nightclub’s actions triggered a statutory exception for intentional torts. It alleged that the nightclub had engaged in conduct that it “knew” was virtually certain to result in injury or death to the employee.” Relying primarily on the conflict between one of the federal claims and the state case, the district court dismissed the case. Defendant appealed.   The Eleventh Circuit vacated the district court’s dismissal held that the district court failed to consider the policy limits claim, missed the efficiency gains that it needed to balance against federalism and comity interests before deciding whether to proceed with the declaratory judgment action. A totality-of-the-circumstances analysis only works when a court considers all of the relevant details. To do otherwise leaves weights that should be balanced off the scales, or, if used more nefariously, would tip them in favor of a result chosen in advance. View "James River Insurance Company v. Rich Bon Corp, et al." on Justia Law

Comegys, an independent insurance agency, had an independent contractor relationship with Safeco, a liability insurer. Comegys marketed Safeco insurance policies to the public. Comegys was allegedly negligent in procuring automobile insurance for one of its clients. Comegys had provided the client with an automobile insurance policy from Safeco, which the client eventually needed to rely on when he caused a car accident that ended in a motorcyclist’s death. Comegys offered to settle (and did settle through the errors and omissions policy it had with Endurance) the potential negligence claims the client had against it.   Relying on the indemnification provision between Safeco and Comegys, Endurance sued Safeco. Endurance wants to be indemnified by Safeco because the attorney Safeco provided to the client after the car accident pointed out the potential negligence claim the client had against Comegys.   The Eleventh Circuit reversed and remanded the district court’s judgment finding in favor of Endurance’s claims for breach of contract and breach of the implied covenant of good faith and fair dealing. The court held that Safeco was entitled to judgment as a matter of law. The court reasoned that under Florida law, “[i]ndemnity contracts are subject to the general rules of contractual construction . . . [and] must be construed on the [express] intentions of the parties.” Here, there is no breach because Endurance never carried its burden at trial of explaining how Safeco breached the indemnification provision of the Limited Agreement. Further, Endurance did not argue that there is any express term of the Limited Agreement (besides the indemnification provision, which requires breach of an independent contract provision) that has been violated. View "Endurance American Specialty Insurance Company v. Safeco Insurance Company of Illinois, et al." on Justia Law

In a consolidated appeal each of the insured businesses, SA Palm Beach, LLC, Emerald Coast Restaurants, Inc., Rococo Steak, LLC, and R.T.G. Furniture, Corporation, were denied after seeking coverage under an all-risk insurance policy that provides compensation for losses and expenses incurred in connection with “direct physical loss of or damage to” the covered property or “direct physical loss or damage to” the covered property. The Eleventh Circuit addressed the question of whether under Florida law, all-risk commercial insurance policies provide coverage for “direct physical loss of or damage to” property or “direct physical loss or damage to” property insure against losses and expenses incurred by businesses as a result of COVID-19. The court affirmed in part and vacated in part, the district court’s dismissal of the complaints. The court held that under Florida law there is no coverage because COVID-19 did not cause a tangible alteration of the insured property. The court reasoned that under Florida law, an insurance policy should be read “as a whole, endeavoring to give every provision its full meaning and operative effect.” Further, Florida Supreme Court has explained, that an “all-risk policy” does not extend coverage to “every conceivable loss.” Thus, the court found that it believes that the Florida Supreme Court would hold that, under the allegations in the complaints before the court, there is no coverage. The court vacated in part the dismissal of Emerald Coast’s complaint finding that the district court did not address the Plaintiff’s Spoilage provision claim. View "SA Palm Beach, LLC v. Certain Underwriters at Lloyd's London, et al." on Justia Law

While driving the co-plaintiffs car, the plaintiff negligently changed lanes and caused a collision, seriously injuring another driver. At the time of the incident at-fault car’s owner had a GEICO insurance policy that provided bodily-injury coverage up to $100,000 per person. The victim and Geico assert they made offers to settle, but the parties never agreed. After the conclusion of the victim's lawsuit, plaintiffs sued GEICO for bad faith, seeking to recover the amounts of the final judgments entered against them that exceeded the $100,000 policy limit. They contended that GEICO had breached its fiduciary duty to them by failing to settle the victim’s case within the policy limit. Plaintiffs challenge Cawthorn v. Auto-Owners Insurance Co 791 F. App’x 60, 65 (11th Cir. 2019), arguing that Florida law doesn’t require that a verdict precede an excess judgment as a prerequisite to proving the causation element of an insurer-bad-faith claim. The court reasoned that plaintiffs' available coverage and final judgments entered against them constituted excess judgments. Thus, plaintiffs could prove causation in their bad-faith case because they were subject to excess judgments. Finally, the court declined to follow Cawthorn because that court incorrectly analyzed Florida's bad-faith law and is unpersuasive. View "Erika L. McNamara v. Government Employees Insurance Company" on Justia Law

The Eleventh Circuit dismissed based on lack of jurisdiction A.B.'s appeal of a declaratory judgment that an insurer has no duty to defend the insured man that sexually abused her. The court explained that the declaratory judgment relieved the insurance company of any obligation to defend the insured which helps, rather than harms, A.B. Furthermore, if A.B. cannot obtain review of the declaratory judgment, it lacks preclusive effect on her. Therefore, A.B. lacks appellate standing as she suffered no injury from the judgment in favor of the insurance company. View "Nationwide Mutual Insurance Co. v. A.B." on Justia Law

Couch falsely represented that he was not HIV positive. Jackson issued Couch a $500,000 life insurance policy. At the time, HIV-positive individuals had a greatly diminished life expectancy, resulting in high demand for HIV-positive insureds willing to engage in viatical settlements. Couch worked with a brokerage, which, months later, found a purchaser, Crum. The premiums were paid through the broker's premium reserve fund until after the two-year contestability period policy expired. Crum paid the premium for eight more years, letting the policy lapse in 2009. In 2016, Crum learned that Couch had died in 2005 and made a claim.Jackson sought a declaration that, under Georgia law, the policy was void as an illegal human life wagering contract. The district court found that Couch took out the policy with the intent to sell it to one without an insurable interest and that the policy was unenforceable as an illegal human life wagering contract under Georgia law. Crum argued that an illegal human life wagering contract involves the knowing, direct involvement of an identified third-party beneficiary at the time of its procurement. The Eleventh Circuit certified, to the Georgia Supreme Court, the question: whether a life insurance policy is void if it is procured by an individual on his own life for the sole purpose of selling the policy to a third party without an insurable interest in the insured, but without the complicity of the ultimate purchaser at the time of procurement. View "Jackson National Life Insurance Co. v. Crum" on Justia Law

The Eleventh Circuit affirmed the district court's order granting summary judgment in part in favor of defendants and holding that James River has a duty to defend the insureds: Ultratec, MST, and Ultratec's employee. The underlying action stemmed from a pyrotechnic explosion at a work place that killed two employees and injured others. The employees filed suit against Ultratec, Ultratec's employee, and MST. James River is Ultratec entities' insurer.The court concluded that it has jurisdiction over the appeal despite its lack of finality because of its injunctive qualities. The court applied Alabama's contract interpretation principles and case law before applying that law to the insurance policy at issue, holding that James River has a duty to defend defendants because the employer's liability exclusion in the policy is ambiguous. The court explained that, because the exclusion did not unambiguously exclude coverage, James River had a duty to defend the insureds. View "James River Insurance Co. v. Ultratec Special Effects Inc." on Justia Law

In 1999, Kristina drugged her sons and put them, and herself, in a running car in a closed garage. Matthew died; Adam and Kristina survived. Kristina was convicted of second-degree murder and remained in prison until 2016. In 1999, Kristina had State Farm automobile and homeowners insurance policies. In 2001, Matthew’s estate, Adam, and their father (the Rotells) sued Kristina for wrongful death and bodily injury.Kristina tendered her defense to State Farm, which filed state court declaratory judgment actions, seeking determinations that her policies did not cover the incident. The Rotells allege that State Farm rejected a settlement offer even though Kristina wished to accept it. The state court then held that the policies did not cover the incident. State Farm withdrew from the wrongful-death lawsuit. The state court entered a default judgment against Kristina; a jury entered a $505 million verdict. Kristina was insolvent, so the Rotells petitioned for involuntary Chapter 7 bankruptcy. The bankruptcy court entered an order subjecting Kristina’s assets (claims against State Farm for bad faith and malpractice) to its control and appointed Carapella as trustee. The verdict is Kristina’s only liability. Carapella sued State Farm in Florida state court. State Farm then sought to intervene, post-judgment, in the wrongful-death action and moved to vacate the judgment, arguing that the Rotells’ fifth amended complaint was untimely and that the default judgment was void.The district court and the Eleventh Circuit affirmed the denial of the motion. The Bankruptcy Code’s “automatic stay” provision, 11 U.S.C. 362(a), precluded State Farm’s motion to intervene. View "State Farm Florida Insurance Co. v. Carapella" on Justia Law

Anderson, the lead plaintiff in a putative class action against her life insurance provider, Wilco, alleged that in 2011-2016, the company breached the terms of her universal life insurance policy by increasing her monthly rate for impermissible reasons. Her policy provides for a “guaranteed maximum monthly cost of insurance rate” and a “current monthly cost of insurance rate.” The guaranteed rate is calculated “based on” Anderson’s “age, sex, and premium class.” The current rate, by contrast, “will be determined by the Company” but cannot exceed the guaranteed rate. As a typical universal life insurance policy, Anderson’s policy was a hybrid investment vehicle and life insurance policy. As her policy aged, Wilco began to increase Anderson’s current rate sharply; her policy’s accumulation value (essentially the investment earnings from which Anderson could cover her monthly payments) was wiped out, and Anderson failed to make the monthly payments out-of-pocket. Her policy lapsed, and Anderson sued.The Eleventh Circuit affirmed the dismissal of her complaint. The policy gave Wilco discretion to set Anderson’s current rate as long as that rate was less than the guaranteed rate and unambiguously gave Wilco discretion to set Anderson’s current monthly rate. View "Anderson v. Wilco Life Insurance Co." on Justia Law

The Eleventh Circuit affirmed the district court's grant of summary judgment in favor of GEICO and its rejection of claimant's attempt to obtain a $14,900,000 bad faith judgment from the insurer. The court concluded that, under the totality of the circumstances, no reasonable jury could conclude that GEICO acted in bad faith before, during, or after sending the proposed release to claimant. The court noted that it was not allowing GEICO to escape liability merely because claimant and his attorney's actions could have contributed to the failure to settle. Rather, the court discussed claimant and his attorney's actions because they show how, in the totality of these circumstances, GEICO did fulfill its good faith duty to the driver and his mother. The court explained that they show how the failure to settle the lawsuit against the insureds did not result from bad faith of the insurer. View "Pelaez v. Government Employees Insurance Co." on Justia Law