Justia Insurance Law Opinion Summaries

Articles Posted in US Court of Appeals for the Ninth Circuit
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HC purchased commercial auto liability, commercial umbrella, and commercial general liability (CGL) coverage from United. An HC employee was operating a company truck and trailer. The trailer detached and hit another vehicle, killing the driver and injuring a passenger. To settle the resulting claims, United paid the combined $3 million limits of the commercial auto and umbrella policies but denied coverage under the CGL policy based on the Aircraft, Auto or Watercraft (AAW) exclusion, and the Multiple Liability Coverages Limitation (MLCL) endorsement. United argued that the injuries arose out of the use of a vehicle pulling a loaded equipment trailer, thus arising out of the use of an “auto,” precluding coverage under the CGL policy under the AAW exclusion. Because coverage was provided under the commercial auto policy, United argued that the CGL policy did not provide coverage, pursuant to the MLCL endorsement.The district court found the provisions unambiguous but unenforceable because they were not listed in a table of contents or notice section of important provisions. The Ninth Circuit certified the question to the Montana Supreme Court: Whether, when an insurance policy does not include either a table of contents or a notice section of important provisions, in violation of Mont. Code 33-15-337(2), the insurer may nonetheless rely on unambiguous exclusions or limitations to the policy’s coverage, given that 33-15-334(2) provides that 33-15-337(2) is “not intended to increase the risk assumed under policies subject to” its requirements? View "High Country Paving, Inc. v. United Fire & Casualty Co." on Justia Law

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The Mundens own ranching property in Bannock County, Idaho. They purchased 768 acres in 2012 and 660 acres in 2014 and purchased title insurance for the first purchase through Stewart and for the second purchase through Chicago Title. The property contains a gravel road. A 2019 ordinance amended a 2006 ordinance that closed specified snowmobile trails, including that gravel road, to motor vehicles except snowmobiles and snow-trail-grooming equipment during winter months. The 2019 ordinance deleted the December-to-April closure, giving the County Public Works Director the discretion to determine when to close specified snowmobile trails, and increased the maximum fine for violations. The Mundens sought an injunction. The county asserted that the road had been listed as a public road on county maps since 1963 and that the Mundens purchased their property expressly subject to easements and rights of way apparent or of record.The Mundens filed a federal complaint, seeking declaratory relief, indemnification, and damages. The district court granted the insurance companies summary judgment. The Ninth Circuit reversed as to Chicago Title, finding that the county road map is a “public record” within the meaning of its policy so that coverage applied. Stewart has no duty to indemnify or defend; its policy disclaims coverage for damages “aris[ing] by reason of . . . [r]ight, title and interest of the public in and to those portions of the above-described premises falling within the bounds of roads or highways.” View "Munden v. Stewart Title Guaranty Co." on Justia Law

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Plaintiffs, domestic entities, entered into an insurance contract providing coverage for a Texas townhome complex that they own and operate. The Policy was underwritten by Lloyd’s, members of a foreign organization, and contains a mandatory arbitration provision, providing that the seat of the Arbitration shall be in New York and the Arbitration Tribunal shall apply the law of New York. In 2017, Hurricane Harvey caused an estimated $5,660,000 in damages to the townhome complex. A third-party claims administrator for Lloyd’s concluded that the Policy’s deductible was $3,600,000.Plaintiffs filed a complaint in the Western District of Washington asserting breach of contract, failure to communicate policy changes, and unfair claims handling practices in violation of Washington law, asserting that the deductible should be $600,000. Lloyd’s moved to compel arbitration and stay proceedings, arguing that the Policy’s arbitration provision falls within the scope of the Convention on the Recognition and Enforcement of Foreign Arbitral Awards. Plaintiffs did not contest that the arbitration provision falls within the Convention’s scope but argued the provision is unenforceable because Washington law specifically prohibits the enforcement of arbitration clauses in insurance contracts. Plaintiffs cited the McCarran-Ferguson Act, 15 U.S.C. 1011–15, which provides that state insurance law preempts conflicting federal law. On interlocutory review, the Ninth Circuit upheld an order granting Lloyd’s motion. Article II, Section 3 of the Convention is self-executing, and therefore is not an “Act of Congress” subject to reverse-preemption under the McCarran-Ferguson Act. View "CLMS Management Services Limited Partnership v, Amwins Brokerage of Georgia" on Justia Law

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The Ninth Circuit affirmed the district court's grant of summary judgment to Starr in an action brought by Adir, seeking insurance defense coverage. The panel held that California Insurance Code section 533.5(b) — which nullifies an insurance company’s duty to defend — does not facially violate a party's due process right to retain counsel. The panel explained that, in civil cases, courts have recognized a denial of due process only if the government actively thwarts a party from obtaining a lawyer or prevents it from communicating with counsel. In this case, Adir has made no such allegation.The panel also rejected Adir's statutory argument that section 533.5 applies to actions involving only monetary relief. Rather, under the plain text of the statute, it applies to actions that seek injunctive relief along with monetary relief. Because it turns out that there is no duty to defend nor to indemnify, the panel affirmed the district court's determination that Starr is entitled to reimbursement under the explicit language of the insurance policy. View "Adir International, LLC v. Starr Indemnity and Liability Co." on Justia Law

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The Ninth Circuit certified to the California Supreme Court the following question: Under California's Motor Carriers of Property Permit Act, Cal. Veh. Code 34600 et seq., does a commercial automobile insurance policy continue in full force and effect until the insurer cancels the corresponding Certificate of Insurance on file with the California Department of Motor Vehicles, regardless of the insurance policy's stated expiration date? View "Allied Premier Insurance v. United Financial Casualty Co." on Justia Law

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In 2020, the Academy filed suit in state court alleging that Continental breached an insurance policy by denying coverage for a claim asserted against it by a former executive. After removal to the district court, the district court issued a sua sponte order remanding the case to state court.The Ninth Circuit concluded that the district court's transmittal of its sua sponte order remanding this civil action to a state court based solely on the notice of removal does not deprive federal courts of jurisdiction. The panel also concluded that despite the district court's characterization of its order, 28 U.S.C. 1447(d) does not bar the panel's review because jurisdiction could not be determined when the district court issued its sua sponte order. The panel explained that section 1447(d) bars review only of a remand order that is based on a colorable section 1447(c) ground. In this case, the district court's requirement that a notice of removal prove subject matter jurisdiction is contrary to Dart Cherokee Basin Operating Co., LLC v. Owens, 574 U.S. 81, 89 (2014), and accordingly, is not a "colorable" ground under section 1447(c). Accordingly, the panel vacated the district court's remand order. View "Academy of Country Music v. Continental Casualty Co." on Justia Law

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The Ninth Circuit filed an order deferring submission and certifying the following questions to the Washington State Supreme Court: 1. Should the filed rate doctrine apply to claims by a Washington homeowner against a loan servicer arising from the placement of lender placed insurance on the Washington homeowner's property where the servicer purchased the insurance from a separate insurance company who filed the insurance product with the Washington State Office of the Insurance Commissioner? 2. In the event the filed rate doctrine does apply to this type of transaction, do the damages requested by plaintiff fall outside the scope of the filed rate doctrine, or rather do they "directly attack agency-approved rates," such that they are barred under McCarthy Finance, Inc. v. Premera, 347 P.3d 872, 875 (Wash. 2015)? View "Alpert v. NationStar Mortgage LLC" on Justia Law

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The Ninth Circuit certified to the Arizona Supreme Court the following questions: 1. In a garnishment action by a judgment creditor against the judgment debtor's insurer claiming that coverage is owed under an insurance policy, where the judgment creditor is not proceeding on an assignment of rights, can the insurer invoke the doctrine of direct benefits estoppel to bind the judgment creditor to the terms of the insurance contract? 2. If yes, does direct benefits estoppel also bind the judgment creditor to the arbitration clause contained in the insurance policy? View "Benson v. Casa de Capri Enterprises, LLC" on Justia Law

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The Ninth Circuit reversed the district court's grant of summary judgment to AXIS in an action seeking reimbursement of an insurance payment that it made, as a secondary excess insurer, to Northrop. AXIS argued that underlying insurers paid an uncovered claim arising from Northrop's settlement of alleged Employment Retirement Income Security Act (ERISA) violations, thereby "improperly eroding" their policies' liability limits and prematurely triggering AXIS's excess coverage.The panel held that, consistent with the limited caselaw and secondary sources that have addressed excess insurer claims of "improper erosion," "improper exhaustion," "wrongful exhaustion," and similar challenges to the payment decisions of underlying insurers, an excess insurer may not challenge those decisions in order to argue that the underlying liability limits were not (or should not have been) exhausted absent a showing of fraud or bad faith, or the specific reservation of such a right in its contract with the insured.In this case, the panel held that no reasonable insured in Northrop's position would understand that it might have to justify its underlying insurers' payment decisions as a prerequisite to obtaining excess coverage from AXIS. The district court misapplied the panel's unpublished decision in Shy v. Insurance Company of the State of Pennsylvania, 528 F. App'x 752 (9th Cir. 2013), ignored the weight of authority rejecting "improper erosion" as a valid basis for denying coverage, and misconstrued the "covered loss" provision in AXIS's excess policy as a reservation of the right to second-guess other insurers' payments. Accordingly, the panel remanded for further proceedings. View "AXIS Reinsurance Co. v. Northrop Grumman" on Justia Law

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Plaintiffs, who have hearing loss severe enough to qualify them as disabled, filed suit claiming that Kaiser's health insurance plan's categorical exclusion of most hearing loss treatment discriminates against hearing disabled people in violation of Section 1557 of the Patient Protection and Affordable Care Act (ACA). The district court ruled that Kaiser's plans do not exclude benefits based on disability because the plans treat individuals with hearing loss alike, regardless of whether their hearing loss is disabling.The Ninth Circuit agreed with the district court that plaintiffs have failed to state a plausible discrimination claim. The panel explained that the ACA specifically prohibits discrimination in plan benefit design, and a categorical exclusion of treatment for hearing loss would raise an inference of discrimination against hearing disabled people notwithstanding that it would also adversely affect individuals with non-disabling hearing loss. However, the exclusion in this case is not categorical. The panel stated that, while Kaiser's coverage of cochlear implants is inadequate to serve plaintiffs' health needs, it may adequately serve the needs of hearing disabled people as a group. Therefore, the panel affirmed the district court's dismissal of the second amended complaint. The panel reversed the district court's dismissal without leave to amend and remanded. View "Schmitt v. Kaiser Foundation Health Plan of Washington" on Justia Law