Justia Insurance Law Opinion Summaries

Articles Posted in Virginia Supreme Court
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The Doctors Company (TDC), a professional liability insurance company, sought a determination that its coverage of policyholder Women's Healthcare Associates (WHA) did not apply to a pending breach of contract action relating to WHA's participation in the Virginia Birth-Related Neurological Injury Compensation Act (the Birth Injury Fund). The Davidson family filed the underlying breach of contract action against WHA, alleging that they entered into an express contract with WHA partly in reliance on WHA's participation in the Birth Injury Fund, and WHA materially breached the contract by failing to pay into the fund as represented to the Davidsons. The circuit court ruled against TDC and in favor of WHA and the Davidsons, finding that the policy covered the claim alleged by the Davidsons in their complaint against WHA. The Supreme Court affirmed, holding (1) the underlying action was covered by the insurance policy; and (2) therefore, TDC must both defend and indemnify WHA in the underling breach of contract action. View "The Doctors Co. v. Women's Healthcare Assocs." on Justia Law

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Plaintiff sought coverage under his homeowners' insurance policy issued by Insurer for damages allegedly caused by sheets of drywall manufactured in China that were installed in his home during its construction. Insurer denied Plaintiff's claim and brought an action in the U.S. district court, seeking a declaratory judgment that Plaintiff's homeowners policy did not provide coverage for such losses. The district court granted Insurer's motion for summary judgment on the basis that the policy did not provide coverage for the damages allegedly caused by the drywall because of certain policy exclusions. The U.S. court of appeals certified to the Virginia Supreme Court the question of whether the policy exclusions were applicable to Plaintiff's claimed losses. The Supreme Court answered in the affirmative, holding that the policy unambiguously excluded from coverage damage caused by the Chinese drywall installed in Plaintiff's residence. View "TravCo Insurance Co. v. Ward" on Justia Law

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In this appeal the Supreme Court determined that the circuit court erred in extending summary judgment entered against a defendant motorist to likewise bind the underinsured motorist (UIM) insurance carrier. The Court reversed, holding that despite the UIM carrier's reliance on the defendant and her liability insurer to mount a defense, the UIM insurance carrier retained its own right to defendant in the event that the interests of the UIM insurance carrier and the defendant or her liability insurer diverged, and the circuit court erred in determining otherwise. Remanded to allow the UIM carrier to present a defense. View "Transp. Ins. Co. v. Womack" on Justia Law

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PBM Nutritionals filed a declaratory judgment action against three insurance companies (collectively the Insurers) seeking insurance coverage for its loss resulting from infiltration of filter elements into the infant formula it manufactured between January 22 and January 30, 2009. The Insurers claimed that the insurance policies' "Pollution Exclusion Endorsements" excluded coverage for PBM's infant formula loss because the formula was "contaminated." The circuit court entered judgment for the Insurers. The Supreme Court affirmed, holding that the circuit court did no err in finding that the Insurers were not liable to provide insurance coverage for PBM's loss of infant formula product.

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On May 21, 2008, Lisa Laws and Carmen Tinker (Plaintiffs) each filed a complaint against Calvin McIlroy, Jr. (McIlroy) and Calvin McIlroy, Sr. for damages arising out of a motor vehicle accident that occurred on June 8, 2007. GEICO and State Farm, the potential uninsured/underinsured motorist carriers were served with a copy of Laws' complaint, and State Farm was served with a copy of Tinker's complaint. Plaintiffs then filed orders of nonsuit. Plaintiffs filed second, identical lawsuits in the circuit court on January 19, 2010 before the nonsuit orders were entered by the court on February 4, 2010. McIlroy filed motions to dismiss the complaints, arguing that both cases were barred by the applicable two-year statute of limitations. Additionally, GEICO filed a plea in bar and State Farm filed a motion to dismiss, raising the same arguments made by McIlroy in his motions. The circuit court dismissed the actions with prejudice, concluding that Plaintiffs' complaints were not timely filed. The Supreme Court reversed, holding that the circuit court erred when it granted the motions to dismiss and the plea in bar, as the court erroneously interpreted the two-year statute of limitations for personal injuries.

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Mary Arnold, who was injured in an automobile collision, brought a negligence action against the other driver, Jonathan Wallace, who was uninsured. Travelers Insurance Company, Arnold's carrier, defended the suit pursuant to its uninsured motorist coverage. The jury awarded a verdict for Arnold in the amount of $9,134. Arnold appealed. The Supreme Court affirmed, holding that the circuit court (1) did not err in admitting medical records under the business records exception, as there was established a sufficient foundation for the admission of the evidence; and (2) did not abuse its discretion in finding an expert physician qualified to testify when her partner previously had been retained by the opposing counsel.

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The AES Corporation paid premiums to Steadfast Insurance Company for commercial general liability (CGL) policies. In February 2008, the village and city of Kivalina, a community located on an Alaskan barrier island, filed a lawsuit (the Complaint) in the U.S. district court against AES and other defendants for allegedly damaging the village by causing global warming through emission of greenhouse gases. Steadfast provided AES a defense under a reservation of rights and filed a declaratory judgment action, claiming that it did not owe AES a defense or indemnity regarding the Complaint. The circuit court granted Steadfast's motion for summary judgment, holding that the Complaint did not allege property damage caused by an "occurrence" as that term was defined in AES's contracts of insurance with Steadfast. The Supreme Court affirmed, holding that Kivalina did not allege that its property damage was the result of a fortuitous event or accident, and therefore, such a loss was not covered under the relevant CGL policies.

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During the course of his employment as a police officer for the Town of Abingdon, Kevin Christy suffered injuries from an automobile accident. Christy was insured under an automobile liability insurance policy issued by Mercury Casualty Company (Mercury). Christy submitted a claim to Mercury for payment of the portion of his medical expenses not paid by the Town's workers' compensation carrier. Mercury denied the claim, asserting that an exclusion in the policy barred Christy from receiving any payment for medical expenses because a portion of those expenses had been paid by workers' compensation benefits. Christy filed a warrant in debt against Mercury seeking contract damages. The district court entered judgment in favor of Christy. The circuit court reversed, concluding that, based on the unambiguous language of the exclusion, payment of workers' compensation triggered the exclusion and precluded payment by Mercury. The Supreme Court affirmed, holding that the language of the exclusion was clear and that the exclusion permitted Mercury to deny coverage for any expenses that would have been subject to workers' compensation coverage without regard to whether all of those expenses were actually paid by the workers' compensation carrier.

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Employee was injured while working for Employer's sheep and wool business, Cestari. Employer failed to maintain workers' compensation insurance for Cestari. Employee filed a workers' compensation claim against Employer and Cestari, as well as a complaint against Employer and Cestari, seeking damages for negligence. The workers' compensation commissioner determined that Employee was entitled to workers' compensation benefits. Finding that Employee had pursued his workers' compensation claim to a final order and that he had a remedy for collection of his workers' compensation award against Cestari and/or the Uninsured Employers' Fund, the circuit court dismissed Employee's civil complaint. The Supreme Court affirmed, holding that Employee had received the recovery he sought under the Workers' Compensation Act, and thus, the circuit court did not err in ruling that Employee could not pursue an action at law against Employer after obtaining a final collectible award of workers' compensation benefits.

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Judy Maretta, as the named beneficiary of a Federal Employees' Group Life Insurance (FEGLI) policy, received FEGLI benefits upon the death of her ex-husband. Jacqueline Hillman, the widow of the deceased, filed an action against Maretta, claiming that pursuant to Va. Code Ann. 20-111.1(D), Maretta was liable to her for the death benefits received. Maretta claimed that the state law was preempted by 5 U.S.C. 8705 and 8705 because the state statutes granted FEGLI benefits to someone other than the named beneficiary in violation of FEGLIA's terms. The circuit court concluded that section 20-111.1(D) was not preempted by FEGLIA and entered judgment against Maretta. The Supreme Court reversed and entered judgment for Maretta, holding that because Congress intended for FEGLI benefits to be paid and to belong to a designated beneficiary, FEGLIA preempts section 20-111.1(D).