Justia Insurance Law Opinion Summaries

The Bunch Company filed consumer complaint, alleging that when BrickStreet Mutual Insurance Company became its insurer, BrickStreet wrongfully included a charge for the expense of an agent commission in the workers' compensation premium. The West Virginia Insurance Commissioner denied relief, upholding the previously approved rates. The circuit court reversed and vacated the Commissioner's administrative order. The Supreme Court reversed, holding (1) the Commissioner did not err in allowing BrickStreet to charge Bunch for a non-incurred agent commission; (2) the Commission properly found the insurance rates at issue were reasonable, and the trial court encroached upon a matter that has been expressly delegated to the executive branch by ignoring the deference the Commissioner was entitled to in connection with the interpretation of its own regulation; and (3) this case did not present any factual disputes requiring the Commissioner to hold a hearing. View "W. Va. Employers' Mut. Ins. Co. v. Bunch Co." on Justia Law

These two consolidated cases involved a bond for which Hartford Fire Insurance Company (Hartford) was the surety. Each bond principal was sued, and both cases resulted in the entry of default judgments. Hartford was not given notice of either lawsuit against its principals or notice that default judgments were being sought. Hartford learned of the default judgments only after the plaintiffs in those cases sought payment on the bonds. In each case, Hartford ultimately was found liable on the bond. Hartford appealed, asserting that the circuit courts erred in finding the bonds to be judgment bonds and in holding Hartford liable on the bonds under the circumstances. The Supreme Court affirmed, holding that the two bonds at issue were judgment bonds, and therefore, the circuit courts correctly found that default judgments entered against the bond principals were conclusive and binding against Hartford. View "Hartford Fire Ins. Co. v. Curtis" on Justia Law

William Piper was killed in a motor vehicle accident in which he was driving. His passenger, Kyle Hoffman, was also killed. The Estate of Hoffman subsequently filed suit against the Estate of Piper. The case was bifurcated into two parts for trial. Relevant to this appeal was the declaratory judgment action of insurance coverage involving State Farm Fire & Casualty Company. The declaratory judgment coverage action involved the question of whether Piper was a resident of the home of his grandparents at the time of his death. If he was, there would be coverage under a State Farm personal liability umbrella policy issued to Piper's grandfather. The jury returned a verdict finding Piper lived with his grandparents, thus finding in favor of Hoffman's Estate on the coverage issue. At issue on appeal was whether the circuit court erroneously applied the Dead Man's Statute in prohibiting the testimony of Piper's family members and the introduction of documentary evidence regarding where Piper was residing on the date of his death. The Supreme Court reversed and remanded for a new trial, holding that the Dead Man's Statute is invalid, as it conflicts with the paramount authority of the West Virginia Rules of Evidence. View "State Farm Fire & Cas. Co. v. Prinz" on Justia Law

Decedent died intestate as a result of a motor vehicle accident. Petitioner, the former spouse of Decedent, sought a share in the settlement proceeds from a wrongful death action based on her monthly receipt of payments from Decedent for a child support arrearage. The circuit court ruled that Petitioner was not entitled to a portion of the subject settlement funds because Petitioner could not demonstrate she was financially dependent on Decedent at the time of trial. The Supreme Court affirmed, holding that the trial court did not err in ruling that Petitioner was not entitled to a share of the wrongful death settlement proceeds, as Petitioner's receipt of monthly arrearage payments was not sufficient to demonstrate the statutory requirement of financial dependence. View "Ellis v. Swisher" on Justia Law

Gerald Kirchner accidentally shot and killed Robbie Bragg while both men were working for Grimmett Enterprises (Grimmett). Kirchner's mother, Barbara Surbaugh, filed a complaint against Bragg and Grimmett. The parties settled, after which Defendants assigned all claims they might have against their respective insurers for refusing to provide a defense and coverage. Thereafter, Surbaugh filed a declaratory judgment action against Grimmett's insurer, American States. Both parties filed motions for summary judgment. At issue was whether an employee exclusion in the policy was ambiguous and whether the exclusion had been brought to the attention of Grimmett. The circuit court denied the motions. After a jury trial, the circuit court concluded that the employee policy exclusion was unenforceable because the exclusionary language had not been brought to the attention of Grimmett. The Supreme Court reversed, holding that summary judgment should have been granted in favor of American States, as American States established at the summary judgment stage that no material issue of fact was in dispute as to the exclusion being unambiguous and disclosed to Grimmett. Therefore, the exclusion was enforceable. View "Am. States Ins. Co. v. Surbaugh" on Justia Law

Plaintiffs were injured when their vehicle was struck by a vehicle driven by Ida Trayter. Trayter's insurer tendered its liability limits, after which Plaintiffs sought underinsured motorist coverage from their insurer, State Farm. State Farm advised Plaintiffs that its settlement offer would be based on the "net" value of the claim after reduction of the liability limits and medical payments already received by Plaintiffs. Plaintiffs filed suit against State Farm seeking a declaratory judgment that a non-duplication provision and reimbursement provision in State Farm's underinsured motorist policy violated W. Va. Code 33-6-31(b). The circuit court granted partial summary judgment to Plaintiffs, finding both provisions at issue violated the statute. The Supreme Court reversed, holding (1) a non-duplication of benefits provision in an underinsured motorist policy, which permits an insurer to reduce an insured's damages by amounts received under medical payments coverage, does not violate the "no sums payable" language of section 33-6-31(b), and the circuit court erred in holding otherwise; and (2) the circuit court's consideration of and entry of summary judgment on the reimbursement provision was erroneous because the provision was not ripe for adjudication in this matter. View "State Farm Mut. Auto. Ins. Co. v. Schatken" on Justia Law

In the instant case, the Supreme Court was once again asked to consider whether medical protective orders are valid and enforceable to limit the dissemination and retention of medical records obtained through discovery. Such orders had been entered in lawsuits filed by plaintiffs seeking compensation for the injuries they sustained in motor vehicle accidents caused by other motorists. Repeatedly, the insurers from whom such compensation had been sought requested the West Virginia Supreme Court, the United States Supreme Court, and a federal district court to invalidate these protective orders as burdensome, restrictive, and/or unconstitutional. Each time the reviewing Court examined these medical protective orders, it upheld the order as substantively valid and enforceable as a proper exercise of the issuing court's supervisory authority over discovery. In the instant case, the Court again declined insurance companies' invitation to invalidate the subject medical protective orders, finding that the insurance companies' arguments were insufficient to overturn precedent. View "State ex rel. State Farm Mut. Auto. Ins. Co. v. Circuit Court" on Justia Law

Plaintiff was injured in an automobile accident with Stephen Stanton. At the time, Plaintiff was operating a vehicle owned by his employer, Bambardier Aerospace Corporation, and Stanton was driving a vehicle owned by his employer, the City of Elkins. Plaintiff and his wife filed an action against the City and Stanton to recover for injuries. Plaintiffs' personal automobile insurer, Westfield Insurance, filed a crossclaim against the City and Stanton and a third party claim against Bombardier and National Union Fire Insurance. The trial court entered an order finding (1) the City, Stanton, and National were immune from liability; (2) Bombardier and Westfield were subject to a payment of damages of not more than $20,000 each; and (3) Plaintiffs were not entitled to auto medical coverage under the policy covering Bombardier and the policy issued by Westfield. The Supreme Court (1) reversed the circuit court's order to the extent it held the uninsured motorist policies for Bombardier and Westfield were not enforceable above the mandatory limits of uninsured motorist coverage required by W. Va. Code 33-6-31; (2) reversed the court's order to the extent it denied Plaintiffs auto medical payment benefits under Bombardier's policy; and (3) affirmed the remainder of the court's judgment. View "Jenkins v. City of Elkins" on Justia Law

Petitioner appealed an order of the West Virginia Workers' Compensation Board of Review through which Petitioner's permanent total disability (PTD) award previously granted was suspended and vacated. Petitioner challenged the Board's determination, upon a reopening of his PTD claim, that he was capable of gainful employment. Petitioner argued that his former employer, Lowe's, violated the statute that authorized the claim reopening because Lowe's was involved in the reevaluation process, and therefore, the order vacating his PTD award was invalid. The Supreme Court affirmed, holding that notwithstanding statutory language that suggests otherwise, an order issued by the Board that modifies or vacates a previous award of PTD is not subject to challenge based on the involvement of a self-insured former employer in the reevaluation process, given that the participation of the self-insured former employer is clearly anticipated and authorized by the provisions of W. Va. Cod 23-4-16(d). View "Justice v. W. Va. Office Ins. Comm'n" on Justia Law

Petitioner, New Hampshire Insurance Company, appealed an order of the circuit court granting partial summary judgment in favor of Respondent, RRK, Inc., finding that pursuant to the commercial marine property insurance policy issued by New Hampshire, RRK's barge and the barge's contents were covered property under the policy and that a wear-and-tear exclusion in the policy was invalid. The Supreme Court affirmed in part and reversed in part, holding (1) the circuit court correctly found that there was no question of fact regarding whether a renewal policy was mailed to and received by RRK; but (2) the circuit court erred by granting partial summary judgment in favor of RRK because there was a question of fact as to whether, under the doctrine of reasonable expectations, the wear-and-tear exclusion present in the policy mailed to RRK was part of the insurance contract. Remanded. View "N.H. Ins. v. RRK., Inc." on Justia Law