Justia Insurance Law Opinion Summaries

Plaintiffs filed suit alleging that Allstate breached the terms of their insurance policies by not using either the "Cost Approach" or "Comparable Sales Approach" to determine the "Actual Cash Value" (ACV) of their automobiles. The Fifth Circuit affirmed the district court's grant of Allstate's motion to dismiss under Federal Rule of Civil Procedure 12(b)(6), concluding that neither the contract nor Texas state law requires either the Cost or the Comparable Sales Approach. View "Cody v. Allstate Fire and Casualty Insurance Co." on Justia Law

Plaintiff filed a class action complaint against Farm Bureau, alleging breach of contract and seeking a declaratory judgment. Plaintiff's breach of contract claim was based, in part, on an alleged violation of Arkansas Insurance Rule and Regulation 43, which he claimed was incorporated into the policy. The district court granted Farm Bureau's motion to dismiss for failure to state a claim. Plaintiff then filed a motion to clarify whether the order also disposed of the common law breach of contract theory, which the district court dismissed.The Eighth Circuit agreed that the Arkansas regulation that Farm Bureau allegedly violated is not incorporated into plaintiff's policy, and thus he cannot use it as the basis for a breach of contract claim. However, because plaintiff also states a breach of contract claim based on the policy language, the court reversed in part. In this case, plaintiff alleges that "a 9% reduction on a used vehicle is not typical and does not reflect market realities," and that dealers' actual practice is not to inflate prices above market value because of the "intense competition in the context of internet pricing and comparison shopping." The court explained that, if this is true, then Farm Bureau did not consider the truck's fair market value. Rather, it considered an artificially lower value, in breach of its contractual duty and thus plaintiff stated a claim for breach of contract based on the policy language. Finally, the court denied plaintiff's motion to certify questions of law to the Arkansas Supreme Court. View "Smith v. Southern Farm Bureau Casualty Insurance Co." on Justia Law

In 1955-1976, WPC, a manufacturer of industrial valves, bought primary and excess level liability insurance policies from OneBeacon’s predecessor. In 2001, asbestos lawsuits started coming against WPC. OneBeacon began its defense. The parties reached an impasse over several issues.WPC sought declaratory relief in Ohio state court concerning OneBeacon’s obligations. WPC also sued OneBeacon in federal court, alleging breach of contract. OneBeacon unsuccessfully moved to dismiss or stay the case. The district court rejected OneBeacon’s argument that the federal and state proceedings were parallel. WPC amended its state complaint, adding breach of contract claims. The state court held that OneBeacon had not committed the alleged breaches. OneBeacon again moved to dismiss WPC’s federal lawsuit, arguing that the state court’s ruling precluded WPC’s federal claims. The court acknowledged that the state court judgment likely satisfied the elements of claim preclusion, but declined to dismiss. The court stayed the case, noting that WPC’s amended state court complaint made the state and federal proceedings parallel. After OneBeacon filed its federal notice of appeal, the Ohio Court of Appeals reversed in part, finding that OneBeacon breached some of the policies. Pennsylvania subsequently liquidated OneBeacon and stayed all litigation.The Sixth Circuit reversed, first holding that exercising appellate jurisdiction here will in no way “hinder [the] operation” of Pennsylvania’s claims process and priority scheme. Claim preclusion bars the federal suit. View "William Powell Co. v. National Indemnity Co." on Justia Law

This appeal stems from a dispute between Great American and Employers Mutual regarding their respective obligations to contribute to a $7 million settlement of a wrongful death suit arising out of a motor-vehicle accident. The district court assumed without deciding that the Employers Mutual policy was required to provide coverage before the Great American policy. However, the district court granted summary judgment in favor of Employers Mutual and concluded that Great American failed to allocate damages between covered and non-covered claims.The Fifth Circuit reversed and remanded, concluding that the district court was correct in its assumption that the EMC Umbrella Policy had priority of coverage but erred in granting summary judgment for Employers Mutual because Great American's evidence created a factual dispute on allocation. In this case, if true, the affidavits at issue established that the covered claims Great American paid on behalf of Employers Mutual were worth at least $7 million—thereby triggering and exhausting the EMC Umbrella Policy. View "Great American Insurance Co. v. Employers Mutual Casualty Co." on Justia Law

The First Circuit affirmed the judgment of the district court granting two summary judgment motions in favor of Defendants in this class action lawsuit, holding that Defendants' actions in this case could not support a claim under the Racketeer Influenced and Corrupt Organizations Act (RICO).In granting the two summary judgment motions at issue, one filed on behalf of all Defendants and on filed behalf of certain Defendants, the district court adopted the findings of law of the Court of Appeals of Puerto Rico in Collazo Burgos v. La Asociación de Suscripción Conjunta del Seguro de Responsabilidad Obligatorio, No. K AC2010-0179, 2017 WL 6884428 (P.R. Cir. Nov. 30, 2017). The court further held that Defendants' actions were required under Puerto Rico law and thus could not support a RICO claim. The First Circuit affirmed, holding that the district court did err under the Erie doctrine in adopting the reasoning of the court of appeals in Collazo Burgos. View "Torres-Ronda v. Nationwide Mutual Insurance Co." on Justia Law

In 2001, Lavastone Capital LLC (Lavastone) entered into an agreement with Coventry First LLC (Coventry) to purchase “life settlements” – life-insurance policies sold on the secondary market. One was that of Beverly Berland. Lincoln Financial (Lincoln) issued the policy to Berland in 2006. But Berland did not act alone in acquiring it. A few months before, she approached a business called “Simba.” As Simba pitched it, the transaction allowed clients to “create dollars today by using a paper asset, (a life insurance policy not yet issued from a major insurance carrier insuring your life)” by selling it on the secondary market. Clients did not need to put up any money upfront. Instead, they got nonrecourse loans to finance the transactions, which allowed them to make all necessary payments without tapping into personal funds. The only collateral for the loan was the life-insurance policy itself. Berland agreed to participate in several transactions with Simba, profiting greatly. Lavastone kept the policy in force, paying all relevant premiums to Lincoln Financial. Upon Berland’s death more than seven years later, Lincoln paid Lavastone $5,041,032.06 in death benefits under the policy. In December 2018, Berland’s estate filed a complaint against Lavastone in the District Court, seeking to recover the death benefits that Lavastone received under 18 Del C. 2704(b). In 2020, the parties filed cross-motions for summary judgment. In 2021, the District Court certified the three questions of law to the Delaware Supreme Court. The Supreme Court responded: (1) a death-benefit payment made on a policy that is void ab initio under 18 Del. C. 2704(a) and PHL Variable Insurance Co. v. Price Dawe 2006 Insurance Trust was made “under [a] contract” within the meaning of 18 Del. C. 2704(b); (2) so long as the use of nonrecourse funding did not allow the insured or his or her trust to obtain the policy “without actually paying the premiums” and the insured or his or her trust procured or effected the policy in good faith, for a lawful insurance purpose, and not as a cover for a wagering contract; and (3) an estate could profit under 18 Del. C. 2704(b) where the policy was procured in part by fraud on the part of the decedent and the decedent profited from the previous sale of the policy, if the recipient of the policy benefits cannot establish that it was a victim of the fraud. View "Lavastone Capital LLC v. Estate of Beverly E. Berland" on Justia Law

The Supreme Court granted a writ of prohibition sought by West Virginia Mutual Insurance Company (Mutual) from the order of the circuit court denying Mutual's motion for summary judgment on common law bad faith claims brought by Michael Covelli, M.D., holding that Mutual demonstrated that the writ of prohibition was appropriate.A jury awarded Dominique Adkins almost $5.8 million on her medical malpractice claim against Dr. Covelli, which was above the limits of his medical malpractice insurance. However, Mutual, Covelli's insurer, settled Adkins's suit within policy limits before the circuit court reduced the verdict to judgment. When a second patient of Dr. Covelli learned of Adkins's large jury award, that patient too sued Dr. Covelli for malpractice. Mutual also settled that claim within policy limits. Thereafter, Dr. Covellie sued Mutual for common law bad faith. At issue was the order of the circuit court denying Mutual's motion for summary judgment on Dr. Covelli's claims. The Supreme Court granted the writ, holding that the circuit court clearly erred by denying Mutual's motion for summary judgment. View "State ex rel. W. Va. Mutual Insurance Co. v. Honorable Salango" 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

Former students sued Kamehameha Schools, alleging sexual abuse by a doctor who had practiced on SFMC’s campus. Kamehameha filed crossclaims against SFMC, which sent these crossclaims to its insurer, Argonaut. Argonaut ultimately represented SFMC subject to a reservation of rights. Neither party could determine the terms of the relevant policies from decades earlier. Argonaut sought declaratory relief in federal court under 28 U.S.C. 2201, as to what policies Argonaut had issued to SFMC during the relevant period and the terms of those policies. SFMC asked the district court to decline jurisdiction and, alternatively counterclaimed for declaratory and monetary relief.The Ninth Circuit affirmed the district court’s order, declining to exercise jurisdiction. Generally, a district court has the discretion to decline jurisdiction over a 28 U.S.C. 2201 declaratory-relief claim, after considering the relevant factors but when a declaratory claim is joined with an independent monetary one, the court usually must retain jurisdiction over the entire action. That mandatory jurisdiction rule did not apply; parties can plead a conditional counterclaim and still preserve objections to jurisdiction. SFMC’s counterclaims were conditional. Because SFMC did not waive its threshold defense, the district court still had discretionary jurisdiction. The district court thoroughly considered and correctly concluded that each relevant factor favored declining jurisdiction, noting that the declaratory claims could be filed in state court and that deciding them would not settle all aspects of the controversy or clarify the parties’ legal relationships. View "Argonaut Insurance Co. v. St. Francis Medical Center" on Justia Law

The Supreme Judicial Court affirmed the judgment of the superior court in this insurance dispute, holding that the superior court properly entered summary judgment in favor of 21st Century Centennial Insurance Company and 21st Century Insurance and Financial Services, Inc. (collectively, 21st Century).Collette Boure and Alexander Meyers took the car of Nancy Snow, Meyers's great aunt, and fled Maine to begin a drive across the country. While the teenage couple was in Oklahoma, they crashed in a chase with police, resulting in Boure's death. Boure's Estate sought uninsured motorist coverage from Concord General Mutual Insurance Company (Concord) on a personal auto policy issued to him and from 21st Century on a personal auto policy issued to Meyers's great aunt. After both insurers denied coverage Concord brought a declaratory judgment action against the Estate. The Estate counterclaimed against Concord and brought a separate action against 21 Century. The court granted summary judgments in favor of Concord and 21st Century. The Supreme Judicial Court affirmed, holding (1) the Estate's appeal of the summary judgment in favor of Concord was untimely; and (2) the court properly entered summary judgment in favor of 21st Century. View "Concord General Mutual Insurance Co. v. Estate of Collette J. Boure" on Justia Law