Justia Insurance Law Opinion Summaries

Plaintiff, which owns and operates a fine arts gallery and dealership in New York City, sought coverage under three provisions of an insurance policy issued by Sentinel for losses and extra expenses incurred when it suspended its operations in accordance with government restrictions on non-essential businesses during the COVID-19 pandemic. After Sentinel denied coverage, plaintiff filed suit in district court.The Second Circuit affirmed the district court's dismissal of plaintiff's claims for breach of contract and declaratory judgment with prejudice. The court concluded that, under New York law, the policy provisions that plaintiff invokes provide coverage only where the insured suspends its operations because its property or property in its immediate area suffered physical damage. In this case, plaintiff does not plausibly allege such physical damage and thus it is not entitled to coverage under the policy. The court denied plaintiff's alternative request to certify a proposed question to the New York Court of Appeals and considered plaintiff's remaining arguments, finding them to be without merit. View "10012 Holdings, Inc. v. Sentinel Insurance Co." on Justia Law

The Supreme Judicial Court affirmed the summary judgment entered in the business and consumer court in favor of UIG, Inc. on Yankee Pride Transportation and Logistics, Inc.'s claims of negligence, breach of contract, and breach of fiduciary duty, holding that there was no genuine issue of material fact as to causation.On appeal, Yankee Pride argued that it had an implied contract with UIG based on the parties' relationship and that UIG breached that contract by failing to make timely efforts to renew Yankee Pride's policy. The Supreme Judicial Court disagreed, holding that Yankee Pride's failure to offer competent evidence of causation precluded a prima facie showing on any of its claims, whether they sounded in contract, tort, or breach of fiduciary duty. View "Yankee Pride Transportation & Logistics, Inc. v. UIG, Inc." on Justia Law

In August 2016, Plaintiff Maribel Ronquillo was in an automobile collision. According to her complaint, Ronquillo was rear-ended by defendant Jesse Williams, who was operating a vehicle owned by an EcoClean employee and towing an EcoClean trailer. Ronquillo suffered serious physical injuries and incurred around $250,000 in medical expenses. At the time of the accident, Ronquillo did not have health insurance, so she entered into a medical finance lien agreement with Injury Finance. Under the terms of that agreement, Injury Finance purchased Ronquillo’s accounts receivable from her healthcare providers at a predetermined, discounted contractual rate, which allowed Ronquillo to receive prompt medical care. Ronquillo remained contractually obligated to repay Injury Finance for “all charges billed by the [medical] [p]roviders” regardless of the result of any litigation. Ronquillo and her husband filed suit alleging negligence and loss of consortium against Williams and asserting a respondeat superior claim against EcoClean. As part of discovery, Defendants subpoenaed Injury Finance, seeking information and documents pertaining to Injury Finance’s accounts receivable purchase rates, provider contracts, and business operations and methodologies. When Injury Finance did not respond to the subpoena, Defendants filed a motion to compel production, which the district court granted. Defendants also filed a “motion for determination of a question of law pursuant to C.R.C.P. 56(h) that Injury Finance . . . is not a collateral source[]” subject to the pre-verdict evidentiary component of the collateral source rule. This interlocutory appeal to the Colorado Supreme Court raised the narrow question of whether a medical finance company was a collateral source for purposes of the pre-verdict evidentiary component of Colorado’s collateral source rule. The Supreme Court agreed with the district court that Injury Finance was not a collateral source, "Collateral sources must confer a 'benefit,' as defined in section 10-1-135(2)(a), C.R.S. (2021), onto the injured party. ... Ronquillo has not received a benefit from Injury Finance for purposes of the collateral source rule because her arrangement with Injury Finance does not reduce her financial obligations." The Court expressed no opinion on whether the disputed evidence could be excluded under other evidentiary rules such as CRE 401 and 403. View "Ronquillo v. EcoClean" on Justia Law

After a RealPage, Inc. employee clicked a fake link in a seemingly innocuous email and provided login information for RealPage's account with Stripe, Inc., a third party payment processor, phishers stole the login credentials and used them to divert millions of dollars in rent payments from tenants intended for RealPage's property manager clients. RealPage and Stripe recovered some of the stolen funds but lost about $6 million. RealPage reimbursed its clients and filed claims under its commercial crime insurance policies for the stolen funds, but its primary insurer denied coverage.The Fifth Circuit affirmed the district court's grant of summary judgment in favor of the insurer, concluding that the funds RealPage lost were not covered losses because RealPage never "held" them. Therefore, the insurer was within its rights to deny coverage of the stolen funds intended for RealPage's property manager clients. Furthermore, because the insurer's coverage was not exhausted, Beazley Insurance was also within its rights to deny coverage under RealPage's excess policy. Finally, because RealPage is not entitled to coverage under the policies at issue, its arguments that the insurer breached Chapter 541 and 542 of the Texas Insurance Code by not timely paying its claims are similarly without merit. View "Realpage, Inc. v. National Union Fire Insurance Co. of Pittsburgh" on Justia Law

The Second Circuit affirmed the district court's judgment holding that an insurance company was not obligated under an insurance policy to defend the insureds in underlying copyright infringement suits. At issue is whether the insureds were subject to the policy exclusion for injury purportedly caused by an insured in the business of "broadcasting" or "telecasting."The court concluded that the insurance company does not owe the insureds a duty to defend under the policy because "broadcasting," as used in its Media Exclusion is not ambiguous and applies to the insureds' business. Furthermore, the insureds' argument that the plain and ordinary meaning of "broadcasting" does not apply here fails. In this case, the language of the policy does not suggest an intention to adopt a specialized definition of "broadcasting." Therefore, the court rejected the insureds' invitation to discard the plain and ordinary meaning of the term "broadcasting" in favor of its preferred definitions. Accordingly, the district court did not err in granting summary judgment to the insurance company. View "Dish Network Corp. v. Ace American Insurance Co." on Justia Law

Goodwill Industries of Central Oklahoma, Inc., suspended operations of its retail stores and donations centers on March 25, 2020, to comply with state and local orders regarding the COVID-19 pandemic. After suffering losses due to the shutdown, Goodwill sued its insurer, Philadelphia Indemnity Insurance Company (“Philadelphia”), under its commercial lines policy. The policy provided coverage for “loss of Business Income” when the insured must suspend its operations due to “direct physical loss of or damage to” covered property. The district court granted Philadelphia’s motion to dismiss, concluding the policy did not cover Goodwill’s loss and that the policy’s Virus Exclusion barred coverage. Finding no reversible error in that judgment, the Tenth Circuit affirmed. View "Goodwill Industries Central v. Philadelphia Indemnity" on Justia Law

The Supreme Court held that the term "civil action" in Mass. Gen. Laws 27-7-2.2 refers to a judicial proceeding that is commenced by the filing in court of a complaint and all other required documents together with fees.This case involved an accident in which Horace Johnson and Carlton Johnson were seriously injured when Horace was driving. Before any party filed suit, Carlton's counsel sent a letter to Arbella Mutual Insurance Company, which had issued an automobile insurance policy to Horace, demanding a settlement in the amount of the $100,000 policy limit. After Arbella indicated its acceptance of the settlement offer Carlton and his mother (together, Plaintiffs) filed suit. The case was removed to federal district court, which granted summary judgment to Defendants, rejecting Carlton's argument that section 27-7-2.2 applied to the case and rendered Arbella's acceptance of the settlement offer ineffective. On appeal, the First Circuit Court of Appeals certified the instant question to the Supreme Court. The Supreme Court answered that "civil action" in section 27-7-2.2 refers to a judicial proceeding which is commenced by the filing of a complaint and all other required documents together with the fees prescribed by law. View "Johnson v. Johnson" on Justia Law

A congregation of the hierarchical Church of God purchased an insurance policy from GuideOne Specialty Mutual Insurance Company (GuideOne) covering the risk of fire damage to a church building that was held by the congregation, as agent of the greater church, in trust for the benefit of the larger church body. After the local congregation voted to sever its relationship with the Church of God, a regional oversight authority took over as the agent/trustee holding the property on behalf of the greater church, after which the previously affiliated local congregation moved out, and the new agent added the property to its own insurance policy, with Church Mutual Insurance Company (Church Mutual), covering the same risk. Fire destroyed the building while both policies were in effect. Church Mutual paid the claim. GuideOne denied coverage on the ground that the former local congregation no longer had an insurable interest in the property. The issue this case presented for the Court of Appeal was whether Church Mutual was entitled to contribution from GuideOne. The trial court concluded the answer was no. While the appellate court disagreed with certain aspects of the trial court’s statement of decision, it concluded the trial court reached the correct result. The Court of Appeal also concluded the trial court correctly determined Church Mutual was not entitled to prevail against GuideOne on a separate subrogation cause of action. View "Church Mutual Ins. Co. v. GuideOne Specialty Mutual Ins. Co." on Justia Law

Plaintiff-Appellant Neil Hall appealed the district court’s grant of summary judgment in favor of Defendant-Appellee Allstate Fire and Casualty Insurance Company (Allstate) on his claim for underinsured motorist benefits. Hall challenged the district court’s determination that Allstate successfully asserted the affirmative defense of failure to cooperate, and that his bad faith claim also failed as a result. Hall was injured in a car accident caused by underinsured motorist Teri Johnson. Johnson only carried $25,000 in liability insurance coverage. Hall carried underinsured motorist coverage through Allstate. Allstate gave Hall permission to settle with Johnson for her $25,000 limit. Hall’s counsel submitted a request for benefits to Allstate asserting that he was entitled to more than the $25,000 he had received. An Allstate claims adjuster reviewed the medical expenses in the letter and determined that the reasonable amount of expenses was $25,011.68. Allstate sent Hall’s counsel a payment of $11.68 along with a letter that stated: “I will be in contact with you to resolve the remaining components of your client’s claim.” Counsel did not respond to any of the five attempts over three months: two voicemails and three letters. Without any prior notice to Allstate, Hall filed suit against Allstate for breach of contract, statutory unreasonable delay or denial of payment of benefits, and common law bad faith. The Tenth Circuit affirmed the district court, finding that because the district court found the insured's failure to cooperate resulted in a material and substantial disadvantage to the insurer, the insurer properly denied coverage on this ground, and summary judgment was proper as to the insured's bad faith claim. View "Hall v. Allstate Fire" on Justia Law

The Supreme Court reversed the decision of the court of appeals affirming an order of the trial court granting summary judgment in favor of Insureds and against Insurer in reliance upon its prior decision in N.C. Farm Bureau Mutual Insurance Co. v. Gurley, 139 N.C. App. 178 (2000), holding that the lower courts erred.Matthew Bronson, who was intoxicated, collided with a vehicle owned by Pamela Dana, resulting in serious injuries to Pamela and William Dana, who was riding in the passenger seat. Pamela died from her injuries. At the time of the accident, Pamela was insured under a policy of automobile liability insurance issued by Insurer. William, individually and as administrator of Pamela's estate, claimed to be entitled to an additional $74,750 in underinsured motorist coverage over the amount that Insurer had already tendered to them. Insurer filed a complaint seeking a declaratory judgment regarding the amount of underinsured motorist coverage it was required to provide to the Danas. The trial court entered summary judgment in favor of the Danas, and the court of appeals affirmed. The Supreme Court affirmed, holding that the application of Gurley in this case was error. View "N.C. Farm Bureau Mutual Insurance Co. v. Dana" on Justia Law