Justia Insurance Law Opinion Summaries

The Supreme Judicial Court affirmed the superior court's summary judgment entered in favor of Metropolitan Property and Casualty Insurance Company as to Progressive Northwest Insurance Company's complaint seeking indemnification for a portion of a final settlement paid involving a mutually-insured party, Vincent Micale, holding that there was no error.Micale rented two jet skis from Jet Ski Guys, Inc. (JSG). Two individuals listed on Micale's rental agreement collided while operating the jet skis, resulting in injuries to one individual. At the time of the accident, Progressive provided a boat and personal watercraft liability insurance policy to Micale, and Metropolitan provided homeowner insurance to Micale. JSG filed a complaint alleging that Micale and others were negligent in the operation of the jet skis. The injured individual filed a cross-claim against Micale. In a settlement, Progressive agreed to pay $300,000 to the injured individual on Micale's behalf. Progressive then sued Metropolitan, arguing that Metropolitan had a duty to indemnify Micale for half the amount that Progressive had paid to the injured individual. The court entered judgment in Metropolitan's favor. The Supreme Judicial Court affirmed, holding that the plain meaning of Metropolitan's policy did not provide coverage for injuries arising out of the use of the watercraft involved in the accident. View "Progressive Northwest Insurance Co. v. Metropolitan Property & Casualty Insurance Co." on Justia Law

This appeal arose from an application by State Farm General Insurance Company (SFG) to increase its homeowners’ insurance rates, under the prior approval system implemented by Proposition 103. Nonprofit Consumer Watchdog (CW) intervened in the proceeding, and challenged SFG’s proposed rates. The Commissioner relied on regulation section 2644.20, addressing projected yield, to use the combined annual statement of SFG’s parent company, State Farm Mutual Automobile Insurance Company (State Farm Mutual) and its property-casualty affiliates. The Commissioner ordered SFG to decrease its rate retroactively and issue refunds (Rate Order). SFG filed a petition for writ of mandate. The superior court determined Insurance Code section 1861.05(a) required the rate to mathematically reflect the applicant insurer’s income, and the Commissioner’s interpretation and application of regulation Insurance Code section 2644.20 to use the income of SFG’s affiliates conflicted with the statute. The court entered judgment for SFG, issued a peremptory writ of mandate requiring the Rate Order be set aside, and remanded remaining issues to the Commissioner, including the propriety of the retroactive rate and refund. The Commissioner and CW (Appellants) appealed the judgment and writ of mandate, contending the Commissioner properly interpreted the statute and regulation and had authority to set an earlier effective date and require refunds. SFG cross-appealed the order directing remand to the Commissioner, which it argued was unnecessary in light of the impropriety of the retroactive rate and refund as well as a subsequent rate change for SFG. The Court of Appeal concluded the superior court correctly determined section 1861.05(a) required use of the applicant insurer’s income, and the Commissioner erred in interpreting and applying Regulation 2644.20 here. Furthermore, the Court concluded the retroactive rate and refund were impermissible, and remand was not warranted under the circumstances. The superior court was directed to modify the writ of mandate to require the Rate Order be vacated in its entirety, and affirmed the judgment and writ of mandate in all other respects. View "State Farm General Insurance Company v. Lara" on Justia Law

State Farm General Insurance Company (SFG) appealed an order awarding attorney fees to intervenor Consumer Watchdog (CW), in a dispute over documents SFG designated as confidential in a rate hearing under Proposition 103. After the administrative law judge (ALJ) denied SFG’s motion to seal, SFG sought writ relief from the superior court, which CW and the Insurance Commissioner successfully opposed. CW then moved for fees under section 1861.10, which provided for reasonable advocacy fees to a consumer representative that makes a substantial contribution to the adoption of an order. The court awarded CW’s requested fees, and SFG appealed, contending the fee motion was untimely, and the fee award was inconsistent with the statutory requirements and an abuse of discretion. Rejecting these arguments, the Court of Appeal affirmed. View "State Farm General Insurance Company v. Lara" on Justia Law

The Fifth Circuit affirmed the district court's issuance of a declaratory judgment that an automobile driver's death was not covered by the terms of the defendant insurance company's policy. In this case, as the driver was driving his personal vehicle to a logging site owned by V & B, he collided with a sawmill's metal gate that had swung out across the road. The driver sustained multiple traumatic injuries and died at the scene. The court agreed with the district court's well-reasoned and thorough order on summary judgment concluding that the policy unambiguously excludes coverage for any injury arising from an automobile accident, regardless of the car's ownership. View "Colony Insurance Co. v. Wright" on Justia Law

The Supreme Court reversed the decision of the circuit court granting judgment as a matter of law in favor of Mutual Benefit Group and against Eric Parks in this action brought by Mutual Benefit as a result of an automobile accident, holding that the circuit court erred.Mutual Benefit brought this action to recover monies it paid in another action stemming from an automobile accident involving Parks. The magistrate court found in favor of Mutual Benefit. After a trial de novo, the circuit court granted judgment as a matter of law to Mutual Benefit on the grounds that Parks had failed to respond to requests for admissions that Mutual Benefit had served upon him in the magistrate court. The Supreme Court reversed and remanded the case for further proceedings, holding that the West Virginia Rules of Civil Procedure for Magistrate Courts provide the exclusive means of discovery in magistrate courts and do not provide for parties to serve requests for admission. View "Parks v. Mutual Benefit Group" on Justia Law

In 1993, the County and the Orange County Employee Retirement System (OCERS) entered into a Memorandum of Understanding (MOU), allowing the County to access surplus investment earnings controlled by OCERS and depositing a portion of the surplus into an account to pay for county retirees' health insurance. The county adopted the Retiree Medical Plan, funded by those investment earnings and mandatory employee deductions. The Plan explicitly provided that it did not create any vested rights. The labor unions then entered into MOUs, requiring the county to administer the Plan and that retirees receive a Medical Insurance Grant. In 1993-2007, retired employees received a monthly grant benefit to defray the cost of health insurance. In 2004, the county negotiated with its unions to restructure the underfunded program, reducing benefits for retirees.Plaintiffs filed suit. The Ninth Circuit affirmed summary judgment in favor of the county. The 1993 Plan explicitly provided that it did not create any vested right to benefits. The Plan was adopted by resolution and became law with respect to Grant Benefits, part of the MOUs. The MOUs expired on their own terms by a specific date. Absent express language providing that the Grant Benefits vested, the right to the benefits expired when the MOUs expired. The Plan was not unilaterally imposed on the unions and their employees without collective bargaining; the unions executed MOUs adopting the Plan. The court rejected an assertion that the Grant Benefit was deferred compensation and vested upon retirement, similar to pension benefits. View "Harris v. County of Orange" on Justia Law

The Supreme Court answered certified questions brought to it by the Ninth Circuit Court of Appeals as to whether, in Nevada, the insured or the insurer has the burden of proving that an exception to an exclusion of coverage provision applies.The Ninth Circuit asked whether, under Nevada law, the burden of proving the applicability of an exception to an exclusion of coverage in an insurance policy falls on the insurer or the insured and whether the party that bears that burden may rely on extrinsic evidence to carry its burden. The Supreme Court answered (1) the burden of proving the applicability of an exception to an exclusion for coverage in an insurance policy falls on the insured; and (2) the insured may rely on any extrinsic evidence that was available to the insurer at the time the insured tendered the defense to the insurer. View "Zurich American Insurance Co. v. Ironshore Specialty Insurance Co." on Justia Law

Petitioner AmGUARD Insurance Group (Carrier), insurer of Pelmac Industries, Inc. (Pelmac), appealed a New Hampshire Compensation Appeals Board (CAB) decision awarding workers’ compensation death benefits to the respondent, the decedent-employee’s estate. The Carrier argued that the decedent’s original June 5, 2018 injury was not a work-related injury, and, in the alternative, that his subsequent death by suicide did not result from the original injury. The Carrier also argued that the CAB violated its due process rights. Finding no reversible error, the New Hampshire Supreme Court affirmed. View "Appeal of Pelmac Industries, Inc." on Justia Law

After a fire at James and Suzanne Skinner's house, their insurer sought a judgment declaring that it did not owe either of them coverage. The circuit court entered summary judgment for Suzanne while the claim against James remained pending. A year later, with the claim against James still pending, the circuit court certified the judgment in Suzanne's favor as final and thus immediately appealable under Rule 54(b), Ala. R. Civ. P. Because the circuit court exceeded its discretion in doing so, the Alabama Supreme Court set aside the Rule 54(b) certification and dismissed this appeal. View "Alabama Insurance Underwriting Association v. Skinner" on Justia Law

The Supreme Judicial Court remanded these consolidated actions against two insurance companies to the superior court for further proceedings, holding that inherent diminished value (IDV) damages, if adequately proved, are recoverable under part 4 of the standard Massachusetts automobile insurance policy, 2008 edition.The three plaintiffs in these actions each owned an automobile that was involved in a collision with an automobile owned or operated by a party insured by either of the two insurance company defendants. Defendants compensated Plaintiffs' for the cost to repair their automobiles to their precollision condition but did not pay Plaintiffs for alleged IDV damages to the vehicles. The judge granted summary judgment in favor of Defendants. The Supreme Judicial Court vacated the judgment in part and affirmed in part, holding (1) the motion judge erred in allowing summary judgment with respect to Plaintiffs' claims of breach of contract; and (2) the motion judge properly granted summary judgment in favor of Defendants on Plaintiffs' unfair business practices claims. View "McGilloway v. Safety Insurance Co." on Justia Law