Justia Insurance Law Opinion Summaries

The Association sought to recover for the damage caused by Hurricane Irma from its insurer, Rockhill. After Rockhill denied coverage and the parties went to trial before a jury, the Association received a little over $2.6 million—a fraction of the $16 million it initially asked for. Both parties appealed, Rockhill challenged the final judgment entered in favor of the Association, and the Association challenged the damages award.The Eleventh Circuit affirmed, concluding that it need not discuss the merits of Rockhill's summary judgment challenge because the court's precedent clearly bars review of an order denying summary judgment after a full trial and judgment on the merits. In regard to the three remaining issues on appeal, the court concluded that the district court did not abuse its discretion by striking Rockhill's expert; the district court did not abuse its discretion by denying Rockhill's Daubert motion; and Rockhill did not preserve its challenge to the denial of its motion for judgment as a matter of law.In regard to the Association's cross-appeal, the court concluded that the evidence is sufficient to support the jury's preexisting damage finding. The court also concluded that Rockhill's failure to comply with Florida Statute 627.701(2) does not render the hurricane deductible unenforceable. View "St. Louis Condominium Association, Inc. v. Rockhill Insurance Co." on Justia Law

Allstate Insurance Company et al. (Allstate) filed a complaint on behalf of itself and the People of California (qui tam) against Dr. Sonny Rubin and related medical providers (Rubin). Allstate generally alleged Rubin prepared fraudulent patient medical reports and billing statements in support of insurance claims. Rubin filed an anti-SLAPP motion, arguing the preparation and submission of its medical reports and bills were protected litigation activities. The trial court denied Rubin’s motion. "Litigation is not 'under [serious] consideration' - and thereby protected activity under the anti-SLAPP statute - if the ligation is merely a 'possibility.'" The Court of Appeal found that Rubin failed to show its medical reports and bills were prepared outside of its usual course of business in anticipation of litigation that was “under [serious] consideration.” Thus, the Court affirmed the trial court’s order denying Rubin’s anti-SLAPP motion. View "California ex rel. Allstate Ins. Co. v. Rubin" on Justia Law

The Supreme Court affirmed the order of the district court finding that an exclusion in a personal umbrella liability insurance policy expressly excluding coverage for damages that are "payable to any insured" was valid and precluded coverage, holding that the district court did not err.Plaintiff sought coverage for injuries he incurred as the passenger on a motorcycle that crashed. At the time of the crash, Plaintiff's wife was the named insured on a personal umbrella policy directly underwritten by Farmers Insurance Exchange. Farmers denied coverage under the umbrella policy under the exclusion at issue. Because Plaintiff was an insured under the umbrella policy, argued Farmers, he was not entitled to payment under the policy. The district court granted summary judgment for Farmers. The Supreme Court affirmed, holding (1) Nev. Rev. Stat. 687B.147 does not apply to umbrella policies; (2) an insured who alleges that an exclusion was not disclosed must make that allegation in an affidavit rather than rely solely on the arguments of counsel; and (3) there was no other error on the part of the district court. View "Sciarratta v. Foremost Insurance Co. Grand Rapids Michigan" on Justia Law

Oral Surgeons submitted a claim to Cincinnati for losses it suffered as a result of the suspension of non-emergency procedures due to the COVID-19 pandemic. Oral Surgeons maintains that the COVID-19 pandemic and the related government-imposed restrictions on performing non-emergency dental procedures constituted a "direct 'loss' to property" because Oral Surgeons was unable to fully use its offices.The Eighth Circuit affirmed the district court's grant of Cincinnati's motion to dismiss, concluding that the policy unambiguously requires direct physical loss or physical damage to trigger business interruption and extra expense coverage, which Oral Surgeons did not allege. Therefore, the policy clearly does not provide coverage for Oral Surgeons' partial loss of use of its offices, absent a showing of direct physical loss or physical damage. View "Oral Surgeons, P.C. v. The Cincinnati Insurance Co." on Justia Law

Plaintiffs filed a declaratory judgment action against Auto-Owners after their family members were killed in an auto accident, alleging that they were entitled to more under Auto-Owners' Policy. After both sides filed motions for summary judgment, the district district court granted in part and denied in part each motion and disposed of all claims.The Eighth Circuit agreed with Auto-Owners that the district court erroneously interpreted the policy to provide $3 million in total coverage. The court explained that there is no reasonable interpretation of the policy that avoids surplusage. In this case, because sections 4.a and 4.b of the policy specify at "most" how much an insured may recover, those sections are properly read as limitations to coverage, not promises to provide a certain amount of coverage. Because there is only one reasonable interpretation of the policy and because 4.a and 4.b do not conflict with each other, the policy is not ambiguous. Accordingly, the court reversed, vacated, and remanded. View "Brazil v. Auto-Owners Insurance Co." on Justia Law

National filed suit against Universal and its parent company, Ally, for breach of contract and other claims after Universal terminated National's non-exclusive right to represent Universal's vehicle warranty program. The district court granted summary judgment in favor of Universal and dismissed National's claims.The Eighth Circuit affirmed, concluding that the termination provision and the representative-fee provision in the 2003 Universal Rep. Agreement unambiguously ended National's entitlement to post-termination representative fees. The court also rejected National's attempt to prove its entitlement to ongoing post-termination representative fees under the 2003 Universal Rep. Agreement via extrinsic evidence—Universal's continued payment of post-termination representative fees under the 2003 VehicleOne Rep. Agreement. The court further concluded that National's fraudulent concealment and negligent misrepresentation claims fail where the terms of the contracts created non-exclusive, limited grants of authority to National, as an independent contractor, that could be terminated at will by either party with sixty days' notice. Therefore, to the extent the alleged statements contradicted these terms, National could not reasonably rely on them under Nebraska law. Finally, National's claims for unjust enrichment and breach of duty of good faith and fair dealing failed because they both depend on its assertion that the district court misinterpreted the effect of termination of the 2003 Universal Rep. Agreement. View "B. Thomas and Co. v. Universal Warranty Corp." on Justia Law

This dispute over uninsured motorist ("UM") coverage arose from a motor vehicle accident on Louisiana Highway 6 near Natchitoches. Martin Baack, an employee of Pilgrim’s Pride Corporation, was driving his work vehicle when he was struck by a vehicle driven by Michael McIntosh. The vehicle Baack was driving belonged to PPC Transportation Company. Both Pilgrim’s Pride and PPC Transportation were subsidiaries of JBS USA Holdings, Inc. (“JBS”). McIntosh was determined to be solely at fault for the accident and pled guilty to improper lane usage. Baack and his wife filed suit individually and on behalf of their minor daughter naming as defendants McIntosh, his insurer, and Zurich American Insurance Company (“Zurich”) in its capacity as the UM provider for PPC Transportation’s vehicle. In JBS’s policy with Zurich, PPC Transportation was listed as a Broad Named Insured. The Baacks sought damages under Zurich’s UM coverage as well as penalties and attorney fees based on Zurich’s failure to timely settle the claim. The Louisiana Supreme Court granted consolidated writs to determine whether an insured’s initial UM coverage waiver remains valid where, upon consecutive renewals, the insured submitted new signed and dated UM forms without initialing the blanks provided to reject UM coverage. Based on the Court's interpretation of the UM statute, it found such a subsequently submitted form changes the prior rejection and operated to provide UM coverage. Additionally, finding no error in the quantum of damages and denial of penalties and attorney fees by the court of appeal, the Court affirmed. View "Baack v. McIntosh et al." on Justia Law

Because the Louisiana Supreme Court found in its original opinion that plaintiffs had a right of action under La. C.C. arts. 2315.1 and 2315.2, their constitutional challenge was pretermitted and “that part of the district court judgment declaring [these code articles and La. C.C. art. 199 to be] unconstitutional as applied to children given in adoption” was vacated. Having found on rehearing that the codal analysis of La. C.C. arts. 2315.1, 2315.2 and 199 foreclosed a right of action to the plaintiff children, who were given in adoption, for the death of their biological parent and half-siblings, the Supreme Court was called on to address the propriety of the district court’s declaration that La. C.C. arts. 2315.1, 2315.2, and 199 are “unconstitutional as applied to children given in adoption.” The Court found a rational basis existed for limiting the categories of eligible claimants in La. C.C. arts. 2315.1 and 2315.2 to those who “are likely to be most affected by the death of the deceased.” Children given in adoption “have moved into a new parental relationship, becoming children ‘by adoption,’ who are eligible claimants in the unfortunate occurrence of the tortious death of their adoptive parents. Likewise, the transfer of children into a new parental unit as children ‘by adoption’ terminates, for purposes of wrongful death and survival actions, any connection between the ‘children given in adoption’ and any biological siblings who were not ‘given in adoption.’” For these reasons, the district court legally erred in finding that the fact that Daniel Goins and David Watts were adopted did not prevent them from bringing survival and wrongful death claims for the deaths of their biological father and biological half-siblings and in overruling the defendant’s exception raising the objection of no right of action. The Supreme Court's original decree was vacated and the district court's judgment was reversed. Judgment was entered sustaining the defendant insurance company's peremptory exception raising the objection of no right of action, and dismissing the claims that were the subject of this exception. View "Rismiller et al. v. Gemini Ins. Co." on Justia Law

After plaintiff filed suit under the Employee Retirement Income Security Act (ERISA) to recover long-term disability benefits from MetLife, the district court severed the coverage issue from the remaining issues. At issue in regards to coverage was whether Standard, the carrier for calendar year 2016, or MetLife, the carrier for 2017, provided coverage. The district court concluded that Standard, which had been previously dismissed, covered this claim.The Fifth Circuit reversed, concluding that the court's reading of the Standard and MetLife policies lead it to conclude that Standard provided no coverage and coverage was afforded to plaintiff under MetLife's policy. The court explained that the Standard and MetLife policies outline how to transition coverage between old and new policies, as well as provide special rules for employees who temporarily recover during a transition. In this case, the plain language of the policies make it clear that plaintiff's benefits coverage for his alleged long-term disability shifted from Standard to MetLife. Accordingly, the court remanded for further proceedings. View "Talamantes v. Metropolitan Life Insurance Co." on Justia Law

The United States Court of Appeals for the Tenth Circuit certified a question of law to the Oklahoma Supreme Court on whether Progressive Northern Insurance Company's Underinsured Motorist (UM) Exclusion--which operated to deny uninsured motorist coverage to insureds who recover at least the statutorily mandated minimum in the form of liability coverage--contravened Oklahoma's Uninsured Motorist Statute, codified at 36 O.S. section 3636. The Supreme Court responded "yes:" Because of the sweeping nature of the UM Exclusion contained in the insurance policy at issue, Progressive found a way to entirely avoid providing the promised coverage. "[A]n insurer in Oklahoma cannot deprive its policyholder of uninsured-motorist coverage for which a premium has been paid through an exclusion that effectively erases its policyholder's choice to purchase that coverage in the first place. We conclude that Progressive's UM Exclusion contravenes section 3636 and is therefore void as against public policy." View "Lane v. Progressive Northern Ins. Co." on Justia Law