Justia Insurance Law Opinion Summaries

The Supreme Court affirmed the determination of the court of appeals that the Uniform Declaratory Judgments Act (UDJA), Tex. Civ. Prac. & Rem. Code 37.001-.011, can be used to establish an insurance carrier's liability for benefits under an underinsured motorist (UIM) policy, holding that a declaratory judgment action can be used for this purpose.On appeal, the Insurer argued that Insured's use of the UDJA to determine Insured's contract rights and to seek attorney's fees in the UIM case impermissibly dodged the Supreme Court's decision in Brainard v. Trinity Universal Insurance Co., 216 S.W.3d 809 (Tex. 2006). The court of appeals affirmed. The Supreme Court affirmed as well, holding (1) a declaratory judgment in the instant case was the proper remedy for resolving this contractual dispute; and (2) attorney's fees may be recovered under the UDJA under the circumstances. View "Allstate Insurance Co. v. Irwin" on Justia Law

The Supreme Court reversed the judgment of the trial court granting the state's motion to dismiss this tort action, holding that a state's waiver of sovereign immunity in Conn. Gen. Stat. 52-556 for claims arising from a state employee's negligent operation of a state-owned and -insured motor vehicle extends to litigants who are state employees.Plaintiff, a state employee, was a passenger in a motor vehicle owned and insured by the state and operated by another state employee, William Texidor, when another vehicle operated by Tyreke Brooks struck their vehicle. Brooks' vehicle was uninsured. Plaintiff, who applied for and received workers' compensation benefits, brought this action agains the state and Metropolitan Casualty Insurance Company alleging that Texidor's operation of the vehicle was negligent. The state filed a motion to dismiss for lack of subject matter jurisdiction on the ground of sovereign immunity. The trial court granted the motion to dismiss. The Supreme Court reversed, holding (1) the trial court had jurisdiction pursuant to the waiver of sovereign immunity in section 52-556; (2) Plaintiff's action against the state was barred by Conn. Gen. Stat. 31-284(a); and (3) therefore, the form of judgment was improper, and the case is remanded with direction to render judgment for the state. View "Feliciano v. State" on Justia Law

Sekura purchased a membership from Krishna that gave her access to L.A. Tan’s salons. Her membership required Sekura to provide Krishna with her fingerprints. Sekura filed a class-action lawsuit against Krishna, alleging that Krishna violated the Biometric Information Privacy Act: because it “systematically and automatically collected, used, stored, and disclosed their [customers’] biometric identifiers or biometric information without first obtaining the written release required by 740 ILCS 14/15(b)(3) … systematically disclosed ... biometric identifiers and biometric information to SunLync, an out-of-state … vendor and … does not provide a publicly available retention schedule or guidelines for permanently destroying its customers’ biometric identifiers and biometric information as specified by the [Act].” The complaint also alleged negligence and unjust enrichment. Krishna tendered Sekura’s lawsuit to West Bend, its insurer.West Bend sought a declaratory judgment that it did not owe a duty to defend Krishna against Sekura’s lawsuit. The trial court entered a judgment for Krishna. The appellate court and Illinois Supreme Court affirmed after construing the policy terms “personal injury or advertising injury,” “publication” of material, and violation of Sekura’s “right of privacy” to conclude that the allegations in Sekura’s complaint fall within or potentially within West Bend’s policies’ coverage for personal injury or advertising injury. A “violation of statutes” exclusion in the policies does not apply to the Act. View "West Bend Mutual Insurance Co. v. Krishna Schaumburg Tan, Inc." on Justia Law

Foremost provided insurance for McIsaac's motorcycle. The uninsured motorist coverage endorsement included an arbitration provision. McIsaac was involved in an accident. The other driver’s insurance policy provided $15,000 of coverage. McIsaac’s policy provided uninsured/underinsured motorist coverage of up to $100,000 per person per accident. McIsaac initiated an uninsured motorist claim. Foremost opened an investigation and sent a settlement offer. McIsaac served Foremost with an arbitration demand. Foremost suggested proceeding with discovery and sent McIsaac interrogatories and a deposition notice.Months later, McIsaac filed suit, alleging breach of contract, unjust enrichment, breach of the covenant of good faith and fair dealing, and bad faith. Foremost filed a petition to compel arbitration. McIsaac argued his dispute was not solely about damages, but whether Foremost breached the contract and acted in bad faith. Foremost argued arbitration was a “condition precedent” to McIsaac’s lawsuit. The trial court denied the petition, stating that arbitration does not apply to claims of bad faith by the insurer.The court of appeal reversed. Under Insurance Code section 11580.2(f), disputes between insureds and insurers over entitlement to recover damages caused by an uninsured or underinsured motorist, or the amount of damages, must be resolved by agreement or arbitration. Foremost made a showing that the parties dispute the amount of damages. View "McIsaac v. Foremost Insurance Co." on Justia Law

When a Colorado court ordered Colorado Health Insurance Cooperative into liquidation, the government owed Colorado Health $24,489,799 for reinsurance debts under the Patient Protection and Affordable Care Act (ACA), 42 U.S.C. 18061. The reinsurance program, which only lasted three years, collected yearly payments from all insurers and made payments to insurers of particularly costly individuals that year. Colorado Health owed the Department of Health and Human Services $42,000,000 for debts under ACA’s risk adjustment program, which charges insurers of individuals who had below-average actuarial risk and pays insurers of individuals who had above-average actuarial risk. The government attempted to leapfrog other insolvency creditors through offset, rather than paying its debt and making a claim against Colorado Health’s estate as an insolvency creditor.The Federal Circuit affirmed the Claims Court in ordering the government to pay. Neither state nor federal law affords the government a right to offset. Colorado law concerning the liquidation of insurance companies is limited to offsetting debts and credits in contractual obligations. ACA does not preempt Colorado insolvency law; a “Netting Regulation” is directed to an ancillary issue, payment convenience. The government has not shown a “significant conflict between an identifiable federal policy or interest and the operation of state law.” View "Conway v. United States" on Justia Law

The Supreme Court answered in the affirmative a question certified to it by the United States Court of Appeals asking whether an insurance policy is "issued for delivery" or "delivered" under Wyo. Stat. Ann. 26-15-101(a)(ii) even if not copy was conveyed to Wyoming and the police listed only an out-of-state address for the insured.Specifically, the Supreme Court held (1) for purposes of Wyo. Stat. Ann. 26-15-101(a)(ii), an insurance contract is "delivered" in Wyoming if it is actually or constructively delivered in Wyoming, and an insurance contract is "issued for delivery" where the policy was intended to be delivered; and (2) absent an insurance contract unambiguously stating otherwise, if the location of the insured and the location of the risk to be insured are both in Wyoming, an insurance policy is intended to be delivered and is issued for delivery in Wyoming. View "Sinclair Wyoming Refining Co. v. Infrassure, Ltd" on Justia Law

The Supreme Court reversed the district court's judgment denying Insurer's motion for directed verdict on this action concerning Insurer's alleged delay in paying a claim, holding that the district court erred in denying the motion for directed verdict on Insured's breach of contract and bad faith causes of action.A fire broke out in Insured's kitchen that resulted in a total loss of the building and its contents. Insured invoked its right to the appraisal process. The appraisers signed an appraisal letter establishing the loss amount at $502,000. Insurer paid the amount in full. Eight months later, Insured sued Insurer for breach of contract and bad faith based on Insured's failure to pay the $550,000 building coverage limit and for its actions during the appraisal hearing. The jury returned a verdict in favor of Insured and awarded $48,000 in damages. The Supreme Court reversed, holding (1) Insured's invocation of the appraisal process and Insurer's timely payment of the appraisal award required dismissal of the claims as a matter of law; and (2) Insured failed to prove bad faith for any actions taken after the appraisal hearing. View "Luigi's Inc. v. United Fire & Casualty Co." on Justia Law

After a car accident, Wilkerson filed a claim with her insurer, American Family. Her policy will pay for “loss of or damage to your insured car and its equipment, less the deductible[.]” A“Limits of Liability” section adds that American Family will pay no more than the lesser of “the actual cash value of the stolen or damaged property” or “the amount necessary to repair or replace the property.” American Family concluded that the cost to “repair or replace” her Impala exceeded its pre-accident “actual cash value,” and contracted with AudaExplore to calculate that value. AudaExplore estimated the Impala’s market value based on its location, mileage, condition, and the recent advertised prices of 2010 Impalas in the area ($8,218-$10,033). AudaExplore valued Wilkerson’s car at $9,979. American Family subtracted Wilkerson’s deductible and paid her $9,479.Wilkerson brought suit under the Class Action Fairness Act, 28 U.S.C. 1332(d), arguing that “actual cash value” includes sales taxes and fees that a party typically must incur when buying a replacement car (whether or not a party actually incurs those expenses in a given case). She sought $673.58 for the taxes and $19.50 for fees Ohio charges to transfer a car’s title and registration. The Sixth Circuit affirmed the dismissal of her complaint. American Family’s policy indicates that “actual cash value” is best read to refer to market value, not replacement costs less depreciation. View "Wilkerson v. American Family Insurance Co." on Justia Law

Plaintiff filed suit against two defendants: a property owner and her alleged liability insurer. The insurer was served with the petition, but plaintiff withheld service on the property owner. The insurer filed an answer on its own behalf within three years of suit being filed, but no action was taken in the suit by any party relative to the property owner within that three years. The Louisiana Supreme Court granted this writ application to determine whether plaintiff’s action against the property owner was abandoned pursuant to La. C.C.P. art. 561(A)(1). The court of appeal found the filing of an answer by the insurer within the three-year abandonment period was effective to interrupt the abandonment period as to the property owner. The Supreme Court held the filing of the insurer’s answer did not serve to interrupt the abandonment period as to the property owner; therefore the appellate court was reversed because plaintiff’s original action against the property owner was abandoned by operation of law. However, the Court found plaintiff’s underlying claims against the property owner, that were subsequently reasserted by amended petition, were not necessarily prescribed due to the potential interruption of prescription resulting from the pending suit against an alleged solidary obligor. Because a determination regarding prescription could not be made based on the existing record, the court of appeal’s ruling on the property owner’s exception of prescription was affirmed, and the matter remanded to the district court for an evidentiary hearing on that exception. View "Williams v. Foremost Ins. Co. et al." on Justia Law

Kristina Knight agreed to an endorsement to her Nationwide automobile insurance policy providing the coverage in the policy would not apply to her husband. During the policy period, Danny Knight was tragically killed in a motorcycle accident. Knight, as personal representative of Danny's estate, recovered $25,000 in UIM coverage under Danny's motorcycle insurance policy with Progressive Casualty Insurance Company and $25,000 in UIM coverage under a policy with ACCC Insurance Company insuring a different vehicle Danny owned. Knight made a claim with Nationwide to recover an additional $25,000 in UIM coverage under her insurance policy. Nationwide denied the claim and filed this lawsuit asking the trial court to declare Nationwide did not have to pay the $25,000 because Danny was excluded from all coverages under the policy. On appeal, Knight claimed the endorsement excluding coverage for her husband violated public policy and Nationwide could not enforce it. The South Carolina Supreme Court found the exclusion was clear and unambiguous and was not in violation of any statute. Therefore, the Court held the exclusion was enforceable. View "Nationwide Insurance Company of America v. Knight" on Justia Law