Justia Insurance Law Opinion Summaries

The Supreme Court affirmed the decision of the court of appeals affirming the holding of the Workers' Compensation Board that the Administrative Law Judge properly found that Plaintiff's claim for workers' compensation benefits was barred by the applicable statute of limitations, holding that there was no error.Plaintiff received a workplace injury and filed a claim for benefits. Plaintiff never sought or received any temporary total disability benefits prior to the applicable statute of limitations expiring. The insurance adjuster for the employer's workers' compensation insurance carrier offered to settle Plaintiff's claim, but the parties never reached a settlement agreement. Plaintiff later filed an application for resolution of his claim, but the employer denied the claim on the grounds that it was time barred. The ALJ found that the claim was not timely under Ky. Rev. Stat. 342.185. The Board affirmed. The Supreme Court affirmed, holding that the ALJ properly determined that equitable principles did not warrant the tolling of the statute of limitations. View "Davis v. Blendex Co." on Justia Law

The Supreme Court affirmed the ruling of the court of appeals excluding from the definition of a "motor vehicle" or "trailer" a horse-drawn wagon for insurance coverage purposes, holding that the insurance policy was unambiguous and did not violate Plaintiff's reasonable expectations when she purchased her motorcycle coverage.While driving her motorcycle, Plaintiff encountered a horse-drawn buggy. The horse became spooked and jumped into oncoming traffic, gravely injuring Plaintiff when she collided with the horse. Plaintiff's motorcycle was insured by Progressive, and neither the driver of the buggy nor his father carried any form of insurance. Progressive denied Plaintiff's claim under the uninsured motorist provision of her motorcycle coverage on the grounds that a horse-drawn wagon was not covered under the policy. The circuit court granted Progressive's motion for summary judgment. The court of appeals affirmed, concluding that the horse-drawn wagon did not qualify as a "motor vehicle" or "trailer of any type" under the policy terms. The Supreme Court affirmed, holding that Plaintiff's assertions on appeal were unsupported. View "Davis v. Progressive Direct Insurance Co." on Justia Law

The Supreme Court reversed the opinion of the court of appeals reversing the decision of the circuit court granting summary judgment in favor of Defendant pursuant to Kentucky's Unfair Claims Settlement Practices Act (UCSPA) and dismissing Plaintiff's bad faith claim as barred by the statute of limitations, holding that the complaint was untimely.Plaintiff was injured in a motor vehicle accident and settled his dram shop liability claim against Pure Country, LLC, an establishment insured by United States Liability Insurance Company (USLI). Several years after settling, Plaintiff brought a bad faith claim against USLI under the UCSPA. The circuit court concluded that the action was untimely and granted summary judgment for Defendant. The court of appeals reversed. The Supreme Court reversed, holding (1) the trial court correctly determined that the bad faith claim against USLI was barred by the statute of limitations; and (2) the USCPA claim was not saved by relation back to an earlier filed or proposed pleading. View "United States Liability Insurance Co. v. Watson" on Justia Law

The Supreme Court affirmed the judgment of the court of appeals affirming the trial court's dismissal of this third-party bad-faith case against Arch Specialty Insurance Company and National Union Fire Insurance Company, holding that there was no error.At issue was whether the two insurance companies acted in bad faith while mediating negligence and wrongful death claims asserted by Plaintiff against the insureds of Arch and National Union after her husband died in a coal mining accident. The Supreme Court affirmed, holding that the trial court did not err in dismissing the third-party bad-faith claims and that there was no other error in the proceedings below. View "Mosley v. Arch Specialty Insurance Co." on Justia Law

A Town of Cottageville police officer shot and killed the former town Mayor Bert Reeves. A federal jury awarded Reeves' estate $97,500,000 in damages. The South Carolina Municipal Insurance and Risk Financing Fund, which insured the town, paid $10,000,000 to settle the federal lawsuit and two other lawsuits. The Settlement Agreement provided for two questions to be submitted to the state courts: (1) whether the amount of indemnity coverage available under the policy was more than $1,000,000; and (2) whether the South Carolina Tort Claims Act applied to a bad faith action against the Fund. The South Carolina Supreme Court answered the first question "yes"; it declined to answer the second. View "Reeves v. South Carolina Municipal Insurance" on Justia Law

In an appeal related to a California insurance insolvency proceeding, the New York Plaintiffs requested clarification from the San Francisco Superior Court as to whether its orders "prohibit or stay" their New York claims. In the insolvency case, the trial court appointed the California Insurance Commissioner (Commissioner) as conservator, and later as liquidator, of CastlePoint. The trial court, as part of the process, issued injunctions and approved releases pertaining to claims filed against or on behalf of CastlePoint or its assets.The Court of Appeal concluded that some of the causes of action in the New York lawsuit are not barred. These causes of action relate to: (i) the alleged breach of so-called "successor obligor provisions"; and (ii) an alleged $143 million payment from ACP to shareholders of TGIL. The court explained that these causes of action are not asserted against CastlePoint or the insurance companies that were merged into it, and there is no indication the Commissioner could have asserted these causes of action on behalf of the insolvent insurance companies. Therefore, the court reasoned that permitting them to proceed in New York will not interfere in any meaningful way with the plan for CastlePoint's liquidation, especially given the New York Plaintiffs' agreement not to assert any judgment against the insolvent insurance companies' estate or assets.However, prior to entering into releases, the Commissioner could have asserted fraudulent conveyance causes of action and a cause of action for unjust enrichment because they are based on alleged improper transfers of assets of the insolvent insurance companies. Accordingly, the court concluded that these causes of action are barred by the injunctions and releases in the liquidation proceeding. The court affirmed in part and reversed in part. View "Lara v. Castlepoint National Insurance Co." on Justia Law

In these appeals arising from adverse jury verdicts rendered in separate trials following an automobile accident involving Joseph Jenkins and Tessa Jordan, the Supreme Court affirmed in part and reversed in part, holding that the circuit court erred in part.The first trial resulted in the jury's calculation of damages sustained by Jenkins and his wife as a result of the accident, which the parties stipulated was caused through the fault of Jordan. The Jenkins also sued Safeco Insurance Company of America and liberty Mutual Insurance Company (collectively, Safeco) for conversion. After a second trial on the Jenkins' claims for compensatory and punitive damages Safeco appealed the jury's determination that the Jenkins were entitled to punitive damages. The Supreme Court (1) reversed the circuit court's order denying the Jordans' motion to set aside the verdict and for a new trial and remanded that case for a new trial, holding that the jury should have been instructed on Jenkins' duty to mitigate the loss of his vehicle; and (2) reversed the court's order denying Safeco's motion to reduce the punitive damages award, holding that remand was necessary to review the punitive damages award for excessiveness. View "Jordan v. Jenkins" on Justia Law

National Western Life Insurance Company (NWL) appealed a jury verdict holding the company liable for negligence and elder abuse arising from an NWL annuity sold to Barney Williams by Victor Pantaleoni, an independent agent. In 2016, Pantaleoni sold a $100,000 NWL annuity to Williams, who had contacted Pantaleoni to revise a living trust after the death of Williams’ wife. When Williams returned the annuity to NWL during a 30-day “free look” period, Pantaleoni wrote a letter over Williams’ signature for NWL to reissue a new annuity. In 2017, when Williams cancelled the second annuity, NWL charged a $14,949.91 surrender penalty. The jury awarded Williams damages against NWL, including punitive damages, totaling almost $3 million. NWL moved for judgment notwithstanding the verdict, which was denied. The Court of Appeal reversed: “Assuming NWL had monitored Pantaleoni as Williams suggested, there was no evidence showing that NWL knew or should have known of Pantaleoni’s fraud. … That Williams wrote the note cancelling the first annuity and Pantaleoni apparently wrote the letter requesting that it be reissued for Williams’ signature did not suggest to NWL that the letter was forged.” View "Williams v. National Western Life Insurance Co." on Justia Law

Wesley Zoo Yang brought an action against Everest National Insurance Company (Everest) and Motorist Mutual Insurance Company (Motorist), seeking to recover personal protection insurance (PIP) benefits under a no-fault insurance policy issued by Everest to Yang and his wife. Everest issued Yang a six-month no-fault insurance policy, the term of which ran from September 26, 2017, through March 26, 2018. On October 9, 2017, Everest mailed Yang a bill for the second monthly payment, stating that if Yang failed to pay the amount due by October 26, 2017, the policy would be canceled, effective October 27, 2017; the policy provided that the cancellation notice did not apply if Yang paid the premium on time. Yang did not pay the premium on time, and Everest sent Yang an offer to reinstate, explaining that the policy was canceled but that Yang could reinstate the policy with a lapse in coverage. On November 15, 2017, plaintiffs were struck by a car when they were walking across a street; Motorist insured the driver of the vehicle that struck plaintiffs. Two days later, on November 17, 2017, Yang sent the monthly premium payment to Everest; the policy was reinstated effective that day, and the notice informed Yang that there had been a lapse in coverage from October 27, 2017, through November 17, 2017. Plaintiffs sued when Everest refused plaintiffs’ request for PIP benefits under the policy. Everest moved for summary judgment, maintaining the policy had been canceled and was not in effect at the time of the accident, and that the policy’s cancellation provision was not inconsistent with MCL 500.3020(1)(b); Motorist disagreed with Everest’s motion and argued that it was entitled to summary disposition under MCR 2.116(I)(2) because it was not the insurer responsible for the payment of PIP benefits. The trial court denied Everest’s motion and granted summary judgment in favor of Motorist, reasoning that Everest’s notice of cancellation was not valid because it was sent before the nonpayment occurred and that Everest was therefore responsible for the payment of PIP benefits; the court thus dismissed Motorist from the action. Everest appealed. The Court of Appeal affirmed the trial court’s order, concluding that the cancellation notice was not valid under MCL 500.3020(1)(b) because Everest sent the notice before the premium was due and that the notice did not satisfy the terms of plaintiffs’ no-fault policy itself. Finding no reversible error, the Michigan Supreme Court affirmed the Court of Appeal. View "Yang v. Everest National Ins. Co." on Justia Law

The plaintiffs retired from the Louisville Metropolitan police department and received free health insurance, administered by Kentucky Retirement Systems. Kentucky initially paid all of their healthcare costs. After the officers turned 65, Medicare became the primary payer, leaving Kentucky to cover secondary expenses. Each officer came out of retirement, joining county agencies different from the ones they served before retiring. They became eligible for healthcare benefits in their new positions. Kentucky notified them that federal law “mandate[d]” that it “cannot offer coverage secondary to Medicare” for retirees “eligible to be on [their] employer’s group health plan” as “active employees.” Some of the officers then paid for insurance through their new employers; others kept their retirement insurance by quitting or going part-time. The officers sued.The district court granted summary judgment to the officers, ordered Kentucky to reinstate their retirement health insurance, and awarded the officers some of the monetary damages requested. The Sixth Circuit affirmed. The officers have a cognizable breach-of-contract claim. Under Kentucky law, the Kentucky Retirement Systems formed an “inviolable contract” with the officers to provide free retirement health insurance and to refrain from reducing their benefits, then breached that contract. The Medicare Secondary Payer Act of 1980 did not bar Kentucky from providing Medicare-eligible police officers with state retirement insurance after they reentered the workforce and became eligible again for employer-based insurance coverage, 42 U.S.C. 1395y. View "River City Fraternal Order of Police v. Kentucky Retirement Systems" on Justia Law