Justia Insurance Law Opinion Summaries

In this dispute over an illegal stranger-originated life insurance (STOLI) policy, the district court found that the AIG Policy at issue lacked an insurable interest at its inception and was therefore void under Delaware Code Annotated Title 18, 2704(a), which, in relevant part, governs the purchase of a life insurance policy on the life of another person.The Eleventh Circuit affirmed the district court's decision allowing the Estate to recover the policy's proceeds under section 2704(b) and finding that the policy was void. However, the court reversed the district court's decision to strike Berkshire's counterclaims for fraudulent and negligent misrepresentations. The court deferred its decision on the remaining issues in this case pending certification of two questions to the Supreme Court of Delaware. The court stated that Berkshire may be entitled to the premiums it paid and the district court erred by striking its misrepresentation counterclaims. The court reserved judgment on the questions of whether the district court properly calculated prejudgment interest to which the Estate is entitled. View "Estate of Malkin v. Wells Fargo Bank, NA" on Justia Law

The United States Court of Appeals for the Tenth Circuit certified two questions of law to the Oklahoma Supreme Court. Plaintiff-appellant George Morgan was driving drunk and hit Jesse Atkins with his truck at more than 40 miles per hour. Atkins was severely injured, and his resulting medical bills totaled more than $2 million. Defendant-appellee State Farm Mutual Automobile Insurance Company provided liability insurance to Morgan at the time of the accident under a policy with a $100,000 limit. State Farm negotiated and executed a settlement with Atkins whereby State Farm paid its policy limit to Atkins and Atkins released his claims against Morgan. During the same timeframe, Atkins pursued a workers' compensation claim because he had been traveling for work when he was injured. The workers' compensation court issued a preliminary order for compensation, and the workers' compensation insurer began making payments to Atkins. The workers' compensation insurer's subrogee, New York Marine and General Insurance Company (NYM), sued Morgan in Oklahoma state court in June 2011 for reimbursement of the amounts paid to Atkins. Morgan retained personal counsel to represent him in the action. State Farm also provided counsel to Morgan and mounted a vigorous defense. A jury would later return a verdict in favor of NYM in the amount of $844,865.89, finding that State Farm knew about NYM's potential claim but failed to apprise NYM of its pending settlement with Atkins. The Oklahoma Court of Civil Appeals affirmed the judgment, and the Oklahoma Supreme Court denied certiorari. Morgan then filed suit against State Farm alleging State Farm's failure to secure NYM's release as part of its settlement with Atkins amounted to: (1) breach of the implied duty of good faith and fair dealing; and (2) breach of contract. The United States District Court for the Western District of Oklahoma found that Morgan's claims accrued in 2010, when State Farm negotiated the original settlement with Atkins and, therefore, concluded the applicable two and five year statutes of limitations for the tort and contract claims, respectively, barred Morgan's suit. Morgan appealed to the Tenth Circuit Court of Appeals. The Tenth Circuit asked: (1) where a plaintiff is injured by entry of an adverse judgment that remains unstayed, is the injury sufficiently certain to support accrual of a tort cause of action based on that injury under 12 O.S. 95 before all appeals of the adverse judgment are exhausted?; and (2) does an action for breach of an insurance contract accrue at the moment of breach where a plaintiff is not injured until a later date? The Oklahoma Court answered the first question with a "no:" the claim accrues when the appeal is finally determined in the underlying case. The Court answered the second question with a "yes:" an action for breach of contract accrues when the contract is breached, not when damages result; the limitations period may be tolled if the defendant fraudulently concealed the cause of action. View "Morgan v. State Farm mutual Automobile Insur. Co." on Justia Law

The Eighth Circuit reversed the district court's grant of summary judgment in favor of Continental and vacated the district court's declaration regarding the scope of Continental's duty to defend in nearly one hundred underlying lawsuits in which Daikin Applied is a defendant. Continental filed suit seeking a declaratory judgment that it has a duty to defend only those underlying asbestos-related suits expressly alleging in some manner that the named Subsequent Entity has been sued on account of McQuay-Perfex's liabilities, which is not true of any of the underlying lawsuits in dispute. Daikin Applied counterclaimed for a declaratory judgment to the effect that Continental owed it a duty to defend in all of the underlying lawsuits in dispute, arguing that the naming of a Subsequent Entity as a defendant was, by itself, sufficient to trigger Continental's duty to defend.The court concluded that the district court misapplied Minnesota law in its declaration regarding the scope of Continental's duty to defend by declaring that Continental's duty to defend arises only where an underlying suit alleges liability arising out of the predecessor's actions or where Daikin has been sued as successor to McQuay-Perfex. The court explained that by failing to declare the "arguably" standard applicable here, the district court erroneously heightened Daikin Applied's burden to trigger Continental's duty to defend. In this case, Daikin Applied need only show that the underlying complaints arguably allege McQuay-Perfex liabilities. The court also found that Daikin Applied's position requires too little to trigger Continental's duty to defend under Minnesota law. Because of its declaration, the court concluded that the district court did not analyze each underlying lawsuit to determine whether the complaint named a Subsequent Entity arguably on account of McQuay-Perfex's liabilities in light of the allegations therein or, if not, whether extrinsic facts proffered by Daikin Applied and known to Continental about that case clearly establish this. Accordingly, the court remanded for the district court to conduct this analysis in the first instance. View "The Continental Insurance Co. v. Daikin Applied Americas Inc." on Justia Law

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