Justia Insurance Law Opinion Summaries

Defendant Factory Mutual Insurance Company (Factory Mutual) appealed a superior court order denying its motion for summary judgment and granting plaintiffs' Daniel Ro and Sebastian Lim motion. Plaintiffs sought a declaration they were implied co-insureds under a fire insurance policy issued by Factory Mutual to the Trustees of Dartmouth College. Plaintiffs were students in 2016 living in campus dormitories. Prior to being assigned a dormitory room, each plaintiff was required to sign a form acknowledging receipt and understanding of the college’s student handbook, which included prohibitions on: (1) possessing charcoal grills in student housing; (2) lighting and burning of any item with an open flame in residence halls; and (3) placing items on, and the use of, “the roof, portico, fire escape, or any other architectural feature not designed for recreational or functional use, except in cases of emergency.” Plaintiffs set up a charcoal grill on a platform outside a fourth floor window in Lim’s dormitory. The grill started a fire on the platform, which then spread to the roof. Firefighters used a substantial quantity of water to extinguish the fire, and all four floors of the dormitory sustained water damage. Factory Mutual, which insured the building, paid the Trustees $4,544,313.55 and then brought a subrogation claim against plaintiffs to recover that amount. The trial court concluded that Factory Mutual could not maintain its counterclaims against either plaintiff, specifically noting, “To the extent Mr. Lim’s possessory interest in Morton Hall is insurable, so is Mr. Ro’s. Mr. Ro’s possessory interest in Morton Hall is analogous to that of a tenant who rents one unit in a residential complex but causes fire damage to another unit in the complex.” In affirming the superior court, the New Hampshire Supreme Court concluded that, even if plaintiffs lacked a possessory interest in their dormitories, and even if their relationship with the college was not strictly that of landlord and tenant, they had a contractual relationship with the college in which they paid for the right, subject to the noted limitations, among others, to occupy a college dormitory for a certain period of time. "This contractual relationship gave rise to the reasonable expectation that Dartmouth College carried fire insurance on its dormitories, that the plaintiffs’ room and board fees contributed, in some way, to the premium for that insurance, and, therefore, that the insurance inured to their benefit." View "Ro v. Factory Mutual Insurance Company, as Subrogee of Trustees of Dartmouth College" on Justia Law

In 2002, Dr. Phillips performed a hysterectomy on Bramlett; she died from complications days later. Bramlett’s family sued Phillips, his clinic, and the hospital. Phillips and his clinic held a $200,000 MedPro professional liability insurance policy. The hospital settled for about $2.3 million. Under Texas law, an insurer who rejects a settlement demand (Stowers demand) within policy limits that a reasonably prudent insurer would accept will later be liable for any amount awarded in excess of the policy limit. MedPro refused two $200,000 Stowers demands. A jury returned a $14 million verdict. In 2009, the Supreme Court of Texas capped Phillips’s liability at $1.6 million. The Bramletts sued MedPro. The parties settled for a confidential amount.MedPro asked its insurer, AISLIC, to cover the settlement. AISLIC refused. The district court rejected MedPro's claims under an exclusion, finding that MedPro’s rejections of the two Stowers demands were Wrongful Acts that MedPro could have reasonably foreseen would lead to a claim.On remand, the district court held that MedPro could invoke coverage without having to prove that it actually committed a “Wrongful Act,” and found that a claim was not first asserted against MedPro for its failure to settle for policy limits before the 2006 AISLIC Policy incepted. A jury found that MedPro did not commit a “Wrongful Act.” The Seventh Circuit affirmed. The district court properly held that MedPro was covered by the 2006 Policy before the jury decided the issue of exclusion. The earlier interpretation of the policy did not require a holding that MedPro never committed a “Wrongful Act” necessary to invoke coverage. MedPro can invoke coverage because the claim that it settled was not brought before the policy period began. View "Medical Protective Company of Fort Wayne v. American International Specialty Lines Insurance Co" on Justia Law

The Court of Appeals held that a change in life insurance beneficiary constitutes a conveyance under the Maryland Uniform Fraudulent Conveyance Act (MUFCA), Md. Code Comm. Law 15-201(c), and that a guardian of property is not granted the authority to change a life insurance beneficiary on a policy of the ward under section 15-102(t) of the Estates and Trusts Article (ET).In a case arising from a decade-long dispute between the adult children of the Buckingham family and United Bank, the United States District Court for the District of Maryland certified two questions of law to the Court of Appeals regarding whether the children intentionally defrauded the Bank when they successfully diverted significant amounts of life insurance proceeds away from the declining family business and to their personal use. The Court of Appeals answered the questions as follows: (1) a change of the beneficiary designation of a life insurance policy constitutes a conveyance under MUFCA; and (2) the guardian of property does not have the authority to change the beneficiary on a life insurance policy of a ward under ET 15-102(t). View "United Bank v. Buckingham" on Justia Law

After judgment was entered against Farmers based solely on a special verdict, Farmers argued that the judgment must be vacated because the jury did not find, and no evidence established, that it acted unreasonably in failing to settle plaintiff’s claim against the insured.The Court of Appeal concluded that, in the context of a third party insurance claim, failing to accept a reasonable settlement offer does not constitute bad faith per se. Rather, bad faith liability requires a finding that the insurer acted unreasonably in some respect. The court explained that, to be liable for bad faith, an insurer must not only cause the insured's damages, it must act or fail to act without proper cause, for example by placing its own interests above those of its insured. In this case, the special verdict was facially insufficient to support a bad faith judgment because it included no finding that Farmers acted unreasonably in failing to accept plaintiff's settlement offer.The court also concluded that a special verdict based solely on an insufficient jury instruction cannot support a judgment. In this case, the jury was neither asked to nor did find that Farmers acted unreasonably or without proper cause in failing to accept plaintiff's settlement offer. Therefore, because a cause of action for bad faith requires a finding that the insurer acted unreasonably, the absence of such a finding precludes judgment for the plaintiff on that claim. Finally, the court concluded that the proper remedy is to vacate the judgment and enter a new judgment for Farmers. View "Pinto v. Farmers Insurance Exchange" on Justia Law

After a Texas condo association suffered property damage during Hurricane Harvey, it filed a property-damage claim against its insurer. When the insurer refused to pay, the association filed suit for breach of its insurance contracts.The Fifth Circuit affirmed the district court's grant of summary judgment in favor of the association, holding the insurer liable. Applying de novo review, the court held that the association established coverage and that the insurer failed to prove that an exclusion applies. In this case, the association met its burden to show that its boat slips are covered in the absence of an applicable exclusion. Furthermore, in the face of an affidavit tending to establish that the boat slips were not destroyed by a "flood," the insurer could not carry its legal burden to prove one of the "flood" exclusions by submitting nothing. The court explained that this is particularly true where the policy exclusions on their face do not apply to the loss of the association's boat slips. Finally, the insurer conceded in the district court that the association's boat slips are covered by the storage provision, and the insurer cannot rely on the governmental-body exclusion. View "Playa Vista Conroe v. Insurance Company of the West" on Justia Law

The Supreme Court reversed in part the order of the district court denying Petitioner's petition for judicial review of an order of the Nevada Division of Insurance, holding that remand was required with the instruction that the district court grant judicial review in part.Choice Home Warranty (CHW) marketed and sold Home Warranty Administrator of Nevada, Inc. (HWAN)'s home warranty service contracts, in which HWAN was the obligor. The Department of Business and Industry, Division of Insurance filed a complaint alleging that HWAN, dba CHW, made false entries by answering no to a question in certificate-of-registration renewal applications, conducted business in an unsuitable manner, and failed to make records available to the Division. A hearing officer found that HWAN committed all of the alleged violations. The district court denied HWAN's petition for judicial review. The Supreme Court reversed in part, holding (1) under Nev. Rev. Stat. 690C.150, a provider of home warranty services is not simply an entity that issues, sells, or offers for sale service contracts but the obligor in those contracts; (2) CHW was not an obligor so it was not a provider and need not have held a certificate of registration; and (3) HWAN did not act improperly by selling its contracts through an unregistered entity. View "Home Warranty Administrator of Nevada, Inc. v. State, Department of Business & Industry" on Justia Law

The First Circuit affirmed the order of the Title III court denying relief from an automatic stay under 11 U.S.C. 362(d), holding that the Puerto Rico Oversight, Management, and Economic Stability Act (PROMESA) Title III court in Puerto Rico did not abuse its discretion in denying relief from the stay.These companion cases from the Title III court involved bonds issued by the Puerto Rico Infrastructure and Financing Authority (PRIFA) and the Puerto Rico Highways and Transportation Authority (HTA). Appellants had insured millions of dollars of these bonds against default. When HTA and PRIFA defaulted on the bonds, causing Appellants to make payments to their insureds, Appellants brought this suit against Puerto Rico, HTA, and PRIFA. Thereafter, Puerto Rico petitioned to begin Title III proceedings under PROMESA, triggering an automatic stay of certain claims against them. Appellants sought relief from the automatic stay under section 362, as incorporated by PROMESA. The Title III denied relief. The First Circuit affirmed, holding that there was no cause to lift the stay as to any of Appellants' claims. View "Assured Guaranty Corp. v. Commonwealth of Puerto Rico" on Justia Law

An excess insurer under a directors’ and officers’ liability insurance policy sought a declaration from the superior court that coverage under the policy was not available to fund the settlement of two lawsuits: a breach of fiduciary duty action in the Court of Chancery, and a federal securities action in the United States District Court for the District of Delaware. In a series of decisions, the superior court rejected the insurer’s claims and entered judgment in favor of the insureds. Aggrieved, the insurer contended the superior court committed several errors: whether the insurance policy, which insured a Delaware corporation and its directors and officers but which was negotiated and issued in California, should have been interpreted under Delaware law; whether the policy, to the extent that it appeared to cover losses occasioned by one of the insureds’ fraud, was unenforceable as contrary to the public policy of Delaware; whether a policy provision that excluded coverage for fraudulent actions defeats coverage; and whether the superior court properly applied the policy’s allocation provision. Finding no reversible error, the Delaware Supreme Court affirmed the superior court. View "RSUI Indemnity Co. v. Murdock, et al." on Justia Law

Plaintiff filed suit against Quicken, on behalf of himself and others similarly situated, alleging causes of action for breach of fiduciary duty and violations of Civil Code section 2954.8 and Business and Professions Code section 17200, contending that section 2954.8 requires a lender to pay interest on insurance proceeds held in escrow following the partial or total destruction of the insured's residence or other structure. In this case, plaintiff's home was destroyed by Ventura's Thomas Fire and his hazard insurance policy jointly paid him and his mortgage lender, Quicken, a total of $1,342,740. The Deed of Trust allowed Quicken to hold the insurance proceeds in escrow and to disburse the funds as repairs to the home were being made.The Court of Appeal affirmed the trial court's decision sustaining Quicken's demurrer to the complaint without leave to amend, concluding that neither section 2954.8 nor the parties' loan agreement required the payment of interest. Based upon the statutory and contractual language, the court agreed with Lippitt v. Nationstar Mortgage, LLC (C.D.Cal. Apr. 16, 2020, No. SA CV 19-1115-DOC-DFM) 2020 U.S. Dist. Lexis 122881, that section 2954.8 "applies to common escrows maintained to pay taxes, assessments, and insurance premiums -- not to the comparatively unique example of hazard insurance proceeds held by a lender pending property rebuilding." Therefore, the court concluded that the insurance proceeds held by Quicken pursuant to section 5 of the Deed of Trust fall outside the scope of section 2954.8. Furthermore, plaintiff's secondary reliance on the purported purposes of section 2954.8 does not and cannot circumvent the statute's plain language. View "Gray v. Quicken Loans, Inc." on Justia Law

Petitioner Andrew Panaggio appealed a New Hampshire Compensation Appeals Board (Board) determination that respondent, CNA Insurance Company (the insurer), could not be ordered to reimburse him for his purchase of medical marijuana because such reimbursement would have constituted aiding and abetting his commission of a federal crime under the federal Controlled Substances Act (CSA). When Panaggio appealed the insurer’s denial to the New Hampshire Department of Labor, a hearing officer agreed with the insurer. Panaggio appealed the hearing officer’s decision to the Board, which unanimously found that his use of medical marijuana was reasonable and medically necessary. Nonetheless, the Board upheld the insurer’s refusal to reimburse Panaggio, concluding that “the carrier is not able to provide medical marijuana because such reimbursement is not legal under state or federal law.” The New Hampshire Supreme Court surmised the issue on appeal raised a question of federal preemption, "which is essentially a matter of statutory interpretation and construction." Although it was an issue of first impression for the New Hampshire Court, other courts considered whether the CSA preempted a state order requiring reimbursement of an employee’s purchase of medical marijuana. Panaggio reasoned that “[b]ecause New Hampshire law unambiguously requires the insurer to pay for the claimant’s medically related treatment,” an insurer that reimburses a claimant for the purchase of medical marijuana acts without the volition required by the federal aiding and abetting statute. The insurer asserted Panaggio’s argument leads to an absurd result, observing that “[c]onflict preemption applies because state law requires what federal law forbids.” The New Hampshire Supreme Court ultimately concluded the CSA did not make it illegal for an insurer to reimburse an employee for his or her purchase of medical marijuana. "[A] Board order to reimburse Panaggio does not interfere with the federal government’s ability to enforce the CSA. Regardless of whether the insurer is ordered to reimburse Panaggio for his medical marijuana purchase, the federal government is free to prosecute him for simple possession of marijuana under the CSA." Under these circumstances, the Court concluded the “high threshold” for preemption “is not met here.” The Board's decision was reversed and the matter remanded for further proceedings. View "Appeal of Andrew Panaggio" on Justia Law