Justia Insurance Law Opinion Summaries

The Supreme Court reversed the judgment of the court of appeals affirming the trial court's grant of summary judgment in favor of Insurer in this insurance dispute, holding that payment of an appraisal award does not absolve the insurer of statutory liability when an insurer accepts a claim but pays only the part of the amount it owed within the statutory deadline for payment.Homeowner reported a claim to Insurer for damage to his home. Insurer accepted Homeowner's claim and paid part of it before the statutory deadline. Dissatisfied with the amount, Homeowner sued, seeking full payment of the claim plus interest and attorney's fees under the Teas Prompt Payment of Claims Act, Tex. Ins. Code Chapter 542. While the suit was pending but after the statutory deadline had passed, Insurer invoked the policy's appraisal process, and the appraised awarded Homeowner more than Insurer paid. Insurer paid the difference then moved for summary judgment. The trial court granted summary judgment, and the court of appeals affirmed. The Supreme Court reversed, holding that because Insurer did not pay the amount that "must be paid" before the statutory deadline, it was not entitled to summary judgment. View "Hinojos v. State Farm Lloyds" on Justia Law

Defendant Foy Insurance Group, Inc. appealed a jury's verdict rendered in favor of the plaintiff, 101 Ocean Blvd., LLC (Ocean), finding that Foy was negligent for failing to advise Ocean to purchase sufficient insurance coverage to rebuild a hotel, damaged in a 2015 fire, in compliance with the current building code and awarding damages to Ocean. After review of the superior court record, the New Hampshire Supreme Court found no reversible error and affirmed the trial court's denial of Foy's motions for a directed verdict and judgment notwithstanding the verdict. View "101 Ocean Blvd., LLC v. Foy Insurance Group, Inc." on Justia Law

The Supreme Court reversed the trial court's grant of summary judgment in favor of Continental Western Insurance Company and dismissing G&G Oil Company of Indiana's claim for losses from a ransomware attack, holding that neither party demonstrated that it was entitled to summary judgment.G&G Oil purchased an insurance policy from Continental. One provision of the policy - the "Computer Fraud" provision - covered loss "resulting directly from the use of any computer to fraudulently cause a transfer of money." G&G Oil was the target of a ransomware attack and submitted a claim for coverage of its losses under the "Commercial Crime" provision of the policy. Continental denied the claim. G&G Oil then brought this complaint. The trial court granted summary judgment for Continental. The Supreme Court affirmed, holding that, although G&G Oil's losses "resulted directly from the use of a computer," neither party was entitled to summary judgment. View "G&G Oil Co. of Indiana v. Continental Western Insurance Co." on Justia Law

An electronic gaming device designed and supplied by Planet Bingo, LLC caused a fire in the United Kingdom. Several third parties made demands that Planet Bingo pay their damages resulting from the fire. However, Planet Bingo’s liability insurer, the Burlington Insurance Company (Burlington), denied coverage. Planet Bingo filed this action for breach of contract and bad faith against Burlington. In a previous appeal, the Court of Appeal held that Burlington’s policy did afford coverage, though only if one of the third-party claimants filed suit against Planet Bingo in the United States or Canada. Such a suit was then filed. Burlington accepted the defense and managed to settle the suit for its policy limits. In this action, the trial court granted summary judgment for Burlington, ruling that Burlington had provided all of the benefits due under the policy. Planet Bingo appealed, contending that Burlington conducted an inadequate investigation, and that Burlington wrongfully failed to settle the third-party claims, instead, denying coverage in the hope that the claimants would sue Planet Bingo in the United Kingdom, which would have let Burlington off the coverage hook. Planet Bingo claimed (and Burlington did not dispute) that it lost profits because the fire claims remained pending and unsettled. The Court of Appeal held Planet Bingo made out a prima facie case that Burlington was liable for failure to settle. Even though none of the claimants made a formal offer to settle within the policy limits, one subrogee sent a subrogation demand letter; according to Planet Bingo’s expert witness, in light of the standards of the insurance industry, this represented an opportunity to settle within the policy limits. The Court therefore did not address Planet Bingo’s claim that Burlington conducted an inadequate investigation. The Court also did not decide whether lost profits were recoverable as damages, because this issue was not raised below. View "Planet Bingo LLC v. The Burlington Ins. Co." on Justia Law

The Supreme Court reversed the judgment of the court of appeal reversing the judgment of the trial court granting a class injunctive relief, holding that Insurer was not entitled to immunity under the Insurance Code and that the Insurance Commission did not have exclusive jurisdiction.At issue was whether, if a title insurer charges rates without filing them with the Insurance Commissioner, a consumer can challenge the charges as unlawful in court. The trial court rejected Insurer's argument that it should be held immune from Plaintiff's putative class action under Cal. Ins. Code 12414.26, but the court of appeals reversed, concluding that the class claims were barred because Insurer was in fact immune and that the trial court lacked jurisdiction. The Supreme Court reversed, holding (1) the statutory immunity for "act[s] done...pursuant to the authority conferred" by the rate-filing statutes does not shield title insurers from suit for charging unauthorized rates; and (2) the Insurance Commissioner does not have exclusive jurisdiction over unfiled-rate claims. View "Villanueva v. Fidelity National Title Co." on Justia Law

The Supreme Court expanded the exception to the parental-immunity doctrine when the minor brings a direct-action suit against an insurance carrier for uninsured-motorist coverage to cover direct-action claims when underinsured benefits are at issue.A minor brought a direct-action suit against an insurance carrier for underinsured-motorist coverage. The insurer maintained that the minor could not recover under Arkansas's parental-immunity doctrine and denied the minor's claim against her mother's policy. The minor then filed a direct-action lawsuit against the insurer. The United States District Court for the Eastern District of Arkansas certified a question of law regarding the exception to the parental-immunity doctrine. The Supreme Court answered that the State of Arkansas recognizes an exception to the parental-immunity doctrine when the source of recovery is uninsured-motorist benefits under a motor-vehicle liability policy. View "Tomey v. Southern Farm Bureau Casualty Insurance Co." on Justia Law

The Supreme Court reversed the judgment of the district court granting summary judgment in favor of State Farm Mutual Automobile Insurance Company in this insurance dispute, holding that the coverage for damage to Plaintiffs' RV was mandated under the plain language of the insurance policy.After Plaintiffs purchased an RV, they purchased a recreational vehicle policy through State Farm. Later, the roof and wall of the RV were damaged. State Farm paid for the roof repair but denied coverage for the wall repair, finding it was not a "covered loss" under the terms of the policy. Plaintiffs then filed this complaint. The Supreme Court granted State Farm's motion for summary judgment and dismissed the issue. The Supreme Court reversed, holding that the coverage for the wall repair was a covered expense under the plain language of the policy. View "Kaul v. State Farm Mutual Automobile Insurance Co." on Justia Law

The Seventh Circuit affirmed the district court's judgment declaring that Zurich had no duty to defend Ocwen in the underlying litigation brought by a consumer. In the underlying case, the consumer's complaint relied on the Fair Debt Collection Practices Act (FDCPA) and the Telephone Consumer Protection Act (TCPA), as well as common law claims of defamation and invasion of privacy. Zurich insured Ocwen under a series of commercial general liability policies, but two provisions in the policies expressly excluded injuries resulting from conduct that violates certain laws.Setting aside the live-operator calls to the consumer's home and the manually dialed calls to her cell phone, and assuming that neither violated the TCPA, the court concluded that it remains true that if Ocwen caused "a telephone to ring … repeatedly or continuously with the intent to annoy, abuse, or harass any person at that called number," which the district court concluded Ocwen did, then it violated the FDCPA. Because the policy exclusion's catch-all clause swept in the FDCPA as an "other statute" that regulates the communication of information, Zurich had not duty to defend based on the factual allegations of the consumer's complaint. View "Zurich American Insurance Co. v. Ocwen Financial Corp." on Justia Law

In 2011, Appellants Eric Monzo and Dana Spring Monzo purchased a homeowners insurance policy issued by Appellee Nationwide Property & Casualty Co. (“Nationwide”). The policy contained standard exclusions for water damage and earth movement, along with optional water backup coverage. In July 2017, a heavy thunderstorm destroyed a pedestrian bridge and retaining wall located at the Monzos’ residence. A pair of engineering reports prepared after the storm indicated that a combination of water backups from drainage systems, scouring of supporting earth embankments, heavy rain, and tree debris caused the damage. The Monzos filed a claim with Nationwide, seeking coverage under the homeowners insurance policy. Nationwide denied coverage, and the Monzos sued. The court granted summary judgment for Nationwide, holding that the policy’s earth movement and water damage exclusions applied. The Monzos appealed, arguing the Superior Court erred by granting summary judgment too early in the discovery process, misinterpreting the policy, and denying a motion for post-judgment relief. Having reviewed the briefs and record on appeal, the Delaware Supreme Court: (1) affirmed the Superior Court’s holding that Nationwide was entitled to summary judgment regarding the collapsed bridge; (2) reversed the Superior Court’s holding that Nationwide was entitled to summary judgment regarding the retaining wall; and (3) affirmed the Superior Court’s denial of the Monzos’ post-judgment motion. View "Monzo v. Nationwide Property & Casualty Insurance Co." on Justia Law

The Supreme Court answered a certified question under Nev. R. App. P. 5 concerning an insurer's right to reimbursement, holding that when a party to a contract performs a challenged obligation under protest and a court subsequently determines that the contract did not require performance, the party may generally recover in restitution, thus giving effect to the terms of the parties' bargain.Insurer filed this declaratory judgment action seeking reimbursement of expenses it had occurred in defending Insured against a suit by a third party. The district court concluded that Insurer was not entitled to reimbursement. The Ninth Circuit Court of Appeals affirmed, concluding that the suit did not trigger a duty to defend. The Supreme Court accepted a certified question from the Ninth Circuit regarding the issue. The Supreme Court then held (1) no contract governed the right to reimbursement in this case; and (2) under the principle of unjust enrichment, a party that performs a disputed obligation under protest and does not in fact have a duty to perform is entitled to reimbursement. View "Nautilus Insurance Co. v. Access Medical, LLC" on Justia Law