Justia Insurance Law Opinion Summaries

The Eighth Circuit affirmed the district court's determination that Westfield had a duty to defend its insurer, Miller Architects and Builders, because the claims against Miller in the underlying action did not "clearly" fall outside the scope of coverage. The court held that the alleged damages from the leaky roof were arguably within the policy's scope and there are no clearly applicable exclusions. View "Westfield Insurance Co. v. Miller Architects & Builders" on Justia Law

USAA Casualty Insurance Company (“USAA”) sought a declaratory judgment that it was not obligated to defend, indemnify, or provide insurance coverage for claims made in two lawsuits against Trinity Carr, the daughter of a USAA homeowner’s-insurance policyholder. The plaintiffs in the underlying lawsuits sought money damages from Carr and others for personal injuries and wrongful death suffered by Amy Joyner-Francis in a physical altercation - described in both complaints as a “brutal, senseless, forseeable [sic] and preventable attack” - between Joyner-Francis and Carr and her friends. USAA argued at trial, as it did before the Delaware Supreme Court, that the incident - whether it be labeled an altercation, an attack, or otherwise - was not an “accident” and therefore not a covered occurrence under the policy and that, even if it were, the purported liability was excluded from coverage. The Superior Court disagreed and entered summary judgment in favor of Carr. The Delaware Supreme Court agreed with USAA’s interpretation of the relevant policy provisions and therefore reversed the Superior Court’s judgment. "To label an intentional assault, as the parties agree occurred here, an accident is to disregard the ordinary, everyday meaning of 'accident.' We thus hold that whether an assault is an 'accident' is determined by the intent of the insured, and not by the viewpoint of the victim. ... even though Carr may not have intended to cause [the victim's] death, she certainly intended to cause injury to her." View "USAA Casualty Ins. Co. v. Carr" on Justia Law

Prime, a trucking company, covered its own liability without insurance for the first $3 million per occurrence and bought excess liability insurance from multiple insurers, following a common industry practice of stacking policies into sequential “layers” of excess insurance coverage. Two accidents occurred in 2015 when Prime was covered by RLI and AIG policies. The two cases settled for $36 million. Prime was covered $3 million for each occurrence. The RLI Policy provided the next layer of coverage with an “Aggregate Corridor Deductible” (ACD) that obligated Prime to pay out an additional $2.5 million annually before RLI began to pay. RLI argued that the ACD sat within RLI’s $2 million layer, leaving RLI with no responsibility for any payment until Prime had both paid $3 million per occurrence and the year’s ACD. AIG argued that the ACD sat below RLI’s $2 million layer, so AIG’s duty to pay would not be triggered until Prime and RLI had together paid $7.5 million for the first occurrence.The district court found that payments toward the ACD erode RLI’s policy layer. The Seventh Circuit affirmed. The custom-tailored ACD feature of the RLI Policy was ambiguous but undisputed extrinsic evidence shows that RLI is correct. RLI has consistently expressed that Prime’s ACD payments reduce its responsibility for losses; Prime did not disagree before this dispute. The only reasonable inference from the parties’ negotiations is that AIG did not believe the ACD affected the threshold at which its layer began—$5 million per occurrence. View "Lexington Insurance Co. v. RLI Insurance Co." on Justia Law

The First Circuit affirmed the judgment of the district court in favor of Sun Life Assurance Company of Canada finding that Sun Life properly permitted an offset of Appellant's benefits under tis employer-sponsored long-term disability insurance policy (the Plan) by the amount of Appellant's service-connection disability compensation (Veterans' Benefits), holding that the district court did not err.Specifically, the First Circuit held (1) Appellant's Veterans' Benefits fell squarely within the definition of "Compulsory Benefit Act or Law"; (2) that the district court did not err by concluding as a matter of law that Veterans' Benefits unambiguously qualify as a form of "Other Income Benefit" covered by the Plan's offset provision; and (3) the district court did not err by rejecting as a matter of law Appellant's assertion that Sun Life's offset determination was motivated, at least in part, by Appellant's military service in violation of the Uniformed Services Employment and Reemployment Rights Act. View "Martinez v. Sun Life Assurance Co. of Canada" on Justia Law

Kiselewski was driving with his two granddaughters in the backseat. Klamm's vehicle crossed the center line and struck Kiselewski’s vehicle. Kiselewski, one granddaughter, and Klamm were killed. Klamm was insured under a Meridian policy issued to his mother that provides coverage for four vehicles. The policy contains an “antistacking clause” with respect to bodily injury liability limits of $100,000 per person and $300,000 per accident. In a declaratory judgment action, the circuit court found that the policy, taken as a whole, was ambiguous and declared that Meridian had a duty under the policy to aggregate the bodily injury coverage limits for all four vehicles covered by the policy, resulting in coverage in the amount of $400,000 per person and $1.2 million per accident.The Illinois Supreme Court reversed. When the declarations are read together with the antistacking clause, there is no ambiguity. The policy provides bodily injury liability coverage of $100,000 per person and $300,000 per accident, regardless of the number of claims, insureds, covered vehicles, premiums, or vehicles involved in the accident. The policy does not list liability limits separately for each covered vehicle. It lists the limits once on the first page of the declarations, next to Autos 1, 2, and 3, and once on the second page, next to Auto 4. View "Hess v. Estate of TJay Klamm" on Justia Law

The Supreme Judicial Court affirmed the superior court judge's decision granting in part Plaintiff's motion for partial summary judgment against Insurer, holding that the standard fire insurance policy set by statute imposes several, rather than joint, rights and obligations on the insureds under the circumstances of this case and that Insurer's redrafting of the statutorily defined policy language was in violation of the statute.Plaintiff owned a home as a tenant in common with Kelly Pastrana, and the two were coinsureds on a homeowners' insurance policy. Pastrana intentionally set fire to the home. Despite Plaintiff's lack of involvement, Insurer denied Plaintiff's claim for coverage, relying on an intentional loss exclusion in the policy barring recovery when any coinsured intentionally causes a loss. The superior court concluded that the intentional loss exclusion in the policy violated the standard policy language mandated under Mass. Gen. Laws ch. 175, 99, Twelfth, and allowed Plaintiff to recover only one-half of the coverage limit. The Supreme Judicial Court affirmed, holding (1) the policy not comply with the statute; and (2) the policy proceeds in this case were severable, and Plaintiff was entitled to only one-half of the proceeds. View "Aquino v. United Property & Casualty Co." on Justia Law

The Supreme Court reinstated the district court's award granting Plaintiff substitution benefits after a court of appeals panel held that married persons cannot be a provider or recipient of substitution services to each other, holding that Plaintiff was entitled to substitution benefits for the amount he promised to pay his wife for what she did resulting from Plaintiff's automobile accident.Insurer insured Plaintiff when he was injured in an automobile accident. When Plaintiff returned from the rehabilitation hospital, he and his wife agreed she would provide caregiver services for $25 a day. Plaintiff sought payment for personal injury protection (PIP) substitution benefits available to him under his policy, but Insurer refused. Litigation ensued, and the district court granted judgment for Plaintiff. The court of appeals reversed, concluding that an injured person's spouse is excluded from providing substitution services. The Supreme Court reversed, holding (1) Kan. Stat. Ann. 40-3103(w) does not expressly preclude Plaintiff's wife from providing substitution services simply because of her marital relationship with Plaintiff; (2) Plaintiff incurred an obligation to pay his wife by entering into a contract with her to perform specific services for him that she would not otherwise have performed while Plaintiff convalesced; and (3) Plaintiff was entitled to PIP substitution benefits. View "Williams v. Geico General Insurance Co." on Justia Law

GAIC filed suit seeking a declaratory judgment that it was not required to defend or indemnify Eastern Concrete because of a pollution exclusion in its insurance policy. The Fifth Circuit affirmed the district court's denial of Eastern Concrete's motion to dismiss for lack of personal jurisdiction and grant of GAIC's motion for summary judgment.After determining that the district court properly exercised personal jurisdiction over Eastern Concrete, the court held that, under Texas law, an unplanned discharge of "rock fines," pellets produced during the course of quarry operations, is not covered by a company's umbrella insurance policy and is excluded by a pollution exclusion. In this case, rock fines are "contaminants" under the policy at issue and thus GAIC had no duty to defend or indemnify Eastern Concrete. View "Eastern Concrete Materials, Inc. v. ACE American Insurance Co." on Justia Law

While driving a car insured by Arizona Automobile Insurance Company, Marlena Whicker rear-ended a taxi and injured its passenger, Georgiana Chavez. Chavez sued Whicker in Colorado state court and won a default judgment when neither Whicker nor Arizona entered a defense. Whicker, unable to satisfy the judgment from the lawsuit, assigned her rights against Arizona to Chavez, who then filed this diversity suit against Arizona in federal court for failure to defend Whicker in the underlying state court action. Her theory was that Arizona had a duty to defend Whicker under Colorado law because Arizona knew that she was a driver covered under its policy. The district court disagreed with Chavez and granted Arizona’s motion to dismiss. The Tenth Circuit determined that under Colorado law, Arizona was only required to defend Whicker if Chavez’s complaint plausibly alleged Whicker was insured under the Arizona policy. It therefore reached the same conclusion as the district court and, affirmed its dismissal of Chavez’s case. View "Chavez v. Arizona Automobile Ins. Co." on Justia Law

GEICO Insurance Company appealed a trial court judgment entered in favor of plaintiffs Johnson Evans, Jimmy Smith, and Bernard Smith on plaintiffs' claims for damages resulting from an automobile accident caused by GEICO's insured, Bernard Grey. GEICO argued that the April 17, 2019, judgment entered against it was void because it did not receive notice of plaintiffs' claims against it or notice of the hearing on plaintiffs' claims. For their part, plaintiffs did not dispute that GEICO never received actual notice of any action pending against it in the present case. Instead, they argued GEICO had "constructive notice of potential litigation" because it had actual notice of Grey's accident involving plaintiffs -- which occurred in 2010 -- and that GEICO was aware that plaintiffs claimed to be injured by Grey's actions. The Alabama Supreme Court agreed with GEIDO that "constructive notice of potential litigation" clearly fell short of "even the most basic requirements of due process." Because it was undisputed GEICO never received notice of any claim pending against it, the April 17 judgment violated due process, and was therefore void. Because a void judgment would not support an appeal, the trial court was instructed to vacate its judgment, and GEICO's appeal was thus dismissed. View "GEICO Insurance Co. v. Evans" on Justia Law