Justia Insurance Law Opinion Summaries

A 2014 hail and wind storm damaged Windridge buildings that were insured by Philadelphia Indemnity. The storm physically damaged the aluminum siding on the buildings’ south and west sides. Philadelphia argued that it is required to replace the siding only on those sides. Windridge argued that replacement siding that matches the undamaged north and east elevations is no longer available, so Philadelphia must replace the siding on all four sides so that all of the siding matches. The Seventh Circuit affirmed summary judgment in favor of Windridge. Each building suffered a direct physical loss, which was caused by or resulted from the storm, so Philadelphia must pay to return the buildings to their pre‐storm status—i.e., with matching siding on all sides. Having mismatched siding on its buildings would not be the same position. The district court’s conclusion that the buildings as a whole were damaged—and that all of the siding must be replaced to ensure matching—is a sensible construction of the policy language as applied to these facts. View "Windridge of Naperville Condominium Association v. Philadelphia Indemnity Insurance Co." on Justia Law

Wadette Cothran incurred approximately $40,000 in medical expenses from injuries she received in an automobile accident. Her employer's workers' compensation carrier paid all of her medical expenses. She was also covered by her automobile insurance policy issued to her and her husband Chris by State Farm Mutual Automobile Insurance Company. The State Farm policy provided PIP coverage with a limit of $5,000. However, State Farm refused to pay her any PIP benefits for medical expenses based on a "Workers' Compensation Coordination" provision in the policy. This appeal requires presented for the South Carolina Supreme Court's consideration whether Section 38-77-144 of the South Carolina Code (2015) prohibited an automobile insurance carrier from reducing its obligation to pay PIP benefits to its insured by the amount of workers' compensation benefits the insured received for medical expenses. The Court held that it did: "[w]hen an insurer seeks to reduce its obligation to pay benefits based on a third party's previous payment for the same claim, it is a setoff. Because that is the precise effect of State Farm's "Coordination" provision, section 38-77-144 prohibits the provision from reducing State Farm's obligation to pay PIP benefits to the Cothrans." the Court reversed the court of appeals and reinstated the summary judgment in the Cothrans' favor. View "Cothran v. State Farm" on Justia Law

The Eighth Circuit affirmed the district court's grant of summary judgment for the insurance company in an action brought by McCrossan, alleging breach of the crime insurance policy after the company denied coverage under the "Forgery" and "Employee Theft" insuring clauses. The court held that the district court properly granted summary judgment to the Company on McCrossan's claims for Stewart's loss, because Stewart did not meet the policy's definition of "subsidiary," and was not an insured. The court also held that the district court properly granted the Company summary judgment on McCrossan's claims for Blakely's loss, because the acts of Blakely's employee, as an unauthorized representative of Blakely, were not covered by the plain and ordinary meaning of the insurance policy. View "C.S. McCrossan Inc. v. Federal Insurance Co." on Justia Law

The Ninth Circuit certified the following question of state law to the Supreme Court of Hawai'i: Under Hawai'i law, is a permissive user of an insured vehicle, whose connection to the insured vehicle is permission to use the vehicle to run errands and drive to work, entitled to uninsured motorist (UM) benefits under the chain-of-events test because he was injured by an uninsured motorist? View "State Farm Mutual Automobile Insurance, Co. v. Mizuno" on Justia Law

The Fifth Circuit affirmed the district court's judgment in an action where the insurance company denied the policyholder's claims under a directors and officers liability policy. The district court held that the insured had learned of a related claim when the previous year's policy was in effect. Therefore, under clear policy provisions, the first policy was the one to cover all of the claims.The court affirmed and held that the 2015 claims arising from lawsuits that were related to the others brought in 2014 were governed by the earlier policy. Therefore, the absence of timely notice meant the claims were properly denied. For the same reasons, the court held that there was no relief to Worldlink under the Texas Prompt Payment Claim. View "ADI Worldlink, LLC v. RSUI Indemnity Co." on Justia Law

The Eighth Circuit affirmed the district court's order granting judgment for GEICO in an action seeking a declaratory judgment that the stacking provisions of other liability coverage in the insurance policy were not applicable to the claims at issue. The court held that the district court did not err in ruling on the declaratory judgment action, because the insurance policy unambiguously did not allow stacking under Missouri law. The court also held that the district court did not abuse its discretion in refusing further discovery, because Missouri law does not permit courts to consider extrinsic evidence in interpreting an unambiguous contract. View "GEICO Casualty Co. v. Isaacson" on Justia Law

Applying North Carolina law, the Fourth Circuit reversed the district court's judgment in favor of Penn National, holding that the district court erred by applying the prior publication exclusions to eliminate Penn National's duty to defend Beach Mart in the underlying lawsuit. In this case, a prior publication exclusion, like the one here, will not bar coverage for offensive publications made during the policy period which differ in substance from those published before commencement of coverage. Furthermore, because the prior publication exclusions could not eliminate Beach Mart's duty to defend, the district court erred in dismissing Beach Mart's counterclaims. Accordingly, the court remanded with instructions. View "Pennsylvania National Mutual Casualty Insurance Co. v. Beach Mart, Inc." on Justia Law

Allstate filed suit seeking a declaratory judgment that the insureds violated the intentional acts exclusion of their insurance policy and that Allstate was entitled to recover its payment to the mortagees. Allstate concluded that the insureds' property was set on fire by or at the direction of one of the insureds. The district court denied the insureds' motion for summary judgment, and Allstate prevailed at trial.The Eighth Circuit affirmed, holding that the district court did not make a clear and prejudicial error affecting the outcome of the proceeding by admitting the expert opinions; the district court did not err in denying the insureds' motion for judgment as a matter of law, because the combination of Allstates' expert testimony regarding the possible causes of the fire, the rapid nature of the blaze, evidence of the insureds' financial incentives, and potential negative credibility determinations by the jury against the insureds suffices to meet the burden of submissibility; the denial of the insureds' motion for a new trial was not a miscarriage of justice in light of the evidence; the district court was entitled to order restitution of the amount paid the mortgagees as a means of effectuating the verdict in favor of Allstate in a declaratory judgment action; and judgment was properly entered against the co-insured, even where the verdict director focused on the other insured. View "Allstate Indemnity Co. v. Dixon" on Justia Law

Bad Habit Trucking LLC owned a 1996 Peterbilt truck. Great West Casualty Company insured the truck. Dusty Weinreis, a member of Bad Habit Trucking LLC, took the truck to Butler Machinery Company for service work. The truck was destroyed by fire after the service work was completed but before Weinreis paid for the services. Great West paid Bad Habit Trucking $85,000 for the loss of the truck in accordance with the insurance policy. In November 2017 Butler sued Weinreis in small claims court for the unpaid service work. Weinreis counterclaimed in small claims court for the statutory maximum, $15,000, alleging loss of use of the truck, lost profits, cost to repair and replace the truck, and loss of personal property. Prior to the small claims hearing Butler moved to dismiss the case without prejudice. Weinreis resisted the motion, and a small claims hearing took place in 2018. The court awarded Butler $8,041.57 for the unpaid service work and awarded Weinreis $15,000 for lost profits. Offsetting the recoveries resulted in a net award to Weinreis of $6,958.43. In June 2018 Great West sued Butler in district court for $81,753.32 for the loss of the truck plus interest and costs. Butler moved to dismiss under N.D.R.Civ.P. 12(b)(6), arguing the case was fully decided in small claims court when Weinreis sued Butler for loss of the truck. The district court granted Butler’s motion to dismiss because the issue stemmed from the same transaction or occurrence, and found Great West should have filed a claim for damages in the small claims action. Great West moved to reconsider on the basis that Weinreis was the defendant in the small claims action, not Great West or Bad Habit Trucking. Great West argued privity did not exist between Weinreis in his personal capacity and Great West as the insurance company for Bad Habit Trucking. The district court denied the motion to reconsider. The North Dakota Supreme Court found the district court erred in dismissing Great West's claim, and reversed and remanded for further proceedings. View "Great West Casualty Company v. Butler Machinery Company" on Justia Law

Plaintiffs appealed the district court's denial of their motion for judgment as a matter of law in an action seeking reimbursement from State Farm after their house was destroyed by fire. The district court found that there was sufficient evidence to allow a reasonable juror to conclude that plaintiffs overstated the value of items lost in the fire by thousands of dollars and thus no expert was required to explain to the jury that fraudulent statements of this magnitude would be material to an insurer.The Eighth Circuit affirmed and held that the record contained sufficient evidence to sustain the jury's determination that plaintiffs made material misrepresentations relating to their insurance claims and thus these material misrepresentations regarding the personal property lost in the fire voided their right to recover at all under the policy. View "Borchardt v. State Farm Fire and Casualty Co." on Justia Law