Justia Insurance Law Opinion Summaries

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After the jury awarded damages to a sexual assault victim who was under the care of New Horizon, RSUI filed this action seeking a declaratory judgment that the policy's "Sexual Abuse or Molestation" exclusion barred coverage for the underlying damage award above Travelers' policy limits. The district court granted summary judgment for New Horizon. The Eighth Circuit held that RSUI, an excess liability insurer that did not control the defense of its insured in the underlying suit, must be afforded an opportunity to prove in a subsequent coverage action that the jury award included damages for uncovered as well as covered claims. If the insurer sustains that burden, the court held that the district court must then allocate the award between covered and uncovered claims. Therefore, the court reversed and remanded. View "RSUI Indemnity Co. v. New Horizon Kids Quest, Inc." on Justia Law

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Integrated Technologies, Inc. (ITI) appealed the grant of summary judgment in favor of Crum & Forster Specialty Insurance Company (Crum). ITI alleged Crum breached its duty to defend ITI against a suit brought by the GOAD Company. The court granted summary judgment to Crum, finding no claim in the GOAD complaint that was potentially covered by the policy’s Errors & Omissions (E&O) Liability Coverage Part. ITI argued on appeal that the trial court misread the allegations in the GOAD complaint and interpreted the policy coverage too narrowly. Finding no reversible error, the Vermont Supreme Court affirmed. View "Integrated Technologies, Inc. v. Crum & Forster Specialty Insurance Company" on Justia Law

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The Supreme Court affirmed the circuit court's order denying State Farm Mutual Auto Insurance Company's motion for a new trial after a jury returned a general verdict in favor of Giyo Miranda and denying State Farm's request for subrogation recovery against Miranda, holding that State Farm was not prejudiced by the court's instructions to the jury on the sudden emergency doctrine. Giyo Miranda was involved in a head-on collision with another vehicle driven by Loyd Nielson after Miranda lost control of his vehicle. State Farm, Nielson's insurer, pursued subrogation recovery against Miranda, but the jury returned a general verdict in favor of Miranda. State Farm filed a motion for a new trial, which the circuit court denied. The Supreme Court affirmed, holding that State Farm failed to establish any prejudice from the circuit court's instructions and that the court was unable to exercise meaningful appellate review on the merits of State Farm's claims. View "State Farm Mutual Automobile Insurance Co. v. Miranda" on Justia Law

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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

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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

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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

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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

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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

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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

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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