Justia Insurance Law Opinion Summaries

In this workers’ compensation case, the issue presented for the Louisiana Supreme Court’s review centered on whether the employer’s appeal, taken with devolutive appeal delays but outside of the suspensive appeal delays, was timely under the special provisions of La. R.S. 23:1310.5(C). While the Court acknowledged La. R.S. 23:1310.5 “is not a model of legislative clarity,” the Court broadly interpreted the statute to find nothing specified the time period in which this appeal have to be filed. The Court found the appeal should have been maintained as timely, but because the appeal was devolutive in nature, the judgment awarding benefits was subject to immediate execution. View "Jackson v. Family Dollar Stores of Louisiana, Inc." on Justia Law

Plaintiff Kerry Maggio was injured in an automobile accident when his vehicle was struck by a vehicle operated by James Parker, an employee of The Sandwich Kings, LLC d/b/a Jimmy Johns (“Sandwich Kings”). The vehicle operated by Parker was owned by Brenda Parker and insured by Louisiana Farm Bureau (“Farm Bureau”). Plaintiff filed a petition for damages naming as defendants: Parker; Sandwich Kings (contending that Parker was in the course and scope of his employment at the time of the accident); Republic Vanguard (Sandwich King’s automobile insurer); and Metropolitan Property Casualty Insurance Company (plaintiff’s uninsured motorist insurer). Notably, plaintiff did not name Brenda Parker or Farm Bureau as defendants. Less than one month later, plaintiff entered into a “Final Release and Settlement of Claim” (“Release”) with Brenda Parker and Farm Bureau. In exchange for Farm Bureau’s $25,000 policy limits, plaintiff executed a release agreement. In this matter, which was at the summary judgment phase, the Louisiana Supreme Court was called upon to decide whether the settlement which purported to release “all other persons, firms, or corporations who are or might be liable” applied to defendants who were not direct parties to the settlement. The Court found that the defendants were not entitled to summary judgment, reversed the opinion of the court of appeal, and remanded for further proceedings. View "Maggio v. Parker" on Justia Law

Ibrahim and Halida Ekic (the Ekics) and the estate of Aldina Ekic appealed district court decisions to grant summary judgment to Geico Indemnity Company (Geico) on their claims of breach of contract, misrepresentations in the inducement, breach of the duty of good faith and fair dealing, and promissory estoppel and to award attorney fees to Geico. Aldina was killed in an automobile accident caused by the negligence of a third party. The Ekics recovered the total policy proceeds of $25,000 from the third party’s insurance carrier. The Ekics demanded payment from Geico for the payment of $25,000 under Aldina’s underinsured motorist policy. Geico refused to issue a payment under the language of the policy. The Ekics filed suit. Sometime after Geico filed an answer, Geico filed a motion for summary judgment with a supporting affidavit from Geico’s counsel that included a copy of the Ekics’ answers to several interrogatories, a copy of Aldina’s Geico policy, and the vehicle collision report for the accident involving Aldina and the third party. The district court granted summary judgment for Geico on each of these claims. The Ekics then amended their complaint, with the permission of the district court, to add the additional claim of promissory estoppel and Geico filed an amended answer. Counsel for Geico advised the district court during a scheduling conference that Geico would be filing a motion for summary judgment on the additional claim. At the hearing, the district court granted Geico’s motion for summary judgment because the court found that “even viewing all the facts in light most favorable to the Plaintiff, there was no admissible evidence to support” their claim. The Ekics filed a motion to set aside the judgment which was denied by the district court. Geico requested attorney fees and the district court awarded them pursuant to Idaho Code section 41- 1839(4). The Ekics argued the district court erred in granting summary judgment in favor of Geico, but finding no such error, the Idaho Supreme Court affirmed the district court's judgments. View "Ekic v. Geico" on Justia Law

The Court of Appeals affirmed the judgment of the Appellate Division concluding that the claims asserted by plaintiff Ambac Assurance Corporation in its appeal from Supreme Court’s judgment in a suit against defendant Countrywide Home Loans, Inc. lacked merit.Ambac, a monoline financial guaranty insurer, agreed to insure payments of principal and interest owed to the holders of residential mortgage-backed securities sponsored by Countrywide. Many of the loans backing those securities went into default following a market downturn, causing substantial losses. Ambac filed suit against Countrywide, alleging that Countrywide breached several contractual representations and warranties and fraudulently induced Ambac to enter into the insurance agreements. The Court of Appeals held that the Appellate Division correctly determined that (1) justifiable reliance and loss causation are required elements of a fraudulent inducement claim; (2) Ambac may only recover damages on its fraudulent inducement claim that flow from nonconforming loans; (3) the remedy for Ambac’s contract claims was limited to the repurchase protocol provided for in the contract’s sole remedy provision; and (4) Ambac was not entitled to attorneys’ fees. View "Ambac Assurance Corp. v. Countrywide Home Loans, Inc." on Justia Law

Doe, an 18-year-old, met Kreka at Sports Bar, to interview for a position at Kreka’s restaurant. Kreka introduced Doe to Deari, who owned another restaurant, Pastazios. Deari tried to order Doe an alcoholic beverage. Sports Bars’s server refused because Doe was underage. Deari suggested that the three go to Pastazios. Along the way, Deari purchased liquor. Neither he nor Pastazios was licensed to serve hard liquor. At Pastazios, Deari placed a beer in front of Doe and encouraged her to drink it then served shots of Crown Royal Black. Doe alleged that, over several hours, Deari and “Pastazios” “continued to encourage and provide [Doe] with more and more alcoholic products from within and owned by Pastazios, despite [Doe] telling them she did not want anymore,” that “[Doe] was effectively detained,” and that “Pastazios” then “allowed” Deari and Kreka to load Doe into a car. A urine test would later reveal that Doe had been given a date-rape drug. Doe regained consciousness in a hotel room. Deari was sexually assaulting her. Deari infected Doe with herpes. Doe sued. Against Pastazios, Doe alleged negligence, gross negligence, Dram Shop liability, false imprisonment, and premises liability. The Fifth Circuit affirmed summary judgment that Pastazio's insurer did not breach a contractual duty to defend and indemnify Pastazios, noting the insurance policy’s liquor-liability and intentional-harm exclusions. All of Doe’s injuries arose out of the restaurant’s criminal act of giving alcohol to a minor, so the criminal-act exclusion bars all coverage claims. View "Century Surety Co. v. Deari" on Justia Law

Fiorentini is the owner and president of a small technology company. When cancer treatment left him unable to perform his job, he received total disability benefits under a Paul Revere policy. Five years later, after Fiorentini was back at work and exercising full control of the company, Paul Revere notified him that he no longer qualified for the benefits. Fiorentini argued that he still satisfied the policy’s requirements for total disability because, although he could perform most of his job duties, he was unable to do what it takes to generate new business. Paul Revere rejected that argument, encouraging him to apply for “residual disability benefits,” which would have required Fiorentini to show that he was either unable to perform “one or more of the important duties” of his occupation or could only perform his important job duties for “80% of the time normally required to perform them” and that he earned at least 20% less than he did predisability. Fiorentini instead sued for breach of contract. The Seventh Circuit affirmed summary judgment for Paul Revere. The total disability provision does not cover the insured who has a diminished ability to perform his occupation, but rather the insured who is unable to continue it. View "Fiorentini v. Paul Revere Life Insurance Co." on Justia Law

At issue was whether the term “others we protect” under a decedent’s employer’s commercial auto policy included the decedent.The decedent was killed by an uninsured driver while the decedent was mowing his home’s lawn near the roadside. The decedent’s estate sought uninsured motorist benefits, arguing that the decedent qualified for coverage under the employer’s commercial auto policy’s term “others we protect.” The insurance company denied the claim. The Supreme Court agreed with the insurance policy, holding (1) the term “others we protect” is unambiguous and impervious to judicial construction; and (2) accordingly, as a matter of law, the decedent did not qualify as “others we protect” under the policy when he was struck and killed by the uninsured motorist. View "Erie Indemnity Co. v. Estate of Brian L. Harris" on Justia Law

Auto-Owners Insurance Company provided automobile insurance to Frank and Nancy Csaszar and their daughter, Jennifer. But when that policy’s term came to a close, Auto-Owners informed Mr. and Mrs. Csaszar that, because of their daughter’s driving record, it would only renew their policy if it excluded her from coverage. The Csaszars agreed. The policy accordingly included an “excluded-driver” provision that stated the policy “shall provide no coverages” for “claims arising out of [Jennifer Csaszar’s] operation or use of any automobile. While this new policy was operative, an uninsured motorist rear-ended Jennifer while she was driving a vehicle not scheduled under her parents’ Auto-Owners policy. Jennifer filed a claim with Auto-Owners, requesting it pay her $500,000 in uninsured and underinsured motorist (UM/UIM) coverage. Auto-Owners denied the claim because it believed the excluded-driver provision barred Jennifer from such coverage. It then sought a declaratory judgment that Jennifer was not entitled to any coverage, including UM/UIM coverage, under her parents’ policy. In response, Jennifer filed a counterclaim seeking a declaration she was, in fact, entitled to this coverage. The district court granted Auto-Owners’ motion for summary judgment. Finding no reversible error in that judgment, the Tenth Circuit affirmed the district court. View "Auto-Owners Insurance Company v. Csaszar" on Justia Law

Plaintiffs Jimmy Larry Beddingfield ("Larry"), his wife, Rebecca, and their adult son, James Cody Beddingfield ("Cody") appealed the grant of summary judgment in favor of the defendants Mullins Insurance Company, Mullins & Company Insurance, Rand Mullins, and David Mullins (referred to collectively as "Mullins"), on the Beddingfields' claims stemming from Mullins's alleged failure to properly procure insurance coverage. In 1997, Larry and Rebecca purchased a homeowners' liability-insurance policy from Rand Mullins that protected Larry and Rebecca's primary residence. In 2001, Larry and Rebecca purchased a second liability-insurance policy that provided coverage for a rental house located in Florence; they later constructed another house in Guntersville and, in 2003, purchased an additional liability-insurance policy for that property. In July 2003, Mullins canceled the insurance policy on the Florence house allegedly based on a belief that "the policy was issued in duplicate." Allegedly unbeknownst to Larry and Rebecca, however, the requested cancellation left the Florence house uninsured. One month later, pursuant to a mortgage refinance on the Beddingfields' residence, Larry and Rebecca paid one year's insurance premium on that residence; the check was endorsed and deposited into Mullins's account. In March 2004, the policy on the Beddingfields' residence was canceled because of nonpayment of the premium; neither Larry nor Rebecca, however, was able to recall receiving notice of the cancellation. After those two events, Larry and Rebecca were without insurance on their residence and the Florence house, leaving them with liability insurance only on their Guntersville house. In July 2004, a minor guest at the Beddingfields' Guntersville house, Trace Linam, suffered a serious eye injury in a fireworks-related incident. In 2008, Linam and his father, Linam, sued the Beddingfields, alleging that they, and particularly Cody (who was a minor at the time), were responsible for the injury. Because the underwriter of the Beddingfields' policy had been placed into receivership in Texas in 2006, the Alabama Insurance Guaranty Association ("AIGA") covered the Beddingfields' legal-defense costs in the Linam litigation; however, the maximum amount of liability coverage available was limited to $100,000 –- the amount of the liability- insurance policy Larry and Rebecca had obtained from Mullins to insure that property -- and not $500,000, the amount they say would have been available had the other two policies not been canceled. In February 2011, a judgment was entered on a $600,000 jury verdict against the Beddingfields in the Linam litigation. The Beddingfields appealed that decision. Because, however, AIGA did not post the requisite supersedeas bond, and the Beddingfields were allegedly unable to obtain a bond, execution of the judgment was not stayed during the pendency of the appeal. In July 2011, while their appeal was pending, the Beddingfields sued Mullins, alleging numerous counts of negligence and wantonness with relation to Mullins's handling of the various insurance policies. After review of the trial court record, the Alabama Supreme Court affirmed summary judgment as to the negligence claims, reversed as to the wantonness claims, and remanded the case for further proceedings. View "Beddingfield et al. v. Mullins Insurance Company et al." on Justia Law

The IHSS program (Welf. & Inst. Code 12300) provides in-home services to elderly or disabled persons so that they may avoid institutionalization. For purposes of the state unemployment insurance system, IHSS service recipients are considered employers of their service providers if the providers are directly paid by the program or the recipient receives IHSS funds to pay their providers (Unemp. Ins. Code 683.) Generally, an employee of a close family member (child, parent or spouse) is excluded from unemployment insurance coverage. The California Unemployment Insurance Appeals Board ruled that, because a close-family-member IHSS service provider under the Direct Payment Mode is employed by the recipient, the provider is subject to the exclusion of Unemployment Insurance Code 631 (Caldera). Skidgel, an IHSS provider for her daughter, challenged the validity of Caldera, arguing government entities were joint employers with the recipient, thereby qualifying providers for unemployment insurance coverage despite the close-family-member exclusion. The court of appeal rejected the challenge, concluding that the Legislature, in enacting Unemployment Insurance Code section 683, intended to designate the recipient as the IHSS provider’s sole employer for purposes of unemployment insurance coverage. View "Skidgel v. California Unemployment Insurance Appeals Board" on Justia Law