Justia Insurance Law Opinion Summaries

The notice and repair process set forth in Fla. Stat. 558 is a “suit” within the meaning of the commercial general liability policy issued in this case by Crum & Forster Speciality Insurance Company (C&F) to Altman Contractors, Inc.According to the policy, C&F had a duty to defend Altman in any “suit” arising from the construction of a condominium. Altman claimed that this duty to defend was invoked when the property owner served it with several notices under chapter 558 cumulatively claiming over 800 construction defects in the project. Altman filed a declaratory judgment action seeking a declaration that C&F owed a duty to defend and to indemnify it under the policy. The federal district court granted summary judgment for C&F, concluding that nothing about the chapter 558 process satisfied the definition of “civil proceeding.” Altman appealed, and the United States Circuit Court of Appeals for the Eleventh Circuit certified the legal issue to the Supreme Court. The Supreme Court answered the certified question in the affirmative because the chapter 558 presuit process is an “alternative dispute resolution proceeding” as included in the policy’s definition of “suit.” View "Altman Contractors, Inc. v. Crum & Forster Specialty Insurance Co." on Justia Law

The Court of Appeals answered a question certified to it by the United States Court of Appeals in the negative, answering that under New York law generally, and particularly in light of the New York Court of Appeals’ decision in Excess Insurance Co. Ltd. v. Factor Mutual Insurance Co., 3 NY3d 577 (N.Y. 2004), there is neither a rule of construction nor a presumption that a per occurrence liability limitation in a reinsurance contract caps all obligations of the reinsurer, such as payments made to reimburse the reinsured’s defense costs. The court held definitively that Excess did not supersede the “standard rules of contract interpretation” otherwise applicable to facultative reinsurance contracts. Therefore, New York law does not impose either a rule or a presumption that a limitation on liability clause necessarily caps all obligations owed by a reinsurer, such as defense costs, without regard for the specific language employed therein. View "Global Reinsurance Corp. of America v. Century Indemnity Co." on Justia Law

Respondent Denise Duncan sued Wal-Mart Stores, Inc. (Wal-Mart) for personal injuries she sustained at one of Wal-Mart’s stores while acting within the course and scope of her employment with Acosta, Inc. (Acosta). The trial court entered judgment finding Wal-Mart liable for Duncan’s injuries. Under Labor Code sections 3852 and 3856, appellant Hartford Accident & Indemnity Company (Hartford) applied for a lien on Duncan’s judgment to obtain reimbursement for the workers’ compensation benefits it paid Duncan, including medical expenses and temporary disability payments for lost wages. Although the judgment included compensation for Duncan’s medical expenses, it did not include compensation for Duncan’s lost wages because she did not seek those damages at trial. The court granted Hartford a lien on Duncan’s judgment, but reduced the lien amount to exclude the indemnity payments for lost wages. Hartford appealed the trial court’s postjudgment order, arguing the court exceeded its authority by reducing the lien amount for any item other than reasonable attorney fees and costs. The Court of Appeal agreed because section 3856’s plain language and the case law applying it granted Hartford a first lien on the judgment in the amount it paid Duncan for worker’s compensation benefits. Duncan’s choice not to seek lost wages at trial did not diminish Hartford’s lien rights under the workers’ compensation statutory scheme. View "Duncan v. Wal-Mart Stores, Inc." on Justia Law

OSC filed suit challenging the district court's grant of summary judgment in favor of LSB on OSC's duty to defend, OSC's breach of that duty, and OSC's liability under the Texas Prompt Payment of Claims Act (PPCA). OSC also appealed the denial of its partial motion for summary judgment based on the anti-stacking rule. The Fifth Circuit held that there were no genuine issues of material fact and LSB was entitled to judgment as a matter of law. Therefore, the court affirmed the district court's grant of summary judgment in LSB's favor on the duty to defend and OSC's breach of that duty. The court also affirmed the district court's denial of OSC's motion for partial summary judgment based on the anti-stacking rule. Likewise, the court also rejected OSC's challenge to the district court's grant of summary judgment in favor of LSB under the PPCA. The court reversed the district court's judgment with respect to LSB's Chapter 541 of the PPCA claim and remanded for further proceedings in light of this opinion and USAA Texas Lloyds Co. v. Menchaca. Finally, the court affirmed the district court's damages determinations. View "Lyda Swinerton Builders, Inc. v. Oklahoma Surety Co." on Justia Law

The insurance policy in question in this case was issued by petitioner Admiral Insurance Company (Admiral) to the real party in interest, A Perfect Match, Incorporated (Perfect Match), a company that "match[es] surrogates and egg donors with infertile families." On the first page of the policy Admiral promised to provide coverage for potential claims that Perfect Match knew or reasonably should have known about, but failed to disclose. In this case, prior to purchasing the Admiral policy, there was no question Perfect Match knew about a potential claim former clients Monica Ghersi and Carlos Arango intended to file arising from the birth of their daughter with a rare form of eye cancer. A lawyer representing Ghersi and Arango sent a letter to Perfect Match in June 2012 giving notice of their intent to file a complaint alleging professional negligence. After consulting with its insurance broker, Perfect Match made the decision not to disclose the potential Ghersi/Arango claim to its current insurer out of concern it would result in a higher premium. When it applied for the Admiral policy in October 2012, Perfect Match likewise did not mention the potential Ghersi/Arango claim. But once the Ghersi/Arango complaint was filed and ultimately served in March 2013, Perfect Match claimed potential coverage under the Admiral policy based on a "professional incident" and asserted its right to a defense. Admiral denied coverage and refused to defend, citing the policy language that excluded coverage for claims the insured reasonably should have foreseen prior to inception of the policy. Perfect Match then sued alleging breach of contract and bad faith. The Court of Appeal found no material factual disputes in this case: Admiral was entitled to insist that Perfect Match disclose all potential claims of which it was, or should have been, aware; it could and did exclude from coverage any such claim that was not disclosed. The superior court erred in failing to grant summary judgment in favor of Admiral. Accordingly, the Court issued a writ of mandate directing the superior court to vacate its order denying Admiral's motion for summary judgment and instead enter an order granting the motion. View "Admiral Ins. Co. v. Superior Court" on Justia Law

At issue was whether an insurer was obligated to indemnify a business owner under a personal insurance policy for liability arising form his false imprisonment of his company’s employee at her workplace. The business owner appealed, challenging the appellate court’s determination that such liability fell under the business pursuits exclusion to coverage under his personal umbrella policy. The Supreme Court reversed, holding (1) neither the appellate court nor the trial court employed the correct standard for determining whether the business owner’s tortious conduct was an occurrence “arising out of” the business pursuits of the insured; (2) remand was necessary to determine whether the business pursuits exception applied under the correct standard; and (3) Plaintiffs could not prevail on their alternative grounds regarding other exclusions and public policy as a matter of law. View "Nationwide Mutual Insurance Co. v. Pasiak" on Justia Law

The Seventh Circuit reversed the district court's judgment in an action filed by an insurance company seeking a declaratory judgment that it had no duty to defend the insured. The court held that it was the insured's responsibility to notify the insurance company that he had been in an accident that might lead to a claim; he failed to do so and his failure was inexcusable under Illinois law; and thus the insurance company had no duty to defend or indemnify the insured in the personal injury suit arising out of the accident. Accordingly, the insurance company was entitled to declaratory relief. View "State Auto Property & Casualty Insurance Co. v. Brumit Services, Inc." on Justia Law

At issue in this discovery dispute arising in the context of multidistrict litigation (MDL) involving allegations of underpaid homeowner insurance claims was whether a party’s attorney-billing information is discoverable when the party challenges an opposing party’s attorney-fee request as unreasonable or unnecessary but neither uses its own attorney fees as a comparator nor seeks to recover any portion of its own attorney fees. The MDL pretrial court ordered the insurer in this case to respond to the discovery requests. The Supreme Court conditionally granted mandamus relief and directed the trial court to vacate its discovery order, holding (1) compelling en masse production of a party’s billing records invades the attorney work-product privilege; (2) the privilege is not waived simply because the party resisting discovery has challenged the opponent’s attorney-fee request; and (3) such information is generally not discoverable. View "In re National Lloyds Insurance Co." on Justia Law

Plaintiff-appellant State Farm Automobile Insurance Company, as subrogee of its insured, sued for damages arising out of an automobile accident between the insured and Defendant-appellee Nicholas Payne. The insured, Tori Ukpaka, originally brought this action, but voluntarily dismissed it after the statute of limitations had run. Whether State Farm could revive that claim depended on whether it could take advantage of the Oklahoma savings statute at 12 O.S. sec. 100, which gives "the plaintiff" up to one year from the date of a non-merits-based termination in which to refile an otherwise time-barred claim. In light of the Oklahoma Supreme Court’s “historic” interpretation of that statute, it concluded that because State Farm was "substantially the same, suing in the same right" as its insured for purposes of a subrogation claim, it should be entitled to the same treatment as its insured for purposes of the savings statute. Accordingly, the Court held State Farm’s, filed within one year after its insured voluntarily dismissed the same, was timely. View "State Farm Mutual Automobile Ins. Co. v. Payne" on Justia Law

Husband Patrick Steiner was an active duty military service member and had a group life insurance policy issued under the Servicemen's Group Life Insurance Act of 1965 (the SGLIA). As part of a status-only dissolution judgment, Husband and Alicja Soczewko Steiner (Wife), stipulated to an order requiring Husband to maintain Wife as the beneficiary of all of Husband's current active duty survivor and/or death benefits pending further court order. Notwithstanding the stipulated order, Husband changed the beneficiary of his life insurance policy to Husband's sister, Mary Furman, who received the policy proceeds upon Husband's death. The court subsequently found applicable federal law preempted the stipulated order and Furman was entitled to the policy proceeds. Wife appealed, contending federal law did not preempt the stipulated order or, alternatively, the fraud exception to federal preemption applies. The Court of Appeal concluded to the contrary on both points and affirmed the order. View "Marriage of Steiner" on Justia Law