Justia Insurance Law Opinion Summaries

In 2011, Roppo suffered serious injuries in an auto accident with Block, who was insured by Travelers. Travelers and the attorneys it retained for Block disclosed only the limits of Block’s automobile liability policy; they did not disclose the existence of his additional umbrella policy. Roppo eventually learned of the umbrella policy and then settled the case. She brought a proposed class action, challenging the company’s alleged practice of not disclosing the existence of umbrella policies. The case was removed to federal court under the Class Action Fairness Act, 28 U.S.C. 1332(d). The district court denied Roppo’s motion to remand to state court but allowed her to file a second amended complaint, which added Block’s defense attorneys as defendants. Her third amended complaint added a cause of action under the Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C. 1962(c). The Seventh Circuit affirmed dismissal with prejudice the complaint’s 11 counts, finding that the district court had jurisdiction and that her complaint did not sufficiently state claims of fraudulent misrepresentation, negligent misrepresentation, and negligence under Illinois law, or violations of the Illinois Insurance Code and the Illinois Consumer Fraud and Deceptive Business Practices Act. View "Roppo v. Travelers Commercial Insurance Co." on Justia Law

An insured sued her auto insurer and one of its adjusters, alleging that the insurer breached the insurance contract and committed tortious bad faith by withholding underinsured motorist benefits and that the adjuster negligently handled her claim for those benefits. The insurer then paid all available underinsured motorist benefits to the insured, including interest. The insured continued her tort claims, alleging additional financial and emotional harm from the delayed benefits payment. The insured proposed a jury instruction addressing the effect of the insurer’s belated payment, but the superior court rejected that instruction. After trial the jury determined that: (1) the insurer had acted in bad faith, but its conduct was not a substantial factor in causing the insured’s asserted harm; and (2) the adjuster had not been negligent. The superior court subsequently ordered the jury to award the insured nominal damages. The jury then awarded the insured $2 in nominal damages and later awarded $450,000 in punitive damages. The superior court awarded the insured prevailing party costs and attorney’s fees against the insurer. The court also awarded the adjuster prevailing party attorney’s fees against the insured. The court rejected the insured’s request that judgment against the insurer be entered nunc pro tunc to the date of the jury verdict so that post-judgment interest on the punitive damages award would start earlier. The insurer appealed the nominal and punitive damages awards and the prevailing party determination. The insured cross-appealed the adjuster’s attorney’s fees award, the jury’s failure to award compensatory damages, the court’s rejection of the insured’s proposed jury instruction, and the court’s refusal to enter judgment effective from the jury verdict date. The Alaska Supreme Court affirmed in all respects save the adjuster’s attorney’s fees award: that was remanded for further proceedings. View "Government Employees Insurance Co. v. Gonzalez" on Justia Law

An employee continued to work for over ten years after a job-related knee injury but had multiple surgeries on her injured knee. Over time, her employer made several permanent partial impairment payments, and she was eventually determined to be permanently and totally disabled because of the work injury. She began to receive Social Security disability at about the same time she was classified as permanently and totally disabled for workers’ compensation. Her employer asked the Alaska Workers’ Compensation Board to allow two offsets to its payment of permanent total disability (PTD) compensation: one related to Social Security disability benefits and one related to the earlier permanent partial impairment (PPI) payments. The Board established a Social Security offset and permitted the employer to deduct the amount of previously paid PPI. The employee appealed to the Alaska Workers’ Compensation Appeals Commission, arguing that the Board had improperly applied one of its regulations in allowing the PPI offset and had incorrectly calculated the amount of the Social Security offset. She also brought a civil suit against the State challenging the validity of the regulation. The State intervened in the Commission appeal; the lawsuit was dismissed. The Commission reversed the Board’s calculation of the Social Security offset and affirmed the Board’s order permitting the PPI offset. The employer appealed the Commission’s Social Security offset decision to the Alaska Supreme Court, and the employee cross- appealed the PPI offset. The Court affirmed that part of the Commission’s decision reversing the Board’s calculation of the Social Security disability offset and reversed that part of the Commission’s decision permitting an offset for permanent partial impairment benefits. The case was remanded back to the Commission for further proceedings. View "Alaska Airlines, Inc. v. Darrow" on Justia Law

Mercury filed suit against the City for inverse condemnation after a tree fell on the home of a couple insured by Mercury. The trial court entered judgment for Mercury, finding the tree that fell on the couple's home was a work of public improvement that supported an inverse condemnation claim. The Court of Appeal held, however, that the tree that fell on the couple's home did not constitute a work of public improvement for purposes of an inverse condemnation claim. In this case, there was no evidence that the City planted the tree as part of a construction project serving a public purpose, such as a roadway beautification project. Therefore, the court reversed the judgment and subsequent order awarding costs because the City could not be held inversely liable for the damage caused to the home. View "Mercury Casualty Co. v. Pasadena" on Justia Law

As Greg Peters and Mike Williams were attempting to position Peters’ fishing boat on its trailer, the winch handle recoiled, struck, and seriously injured Williams. Peters, who owned the truck, the trailer, and the boat, had two liability insurance policies covering bodily injury: his truck and trailer were insured by Allstate Property and Casualty Insurance Company (Allstate) and his boat was insured by Continental Casualty Company (Continental). Ultimately, the insurers settled with Williams for $460,000, each paying $230,000 toward the total settlement. Prior to settlement, however, the insurers had not agreed on apportionment. Continental sought a declaratory judgment that it was indemnified by Allstate based on its apportionment theory and also reimbursement for the defense costs it had incurred investigating the claim. Allstate moved to dismiss, seeking indemnity from Allstate based on its own apportionment theory and also sanctions against Continental for having made its defense costs and expenses claim. The circuit court treated the motion to dismiss as a motion for partial summary judgment and granted summary judgment in Allstate’s favor, but declined to award sanctions. Allstate then moved for summary judgment on Continental’s remaining indemnity claim, which the circuit court granted. Continental appealed the grant of summary judgment on its indemnity claim. Allstate cross-appealed the denial of sanctions. As to Continental’s indemnity claim, the Mississippi Supreme Court reversed summary judgment to Allstate and rendered judgment in favor of Continental. As to Continental’s claim of entitlement to defense costs, the Court affirmed summary judgment for Allstate. The Court affirmed the denial of sanctions. View "Continental Casualty Co. v. Allstate Property & Casualty Ins. Co." on Justia Law

While employed by Zing LLC, Josue Barrios (“Claimant”) was totally and permanently disabled as a result of an industrial accident when he fell about twelve feet from a ladder and hit his head face first on a concrete floor. He suffered multiple facial fractures, a frontal bone fracture, the loss of sight in his left eye, and a severe traumatic brain injury that caused a major neurocognitive disorder and speech language deficits. This case was an appeal of an Industrial Commission order requiring an employer and its surety to pay the cost of a guardian and a conservator for Barrios. Finding no reversible error in the Commission's order, the Idaho Supreme Court affirmed. View "Barrios v. Zing, LLC" on Justia Law

Roniesha Adams, her son, and her son’s father, Barry Adams (Barry), were passengers in Milton Mitchell’s car when the car was rear ended. Mitchell and his three passengers asserted claims against State Farm, seeking personal injury protection and uninsured motorist benefits. Because they allegedly gave inconsistent statements to State Farm regarding “substantive issues,” State Farm advised Mitchell, Adams, and Barry that they were required to submit to questioning under oath. Adams and Barry refused to submit to questioning under oath, and State Farm refused to pay additional benefits. Adams and Barry filed suit, and State Farm filed a counterclaim seeking a declaratory judgment that it did not have to provide coverage because Adams and Barry failed to cooperate with its investigation. The circuit court granted summary judgment for State Farm. Adams appealed. The court of appeals reversed, ruling that State Farm was required to obtain a court order before it could require Adams to submit to questioning under oath. The Supreme Court reversed, holding that the circuit court correctly found that Adams was required to submit to questioning under oath regarding issues as a condition precedent to coverage. View "State Farm Mutual Automobile Insurance Co. v. Adams" on Justia Law

KESA, the Kentucky Workers’ Compensation Fund, on behalf of its insureds, filed five separate medical fee disputes against the Injured Workers’ Pharmacy (IWP) and the insureds’ employees and former employees, all of whom had their prescriptions filled by IWP. The chief administrative law judge (CALJ) found (1) a pharmacy/pharmacist is a medical provider, which entitles an injured worker to choose where to have his or her prescriptions filled; (2) the pharmacy fee schedule is based on the amount a pharmacist pays a wholesaler for medication, and IWP is entitled to interest on any underpayment by KESA; and (3) because KESA brought its medical fee disputes without reasonable ground and without reasonable medical or factual foundation, KESA was required to pay the cost of the proceedings. The Workers’ Compensation Board reversed the award of costs but otherwise affirmed. The court of appeals affirmed. The Supreme Court affirmed in part, vacated in part, and remanded, holding (1) the court of appeals did not err regarding the assessment of interest and sanctions or in concluding that a pharmacy is a medical provider; but (2) the remainder of the court of appeals opinion is vacated and remanded because the CALJ did not make a determination regarding the actual average wholesale price paid by IWP. View "Steel Creations by and through KESA, the Kentucky Workers’ Compensation Fund v. Injured Workers’ Pharmacy" on Justia Law

When Plaintiff learned that a family occupying a residence nearby to a vacant property owned by Plaintiff was pursuing environmental claims against him, he notified his liability carrier, the Indiana Insurance Company. Indiana Insurance provided a defense and eventually settled the claims. Plaintiff later sued Indiana Insurance for bad faith arising from a breach of his insurance contract. The jury awarded Plaintiff $925,000 in emotional distress damages and $2,500,000 in punitive damages. The court of appeals affirmed. On appeal, Indiana Insurance argued that, having provided a defense and indemnification, Plaintiff had no viable bad faith claim. The Supreme Court affirmed, holding (1) Plaintiff presented sufficient evidence to support the jury’s determination that Indiana Insurance breached its contract with Plaintiff and that Indiana Insurance’s acts or omissions violated the Unfair Claims Settlement Practices Act; (2) the trial court did not err in denying Indiana Insurance’s motion for directed verdict or judgment notwithstanding the verdict on Plaintiff’s Kentucky Consumer Protection Act claim; (3) expert testimony is unnecessary to substantiate damages for emotional distress in a bad faith case; and (4) Indiana Insurance’s two remaining allegations of error were not properly before the court for review. View "Indiana Insurance Co. v. Demetre" on Justia Law

In this insurance coverage dispute, the Supreme Court affirmed the denial of summary judgment in favor of Insurer but reversed the denial of summary judgment in favor of General Contractor. Homeowners sued General Contractor and Subcontractor for damages to their home. General Contractor, which was insured under a commercial general liability policy (CGL), requested defense and indemnification from Insurer. Insurer defended General Contractor under a reservation of rights. Insurer then filed a declaratory judgment action seeking a judgment that the CGL policy did not provide coverage for General Contractor in the underlying case. General Contractor and Insurer filed cross-motions for summary judgment. The circuit court denied the motions on the ground that a genuine issue of material fact existed regarding the foreseeability of Homeowners’ damages. The Supreme Court reversed the judgment denying General Contractor’s motion and remanded for further proceedings, holding that the CGL policy required Insurer to defend General Contractor against Homeowners’ suit for damages and that factual questions regarding foreseeability were not relevant to the existence of coverage under the policy. View "Owners Insurance Co. v. Tibke Construction, Inc." on Justia Law