Justia Insurance Law Opinion Summaries

In this subrogation action filed by Educators Mutual Insurance Association (EMIA) against a tortfeasor in a personal injury case, the Supreme Court reversed the court of appeals’ dismissal for lack of standing. The court of appeals ruled that an insurer may file suit for subrogation only in the name of its insured, and not in its own name. The Supreme Court upheld EMIA’s standing to sue for subrogation in its own name under the terms of the insurance policy where the terms of the insurance policy at issue in this case expressly recognized EMIA’s authority “to pursue its own right of subrogation against a third party” without regard to whether the insured “is made whole by any recovery.” View "Wilson v. Educators Mutual Insurance Ass’n" on Justia Law

The State of California sued to recover from various insurers the costs of cleaning up the Stringfellow hazardous waste site, pending since 1993. The only remaining insurers were the Continental Insurance Company and Continental Casualty Company (collectively Continental), and the only remaining issues related to prejudgment interest. In 2015, Continental paid the State its full policy limits of $12 million. The trial court ruled that the State was entitled to mandatory prejudgment interest on that amount at seven percent, dating back to 1998. In the alternative, it also ruled that the State was entitled to discretionary prejudgment interest, at seven percent, dating back to 2002. Continental appealed. In the published portion of its opinion, the Court of Appeal addressed Continental’s contentions that the award of mandatory prejudgment interest was erroneous because: (1) the award was premised on the trial court’s erroneous ruling as to when Continental’s policies attached; and (2) the State was not entitled to mandatory prejudgment interest because the amount of its damages was uncertain. Continental further contended the award of discretionary prejudgment interest was erroneous because the trial court used an inapplicable interest rate. Finding no error affecting the award of mandatory prejudgment interest, the Court of Appeal affirmed. The Court did not review the award of discretionary prejudgment interest. View "California v. Continental Ins. Co." on Justia Law

Southern-Owners filed suit seeking a declaratory judgment absolving it of the duty to indemnify or defend Easdon Rhodes, or the other defendants, in an underlying negligence suit. The Fifth Circuit affirmed the district court's grant of summary judgment, holding that the vehicle driven by Joshua Rhodes, one of Easdon Rhodes' members, did not qualify for coverage under the terms of the Endorsement, and, even if the vehicle had qualified, the existence of a separate insurance policy also covering the accident triggered the Endorsement's exclusion clause absolving Southern-Owners of its duties under the policy. View "Southern-Owners Insurance Co. v. Moore" on Justia Law

In this discretionary appeal, and in a matter of first impression, the Pennsylvania Supreme Court considered the elements of a bad faith insurance claim brought pursuant to Pennsylvania’s bad faith statute, 42 Pa.C.S. section 8371. In 1992, while working for the United States Postal Service (“USPS”) Appellee LeAnn Rancosky purchased a cancer insurance policy as a supplement to her primary employer-based health insurance. The cancer policy was issued by Appellant Conseco Health Insurance Company (“Conseco”). To pay for the policy, Rancosky’s employer automatically deducted bi-weekly payments of $22.00 from her paycheck. The policy contained a waiver-of premium provision, which excused premium payments in the event Rancosky became disabled due to cancer. In 2003, Rancosky was diagnosed with ovarian cancer and underwent surgery and chemotherapy. Though, Rancosky did not return to her job with USPS following her hospital admission, she remained on her employer’s payroll for several months because she had accrued unused vacation and sick days. Consequently, Conseco continued to receive payroll deducted premiums from Rancosky until June 24, 2003, when Rancosky went on disability retirement. Premium payments were made in arrears; the final premium payment extended coverage under her policy to May 24, 2003. Unbeknownst to Rancosky, her physician statement inaccurately specified her date of disability as beginning on April 21, 2003, rather than on February 4, 2003. 5 Believing that the premiums had been waived and that no further premiums were due on the policy because of her disability from cancer, Rancosky’s final premium payment came from her June 24, 2003, payroll-deducted premium. Over the next two years, as Rancosky experienced several recurrences of her cancer, she continued to submit claims to Conseco. Conseco eventually started denying Rancosky’s claims for further benefits based upon her failure to pay premiums. The Supreme Court adopted the two-part test articulated in Terletsky v. Prudential Property & Cas. Ins. Co., 649 A.2d 680 (Pa. Super. 1994) in order for a plaintiff to recover in a bad faith action; proof of an insurance company’s motive of self-interest or ill-will is not a prerequisite to prevailing in a bad faith claim under Section 8371, as was argued by Appellant. The Court affirmed the superior court, which partially vacated the trial court’s judgment and remanded for further proceedings on Appellee’s bad faith claim. View "Rancosky v. Washington National Ins. Co." on Justia Law

The Supreme Court affirmed the circuit court’s order rejecting the Board of Trustees of the Kentucky Schools Boards Insurance Trust’s (KSBIT) claim of governmental immunity and thus denying its motion for summary judgment. In this complaint filed by the Deputy Rehabilitator of the Kentucky School Boards Trust Workers’ Compensation Self-Insurance Fund and of the Kentucky School Boards Insurance Trust Property and Liability Self Insurance Fund against the KSBIT Board for, inter alia, negligence, the KSBIT Board asserted a defense of governmental immunity and moved for summary judgment. The circuit court determined that the KSBIT Board was not entitled to governmental immunity because its “parent” entity was not an agency of state government that enjoyed governmental immunity and because it did not perform a function that was integral to state government. The Supreme Court affirmed, holding (1) because the KSBIT Board is not the offspring of local public school boards, it does not have the governmental immunity accorded to those governmental bodies; and (2) the KSBIT Board does not serve a function integral to state government. View "Board of Trustees of Kentucky School Boards Insurance Trust v. Pope" on Justia Law

Defendant Arch Specialty Insurance Company (Arch) appealed multiple superior court orders granting summary judgment to defendants Triage Staffing, Inc. (Triage), Exeter Hospital, Inc. (Exeter), and American Healthcare Services Association (AHSA) on their petitions for declaratory judgment, and denying Arch’s cross-motion for summary judgment. The court ruled that Arch was required to defend and indemnify Triage, Exeter, and AHSA, pursuant to two insurance policies that Arch issued to Triage, for claims asserted against the defendants by patients of Exeter who contracted Hepatitis C (Exeter Patients). On appeal, Arch argued the trial court erred in finding inapplicable certain exclusions found in the insurance policies and in determining that the claims involved multiple occurrences under the policies. After review, the New Hampshire Supreme Court reversed the superior court’s grant of summary judgment in favor of Triage and Exeter regarding Arch’s duty to defend and indemnify them pursuant to the general liability coverage forms; the Court reversed the trial court’s grant of summary judgment in favor of Exeter regarding Arch’s duty to defend and indemnify it pursuant to the umbrella coverage forms; reversed in part and vacated in part the trial court’s grant of summary judgment in favor of Triage regarding Arch’s duty to defend and indemnify it pursuant to the umbrella coverage forms, and remanded all matters to the trial court for further proceedings. View "Massachusetts Bay Insurance Company v. American Healthcare Services Association" on Justia Law

Plaintiff filed a putative class action, alleging that State Farm's practice of deducting "labor depreciation" from estimated replacement cost in determining actual cash value breached the insurance contract. The Eighth Circuit reversed the district court's denial of State Farm's motion to dismiss and certify a class. Although the court did not rule out the possibility that State Farm's use of the estimating methodology tool would produce an unreasonable estimate of the actual cash value of some partial losses, this issue may only be determined based on all the facts surrounding a particular insured's partial loss. Therefore, there were no predominant common facts at issue. Furthermore, the district court's order upholding premature classwide discovery was vacated. The court remanded with directions to dismiss the complaint and held that State Farm's petition for writ of mandamus was moot. View "In Re: State Farm Fire & Casualty Co." on Justia Law

The district court lacked jurisdiction to vacate an arbitration award under the Federal Arbitration Act (FAA).Matt Karo and Michael Karo obtained federally reinsured crop insurance policies serviced by NAU Country Insurance Company (NAU). The Karos submitted “prevented planting” claims under their crop insurance policies alleging that they were unable to plant corn on certain acres due to wet conditions. NAU denied the Karos’ prevented planting claims. The parties then submitted their disputes to binding arbitration pursuant to a mandatory arbitration clause in the crop insurance policies. The arbitrator denied coverage. The Karos then sought to vacate the arbitration award under section ten of the FAA. The district court vacated the arbitration award, finding that the arbitrator exceeded his powers and manifestly disregarded the law. The Supreme court vacated the district court’s judgment and dismissed this appeal for lack of jurisdiction, holding that the district court lacked jurisdiction to enter a judgment vacating the arbitration award under the FAA because the Karos failed to comply with the three-month notice requirement of section twelve of the FAA. View "Karo v. NAU Country Insurance Co." on Justia Law

Mainali filed suit against Covington for breach of contract, breach of the duty of good faith and fair dealing, fraud, and violations of the Texas Insurance Code and Texas Deceptive Trade Practices Act. The Fifth Circuit affirmed the district court's grant of summary judgment for Covington on all of Mainali's claims. The court rejected Mainali's contention that the appraisal award was incomplete because it excluded damage to items covered by the policy where Mainali cited nothing in the record to show that these items were not included. The court also held that Covington did not violate the Prompt Payment of Claims Act where Covington was not trying to avoid payment of the claim; it was invoking a contractually agreed to mechanism for assessing the amount it owed. View "Mainali Corp. v. Covington Specialty Insurance Co." on Justia Law

The First Circuit affirmed in part and reversed in part a district court order dismissing claims brought by Ironshore Specialty Insurance Company, the entity that paid the clean-up costs after a large military vessel spilled over 11,000 gallons of fuel next to Boston Harbor, against American Overseas Marine Company, LLC (AMSEA) and the United States. Ironshore sought cleanup costs and damages under the Oil Pollution Act (OPA) of 1990, a declaratory judgment finding AMSEA and the United States to be strictly liable under the OPA, and damages sounding in general admiralty and maritime law as a result of AMSEA’s and the United States’ alleged negligence. The district court dismissed all claims. The First Circuit (1) affirmed the dismissal of all of Ironshore’s claims against AMSEA; (2) affirmed the district court’s dismissal of Ironshore’s OPA claims against the United States; but (3) reversed the district court’s dismissal of Ironshore’s general admiralty and maritime negligence claims brought against the United States under the Suits in Admiralty Act because these claims were not foreclosed by the OPA. View "Ironshore Specialty Insurance Co. v. United States" on Justia Law