Justia Insurance Law Opinion Summaries

Adrian Burdette was seriously injured when he fell while attempting a controlled descent from a cell-phone tower in contravention of instructions by his employer, Chandler Telecom, LLC (“Chandler”), that technicians must climb down from towers. This case presented the question of whether an employee could, in deliberate disobedience of his employer’s explicit prohibition, act in a knowingly dangerous fashion with disregard for the probable consequences of that act, and still recover workers’ compensation when injured by that disobedient act. The Supreme Court concluded that OCGA 34-9-17(a) could bar recovery in such cases. View "Chandler Telecom, LLC v. Burdette" on Justia Law

Plaintiffs, elderly Oregonians or their successors who purchased long-term healthcare insurance policies sold by Bankers, filed suit alleging that Bankers developed onerous procedures to delay and deny insurance claims. The court certified the following question to the Oregon Supreme Court, pursuant to Oregon Revised Statues 28.200: Does a plaintiff state a claim under Oregon Revised Statutes 124.110(1)(b) for wrongful withholding of money or property where it is alleged that an insurance company has in bad faith delayed the processing of claims and refused to pay benefits owed under an insurance contract? View "Bates v. Bankers Life & Casualty" on Justia Law

Before resigning his director and treasurer positions with Briar Green, Robert Primo wrote himself two checks from Briar Green’s account totaling approximately $100,000. Briar Green made a claim for the alleged loss with its fidelity insurer, Travelers Casualty & Surety Company, which paid the claim in exchange for an assignment of Briar Green’s rights and claims against Primo. Travelers then sued Primo to recover the funds. Primo asserted a third-party claim against Briar Green and demanded that Great American Insurance Co., which carried Briar Green’s directors-and-officers (D&O) liability policy, defend him in the Travelers suit. Travelers subsequently non-suited its claims against Primo, and Primo non-suited his third-party claims. Primo then filed a contractual-indemnity action against Briar Green to recover the fees and expenses he had incurred in the Travelers suit. The suit resulted in a judgment for Primo. Meanwhile, Primo sued Great American in another action seeking reimbursement for the fees and expenses incurred in the Travelers suit. The trial court granted summary judgment for Great American. The court of appeals reversed. The Supreme Court reversed, holding that the policy provided no coverage for Primo’s claims because an insured-versus-insured exclusion in the D&O liability insurance policy applied. View "Great American Insurance Co. v. Primo" on Justia Law

Defendant Century Surety Company (Century) issued a Commercial Lines Policy to Plaintiff Siloam Springs Hotel, L.L.C. (Siloam). This policy included general liability insurance coverage of Siloam's hotel in Siloam Springs, Arkansas, for the policy period from November 13, 2012, through November 13, 2013. The insuring agreement of the general liability coverage form provided that Century would pay sums the insured was legally obligated to pay as damages because of bodily injury to which the insurance applies and that Century would have the right and duty to defend the insured against any suit seeking such damages. On January 17, 2013, several guests inside of the hotel allegedly suffered bodily injury due to carbon monoxide poisoning. The carbon monoxide allegedly escaped into the air due to leakage from the hotel's indoor swimming pool heater. Siloam sought coverage under its policy from Century, which Century denied based on an Indoor Air Exclusion at issue. The United States District Court for the Western District of Oklahoma certified a single question of Oklahoma law to the Oklahoma Supreme Court under the Revised Uniform Certification of Questions of Law Act, 20 O.S. 2011 sections 1601-1611: “Does the public policy of the State of Oklahoma prohibit enforcement of the Indoor Air Exclusion, which provides that the insurance afforded by the policy does not apply to ‘Bodily injury', 'property damage', or 'personal and advertising injury' arising out of, caused by, or alleging to be contributed to in any way by any toxic, hazardous, noxious, irritating pathogenic or allergen qualities or characteristics of indoor air regardless of cause?” The Oklahoma Supreme Court answered the question in the negative. View "Siloam Springs Hotel, LLC v. Century Surety Co." on Justia Law

Pertinent to this appeal, the Motor Vehicle Financial Responsibility Law (“MVFRL”) required insurers to offer insureds Underinsured Motorist coverage. Subsection 1731(c.1) of the MVFRL stated that any UIM coverage rejection form that does not “specifically comply” with Section 1731 of the MVFRL was void and that, if an insurer failed to produce a valid UIM coverage rejection form, then UIM coverage shall be equal to the policy’s bodily injury liability limits. The Pennsylvania Supreme Court granted allowance of appeal in this matter to determine whether an insurer’s UIM coverage rejection form “specifically compl[ied]” with Section 1731 of the MVFRL if the insurer’s form was not a verbatim reproduction of the statutory rejection form found in Subsection 1731(c) of the MVFRL but, rather, differed from the statutory form in an inconsequential manner. The Court held that a UIM coverage rejection form specifically complies with Section 1731 of the MVFRL even if the form contains de minimis deviations from the statutory form. Because the Superior Court reached the proper result in this case, the Supreme Court affirmed that court’s judgment. View "Ford v. American States Ins." on Justia Law

After Robert Fitte burned tree branches on his property, a fire rose from the ashes of the burn and erupted into a wildfire known as the Corral Fire. At the time of the fire, Fitte carried two insurance policies issued by Mountain West Farm Bureau Mutual Insurance Company, including the commercial automobile policy at issue in this appeal. Fitte stipulated to entry of a judgment in favor of Associated Dermatology and Skin Cancer Clinic of Helena, P.C. Profit Sharing Plan and Trust for the benefit of Stephen D. Behlmer, M.D. (Behlmer). Fitte and Behlmer subsequently entered into an agreement wherein Fitte assigned his rights in the Mountain West policies to Behlmer. Behlmer then filed this action seeking a declaration that the automobile policy provided coverage for the Corral Fire damages. The district court ruled in favor of Behlmer and directed that the insurance proceeds be deposited into the district court. The Supreme Court reversed, holding that the district court erred in holding that there was coverage for the Corral Fire damage under Mountain West’s commercial automobile policy. View "Associated Dermatology & Skin Cancer Clinic of Helena, P.C. Profit Sharing Plan & Trust for the Benefit of Stephen D. Behlmer v. Mountain West Farm Bureau Mutual Insurance Co." on Justia Law

The Indianapolis Airport Authority sued Travelers Property Casualty over Travelers’ partial denial of a claim for coverage arising from an airport construction accident that occurred in 2007. On motions for summary judgment, the district court interpreted the insurance contract in favor of Travelers on several issues, narrowing the Authority’s case to a claim for unreimbursed inspection costs associated with the incident. Two weeks before trial was set to begin on that claim, the district court entered an evidentiary order that effectively precluded the Authority from proving that sole remaining claim by restricting the testimony of two “hybrid fact/expert” witnesses, leaving the Authority with no designated damages expert. The Seventh Circuit affirmed in part and reversed in part the district court’s summary judgment order, and vacated the evidentiary order. The court upheld the district court’s construction of the General Coverage Provision and agreed that the Authority has no compensable soft cost claim because of the deductible, but stated that, if the Authority can demonstrate with competent evidence that it incurred expenses to reduce soft costs for which Travelers otherwise would have been liable, it may recover those expenses under the “expenses to reduce the amount of loss” provision, subject to policy limits. View "Indianapolis Airport Authority v. Travelers Property Casualty Co." on Justia Law

Rosemary Henn filed a putative class action in a federal court alleging that American Family Mutual Insurance Company wrongfully failed to compensate her and others similarly situated by depreciating labor costs in calculation of “actual cash value” for loss or damage to a building under its homeowner’s insurance policies. The federal court certified a question to the Nebraska Supreme Court asking whether an insurer, in determining the “actual cash value” of a covered loss, may depreciate the cost of labor when the policy does not state explicitly that labor costs will be depreciated and the terms “actual cash value” and “depreciation” are not defined in the policy. The Supreme Court answered in the affirmative, holding that the term “actual cash value” is unambiguous and that labor can be depreciated. View "Henn v. American Family Mutual Insurance Co." on Justia Law

Debra Jarvis was driving a bus owned by Lake Shore Motor Coach Lines, Inc. when she experienced a sudden and unforeseeable loss of consciousness. Her loss of consciousness caused the bus to roll over, injuring several passengers. Some of the injured passengers filed separate lawsuits in a Utah court seeking damages. Two of the plaintiffs moved for partial summary judgment, asserting that Lancer Insurance Co., Lake Shore’s insurer, was strictly liable for the passengers’ injuries under Utah Code 31A-22-303(1). The motions were denied. Lancer Insurance filed a separate federal case seeking a declaratory judgment confirming the state district court’s interpretation of Utah Code section 31A-22-303(1), thus reinforcing the conclusion that this provision preserves the common-law “sudden incapacity” defense and requires proof of fault to sustain liability. The federal district court certified two questions to the Supreme Court regarding the proper interpretation of section 31A-22-303(1). The Supreme Court answered (1) section 31A-22-303(1) overrules the common-law doctrine of sudden incapacity in a manner imposing strict liability on a driver (and her insurer); and (2) a driver (and her insurer) is subject to liability only up to the amount of the insurance coverage available under an applicable policy. View "Lancer Insurance Co. v. Lake Shore Motor Coach Lines, Inc." on Justia Law

Kara Sidebottom was injured during the course of her employment. Sidebottom filed a workers’ compensation claim in connection with the work-related injury. In determining Sidebottom’s weekly compensation benefit, the administrative law judge (ALJ) applied Ky. Rev. Stat. 342.140(1)(d). The ALJ determined that Sidebottom was a variable wage employee working on a “wage plus tips” arrangement at the time of her injury. The Uninsured Employers’ Fund appealed, arguing that, at the time of her injury, Sidebottom was a salaried, or fixed wage, employee whose average weekly wage should have been determined in accordance with Ky. Rev. Stat. 342.140(1)(a). The Workers’ Compensation Board disagreed and affirmed the ALJ’s decision. The court of appeals affirmed. The Supreme Court affirmed, holding that the ALJ, and hence the Board, applied the correct statute to the facts in determining Sidebottom’s average weekly wage. Remanded. View "Commonwealth, Uninsured Employers’ Fund v. Sidebottom" on Justia Law