Justia Insurance Law Opinion Summaries

After Darcia Dominguez died in an automobile accident with a Hillsborough County employee, her personal representative, Jorge Dominguez, filed a wrongful death suit against the County in state court, which is still pending. This instant action involves an insurance dispute between the County, Mr. Dominguez, and the County's excess carrier, Star Insurance. The court addressed an issue of first impression under Florida law - the interplay between the limited waiver of sovereign immunity set forth in Fla. Stat. 768.28(5) and the language of the self-insured retention limit (SIRL) contained in an endorsement to the excess liability policy issued to the County by Star. The district court granted Mr. Dominguez's motion for entry of judgment. The court affirmed the portions of the summary judgment order and final judgment which (a) declared that the County cannot unilaterally settle Mr. Dominguez's claim within policy limits without Star’s consent, and (b) explained that other issues related to the proposed settlement are unripe for resolution on the current record; vacated the portion of the summary judgment order and the final judgment which declares that the $350,000 SIRL can be satisfied without the passage of a special claims bill; concluded that, on this record, the district court's reliance on the frustration of purpose doctrine was misplaced, and the court has no basis to address the interplay between section 768.28(5) and the policy's SIRL because the proposed settlement between the County and Mr. Dominguez anticipates the need for, and passage of, a special claims bill; and affirmed the district court's denial of Star's belated motion for discovery. View "Hillsborough County v. Star Insurance Co." on Justia Law

In 2007, the legislature passed, and the voters ratified, the Insurance Fair Conduct Act (IFCA), RCW 48.30.015. IFCA gave insureds a new cause of action against insurers who unreasonably deny coverage or benefits. IFCA also directed courts to grant attorney fees and authorizes courts to award triple damages if the insurer either acts unreasonably or violates certain insurance regulations. The issue this case presented for the Supreme Court's review was whether IFCA also created a new and independent private cause of action for violation of these regulations in the absence of any unreasonable denial of coverage or benefits. The Court concluded it did not and affirmed. View "Perez-Crisantos v. State Farm Fire & Cas. Co." on Justia Law

In 2011, plaintiff discovered a leak under her kitchen sink, which had caused extensive damage to her home, and filed a claim with her insurer, Farmers Insurance Company of Oregon (Farmers). In early 2012, Farmers voluntarily paid plaintiff a sum that it determined constituted the actual cash value of plaintiff’s losses less a deductible, $3,300.45. At around that time, it also paid plaintiff $2,169.22 in mitigation expenses. A few weeks later, plaintiff submitted to Farmers a proof of loss that included estimates of her mitigation costs and the actual cash value of her losses that far exceeded the sum that Farmers had paid her. Because plaintiff had not yet replaced any of the damaged items, she did not, at that time, submit a proof of loss that included the replacement cost of her losses. A year later, the parties had not resolved plaintiff’s claim, and in January 2013, plaintiff initiated this action. ORS 742.061 required an insurer to pay its insured’s attorney fees if, in the insured’s action against the insurer, the insured obtains a “recovery” that exceeds the amount of any tender made by the insurer within six months from the date that the insured first filed proof of a loss. In this case, the Supreme Court found that, when an insured files an action against an insurer to recover sums owing on an insurance policy and the insurer subsequently pays the insured more than the amount of any tender made within six months from the insured’s proof of loss, the insured obtains a “recovery” that entitles the insured to an award of reasonable attorney fees. View "Long v. Farmers Ins. Co." on Justia Law

Plaintiff Givaudan Fragrances Corporation (Fragrances) faced liability as a result of environmental contamination from a manufacturing site that a related corporate entity operated in a facility in Clifton. The issue this case presented for review involved Fragrances' effort to obtain insurance coverage for environmental claims brought by governmental entities in response to discharges of hazardous substances that occurred during the pertinent policy periods running through January 1, 1986. Fragrances claimed that the defendant insurance companies (defendants) wrote liability policies for Givaudan Corporation during those relevant years. Fragrances argued that it was entitled, either as an affiliate of Givaudan Corporation or by operation of an assignment of rights, to have the insurers provide it with coverage for that environmental liability. Defendants claimed that they insured Givaudan Corporation as their named insured, not Fragrances, and that any assignment to Fragrances was invalid because defendants did not consent to the assignment, as was required for a valid assignment according to the language of the insurance policies. Therefore, collectively, defendants refused to honor Fragrances' right to bring insurance contract claims against them. Fragrances filed its complaint in February 2009 seeking a declaratory judgment that it was entitled to coverage under the policies. In February 2010, while the declaratory judgment action was pending, Fragrances notified defendants that Givaudan Roure Flavors Corporation (corporate successor-in-interest to Givaudan Corporation) planned to assign its post-loss rights under the insurance policies to Fragrances. Defendants refused to consent to the assignment. Nevertheless, Flavors executed the assignment to Fragrances. Both sides moved for summary judgment. Because Fragrances was not acquired by Givaudan Corporation during the policy period, the trial court determined that it could not be an affiliated corporation covered under the policies. The court also determined that the assignment in this case was an assignment of policies, which could not be assigned. The court denied Fragrances' motion and granted defendants' cross-motion for summary judgment. The Appellate Division reversed and remanded, explaining that although the anti-assignment clauses in the occurrence policies at issue would prevent an insured from transferring a policy without the consent of the insurer, once a loss occurs, an insured s claim under a policy may be assigned without the insurer s consent.The Supreme Court affirmed, concluding that, once an insured loss has occurred, an anti-assignment clause in an occurrence policy may not provide a basis for an insurer s declination of coverage based on the insured's assignment of the right to invoke policy coverage for that loss. The assignment at issue in this case was a post-loss claim assignment and therefore the rule voiding application of anti-assignment clauses to such assignments applied. View "Givaudan Fragrances Corp. v. Aetna Casualty & Surety Co." on Justia Law

Hiland filed suit against National Union, alleging that National Union had a duty to defend and indemnify it in connection with a lawsuit arising from an explosion at its natural gas processing facility. The district court entered summary judgment for National Union. The court concluded that National Union did not have a duty to defend or indemnify Hiland because the allegations in the underlying complaint fell within the policy's pollution exclusion. The court also concluded that, because Hiland did not offer specific facts showing that it reported the pollution to National Union within twenty one days, the district court did not err by concluding that the exception to the exclusion did not apply. Accordingly, the court affirmed the judgment. View "Hiland Partners GP Holdings v. National Union Fire Insurance" on Justia Law

William Poremba (Appellant) was injured in an accident during the course of his employment with Southern Nevada Paving. Southern Nevada Paving, through S&C Claims (collectively, Respondents), accepted Appellant’s workers’ compensation claim and eventually closed the claim. Approximately four years later, Appellant sought to reopen his claim. Respondents denied the request. Appellant administratively appealed. The appeals officer denied Appellant’s attempt to reopen his claim. The district court denied Appellant’s petition for judicial review. The appeals officer and the district court apparently resolved the petition to reopen based on whether Appellant exhausted his funds from a settlement with third-parties involved in the accident on medical expenses. Appellant appealed, arguing, inter alia, that the appeals officer erred in granting summary judgment because he was not required to prove that he spent his excess recovery on medical expenses. The Supreme Court reversed, holding (1) Nev. Rev. Stat. 616C.390 does not require exhaustion or reimbursement as a condition precedent to reopening a workers’ compensation claim; and (2) insurers are only entitled to reimbursement from the portions of third-party recovery allocated to expenses within the scope of workers’ compensation. View "Poremba v. Southern Nevada Paving" on Justia Law

Elie and Rhonda Nassar filed a claim with Liberty Mutual Insurance Policy under their homeowners’ policy when their property was damaged by Hurricane Ike. Disputes arose over the value of various items of damaged property, and this appeal concerned which party of the Liberty Mutual insurance policy covered the Nassars’ damaged fencing. At issue was the proper interpretation of two policy provisions that separate coverage for the “dwelling” and “other structures.” The trial court entered final judgment in favor of Liberty Mutual, concluding that the Nassars’ fencing was an “other structure.” The court of appeals affirmed. The Supreme Court reversed, holding that the Nassars’ interpretation of the policy language was reasonable and the policy was unambiguous, and therefore, the Nassars’ fencing was covered under the “dwelling” provision as a matter of law. Remanded. View "Nassar v. Liberty Mutual Fire Insurance Co." on Justia Law

Warren and Johanna Grimes appealed a declaratory judgment holding that a liability policy issued by Alfa Mutual Insurance Company ("Alfa") did not provide coverage for a user of an automobile who did not have the express permission of the owner or drivers covered by the policy. Teresa Boop added liability coverage and uninsured/underinsured-motorist coverage for a pickup truck to her automobile insurance with Alfa. Boop also added her minor son as a driver under the policy. Amy Arrington was operating the pickup truck when it collided with a vehicle owned and occupied by the Grimeses. Both of the Grimeses suffered personal injuries as a result of the collision. The Grimeses’ insurer, Liberty Mutual, sued Arrington, alleging negligence and wantonness and seeking recovery of damages for the Grimeses' vehicle. Later the Grimeses sued Arrington and Boop, alleging negligence, wantonness, and negligent entrustment, and seeking damages for their personal injuries. Arrington filed answers, arguing that she was a covered person under the terms of Boop's policy with Alfa and that Alfa, therefore, should provide her with a defense in the Grimeses' action and in Liberty Mutual's action. The Supreme Court affirmed, finding that the trial court did not err in its conclusion that the Alfa policy did not provide coverage for a user of a motor vehicle who did not have the express permission of the owner or drivers who were covered. View "Grimes v. Alfa Mutual Ins. Co." on Justia Law

A driver lost control of his truck and crashed into a cabin, causing property damage and personal injuries to the cabin owner. The cabin owner brought suit against both the driver and the driver’s insurance company, alleging in part that the insurance company subsequently took charge of and negligently handled the fuel spill cleanup on the cabin owner’s property. The superior court granted the insurer summary judgment, concluding as a matter of law that the insurer could not owe the cabin owner an actionable duty. The cabin owner appealed, arguing that Alaska case law did not preclude a duty in this context. The Supreme Court agreed with the cabin owner and therefore reversed the superior court’s grant of summary judgment. View "Burnett v. Government Employee Ins. Co." on Justia Law

This case related to three actions: (1) an Endangered Species Act case (ESA case), where the Fund for Animals, Inc. (FFA) and other plaintiffs sued Ringling Brothers and its owner, Feld Entertainment, (collectively, Feld) for the mistreatment of Asian elephants in the Ringling Brothers’ Circus; (2) the Racketeer Influenced and Corrupt Organizations Act case (RICO case), where Feld sued FFA and the other plaintiffs in the ESA case for improper conduct; and (3) the coverage case, where FFA sued its insurer (National Union) for not providing coverage to FFA when it was sued by Feld in the RICO case. The findings in the ESA case were adverse to FFA and could have been used against it in the RICO case, thus prejudicing National Union. In this appeal stemming from the coverage dispute, FFA argued that although notice of the RICO claim was late under the policy, the late notification was not prejudicial to National Union. The circuit court entered judgment in favor of National Union. The Court of Special Appeals reversed. The Court of Appeals affirmed, holding that National Union was not prejudiced in investigating, settling, or defending the RICO claim as a result of any delay in receiving notice of claims brought by FFA. View "National Union Fire Insurance Co. of Pittsburgh, Pa. v. Fund for Animals, Inc." on Justia Law