Justia Insurance Law Opinion Summaries

Employers must cover certain contraceptives as part of their health plans unless the employer submits a form to their insurer or to the federal government, stating that they object on religious grounds to providing contraceptive coverage. The plaintiff-employers alleged that submitting this notice substantially burdened the exercise of their religion, in violation of the Religious Freedom Restoration Act of 1993,, 42 U.S.C. 2000bb. In supplemental briefing, the parties acknowledged that contraceptive coverage could be provided to employees, through insurance companies, without such notice. Plaintiffs “need to do nothing more than contract for a plan that does not include coverage for some or all forms of contraception,” and employees could receive cost-free contraceptive coverage from the same insurance company, seamlessly, with the rest of their coverage. Based on these stipulations, the Supreme Court vacated the judgments below and remanded to determine an approach that will accommodate the employers’ religious exercise while ensuring that women covered by their health plans “receive full and equal health coverage, including contraceptive coverage.” The Court did not decide whether the employers’ religious exercise has been substantially burdened, whether the government has a compelling interest, or whether the current regulations are the least restrictive means of serving that interest. View "Zubik v. Burwell" on Justia Law

After Tenant moved into her apartment, her apartment and several adjoining units were severely damaged in a fire that originated in Tenant’s clothes dryer. Insurer paid Landlord’s insurance claim and then sued Tenant for negligence and breach of the Apartment Lease Contract. The jury found that Tenant breached the lease agreement and awarded $93,498 in actual damages and attorney’s fees from Insurer. Tenant filed a motion for judgment notwithstanding the verdict, asserting several grounds for avoiding enforcement of the contract. The trial court granted Tenant’s motion and rendered a take-nothing judgment. The court of appeals affirmed, concluding that the residential-lease provision imposing liability on Tenant for property losses resulting from “any other cause not due to [the landlord’s] negligence or fault” was void and unenforceable because it broadly and unambiguously shifted liability for repairs beyond legislatively authorized bounds. The Supreme Court affirmed in part and reversed in part, holding (1) the court of appeals properly rejected Tenant’s ambiguity defense; but (2) the court of appeals erred in invalidating the lease provision on public-policy grounds. Remanded. View "Philadelphia Indem. Ins. Co. v. White" on Justia Law

Plaintiffs, two individual psychiatrists and three professional associations of psychiatrists, filed suit against defendants, four health‐insurance companies, alleging that the health insurers’ reimbursement practices discriminate against patients with mental health and substance use disorders in violation of the Mental Health Parity and Addition Equity Act of 2008 (MHPAEA), 29 U.S.C. 1185(a), and the Employee Retirement Income Security Act (ERISA), 29 U.S.C. 1001-1461. The court concluded that, because the psychiatrists are not among those expressly authorized to sue, they lack a cause of action under ERISA. The court also concluded that the association plaintiffs lack constitutional standing to pursue their respective ERISA and MHPAEA claims because their members lack standing. Accordingly, the court affirmed the judgment. View "Am. Psychiatric Ass’n v. Anthem Health Plans, Inc." on Justia Law

After a Bamford employee caused a car accident resulting in third party injuries, Bamford requested that its insurer, Regent, settle the claims within Bamford's policy limits. Regent did not settle the claims, the case proceeded to trial, and a jury returned a verdict in excess of Bamford’s policy limits. Bamford filed suit against Regent, alleging that Regent acted in bad faith in not settling the claims. The jury returned a verdict for Bamford. In this appeal, Regent challenged the district court's denial of its post-verdict motion for judgment as a matter of law or for a new trial. The court affirmed, holding that Bamford presented sufficient evidence from which a reasonable jury could conclude that Regent acted in bad faith in failing to settle the third party claims within the policy limits. Based on the same record of evidence, the court held that the district court did not abuse its discretion in denying Regent’s motion for a new trial predicated on the sufficiency of the evidence. Finally, the court held that the district court did not abuse its discretion in giving the challenged jury instructions, which were nearly identical to instructions approved by the Nebraska Supreme Court, and must be read as a whole with all of the instructions. View "Bamford, Inc. v. Regent Ins. Co." on Justia Law

Plaintiffs sued World Harvest Church (WHC) for claims arising from an incident involving Plaintiffs’ two-year-old son, who attended WHC’s daycare. Plaintiffs alleged that WHC’s employee had beaten their son with a knife. Final judgment was entered in favor of Plaintiffs in the amount of $2.87 million. The court of appeals affirmed. WHC subsequently filed suit against Grange Mutual Casualty Company, which insured WHC under a commercial liability insurance policy and an umbrella policy and had defended the matter but reserved its right to deny coverage. Plaintiffs alleged that Grange improperly refused to indemnify it for any portion of the judgment awarded to Plaintiffs. The trial court entered judgment in favor of WHC, finding that Grange was obligated to indemnify WHC in the amount of $1.47 million but that Grange was not responsible to indemnify WHC for the punitive damages awarded to Plaintiffs. The Supreme Court reversed, holding (1) the abuse or molestation exclusion in the commercial liability insurance policy barred coverage for an award of damages based on WHC’s vicarious liability for intentional infliction of emotional distress arising from WHC’s employee’s abuse of Plaintiff’s son while in WHC’s care and custody; and (2) the policy did not provide coverage for an award of attorney fees and postjudgment interest. View "World Harvest Church v. Grange Mut. Cas. Ins. Co." on Justia Law

Mark Ibsen, Inc., the owner and operator of the Urgent Care Plus medical clinic in Helena, purchased health insurance coverage for its employees from Blue Cross and Blue Shield of Montana (BCBSMT) through a Chamber of Commerce program. Health Care Corporation (Health Care) subsequently acquired BCBSMT’s health insurance business and changed its name to Caring for Montanans, Inc. (Caring). Less than one year later, Ibsen filed a complaint and class action against Caring and Health Care claiming that they had violated the Unfair Trade Practices Act (UTPA). Health Care filed a motion to dismiss and Caring filed a motion for summary judgment. The district court granted the motions, concluding that the legislature did not provide private citizens with the right to bring a cause of action to enforce the UTPA. The Supreme Court affirmed, holding (1) Ibsen may not maintain a private right of action for violation of Mont. Code Ann. 33-18-208 and -212 of the UTPA; and (2) in the alternative, Ibsen’s claims cannot be sustained as common law claims. View "Mark Ibsen, Inc. v. Caring for Montanans, Inc." on Justia Law

Powers drove through a stop sign and caused a four-vehicle accident. The plaintiffs suffered personal injuries. Trotter was the driver of the vehicle; Jackson and Petrie were passengers. Powers was insured under a policy with liability limits of $250,000 per person and $500,000 per accident. The plaintiffs settled with Powers’s insurer for the per-accident limit of $500,000; Trotter received $250,000 and Jackson and Petrie split the remaining $250,000. The plaintiffs believed that the settlement did not make them whole and submitted claims to Harleysville, Trotter’s insurer under a policy that provides that Trotter and any occupant of his vehicle is an “insured” for purposes of underinsured motorist coverage. The policy's declaration page states that underinsured motorist coverage is limited to $500,000 for “each accident.” Because the plaintiffs had together already recovered $500,000 under the Powers policy, Harleysville denied their claims, concluding that Powers was not an “underinsured motorist.” The plaintiffs argued the policy can reasonably be construed to mean that the $500,000 limit applies on a per-person, rather than a per-accident, basis. The court entered summary judgment in favor of Harleysville. The Seventh Circuit affirmed, finding that the policy unambiguously states that coverage is subject to a $500,000 per-accident maximum, regardless of the number of insureds involved. View "Trotter v. Harleysville Ins. Co." on Justia Law

The Glidden Company - now known as Akzo Nobel Paints LLC (ANP) - made, marketed, and sold lead paint. Based on a 1986 purchase agreement, Millennium Holdings LLC, which Appellant insurance companies insured, and its predecessors were required to indemnify ANP and its predecessors from 1986 to 1994. In turn, ANP and its predecessors were required to indemnify Millennium and its predecessors from 1994 onward. Beginning in 1987, a number of lead paint related lawsuits were filed against the predecessors of Millennium and ANP (the lead cases). Appellants satisfied Millennium’s obligations pursuant to monetary settlements reached in the cases. Appellants subsequently commenced this action against ANP seeking to be subrogated to the right of Millennium to indemnification against ANP. Supreme Court determined that the antisubrogation rule prohibited Appellants' right of subrogation. The Appellate Division affirmed. The Court of Appeals reversed, holding that there was no reason to apply to antisubrogation rule under the facts of this case, and therefore, the courts below erred in granting summary judgment for ANP on that basis. View "Millennium Holdings LLC v. Glidden Co." on Justia Law

Craig Smith, who suffered injuries in a motor vehicle accident, submitted an underinsured motorist coverage (UIM) claim to his insurer, Allstate Insurance Company. Allstate denied the claim because Smith’s policy did not provide for UIM coverage. Smith sued Allstate for breach of contract and a declaration of rights as to UIM coverage. The trial court granted summary judgment for Allstate because Smith had not paid a premium for UIM or requested UIM coverage. The court of appeals reversed, finding that Allstate had a duty under the Kentucky Motor Vehicle Reparations Act (MVRA) to advise Smith of possible UIM coverage. The Supreme Court reversed the decision of the court of appeals and reinstated the trial court’s judgment, holding that Allstate had no affirmative duty under the MVRA to notify or counsel Smith on the availability of UIM coverage. View "Allstate Ins. Co. v. Smith" on Justia Law

Roger and Carrie Peters and Daggin’ Y Cattle Company (collectively, Peters) filed a complaint against Junkermier, Clark, Campanella, Stevens, P.C. and Larry Addink (collectively, Junkermeir) alleging multiple counts stemming from tax services Junkermier performed for Peters. New York Marine, which insured Junkermier under a professional liability policy, defended Junkermeir subject to a reservation of rights. Peters and Junkermeir eventually entered into a settlement agreement and stipulation for entry of judgment without New York Marine’s participation, and the district court scheduled a hearing on the stipulated settlement’s reasonableness. The district court allowed New York Marine to intervene. After a hearing, the district court found that the stipulated settlement amount was reasonable, entered judgment in Peters’s favor, and ordered that Junkermier was not liable for the stipulated settlement. New York Marine appealed, asserting for the first time that the district court judge erred by not disclosing an apparent conflict of interest. The Supreme Court dismissed the appeal without prejudice pending referral to a district judge for hearing on New York Martine’s request for disqualification for cause, holding (1) New York Marine did not waive its disqualification claim; and (2) the presiding judge should have disclosed circumstances that could potentially cause the judge’s impartiality reasonably to be questioned. View "Draggin’ Y Cattle Co. v. Addink" on Justia Law