Justia Insurance Law Opinion Summaries

Two insurers shared indemnification costs to settle claims made against mutual insureds in a construction defect litigation brought by third parties. One insurer, defendant Arch Specialty Insurance Company (Arch), refused to share the costs to defend the insureds in the underlying litigation. The other insurer, plaintiff Certain Underwriters at Lloyds, London (Underwriters), paid all defense costs and then sought equitable contribution from Arch. In ruling on cross-motions for summary judgment/adjudication, the trial court concluded Arch had no duty to defend the insureds in the underlying litigation, because Arch's insurance policy expressly stated it had a duty to defend provided no "other insurance" afforded a defense, and Underwriters' policy did afford a defense. Underwriters appealed summary judgment entered in favor of Arch and also challenged the trial court's denial of Underwriters' motion for summary adjudication of Arch's responsibility to contribute to defense costs. After review, the Court of Appeal concluded Arch's "other insurance" clause could not be enforced in this equitable contribution action between successive primary insurers, "[e]nforcement of such a clause in a primary CGL policy would violate public policy." The Court also concluded Arch did not successfully circumvent this result by including the clause in the "coverage" section of the insurance policy as well as the "limitations" section. Accordingly, the trial court's judgment was reversed and the trial court directed to enter an order denying summary judgment to Arch and granting Underwriters' cross-motion for summary adjudication that Underwriters was entitled to equitable contribution. View "Certain Underwriters at Lloyds, London v. Arch Specialty Ins. Co." on Justia Law

In the early morning of November 11, 2007, Sofia Roberts caused a motor-vehicle accident that killed five people (including herself) and severely injured two others. She was driving a Chrysler 300 that she had obtained from the Marc Heitz Auto Valley automobile dealership (Heitz) a few days earlier. The Chrysler had been delivered to Heitz by Bob Moore Auto Group (Moore) earlier that day. Her estate was sued by the estates of Brant Winton and Rebecca Burgess (two of the others killed in the accident) and two survivors, Daniel Cosar and Marcus Moore (collectively, the Victims). The suits were settled for $3,000,000 each for the survivors and the Winton estate and $5,000,000 for the Burgess estate. Allstate Insurance Company (Allstate), the insurer on Roberts’s personal automobile-liability policy, contributed its policy limit of $50,000. The judgment limited execution to other applicable insurance policies. Three insurance carriers (for the Heitz or Moore dealerships), Universal Underwriters Insurance Company (Universal), Phoenix Insurance Company (Phoenix), and National Union Fire Insurance Company of Pittsburgh, PA (National) (collectively, the Insurers), then sued the Victims at a federal district court in Oklahoma under diversity jurisdiction, seeking declaratory judgments that their policies did not cover Roberts for the accident. The district court granted summary judgment to the Insurers. The Victims appealed, arguing Heitz still owned the Chrysler at the time of the accident and that Universal is therefore responsible under the “garage” and “umbrella” coverages of its policy for Heitz. Alternatively, the Victims argued that Moore owned the vehicle at the time of the accident and that Phoenix and National were liable under their policies for Moore. After review, the Tenth Circuit found no reversible error and affirmed the district court’s judgments. View "Universal Underwriters Ins Co. v. Winton" on Justia Law

In Employers Insurance Co. of Nevada v. Chandler, the Supreme Court held that an insurer may refuse to pay additional funds when a claimant reopens a workers’ compensation claim until the claimant demonstrates that he or she has exhausted any third-party settlement funds. In the instant case, Appellant, a construction driver, was injured by another driver during the course of his employment. Appellant filed a workers’ compensation claim, which his employer, through a workers’ compensation administrator (collectively, Employer), accepted. Employer eventually closed the claim. When Appellant was unable to return to work, he sought to reopen his claim, but Employer denied it. Appellant filed an administrative appeal. An appeals officer granted Employer summary judgment. At issue on appeal was whether Chandler precluded Appellant from reopening his claim because he spent settlement funds on expenses other than medical costs. The Supreme Court reversed, holding (1) a claimant may reopen his workers’ compensation claim after exhausting his settlement funds on nonmedical expenses; and (2) the appeals officer erred when issuing a decision without detailed findings of fact and conclusions of law. View "Poremba v. Southern Nevada Paving" on Justia Law

Petitioner Thomas Todd, a Massachusetts resident, is a member of the New Hampshire Chapter of the Appalachian Mountain Club (AMC). He was a member of the AMC’s paddling committee since 1989 and was the committee’s co-chair in 2009 and 2010. Sally Leonard was also a member of the AMC’s paddling committee. In January 2014, Leonard filed a stalking petition against Todd, alleging Todd "hacked" her computer and broke her vehicle’s window after she had voiced her opinion at an AMC meeting that Todd should not be allowed to participate in a paddling committee event "due to his history of aggressive behavior toward females." Todd was insured under a homeowner’s insurance policy and an umbrella liability policy issued to him by Vermont Mutual Insurance Company. After the stalking petition was filed, Todd notified Vermont Mutual of the action and requested that it provide a defense under one or both of the policies. Vermont Mutual declined. The AMC was insured by Hanover Mutual Insurance Company under an employment practices liability (EPL) policy and a nonprofit directors, officers and organizations liability (D & O) policy. Todd informed the AMC of the stalking petition and requested that it notify Hanover to provide him with a defense. Hanover declined too. In March 2014, the Circuit Court ultimately found that Leonard “failed to sustain [her] burden of proof,” and, therefore, the court did not issue a restraining order against Todd. Todd incurred approximately $18,000 in attorney’s fees and costs in defending against the stalking petition. In June 2014, Todd filed this declaratory judgment proceeding, seeking a declaration that Vermont Mutual and Hanover owed a duty to defend him against the stalking petition and to reimburse him for the attorney’s fees and costs incurred in defending against the stalking petition. In addition, he sought attorney’s fees and costs for bringing the declaratory judgment proceeding. Todd appealed when cross-motions for summary judgment and summary judgment were granted favor of the insurance companies. Finding no reversible error, the Supreme Court affirmed the circuit court. View "Todd v. Vermont Mutual Insurance Co." on Justia Law

In 2007, Appellant was injured in a motor vehicle collision. After settling her primary uninsured motorist (UM) claim, Appellant sought excess UM benefits from an American Family Mutual Insurance Group policy that covered her vehicle. American Family denied the claim. In 2013, Appellant filed a lawsuit seeking excess UM benefits from American Family. The district court granted summary judgment in favor of American Family, concluding that the excess UM claim was barred by the six-year statute of limitations for contract actions and that Appellant’s claim accrued on the date of the accident. The court of appeals affirmed. The Supreme Court affirmed, holding that claims for excess UM benefits accrue on the date of the accident, and therefore, summary judgment was properly granted in favor of American Family. View "Hegseth v. Am. Family Mut. Ins. Group" on Justia Law

Stacey and Mark Bent sued USAA for breach of their homeowners’ policy and violations of the Texas Insurance Code. The Bents subsequently stopped making mortgage payments, and their lender foreclosed on their home. The Bents’ case against USAA, however, proceeded to trial. The jury concluded that USAA had not breached the homeowner’s policy but did violate chapter 541 of the Insurance Code. The trial court entered judgment on the jury’s verdict but later granted the Bents’ motion for new trial. The court of appeals conditionally granted a writ of mandamus directing the trial court to vacate its order and render judgment on the jury’s verdict, concluding that the trial court abused its discretion on each of its bases for ordering a new trial. The Bents sought relief in mandamus from the Supreme Court. The Supreme Court denied the Bents’ mandamus petition, holding (1) three of the trial court’s bases for ordering a new trial failed to satisfy the facial requirements set forth in In re Columbia Med. Ctr. of Las Colinas, Subsidiary, L.P. and In re United Scaffolding, Inc.; and (2) on the remaining basis at issue on appeal, the court of appeals correctly found that the record did not support the trial court’s stated rationale. View "In re Bent" on Justia Law

Stacey and Mark Bent sued USAA for breach of their homeowners’ policy and violations of the Texas Insurance Code. The Bents subsequently stopped making mortgage payments, and their lender foreclosed on their home. The Bents’ case against USAA, however, proceeded to trial. The jury concluded that USAA had not breached the homeowner’s policy but did violate chapter 541 of the Insurance Code. The trial court entered judgment on the jury’s verdict but later granted the Bents’ motion for new trial. The court of appeals conditionally granted a writ of mandamus directing the trial court to vacate its order and render judgment on the jury’s verdict, concluding that the trial court abused its discretion on each of its bases for ordering a new trial. The Bents sought relief in mandamus from the Supreme Court. The Supreme Court denied the Bents’ mandamus petition, holding (1) three of the trial court’s bases for ordering a new trial failed to satisfy the facial requirements set forth in In re Columbia Med. Ctr. of Las Colinas, Subsidiary, L.P. and In re United Scaffolding, Inc.; and (2) on the remaining basis at issue on appeal, the court of appeals correctly found that the record did not support the trial court’s stated rationale. View "In re Bent" on Justia Law

An SUV was being driven in the wrong direction on a highway when it collided with a semi-tractor-trailer. The SUV was totaled, and the SUV’s driver was killed. Second later, a motorcyclist ran into the SUV that was still in the middle of the highway. The drivers of both the semi and the motorcycle suffered injuries. The drivers jointly filed a petition for declaratory judgment against the insurer of the SUV asking the district court to declare that there had been two accidents for purposes of the insurance policy’s per-accident limit on bodily injury liability. The district court granted summary judgment for the insurer, concluding that the injuries suffered by the plaintiffs arose from one accident. The Supreme Court affirmed, holding that, under the terms of the SUV driver’s insurance policy, there was only one accident. View "Hughes v. Farmers Auto. Ins. Ass’n" on Justia Law

An SUV was being driven in the wrong direction on a highway when it collided with a semi-tractor-trailer. The SUV was totaled, and the SUV’s driver was killed. Second later, a motorcyclist ran into the SUV that was still in the middle of the highway. The drivers of both the semi and the motorcycle suffered injuries. The drivers jointly filed a petition for declaratory judgment against the insurer of the SUV asking the district court to declare that there had been two accidents for purposes of the insurance policy’s per-accident limit on bodily injury liability. The district court granted summary judgment for the insurer, concluding that the injuries suffered by the plaintiffs arose from one accident. The Supreme Court affirmed, holding that, under the terms of the SUV driver’s insurance policy, there was only one accident. View "Hughes v. Farmers Auto. Ins. Ass’n" on Justia Law

Defendant, Avanguard Medical Group, PLLC was accredited by the State of New York as a facility for the provision of office-based surgery (OBS). Plaintiffs (collectively, GEICO) commenced this action for a declaratory judgment that GEICO was not legally obligated under N.Y. Ins. Law 5102 to reimburse Avanguard for facility fees related to the use of its physical location and related support services. Supreme Court denied GEICO’s motion for summary judgment. The Appellate Division reversed and granted the motion, declaring that GEICO was not required to reimburse Avanguard for OBS facility fees. The Court of Appeals affirmed, holding that neither the applicable statutory nor regulatory framework mandate that a no-fault insurance carrier pay a facility fee to an accredited OBS center. View "Gov’t Employees Ins. Co. v. Avanguard Med. Group, PLLC" on Justia Law