Justia Insurance Law Opinion Summaries

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

Richard and Susan Millies purchased a secluded piece of property in Stevens County overlooking Deer Lake. Their title company overlooked an easement that could have rendered the property far less secluded. The title insurer, LandAmerica Transnation Title Insurance Company, conceded that the easement had been overlooked in the title search and conceded coverage for the omission. After the two sides could not agree on the proper amount of compensation, the Millies sued on a variety of grounds. The jury returned a verdict in favor of LandAmerica, and the Millies appealed. Finding no reversible error, the Supreme Court affirmed. View "Millies v. LandAmerica Transnation" on Justia Law

A jury found that Defendant-Appellant American Family Mutual Insurance Company (American Family) breached its insurance contract and unreasonably denied payment of underinsured motorist (UIM) benefits to Plaintiff-Appellee Patrick Adamscheck. On appeal, American Family challenged three district court rulings: (1) the district court’s decision denying American Family’s motion for partial summary judgment on the ground that workers’ compensation benefits could not be offset against any recovery at trial; (2) the district court’s pre-trial decision to exclude American Family’s biomechanics engineering expert; and (3) the district court’s post-verdict calculation of damages to include the jury’s award of $395,561 in UIM benefits, plus twice that amount for statutory damages on the unreasonable-denial-of-benefits claim. After review of the trial court record, the Tenth Circuit affirmed in part, but vacated the verdict and remanded for additional proceedings. The Tenth Circuit concluded the district court correctly determined that workers’ compensation benefits may not be offset against UIM coverage under Colorado law. But the district court failed to fulfill its gatekeeping obligation under Rule 702 of the Federal Rules of Evidence, and therefore erred in excluding American Family’s expert. Because the record was inadequate to allow the Court to perform the district court’s gatekeeping function in the first instance, and because it could not conclude this error was harmless, the Tenth Circuit vacated the verdict and remanded for a new trial. The Tenth Circuit did not reach American Family’s objection to the calculation of statutory damages, which was not first presented to the district court. View "Adamscheck v. American Family Mutual Ins." on Justia Law

Plaintiff was seriously injured while working for Employer. Plaintiff’s injury was caused by the use of her personal vehicle. Plaintiff was able to recover benefits under her auto insurance policy but also sought benefits under Employer’s commercial auto policy. Employer’s insurer (Insurer) denied coverage. Plaintiff brought a claim for coverage, arguing that she was a named insured under Employer’s policy and that she was occupying a temporary substitute for an insured vehicle at the time of her injury. The district court granted summary judgment in favor of Insurer. The Supreme Court (1) affirmed the grant of summary judgment on the issue of whether Plaintiff was a named insured under Employer’s commercial auto policy; but (2) reversed the district court’s order granting Insurer’s motion for summary judgment on the issue of whether Plaintiff’s pickup was a temporary substitute for a covered auto and directed the district court to enter judgment in favor of Plaintiff on her coverage claim, as the evidence was sufficient to establish that Plaintiff’s pickup was a temporary substitute for an insured vehicle, entitling her to judgment on her coverage claim.. View "Stonehocker v. Gulf Ins. Co." on Justia Law