Justia Insurance Law Opinion Summaries

In 2012, plaintiff Heidi Kroeber was shot outside the Bad Monkey Bar in Kent, Washington by Matthew Atkinson, who was driving an uninsured truck belonging to a friend at the time he opened fire. Plaintiff and her boyfriend had antagonized Atkinson earlier that evening. After pleading guilty to the crime of "Drive-By Shooting," Atkinson claimed that he had not intended to injure anyone and later claimed that he did not know that he was shooting where people were standing. There were factual disputes concerning whether Atkinson's truck was stopped or in motion at the time that he opened fire, and whether he accelerated rapidly away from the scene after the shooting. Plaintiff filed a claim with defendant, GEICO Insurance Company, to recover damages under the UIM coverage provision of her own automobile insurance policy. Under the relevant parts of this policy, GEICO was liable for "damages an insured is legally entitled to recover from the owner or operator of an underinsured motor vehicle due to: 1. bodily injury sustained by that insured and caused by an accident; and 2. the liability of the owner or operator for these damages must arise out of the ownership, maintenance or use of the underinsured motor vehicle." GEICO denied plaintiffs claim, asserting that her injuries did not arise out of the use of Atkinson's truck. Plaintiff sued GEICO, claiming that she was entitled to UIM coverage. The case was removed to the United States District Court for the Western District of Washington, and that court certified two questions to the Washington Supreme Court: (1) whether an injury to an insured pedestrian "arose out of" the intentional firing of a gun from an uninsured pickup truck; and (2) whether it is material if the shooter intended to harm anyone when firing the gun. The Washington Supreme Court answered the first question by holding that an injury "arises out of' vehicle use so long as some causal connection is present between a condition of, an attachment to, or some aspect of a vehicle and the resulting injury. "The converse is also true-·-an injury does not 'arise out of' vehicle use under circumstances where no such causal connection exists, making the vehicle the mere situs of the accident." The Court answered the second question in the negative. View "Kroeber v. Geico Ins. Co." on Justia Law

The plaintiffs both have policies with State Farm Mutual Automobile Insurance Company and both submitted claims that State Farm failed to pay within the statutory thirty-day period. The plaintiffs earlier alleged that State Farm had failed to make the required statutory interest payments to them and other claimants whose PIP claims had not been processed within thirty days. When that theory did not pan out and they faced summary judgment, the plaintiffs reformulated their pursuit of class-wide relief by proposing to file an amended complaint seeking a declaratory judgment from the Superior Court that State Farm must process all PIP claims within thirty days. The Superior Court denied the motion for leave to amend, reasoning that amending the complaint would be futile because no case or controversy existed because the plaintiffs had been paid the required statutory interest. The court then granted summary judgment to State Farm. In this appeal, the plaintiffs alleged that the Superior Court was wrong to dismiss their claim, arguing that they have a ripe disagreement with State Farm over its failure to comply invariably with the thirty-day deadline set forth in 21 Del. C. 2118B(c). After review, the Supreme Court affirmed the Superior Court, but on a somewhat different ground. The plaintiffs were correct that absent declaratory (or injunctive) relief, it may be that they and other class members will have a claim in the future processed by State Farm in more than thirty days. But, the Court agreed with the Superior Court that the amended complaint is futile because as plainly written, section 2118B(c) did not impose an invariable standard that every PIP claim must be processed within thirty days and, in fact, contemplated that will not be the case by establishing a statutory consequence for the failure to do so. View "Clark v. State Farm Mutual Automobile Insurance Co." on Justia Law

Keller Transport, Inc. leased a tanker truck from Wagner Enterprises, LLC to transport gasoline. The truck’s trailer overturned and spilled 6,380 gallons of gasoline, which flooded several homeowners’ properties. Keller and Wagner were both insured under a commercial transportation policy. Westchester Surplus Lines Insurance Company insured both Keller and Wagner under an excess liability policy. Homeowners initiated suit against Keller and Wagner. Westchester undertook defense of the suit on behalf of Kohler and Wagner pursuant to a reservation of rights and defended Keller and Wagner until the limit of its excess coverage had allegedly been exhausted. Westchester sought a declaration that the limit under its excess policy was $4 million in total and that the limit had been exhausted. As relevant to this appeal, the district court granted summary judgment against Westchester. The Supreme Court affirmed in part and reversed in part, holding that the district court (1) did not err by determining that Westchester’s policy was ambiguous and that it provided an additional $4 million in coverage under the “general aggregate” limit; but (2) erred by holding that Westchester breached its duty to defend the insureds under its policy. View "Westchester Surplus Lines Ins. Co. v. Keller Transport, Inc." on Justia Law

Decedent was a passenger in his own vehicle when the vehicle was involved in an automobile accident, killing Decedent. The vehicle was being driven by Decedent’s friend (Driver) at the time of the accident and was insured by Insurer. Driver was a covered permissive driver under the policy. The executrix of Decedent’s estate (Estate) filed a wrongful death action against Driver. Insurer subsequently filed this declaratory judgment action against Estate and Driver seeking a ruling that the policy did not provide coverage for Estate’s claims against Driver and that Insurer had no duty to defend Driver. The trial court rendered summary judgment in favor of Insurer, concluding that an exclusion in the policy unambiguously barred Estate’s claims against Driver. The Supreme Court reversed, holding that the exclusion at issue was void and unenforceable due to its failure to comply with the clear and unambiguous requirements of Conn. Gen. Stat. 38a-335(d). Remanded. View "Dairyland Ins. Co. v. Mitchell" on Justia Law

J&D Towing, LLC, a towing company, owned only one tow truck that was rendered a total loss when a negligent motorist collided with the truck. J&D filed a claim with American Alternative Insurance Corporation (AAIC) under an underinsured-motorist policy issued by AAIC requesting compensation for the loss of use of the truck. AAIC denied the claim. Thereafter, J&D sued AAIC seeking loss-of-use damages. The trial court entered judgment in favor of J&D. The court of appeals reversed, concluding that Texas law allows loss-of-use damages for partial destruction but not for total destruction of personal property. The Supreme Court reversed, holding that Texas law permits loss-of-use damages in total-destruction cases. View "J&D Towing, LLC v. Am. Alternative Ins. Corp." on Justia Law

Cherri Porter’s beachfront vacation home was completely destroyed during Hurricane Katrina. Porter claimed the destruction was the result of a barge, owned by Grand Casino of Mississippi, Inc.–Biloxi, breaking free from its moorings and alliding with her home. Because Porter’s all-risk insurance policy excluded from coverage damage caused by water or windstorm, State Farm Fire and Casualty Company denied Porter’s claim. Porter filed suit against the insurance agent who maintained the policy, Max Mullins, against State Farm, and against Grand Casino. The trial court granted summary judgment in favor of each defendant, and the Court of Appeals affirmed. Porter filed a petition for writ of certiorari claiming genuine issues of fact existed as to each defendant, and the Mississippi Supreme Court granted her petition. Because Porter’s all-risk insurance policy unambiguously excluded from coverage loss that would not have occurred absent water damage, no genuine issue of material fact existed as to Porter’s bad-faith denial of coverage claim against State Farm. Additionally, Porter failed to produce sufficient evidence showing a genuine issue of fact as to whether Grand Casino breached its duty to take reasonable measures to prevent foreseeable injury. The Court therefore affirmed the decisions of the trial court and of the Court of Appeals as to all issues. View "Porter v. Grand Casino of Mississippi, Inc.- Biloxi" on Justia Law

In this suit alleging breach of an insurance contract, plaintiff appealed the trial court's grant of defendant's motion for directed verdict. Plaintiff contended that the trial court’s intended jury instruction violated the efficient proximate cause doctrine and there was sufficient evidence to permit the jury to determine whether plaintiff met his burden of proving his claim for punitive damages. The court concluded that plaintiff’s interpretation of the Other Coverage 9 provision is the correct interpretation, consistent with the efficient proximate cause doctrine. A policy cannot extend coverage for a specified peril, then exclude coverage for a loss caused by a combination of the covered peril and an excluded peril, without regard to whether the covered peril was the predominant or efficient proximate cause of the loss. Because the trial court granted the motion for a directed verdict based on the effect the erroneous proposed jury instruction would have had on plaintiff’s case, the court reversed and remanded as to this issue. Because defendant's special instruction No. 12 improperly shifted the burden of proof, the trial court erred in its decision to instruct the jury with defendant’s proposed special instruction and in granting defendant’s motion for directed verdict based on the decision to give that instruction. The court reversed and remanded as to this issue. Finally, the court found no error in the trial court's punitive damages claim. View "Vardanyan v. Amco Ins. Co." on Justia Law

After the parties' dispute over insurance policy liability coverage, plaintiffs and Cincinnati submitted a joint complaint for declaratory judgment. The court concluded that the district court did not err in finding that the Business Owners Package (BOP) and Commercial General Liability (CGL) policies issued by Cincinnati prohibited stacking where both policies cover the same injury, such that the maximum coverage for the injury is $1,000,000. Accordingly, the court affirmed the district court's grant of summary judgment to Cincinnati. View "Gohagan v. The Cincinnati Ins. Co." on Justia Law

Plaintiffs filed a purported class action challenging their insurer's interpretation of Fla. Stat. 627.736(1)(a)(3)–(4). In consolidated appeals, plaintiffs presented the issue of what the Florida Motor Vehicle No-Fault Law, Fla. Stat. 627.730–627.7405, places on an insured’s personal injury protection (PIP) benefits where no medical provider has made any determination about whether the insured’s injury was an emergency medical condition. The legislative history clearly shows that the Florida legislature sought to reduce fraudulent claims by making the full $10,000 amount of benefits available only to those insureds who suffered severe injuries, a restriction defined into the term “emergency medical condition.” The court held that Fla. Stat. 627.736, as amended, limits an insurer’s obligation to provide personal injury protection benefits to $2,500, unless one of the medical providers listed in subparagraph (1)(a)(3) has determined that the injured person had an emergency medical condition. Because neither plaintiffs' claim was supported by such a determination, neither insurer violated Fla. Stat. 627.736 by limiting benefits to $2,500. Accordingly, the court affirmed the dismissal of the suits. View "Robbins v. Garrison Prop. & Cas. Ins. Co." on Justia Law

Samuel Heckart brought this action against A-1 Self Storage, Inc., Caster Properties, Inc., Caster Family Enterprises, Inc., Caster Group LP, and Deans & Homer (together, Defendants) for violations of the Unfair Competition Law, violations of the Consumers Legal Remedies Act, negligent misrepresentation, and civil conspiracy. Heckart alleged A-1's sale of a Customer Goods Protection Plan (the Protection Plan) in connection with its rental of storage space constituted unlicensed sale of insurance. The form Protection Plan required the tenant to either initial to accept or decline participation in the plan. Heckart declined participation by initialing that option, which provided: "No, I decline participation in the . . . Protection Plan. I am currently covered by an insurance plan that covers my belongings in the storage facility. I understand that I need to provide the policy information in writing to the facility Owner within 30 days or I will automatically be enrolled in the . . . Protection Plan until I do provide such information to the Owner." Heckart "inadvertently" purchased the Protection Plan and was enrolled in it, presumably because he failed to provide proof of insurance within 30 days. In April 2013, Heckart, on behalf of himself and other similarly situated California residents, sued A-1 and Caster Group. The trial court sustained Defendants' demurrer to Heckart's first amended complaint without leave to amend, concluding the Protection Plan was not insurance. Heckart appealed, contending his allegations were sufficient to state the asserted causes of action because the Protection Plan was insurance that must comply with the Insurance Code. The Court of Appeal found his arguments unavailing and affirmed. View "Heckart v. A-1 Self Storage" on Justia Law