Justia Insurance Law Opinion Summaries

Russ Irwin brought an arbitration proceeding against Lyman Morse Boatbuilding, Inc. (LMB) of Maine and Cabot Lyman, the controlling owner of LMB, claiming damages related to the allegedly defective construction of a luxury yacht. After Northern Assurance Company of America, the insurer for LMB and Lyman, refused the insureds’ request for defense, LMB and Lyman filed this federal suit seeking to recover the costs and attorneys’ fees they incurred in the arbitration proceeding. The district court concluded that Northern Assurance had a duty to defend Lyman but did not have a duty to defend LMB. The First Circuit affirmed in part, reversed in part, and remanded for entry of judgment in favor of Northern Assurance, holding that, under Maine law, the insurer did not owe a duty to defend LMB or Lyman in the underlying arbitration proceeding. View "Lyman Morse Boatbuilding Inc. v. N. Assurance Co." on Justia Law

Between July 30, 2003, and August 31, 2003, Sunline imported eight entries of freshwater crawfish tailmeat from Chinese producer Hubei, which were subject to a U.S. Department of Commerce antidumping duty order covering freshwater crawfish tailmeat from China. The Hubei Entries were entered following approval by Customs of eight single-entry bonds that covered the estimated antidumping duties and designated Hartford as surety. The Hubei Entries were made during the pendency of Hubei’s “new shipper review.” After Hubei’s new shipper review was rescinded, meaning Hubei did not qualify for an individual antidumping duty rate, Customs liquidated the Entries at the 223.01% country-wide rate. After Sunline failed to pay, Customs demanded payment from Hartford, which filed a complaint at the Court of International Trade, seeking to void its obligations under the bonds because Customs had been investigating Sunline for possible import law violations during the period in which the bonds were secured and did not inform Hartford of the investigation. The Trade Court dismissed. The Federal Circuit affirmed. Hartford did not allege any facts that establish a connection between the investigation and Sunline’s failure to pay its antidumping duties after liquidation. View "Hartford Fire Ins. Co. v. United States" on Justia Law

Claimant-appellant Trudy Deon brought worker compensation claims against her employer, H&J, Inc., and its surety, Liberty Northwest, (Employer/Surety) and the Idaho Special Indemnity Fund (ISIF). Deon eventually settled with ISIF but the claim against Employer/Surety went to a hearing that resulted in the Idaho Industrial Commission finding Employer/Surety 100% liable for her total and permanent disability (TPD). The Commission decided sua sponte to reconsider its decision and invited the parties to brief the issue of whether Deon was estopped from arguing Employer/Surety was 100% liable, given her settlement with ISIF. In an order on reconsideration, the Commission held that Deon was so estopped and apportioned 23.92% of her TPD to Employer/Surety. Deon appealed. Upon review, the Supreme Court determined the Commission erred by sua sponte raising the issue of collateral estoppel. The Commission and Employer/Surety knew about the ISIF settlement agreement for months before a decision was rendered and never raised the estoppel issue. Deon filed complaints against both her Employer/Surety and the ISIF. As a result of mediation, she reached a tentative settlement agreement with ISIF on October 5, 2012. The agreement was reduced to writing, signed by the parties on October 19, 2012, and approved by the Commission on November 8, 2012. When the Commission issued its Decision, it determined that Deon was totally and permanently disabled and that Employer/Surety was 100% liable under the odd-lot doctrine as Deon had argued. After considering all the hearing evidence and the parties’ briefing, the Commission found apportionment between the ISIF and Employer/Surety “is not appropriate” because “[t]he record does not establish that Claimant’s pre-existing leg condition combined with her 2008 industrial accident to render her totally and permanently disabled. However, on the same day the Commission issued its Decision, it also issued a notice of reconsideration pursuant to Idaho Code section 72-718, which raised for the first time the collateral estoppel. Specifically, the Commission wanted to know whether Deon’s stipulation to ISIF’s partial liability for her TPD estopped her from then arguing that Employer/Surety was 100% liable. After the parties briefed the issue, the Commission issued a new order holding that Deon was estopped from asserting a position inconsistent with her stipulation that ISIF was partially liable for her TPD. It then apportioned TPD liability according to the "Carey" formula, changing Employer/Surety’s liability from 100% to 23.92%. The Supreme Court concluded the revised findings were hinged solely on the Commission’s erroneous view of the law, and were without any support in the hearing record. Therefore, the Court reversed the Order on Reconsideration. Because the Commission did, in fact, hear Deon’s claim against Employer/Surety on the merits and determined Employer/Surety was 100% liable, Deon was entitled to 100% of her benefits from Employer/Surety. View "Deon v. H &J, Inc." on Justia Law

Hollybrook contracted with Carver for cotton processing equipment as part of its operation of a cotton mill. After the equipment repeatedly broke down, Hollybrook filed suit against Carver for breach of contract and redhibition. Hollybrook also sued Carver's primary insurer (Sentry) and its excess insurer (American). Defendants removed to federal court and Hollybrook settled its claims against Carver and Sentry. Hollybrook proceeded against American. On appeal, the court concluded that there was no error in the district court's order granting a new trial where the district court did not abuse its discretion in determining that the submission of the prejudicial information at issue was not harmless, or its determination that the jury's damage award was covered under the applicable insurance policy. However, the court concluded that the district court incorrectly determined that Hollybrook's attorney's fees were not covered by the policy. Accordingly, the court affirmed in part, reversed in part, and remanded for further proceedings. View "Hollybrook Cottonseed Processing LLC v. Carver, Inc." on Justia Law

Minn. Stat. 176.081(1)(a) requires employers and insurers to pay attorney fees calculated by a statutory formula not subject to judicial review. In this case, Respondent injured his back while working for Employer. Employer and its insurer (together, Relators) settled with Respondent. Respondent’s attorney then sought an award of contingent attorney fees in an amount that was calculated by applying the statutory formula in section 176.081 but which disregarded the upper limit set by the formula. Relators objected, arguing that, in the absence of judicial review to ensure a fee award is not excessive, application of the statutory formula violates separation of powers principles. The compensation judge applied the statutory formula and concluded that $13,000 would adequately compensate Respondent’s attorney but refused to consider whether the statutory fee was reasonable. The Workers’ Compensation Court of Appeals affirmed the compensation judge’s fee award. The Supreme Court affirmed, holding (1) the Court will recognize the Legislature’s statutory formula as presumptively reasonable, and, absent exceptional circumstances, further judicial review of an award based on the statutory formula is unnecessary; and (2) Relators failed to present any exceptional circumstances to challenge this presumption. View "David v. Bartel Enters." on Justia Law

WTS Acquisition Corporation purchased Ameritemps, Inc. and then transferred the assets to its wholly owned subsidiary, RFFG, LLC. RFFG continued operating the business under the Ameritemps name. The Ohio Bureau of Workers’ Compensation notified RFFG that it had determined that RFFG was a successor employer for workers’ compensation purposes and that it intended to calculate RFFG’s workers’ compensation premium rate based on Ameritemps’ experience rating. RFFG filed a complaint for a writ of mandamus alleging that the Bureau had abused its discretion when it determined RFFG to be the successor in interest to Ameritemps. The court of appeals denied the writ. The Supreme Court affirmed, holding that the court of appeals did not err in concluding that the decision of the Bureau was supported by the evidence and was not an abuse of discretion. View "State ex rel. RFFG, LLC v. Ohio Bureau of Workers' Comp." on Justia Law

While working on a fall clean-up job for defendant All Star Specialists Plus, Inc., defendant Joseph Derry was loading leaves into a truck using a leaf vacuum machine when the machine tipped over, injuring him. At the time, All Star had three insurance policies issued by Auto-Owners Insurance Company: (1) a commercial general liability policy, (2) a commercial automobile insurance (no-fault) policy, and (3) a commercial workers’ compensation policy. The general liability policy excludes from coverage “[a]ny obligation of the insured under a workers[’] compensation . . . law,” and the no-fault policy excludes coverage for “any expenses that would be payable under any workers[’] compensation law . . . .” Derry brought a negligence suit against All Star and one of its owners, Jeffery Harrison, for his injuries and sued Auto-Owners for no-fault benefits. Plaintiff Auto-Owners later filed this declaratory judgment action, seeking a determination that Derry was an employee of All Star and, thus, that the only insurance coverage available was under the workers’ compensation policy. The trial court concluded that because it was uncontroverted that Derry held himself out to the public to perform the same services as the work he performed for All Star, Derry was an independent contractor at the time of his injury and not an employee, and that Derry was therefore entitled to coverage under Auto-Owners’ general liability and no-fault policies. The court denied Auto-Owners’ motion for summary judgment and granted summary judgment in favor of Derry. Auto-Owners appealed to the Court of Appeals, and the panel affirmed in part and reversed in part. The panel affirmed the trial court’s conclusion that Derry was an independent contractor for purposes of the Worker's Disability Compensation Act (WDCA). However, the panel only reached this conclusion because it was bound under MCR 7.215(J)(1) to follow the Court of Appeals’ prior decision in "Amerisure." A special panel was convened, and in a published 4-3 decision, the majority reversed the trial court’s order granting summary judgment in favor of Derry and, thus, its determination that Derry was an independent contractor. Because the Supreme Court believed the term “employee” as defined in the WDCA was properly interpreted in "Amerisure," the Court reversed the Court of Appeals. View "Auto-Owners Insurance Co. v. All Star Lawn Specialists Plus, Inc." on Justia Law

Allstate Insurance Company issued a policy of liability insurance to the landlord of a two-family house. The policy, which was renewed annually for the next two years, stated a $500,000 limit for “each occurrence” and contained a “noncumulation clause.” Felicia Young and her children and, subsequently, Lorenzo Patterson and his children lived in one of the apartments during the years covered by the policy. In 2004, Young, on behalf of her children, and Jannie Nesmith, on behalf of the Patterson children, her grandchildren, brought two separate actions against the landlord for personal injuries allegedly caused by lead paint exposure. Young’s action was settled for $350,000, which Allstate paid. Nesmith’s action was settled for $150,000, which Allstate claimed was the remaining coverage. Nesmith then brought the present action against Allstate seeking a declaration that a separate $500,000 limit applied to each family’s claim, entitling her grandchildren to an additional $350,000. Supreme Court granted Nesmith the declaration she sought. The Appellate Division reversed. The Court of Appeals affirmed, holding that because Young’s children and Nesmith’s grandchildren were injured by exposure to the same general conditions, their injuries were part of a single loss, and only one policy limit was available to the two families. View "Nesmith v Allstate Ins. Co." on Justia Law

Plaintiffs DISH Network Corporation and DISH Network LLC sought a declaratory judgment that their commercial general liability and excess liability insurers (collectively the Insurers), Arch Specialty Insurance Company, Arrowood Indemnity Company, Travelers Indemnity Company of Illinois, XL Insurance America, Inc., and National Union Fire Insurance Company of Pittsburgh, Pa., had a duty to defend and indemnify plaintiffs in an underlying patent infringement action. The district court granted summary judgment in favor of the Insurers, plaintiffs appealed, and the Tenth Circuit reversed and remanded for further proceedings. On remand, the Insurers moved again for summary judgment, but on different grounds. The district court granted the Insurers’ motions, and plaintiffs appealed. Finding no reversible error this time, the Tenth Circuit affirmed the district court's judgment. View "Dish Network v. Arch Specialty Insurance" on Justia Law

This suit arose out of an insurance policy SWEPCO, a public electric utility serving Louisiana, Arkansas, and Texas, purchased from Underwriters for coverage associated with the construction of a power plant in Louisiana. On appeal, SWEPCO challenged the district court's order granting Underwriters' motion to compel arbitration. The court concluded that the district court's order was not a final, appealable order within the meaning of the United Nations Convention on the Recognition and Enforcement of Foreign Arbitral Awards, 9 U.S.C. 201-08, or the Federal Arbitration Act (FAA), 9 U.S.C. 1-16. Accordingly, the court dismissed the case for lack of appellate jurisdiction. View "Southwestern Elec. Power Co., et al. v. Certain Underwriters at Lloyds of London" on Justia Law