Justia Insurance Law Opinion Summaries

Plaintiff was seriously injured in a collision while he was a passenger in a motor vehicle owned by the insureds of Defendant. Defendant obtained a judgment for money damages but subsequently settled with the insureds in exchange for an assignment of claims the insureds had against Defendant. Plaintiff then filed this action seeking a declaratory judgment requiring Defendant to pay the entire judgment from the underlying tort action (count one) and a declaration that Defendant was liable for prejudgment interest on the judgment in the underlying tort action (count two). A superior court justice granted summary judgment for Plaintiff on counts one and two. The Supreme Court vacated the judgment in count one and remanded for a new trial and affirmed the judgment in count two. On remand, Plaintiff sought a calculation of prejudgment interest. The superior court granted the motion, determining that Defendant’s argument with respect to the judgment satisfied order had been waived in regards to count two. The court subsequently ordered Defendant to make payment to Plaintiff. Defendant appealed from that order. The Supreme Court affirmed, holding that Defendant waived its arguments with respect to the judgment satisfied order and that the superior court had subject matter jurisdiction over the dispute throughout the litigation. View "DeMarco v. Travelers Ins. Co." on Justia Law

The Strauss home in Mequon was built in 1994. They insured the home with policies issued by Chubb from October 1994 to October 2005. Water infiltrated and damaged the home through a defect present since the completion of construction; the damage went undiscovered until 2010, after those policies expired. Chubb denied coverage, contending that because the damage manifested in 2010 and the “manifestation” trigger applies to first-party property insurance, it could not be responsible for the damage. Chubb also asserted that the claim was submitted after expiration of the applicable statute of limitations. The district court concluded that the “continuous” trigger theory applied due to the language of the Policy such that coverage existed for the entire loss and that the claims were not time-barred. The Seventh Circuit affirmed. In Wisconsin, under the continuous trigger theory, a progressive loss “occurs continuously from exposure until manifestation.” Here, the loss was ongoing and occurred with each rainfall and the policy itself states that “[c]ontinuous or repeated exposure to substantially the same general conditions unless excluded is considered to be one occurrence.” The loss, for purposes of the statute of limitations, occurred all the way up until the damage manifested in October 2010. View "Strauss v. Chubb Indem. Ins. Co." on Justia Law

Wayne Farms owned and operated a chicken processing plant in Oakwood. A fire broke out at the plant in 2003. Roughly three years later, Wayne Farms and its insurers filed suit against Crane Composites, Inc., which manufactured interior panels used in the plant, alleging Crane’s negligence caused the fire to spread extensively. In the meantime, the legislature enacted OCGA 9-11-68 (b) (1). The question for decision in this case is whether OCGA 9-11-68 (a tort reform, fee-shifting statute) could be applied to a negligence action in which the injury occurred prior to the effective date of the statute, but in which the action was filed after that date. The Supreme Court concluded that it could, and in so doing, overruled the case law set forth in "L. P. Gas Industrial Equipment Co. v. Burch," (701 SE2d 602) (2010)). View "Crane Company v. Wayne Farms, LLC" on Justia Law

After Hot Stuff recalled mislabeled sandwiches containing MSG, Hot Stuff sought indemnification from HCC for losses sustained due to the recall. HCC denied coverage on the ground that the claim did not involve an "Accidental Product Contamination" as defined by the policy. The district court granted Hot Stuff's motion for partial summary judgment. The court disagreed with the district court's interpretation of the policy term "may likely result." The court concluded that whether the consumption of the mislabeled sandwiches "may likely result" in physical symptoms of sickness or disease is a genuine dispute of material fact that cannot be answered by a summary judgment record that consists of inconclusive government reports and scientific studies and the dueling opinions of experts far removed from the relevant marketplace. Unless the district court determines on remand that summary judgment is appropriate based on the full trial record, the coverage question must be submitted to the jury. However, as the damages issues appear to be distinct and separable from the question of coverage, damages need not be retried. Further, the court concluded that the district court did not err when it denied HCC's motion for judgment as a matter of law in regards to the loss gross profit award, and the district court did not clearly err in denying an award of attorney's fees. View "Hot Stuff Foods, LLC v. Houston Casualty Co." on Justia Law

Petitioners, the West Virginia Investment Management Board (IMB) and the West Virginia Consolidated Public Retirement Board (Board), instituted a declaratory judgment action against the Variable Annuity Life Insurance Company (VALIC) requesting judicial resolution of Petitioners’ entitlement to a full surrender of two annuity contracts without delays in payment or surrender charges. The trial court granted VALIC’s motion for summary judgment, resolving Petitioners’ claims on grounds of standing, the absence of a justiciable controversy, and the lack of ambiguity concerning the language of a policy endorsement in dispute. The Supreme Court reversed, holding (1) the trial court erred in finding that no justiciable controversy existed between the parties and that Petitioners lacked standing in relation to the contracts; and (2) the policy endorsement language under review was of such doubtful meaning that reasonable minds might disagree as to its meaning. View "W. Va. Inv. Mgmt. Bd. v. Variable Annuity Life Ins." on Justia Law

This case arose from injuries suffered by several students during scholastic athletic activities. The students were insured by Central States, an Employee Retirement Income Security Act (ERISA), 29 U.S.C. 1001 et seq., employee welfare benefit plan that provides health insurance to participating Teamsters and their dependents. The students were also directly insured by separate accident policies written by Gerber. Central States subsequently filed suit against Gerber, alleging various claims for declaratory judgment and injunctive relief pursuant to federal common law and ERISA section 502(a)(3). The court held that although Central States might well be left without an appropriate remedy as a result of this decision, and that in the future its beneficiaries may be put in the unfortunate position of having to sue their insurance companies to receive benefits to which they are indisputably entitled, the claims raised by Central States are legal, not equitable, and therefore may not be brought under section 502(a)(3). Accordingly, the court affirmed the district court's grant of Gerber's motion to dismiss under Rule 12(b)(6). View "Cent. States, Se. & Sw Areas Health & Welfare Fund v. Gerber Life Ins. Co." on Justia Law

In a consolidated appeal, Aviva Life & Annuity challenged identical orders of the U.S. District Court for the Western District of Oklahoma sitting in its capacity as a bankruptcy appellate court. The district court entered the orders in two directly related cases brought by Aviva in the nature of interpleader pursuant to the Federal Interpleader Act, and Federal Rule of Civil Procedure 22. Aviva argued the court erred by limiting the scope of the interpleader relief granted. This case stemmed from the Chapter 11 bankruptcy proceedings of the Millennium Multiple Employer Welfare Benefit Plan. Prior to seeking the protection of the bankruptcy court, the Millennium Plan was an employee welfare benefit plan providing medical, disability, long term care, severance, and death benefits. Participants made contributions to the Millennium Plan, which then purchased life insurance policies (Policies) on the lives of the participants from Aviva and other insurance companies. Finding no reversible error in the district court's decision, the Tenth Circuit Court of Appeals affirmed. View "Aviva Life & Annuity v. Millennium Multiple Employer" on Justia Law

Jose Campos was injured while working for Daisy Construction Company. While Campos was receiving total disability payments from Daisy, Daisy performed an investigation of his social security number at the request of its workers' compensation insurance carrier and discovered that Campos was an undocumented worker. When Campos could not provide a valid number, Daisy terminated his employment. Around the same time, Daisy hired a doctor to re-evaluate Campos' medical condition. The doctor concluded that although Campos remained partially disabled, he could perform "light duty" work with restrictions. Daisy then filed a petition with the Industrial Accident Board to terminate Campos' total disability benefit payments. The Board granted Daisy's petition because Campos was physically capable of working and therefore was not totally disabled. The Board also found that Campos was not eligible for partial disability benefits, reasoning that Daisy had met its burden of showing that Campos had no decrease in earning capacity by testifying that Campos would be eligible for light duty jobs at Daisy at his pre-injury wage rate if he could provide a valid social security number. The Superior Court affirmed the Board's decision. After its review, the Delaware Supreme Court concluded the Board erred when it found that Campos was not eligible for partial disability benefits: "If we were to hold that Daisy's testimony constituted sufficient proof of job availability, an employer could always hire an undocumented worker, have him suffer a workplace injury, and then avoid partial disability benefit payments by 'discovering' his immigration status, offering to re-employ him if he could fix it, and claiming that a job is available to him at no loss in wages. This outcome would be contrary to the Workers' Compensation Act and our case law interpreting it, [...] which prevents employers from depriving undocumented workers of employment benefits. [...]Accordingly, Daisy must continue to pay partial disability payments until it can demonstrate that Campos has no decrease in earning power from his workplace injury, or until the statutory period for partial disability benefit eligibility expires. Federal restrictions that prevent employers from hiring undocumented workers may make it more difficult for Daisy to prove job availability, but any difficulty is appropriately borne by it as the employer, who must take the employee, Campos, as it hired him." View "Campos v. Daisy Construction Co." on Justia Law

Calvin Stucky was injured in a motor vehicle accident. Calvin’s child, Sadee, was eighteen years old at the time of the accident. Sadee claimed damages for loss of parental services, society, or consortium, among other claims. Defendant-insurer moved for summary judgment with respect to Sadee’s loss of consortium claim, arguing that Montana law does not recognize a claim for loss of consortium by the adult child of an injured parent. The federal court, which had diversity jurisdiction, certified the matter to the Supreme Court. The Supreme Court accepted the certified questions of law and answered (1) Montana law recognizes a claim for loss of consortium by the adult child of an injured parent; and (2) to assert such a claim, the plaintiff must show that a third party tortiously caused the parent to suffer a serious, permanent, and disabling injury compensable under Montana law, and that the parent’s ultimate condition of impairment is so overwhelming and severe that it has caused the parent-child relationship to be destroyed or nearly destroyed. View "N. Pac. Ins. Co. v. Stucky" on Justia Law

Plaintiff Sonia Graciano was injured after she was hit by a car driven by Saul Ayala. Ayala was insured by defendant California Automobile Insurance Company (CAIC). Three weeks after Graciano's attorney first contacted CAIC regarding the accident, Graciano misidentified both the driver and the applicable insurance policy. CAIC investigated the accident, identified the applicable policy and the correct driver, and offered to settle Graciano's claim with a "full policy limits offer." Graciano did not accept CAIC's full policy limits offer and, in this suit, alleged CAIC and its parent and affiliated companies acted in bad faith, based on an alleged "wrongful failure to settle." Graciano argued CAIC could have and should have earlier discovered the facts, and should have made the full policy limits offer more quickly. The jury found in favor of Graciano and this appeal followed. CAIC argued that, as a matter of law, there was no evidence to support the verdict that CAIC acted in bad faith by unreasonably failing to settle Graciano's claim against Saul. The Court of Appeal agreed, and reversed the judgment. View "Graciano v. Mercury General Corp." on Justia Law