Justia Insurance Law Opinion Summaries

Hartford Casualty Insurance Company issued a commercial general liability policy to Ultimate Support Systems, a company that sold the Ulti-Cart. The policy covered “personal and advertising injury,” which included claims arising out of publication of material that "disparages a person’s or organization’s goods, products or services.” Gary-Michael Dahl, the manufacturer of the Multi-Cart, sued Ultimate for patent and trademark infringement, false designation of origin, and damage to business, reputation, and goodwill. Hartford denied coverage on the ground that the suit did not allege that Ultimate had disparaged the Multi-Cart or Dahl. The Supreme Court affirmed, holding (1) a claim of disparagement requires a plaintiff to show a false or misleading statement that specifically refers to the plaintiff’s product or business and clearly derogates that product or business; and (2) because Dahl’s suit did not allege that Ultimate clearly derogated the Multi-Cart, there was no claim of disparagement triggering Harford’s duty to defend.View "Hartford Cas. Ins. v. Swift Distrib., Inc." on Justia Law

Plaintiff injured his shoulder while working for Employer. Plaintiff was terminated later that year for “reduction of staff due to lack of work.” Employer accepted Plaintiff’s injury as compensable. In January 2009, Plaintiff began to receive unemployment benefits from Employer and Insurer (together, Defendants). In December 2010, Defendants sought to terminate payment of compensation, alleging that Plaintiff could no longer show he was disabled. The Industrial Commission concluded that Plaintiff was not entitled to disability payments made after December 2010 and that Defendants were entitled to a credit for any payments they had made after that date, finding that Plaintiff’s inability to find work was not due to his injury but to large-scale economic factors. The Supreme Court affirmed, holding that the Commission properly concluded that Plaintiff failed to prove that his inability to earn the same wages as before his injury resulted from his work-related injury.View "Medlin v. Weaver Cooke Constr., LLC" on Justia Law

Plaintiff, a Milwaukee County sheriff’s deputy, was injured while on duty by a motorist to whom she had just given directions and was allegedly helping to get back into the lane of moving traffic. Plaintiff sought coverage under her employer’s underinsured motorist policy, which pays sums owed by an underinsured tortfeasor to an insured person who is injured while “using an automobile” within the scope of her employment or authority. Plaintiff claimed that she was “using” the automobile that hit her because she was essentially controlling the vehicle. The circuit court granted summary judgment to the insurer. The court of appeals reversed. The Supreme Court reversed the court of appeals, holding that Defendant was not using the vehicle at the time of her injury. View "Jackson v. Wis. County Mut. Ins. Corp." on Justia Law

Defendants issued excess insurance policies to Plaintiff that required, as a threshold condition for coverage, Plaintiff to provide timely notice of any occurrence that potentially implicated Defendants’ duty of indemnification. This case concerned the investigation and remediation of environmental damage at manufactured gas plant (MGP) sites owned by Plaintiff. When Defendants denied coverage, Plaintiff commenced a declaratory judgment action. The Appellate Division concluded that Plaintiff failed to provide timely notice under the policies of environmental contamination at the MGP sites but denied summary judgment to Defendants, determining that material issues of fact remained as to whether Defendants waived their right to disclaim coverage of Plaintiff’s claims. The Court of Appeals reversed, holding that the Appellate Division erred in considering the waiver issue under N.Y. Ins. Law 3420(d)(2) because Plaintiff never relied on the statute and instead asserted a common-law waiver defense.View "KeySpan Gas E. Corp. v. Munich Reins. Am., Inc." on Justia Law

Plaintiffs’ insured vehicle was struck by a Jeep driven by a hit-and-run driver. Plaintiffs sought coverage for property damage under the uninsured motorists coverage of the family auto insurance policy issued by Erie Insurance Exchange. Erie denied the claim. The trial court granted summary judgment for Erie on the coverage issue. The court of appeals reversed. The Supreme Court affirmed the judgment of the trial court, holding that under the clear and unambiguous language of the Erie policy, the policy did not provide uninsured motorists coverage with respect to the property damage sustained by Plaintiffs’ vehicle because personal injury did not result to Plaintiffs in the accident.View "Robinson v. Erie Ins. Exch." on Justia Law

At issue in this case was which party was entitled to insurance funds under an insurance policy on a parcel of property that sustained water damage. Stanley Gurnick and Phoenix-Gurnick, RIGP claimed they owned the property as a result of a foreclosure sale. Navigant Credit Union claimed it was entitled to the funds as the named mortgagee/loss payee in the insurance policy. The superior court decided that Navigant was entitled to the insurance proceeds because the funds were personal property under the insurance contract and Navigant was named a loss payee under that contract. The Supreme Court affirmed, holding that the hearing justice correctly determined that Navigant was entitled to the insurance proceeds.View "R.I. Joint Reinsurance Ass’n v. O’Sullivan" on Justia Law

While working for Vista Care (Employer), appellant Sherrie Fowler suffered a back injury. Appellant began receiving TTD and subsequently underwent back surgery. Several years later, a physician determined that appellant reached maximum medical improvement (MMI). This case began when appellant filed a complaint with the Workers' Compensation Act (WCA) in 2010, for reinstatement of her TTD benefits and for an increase in her PPD rating. The Court of Appeals held that the Act limited appellant's eligibility for TTD benefits to 700 weeks of benefits and reversed a contrary decision of the Workers’ Compensation Administration judge. Upon review of the matter, the Supreme Court concluded that the Act imposed no such limitation; TTD benefits are payable during any period of total disability for the remainder of a worker’s life. View "Fowler v. Vista Care" on Justia Law

Paul Lightner filed a consumer complaint on behalf of himself and other policyholders before the Insurance Commissioner against CitiFinancial and Triton Insurance Company challenging the rates for certain insurance products. Following the Commissioner’s investigation and consideration of Lightner’s complaint, the Commissioner denied Lightner’s request for a hearing and found the challenged rates were reasonable. Lightner filed a petition appealing the Commissioner’s order denying his request for a hearing. The circuit court affirmed. The Supreme Court affirmed, holding that the circuit court (1) did not err in upholding the Commissioner’s order denying a hearing because this case did not present any factual disputes warranting a hearing in this case; and (2) properly concluded that the Commissioner’s handling of the rate issues raised in Lightner’s complaint met statutory, regulatory, and constitutional standards.View "Lightner v. Riley" on Justia Law

Insurer issued a commercial general liability insurance policy to Nightclub. After an altercation resulted in three Nightclub patrons receiving gunshot wounds, one of the injured patrons notified Nightclub that he intended to sue. Insurer subsequently filed a declaratory judgment action to determine coverage. The circuit court granted declaratory judgment to Insurer. The Supreme Court affirmed in part and reversed in part, holding (1) the circuit court erred in finding that the policy permitted Insurer to terminate its duty to defend once the policy limits were exhausted through the expenditure of attorney’s fees and costs related to the defense of the underlying tort actions; and (2) the circuit court did not err in ruling that the “Limited Assault and Battery Coverage” endorsement to the policy applied to the facts of this case and that coverage for the alleged injuries and damages was limited to $25,000. Remanded.View "Flowers v. Max Specialty Ins. Co." on Justia Law

After four people died from carbon monoxide poisoning while sleeping in a room above a pool heater in a motel, the motel sought coverage for the deaths from its insurer. The insurer denied coverage based on two provisions of the motel’s general liability policy, the absolute pollution exclusion and the indoor air quality air quality exclusion. The federal district court determined that the policy exclusions were ambiguous and interpreted the ambiguity in the motel’s favor. On appeal, the federal court of appeals certified questions of Nevada law to the Nevada Supreme Court. The Court answered the questions in the negative, concluding that neither the pollution exclusion nor the indoor air quality exclusion clearly excluded coverage for carbon monoxide exposure under the circumstances of this case.View "Century Sur. Co. v. Casino W., Inc." on Justia Law