Justia Insurance Law Opinion Summaries

Katie Graf was injured on the premises of Fat Cat Bar & Grill. Graf was awarded $500,000 in damages and $111,124 in prejudgment interest against Torcia & Sons, Inc, the owner of Fat Cat. Torcia was insured by Hospitality Mutual Insurance Company under a liquor liability insurance policy. Hospitality disclaimed liability for the prejudgment interest portion of the award. Consequently, Graf was granted a writ of attachment on Torcia’s liquor license to secure the excess payment. Graf and Torcia sought payment from Hospitality for the cost of a bond to release the attachment. When Hospitality refused, the parties entered into a settlement agreement under which Graf discharged the attachment of the liquor license and Torcia assigned its rights against Hospitality to Graf. Graf sued Hospitality. A federal judge granted Hospitality’s motion to dismiss, concluding (1) the $500,000 damages award represented the full extent of recoverable proceeds under the policy, and (2) to require Hospitality to pay for the cost of the bond would have expanded Hospitality’s liability in contravention of the terms of the policy. The First Circuit affirmed, holding that the policy unambiguously obligated Hospitality to pay the cost of bonds only for bond amounts that, together with any other liabilities, fell within the liability cap of $500,000. View "Graf v. Hospitality Mut. Ins. Co." on Justia Law

Plaintiffs are non-profit entities affiliated with the Catholic Church who have religious objections to certain preventive care standards under the Patient Protection and Affordable Care Act, 42 U.S.C. 300gg-13, particularly the requirement that their employer-based health insurance plans cover all FDA-approved contraception, sterilization methods, and counseling. All are eligible for either an exemption from the requirement or an accommodation to the requirement, through which the entities will not pay for the contraceptive products and services and the coverage will be independently administered by an insurance issuer or third-party administrator. Nonetheless, they alleged that the contraceptive-coverage requirement violated the Religious Freedom Restoration Act; the Free Speech, Free Exercise, and Establishment Clauses of the First Amendment; and the Administrative Procedure Act. Two district courts denied the appellants’ motions for a preliminary injunction. The Sixth Circuit affirmed, finding that the plaintiffs did not demonstrate a strong likelihood of success on the merits of any of their properly raised claims; because they did not demonstrate a strong likelihood of success on the merits of their claims, they also do not demonstrate that they will suffer irreparable injury without the injunction. View "MI Catholic Conference v. Sebelius" on Justia Law

This case arose from general liability insurance policies, including advertising injury coverage, that Great American issued to Street Surfing. At issue was whether those policies obligated Great American to defend Street Surfing in an action alleging trademark infringement, unfair competition, and unfair business practices under federal and California law (Noll action). The court accepted Great American's concession that the Noll action potentially falls within coverage for use of another's advertising idea, but rejected Street Surfing's argument that the action would also fall within the policies' coverage for slogan infringement. The court held that the prior publication exclusion relieves Great American of its duty to defend Street Surfing in the Noll action because the extrinsic evidence available to Great American at the time of tender conclusively establishes: (1) that Street Surfing published at least one advertisement using Noll's advertising idea before coverage began; and (2) that the new advertisements Street Surfing published during the coverage period were substantially similar to that pre-coverage advertisement. Accordingly, the court affirmed the district court's grant of summary judgment in favor of Great American. View "Street Surfing v. Great Am. E&S Ins. Co." on Justia Law

This declaratory judgment action under New York law involves Hartford's issuance to Euchner of comprehensive general liability insurance with an endorsement covering the company's employee benefits program. Hartford denied coverage and refused a defense as to a suit in which plaintiff alleged that she was sexually harassed and that she was coerced into accepting a changed status that Euchner improperly classified as an independent sales position. Euchner appealed from the district court's grant of Hartford's motion for summary judgment on the ground that the underlying suit alleged only intentional wrong. The court concluded that a reasonable possibility existed that some claims in the former employee's (amended) complaint might implicate the coverage extended by endorsement, and that Hartford therefore owed a duty to defend. The court did not reach the issue of indemnity. Accordingly, the court vacated and remanded in part. The court affirmed the dismissal of the claim brought under N.Y. Gen. Bus. Law 349. View "Euchner-USA, Inc. v. Hartford Casualty Ins. Co." on Justia Law

The lawsuit underlying this action alleged that Glynis McCormack’s ward sexually and physically abused a younger boy. In this declaratory judgment action, the district court ruled that Metropolitan Property and Casualty Insurance Company, McCormack’s insurer, had a duty to defend McCormack in the underlying lawsuit. Metropolitan appealed, arguing that the alleged harmful conduct was excluded from coverage under the governing policy. The First Circuit affirmed, holding that, under the facts of this case, McCormack’s policy would cover the harm alleged in the complaint, and therefore, Metropolitan had a duty to defend McCormack in the underlying action. View "Metro. Prop. & Cas. Ins. Co. v. McCarthy" on Justia Law

Richard Feingold’s mother purchased a life insurance policy from an Insurer listing her husband as the only beneficiary. Feingold's mother died in 2006. In 2012, Richard informed Insurer of his mother's death. The Insurer issued Feingold a check for death benefits but did not provide a copy of his mother's life insurance policy. Feingold filed a class action complaint against Insurer in 2013, alleging that the Insurer owed Feingold and the putative class of similarly situated beneficiaries damages based on the Insurer’s handling of unclaimed benefits under its life insurance policies. Specifically, Feingold claimed that the Insurer had an obligation, arising from a regulatory agreement (“Agreement”) between the Insurer and several states, to discover the death of its insureds and notify beneficiaries. The district court dismissed the complaint for failure to state a claim, noting that the Agreement was a contract only between Insurer and participating states. The First Circuit affirmed, holding that because Feingold was neither a party nor a third-party beneficiary of the Agreement, he had no authority to enforce the terms of the Agreement. View "Feingold v. John Hancock Life Ins. Co." on Justia Law

Elizabeth Mosley, a volunteer driver for LogistiCare, provided non-emergency medical transportation services for Medicaid patients using an automobile insured by State Farm. After Mosley was involved in an accident in which she was driving and Pearlie Graham was injured, Graham's heirs filed suit against Mosley and LogistiCare in Mississippi state court. State Farm filed suit in federal court seeking a declaration that it had no duty to defend or indemnify Mosley or LogistiCare in the underlying action. The court concluded that collateral estoppel did not prevent State Farm from litigating the "for a charge" exclusion contained in the insurance policy in the present case; the allegations do not sufficiently trigger the "for a charge" exclusion and therefore do not absolve State Farm of its duty to defend LogistiCare and Mosley; the district court erred in granting summary judgment in favor of State Farm as to the duty to defend; but the district court did not err in granting summary judgment in favor of State Farm as to the duty to indemnify. Accordingly, the court affirmed in part, reversed in part, and remanded for further proceedings. View "State Farm Mutual Auto Ins. Co. v. Mosley, et al." on Justia Law

Lejuan Rambin sued Allstate Insurance Company and Titan Insurance Company, seeking payment of personal protection insurance (PIP) benefits under the no-fault act. Rambin had been injured while riding a motorcycle owned by and registered to Scott Hertzog. At the time of the accident, Rambin did not own a motor vehicle. The car involved in the accident was uninsured, but Rambin averred that Hertzog owned a car that Allstate insured. Allstate denied Rambin’s claim for PIP benefits. Rambin alternatively alleged that if Allstate was not the responsible insurer, he was entitled to PIP benefits from Titan, the insurer to which the Michigan Assigned Claims Facility had assigned his claim. Titan and Allstate moved for summary judgment, arguing that Rambin took the motorcycle unlawfully and was therefore barred from recovering PIP benefits. Rambin also moved for summary judgment, arguing: (1) that he had joined a motorcycle club even though he did not own a motorcycle; (2) that Hertzog’s motorcycle was subsequently stolen; (3) that Rambin needed a motorcycle to participate in a club ride; (4) that a colleague offered to loan him a motorcycle; and (5) that during the ride he collided with the uninsured automobile while riding the motorcycle. The trial court granted both insurance companies' motion and Rambin appealed. The Court of Appeals reversed and remanded, holding that Rambin had not taken the motorcycle unlawfully. Allstate appealed. The Supreme Court affirmed the Court of Appeals’ decision insofar as it held that plaintiff was entitled to PIP benefits if the evidence established he did not know the motorcycle he had taken was stolen. The Court disagreed, however, with the Court of Appeals’ conclusion that plaintiff was entitled to a finding as a matter of law that he did not take the motorcycle unlawfully, given the circumstantial evidence presented in this case. "The Court of Appeals improperly made findings in regard to the facts of this case that were still very much in dispute." The Court therefore affirmed in part, reversed in part, and remanded the case to the circuit court for further proceedings. View "Rambin v. Allstate Insurance Co." on Justia Law

Acorn Investment Co. sued the Michigan Basic Property Insurance Association seeking to recover losses suffered in a fire on Acorn’s property. Michigan Basic had denied coverage on the basis that the policy had been canceled before the fire occurred. The case proceeded to case evaluation, which resulted in an award of $11,000 in Acorn’s favor. Acorn accepted the award, but Michigan Basic rejected it. The circuit court granted summary judgment in Acorn’s favor, ruling that the notice of cancellation was insufficient to effectively cancel the policy. The parties then agreed to submit the matter to an appraisal panel as permitted in the insurance policy and by statute. The appraisal panel determined that Acorn’s claim was worth $20,877. Acorn moved for entry of a judgment and also sought interest, case evaluation sanctions, and expenses for the removal of debris. The court entered a judgment in Acorn’s favor for $20,877 plus interest but declined to award case evaluation sanctions or debris-removal expenses. Michigan Basic paid the judgment, and Acorn appealed the denial of the sanctions and expenses. The Court of Appeals affirmed, but the Supreme Court affirmed in part and reversed in part. The Court held that the circuit court could award actual costs to Acorn. The Supreme Court vacated the appellate court with respect to the award of debris-removal expenses: the issue was remanded to the circuit court to determine whether the appraisal panel awarded expenses as part of its award, left them for the circuit court to determine, or whether Acorn waived its right to claim them. View "Acorn Investment Co. v. Michigan Basic Property Insurance Assn." on Justia Law

Pyramid Tech filed suit against its insurer, alleging express breach of contract and breach of the implied covenant of good faith. Without holding a Daubert hearing, the district court excluded Pyramid Tech's expert witnesses and granted summary judgment to the insurer, finding insufficient evidence that a flood caused damage to Pyramid Tech's property. The court held that, after an expert establishes admissibility to the judge's satisfaction, challenges that go to the weight of the evidence are within the province of a fact finder, not a trial court judge. A district court should not make credibility determinations that are reserved for the jury. In this instance, the district court abused its discretion in excluding the expert evidence of David Spiegel and Ken Pytlewski, but did not abuse its discretion in excluding the expert evidence of Del Mortenson. The district court erred in granting summary judgment against Pyramid Tech's claims where genuine issues of material fact existed as to whether the insurer breached its contract with Pyramid Tech and breached the implied covenant of good faith. However, to the extent such claims were premised on Pyramid Tech's business interruption theory, no material issues of fact existed and the district court did not err in granting summary judgment against that theory of liability. Accordingly, the court affirmed in part, reversed in part, and remanded for retrial. View "Pyramid Tech. v. Allied Public Adjusters" on Justia Law