Justia Insurance Law Opinion Summaries

Respondents The Local Government Center, Inc. (LGC), Local Government Center Real Estate, Inc., Local Government Center Health Trust, LLC, Local Government Center Property-Liability Trust, LLC, Health Trust, Inc., New Hampshire Municipal Association Property-Liability Trust, Inc., LGC-HT, LLC, and Local Government Center Workers' Compensation Trust, LLC, appealed a final order of a presiding officer of petitioner the New Hampshire Bureau of Securities Regulation (Bureau), finding that they violated RSA 5-B:5, I(c) (2013) and required, among other things, HealthTrust to return $33.2 million to its members, P-L Trust to return $3.1 million to its members, and P-L Trust to transfer $17.1 million to HealthTrust. After its review of the matter, the Supreme Court agreed with one of respondents' arguments with respect to the purchase of reinsurance: the presiding officer erred by requiring HealthTrust to purchase it. The Court affirmed the presiding officer in all other respects, and remanded the case for further proceedings on the reinsurance issue. View "Appeal of the Local Government Center, Inc." on Justia Law

The issue in this case centered on a workers' compensation lump-sum award to a claimant who passed away while an appeal of her award was pending. At issue before the Supreme Court was a Court of Appeals opinion that refused to reach Respondents-Petitioners' argument that the award abated upon the beneficiary's death; granted the entire lump-sum award to beneficiary's dependent grandsons; reversed the grant of interest on the award; and affirmed the reinstatement of a ten-percent penalty. Upon review, the Supreme Court affirmed the Court of Appeals' decision with respect to the abatement issue and that court's holding that the ten-percent penalty should have been imposed in this case. The Supreme Court reversed the Court of Appeals decision requiring the entire lump-sum award be paid to the Grandsons, and reinstated the Estate's and Grandsons' settlement. The Court also reversed the Court of Appeals decision to remove the assessment of interest. The case was remanded for further proceedings on what sums were due pursuant to the Court's holding here. View "Hudson v. Lancaster Convalescent Center" on Justia Law

Chapter 2007-1 of the Laws of Florida made state-subsidized reinsurance available to Florida insurers at rates lower than those offered in the private market. Plaintiffs filed suit against Allstate alleging that it violated Chapter 2007-1 by failing to promptly reduce its premiums and retaining the costs savings resulting from the state's subsidy of its reinsurance. The district court dismissed the claim for failure to state a claim under Rule 12(b)(6). The district court relied on several alternative grounds to reach the conclusion that plaintiffs failed to state a claim. Plaintiffs failed to clearly raise any challenge to the alternative holdings. Therefore, the court concluded that plaintiffs abandoned any argument they may have had that the district court erred in its alternative holdings that each of their four claims was inadequate as a matter of Florida law independent of any issue concerning the filed rate doctrine or whether there was a private right of action for insureds against insurers who violate Chapter 2007-1. Accordingly, the court affirmed the judgment of the district court. View "Sapuppo, et al. v. Allstate Floridian Ins. Co." on Justia Law

Plaintiff filed suit against their insurer, American Bankers, after American Bankers denied plaintiffs' claim to recover for property damage under their Standard Flood Insurance Policy. Although plaintiffs filed a proof of loss for their undisputed claims, including the damage to their residence, they never filed a proof of loss for their disputed debris removal claim. The court concluded that plaintiffs' failure to file a proof of loss for their debris removal costs was a complete bar to recovery under the policy. Accordingly, the court reversed the district court's grant of summary judgment in favor of plaintiffs and remanded for entry of judgment in favor of American Bankers. View "Dickson, et al. v. American Bankers Ins. Co." on Justia Law

Plaintiff filed suit against CRST in state court alleging that CRST negligently failed to maintain his workers' compensation insurance coverage. CRST removed the case to federal court and the district court granted summary judgment to CRST. The court affirmed the district court's holding that plaintiff's action was barred by the applicable Missouri statute of limitations. View "Brown v. CRST Malone" on Justia Law

In 1997, the U.S. Department of Commerce determined, under 19 U.S.C. 1673b, that freshwater crawfish tail meat from China was being sold in the U.S. at less than fair value and directed Customs to suspend final computation of duties on such entries and to require a deposit or bond to cover estimated duties. In 2000-2001, New Phoenix made entries of the product. The exporters were subject to “new shipper” review to determine whether they were entitled to antidumping-duty rates distinct from the default rate. Each of five bonds issued by Great American to cover anticipated duties was for $1,219,458 and was signed by Davis and accepted by the government, although the power-of-attorney filed with Customs indicated a limit of $1 million on his authority. Great American later revoked his authority. In 2003, Commerce published final results, finding that the exporter was not entitled to a different rate and sought payment from New Phoenix and Great American. The amount owed is greater than the amounts of the bonds. The trial court granted the government summary judgment, without pre- and post-judgment interest, finding that the government did not timely address those issues. The Federal Circuit affirmed that the bonds were not enforceable beyond Davis’s stated authority and the denial of pre-judgment interest View "United States v. Great Am. Ins. Co" on Justia Law

Defendant-sellers obtained a policy from American Family Mutual Insurance Company insuring an apartment building. When preparing for the sale of the building, Defendants signed a real estate condition report stating that they were not aware of the presence of asbestos on the premises. After Plaintiff-buyers purchased the building, their contractor discovered asbestos in the building. Plaintiffs filed an action against Defendants for breach of contract/warranty and negligence in failing to adequately disclose defective conditions. The circuit court held that American Family had no duty to defend or indemnify Defendants because an asbestos exclusion in the American Family policy precluded coverage. The court of appeals affirmed, concluding that the policy precluded coverage. The Supreme Court affirmed, holding that the asbestos exclusion in the American Family policy precluded coverage for the losses alleged by Plaintiffs. View "Phillips v. Parmelee" on Justia Law

Claimant injured his low back while at work in April 2008, and his employer accepted his subsequent claim for a lumbar strain. Claimant was taken off work after his injury and, during the next several months, received an extensive course of chiropractic care. In An examining physician declared claimant medically stationary and released him to regular work without restriction. Based on the physician's findings, the employer issued a notice of closure that did not award benefits to claimant. Claimant was unsuccessful in his request for reconsideration. The Supreme Court, after its review of this case, concluded that the Department of Consumer and Business Services (DCBS) erred in its interpretation of the rules with regard to claimant's injury and determination for benefits. Accordingly, the case was remanded to the board for further proceedings. View "Schleiss v. SAIF Corporation" on Justia Law

This action arose from a rear-end collision allegedly caused by Zabian Bailey. Plaintiff filed a complaint against Bailey for negligence and against Progressive Northern Insurance Company for underinsured motorist benefits. A jury returned a verdict in favor of Plaintiff. Progressive filed a motion to set aside the verdict and for judgment in accordance with the motion for a directed verdict, claiming that Plaintiff failed to present sufficient evidence for the jury to reasonably find or infer negligence and proximate cause. The trial court denied the motion. The appellate court reversed and remanded with direction to grant Progressive’s motion. The Supreme Court reversed, holding that the evidence in this case was sufficient for a jury reasonably to find or infer that it was more probable than not that Bailey was negligent and that his negligence caused the collision. Remanded. View "Rawls v. Progressive N. Ins. Co." on Justia Law

The Superior Court dismissed the underlying complaint in this case based solely upon its determination that a 2011 Settlement Agreement barred the Plaintiffs’ claims as constituting an impermissible collateral attack on a 2009 Insurance Agreement. The Superior Court did not address the sufficiency of the Plaintiffs’ allegations supporting their claims. In this appeal, Plaintiffs contended that the Superior Court should not have dismissed their claims because the 2011 Settlement Agreement was reasonably susceptible to the Plaintiffs’ interpretation. Therefore, extrinsic evidence of the parties’ intent was necessary to resolve any dispute over the 2011 Settlement Agreement’s terms. After its review, the Supreme Court concluded the Superior Court erred in holding that, as a matter of law, the 2011 Settlement Agreement unambiguously precluded the Plaintiffs from asserting the claims that are at issue in this action. The intent of the parties in negotiating the 2011 Settlement Agreement was a factual question inappropriate for resolution on a Rule 12(b)(6) motion to dismiss. View "Nicholas, et al. v. National Union Fire Insurance Co. of Pittsburgh, PA, et al." on Justia Law