Justia Insurance Law Opinion Summaries

Plaintiff contracted with a shipper agent to move his household goods and personal property from Nebraska to Florida, but the movers who took possession of Plaintiff's property demanded additional payment before the property was delivered, and the property was never delivered to Florida or returned to Plaintiff. Plaintiff sought coverage under his homeowner's policy for loss of personal property due to theft. Insurer denied coverage, claiming that a theft had not occurred. Plaintiff sued Insurer for breach of contract and bad faith in denying the insurance claim. The district court granted summary judgment for Insurer, concluding that Plaintiff lost his property in a contractual dispute and that there was no showing of criminal intent. The Supreme Court reversed, holding that genuine issues of material fact existed as to whether a theft occurred in this case. Remanded. View "Peterson v. Homesite Indem. Co." on Justia Law

Warren Parsons appealed a judgment affirming a Workforce Safety and Insurance Fund ("WSI") decision that denied his claim for workers' compensation benefits. Parsons applied for workers' compensation benefits from WSI, alleging he sustained an injury to his left shoulder and neck while working for Ames Construction. He claimed he developed pain at the base of his neck and into his left shoulder from hitting the seat belt repeatedly while driving the dump truck on rough roads. Parsons argued his cervical spine and left shoulder injuries were "compensable injuries" by law. Upon review, the Supreme Court concluded WSI erred in determining Parsons' injury was not a compensable injury and in denying his claim for benefits. View "Parsons v. WSI" on Justia Law

Plaintiff was the minor beneficiary of a $100,000 life insurance policy. Plaintiff filed a complaint against his financial guardian and the insurance company after the guardian misappropriated the insurance proceeds. The trial court entered judgments in favor of Plaintiff. The insurance company appealed. The court of appeals affirmed, concluding that, by entrusting the proceeds to the guardian, the insurance company breached its contractual duties. The Supreme Court reversed, holding (1) the insurance company acted in good faith when it relied upon the validity of a juvenile court order establishing a financial guardianship in making payment of the life insurance proceeds, and (2) therefore, the insurance company could not be liable for breach of contract. View "Hood v. Jenkins" on Justia Law

A county-owned police patrol vehicle was damaged in a single-car collision while Respondent, a county police officer, operated the vehicle under the influence of alcohol. The County, a self-insured entity, filed a complaint against Respondent seeking to recover the cost of repairs to the vehicle. The district court ruled that the County could recover damages against Respondent based on an exclusion in the self-insurance guarantee purportedly excluding or disclaiming all insurance coverage on the basis that Respondent operated his vehicle under the influence of alcohol. The circuit court reversed. The Supreme Court affirmed, holding (1) Maryland's compulsory motor vehicle insurance scheme does not permit a self-insurer such as the County to disclaim or exclude insurance coverage in a self-insurance guarantee where an individual causes a collision while driving under the influence of alcohol; and (2) the exclusion in the guarantee in this case was invalid because it violated the state compulsory motor vehicle insurance scheme, was not expressly authorized by the General Assembly, and was against public policy. View "Montgomery Co. v. Distel" on Justia Law

Angela Frye filed a workers' compensation claim against her employer alleging that in 2008 she suffered a work-related injury. The administrative law judge (ALJ) awarded Frye benefits related to the injury. In 2009, after the final hearing in the 2008 claim but before the ALJ took that claim under submission or rendered an opinion, Frye allegedly suffered a second work-related injury. In 2010, Frye filed a claim related to the 2009 accident. The ALJ dismissed the 2010 claim, concluding that Frye was required by Ky. Rev. Stat. 342.270(1) to file her claim for benefits related to the 2009 accident and join it to her pending 2008 claim, which she failed to do. The Workers' Compensation Board reversed, concluding that a claim is no longer pending for section 342,270(1) purposes after the date of the final hearing. The court of appeals affirmed. The Supreme Court affirmed, holding that in this case and under these facts, Frye's first injury claim was not pending between the date of the hearing and the date the ALJ rendered his opinion regarding that claim. Remanded. View "Saint Joseph Hosp. v. Frye" on Justia Law

Reyes was driving in Elgin when she was involved in an accident with pedestrians, a mother and her four-year-old son. The boy died. The mother and her husband sued Reyes for negligence and wrongful death. American Access Casualty sought a declaration that the policy it had issued to Reyes provided no coverage. The policy had been issued to Reyes on her 1999 Chrysler. She was identified as the titleholder of the vehicle, the named insured, and as “driver number one.” Next to her name, where her driver’s license number should be, was the language “Title Holder Exclude.” A friend, was listed as “driver number two” and identified as the primary driver. An endorsement excluded from coverage vehicle operation by Reyes. State Farm, which provided uninsured-motorist coverage to the mother and son, filed a counterclaim, seeking a declaration that American Access’ attempt to exclude Reyes under its own insurance policy violated public policy and was unlawful. The trial court granted American Access summary judgment, finding that the policy in question provided no coverage for the accident. The appellate court and Illinois Supreme Court disagreed. Section 7-601(a) of the Illinois Safety and Family Financial Responsibility Law, part of the Illinois Vehicle Code, requires liability insurance for vehicles on the road for the protection of the public. Although the exclusion of named drivers is permitted, exclusion of a vehicle owner who is also the named insured is a violation of the public policy expressed in the statute. View "Am. Access Cas. Co. v. Reyes" on Justia Law

The worker was injured in a 2006 automobile accident near Cordova, where he was working temporarily for Venture. Cordova is 200 miles from Springfield, where he lived and where his plumbers’ and pipefitters’ union was. He was living a motel 30 miles from the worksite with a coworker, also from Springfield, who was driving when the accident occurred. An arbitrator denied his workers’ compensation claim. The Workers’ Compensation Commission reversed; the trial court set aside the Commission’s finding. The Workers’ Compensation Division of the Appellate Court granted relief to the worker. The Illinois Supreme Court reversed, holding that the worker was not a “traveling employee” and could not be compensated. An injury incurred by an employee in going to or returning from the place of employment is not compensable, because it is not arising out of or in the course of employment, unless the worker can be categorized as a “traveling employee.” The employer did not direct the worker to accept the position at the Cordova location; he accepted it with full knowledge of the commute involved. His course or method of travel was not determined by the demands and exigencies of the job. He was not reimbursed for travel time or expenses or told what route to take.View "The Venture-Newberg Perini Stone v. IL Workers' Compensation Comm'n" on Justia Law

Plambeck owned two Kentucky chiropractic clinics that treated patients injured in car accidents, including some State Farm customers. All of the treating chiropractors were licensed to practice in Kentucky. Plambeck was not, although he was licensed elsewhere, and did not treat any patients in Kentucky. State Farm assumed that Plambeck had a license because Kentucky law requires chiropractic practitioners and owners of chiropractic clinics to hold one. When State Farm discovered that Plambeck lacked a state license, it stopped paying the clinics and sued Plambeck to recover all payments since 2000. The district court granted summary judgment to State Farm and awarded $557,124.78 in damages. The Sixth Circuit reversed. Kentucky common law claims for recovery of funds mistakenly paid are based on unjust enrichment. Because State Farm and the clinics never had a contractual relationship, the only applicable theory would require State Farm to show that it paid money to the clinics not due “either in law or conscience.” State Farm did not offer such proof. View "State Farm Auto. Ins. Co. v. Newburg Chiropractic" on Justia Law

PTJV filed suit against ACE claiming coverage under primary and excess insurance policies with regard to a large-scale construction project in Maryland. The court affirmed the district court's grant of summary judgment in favor of ACE, holding that under Maryland and Tennessee law, PTJV violated the terms of both the primary and excess policies by not obtaining ACE's consent before settlement, and as such, could not now claim reimbursement under those policies. View "Perini/Tompkins Joint Venture v. ACE American Ins. Co." on Justia Law

Phusion manufactures and distributes an alcoholic beverage called “Four Loko.” Its original formula contained energy stimulants, such as caffeine, guarana, taurine, and wormwood. Phusion purchased a commercial general liability insurance policy and a umbrella policy from members of the Liberty Mutual Group. The policies include identical provisions, excluding coverage for bodily injury or property damage when the insured may be held liable by reason of causing or contributing to intoxication. Plaintiffs sued Phusion in separate state court actions, alleging injuries caused by consumption of Four Loko. Two cases involved traffic accidents, one involved a shooting, another involved paranoid behavior resulting in accidental death, and a fifth claim involved a death from heart trouble. Phusion notified Liberty, which sought a declaratory judgment regarding the scope of coverage. The district court examined the underlying cases in the context of comparable automobile exclusions and ruled that four of the five cases fell within the Liquor Liability Exclusion. The Seventh Circuit affirmed. The Liquor Liability Exclusions in the policies are unambiguous and apply to Phusion. The allegations of simple negligence raised by the plaintiffs in the underlying complaints are not sufficiently independent from the allegations that Phusion caused or contributed to the intoxication of any person. View "Netherlands Ins.. Co. v. Phusion Projects, Inc." on Justia Law