Justia Insurance Law Opinion Summaries

Bennett was walking her dog in Garfield Heights, Ohio when she was struck on the left knee by a vehicle driven by Pastel. The accident threw Bennett onto the car’s hood. Bennett sued Pastel’s insurer, State Farm, which characterized as “ridiculous” her assertion that she was an “occupant” of the car, as that term is defined by State Farm’s policy, at the time she was on the vehicle’s hood. The district court granted summary judgment to State Farm. The Sixth Circuit reversed. The policy defines “occupying” as “in, on, entering or alighting from.” The court stated that “we have no reason to explore Bennett’s relationship with the car… the policy marks out its zone of coverage in primary colors.” View "Bennett v. State Farm Mut. Auto. Ins." on Justia Law

Claimant suffered a lower back injury during the course of his employment and filed notice of a workers' compensation claim. Employer later informed Claimant he would be discharged from his employment. Claimant signed a termination agreement in order not to forfeit his severance pay. The agreement stipulated that Claimant released his previously accepted workers' compensation claim. The Workers' Compensation Commissioner refused to approve the termination agreement, finding there was no consideration offered by Employer to Claimant in exchange for Plaintiff's release of the workers' compensation clim. The Workers' Compensation Review Board affirmed. The Supreme Court affirmed, holding that the Board properly affirmed the Commissioner's decision not to approve the agreement as a "voluntary agreement" or stipulation in light of its finding that Claimant's release of his workers' compensation claim was not supported by consideration. View "Leonetti v. MacDermid, Inc." on Justia Law

Owners Insurance Company appealed a circuit court judgment declaring Owners was obligated to pay an arbitration award entered against Jim Carr Homebuilder, LLC ("JCH"), under the terms of a commercial general-liability insurance policy Owners had issued. Owners initiated a declaratory-judgment action against JCH seeking a declaration that it was not obligated to indemnify JCH for any judgment entered against JCH arising from a dispute that a house JCH constructed was poorly built. After the homeowners prevailed in their action against JCH, the trial court in the declaratory-judgment action entered a summary judgment holding that Owners was required to pay pursuant to the terms of the Owners policy. Upon review, the Supreme Court found that because JCH's faulty workmanship was not an "occurrence," the trial court's judgment was in error, and it was hereby reversed. View "Owners Insurance Company v. Jim Carr Homebuilder, LLC et al. " on Justia Law

Plaintiff's property was insured by a standard flood insurance policy (SFIP) issued by Allstate Insurance Company, a private insurer participating in the National Flood Insurance Program (NFIP). Allstate issued Plaintiff's SFIP on behalf of FEMA, the federal agency that administers the NFIP. After Plaintiff's property was damaged by a flood, Allstate paid him for some but not all claims. Plaintiff sued Allstate for the alleged remaining unpaid covered losses, and the district court entered judgment in favor of Plaintiff. The First Circuit Court of Appeals reversed and remanded with directions to enter summary judgment in favor of Allstate, holding that Plaintiff's failure to comply with the SFIP's requirement that he file a proof of loss as to all damages sought barred recovery under his policy for those damages and required dismissal. View "DeCosta v. Allstate Ins. Co." on Justia Law

Real party in interest, a homeowner's association (HOA), filed construction defect actions against Petitioners. During discovery, Petitioners disclosed some of their primary insurance agreements to the HOA pursuant to Nev. R. Civ. P. 16.1(a)(1)(D). Petitioner refused to disclose additional undisclosed policies covering it that may have been purchased by its parent companies. A special master ordered Petitioner to disclose those agreements. Petitioner objected to the order and filed this writ petition, contending that the disclosed insurance policies were more than sufficient to satisfy any judgment that may be entered against them. The Supreme Court denied the petition, holding that section 16.1(a)(1)(D) requires disclosure of any insurance agreement that may be liable to pay a portion of a judgment. View "Vanguard Piping v. Eighth Judicial Dist. Court" on Justia Law

This appeal arose out of an insurance dispute between TMM, which owned a shopping center, and OCIC, which insured the property. At issue was the extent of damage that was caused to the property during a hailstorm. An appraisal was conducted but the district court set aside the appraisal award and had the case proceed to trial where an advisory jury assessed a damage award. The court held that the appraisal award was incorrect in that it excluded damage to the HVAC unit from the award, but that the rest of the award should remain unaffected by this determination; the appraisers did not exceed their authority when they considered causation issues, and therefore the appraisal award should not have been set aside; OCIC was only obligated to pay the amount articulated in the award, plus the cost of repair for the HVAC system; and, therefore, OCIC fulfilled the terms of the insurance contract when it tendered the amount articulated in the award and the cost of the repair to the HVAC system to TMM. Accordingly, the court held that there was no breach of contract and TMM's cross-appeal was moot. The court reversed and remanded so that the district court could reinstate the appraisal award. View "TMM Investments, Ltd. v. Ohio Casualty Ins. Co." on Justia Law

Kennedy family members own a controlling interest in corporate entities that comprise Autocam. John Kennedy is Autocam’s CEO. The companies are for-profit manufacturers in the automotive and medical industries and have 661 employees in the U.S. The Kennedys are practicing Roman Catholics and profess to “believe that they are called to live out the teachings of Christ in their daily activity and witness to the truth of the Gospel,” which includes their business dealings. Regulations under the Patient Protection and Affordable Care Act of 2010 (ACA), 124 Stat. 119, require that Autocam’s health care plan cover, without cost-sharing, all FDA-approved contraceptive methods, sterilization, and patient education and counseling for enrolled female employees. Autocam and the Kennedys claim that compliance with the mandate will force them to violate their religious beliefs, in violation of the Religious Freedom Restoration Act, 42 U.S.C. 2000bb. The district court denied their motion for a preliminary injunction. The Sixth Circuit affirmed for lack of standing. Recognition of rights for corporations under the Free Speech Clause 20 years after RFRA’s enactment does not require the conclusion that Autocam is a “person” that can exercise religion for purposes of RFRA. View "Autocam Corp. v. Sebelius" on Justia Law

This case presented an issue of first impression for the Supreme Court: the allocation of defense costs incurred by the common insured of several carriers. Specifically, the issue was whether one insurer with an obligation to indemnify and defend the insured had a direct claim for contribution against its co-insurer for defense costs arising from continuous property damage litigation. Furthermore, the Court considered whether such a claim was extinguished when the insured gave up its claims against the co-insurer in a release negotiated and signed only by the insured and the co-insurer. The dispute arose from construction litigation brought by the Township of Evesham against a contractor, Roland Aristone Inc. for property damage. Although plaintiff, OneBeacon Insurance Company paid half of Aristone's legal fees and defense expenses, Pennsylvania Manufacturers’ Insurance Company, which also insured Aristone, initially disclaimed coverage and did not pay any of Aristone’s defense costs. The Appellate Division affirmed the portion of the trial court’s decision allocating defense costs among the several insurers. It recognized OneBeacon’s claim for contribution against PMA and affirmed the trial court’s holding that OneBeacon’s claim was not extinguished by the release negotiated by Aristone and PMA. Upon review, the Supreme Court held that, in light of each insurer’s obligation to indemnify and defend Aristone for a portion of the period in which the continuing property damage occurred, the trial court properly held that OneBeacon had a contribution claim against PMA. View "Potomac Ins. Co. of Ill. v. Pa. Mfrs. Ass'n Ins. Co." on Justia Law

At issue in this case was whether the omnibus clause in a automobile insurance policy provided coverage to a permittee to whom the insured owner loans the car when that first permittee was subject to a negligent entrustment claim for loaning the car to a second permittee. A vehicle owner gave her car keys to defendant, who in turned passed them to another driver. The driver was involved in a fatal, single-car accident and the driver's estate sued defendant for negligent entrustment. Defendant sought coverage under the vehicle owner's automobile insurance policy. Defendant appealed the trial court's order granting summary judgment in favor of the insurer and finding that, as a matter of law, defendant did not qualify for coverage under the policy. Upon review of the trial court record, the Supreme Court concluded that defendant’s entrustment of the vehicle to the driver constituted "use" under the omnibus clause of the policy and that the undisputed evidence supported the conclusion that the insured did not consent to defendant's allowing the driver to drive the car, but that a material issue of fact existed with respect to whether defendant entrusted the car keys to driver reasonably believing that driver would not drive the car. Accordingly, the Court reversed and remanded the case for further proceedings. View "State Farm Mutual Automobile Co. v. Colby" on Justia Law

Garold Charles was in an accident while riding as a passenger in a vehicle belonging to Tara and Anthony Stout. He brought negligence claims against the Stouts and Credit Union 1, the lienholder of the Stouts’ vehicle. Credit Union 1 moved for summary judgment. Charles opposed the motion, relying on testimony from Tara’s deposition and contending in part that he was a third-party beneficiary of an alleged contract between Credit Union 1 and the Stouts by which the credit union agreed to provide liability insurance. The superior court struck Tara’s testimony and granted summary judgment to Credit Union 1. Charles appealed. Finding no error in the trial court's decision, the Supreme Court affirmed. View "Charles v. Stout" on Justia Law