Justia Insurance Law Opinion Summaries

The Federal Depository Insurance Corporation (FDIC), acting as receiver of the New Frontier Bank, used proceeds from the sale of cattle belonging to a limited liability company (LLC) to pay down a loan of one of the two LLC members. According to the complaint, the FDIC had no authority to do so because the payment was contrary to the members' agreement. Ignoring the separate entity status of an LLC, the other LLC member brought suit in its own name against the United States under the Federal Tort Claims Act (FTCA) for what it claimed to be the FDIC's wrongful disbursement of the proceeds. The LLC sued the government under the Fifth Amendment Takings Clause. The district judge dismissed the suit for failure to state a claim. The Tenth Circuit agreed dismissal was appropriate, the Appellate Court concluded dismissal should have been for lack of jurisdiction as to the member's claims and as to the LLC's claim because the United States Court of Federal Claims had exclusive jurisdiction. View "ECCO Plains, LLC., et al v. United States" on Justia Law

Claimant suffered a compensable injury to his right ankle in 1991 and developed reflex sympathetic dystrophy in the injured ankle. In 1997, the appeals panel determined Claimant was entitled to Lifetime Income Benefits (LIBs). The workers' compensation carrier for Claimant's employer (Insurer) did not seek judicial review of that decision. More than a decade later, Insurer sought a new contested case hearing on Claimant's continuing eligibility for LIBs. A hearing officer found that Insurer could re-open the previous LIB determination but that Claimant remained entitled to LIBs. The appeals panel affirmed. Both parties sought judicial review. The trial court granted Claimant's motion for summary judgment, concluding that the hearing officer lacked jurisdiction to re-open the previous LIB determination. The court of appeals affirmed. The Supreme Court affirmed, holding that the Legislature does not allow permanent benefit determinations like LIBs to be re-opened. View "Liberty Mut. Ins. Co. v. Adcock" on Justia Law

Claimant Rubio Izaguirre settled with a third-party tortfeasor following a work-related automobile accident. His employer and surety asserted a right of subrogation against the entirety of that settlement. On appeal, claimant argued that subrogation rights should have extended only to damages that workers’ compensation typically insures and not to pain and suffering. The Commission found in favor of the employer and surety, holding that all of the settlement proceeds were subject to subrogation. Finding no error, the Supreme Court affirmed. View "Izaguirre v. R&L Carriers" on Justia Law

Defendants, Nancy and Thomas Bernheim, appealed the trial court’s summary judgment decision granting plaintiff GEICO Insurance Company’s claim against them for reimbursement of $10,000 that GEICO had paid defendants under the medical-payments provision of their automobile insurance policy. Although the Supreme Court agreed with the trial court that defendants should have reimbursed GEICO, it reversed and remanded for a determination of the proper reimbursement amount. View "GEICO Insurance Co. v. Bernheim" on Justia Law

This case arose when the EPA sent two letters to Anderson notifying Anderson of its potential liability under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), 42 U.S.C. 9601 et seq., for environmental contamination of the Portland Harbor Superfund Site. Anderson's general liability insurer, St. Paul, declined to provide Anderson with a legal defense. St. Paul argued that the letters sent to Anderson were not "suits" because they were not filed in a court of law. The court held that the letters were "suits" within the meaning of the policies; the letters alleged facts sufficient to alert Anderson to its potential liability for environmental contamination under CERCLA; and, therefore, St. Paul breached its duty to defend Anderson. Accordingly, the court affirmed the judgment of the district court in favor of Anderson and also affirmed the attorney's fee award in Anderson's favor in light of the court's holding on the merits. View "Anderson Bros. v. St. Paul Fire & Marine Ins. Co." on Justia Law

The parties disputed ownership of life insurance policies and, according to their contract, submitted the dispute to a rabbinical arbitration panel. The arbitration panel appointed by the parties entered an award mandating the immediate transfer of the insurance policies at issue to Kolel and appellants subsequently appealed. The court concluded that the district court properly denied vacatur based on claims of bias and corruption; properly denied vacatur based on claims of premature decision and failure to consider evidence; and properly denied appellants' motion for reconsideration. Therefore, appellants have not presented any evidence that meets the high burden of proof necessary to vacate an arbitration award, and therefore the district court properly denied their motion for vacatur and granted Kolel's motion for confirmation of that same arbitration award. View "Kolel Beth Yechiel Mechil v. YLL et al." on Justia Law

Jason Morris worked for Owensboro Grain, a refinery located on the Ohio River. Morris suffered a work-related injury while performing deckhand duties, including loading items onto a barge. Morris received benefits from Owensboro Grain's Longshore and Harbor Workers' Compensation Act (LHWCA) insurance policy. Later, Morris filed a claim for Kentucky workers' compensation benefits. Owensboro Grain denied the claim on the grounds that the injury was not covered under the Kentucky Workers' Compensation Act. An ALJ dismissed Morris's claim, finding that Morris's injury fell under the LHWCA, and therefore, Kentucky had no subject matter jurisdiction over his claim. The Workers' Compensation Board and court of appeals affirmed. The Supreme Court affirmed, holding (1) because Morris was covered under the LHWCA, he was exempt from Kentucky's workers' compensation law unless Owensboro Grain provided him voluntary coverage; and (2) there was insufficient evidence to prove that Owensboro Grain provided voluntary workers' compensation coverage to Morris. View "Morris v. Owensboro Grain Co., LLC" on Justia Law

Sarah Crossett was employed by Jackson Purchase Medical Associate (JPMA), which leased space within a medical pavilion. Crossett was injured when she slipped and fell in snow that had accumulated outside of the building. Crossett filed for workers' compensation. JPMA disputed Crossett's claim, asserting that the injury did not occur on its operating premises under the going and coming rule, which provides that injuries that occur while an employee is on the way to or from a worksite are not compensable. An ALJ concluded that Crossett's injury was compensable, finding that Crossett fell within the operating premises of JPMA. The court of appeals affirmed. The Supreme Court affirmed, holding that because JPMA could assert control over the parking area and because Crossett was not taking an unreasonable path between her car and her office, she was entitled to workers' compensation benefits for her injury. View "Jackson Purchase Med. Assocs. v. Crossett" on Justia Law

The EPA filed suit under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA), 42 U.S.C. 9601 et seq. against Land O'Lakes, alleging that Land O'Lakes was responsible for cleanup costs at a contaminated refinery site. Land O'Lakes subsequently filed suit against its insurers, Wausau and Travelers, seeking payment of defense costs and indemnification under commercial general liability (CGL) policies that the insurers issued in connection with the CERCLA suit. The court concluded that Land O'Lakes's 2009 duty-to-defend claims were barred by the Minnesota statute of limitations where the 2001 Potentially Responsible Party (PRP) letter was a "suit" for arguably-covered damages as contemplated under the pertinent CGL policies. The court also concluded that Land O'Lakes's costs to remediate the refinery site fell within the owned-property exclusion. Accordingly, the court affirmed the judgment of the district court. View "Land O'Lakes, Inc. v. Employers Ins. Co., et al." on Justia Law

Pacific issued a fire insurance policy to plaintiff on a home that was destroyed by fire during the policy period. On appeal, Pacific challenged the district court's grant of summary judgment to plaintiff on its claim for a declaratory judgment that an apportionment-of-loss clause in the policy was void as a matter of New York law, and that Pacific was liable to plaintiff for the entire amount of loss coverage shown in the fire insurance policy. Plaintiff cross-appealed from so much of the judgment as ruled that it was not entitled to recover replacement costs in excess of the stated loss coverage amount on the house. The court concluded that plaintiff's contentions were without merit and affirmed to the extent that the district court dismissed plaintiff's claim for extended replacement costs. In regards to Pacific's appeal, the court certified questions to the New York Court of Appeals. View "Quaker Hills, LLC v. Pacific Indemnity Co." on Justia Law