Justia Insurance Law Opinion Summaries

Companion, a South Carolina insurer, appealed the district court's dismissal of its complaint alleging legal malpractice against defendants, Louisiana residents and attorneys at a Louisiana law firm. The court concluded that the district court properly dismissed Companion's complaint against defendants for lack of personal jurisdiction in a Texas Forum where defendants maintained no offices in Texas, had no personnel stationed there, paid no Texas taxes, and had no registered agent for service of process; defendants transacted only limited and discrete business in Texas over an appreciable period; and the venue issue was unnecessary for a decision in this case because the court affirmed the dismissal on personal-jurisdiction grounds. View "Companion Property and Casualty Co. v. Palermo, et al." on Justia Law

The Fund is a multi-employer trust fund under the Taft-Hartley Act, 29 U.S.C. 186, and the Employee Retirement Income Security Act, 29 U.S.C. 1001. Blue Cross is a Michigan non-profit corporation; its enabling statute authorizes the State Insurance Commissioner to require it to pay a cost transfer of one percent of its “earned subscription income” to the state for use to pay costs beyond what Medicare covers. In 2002 the Fund converted to a self-funded plan, and entered into an Administrative Services Contract with Blue Cross, which states that Blue Cross is not the Plan Administrator, Plan Sponsor, or fiduciary under ERISA; its obligations are limited to processing and paying claims. In 2004 the Fund sued, claiming that Blue Cross breached ERISA fiduciary duties by imposing and failing to disclose a cost transfer subsidy fee to subsidize coverage for non-group clients. The fee was regularly collected from group clients. Self-insured clients were not always required to pay it. Following a first remand, the district court granted class certification and granted the Fund summary judgment. On a second remand, the court again granted judgment on the fee imposition claim and awarded damages of $284,970.84 plus $106,960.78 in prejudgment interest. The Sixth Circuit affirmed. View "Pipefitters Local 636 Ins. Fund v. Blue Cross & Blue Shield of MI" on Justia Law

In a declaratory judgment action, the issue before the Supreme Court was whether the circuit court erred when it found a commercial general liability (CGL) policy provided coverage when a brick face was damaged by improper cleaning after the insured general contractor completed its installation. After review, the Court concluded the policy did not provide coverage. View "Bennett & Bennett Construction v. Auto Owners Insurance" on Justia Law

Following Appellant Darren Pollack's injury on the job, his employer accommodated his work restrictions by providing him light duty employment. Later, Appellant was discharged for violating a company policy by failing to report an accident involving an employer vehicle. Appellant filed a claim seeking Temporary Total Disability benefits. The Workers' Compensation Commission denied the claim, holding Appellant's termination and resulting incapacity to earn wages was due to his violation of company policy and not his work-related injury. Finding no error in the Commission's decision, the Supreme Court affirmed. View "Pollack v. Southern Wine & Spirits" on Justia Law

Plaintiff maintained a homeowners insurance policy with Insurer that excluded from coverage any claims for "injury arising out of the business pursuits" of Plaintiff. In 2011, a third party filed a complaint against Plaintiff, contending that Plaintiff published false and defamatory statements regarding the third party. In response to the complaint, Plaintiff tendered defense of the suit to Insurer, which declined to defend Plaintiff. Plaintiff then filed a complaint seeking a declaratory judgment that Insurer had a duty to defend him in the pending action by the third party. The superior court granted Plaintiff's motion for summary judgment. The Supreme Court vacated the judgment and remanded for entry of a summary judgment in favor of Insurer, holding that Insurer had no duty to defend Plaintiff because the third party suit was based entirely on activity falling within the policy's exclusion for Plaintiff's "business pursuits." View "Hardenbergh v. Patrons Oxford Ins. Co." on Justia Law

Amicas agreed to a merger for $5.35 per Amicas share. Shareholders sued in Massachusetts state court, contesting the adequacy of a proxy statement used to seek approval. A preliminary injunction stopped the vote. The suit settled when a third party made a $6.05 per-share tender offer. Amicas shareholders gained $26 million. The lawyers who filed the suit sought attorneys’ fees based on the difference between the bids. Carolina Casualty had issued a policy covering what Amicas and its directors pay their own litigation lawyers and what Amicas must pay adversaries’ lawyers. The state court awarded $3,150,000, using a lodestar of $630,000 (1,400 hours at $450 per hour) times five, to reflect the risk of nonpayment and “an exceptionally favorable result.” Carolina Casualty filed a diversity suit, claiming that coverage was limited to $630,000. The district judge affirmed, but denied damages for bad faith or vexatious failure to pay. The Massachusetts appeal settled with payment of a sum that cannot be affected by the results of federal litigation. The Seventh Circuit held that the case was not moot, but affirmed, rejecting an argument that the award constituted excluded “civil or criminal fines or penalties … punitive or exemplary damages, the multiplied portion of multiplied damages.” View "Carolina Cas. Ins. Co v. Merge Healthcare Solutions, Inc." on Justia Law

Plaintiff was withdrawing money from an ATM when Tortfeasor struck her with his car. Tortfeasor was insured under a policy written by Insurer to a limit of $100,000 for bodily injury to one person. Plaintiff and several of her family members brought this action against Tortfeasor and his brother, the named insured on the policy, (collectively, Tortfeasor) and Insurer. The district court originally entered judgment ordering Insurer and Tortfeasor to pay one-and-a-half million dollars to Plaintiffs. Insurer paid into court $75,000, the remainder of its policy limit. The district court later amended its judgment, holding Tortfeasor and Insurer liable for six million dollars in damages. Plaintiffs then unsuccessfully sought to compel Insurer to pay postjudgment interest on the full judgment. The First Circuit Court of Appeals reversed the deniial of Plaintiff's request for postjudgment interest, holding that Insurer was responsible for postjudgment interest from the date of entry of the original judgment and the date of the deposit of the policy limit. View "Vazquez-Filippetti v. Cooperativa de Seguros Multiples de P.R." on Justia Law

Defendant hosted an underage drinking party in which one of the guests known to become belligerent when intoxicated assaulted and seriously injured another guest. The victim sued Defendant and his insurer (Insurer) for damages for his injuries. Insurer disputed coverage, arguing that it had no duty to defend and indemnify Defendant because there was no "accident" or "occurrence" under Defendant's family's homeowner's insurance policy where Defendant's actions were intentional. The circuit court granted summary judgment to Insurer. The court of appeals reversed, concluding that there was an occurrence because the assault was an accident when viewed from the standpoint of the injured person or Defendant, the insured. The Supreme Court reversed, holding (1) viewed from the standpoint of a reasonable insured, Defendant's intentional actions in setting up a drinking party and procuring alcohol for underage guests, including one known to become belligerent when intoxicated, created a direct risk of harm resulting in bodily injury; and (2) thus, the victim's bodily injury was not caused by an "occurrence" within the meaning of the policy, and Insurer was not obligated to provide insurance coverage for Defendant. View "Schinner v. Gundrum" on Justia Law

Plaintiff injured his shoulder while working for his employer, who was insured by the Montana State Fund. The State Fund paid for Plaintiff's two shoulder injuries and paid temporary total disability (TTD) benefits after informing Plaintiff that if he returned to gainful employment without the State Fund's knowledge and continued to receive benefits, he would be subject to legal action or criminal prosecution. After the State Fund discovered that Plaintiff had built and sold furniture and worked at a vacuum cleaner store while receiving TTD benefits, the assistant attorney general charged Plaintiff with theft, a felony. The State Fund subsequently terminated Plaintiff's TTD benefits. Plaintiff filed suit against the State fund and its private investigators, alleging that Defendants violated Montana's Insurance Code regarding unfair claim settlement practices and pleaded a variety of common law causes of action. The district court ruled in favor of Defendants. The Supreme Court affirmed the district court's entry of judgment in favor of the State Fund, holding that the district court did not err in (1) granting the State Fund's motion to dismiss Defendant's claims under the Insurance Code; and (2) granting the State Fund's motion for summary judgment regarding Plaintiff's common law claims. View "White v. State ex rel. Mont. State Fund" on Justia Law

Defendant City of Burlington Retirement System appealed a superior court judgment that reversed its decision to terminate the disability retirement of plaintiff, a former City firefighter. Upon review, the Supreme Court concluded the record fully supported the superior court's conclusion that there was no reasonable basis for the Board's decision to terminate plaintiff's disability retirement. View "Preston v. Burlington City Reitrement System" on Justia Law