Justia Insurance Law Opinion Summaries

Appellant Tommie Patterson was involved in a motor vehicle accident. His insurance company paid his medical providers to the policy limit. Two years later, Appellant sued the insurance company, arguing it had shown bad faith following the accident. The company moved for summary judgment, which was granted. A month after that decision, Appellant filed a second lawsuit, alleging the company falsely advertised its services, breached his insurance contract, embezzled money from him, falsified documents and threatened to make him at fault for the accident. The company moved for summary judgment again, which was granted. After review, the Supreme Court concluded that because Appellant's embezzlement claim in the second lawsuit alleged a different cause of action than in the first, the trial court improperly granted summary judgment with regards to that claim. All other claims were barred by res judicata. Therefore the Supreme Court affirmed the trial court in all other respects. View "Patterson v. Infinity Insurance Co." on Justia Law

Claimant Deborah Lydy was a traveling licensed practical nurse employed by defendant Trustaff, Inc. While on duty, a patient attacked her causing her to suffer (among other things) an acute cervical sprain. The issue before the Supreme Court in this case centered on whether employer-health insurance premiums should have been included when calculating claimant's average weekly wages under the state workers' compensation laws. The Department of Labor concluded that such premiums were not "wages" and should not have been included. Concluding that the Vermont Legislature did not intend for wages to include payments made on behalf of employees for the purpose of acquiring health insurance. Accordingly, the Court affirmed the Commissioner's judgment. View "Lydy v. Trustaff, Inc." on Justia Law

Pruco Life Insurance Company sought rescission of a life insurance policy, owned by the Paul E. L'Archevesque Special Revocable Trust on the life of Paul L'Archevesque, after it discovered that the policy application contained material misrepresentations about the health of Paul. Pruco tendered to Wilmington Trust Company, a co-trustee of the trust, a check in the amount of the policy premiums paid along with a letter stating Pruco was rescinding the policy. Wilmington cashed the check. Pruco subsequently filed a complaint seeking a rescission of the policy and a declaration that the policy was void ab initio. The district court granted summary judgment to Pruco, concluding that, under the circumstances, a mutual rescission had taken place as a matter of law. The First Circuit Court of Appeals affirmed, holding (1) the district court properly interpreted Rhode Island law regarding the standard for mutual rescission; (2) there were no genuine issues of material fact concerning whether Pruco made material misrepresentations in its rescission letter that could have prevented summary judgment; and (3) the district court did not err in finding that the issue of whether Pruco acted in bad faith was irrelevant to the rescission analysis. View "Pruco Life Ins. Co. v. Wilmington Trust Co." on Justia Law

Exchange is a reciprocal insurance exchange, under 40 PA. STAT. 961. Members purchase insurance policies and receive indemnification for losses out of Exchange’s pool of funds. A 2012 Complaint alleged that Exchange is owned by subscribers and has no independent officers or governing body; that Indemnity is a public corporation that serves as Exchange’s attorney-in-fact; that Indemnity is permitted to retain up to 25% of Exchange’s premiums; that the balance of premiums is to be used for insurance losses and operational costs and may be distributed to Exchange members as dividends at Indemnity’s discretion; that members who pay premiums in installments must pay service charges and are subject to late payment and policy reinstatement fees; that, beginning in 1997, Indemnity began to retained for itself service charges paid to Exchange, which belonged to Exchange; and that, beginning in 2008, Indemnity misappropriated fees, totaling more than $300 million. The complaint was filed for Exchange by certain members and “on behalf of” all other members. Contending that the words “on behalf of” converted the case into a class action, Indemnity removed the case to federal court. The district court remanded to state court. The Third Circuit affirmed, stating that the case was brought under state rules that bear no resemblance to Rule 23 in that they allow for suits by entities, not a conglomerate of individuals, and does not meet the statutory definition of “class action.” View "Erie Ins. Exch. v. Erie Indem. Co" on Justia Law

Plaintiff's automobile insurance policy with Geico included a condition that Plaintiff submit to examination under oath (EUO) before recovering personal injury protection (PIP) benefits. Geico denied Plaintiff's PIP claim due to her failure to satisfy this condition after she was injured in a car accident. Plaintiff filed a class action complaint alleging that Geico had violated Florida's PIP statute. The federal district court dismissed the case, concluding that the PIP statute did not prohibit an insured from requiring an EUO. On appeal, the Eleventh Circuit certified a question of law to the Florida Supreme Court, which answered by holding that, under Fla. Stat. 627.736, an insurer cannot require an insured to attend an EUO as a condition precedent to recovery of PIP benefits. View "Nunez v. GEICO Gen. Ins. Co." on Justia Law

Employee was employer at Employer's aluminum-processing plant from 1957 to 1989. In 2009, Employee filed an occupational-disease claim for benefits with the Arkansas Workers' Compensation Commission, alleging that he suffered from cancer caused by his exposure to asbestos while working for Employer. A law judge found Employee's complaint was time barred. Rather than appeal the decision to the full Commission, Employee filed suit against Employer in circuit court. Employer filed a motion to dismiss based on the exclusive remedy afforded by the Workers' Compensation Act. The circuit court denied the motion, concluding that, where a plaintiff's disease manifests after the statute of limitations has expired, a circuit court has authority to exercise jurisdiction over the plaintiff's claims. The Supreme Court granted Employer's requested writ of prohibition, holding that the Commission had exclusive jurisdiction to decide the issue in the first instance, and because Employee's claim was not submitted to the Commission, the circuit court lacked jurisdiction to decide the case. View "Reynolds Metal Co. v. Circuit Court" on Justia Law

Appellees, the Rubins, requested that the district court issue a Writ of Garnishment against the assets of Hamas and HLF after obtaining a judgment against Hamas for damages resulting from a terrorist attack in an outdoor pedestrian mall in Jerusalem. The district court executed the writ but the Rubins could not execute against HLF's assets because those assets had been restrained under 21 U.S.C. 853 to preserve their availability for criminal forfeiture proceedings. The district court subsequently denied the government's motion to dismiss the Rubins' third-party petition under section 853(n) to assert their interests in the restrained assets and vacated the preliminary order of forfeiture. The district court held that the Terrorism Risk Insurance Act of 2002 (TRIA), Pub. L. No. 107-297, title II, 201, 116 Stat. 2337, allowed the Rubins to execute against HLF's assets not withstanding the government's forfeiture proceedings. The court reversed, holding that section 853(n) did not provide the Rubins with a basis to prevail in the ancillary proceeding; TRIA did not provide the Rubins a basis to assert their interest in the forfeited property; TRIA did not trump the criminal forfeiture statute; and the in custodia legis doctrine did not preclude the district court's in personam jurisdiction over HLF. View "United States v. Holy Land Foundation for Relief, et al." on Justia Law

Employee-claimant Cathy Bone filed a workman's compensation claim for a work-related injury. The employer, U.S. Food Service, and its carrier Indemnity Insurance Co. of North America disputed the claim. The single commissioner and an Appellate Panel of the South Carolina Workers' Compensation Commission issued orders denying the claim. Under the procedure then in place, Bone appealed to the circuit court, which concluded the injury was compensable and remanded the matter to the Commission for further proceedings. The employer appealed the circuit court's order, and the Court of Appeals dismissed the appeal on the basis the order was not a "final judgment" and thus not immediately appealable because further proceedings were ordered before the administrative agency. The Supreme Court granted Petitioners' petition for a writ of certiorari to review the decision of the Court of Appeals, and the Supreme Court affirmed. The high court subsequently granted a petition for rehearing filed by the employer, and it additionally granted the following two motions: (1) Bone's motion to argue against precedent, and (2) the motion of the South Carolina Defense Trial Attorneys' Association to accept its Amicus Curiae Brief in support of Petitioners. After considering the record in this matter, as well as the briefs and arguments, the Court adhered to its original decision to affirm. View "Bone v. U.S. Food Service" on Justia Law

An Oklahoma City car dealer, Automax Hyundai South, sued its insurance company for refusing to defend it when the dealership was sued by customers. Two aggrieved customers brought claims against Automax relating to car purchases they made. The customers won their cases at the state court. The district court ruled that the insurance company had no duty to defend or indemnify Automax in the underlying lawsuits. Upon review of the district court record and the policy at issue, the Tenth Circuit agreed with Automax and concluded the insurance company had a duty to defend. View "Automax v. Zurich, et al" on Justia Law

This appeal was consolidated from lawsuits brought by the City against two insurance companies. Both insurers rejected the City's claims for coverage for the underlying litigation between the City and condominium buyers. The insurers claimed that the City's alleged negligence and wrongful conduct in connection with the underlying litigation occurred prior to their policy periods. The district court agreed and granted summary judgment in favor of the insurers. The court rejected the City's argument for extending Montrose Chemical Corp. v. Admiral Insurance Co., which held that claims for pollutants deposited in the ground prior to the policy period, but continuing to leach into soil and groundwater during the policy period, gave rise to a duty to defend, because continuance of the property damage during the policy period gave rise to coverage. View "City of San Buenaventura v. The Ins. Co. of PA" on Justia Law