Justia Insurance Law Opinion Summaries

The Providence School Board (Board) provided health insurance to active employees and retirees. In 2006, the Providence Teachers Union (Union) filed a grievance protesting a difference in the increase of premium costs for retirees compared with a more modest increase in premium costs for active employees. The Union argued that the Board's action violated three provisions of the collective bargaining agreement (CBA) between the board and the union. An arbitrator ruled in the Union's favor, concluding that the Board violated the CBA by failing to include retirees and active employees in a single group when it calculated the healthcare premium rates. The trial justice vacated the arbitration award, concluding (1) the Union did not have standing to pursue a grievance on behalf of retirees, and (2) the issue of the calculation of the group premium rate was not arbitrable. The Supreme Court affirmed, holding (1) pursuant to Arena v. City of Providence and City of Newport v. Local 1080, the Union could not pursue this grievance on behalf of the retirees; and (2) because the Union had no standing to pursue this particular grievance, the grievance was not arbitrable. View "Providence Sch. Bd. v. Providence Teachers Union, Local 958" on Justia Law

Workforce Safety & Insurance (WSI) appealed a district court's judgment reversing its denial of worker's compensation benefits to claimant Brenda Albright. Albright submitted her claim to WSI for a work-related back injury. Albright had a history of back problems; an independent medical records review of Albright's case showed she had "well-documented multilevel degenerative disk pathology" which contributed to the claim at issue here. The ALJ hearing Albright's case concluded her injury was not the result of a single incident, and denied her application for benefits. Finding that the evidence in the record supported the ALJ's decision to deny Albright's application for benefits, the Supreme Court reversed the district court, affirmed the ALJ and reinstated WSI's order denying benefits. View "Albright v. ND Workforce Safety & Ins" on Justia Law

Plaintiff filed suit seeking interest on benefits she received under an Accidental Death and Dismemberment (ADD) insurance policy issued by Hartford. The parties disagreed on whether Tennessee law or Missouri law applied. Plaintiff did not dispute Hartford's argument that under Missouri law and the policy language, Hartford paid the benefit to her when it was payable. Accordingly, the court concluded that plaintiff was not entitled to interest under Missouri law. Assuming Tennessee law applied, the court relied on Performance Sys., Inc. v. First Am. Nat'l Bank, to conclude that the Tennessee Supreme Court would likely construe "due" in Tenn. Code Ann. 7-14-109(b) to mean the time of payment designated in the policy, not the date of loss. In this instance, Hartford paid the benefit to plaintiff within the time of payment designated in the policy and, therefore, plaintiff was not entitled to interest under subsection (b). Accordingly, the court affirmed the judgment. View "Williamson v. Hartford Life & Accident, etc." on Justia Law

Lisbeth Cherrington entered into a contract with the Pinnacle Group for the construction of a home. Anthony Mamone worked with Cherrington during the contract and construction process. After the construction was completed, Cherrington filed this action against Pinnacle and Mamone, alleging, inter alia, negligence, misrepresentation, and breach of fiduciary duty. Pinnacle and Mamone requested Erie Insurance Property and Casualty Company, with whom they had insurance policies, to provide coverage and a defense. Because Erie denied both coverage and a duty to defend, Pinnacle and Mamone filed a third-party complaint against Erie seeking a declaration of the coverage provided by their policies. The circuit court granted Erie's motion for summary judgment, finding that the three policies issued to Pinnacle and Mamone did not provide coverage for the injuries and property damage allegedly sustained by Cherrington. The Supreme Court (1) affirmed the circuit court's finding that neither Mamone's homeowners policy nor his umbrella policy provided coverage under the facts of this case; but (2) reversed the circuit court's ruling finding no coverage to exist under Pinnacle's commercial general liability policy. Remanded. View "Cherrington v. Erie Ins. Prop. & Cas. Co." on Justia Law

Appellant was employed as a laborer by County Saw & Knife. Appellant successfully sought workers' compensation after he developed respiratory problems from his exposure to metal dust. One year later, Appellant applied for an additional award, alleging that Country Saw violated specific safety requirements (VSSRs). The Industrial Commission denied Appellant's application, concluding that County Saw had not violated the VSSRs. The court of appeals denied Appellant's request for a writ of mandamus that would require the Commission to vacate its order denying Appellant's application. The Supreme Court affirmed, holding that Appellant did not present sufficient evidence to establish that he was entitled to an award for a VSSR in addition to his extant workers' compensation benefits. View "State ex rel. Scott v. Indus. Comm'n" on Justia Law

This diversity case involved a dispute over insurance coverage between Starr and SGS. The district court, relying on Matador Petroleum Corp. v. St. Paul Surplus Lines Ins. Co., held that Starr did not need to show prejudice before denying coverage to SGS for late notice under the pollution buy-back provision. Bound by Matador, which concluded that a notice requirement in this type of supplemental pollution endorsement was essential to the bargained-for coverage, the court affirmed the judgment and found SGS's arguments unpersuasive. View "Starr Indemnity & Liablity Co. v. SGS Petroleum Serv. Corp." on Justia Law

This appeal arose out of an allision between a vessel owned by Settoon and an oil well. On appeal, Settoon challenged the district court's grant of summary judgment in favor of the umbrella insurers. The court concluded that the umbrella insurers were not liable for damages resulting from the allision because Settoon failed to provide them notice within 30 days; SNIC was liable to Settoon because delayed delivery prevented SNIC from relying on the exclusions in the policy and the conditions precedent of the exceptions to the exclusions; and prejudgment interest should be calculated from the date Settoon paid for the allision. Accordingly, the court reversed and remanded for calculation of prejudgment interest and affirmed the district court's judgment in all other respects. View "In Re: Settoon Towing, L.L.C." on Justia Law

The United States District Court for the Northern District of Georgia certified two questions to the Georgia Supreme Court. The questions related to the Automobile Insurance Company of Hartford Connecticut's umbrella policy issued to Louis and Betty Wilson. At the time, Georgia law required policies to have uninsured motorist coverage unless the insured rejected that coverage in writing. The Wilsons did not reject uninsured motorist coverage; their policy excluded such coverage despite being required by law. Because it was not written into the policy but required, it was implied by operation of law. In 2010, Louis Wilson was seriously injured in an accident, and gave notice of a claim for uninsured motorist benefits. The insurance company denied the claim, contending that a 2008 amendment to the Georgia law specifically excluded umbrella policies from mandatory uninsured motorist coverage. The questions from the federal court centered on whether the amendment to the applicable Georgia law applied to the Wilson's umbrella policy after 2009, and whether the notice requirements of the amended law applied to umbrella policies. After review, the Georgia Court concluded that the amendment in question here did not apply to the Wilson's umbrella policy, nor did the notice requirement. View "Wilson v. Automobile Insurance Co. of Hartford, Connecticut" on Justia Law

Appellee Young's Sales & Service submitted a claim with Appellant Underground Storage Indemnification Fund for reimbursement of remediation costs it incurred following the release of certain regulated chemicals stored in underground tanks on its property. The claim was denied, and Appellee appealed. The issue before the Supreme Court in this case was whether the Commonwealth Court correctly held that section 706(2) of the Storage Tank Spill Prevention Act applied on a per tank basis. Upon review, the Supreme Court concluded it did not. Accordingly, the Court reversed the Commonwealth Court and reinstated the Board's order denying Appellee's claim. View "Young's Sales & Service v. Underground Storage Tank Indemnification Board" on Justia Law

Employee filed a petition for workers' compensation benefits for injuries he received during his employment with Employer. In accordance with Neb. Rev. Stat. 48-139(3), Employee entered into a lump-sump settlement with Employer and its workers' compensation insurance carrier. Pursuant to the statute, Employee filed a release in which he waived his rights under the Nebraska Workers' Compensation Act (Act) and discharged Employer from further liability arising from the injury. Employer paid the lump-sum amount forty-two days after the filing of the release. Employee subsequently sought and received a workers' compensation court order awarding a waiting-time penalty and attorney fees. The Supreme Court reversed, holding (1) a worker waives all of his rights under the Act when he files a release pursuant to the settlement procedures in section 48-139(3), including the right to penalties; and (2) therefore, a waiting-time penalty and the corresponding attorney fees cannot be imposed following a settlement reached under section 48-139(3). Remanded. View "Holdsworth v. Greenwood Famers Coop." on Justia Law