Justia Insurance Law Opinion Summaries

In 2003, multiple residents of a nursing home (Greenwood) died or were injured when another resident set fire to the facility. Consequently, thirteen negligence actions seeking damages for serious bodily injury or wrongful death were filed against Greenwood, the owner of the property housing Greenwood, the lessee of the property (Lexington Healthcare), and the operator of Greenwood. Plaintiff issued a general liability and professional liability insurance policy to Lexington Healthcare. At issue in this case was the amount of liability insurance coverage available for the claims. The trial court determined the amount available under the policy and rendered judgment accordingly. The Supreme Court reversed in part, holding (1) the trial court improperly interpreted a policy endorsement in the policy relating to the aggregate policy limit; and (2) the trial court improperly applied a self-insured retention endorsement to reduce the available coverage. Remanded. View "Lexington Ins. Co. v. Lexington Healthcare Group, Inc." on Justia Law

Charter appealed the district court's holding that it was liable to CGS for its expenses in defending and settling a trademark infringement suit. The court concluded that the relevant insurance policy did not cover the liability alleged in the trademark action and Charter was not liable for the settlement amount; however, there was sufficient legal uncertainty about the coverage issue to oblige Charter to defend the action; and, therefore, the district court's ruling was affirmed insofar as it held that Charter was liable for defense costs, but reversed insofar as it held that Charter was liable for the settlement. Accordingly, the court vacated and remanded for further proceedings. View "CGS Indus., Inc. v. Charter Oak Fire Ins. Co." on Justia Law

Atkinson filed suits against Kenray. Kenray filed a separate action against Hoosier, seeking insurance coverage for Atkinson’s claims. Atkinson and Kenray settled their suits. Kenray agreed to entry of judgments in favor of Atkinson. Atkinson agreed not to execute the judgments if Kenray pursued the coverage action against Hoosier. Kenray assigned claims against its insurance agent to Atkinson. State courts entered judgment in favor of Hoosier. Meanwhile, Atkinson sued Kenray’s insurance agent asserting errors and omissions claims. The agent obtained summary judgment. Atkinson returned to the district court that presided over the original suits to set aside the settlement covenant. Atkinson claimed fraudulent inducement: that it entered the agreement based upon Kenray’s representations that its agent had confirmed that Kenray had insurance coverage for Atkinson’s claims. The court held that, because the covenant contained an unambiguous integration clause, parol evidence could not be considered, but that if Atkinson could prove fraud in the inducement specific to the integration clause, it might prevail. Atkinson conceded that it could not establish fraudulent inducement as to the integration clause itself. The court declined to set aside the agreement. The Seventh Circuit reversed, holding that Indiana law does not impose the bright-line rule applied by the trial court. View "Judson Atkinson Candies, Inc. v. Kenray Assocs., Inc." on Justia Law

Petitioner was a passenger in an uninsured vehicle that was in an accident. At the time, Petitioner had a certificate policy issued by the Department of Human Services through its Joint Underwriting Program (JUP). The JUP Bureau determined Petitioner was entitled to receive benefits under the JUP and assigned Petitioner's claim to Respondent. Respondent, however, denied Petitioner's request for coverage because Petitioner's certificate policy did not include uninsured motorist coverage. Petitioner sued Respondent, alleging claims of, inter alia, bad faith. The circuit court entered summary judgment for Respondent. The intermediate court of appeals (ICA) affirmed, concluding that an underlying insurance contract was required to assert a claim of bad faith against an insurer. The Supreme Court vacated the judgments of the lower courts, holding (1) under the JUP, the insurer assigned to a claim owes the same rights to the person whose claim is assigned to it as the insurer would owe to an insured to whom the insurer had issued a mandatory motor vehicle insurance policy; (2) the insurer's good faith covenant implied in such motor vehicle policies applies to claimants under the assigned claim procedure despite the absence of an insurance policy; and (3) accordingly, Respondent owed Petitioner a duty of good faith. View "Willis v. Swain " on Justia Law

Prince was the general contractor for construction of an apartment building. Rybaltowski was an employee of a waterproofing company. His boss took Rybaltowski to the project site to perform an unpaid demonstration of the proposed caulking of windows. While Rybaltowski was at the site, a beam supporting masonry equipment fell on him. Less than an hour after the accident, Prince signed a subcontract with the waterproofing company. The insurance policy at issue was a Commercial General Liability Insurance policy with an exclusion from coverage for bodily injury to any contractor arising out of or in the course of the rendering or performing services of any kind or nature whatsoever by such contractor. “Contractor” was defined to include employees of subcontractors. The district court entered judgment in favor of the insurer, finding it had no duty to defend. The Seventh Circuit reversed and remanded, reasoning that the policy can be interpreted so that services are not provided until the contractor begins compensated work on the project. View "Atl. Cas. Ins. Co. v. Prince Contractors, Inc." on Justia Law

The Bunch Company filed consumer complaint, alleging that when BrickStreet Mutual Insurance Company became its insurer, BrickStreet wrongfully included a charge for the expense of an agent commission in the workers' compensation premium. The West Virginia Insurance Commissioner denied relief, upholding the previously approved rates. The circuit court reversed and vacated the Commissioner's administrative order. The Supreme Court reversed, holding (1) the Commissioner did not err in allowing BrickStreet to charge Bunch for a non-incurred agent commission; (2) the Commission properly found the insurance rates at issue were reasonable, and the trial court encroached upon a matter that has been expressly delegated to the executive branch by ignoring the deference the Commissioner was entitled to in connection with the interpretation of its own regulation; and (3) this case did not present any factual disputes requiring the Commissioner to hold a hearing. View "W. Va. Employers' Mut. Ins. Co. v. Bunch Co." on Justia Law

Employee was injured during the course of his employment with Employer. Employer subsequently issued a notice of claim acceptance to Employee. Two years after his claim's closure, Employee unsuccessfully asked Employer to reopen his claim. An appeals officer affirmed. At issue on appeal was Nev. Rev. Stat. 616C.390, which bars an employee from applying to reopen his workers' compensation claim after a year from its closure if the employee was "not off work as a result of the injury." The appeals officer interpreted the statute as requiring that an injured employee miss at least five days of work as a result of the injury to be considered "off work." The Supreme Court reversed, holding (1) section 616.390 does not bar an employee from applying to reopen his claim after a year from its closure if the employee missed time from work as a result of his injury; (2) the appeals officer erred in reading a minimum-time-off-work requirement into the statute; and (3) because Employee missed the remainder of his shift on the day of his injury, he was "off work" as a result of his injury and was not therefore subject to the one-year limit on the reopening of his claims. View "Williams v. United Parcel Servs." on Justia Law

Defendants Pam Wood, David Wood, Justin Wood, Josh Wood and Jacob Wood filed an interlocutory appeal for the Supreme Court to determine whether the circuit court abused its discretion in denying their motion to transfer this case to another county. The underlying case involved a car accident in which a question arose over who was covered by an insurance policy. Defendant Pam Wood applied for the coverage in Covington County; the application was faxed from an insurance agent's office in Covington to Plaintiff Safeway Insurance Company's Rankin County office where it was approved. Safeway opposed the transfer of venue. Upon review, the Supreme Court concluded that Safeway could not demonstrate sufficient facts to support that venue was proper in Rankin County. Therefore the Court reversed the circuit court's order and remanded the case with instructions to transfer it to a permissible venue. View "Wood v. Safeway Insurance Co." on Justia Law

Plaintiffs appealed the district court's grant of summary judgment to Grinnell on their claim for equitable garnishment of a personal liability insurance policy issued to the sellers of the home. Plaintiffs claimed that the insureds' misrepresentations regarding the condition of the home qualified as a covered occurrence under the policy. The court concluded, however, that the policy provided coverage only for property damage caused by the occurrence. In this instance, there was no property damage caused by the asserted occurrence, and therefore, there was no applicable coverage. Plaintiffs' alternative argument failed where, even if plaintiffs were correct that the structural damage was caused by a covered occurrence, the damage would be excluded from coverage by the policy. Accordingly, the court affirmed the judgment. View "Payne, et al. v. Grinnell Mutual Reinsurance Co." on Justia Law

Plaintiffs served as the general contractor and the project developer for construction of a student housing complex at the University of Connecticut (UConn). UConn procured a commercial general liability (CGL) policy for the project, which insured Plaintiffs and their work. Defendant, American Motorists Insurance Company (AMICO), was the issuing insurer's successor in interest. UConn alleged that Plaintiffs breached the agreement with UConn, and Plaintiffs demanded that AMICO defend against UConn's claims. AMICO denied coverage. Plaintiffs settled their claims with UConn and then brought this action against Defendant for breach of contract and bad faith. The U.S. district court certified three questions of law for the Connecticut Supreme Court's consideration. The Court answered (1) allegations of unintended defective construction work by a subcontractor that damages nondefective property may trigger coverage under a CGL policy; (2) under the plain language of the insurance policy in this case, there is no cause of action based on AMICO's failure to conduct a discretionary investigation of claims for coverage; and (3) in global settlements encompassing multiple claims, the insured has the burden of proving that a pre-suit settlement is reasonable in proportion to claims that the insurer has a duty to defend. View "Capstone Bldg. Corp. v. Am. Motorists Ins. Co." on Justia Law