Justia Insurance Law Opinion Summaries

Plaintiff filed individual and class claims in Montana state court against GEICO after GEICO failed to advance pay Plaintiff’s medical bills and lost wages following a car accident caused by GEICO’s insured. GEICO removed the lawsuit to federal court, asserting jurisdiction under the Class Action Fairness Act (CAFA). Neither Plaintiff nor the district court questioned whether CAFA jurisdiction was proper.   The Ninth Circuit vacated the district court’s judgment and remanded for the district court to conduct the necessary evidentiary inquiry and determine whether GEICO can sufficiently establish that more than $5 million is in dispute. The panel held that it could sua sponte question a defendant’s allegation of CAFA jurisdiction. The panel further concluded that the current record did not sufficiently demonstrate that CAFA’s amount-in-controversy requirement was met because it was not evident from the face of the complaint and the nature of the class claims that this controversy involved more than $5 million, nor did GEICO’s notice of removal and supporting declaration satisfactorily establish that more than $5 million was in dispute. View "BRANDON MOE V. GEICO INDEMNITY COMPANY, ET AL" on Justia Law

The Supreme Court reversed the judgment of the court of appeals reversing the judgment of the trial court determining that Plaintiff could not recover under a commercial general-liability (CGL) insurance policy issued by United Specialty Insurance Company, holding that when a CGL insurance policy excludes coverage for injuries arising out of an "assault or battery," the subjective intent of the person who committed the assault or battery is irrelevant.Brown County Care Center, an adult care facility, contracted with United for CGL insurance. The policy excluded coverage for bodily injury arising from "any actual, threatened or alleged assault or battery." Plaintiff was living at the Center when he was attacked by another resident, who was later found by the trial court to be not guilty of felonious assault by reason of insanity. Plaintiff sued, and he and the Center entered into a settlement. Plaintiff later brought a declaratory judgment action against United to collect on the judgment. The trial court determined that Plaintiff could not recover under the policy. The court of appeals reversed. The Supreme Court reversed, holding (1) the attack on Plaintiff qualified as a civil-law assault; and (2) because the policy excluded coverage for bodily injuries arising for civil assaults the trial court did not err in its judgment. View "Krewina v. United Specialty Insurance Co." on Justia Law

Rosenberg-Wohl had a State Farm homeowners insurance policy, covering her San Francisco home. The policy required lawsuits to be “started within one year after the date of loss or damage.” In late 2018 or early 2019, Rosenberg-Wohl noticed that an elderly neighbor twice stumbled on Rosenberg-Wohl’s outside staircase and learned that the pitch of the stairs had changed. The staircase needed to be replaced. In April 2019, Rosenberg-Wohl authorized the work and contacted State Farm. On August 9, she submitted a claim for the money she had spent. On August 26, State Farm denied the claim. Rosenberg-Wohl’s husband, an attorney, later contacted State Farm “to see if anything could be done.” In August 2020 a State Farm adjuster said it had reopened the claim. Days later, it was denied.In October 2020, Rosenberg-Wohl filed suit, alleging breach of the policy and bad faith. That lawsuit was removed to federal court and was dismissed based on the one-year limitation provision. It is currently on appeal. Another action alleges a violation of California’s unfair competition law. The California court of appeal affirmed the dismissal of that suit, rejecting arguments that the one-year limitation provision does not apply to the unfair competition claim, and that State Farm waived the limitation provision. View "Rosenberg-Wohl v. State Farm Fire and Casualty Co." on Justia Law

A Listeria outbreak led to a shutdown of Blue Bell factories and a nationwide recall of its products. Consequently, Blue Bell suffered a substantial financial loss. A shareholder of Blue Bell Creameries brought a derivative action against Blue Bell’s directors and officers, alleging a breach of fiduciary duties. The shareholder, on behalf of Blue Bell, alleged that Blue Bell’s officers and directors breached their fiduciary duties of care and loyalty by failing “to comply with regulations and establish controls.” The Blue Bell Defendants appealed the district court’s grant of summary judgment in favor of Discover Property & Casualty Insurance Company and the Travelers Indemnity Company of Connecticut.   The Fifth Circuit affirmed. Here, only the duty to defend is at issue because the parties have stipulated that “If the district court finds there is no duty to defend, it may also find there is no duty to indemnify, but otherwise the duty to indemnify will not be a subject of the Parties’ motions.” Accordingly, the court wrote that it is confined by Texas’s “eight-corners rule,” which directs courts to determine an insurer’s duty to defend based on: (1) the pleading against the insured in the underlying litigation and (2) the terms of the insurance policy. The court explained that while it disagrees with the district court’s determination as to whether the directors and officers are “insureds” in relation to the shareholder lawsuit, it agreed with its determination that the complaint in the shareholder lawsuit does not allege any “occurrence” or seek “damages because of bodily injury.” Each issue is independently sufficient for affirmance. View "Discover Property Cslty v. Blue Bell" on Justia Law

The Supreme Court reversed the judgment of the South Dakota Life and Health Guaranty Association denying the protests brought by the South Dakota Bankers Benefit Plan Trust as to the Association's assessment schedule it established to cover an insolvent insurer's obligations, holding that the Trust was not liable to pay the contested assessments.In 2017, the Association, which covers impaired and insolvent insurers' obligations to their insureds by assessing Association members, assumed liability for the insolvent insurer at issue and established a five-year assessment schedule. The Trust paid three years of the five-year schedule but protested the requirement to pay the remaining two because they were assessed after the insolvent insurer's membership in the Association ended. The Association denied the protests. The South Dakota Division of Insurance's Office of Hearing Examiners reversed, determining that the Association lacked authority to assess the Trust for the last two assessments. The circuit court reversed. The Supreme Court reversed, holding that the Trust was not liable to pay the Association's 2020 and 2021 assessments. View "S.D. Life & Health Guaranty Ass'n v. S.D. Bankers Benefit Plan Trust" on Justia Law

In this case stemming from a dispute involving an insurance claim the Supreme Court affirmed the decision of the court of appeals reversing the judgment of the district court dismissing, with prejudice, Plaintiff's complaint under Minn. R. Civ. P. 5.04(a) on the grounds that the complaint was not filed within one year of service, holding that Plaintiff satisfied Rule 5.04(a).Plaintiff served Defendant with a summons and complaint but did not file the summons and complaint with the district court at that time. Later, Plaintiff filed a copy of the summons and complaint but did not file the summons and complaint as a standalone document until more than one year after it had served Defendant. The district court dismissed the case with prejudice under Rule 5.04(a). The court of appeals reversed. The Supreme Court affirmed, holding (1) filing an "action" under Rule 5.04(a) refers to filing the summons and complaint; and (2) Plaintiff satisfied Rule 5.04(a) when it filed a copy of the summons and complaint as an exhibit in an ancillary motion pertaining to the same action. View "Glen Edin of Edinburgh Ass'n v. Hiscox Insurance Co." on Justia Law

This appeal arose out of an insurance dispute between Plaintiff and Safeco Insurance Company of Illinois. After an accident in which her vehicle suffered substantial damage, Plaintiff made a claim under her Safeco-issued insurance policy for the damage. Safeco declared her vehicle a total loss and paid her what it deemed to be the actual cash value of her vehicle. The district court granted summary judgment to Safeco.   The Eleventh Circuit affirmed. The court explained that as proof that a policyholder is reasonably likely to need to incur dealer fees, Plaintiff pointed to the facts that (1) she incurred dealer fees in purchasing both the Lexus that was totaled and her Subaru replacement vehicle, (2) approximately 50-70% of Safeco policyholders are likely to purchase a vehicle from a dealer, and (3) approximately 85-95% of dealerships charge dealer fees. These facts, viewed in the light most favorable to Plaintiff, do not give rise to a genuine dispute of material fact. Plaintiff’s three data points show a reasonable likelihood that a policyholder will incur dealer fees if she chooses to purchase her replacement vehicle from a dealer. And they show that a policyholder is reasonably likely to purchase a replacement vehicle from a dealer. But they do not show that a policyholder is reasonably likely to need to purchase a replacement vehicle from a dealer. Plaintiff has failed as a matter of law to satisfy the Mills standard; therefore, the district court correctly awarded Safeco summary judgment on this issue. View "Gina Signor v. Safeco Insurance Company of Illinois" on Justia Law

The Wongs stored some embryos at a facility that kept them in a cryogenic tank that failed to maintain the temperature necessary to store the embryos. The Wongs’ fertility doctor told them they should consider the embryos “compromised” and “no longer viable, and lost.” The Wongs had a homeowners insurance policy with Stillwater, a specified perils policy providing that “We insure for direct physical loss to the property described in Coverage C caused by any of the following perils,” listing 16 specified perils. Stillwater denied their claim for property damage.The trial court granted Stillwater summary judgment. The court of appeal affirmed. The mere possibility that the embryos had suffered physical damage was insufficient to create a triable issue of fact to trigger coverage. The Wongs did not meet their burden of submitting evidence of actual physical alteration of the embryos. The insured also has “the threshold burden of proving the loss was caused by a specifically-enumerated peril.” The Wongs failed to prove their claim of “explosion.” View "Wong v. Stillwater Insurance Co." on Justia Law

Penn-Star Insurance Company (Penn-Star) appealed a trial court’s denial of its motion for summary judgment. The Mississippi Supreme Court found after review of the trial court record that because the commercial general liability policy at issue did not cover the sustained losses, the trial court’s order was reversed, judgment was rendered in favor of Penn-Star, and this case was remanded to the trial court for consideration of the remaining issues. View "Penn-Star Insurance Company v. Thompson, et al." on Justia Law

The case arose following an insurance dispute between Travelers Property Casualty Company of America (“Travelers”) and Ocean Reef Charters LLC (“Ocean Reef”), a Florida Limited Liability Company. On cross-motions for summary judgment, the district court granted summary judgment for Travelers, agreeing with it that federal law applied and that Ocean Reef, therefore, forfeited its insurance coverage. On appeal, the Eleventh Circuit reversed, holding that under Wilburn Boat Co. v. Fireman’s Fund Insurance Co., Florida law applied. At issue is whether, under Florida’s anti-technical statute, the insurance company must prove that the breach of the Captain Warranty “contribute[d] to” the specific accident. Further, in meeting its burden of proof under Florida law, Travelers needed to introduce expert testimony in its case-in-chief about what would have been different if Ocean Reef had complied with the applicable warranties.   The Eleventh Circuit affirmed on remand. The court held Travelers offered no expert witness— such as a licensed captain competent to speak to the issue—to prove that the lack of a full-time captain and crew played a role in the destruction of the yacht during Irma. The court explained that the Captain—whom Travelers did not disclose as an expert witness—could not provide his opinion on what would have happened to the My Lady if a licensed, professional captain were employed full-time. He could discuss the weather forecasts he observed. But those facts would leave the jury to speculate about what a captain would have done differently to avoid the storm under the specific circumstances of this case. View "Travelers Property Casualty Company of America v. Ocean Reef Charters LLC" on Justia Law