Justia Insurance Law Opinion Summaries

A passenger, after being injured in a hit-and-run rear-end collision while riding in a vehicle arranged through a rideshare application, sought damages for bodily injuries. The passenger alleged that the rideshare company, its subsidiary, and its insurer either provided or were required by law to provide uninsured motorist (UM) coverage, and that their rejection of such coverage violated Louisiana law.The action began in Louisiana state court, initially naming only the insurer as a defendant. The passenger later amended the complaint to add the rideshare company and its subsidiary, arguing that they were not permitted to reject UM coverage. With all defendants’ consent, the insurer removed the case to the United States District Court for the Eastern District of Louisiana, citing diversity jurisdiction. Multiple motions followed, including motions to dismiss by the rideshare entities and a motion for summary judgment by the insurer. The district court found that Louisiana statutes allow transportation network companies to reject UM coverage and that the defendants had properly done so. Accordingly, the district court dismissed all claims with prejudice and denied the passenger’s request to certify a question to the Louisiana Supreme Court.On appeal, the United States Court of Appeals for the Fifth Circuit reviewed the statutory interpretation de novo. The court concluded that Louisiana Revised Statute § 45:201.6 incorporates, by general reference, the provisions of § 22:1295, including the right to reject UM coverage. The court found support for this interpretation in state appellate decisions and statutory context. The Fifth Circuit affirmed the district court’s judgment and denied the motion to certify the question to the Louisiana Supreme Court. The holding is that transportation network companies in Louisiana may reject uninsured motorist coverage if they follow the procedures in § 22:1295. View "Guerrera v. United Financial Casualty Co." on Justia Law

A Texas-based firearms retailer sold and shipped large quantities of unfinished firearm frames and receivers to New York, including products easily convertible into untraceable “ghost guns.” State and city authorities in New York alleged that the retailer intentionally marketed and sold these products to purchasers likely to be legally prohibited from owning firearms. The authorities claimed this resulted in increased gun violence and compelled them to spend additional resources on law enforcement, public health, and community services.Following these lawsuits, the retailer demanded that its liability insurers provide defense and indemnification under policies that covered damages caused by an “accident.” The insurers denied coverage and sought a declaratory judgment in the United States District Court for the Southern District of New York, arguing that the underlying suits did not allege harm resulting from an “accident” as required under Texas law and the policies’ terms. The district court granted summary judgment for the insurers, finding that the complaints alleged intentional conduct with expected consequences, not an “accident.” The judgment also encompassed indemnification after the parties agreed that the same reasoning applied.The United States Court of Appeals for the Second Circuit reviewed the case de novo. It held that, under Texas law, the policies only covered injuries arising from an “accident,” which is defined as a fortuitous, unexpected, and unintended event. The Court concluded the underlying lawsuits described intentional acts by the retailer that led to expected injuries, rather than accidental harm. Therefore, the insurers had no duty to defend or indemnify the retailer in these lawsuits. The Court of Appeals affirmed the judgment of the district court. View "Granite State Insurance Co. v. Primary Arms, LLC" on Justia Law

A young man named Christoffer suffered a severe spinal cord injury in a friend’s home after ingesting what he believed to be LSD and a THC gummy. The incident occurred after he fell off a bed, followed by several hours during which he received no medical attention. Later, he was moved by his friends without stabilizing his neck or spine, which medical testimony suggested may have contributed to the severity of his injury, ultimately leaving him a quadriplegic. The circumstances involved both the use of alleged controlled substances and subsequent actions by others in the house.Christoffer and his family sued the homeowner’s son in Texas state court, prompting Occidental Fire & Casualty Company, the homeowner’s insurer, to seek a declaratory judgment in the U.S. District Court for the Southern District of Texas, arguing that their policy excluded coverage for injuries arising from the use of controlled substances. The parties settled the state lawsuit and stipulated that the sole fact issue for the federal jury was whether Christoffer’s injuries “arose out of the use by any person” of a controlled substance, as defined by federal law.The jury in the district court found that Christoffer’s injuries did not arise out of the use of a controlled substance, indicating that the policy exclusion did not apply. However, the district judge set aside the jury’s verdict and granted judgment as a matter of law for Occidental, concluding the evidence was insufficient to support the jury’s finding. On appeal, the United States Court of Appeals for the Fifth Circuit held that the district court erred, as there was a legally sufficient basis for a reasonable jury to find that the injury did not arise from drug use. The Fifth Circuit reversed the district court’s judgment and reinstated the jury’s verdict in favor of coverage. View "Occidental Fire v. Cox" on Justia Law

The dispute centers on insurance policies purchased by several Louisiana public entities, including the Town of Vinton, from a group of foreign and American insurers. The policies included an arbitration clause and a contract endorsement stating that each policy is a “separate contract” between the insured and each insurer. After alleged breaches, the insured entities sued all participating insurers in Louisiana state court. Subsequently, the insureds dismissed the foreign insurers with prejudice, leaving only American insurers as defendants.Following the dismissal of the foreign insurers, the remaining American insurers removed the cases to the United States District Court for the Western District of Louisiana. They sought to compel arbitration under the Convention on the Recognition and Enforcement of Foreign Arbitral Awards and the Federal Arbitration Act. The district court denied these motions, holding that the contract endorsement created separate agreements between each insurer and the insured, and, since the foreign insurers were no longer parties, no agreement involved a non-American party. The court also rejected the American insurers’ equitable estoppel argument, finding it precluded by Louisiana law, which expressly bars arbitration clauses in insurance contracts covering property in the state.On appeal, the United States Court of Appeals for the Fifth Circuit affirmed the district court’s decision. The Fifth Circuit held that the Convention does not apply because no foreign party remains in any agreement to arbitrate. The court further concluded that Louisiana law prohibits enforcement of arbitration clauses in these insurance contracts and that equitable estoppel cannot override this prohibition. Lastly, the court determined that the delegation clause in the arbitration agreement could not be enforced because Louisiana law prevents the valid formation of an arbitration agreement in this context. View "Town of Vinton v. Indian Harbor" on Justia Law

A dispute arose between the California FAIR Plan Association (CFPA), a statutorily created insurer of last resort, and the state’s Insurance Commissioner. The Commissioner issued an order in 2021 directing CFPA to submit a plan to offer and sell a comprehensive “Homeowners’ Policy” that included, among other coverages, premises liability and incidental workers’ compensation. CFPA challenged this order, contending that the Basic Property Insurance Law only required it to provide first-party property insurance—coverage for direct loss to property—not liability coverage or similar third-party protections.The Superior Court of Los Angeles County denied CFPA’s petition for a writ of mandate. The court found ambiguity in the statutory definition of “basic property insurance,” specifically in the phrase allowing for “other insurance coverages as may be added.” Deeming the term ambiguous, the court deferred to the Department of Insurance’s interpretation that allowed the Commissioner to require CFPA to offer additional coverages, including liability insurance, so long as such coverages had a connection to the insured property. The court relied in part on the longstanding approval of liability coverage in certain businessowner policies since the early 1990s.The California Court of Appeal, Second Appellate District, Division Three, reviewed the lower court’s decision de novo. It concluded that, while the statutory language was ambiguous, extrinsic evidence such as legislative history and statutory context demonstrated that the Legislature intended for CFPA to be limited to providing first-party property insurance. The court found no sufficient basis to defer to the Department of Insurance’s later-adopted interpretation that expanded coverage to liability. The Court of Appeal reversed the judgment and directed the trial court to grant CFPA’s petition for writ of mandate, holding that the Commissioner lacked authority under the Basic Property Insurance Law to require CFPA to offer liability coverage. View "California FAIR Plan Assn. v. Lara" on Justia Law

A teacher employed by the Los Angeles Unified School District purchased a variable annuity with an optional Guaranteed Minimum Income Benefit (GMIB) rider from an insurance company in 2010. The GMIB rider, which provided a guaranteed minimum level of payments, was subject to an annual fee that was disclosed both to the purchaser and on a state-maintained website as required by the California Education Code at the time of purchase. In 2018, the insurer ceased offering the GMIB rider to new customers, but permitted existing holders, including the plaintiff, to maintain the rider and continue paying the associated fee. After January 2019, the fee for the GMIB rider was no longer listed on the state-administered website, although the underlying annuity product remained available to new purchasers.The plaintiff filed a lawsuit in the Superior Court of Los Angeles County, alleging that the insurer’s collection of the GMIB rider fee after it was no longer disclosed on the state website constituted an unlawful business practice under California’s Unfair Competition Law (UCL). The plaintiff did not claim to have relied on the website or to have been misled about the fee, but asserted that the insurer was statutorily barred from collecting undisclosed fees. The trial court sustained the insurer’s demurrer, finding that the plaintiff failed to allege reliance necessary for standing under the UCL, and dismissed the action with prejudice when the plaintiff declined to amend the complaint.The California Court of Appeal, Second Appellate District, Division One, affirmed the dismissal, albeit on different grounds. The court held that the Education Code does not require continued disclosure of fees for optional product features, such as the GMIB rider, after those features are no longer offered to prospective purchasers. As a result, the insurer was not prohibited from collecting the fee from existing holders, and the plaintiff’s UCL claim failed as a matter of law. The court awarded the insurer its costs on appeal. View "Jacobson v. Metropolitan Life Insurance Co." on Justia Law

The case concerns an insurance dispute in which the plaintiff’s father purchased liability insurance for three vehicles from Progressive Direct Insurance Company, but rejected uninsured/underinsured motorist (UM/UIM) coverage by signing a rejection form. After the plaintiff was seriously injured in a car accident where damages exceeded the other driver’s coverage limits, he filed a claim for UIM coverage with Progressive, which was denied due to the prior rejection of coverage. The plaintiff then sued Progressive, arguing that the insurer’s offer of UM/UIM coverage was invalid because it was made on a per-policy, rather than a per-vehicle, basis.At the trial level, the District Court granted summary judgment in favor of Progressive, dismissing the plaintiff’s claims with prejudice. The New Mexico Court of Appeals affirmed the dismissal, relying on its earlier ruling in Lueras v. GEICO General Insurance Co., which found that New Mexico law did not require UM/UIM coverage to be offered on a per-vehicle basis. The Court of Appeals concluded that Progressive’s per-policy offer complied with existing law, and thus the plaintiff’s rejection of coverage was valid.The Supreme Court of the State of New Mexico reviewed the case on certiorari and held that New Mexico’s UM/UIM statute requires insurers to offer UM/UIM coverage on a per-vehicle basis and disclose premiums for each vehicle accordingly. The Court found that per-policy, all-or-nothing offers frustrate the legislative purpose of encouraging consumers to purchase UM/UIM insurance and limit consumer choice. The Court ruled that the plaintiff’s rejection of coverage was invalid because it was not knowingly and intelligently made under the required per-vehicle offer structure. The Supreme Court reversed the lower courts’ decisions and remanded for further proceedings, applying its holding with selective prospectivity. View "Kileen v. Didio" on Justia Law

In this case, Roland Pour Sr. purchased and insured a home in Minnesota, where his children Kmontee and Roland Jr. lived. Pour Sr. moved to Georgia in 2019, updating all personal records to reflect his new residence but did not sell the Minnesota home or notify the insurer of his change in residence. He maintained some belongings in the Minnesota home and visited occasionally, while his children continued to live there and paid for utilities. In September 2021, a fire damaged the home and personal property. Pour Sr., living in Georgia at the time, filed a claim under the homeowners insurance policy for damages to the house, his own property stored there, and his children’s property and living expenses.The United States District Court for the District of Minnesota reviewed cross motions for summary judgment. Applying Minnesota law, the court granted summary judgment to Liberty Mutual, holding that the policy did not cover the home or attached structures because Pour Sr. did not “reside” at the house at the time of the fire. The court also held that Kmontee and Roland’s property was not covered because, although they lived in the home, they were not “residents of Pour Sr.’s household” as defined by the policy and Minnesota law. Pour Sr.’s claim for his own property was settled and not at issue.On appeal, the United States Court of Appeals for the Eighth Circuit reviewed the district court’s ruling de novo. The appellate court affirmed the district court’s judgment, holding that, under the unambiguous terms of the policy and Minnesota law, Pour Sr. did not reside at the Minnesota home during the relevant period, and his children were not insureds under the policy because they did not reside in his household. The court found no conflict with Minnesota’s Standard Fire Insurance Policy and rejected arguments regarding ambiguity or illusory coverage. View "Pour v. Liberty Mutual Pers. Ins. Co." on Justia Law

The case concerns an automobile accident in Prince George’s County, Maryland, involving George Bowens and a driver named Lisa Daniels, who was at fault. Bowens sustained injuries and held a $50,000 underinsured motorist (UIM) policy with State Farm. Daniels’ insurance had a $30,000 liability limit, which was offered to Bowens as a settlement for his injuries. Following established statutory procedures, Bowens notified State Farm of this offer, State Farm consented and waived subrogation rights, and Bowens accepted the $30,000. Bowens then sought to recover the remaining $20,000 available under his UIM policy from State Farm, which denied the claim.Bowens filed a breach of contract action in the District Court for Prince George’s County, seeking $20,000. State Farm moved to dismiss, arguing that the District Court lacked subject matter jurisdiction because Bowens would have to prove total damages of $50,000—exceeding the court’s $30,000 jurisdictional cap. The District Court agreed and dismissed the case. Bowens appealed to the Circuit Court for Prince George’s County, which affirmed the dismissal, reasoning that the District Court would need to find damages over $30,000 and thus could not grant relief.The Supreme Court of Maryland reviewed the case and held that the District Court’s jurisdiction is determined by the amount the plaintiff seeks from the defendant in the pending action, not by the total underlying damages or prior settlements received from the tortfeasor’s insurer. Since Bowens’ claim against State Farm was for $20,000, the District Court had jurisdiction. The Supreme Court of Maryland reversed the judgment of the circuit court and ordered the case remanded to the District Court for further proceedings. View "Bowens v. State Farm Mut. Auto. Ins." on Justia Law

After a car accident in Prince George’s County, Maryland, George Bowens, who was injured by the clear negligence of another driver, sought to recover compensation for his injuries. The at-fault driver had $30,000 in liability insurance, which was offered to Bowens in settlement. Bowens, however, had a $50,000 underinsured motorist (UIM) policy with his own insurer, State Farm. After accepting the $30,000 from the at-fault driver’s insurer (with State Farm’s consent and waiver of subrogation rights), Bowens sought the remaining $20,000 from State Farm under his UIM policy, claiming breach of contract when State Farm denied the claim.Bowens filed his action in the District Court of Maryland, which has jurisdiction over contract claims not exceeding $30,000. State Farm moved to dismiss, arguing that to recover the $20,000, Bowens would have to prove total damages of $50,000—an amount above the District Court’s jurisdictional cap. The District Court granted the motion to dismiss for lack of subject matter jurisdiction, and the Circuit Court for Prince George’s County affirmed, reasoning that the court would need to find Bowens’ damages exceeded $30,000, thus exceeding the District Court's authority.The Supreme Court of Maryland reviewed the case and reversed the lower courts. It held that, for purposes of determining the District Court’s jurisdiction under § 4-401(1) of the Courts and Judicial Proceedings Article, the relevant amount is the “debt or damages claimed” in the pleadings—that is, the net recovery sought from the defendant in the action—not the plaintiff’s total damages. Because Bowens sought only $20,000 from State Farm, the District Court had jurisdiction to hear the case. The Supreme Court of Maryland remanded the case for further proceedings consistent with this opinion. View "Bowens v. State Farm Mutual Automobile Insurance Co." on Justia Law