Justia Insurance Law Opinion Summaries

The plaintiffs are food service, medical, health and wellness, art, music, and legal businesses in Pennsylvania, New Jersey, New York, Maryland, and Delaware. In March 2020, to curb the spread of COVID-19, the governors of those states issued executive orders closing or restricting the activities of nonessential businesses and urging people to stay home whenever possible. The businesses were forced to close or significantly limit their operations.The businesses filed claims under their commercial property insurance policies. Their insurers universally denied coverage, reasoning that the businesses did not suffer a “physical loss of or damage to” property necessary to trigger coverage or that a “virus exclusion” barred coverage. The businesses argued that their loss of the ability to use their properties for their intended business purposes was a “physical loss of” property and that either the exclusions did not apply or the insurers were estopped from arguing that they do. The district courts all ruled in favor of the insurers. The Third Circuit affirmed, concluding that the loss of use of a property’s intended business purpose is not a physical loss of property covered by the businesses’ insurance policies. The court did not reach the issue of whether the virus exclusions or any other exclusions apply. View "Wilson v. USI Insurance Services LLC" on Justia Law

Admiral Insurance Co. (“Admiral”) sought a declaration that it need not defend or indemnify its historical insured, Niagara Transformer Corp. (“Niagara”), in potential litigation between Niagara and nonparties Monsanto Co., Pharmacia LLC, and Solutia Inc. (collectively, “Monsanto”) over harms caused by polychlorinated biphenyls that Monsanto had sold to Niagara in the 1960s and 1970s. Admiral appealed from the order of the district court dismissing its action for lack of a justiciable “case of actual controversy” within the meaning of the Declaratory Judgment Act (the “DJA”). The district court principally relied on (1) the fact that Monsanto has not commenced or explicitly threatened formal litigation against Niagara, and (2) its assessment that Monsanto would not be likely to prevail in such litigation.   The Second Circuit affirmed the district court’s order dismissing Admiral’s action to the extent that it sought a declaration of Admiral’s duty to indemnify Niagara, and remanded for the district court to determine whether there exists a practical likelihood that Monsanto will file suit against Niagara. The court explained that while the district court properly concluded that it lacked jurisdiction to declare Admiral’s duty to indemnify Niagara, it did not adequately distinguish between that duty and the insurer’s separate duty to defend its insured. Because a declaratory-judgment action concerning either duty becomes justiciable upon a “practical likelihood” that the duty will be triggered, the justiciability of Admiral’s duty-to-defend claim turns on the practical likelihood that Monsanto will file suit against Niagara – not on whether Monsanto has already in fact done so. View "Admiral Ins. Co. v. Niagara Transformer Corp." on Justia Law

Shusha, Inc., dba La Cava (La Cava) appeals from the judgment of dismissal entered after the trial court sustained without leave to amend the demurrer filed by Century-National Insurance Company (Century-National) to La Cava’s first amended complaint. La Cava sued Century-National for breach of an insurance contract and related claims after Century-National denied coverage for La Cava’s lost business income as a result of its suspension of restaurant operations in March 2020 due to the COVID-191 pandemic and associated government shutdowns.   On appeal, La Cava contended the trial court erred in concluding the alleged presence of the COVID-19 virus in its restaurant did not constitute “direct physical loss of or damage to” the restaurant necessary for coverage under the terms of the policy at issue. La Cava also argued Century-National acted in bad faith by summarily denying coverage without investigating La Cava’s claim.   The Second Appellate District reversed the trial court’s order and remanded for the trial court to vacate its order sustaining the demurrer without leave to amend and to enter a new order overruling the demurrer. The court held that La Cava’s allegations that contamination by the COVID-19 virus physically altered its restaurant premises were sufficient to withstand demurrer. The court explained that Century-National’s denial of coverage just three weeks after La Cava tendered its claim and in the earliest days of our understanding of the novel COVID-19 virus, cannot be deemed as a matter of law to have been made in good faith with reasonable grounds. View "Shusha, Inc. v. Century-National Ins. Co." on Justia Law

In 2021, the South Carolina General Assembly passed the Fetal Heartbeat and Protection from Abortion Act ("the Act"), which prohibited an abortion after around six weeks gestation. This was before many women—excluding those who were trying to become pregnant and were therefore closely monitoring their menstrual cycles—even know they were pregnant. The Supreme Court held that the decision to terminate a pregnancy rested upon the "utmost personal and private considerations imaginable," and implicates a woman's right to privacy. "While this right is not absolute, and must be balanced against the State's interest in protecting unborn life, this Act, which severely limits—and in many instances completely forecloses—abortion, is an unreasonable restriction upon a woman's right to privacy and is therefore unconstitutional." View "Planned Parenthood South Atlantic, et al. v. South Carolina, et al." on Justia Law

An insured fell from a roof and became paralyzed from the waist down, never to walk again. Within months, his medical bills climbed past $400,000, and future costs were projected into the millions. Three insurance companies potentially provided coverage for the insured. This appeal is a battle between the two of them. The primary insurer was Southern Owners Insurance Company. At the time of the accident, the insured was performing subcontracting work for Beck Construction, which had a policy with American Builders Insurance Company and an excess policy with Evanston Insurance Company. American Builders investigated the accident, assessed Beck Construction’s liability, and evaluated the claim. Southern-Owners did little to nothing for months. American Builders then sued Southern-Owners for common law bad faith under Florida’s doctrine of equitable subrogation. Southern-Owners moved for summary judgment, but the district court denied the motion. A federal trial jury heard the case and found in favor of American Builders. After the entry of final judgment, Southern-Owners sought judgment matter of law or, in the alternative, a new trial. On appeal, Southern-Owners challenges the denials of its summary judgment and post-trial motions.   The Eleventh Circuit affirmed. The court held that taking the evidence in the light most favorable to American Builders, a reasonable jury could have found (as it did) both that Southern-Owners acted in bad faith and that its bad faith caused American Builders to pay its policy. Moreover, American Builders did not breach Southern-Owners’ contract and relieve Southern-Owners of its good-faith duties. The district court did not err in denying Southern-Owners’ Rule 50(b) motion. View "American Builders Insurance Company v. Southern-Owners Insurance Company" on Justia Law

This appeal arises out of an insurance dispute involving a yacht, the Serendipity, that was destroyed by Hurricane Dorian, a Category 5 storm, that slammed into Great Abaco Island in the Bahamas. Serendipity at Sea, LLC (“Serendipity, LLC”), a holding company created by M.S. and J.E. (“the Managers”) to manage the Serendipity, sued Underwriters at Lloyd’s of London Subscribing to Policy Number 187581 (“Lloyd’s”) for breach of contract after Lloyd’s denied the the Managers insurance claim for the damage Hurricane Dorian caused to the Serendipity. In denying that it had breached the contract, Lloyd’s argued that it was not liable because Serendipity, LLC did not employ a full-time licensed captain in violation of the policy’s Captain Warranty, and that the breach increased the hazard to the yacht because a licensed captain would have operated the vessel back to Florida when Hurricane Dorian formed and was forecast to hit the Bahamas.   The district court granted summary judgment in favor of Lloyd’s. It found that the Captain Warranty was unambiguous; that Serendipity, LLC breached the agreement by failing to hire a full-time licensed captain; and that the breach increased the hazard posed to the Serendipity based on the purportedly undisputed testimony of an expert hired by Lloyd’s. The Eleventh Circuit reversed the district court’s grant of summary judgment in favor of Lloyd’s and remanded. The court explained that while it agreed with the district court’s conclusion that Serendipity, LLC breached the Captain Warranty, a disputed question of material fact remains about whether the breach increased the hazard posed to the vessel. View "Serendipity at Sea, LLC v. Underwriters at Lloyd's of London Subscribing to Policy Number 187581" on Justia Law

Sagome, Inc.’s restaurant, L’Hostaria, suffered significant financial losses from reduced customer traffic and government lockdowns and restrictions relating to the COVID-19 pandemic. It sought to recover under its comprehensive general insurance policy. And like many insurers, The Cincinnati Insurance Company denied coverage because the virus did not impose physical loss or damage as required by the policy. Sagome sued, but the district court concluded its financial losses were not covered. Addressing Sagome’s coverage under Colorado law, the Tenth Circuit Court of Appeals agreed and affirmed: COVID-19 did not cause Sagome to suffer a qualifying loss because there was never any direct physical loss or damage to L’Hostaria. View "Sagome v. Cincinnati Insurance Company" on Justia Law

The First Circuit affirmed the judgments of the district court dismissing part of Plaintiff's putative class action for failure to state a claim and entering summary judgment disposing of the remainder of his claims, holding that there was no error in the proceedings below.In his complaint, Plaintiff argued that an increased coverage limit on his house and premium violated the terms of his contract with Amica Mutual Insurance Company and that he and other Amica insureds paid too much to insure their homes. The district court dismissed the breach of contract and implied covenant of good faith and fair dealing claims and then granted summary judgment for Amica on the unjust enrichment, money had and received, and Mass. Gen. Laws ch. 93A claims. The First Circuit affirmed, holding that there was no reversible error in the proceedings below. View "Gottlieb v. Amica Mutual Insurance Co." on Justia Law

Evanston Insurance Company appealed the judgment following a bench trial on an insurance-coverage dispute. After determining that Evanston failed to timely rescind the policy and that a policy exclusion did not apply, the district court required Evanston to continue defending Desert State Life Management against a class action arising from its former CEO’s embezzlement scheme. Though the Tenth Circuit agreed with the district court that rescission was untimely, it disagreed about the likely application of New Mexico law on applying policy exclusions. Judgment was thus affirmed in part and reversed in part. View "Evanston Insurance Company v. Desert State Life Management, et al." on Justia Law

Plaintiff brought a lawsuit against Allianz Life Insurance Company of North America (“Allianz”) in Plaintiff’s capacity as a trustee of the Zupnick Family Trust 2008A (“Trust”). Plaintiff sought a declaratory judgment that an Allianz life insurance policy (“Zupnick Policy”), which Plaintiff contends is owned by the Trust, remains in effect. The district court concluded that the Trust was not the actual owner of the Zupnick Policy under New York law because any assignment of the policy to the Trust failed to comply with the Zupnick Policy’s provision that assignment would be effective upon Allianz’s receipt of written notice of the assignment. The district court held that the Trust lacked contractual standing to sue on the Zupnick Policy, and granted Allianz’s motion to dismiss. On appeal, Plaintiff argued that failure to comply with the provisions of a life insurance policy requiring written notice of assignment cannot, under New York law, render an assignment ineffective.   The Second Circuit certified the question to the Court of Appeals because the argument turns on a question of state law for which no controlling decision of the New York Court of Appeals exists. The court certified the following question: Where a life insurance policy provides that “assignment will be effective upon Notice” in writing to the insurer, does the failure to provide such written notice void the assignment so that the purported assignee does not have contractual standing to bring a claim under the Policy? View "Brettler v. Allianz Life Insurance Company of North America" on Justia Law