Justia Insurance Law Opinion Summaries

ResCap Liquidating Trust (“ResCap”) pursued indemnification claims against originator Primary Residential Mortgage, Inc. (“PRMI”), a Nevada corporation. ResCap asserted breach of contract and indemnification claims, seeking to recover a portion of the allowed bankruptcy claims for those holding units in the liquidating trust. The district court concluded that ResCap had established each element of its contractual indemnification claim. The district court awarded ResCap $10.6 million in attorney’s fees, $3.5 million in costs, $2 million in prejudgment interest, and $520,212 in what it termed “post-award prejudgment interest” for the period between entry of judgment and the order awarding attorney’s fees, costs, and prejudgment interest. Defendant appealed.   The Eighth Circuit remanded for a recalculation of postjudgment interest but otherwise affirmed. The court explained that the district court held that, as a matter of Minnesota law governed by Section 549.09, a final judgment was not “finally entered” until its Judgment in a Civil Case resolving attorney’s fees, costs, and interest was entered on April 28, 2021, and therefore Minnesota’s ten percent prejudgment rate applied in the interim period. But Section 1961(a) does not say “final judgment,” it says “money judgment.” The district court, on August 17, 2020, entered a “money judgment.” Thus, the district court erred in applying Minnesota law to calculate interest after August 17, 2020, rather than 28 U.S.C. Section 1961(a). View "ResCap Liquidating Trust v. Primary Residential Mortgage" on Justia Law

In this insurance dispute brought by Insured seeking declarations that the policies issued by Insurer covered the losses it had suffered from repairing and remediating its physical space to accommodate the health necessities brought about by the COVID-19 pandemic, holding that the allegations did not trigger the primary coverage provided by the relevant policies.Insured asserted that it suffered hundreds of millions of dollars for health and safety protocols and modifications to its stores due to the presence of COVID-19. After Insurer denied coverage Insured brought this lawsuit. Insurer moved to dismiss the complaint, after which Insured filed a motion to certify a question of law to the Court of Appeals. The Court of Appeals answered that when a first-party, all-risk property insurance policy covers "all risks of physical loss or damage" to insured property from any cause unless excluded, coverage is not triggered when a toxic, noxious, or hazardous substance such as COVID-19 is physical present in the indoor air of that property, is also present on and can later be dislodged from physical items on the property, and causes a loss of the functional use of the property. View "Tapestry, Inc. v. Factory Mutual Insurance" on Justia Law

The 2010 ACA (Patient Protection and Affordable Care Act; Health Care and Education Reconciliation Act) created a three-year Risk Corridors program with the creation of new health-insurance marketplaces, which presented uncertain risks for participating health-insurance companies. Qualified health-plan issuers (QHP issuers) that offered their products in the new marketplaces were entitled to payments from HHS if they suffered sufficient losses, 42 U.S.C. 18062(b).The government failed to make those payments. QHP issuers sued under the Tucker Act, 28 U.S.C. 1491(a)(1). In two such lawsuits, the Quinn law firm was lead counsel for classes of QHP issuers seeking payments. In the opt-in notices sent to potential class members with court approval, Quinn represented that it would seek attorney’s fees out of any recovery, that it would seek no more than 5% of any judgment or settlement, and that the Claims Court would determine the exact amount by considering how many issuers participated, the amount at issue, and a “lodestar cross-check” (based on hours actually worked). Meanwhile, the Supreme Court, in other cases, held that QHP issuers were entitled to collect ACA-promised payments.The Claims Court entered judgments in favor of the classes, totaling about $3.7 billion, then awarded Quinn 5% of the common funds, rejecting objections. The total fee was about $185 million. The Federal Circuit vacated. The Claims Court’s analysis was inconsistent with the class opt-in notices and did not adequately justify the extraordinarily high award. View "Health Republic Insurance Co. v. United States" on Justia Law

PHI Group, Inc. (“PHI”), offers helicopter services for numerous global customers in the oil and gas, air medical, technical services, and healthcare industries. Zurich American Insurance Company (“Zurich”) sold an “all-risk” insurance policy covering PHI. PHI sued Zurich in a civil action in diversity to recover economic losses for the partial interruption of its business during the COVID pandemic. The district court dismissed PHI’s claims because its losses were not caused by a physical loss or damage to corporeal property, its claims were not novel in the post-pandemic legal environment, and the Fifth Circuit has resolved comparable cases similarly.   The Fifth Circuit affirmed. The court explained that PHI alleged a material difference in the insurance policies in Q Clothier and here. In Q Clothier, the policy covered “direct physical loss of or physical damage” to property, while here, the policy covers “direct physical loss or damage” to property. But the Fifth Circuit has found no ambiguity here, regardless of whether “physical” modifies only loss or both loss and damage. Further, PHI has not established any facts that indicate that coronavirus caused direct physical loss or damage, which remains at the crux of any recovery under its insurance policy. Regardless of the contamination exclusion, PHI does not have a plausible claim for coverage. An exclusion cannot create coverage that does not exist under the plain meaning of the policy. View "PHI Group v. Zurich American Insurance" on Justia Law

The Supreme Judicial Court reversed the order of the superior court allowing Plaintiff's motion for summary judgment in this lawsuit brought against the Executive Office of Health and Human Services and Nationwide Life Insurance Company in this dispute over the remainder of an annuity issued by Nationwide, holding that the superior court erred.Robert Hamel purchased the annuity at issue to help Joan Hamel, his wife, become eligible for Medicaid benefits, which was necessary to pay for her long-term care. Robert named the Commonwealth as the primary remainder beneficiary to the "extent benefits paid" and Plaintiff, his daughter, as the contingent remainder beneficiary. Before the end of the annuity period Robert died. Plaintiff filed this lawsuit alleging that she was entitled to the remainder. The superior court entered summary judgment in favor of Plaintiff and denied the Commonwealth's motion for summary judgment as to Plaintiff's claim for declaratory judgment. The Supreme Judicial Court vacated and reversed the judgment below, holding that, upon Robert's passing, the remainder of the annuity properly belonged to the Commonwealth up to the amount it paid for Joan's care. View "Dermody v. Executive Office of Health & Human Services" on Justia Law

The Supreme Court vacated the judgment of the superior court granting Insurer's motion for summary judgment in this insurance dispute, holding that Insured was entitled to judgment as to counts one, four, and five of its complaint.Insured, a company that sold and serviced residential heating and air-conditioning systems, was sued by a former customer who alleged negligence and demanded remediation from property damaged by 170 gallons of home heating oil that leaked into his basement. Insured demanded that Insurer defend and indemnify against the claim. The hearing justice granted summary judgment in favor of Insurer. The Supreme Court vacated the judgment below, holding (1) the relevant insurance policy's definition of "pollution" was ambiguous as applied to Insured's claims; and (2) the hearing justice erred in granting summary judgment in favor of Insurer and in denying Insured's motion for summary judgment as to certain counts of the complaint. View "Regan Heating & Air Conditioning, Inc. v. Arbella Protection Insurance Co., Inc." on Justia Law

The Supreme Court affirmed the decision of the court of appeals panel reversing the judgment of the district court against Key Insurance Company in this garnishment action brought by Nancy Granados seeking pay under the liability insurance policy Key had issued to John Wilson, holding the court of appeals made the correct conclusion.John Wilson struck a car while he was driving under the influence and killed the driver. The driver's wife, Granados, brought a wrongful death lawsuit against Wilson. The district court entered a judgment against Wilson for nearly $3.5 million. Granados then filed this garnishment action seeking payment from Key under the automobile liability insurance policy it had issued to Wilson and under which Key limited tis coverage for bodily injuries caused by Wilson to $50,000 in the aggregate. Granados argued that, despite the policy limits, Key's negligent and bad-faith handling of Wilson's claim rendered it liable for the entire judgment. The trial court agreed and entered judgment against Key. The court of appeals reversed. The Supreme Court affirmed, holding that Granados failed to meet her burden to prove that Key's handling of the claim caused the judgment exceeding policy limits. View "Granados v. Wilson " on Justia Law

The Supreme Court reversed the decision of the court of appeals affirming the circuit court's grant of summary and declaratory judgment in favor of State Farm in this insurance dispute, holding that issue preclusion did not bar Lindsey Dostal from seeking insurance coverage for her claims against Curtis Strand.The daughter of Dostal and Strand died as a result of head trauma that occurred while she was in Strand's care. Strand was convicted of second-degree reckless homicide. Dostal subsequently brought this civil action against Strand for negligence and wrongful death. Strand tendered the matter to his homeowner's insurer, State Farm, seeking defense and indemnification. The circuit court granted summary and declaratory judgment in favor of State Farm. The court of appeals affirmed, determining that Strand's conduct did not constitute an "occurrence" covered by the policy at issue because Defendant's criminal conviction established that the death was not the result of an accident. The Supreme Court reversed, holding (1) the issue of whether Strand's conduct was an "accident" was not actually litigated in the prior criminal proceeding; and (2) there were genuine issues of material fact such that summary judgment was inappropriate. View "Dostal v. Strand" on Justia Law

Joy Global and Komatsu agreed to merge. Joy sent its investors disclosures required under the Securities Exchange Act, 15 U.S.C. 78n. Subsequent suits contended that Joy violated the Act by not disclosing some internal projections of Joy’s future growth that could have been used to negotiate a higher price, rendering the proxy statements fraudulent, and that Joy’s directors violated their state law duties by not maximizing the price for the shareholders. The suits settled for $21 million.The district court held that the $21 million loss is not covered by insurance. The policies do not require indemnification for “any amount of any judgment or settlement of any Inadequate Consideration Claim other than Defense Costs.” An “inadequate consideration claim” is that part of any Claim alleging that the price or consideration paid or proposed to be paid for the acquisition or completion of the acquisition of all or substantially all the ownership interest in or assets of an entity is inadequate.The Seventh Circuit affirmed. The suits assert the wrongful act of failing to disclose documents that could have been used to seek a higher price and are within the definition of “inadequate consideration claim.” The claims do not identify any false or deficient disclosures about anything other than the price. The only objection to this merger was that Joy should have held out for more money, and that revealing this would have induced the investors to vote “no.” View "Joy Global Inc. v. Columbia Casualty Co." on Justia Law

Van Dermark served in the Navy from 1963 until his 1976 honorable discharge. The VA found Van Dermark to be totally and permanently disabled due to service-connected injuries. Van Dermark received treatment in Thailand (where he lived) at non-VA facilities, from physicians and others not affiliated with VA, in 2016 and in 2018, both times for cardiac conditions not related to his service-connected disability. For each of the two instances of treatment abroad, Van Dermark filed a claim with VA under 38 U.S.C 1728 and 1725 seeking VA payment—to him or his medical creditors—for the surgical or other heart-related treatment he received abroad.VA Community Care denied both claims. The Board of Veterans’ Appeals maintained the denials. The Veterans Court and Federal Circuit affirmed. Section 1724(a) prohibits the VA from “furnish[ing] hospital . . . care or medical services” abroad, where the care or services are unrelated to the service-connected disability. The “furnishing” phrase encompasses the payment for a veteran’s hospital care or medical expenses abroad at issue here; sections 1728 and 1725 do not override that prohibition. View "Van Dermark v. McDonough" on Justia Law