Justia Insurance Law Opinion Summaries

Appellant is a self-described “watchdog association” that brings actions for injunctive relief against immigration consultants under section 22446.5, which provides a right of action against an immigration consultant to anyone who suffers damages by reason of the immigration consultant’s fraud, misrepresentation, or failure to provide services.In October 2017, Appellant brought over 90 actions against immigration consultants, two of whom had bonds issued by Appellee insurance company. After Appellant prevailed at trial against the consultants, it filed suit against Appellee to recover its attorney fees and costs against the Immigration Consultant Act bond. The trial court granted summary judgment in the insurance company's favor.On appeal, the Second Appellate District affirmed, explaining a surety issuing a statutory bond is liable only to the extent indicated in the code section under which the surety executes the bond and under the plain language of the relevant bond statutes, a non-aggrieved person who suffers no damages is not entitled to recovery from an Immigration Consultant Act bond. View "Immigrant Rights Defense etc. v. Hudson Insurance Co." on Justia Law

Plaintiff sought accidental death benefits under an employee benefit plan governed by the Employee Retirement Income and Security Act of 1974 (ERISA) after his wife died from injecting herself with a cocktail of unprescribed narcotics. The district court upheld the Life Insurance Company of North America’s (LINA) decision to deny benefits based on a policy exclusion for the “voluntary ingestion of any narcotic, drug, poison, gas or fumes unless prescribed or taken under the direction of a Physician.” Plaintiff appealed, contending that the district court erred because LINA’s decision was unreasonable and not supported by substantial evidence.   The Eighth Circuit affirmed. The court decided that LINA’s interpretation of “ingestion” was reasonable. The court then turned to whether LINA’s application of its interpretation to the facts is supported by substantial evidence. Here, the wife undisputedly died because she willingly injected herself with a combination of unprescribed narcotics. Therefore, there is sufficient evidence to support LINA’s application of the voluntary ingestion exclusion to the wife’s death. Thus, because the court agreed with the district court’s conclusion that LINA’s denial of benefits was justified in light of the voluntary ingestion exclusion, the court wrote it need not address LINA’s assertion that the wife’s death was not accidental. View "Jay Richmond v. Life Insurance Company" on Justia Law

Olson and Zdroik sustained injuries while volunteering at municipal fireworks displays in 2018. Fireworks distributed by Spielbauer Fireworks exploded prematurely at both events, severely burning the two. Both towns used teams of volunteers to operate their Fourth of July displays. Olson opened and closed a bin from which other volunteers retrieved fireworks during the Rib Lake show. Zdroik worked at the Land O’Lakes event as a “shooter,” manually lighting the fuses on mortar shells.Spielbauer’s insurer, T.H.E. Insurance, contested coverage under Spielbauer’s general and excess liability policies, which stated: This policy shall NOT provide coverage of any kind ... for any claims arising out of injuries or death to shooters or their assistants hired to perform fireworks displays or any other persons assisting or aiding in the display of fireworks whether or not any of the foregoing are employed by the Named Insured, any shooter or any assistant. The issue was whether the exclusion extends to all volunteers or only to those assisting hired shooters or hired assistants.The Seventh Circuit affirmed, in favor of T.H.E. Insurance. The Shooters Endorsement plainly and unambiguously excludes from coverage hired shooters and their hired assistants and “any other persons” who assist the fireworks display, regardless of whether they assist hired persons. View "T.H.E. Insurance Co. v. Olson" on Justia Law

The Supreme Court affirmed in part and reversed in part the decision of the court of appeals reversing the judgment of the district court dismissing Millard Gutter Company's suit against Farm Bureau Property & Casualty Insurance Company without prejudice, holding that the district court correctly dismissed the first-party bad faith claims for lack of standing.After a storm, Millard Gutter obtained assignments of the right to insurance proceeds due under policies of Shelter. Thereafter, Millard filed suit against Shelter in its own name, as assignee, alleging breach of contract and first-party bad faith in failing to settle the claims. The district court granted Shelter's motion to dismiss, concluding that the complaint did not contain sufficient factual allegations to establish standing to assert first-party bad faith claims. The court of appeals reversed in part, concluding that Millard Gutter had stated a plausible claim for first-party bad faith. The Supreme Court reversed in part, holding that Millard Gutter lacked standing to prosecute the policyholders' tort actions for first-party bad faith against Shelter. View "Millard Gutter Co. v. Farm Bureau Property & Casualty Insurance Co." on Justia Law

The Supreme Court affirmed the judgment of the district court dismissing this action brought by Millard Gutter Company against Shelter Mutual Insurance Company seeking to recover damages for breach of insurance contracts and for first-party bad faith, holding that the district court did not err in concluding that Millard Gutter did not have standing to assert first-party bad faith claims against Shelter.After a storm, Millard Gutter obtained assignments from various policyholders of Shelter. Thereafter, Millard filed suit against Shelter in its own name, as assignee, alleging breach of contract and first-party bad faith in failing to settle the claims. The district court granted Shelter's motion to dismiss, concluding that the complaint did not contain sufficient factual allegations to establish standing to assert first-party bad faith claims. The Supreme Court affirmed, holding that Millard Gutter lacked standing to prosecute the policyholders' tort actions for first-party bad faith against Shelter. View "Millard Gutter Co. v. Shelter Mutual Insurance Co." on Justia Law

The Supreme Court reversed the decision of the court of appeals in this appeal involving a dispute between a homeowner and an insurance company over prejudgment interest, holding that Minnesota standard fire insurance policy, Minn. Stat. 65A/01, entitled Homeowner to prejudgment interest in an amount that may result in a total recovery that exceeded the policy limit.Homeowner sought coverage from Insurer after fires damaged his home. Insurer denied coverage, leading Homeowner to bring this lawsuit. A jury found for Homeowner. The district court award awarded Homeowner prejudgment interest in a limited amount, finding that Homeowner's total recovery for his personal property loss could not permissibly exceed the policy coverage limit. The court of appeals affirmed. The Supreme Court reversed and remanded the case to the district court to recalculate prejudgment interest, holding that, consistent with past precedent interpreting the standard fire policy, prejudgment interest can lawfully begin accruing before ascertainment of the loss when the insurer denies all liability. View "Else v. Auto-Owners Insurance Co." on Justia Law

Amy’s employs 2,500 people to manufacture vegetarian meals. It purchased comprehensive property insurance from Fireman’s for a period ending in July 2020. The policy included coverage extensions for communicable diseases and for loss avoidance and mitigation: Fireman’s “will pay for direct physical loss or damage to Property" caused by or resulting from a "communicable disease event at a location.” The policy defines “communicable disease event” as one in which “a public health authority has ordered that a location be evacuated, decontaminated, or disinfected due to the outbreak of a communicable disease.” Amy’s incurred costs “to mitigate, contain, clean, disinfect, monitor, and test for the effects of” the coronavirus at insured locations, and to avoid or mitigate potential coronavirus-related losses, including temperature-screening equipment to test for COVID, protective shields to prevent transmission on assembly lines, masks and goggles, cleaning supplies, and “hero pay.” People with confirmed COVID-19 cases were on Amy’s premises. The complaint cited “various require[d safety measures] for all essential businesses.”Fireman’s denied Amy’s claim. The court of appeal affirmed the dismissal of the complaint. Under communicable disease extension, the need to clean or disinfect infected or potentially infected covered property constitutes “direct physical loss or damage” of the property; Amy’s has not pled a “communicable disease event” but should be given leave to amend to do so. View "Amy's Kitchen, Inc. v. Fireman's Fund Insurance Co." on Justia Law

Petitioners Javier Vasquez and his employer, Matosantos International Corporation (MIC), appealed a New Hampshire Compensation Appeals Board (CAB) determination that it could not order respondent, The Hartford Insurance Company, to pay workers’ compensation benefits to Vasquez. The CAB concluded that the Department of Labor (DOL), and therefore the CAB, lacked jurisdiction under the New Hampshire Workers’ Compensation Law to interpret the workers’ compensation insurance policy that MIC had purchased from The Hartford. Because the New Hampshire Supreme Court concluded the CAB did have jurisdiction to consider and resolve the coverage dispute between MIC and The Hartford, it vacated the CAB’s decision and remanded for its consideration, in the first instance, of whether the policy purchased by MIC covered Vasquez when he was injured while working in New Hampshire. View "Appeal of Vasquez" on Justia Law

Geist, seriously injured in an automobile accident, settled a claim against the driver and his insurer, which did not fully compensate her. Geist sought to recover underinsured motorist (UIM) benefits from State Farm under a policy issued to her parents. When State Farm issued the policy in 2010, it provided liability coverage of $100,000 per person / $300,000 per accident for bodily injuries. Geist’s parents elected UIM benefits of up to $50,000 per person / $100,000 per accident. When they added a third vehicle to the policy, her parents did not execute an acknowledgment for UIM-coverage limits below the bodily injury limits. Geist believed that she could recover up to $200,000 in UIM benefits, the stacked total of the $100,000 UIM coverage for each insured vehicle. State Farm paid her $100,000.The Third Circuit affirmed the dismissal of Geist’s purported class action. Under Pennsylvania’s Motor Vehicle Financial Responsibility Law an insurer must seek an election of UIM-coverage limits that are less than the bodily injury coverage limits only when it issues a new policy; the UIM-coverage limits remain in effect as long as the policy does. Geist’s parents executed a written election for lower limits when State Farm issued the policy, and never sought a new policy. View "Geist v. State Farm Mutual Automobile Insurance Co." on Justia Law

Cope, injured on a Kentucky job site, filed a workers’ compensation claim. The subcontractor who hired him for the project, CMC, is based in Southern Indiana, and had an insurance policy with AFICA. Schultheis Insurance Agency procured the policy for CMC, but failed to inform AFICA that CMC did business in Kentucky. AFICA sought a declaration that its policy does not cover Cope’s claim.The district court granted AFICA summary judgment. The Seventh Circuit affirmed. The plain text of the policy is unambiguous: because CMC failed to notify AFICA until after Cope’s accident that it was working in Kentucky, AFICA is not liable for Cope’s workers’ compensation claim. The policy states : “If you have work on the effective date of this policy in any state [other than Indiana], coverage will not be afforded for that state unless we are notified within thirty days.” View "Accident Fund Insurance Co. v. Schultheis Insurance Agency, Inc." on Justia Law