Justia Insurance Law Opinion Summaries

The owners of Hotel Erwin and Larry’s (a restaurant adjacent to the hotel) in Venice Beach—Marina Pacific Hotel & Suites, LLC; Venice Windward, LLC; Larry’s Venice, L.P.; and Erwin H. Sokol, as trustee of the Frances Sokol Trust (collectively insureds)—sued Fireman’s Fund Insurance Company alleging the COVID-19 virus was present on and had physically transformed, portions of the insured properties—“direct physical loss or damage” within the meaning of Fireman’s Fund’s first party commercial property insurance policy—but Fireman’s Fund refused to pay policy benefits for covered losses incurred as a result. The trial court sustained Fireman’s Fund’s demurrer to the insureds’ first amended complaint without leave to amend and dismissed the lawsuit, ruling the COVID-19 virus cannot cause direct physical loss or damage to property for purposes of insurance coverage.   The Second Appellate District reversed the trial court’s judgment sustaining Defendant’s demurrer to the insureds’ first amended complaint without leave to amend and dismissed the lawsuit, ruling the COVID-19 virus cannot cause direct physical loss or damage to property for purposes of insurance coverage. The court held it was an error at the nascent phase of the case. The court explained that because the insureds adequately alleged losses covered by Fireman’s Fund’s policy, they are entitled to an opportunity to present their case, at trial or in opposition to a motion for summary judgment. The judgment of dismissal based on the trial court’s disbelief of those allegations, whether ultimately reasonable or not, must be reversed. View "Marina Pacific Hotel and Suites, LLC v. Fireman's Fund Ins. Co." on Justia Law

The Multiemployer Pension Plan Amendments Act (“MPPAA”) requires an employer to pay “withdrawal liability” if it decides to leave a multiemployer pension plan. Calculating the amount of money the employer owes the plan requires an actuary to project the plan’s future payments to pensioners. The MPPAA requires the actuary to use “assumptions and methods which, in the aggregate, are reasonable (taking into account the experience of the plan and reasonable expectations) and which, in combination, offer the actuary’s best estimate of anticipated experience under the plan.” 29 U.S.C. Section 1393(a)(1).   The Energy West Mining Company (“Energy West”) withdrew from the United Mine Workers of America 1974 Pension Plan (“Pension Plan”). In calculating Energy West’s withdrawal liability, the actuary did not rely on the Pension Plan’s performance to determine what discount rate to use but instead adopted a risk-free discount rate. An arbitrator upheld the risk-free discount rate and the district court granted summary judgment to the Pension Plan, enforcing the arbitral award.   The Second Circuit reversed because the actuary’s choice of a risk-free rate violates the MPPAA’s command. The court explained that to calculate Energy West’s withdrawal liability from the Pension Plan, the actuary was required to base his assumptions on the Plan’s actual characteristics. Because the actuary failed to do so, the court reversed the judgment of the district court and remanded for vacatur of the arbitration award. When the actuary calculates Energy West’s withdrawal liability, the discount rate assumption must be similar, but need not be identical, to the discount rate assumption used to calculate minimum funding. View "United Mine Workers of America v. Energy West Mining Company" on Justia Law

In this insurance dispute, the Supreme Court affirmed in part, vacated in part and reversed in part the decision of the district court granting summary judgment in favor of North Star Mutual Insurance Company and against Old Mill Bulk Foods, holding that the district court erred by not granting summary judgment in favor of Old Mill.In July 2018 a fire destroyed the premises of a deli-grocery store. Old Mill elected to renovate another building in which to relocate is business and sought $159,879 under the "extra expense" provision of its insurance policy through North Star. North Star denied coverage and then filed this declaratory judgment to determine the parties' rights and obligations under the policy. The district court denied the extra expenses. The Supreme Court held that the district court (1) erred by not granting summary judgment in favor of Old Mill as to the claimed extra expenses; and (2) properly granted summary judgment with respect to the claim for a walk-in cooler. View "North Star Mutual Insurance Co. v. Miller" on Justia Law

The Supreme Judicial Court reversed the judgment of the superior court in favor of Insureds in this insurance dispute over attorney's fees, holding that attorney's fees under Mass. Gen. Laws ch. 93A are not awarded as "damages because of 'bodily injury' and are not 'costs taxed against the insured.'"At issue was whether Insureds' insurance policy, which covered "sums that the insured becomes legally obligated to pay as damages because of 'bodily injury,'"included Insureds' liability for attorney's fees under chapter 93A, section 9(4) in an action for breach of warranty resulting in bodily injury. After paying the substantive damages on the claim, Insurer brought this declaratory judgment action to determine whether it was also responsible for attorney's fees. The superior court concluded that the policy did cover attorney's fees. The Supreme Judicial Court reversed, holding that Insureds' policy did not cover the award of attorney's fees under chapter 93A. View "Vermont Mutual Insurance Co. v. Poirier" on Justia Law

While working at Dura-Bond’s Duquesne, Pennsylvania plant, Marshall stepped out of his truck, while others were loading metal pipes onto it. A worker accidentally ran a forklift into the pipes, causing one to roll off the truck and crash into Marshall. Doctors had to amputate both of Marshall’s legs, leaving him totally disabled.Russell Trucking had contracted with Express to use its license. Express would ensure that drivers met federal requirements, but Russell could otherwise retain the drivers they wanted. Marshall had completed an Express application, passed a background check, and completed training with Russell. Marshall leased a truck from Russell and drove it under Express’s license. Although he signed a contract stating that he was an independent contractor, Marshall believed that he was an employee of both Express and Russell.Marshall filed a workers’ compensation claim. Russell, Express, and Dura-Bond all disclaimed an employment relationship with Marshall. Marshall conceded that he had agreed to obtain his own workers’ compensation insurance and had failed to do so. An ALJ found that Russell was Marshall’s “immediate employer” and that Express and Dura-Bond were Marshall’s “statutory employers” under Pennsylvania’s workers’ compensation statute. Neither Express nor Russell had insurance for Marshall. The judge ordered Dura-Bond (which had insurance) to pay Marshall’s benefits and allowed it to seek indemnity. Express reimbursed Dura-Bond for the benefits.Marshall subsequently brought tort claims against Express and Russell. RLI, which had issued Express a commercial general liability policy, refused to reimburse for a $2.4 million settlement, citing policy exclusions for “[a]ny obligation” “under a workers’ compensation” “law” and for injuries to an “employee.” The Sixth Circuit affirmed a jury finding that Marshall was a “temporary worker,” leaving the tort-suit settlement covered by the policy. View "P.I. & I. Motor Express, Inc. v. RLI Insurance Co." on Justia Law

Lawyers brought claims against schools under the Individuals with Disabilities Education Act (IDEA), 20 U.S.C. 1400. After the claims failed, the schools sought their attorney’s fees from the lawyers under the IDEA’s fee-shifting provision. The School Districts alleged that, during the administrative process, the attorneys presented sloppy pleadings, asserted factually inaccurate or legally irrelevant allegations, and needlessly prolonged the proceedings. The lawyers asked their insurer, Wesco, to pay the fees. Wesco refused on the ground that the requested attorney’s fees fell within the insurance policy’s exclusion for “sanctions.”The Sixth Circuit affirmed summary judgment in favor of Wesco. The IDEA makes attorney misconduct a prerequisite to a fee award against a party’s lawyer, so the policy exclusion applied. The court noted that the legal community routinely describes an attorney’s fees award as a “sanction” when a court grants it because of abusive litigation tactics. View "Wesco Insurance Co. v. Roderick Linton Belfance, LLP" on Justia Law

Ila Reid appealed a district court’s summary judgment dismissal of her breach of contract claim against Primerica Life Insurance Company (“Primerica”). Reid brought her claim after Primerica filed an interpleader action to resolve competing claims to her late husband Garvin Reid’s life insurance beneficiary proceeds. She contended Primerica acted unfairly in multiple ways to create the controversy and thus the district court should not have permitted Primerica to use interpleader as a shield against her breach of contract claim. Finding no reversible error, the Eighth Circuit Court of Appeals affirmed the district court’s summary judgment order in favor of Primerica. View "Primerica Life Insurance Co. v. Reid" on Justia Law

The Louisiana Supreme Court granted review in this case to determine whether a stamped signature on an uninsured/underinsured motorist (“UM”) coverage rejection form, affixed by the administrative assistant of the corporate insured’s owner and president, complied with the statutory requirement that the UM form be signed by the named insured or his legal representative. Because the stamped signature was affixed on behalf of the legal representative and not by the legal representative himself, the Supreme Court agreed with the court of appeal that the lack of prior written authorization to the administrative assistant rendered the UM form invalid. View "Havard v. JeanLouis, et al." on Justia Law

Lia Kazan (“Lia”) visited an Alexandria, Louisiana motel to meet some friends. During the course of her visit, she went went to the motel parking lot to retrieve something from her vehicle. Anthony Murray, another motel guest, exited his room and approached the vehicle with Lia inside. Audio from the camera footage recorded Lia screaming “stop,” “no,” and calling for help accompanied by repeated honking of the vehicle’s horn. Murray then started the ignition and, with Lia in the passenger seat, reversed out of the parking lot onto the service road. The vehicle was later found submerged in Lake Dubuisson – the bodies of Murray and Lia were recovered in the water. Lia’s death was classified as a homicidal drowning. Ali Kazan and Ebony Medlin filed suit, individually, and on behalf of their daughter, Lia (collectively “Plaintiffs”) against several parties, including the motel’s owner, Vitthal, LLC, and its insurer, Great Lakes Insurance Company SE (“Great Lakes”), seeking damages for Lia’s kidnapping and death. In response, Great Lakes filed a petition for declaratory judgment averring it had no obligation under the operable commercial general liability policy (“the CGL Policy”) to defend or indemnify the other defendants. Great Lakes moved for summary judgment on its petition arguing the CGL Policy contained an exclusion – specifically defining “assault,” “battery,” and “physical altercation” – which barred coverage for Lia’s kidnapping and death. The Louisiana Supreme Court granted review in this case to determine whether an insurance policy, by its own terms, excluded coverage for damages arising from a kidnapping resulting in death. The Court found the clear and unambiguous language of the relevant policy exclusion barred coverage. View "Kazan et al. v. Red Lion Hotels Corporation, et al." on Justia Law

Brown’s company, TME, owned the House of Blues recording studio in Memphis and leased a studio to Falls. Hanover issued separate insurance policies to TME and Falls. Intruders vandalized and burgled the studio, and committed arson. Hanover made advance payments to TME and Falls, then discovered that Brown had submitted false receipts and had been the target of several similar arson incidents. Hanover sued Brown, TME, and Falls, seeking recovery of the prepaid funds and a declaratory judgment. A jury returned a verdict against Brown but found that Falls was entitled to recover the full insurance coverage. Hanover unsuccessfully moved to overturn that verdict because TME was named as an additional insured on Falls’s policy and his policy voided coverage if “you or any other insured” misrepresented a material fact. Meanwhile, Falls sought monetary damages and declaratory relief against Brown and TME in Tennessee state court.Hanover filed an interpleader complaint against Brown, TME, and Falls in federal court, requesting that the court find the insurance award void under Tennessee public policy or, alternatively, determine to whom Hanover should pay the award. The district court enjoined Falls’s state court action, citing the Anti-Injunction Act, 28 U.S.C. 2283, The Sixth Circuit reversed. The Act allows an injunction only for necessity, not simply for efficiency. Because the district court proceedings were not in rem, an injunction was not “necessary” to aid the district court’s jurisdiction. View "Hanover American Insurance Co. v. Tattooed Millionaire Entertainment, LLC" on Justia Law