Articles Posted in Insurance Law

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Carol Jakubowicz and her two minor sons were involved in a car accident with Ronald Williams that resulted in injuries to the Jakubowiczs. Jakubowicz filed suit on behalf of herself and her sons against Williams. More than three years after the accident, Jakubowicz filed a motion for leave to amend her complaint and add an underinsured motorist (UIM) claim against State Farm, the Jakubowiczs’ insurer, stating that she believed Williams’ insurance policy would be insufficient to cover her damages. The trial court granted Jakubowicz’s motion for leave to amend. State Farm moved for summary judgment on the UIM claim, claiming it was barred because it was filed after the three-year limitation period in Jakubowicz’s insurance policy. The trial court denied the motion. The Supreme Court affirmed, holding that because the provision in the policy requiring an insured to bring suit within three years is in direct conflict with the policy’s requirement that State Farm will only pay if the underinsured motorist’s insurance has been exhausted, the policy is ambiguous and must be construed in favor of the insured. Remanded. View "State Farm Mut. Auto. Ins. Co. v. Jakubowicz" on Justia Law

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Plaintiff filed an application for insurance on his property, despite his property being vacant and uninhabitable. Based on the application, the insurance company issued a “Dwelling Fire Policy” on the property. Two months later, the property was destroyed by fire. The insurance company denied coverage and rescinded the policy because it contained material misrepresentations and false statements. Plaintiff filed suit against the company that issued the policy, the insurance agency, and the insurance agents, alleging that the agents made false representations as to the occupancy status of the house and committed forgery, deception, and insurance fraud. The trial court granted summary judgment for the agents and directed entry of judgments for all defendants. The Supreme Court (1) reversed in part the trial court’s entry of summary judgment for the agents to the extent that it may apply to Plaintiff’s claim for negligent procurement of insurance, holding that summary judgment was improperly entered on this claim; but (2) directed the entry of partial summary judgment for the agents as to Plaintiff’s claim alleging that the agents failed accurately to report dwelling fire policy information to the insurance company, holding that summary judgment was proper on this claim. View "Schmidt v. Indiana Insurance Co." on Justia Law

Posted in: Insurance Law

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Jerry Earl sustained severe injuries in a motorcycle accident. Jerry had a policy with State Farm, which provided uninsured motorist coverage. Earl and his wife Kimberly (together, Plaintiffs) sued State Farm when State Farm refused to pay out the full amount under the policy. State Farm admitted liability, and the case proceeded to a jury on the question of damages. The jury returned a verdict of $250,000, the exact amount of the coverage limit. State Farm appealed, arguing that the trial court abused its discretion by allowing the coverage limit into evidence. The Supreme Court affirmed, holding that the trial court did not abuse its discretion in admitting the coverage limit. View "State Farm Mut. Auto. Ins. Co. v. Earl" on Justia Law

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Jefferson County awarded the first phase of its courthouse remodeling plan to a contractor. Two subcontractors aided in the repairs. While the repairs were underway, a fire severely damaged the courthouse. Jefferson County’s contract with the contractor incorporated an American Institute of Architects (AIA) standard form. The AIA contract waives subrogation rights for damages caused by fire “to the extent covered by property insurance.” Jefferson County filed a subrogation claim against the Contractors to recover damages caused to its property unrelated to repairs. Defendants moved for summary judgment, arguing that Jefferson County had waived its claim under the AIA waiver because its insurance policy covered all the damages. The County responded that the subrogation waiver applied only to construction-related damages. The trial court granted summary judgment for Defendants, concluding that Jefferson County had waived subrogation rights for all claims. The Supreme Court affirmed, holding (1) the plain language of the AIA contract restricts the scope of the waiver based on the source and extent of property insurance coverage, not the nature of the damages; and (2) the County agreed to waive its rights to bring this subrogation claim by relying on its existing “all-risk” property insurance policy that covered the work and all other losses suffered in the fire. View "Bd. of Comm’rs v. Teton Corp." on Justia Law

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Appellant, a large managed health care organization, settled certain federal multi-district litigation without admitting liability. At all times relevant to this litigation, Appellant was was its own primary and excess insurer for errors and omissions liability, with a certificate of reinsurance on its primary policy issued by one reinsurer and numerous certificates of reinsurance on its excess policies issued by additional reinsurers. Appellant sought indemnification from its reinsurers. Some of those reinsurers denied coverage, whereupon Appellant filed the instant suit claiming professional liability coverage under the policies. The trial court granted summary judgment in favor of the reinsurers. The Supreme Court reversed and in large part granted summary judgment for Appellant, holding that Appellant was largely entitled to coverage for defense costs under its policies with the reinsurers. View "WellPoint, Inc. v. Nat’l Union Fire Ins. Co." on Justia Law

Posted in: Insurance Law

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Plaintiffs’ insured vehicle was struck by a Jeep driven by a hit-and-run driver. Plaintiffs sought coverage for property damage under the uninsured motorists coverage of the family auto insurance policy issued by Erie Insurance Exchange. Erie denied the claim. The trial court granted summary judgment for Erie on the coverage issue. The court of appeals reversed. The Supreme Court affirmed the judgment of the trial court, holding that under the clear and unambiguous language of the Erie policy, the policy did not provide uninsured motorists coverage with respect to the property damage sustained by Plaintiffs’ vehicle because personal injury did not result to Plaintiffs in the accident. View "Robinson v. Erie Ins. Exch." on Justia Law

Posted in: Insurance Law

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Plaintiff, an Indiana resident, was driving a semi-tractor trailer on behalf of Werner Transportation, a Georgia company, when he was injured in West Virginia after another truck hit his rig. Werner insured the truck under a policy from Empire Fire and Marine Insurance Co., which provided $5 million liability coverage. Empire, however, claimed that the policy included only $75,000 in underinsured motorist coverage. Applying Georgia law, the trial court granted summary judgment in favor of Empire, finding there was sufficient evidence that Werner made the affirmative choice to purchase underinsured motorist coverage in a lower amount than the liability policy limit. The court of appeals determined that Indiana law applied but nonetheless affirmed the trial court, concluding the evidence was sufficient under Indiana law to establish that Werner had explicitly rejected the default $5 million coverage limit and instead purchased coverage only in the amount of $75,000. The Supreme Court reversed, holding that the issue of whether Werner waived the higher liability limit for underinsured motorist insurance was “unsuitable for summary judgment and best left to the fact-finder.” View "Asklar v. Gilb" on Justia Law

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Plaintiffs obtained a homeowners insurance policy from American Family Mutual Insurance Company. After Plaintiffs’ home sustained substantial fire damage, a dispute arose regarding the amount of insurance claim benefits payable under the policy. Plaintiffs subsequently filed a complaint against American Family and Michael Meek, the insurance agent through whom they obtained their insurance, for negligence. The trial court granted summary judgment for Defendants, concluding that Plaintiffs failed to commence the action within the applicable statute of limitations. The court of appeals affirmed. The Supreme Court affirmed, holding that the trial court was correct to grant summary judgment on the basis of the applicable two-year statute of limitations. View "Groce v. Am. Family Mut. Ins. Co." on Justia Law

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An underinsured motorist collided with a city bus driven by Plaintiff. Plaintiff received a net workers’ compensation award of $71,958. Plaintiff also received $25,000 from the tortfeasor’s insurer. Plaintiff carried an underinsured (UM) policy issued by American Family Mutual Insurance Company that provided coverage up to $50,000 per person. Plaintiff submitted a UM claim to American Family, which denied coverage. Plaintiff filed a breach of contract action against American Family, asserting that he was entitled, under the terms of the policy, to $25,000 - the difference between his UM policy limit of $50,000 and the $25,000 he received from the tortfeasor’s insurer. The trial court granted summary judgment for American Family, concluding that the workers’ compensation benefits Plaintiff received operated as a setoff against the policy limit, thus reducing American Family’s liability to zero. The Supreme Court reversed, holding (1) the policy language unambiguously provided for a setoff against the policy limit; but (2) because this particular set-off would reduce the policy limit below the statutory minimum, Plaintiff was entitled to recover the remaining $25,000 from American Family. View "Justice v. Am. Family Ins. Co." on Justia Law

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Motel was insured under a policy issued by Insurer. The policy provided coverage for, as well as a duty to defend against, claims for bodily injury and personal and advertising injury liability. The policy expressly disclaimed coverage for both bodily injury and personal and advertising injury when the injury arose out of intentional conduct. Specifically, the policy excluded coverage for harm resulting from acts of sexual molestation by motel employees. After an off-duty motel employee molested a young motel guest, Insurer sought a declaratory judgment to enforce its reading of the contract disclaiming coverage for, and its duty to defend against, a civil complaint brought by the motel guest. The trial court granted summary judgment in favor of Insurer. The Supreme Court affirmed, holding that the abuse/molestation exclusion excluded from coverage the act of the employee, as the victim was in the "care" of the motel at the time of the molestation per the language of the exclusion. View "Holiday Hospitality Franchising, Inc. v. Amco Ins. Co." on Justia Law