Justia Contracts Opinion Summaries

A construction company (Constructor) retained Defendant to arrange insurance for a new housing development. Defendant procured insurance from two insurance companies (Peerless and Hartford). Peerless denied coverage for a house destroyed by fire that was built on a lot not listed in Peerless's policy. Haynes claimed against Defendant for its negligent omission of the lot. Defendant gave notice of the loss to Plaintiff, from whom Defendant had purchased errors and omissions coverage. Defendant and Plaintiff settled with Constructor for $354,000. Constructor assigned its rights against Peerless and Hartford to Plaintiff and Defendant collectively. Defendant and Plaintiff then proceeded against the insurers for the $354,000. After the parties settled, $208,000 was deposited in an escrow account. Plaintiff sought a declaration that it was entitled to all of the escrow funds. Defendant counterclaimed for a declaration that, under Connecticut's make whole doctrine, it was entitled to recover the $150,000 deductible it contributed to the $354,000. The district court granted summary judgment for Plaintiff. The Supreme Court accepted certification from the appellate court and answered its questions by holding (1) the make whole doctrine is the default rule under Connecticut law; and (2) the make whole doctrine does not apply to insurance policy deductibles. View "Fireman's Fund Ins. Co. v. TD Banknorth Ins. Agency, Inc." on Justia Law

In an insurance coverage dispute with a policyholder, Cincinnati appealed the district court's adverse summary judgment rulings. The policyholder sought a claim of total loss for a vertical lathe that it purchased from a manufacturer in Taiwan and that was destroyed in Los Angeles. Cincinnati denied coverage, claiming that the coverage extension for newly acquired property did not apply. The court concluded that the extension of coverage to "any location you acquire" was ambiguous and, under Iowa law, the court construed that ambiguity in the policyholder's favor. The court also concluded that the district court did not err in awarding prejudgment interest under Iowa law. Accordingly, the court affirmed the judgment of the district court. View "Amera-Seiki Corp. v. The Cincinnati Ins. Co." on Justia Law

The Fund is a multi-employer trust fund under the Taft-Hartley Act, 29 U.S.C. 186, and the Employee Retirement Income Security Act, 29 U.S.C. 1001. Blue Cross is a Michigan non-profit corporation; its enabling statute authorizes the State Insurance Commissioner to require it to pay a cost transfer of one percent of its “earned subscription income” to the state for use to pay costs beyond what Medicare covers. In 2002 the Fund converted to a self-funded plan, and entered into an Administrative Services Contract with Blue Cross, which states that Blue Cross is not the Plan Administrator, Plan Sponsor, or fiduciary under ERISA; its obligations are limited to processing and paying claims. In 2004 the Fund sued, claiming that Blue Cross breached ERISA fiduciary duties by imposing and failing to disclose a cost transfer subsidy fee to subsidize coverage for non-group clients. The fee was regularly collected from group clients. Self-insured clients were not always required to pay it. Following a first remand, the district court granted class certification and granted the Fund summary judgment. On a second remand, the court again granted judgment on the fee imposition claim and awarded damages of $284,970.84 plus $106,960.78 in prejudgment interest. The Sixth Circuit affirmed. View "Pipefitters Local 636 Ins. Fund v. Blue Cross & Blue Shield of MI" on Justia Law

In a declaratory judgment action, the issue before the Supreme Court was whether the circuit court erred when it found a commercial general liability (CGL) policy provided coverage when a brick face was damaged by improper cleaning after the insured general contractor completed its installation. After review, the Court concluded the policy did not provide coverage. View "Bennett & Bennett Construction v. Auto Owners Insurance" on Justia Law

Plaintiff maintained a homeowners insurance policy with Insurer that excluded from coverage any claims for "injury arising out of the business pursuits" of Plaintiff. In 2011, a third party filed a complaint against Plaintiff, contending that Plaintiff published false and defamatory statements regarding the third party. In response to the complaint, Plaintiff tendered defense of the suit to Insurer, which declined to defend Plaintiff. Plaintiff then filed a complaint seeking a declaratory judgment that Insurer had a duty to defend him in the pending action by the third party. The superior court granted Plaintiff's motion for summary judgment. The Supreme Court vacated the judgment and remanded for entry of a summary judgment in favor of Insurer, holding that Insurer had no duty to defend Plaintiff because the third party suit was based entirely on activity falling within the policy's exclusion for Plaintiff's "business pursuits." View "Hardenbergh v. Patrons Oxford Ins. Co." on Justia Law

Plaintiff was withdrawing money from an ATM when Tortfeasor struck her with his car. Tortfeasor was insured under a policy written by Insurer to a limit of $100,000 for bodily injury to one person. Plaintiff and several of her family members brought this action against Tortfeasor and his brother, the named insured on the policy, (collectively, Tortfeasor) and Insurer. The district court originally entered judgment ordering Insurer and Tortfeasor to pay one-and-a-half million dollars to Plaintiffs. Insurer paid into court $75,000, the remainder of its policy limit. The district court later amended its judgment, holding Tortfeasor and Insurer liable for six million dollars in damages. Plaintiffs then unsuccessfully sought to compel Insurer to pay postjudgment interest on the full judgment. The First Circuit Court of Appeals reversed the deniial of Plaintiff's request for postjudgment interest, holding that Insurer was responsible for postjudgment interest from the date of entry of the original judgment and the date of the deposit of the policy limit. View "Vazquez-Filippetti v. Cooperativa de Seguros Multiples de P.R." on Justia Law

Defendant hosted an underage drinking party in which one of the guests known to become belligerent when intoxicated assaulted and seriously injured another guest. The victim sued Defendant and his insurer (Insurer) for damages for his injuries. Insurer disputed coverage, arguing that it had no duty to defend and indemnify Defendant because there was no "accident" or "occurrence" under Defendant's family's homeowner's insurance policy where Defendant's actions were intentional. The circuit court granted summary judgment to Insurer. The court of appeals reversed, concluding that there was an occurrence because the assault was an accident when viewed from the standpoint of the injured person or Defendant, the insured. The Supreme Court reversed, holding (1) viewed from the standpoint of a reasonable insured, Defendant's intentional actions in setting up a drinking party and procuring alcohol for underage guests, including one known to become belligerent when intoxicated, created a direct risk of harm resulting in bodily injury; and (2) thus, the victim's bodily injury was not caused by an "occurrence" within the meaning of the policy, and Insurer was not obligated to provide insurance coverage for Defendant. View "Schinner v. Gundrum" on Justia Law

In a commercial general liability policy (GCL) coverage case, the United States Court of Appeals for the Eleventh Circuit certified two questions to the Georgia Supreme Court: (1) whether, for an "occurrence" to exist under a standard CGL policy, Georgia law requires there to be damage to "other property;" and (2) if "no" to the first question, whether for an "occurrence" to exist under a standard CGL policy, Georgia law requires that the claims being defended not be for breach of contract, fraud, or breach of warranty from the failure to disclose material information. The Supreme Court answered the first question in the negative, and the second in the affirmative to fraud, but negative as to breach of warranty. View "Taylor Morrison Services, Inc. v. HDI-Gerling America Insurance Co. " on Justia Law

Appellant received treatment at Hospital for injuries she sustained in an automobile accident. Appellant granted two statutory liens to Hospital on settlement proceeds she obtained from the tortfeasor for hospital services rendered. Appellant subsequently settled her case against the tortfeasor, and the tortfeasor's insurer (Insurer) agreed to pay Appellant $1.3 million in exchange for Appellant's agreement to indemnify Insurer from all healthcare provider liens. Hospital subsequently sued Insurer, and Appellant tendered to Hospital all money it asserted was due. Appellant then filed a complaint against Hospital, alleging that Hospital overcharged her pursuant to Nev. Rev. Stat. 439B.260(1), which provides that hospitals must reduce charges by thirty percent to inpatients who lack insurance "or other contractual provision for the payment of the charge by a third party." The district court entered judgment in favor of Hospital, finding that Appellant's settlement agreement with the tortfeasor rendered Appellant ineligible for the thirty percent statutory discount. The Supreme Court reversed in part, holding that a patient's eligibility is determined at the commencement of hospital services, and therefore, a later settlement agreement with a third party for the payment of such services does not disqualify the patient for the statutory discount. View " Bielar v. Washoe Health Sys., Inc." on Justia Law

Karla Brown brought a lawsuit against Deutsche Bank and others seeking rescission of a note and first mortgage securing that note, alleging that she was the victim of a predatory lending scheme. The mortgage was originated by Deutsche Bank's predecessor in interest in connection with the purchase of Brown's home. Deutsche Bank requested that First American Title Insurance Company defend Deutsche Bank's mortgage interest pursuant to the terms of its title insurance policy. First American refused coverage, claiming the lawsuit did not trigger its duty to defend because Brown was claiming she was misinformed as to the terms of the note rather than challenging that she granted the mortgage. Deutsche Bank subsequently brought this action seeking a judgment declaring First American had a duty to defend it in Brown's lawsuit. The superior court granted summary judgment in favor of First American. The Supreme Court affirmed, holding that the allegations in Brown's complaint did not trigger First American's duty to defend because the complaint's claims were not specifically envisioned by the terms of the title insurance policy. View "Deutsche Bank Nat'l Ass'n v. First Am. Title Ins. Co." on Justia Law