Justia Contracts Opinion Summaries

Plaintiffs sought to recover on behalf of themselves and similarly-situated employees and retirees of the City of Cincinnati the current value of the 870,021 shares of Anthem stock that the City received from Anthem’s demutualization. Plaintiffs asserted eight claims for breach of contract and four tort claims against Anthem and three breach of contract claims and four tort claims against the City. The district court certified the class: 2,536 people named as insureds, or former members of a group of insured persons, covered under a health care group policy from June 18 through November 2, 2001. The class included “Class A” members, who had an insurance policy with Anthem prior to its merger with Community in 1995 and “Class B” members who received a health insurance group policy after the merger. The court later dismissed. The Sixth Circuit, exercising jurisdiction under the Class Action Fairness Act of 2005, 28 U.S.C. 1332(d), affirmed. Plaintiffs cannot recover any demutualization compensation; the City was the policyholder before the merger and maintained its policyholder rights post-merger through a grandfather clause, including any rights to demutualization proceeds. The 2001 demutualization process did not disrupt the City’s membership interests or confer any equity rights to Plaintiffs.

Robert and Ethel Youngs' home and personal property were insured under a policy issued by Allstate Insurance Company. The policy provided that Allstate would "not cover any loss or occurrence in which any insured person has concealed or misrepresented any material fact or circumstance." After a fire broke out in the Youngs' garage, damaging or destroying many of its contents, AllState denied the Youngs' insurance claim, asserting that the Youngs misrepresented material facts regarding their losses. The Youngs filed suit against Allstate for breach of contract and vexatious refusal to pay. The district court granted summary judgment for Allstate. The Eighth Circuit Court of Appeals reversed, holding that there were genuine issues of fact for trial.

Liberty entered into a Master Declaration and Easements, Covenants, Conditions and Restrictions for a shopping mall. PMI purchased the property and entered into a Declaration that gave Liberty the right to prior approval of future purchasers and an option to purchase. PMI borrowed $3.5 million from Nationwide, using the property as collateral. Nationwide purchased title insurance from Commonwealth, containing the ALTA 9 endorsement. PMI defaulted and conveyed the property to Nationwide, which attempted to sell to Ironwood. Liberty’s successor, Franklin, refused to approve Ironwood under its rights conferred by the Declaration, based on Ironwood’s planned use as a school. Nationwide claimed that the restrictions upon which Franklin justified refusal rendered the property unusable and unsalable. Commonwealth denied the claim. The district court dismissed. The Third Circuit remanded, holding that Commonwealth is obligated to cover the claim if the restriction causing Nationwide’s harm was covered by the ALTA 9 Endorsement and not expressly excepted on Schedule B. The district court then ruled in favor of Nationwide. The Third Circuit affirmed and remanded for determination of damages owed Nationwide, relying on the plain language of the ALTA 9 rather than deferring to industry custom and usage.

After coming home drunk, Wesley Vincent was found face-down in front of his house by his wife, Cheryl Likens. Vincent was taken to the hospital but eventually died. Likens tried to collect as the beneficiary of an accidental-death insurance policy, but the claim was denied under an alcohol exclusion because Hartford Life and Accident Insurance Company determined that the injury resulted from being legally intoxicated from alcohol. The district court granted summary judgment for Hartford based on the alcohol exclusion. The Fifth Circuit Court of Appeals affirmed, holding that a reasonable jury could not help but conclude that Vincent fell and suffered injuries as a result of his intoxication. On these facts, intoxication may not have been the only cause, but it did not have to be so to satisfy the exclusion.

Dameware Development, LLC Defined Benefit Pension Plan and Trust bought several life insurance policies from American General Life Insurance Company. After Dameware was unable to obtain the tax benefits it hoped would result from purchasing the policies, it sued American General for damages and for rescission of the contract. The district court granted summary judgment to American General. The Fifth Circuit Court of Appeals affirmed, holding that Dameware had not shown any basis for rescinding the contract nor any contractual duties breached by American General, and therefore, the district court did not err in granting summary judgment to American General.

A "discrete, narrow legal question" came before the Supreme Court: is a health care provider who has received an assignment of personal injury protection (PIP) benefits from an insured obligated upon request to furnish to the insurer broad information with respect to the provider’s ownership structure, billing practices, and regulatory compliance? Plaintiffs in this matter consist of six “Selective Insurance Company” entities. Individuals insured by Selective sought medical treatment from defendants for injuries received in automobile accidents. Those insureds assigned to defendants the benefits to which they were entitled under their PIP coverage, giving defendants the contractual right to seek PIP reimbursement under those policies. In reviewing claims submitted for payment, Selective detected what it considered to be suspicious patterns in both the treatments defendants had provided and the corporate links among the treating entities. Selective requested that defendant supply to it a variety of data with respect to their ownership, structure, billing practices, and compliance with certain regulations. In support of its request, Selective cited the provision within the insureds’ insurance policies requiring the insureds to cooperate with Selective in the investigation of any claim under the policy. When defendants refused to supply the material Selective sought, Selective sued, alleging that defendants' failure to supply the information was a breach of they duty to cooperate and a violation of the PIP discovery statute. After hearing oral argument, the trial court denied defendants’ motion to dismiss and granted Selective the relief it had requested by directing defendants to respond to Selective’s discovery requests. Defendants thereafter moved for reconsideration, but the trial court denied that motion, together with defendants’ request for a stay. Upon review of the matter, the Supreme Court held that an insured had no duty to provide information to plaintiff with respect to the ownership structure, billing practices, or referral methods of the medical providers from whom he or she sought treatment for his or her injuries. Because an insured had no obligation to supply that information to plaintiff, the assignment of benefits executed by an insured could not serve to impose that duty on the providers.

Appellant was injured in a car accident. The other car in the accident was owned by Amanda Salgado, a superintendent of a church (the Church), and driven by Michael Meyer, a member of the Church. The accident occurred while Meyer and other Church members were taking a lunch break from cleaning and repairing Church property. Appellant sued the Church, Salgado, and Meyer in state court. The Church's insurer (Insurer) then sought a declaratory judgment in federal court resolving whether its insurance policy covered Appellant's accident. The district court held that Insurer had no duty to defend the Church and Salgado. The Fifth Circuit Court of Appeals vacated the district court's judgment, holding that the district court (1) erroneously held that Insurer had no duty to defend the Church and Salgado, (2) improperly adjudicated the scope of Insurer's duty to indemnify, and (3) improperly asserted jurisdiction over Appellant's state-law claims. Additionally, the Court held (1) Insurer had a duty to defend the Church and Salgado in Appellant's underlying state lawsuit, and (2) the scope of Insurer's duty to indemnify could not be adjudicated until after Appellant's claims are decided in state court.

This declaratory judgment action concerned a controversy over the limits of an insurance policy issued by Insurer to Insured. A livestock company (Company) brought suit in Minnesota state court against Insured after Company's cattle in Insured's care died in unusually high numbers. Insured submitted the complaint in the underlying action to Insurer. Insurer refused to defend or indemnify Insured in the case brought by Company, basing its denial of coverage on an exclusion in the liability insurance policy for damage to property in the "care, custody, or control" of the insured. The Minnesota district court entered judgment against Insured. Insurer then commenced this action against Company and Insured in federal district court, seeking a declaratory judgment that the claims alleged in the underlying action were not covered under Insured's policy with Insurer and that Insurer therefore had no obligation to defend or indemnify Insured. The district court concluded that the claims were covered by the policy and granted Company and Insured's motion for summary judgment. The Eighth Circuit Court of Appeals reversed, holding that because Company's cattle were under Insured's care, custody, and control when they were damaged, the policy did not provide coverage for Company's claimed loss. Remanded.

At issue before the Ninth Circuit Court of Appeals in this case was whether an adverse claim to a stake may be so lacking in substance that a neutral stakeholder cannot interplead in good faith. Interpleader is proper when a stakeholder has at least a good faith belief that there are conflicting colorable claims. Appellee in this case was an insurance company that sought to interplead disputed insurance proceeds. Seeking to interplead the insurance funds, Appellee filed a counterclaim against Appellant and a third party complaint against Appellant's former husband. The district court found that interpleader was appropriate. The Ninth Circuit affirmed, holding that Appellee interpleaded in good faith, and consequently, the district court's judgment in interpleader was proper.

Plaintiffs purchased furniture from the Fortunoff store and purchased a furniture protection plan. Defendant sold the plans to Fortunoff, which in turn sold them to plaintiffs. After the Fortunoff store closed and the company went into bankruptcy, defendant rejected plaintiffs’ claims under the plan. Plaintiffs filed a putative class action alleging breach of contract, that the store closing termination clause in the plan violated New York General Business Law 395-a, and deceptive business practices in violation of General Business Law 36 349. The district court dismissed, holding that there was no implied cause of action under 395-a. The Second Circuit certified to the New York Court of Appeals: May parties seek to have contractual provisions that run contrary to General Business Law 395-a declared void as against public policy? May plaintiffs bring suit pursuant to 349 on the theory that defendants deceived them by including a contractual provision that violates 395-a and later enforcing this agreement?