Justia Contracts Opinion Summaries
Articles Posted in Insurance Law
Janney v. CSAA Insurance Exchange
Peggy Baltar’s home was destroyed by wildfire in 2014. She had a new house built on the same property. Her insurer, CSAA Insurance Exchange (CSAA), paid the full amount charged by her contractor for construction of the new house. Altar sued for breach of contract and breach of the implied covenant of good faith and fair dealing. According to Baltar, CSAA breached the policy by, among other things, failing to provide her with a complete and accurate estimate for replacing the original house, which would have provided her with a budget for the construction of the new house. Without such a budget, she claimed she was forced to build a cheaper house than the one destroyed by the fire. She claimed this, and other asserted breaches of the policy, amounted to bad faith and entitled her to punitive damages. The trial court granted CSAA’s motion for summary judgment and entered judgment in favor of the company. Baltar appealed, but finding no reversible error, the Court of Appeal affirmed. View "Janney v. CSAA Insurance Exchange" on Justia Law
AKC, Inc. v. United Specialty Insurance Co.
The Supreme Court held that a provision found in just about every commercial and personal-property insurance policy issued in Ohio that bars coverage for damage caused by "water that backs up or overflows from a sewer" includes damage caused by sewage carried into an insured property by a backup or overflow event.Sewage from the local sewer system backed up into the Bank Nightclub, a bar that was insured at the time by United Specialty Insurance Company. The bar subsequently hired Cleantech to clean up the site and submitted a claim to its insurer. United Specialty denied the claim, citing an exclusion in the bar's policy for damage caused by water that backs up or overflows from a sewer. The bar assigned AKC any claims it might have against United Specialty, and AKC then brought this breach of contract claim. The trial court granted summary judgment in favor of United Specialty. The court of appeals reversed. The Supreme Court reversed, holding that the water-backup exclusion in the policy included damage caused by the sewage. View "AKC, Inc. v. United Specialty Insurance Co." on Justia Law
Vulk v. State Farm General Ins. Co.
Three appeals arose from an insurance coverage dispute following a wildfire that burned in Siskiyou County, California. In September 2014, the Boles Fire damaged and destroyed numerous homes in the town of Weed, including the homes owned by plaintiffs Gary Andrighetto, James Dalin, and Matthew Vulk. Plaintiffs and others filed suit against their insurance company, defendant State Farm General Insurance Company, alleging various claims, including breach of contract and negligence. Central to the parties’ dispute was whether State Farm intentionally or negligently underinsured plaintiffs’ homes. Plaintiffs argued their homes were insufficiently insured due to State Farm’s alleged failure to calculate reasonable or adequate policy limits on their behalf for the full replacement cost of their homes. After the trial court granted State Farm’s motion for summary judgment against Andrighetto, Dalin and Vulk stipulated to entry of judgment in favor of State Farm. Each plaintiff timely appealed, and the Court of Appeal consolidated the appeals for argument and disposition. Thereafter, the Court requested that the parties discuss in their briefing whether the judgments in the Dalin and Vulk matters needed to be reversed pursuant to Magana Cathcart McCarthy v. CB Richard Ellis, Inc., 174 Cal.App.4th 106 (2009). After review, the Court affirmed the trial court in the Andrighetto matter; the Court reversed in the Dalin and Vulk matters, and remanded those for further proceedings. View "Vulk v. State Farm General Ins. Co." on Justia Law
Batten v. State Farm Mutual Automobile Ins. Co.
Consolidated cases presented a certified question from the United States District Court for the District of Oregon. The Oregon Supreme Court was asked to determine whether Oregon law precluded an insurer from limiting its liability for uninsured/underinsured motorist (UM/UIM) benefits on the basis that another policy also covered the insured’s losses. Each plaintiff suffered injuries caused by an uninsured or underinsured motorist, and each plaintiff incurred resulting damages that qualify as covered losses under multiple motor vehicle insurance policies issued by defendant State Farm Mutual Automobile Insurance Company (State Farm). Each plaintiff alleged a loss that exceeded the declared liability limits of any single applicable policy and sought to recover the excess under additional applicable policies, up to the combined total of the limits of liability. In each case, however, State Farm refused to cover the excess loss, citing a term in the policies that allowed State Farm to limit its liability to the amount that it agreed to pay under the single policy with the highest applicable limit of liability. The Oregon Supreme Court concluded that that term made State Farm’s uninsured motorist coverage less favorable to its insureds than the model coverage that the legislature has required and, thus, was unenforceable. View "Batten v. State Farm Mutual Automobile Ins. Co." on Justia Law
Drew v. Pacific Life Insurance Co.
The Supreme Court vacated the determination of the court of appeals that R. Scott National, Inc. (RSN) was an "agent" of Pacific Life Insurance Company (Pacific Life) based on Utah Code 31A-1-301(88)(b), and therefore granting partial summary judgment to Plaintiffs on their claim that Pacific Life should be held liable for RSN's alleged misdeeds, holding that remand was required.The district court granted summary judgment to Pacific Life, concluding that nothing RSN did was within the actual or apparent authority Pacific Life granted RSN. The court of appeals reversed and granted partial summary judgment for Plaintiffs, holding that RSN was Pacific Life's agent and that RSN's actions fell within the scope of authority Pacific Life had granted RSN. The Supreme Court vacated the judgment below, holding that the court of appeals (1) erred in ruling that section 31A-1-301(88)(b) made RSN an agent of Pacific Life and in injecting respondeat superior principles into Utah Code 31A-23a-405(2); and (2) Plaintiffs were entitled to the entry of partial summary judgment on the issue of RSN's apparent authority from Pacific Life. View "Drew v. Pacific Life Insurance Co." on Justia Law
Mathis v. Metropolitan Life Insurance Co
In 2006, Moore, an Indiana-based insurance broker, advised Mathis, an Alabama surgeon, to replace his Standard disability insurance policy with a MetLife disability-insurance policy with higher limits that had occupational disability coverage, like the Standard policy. The MetLife policy did not actually provide occupational disability coverage but provided total disability coverage only if Mathis was not gainfully employed and provided residual disability coverage only under various limitations. Mathis became disabled in 2017. Neck and arm problems prevented him from performing some of his duties. He underwent surgery but could no longer work at his usual level; his income decreased. He left his practice in March 2018 and began working for a device manufacturer in a nonsurgical capacity. MetLife paid Mathis residual disability benefits, April-August 2017, then determined he was not entitled to residual disability benefits. The policy lapsed.Mathis sued Moore and Source Brokerage for negligent procurement and brought a breach of contract claim against MetLife. The Seventh Circuit affirmed the dismissal of the claims, applying Alabama law, rather than Indiana law. Mathis’s contributory negligence in failing to read the new policy and the Alabama statute of limitations barred the negligence claims. The court rejected the contract claim because Mathis failed to comply with his contractual obligation to submit proof of loss for any period after September 2017. View "Mathis v. Metropolitan Life Insurance Co" on Justia Law
Rodenburg LLP v. Cincinnati Insurance Co.
Rodenburg purchased a Commercial Umbrella Liability Policy from Cincinnati. In the underlying action, a plaintiff filed suit against Rodenburg, asserting several theories including wrongful garnishment, tort-based claims, and violations of the Fair Debt Collection Practices Act (FDCPA). Rodenburg filed a claim under the policy for coverage of the underlying lawsuit, but Cincinnati denied coverage.The Eighth Circuit affirmed the district court's grant of summary judgment in favor of Cincinnati, concluding that the policy did not provide coverage for the underlying lawsuit and Cincinnati had no duty to defend Rodenburg under the policy. In this case, the underlying complaint alleged "personal and advertising injury" that was not "caused by an 'occurrence.'" The court explained that any potential liability arose either directly or indirectly from conduct that was alleged to violate the FDCPA, however, and was thus excluded from coverage by the Violation of Statutes Exclusion. Therefore, Cincinnati did not breach its contractual duty to defend Rodenburg. View "Rodenburg LLP v. Cincinnati Insurance Co." on Justia Law
Donovan, et al. v. State Farm Mutual Ins. Co.
The United States Third Circuit Court of Appeals certified a question of law to the Pennsylvania Supreme Court involving the state's Motor Vehicle Financial Responsibility Law (“MVFRL”). In July 2015, Corey Donovan (“Corey”) suffered significant injuries due to a collision between a motorcycle, which he owned and was operating, and an underinsured vehicle. He recovered the $25,000 limit of coverage available under the policy insuring the underinsured vehicle as well as the $50,000 per person limit of UIM coverage available under Corey’s policy insuring the motorcycle, issued by State Farm Automobile Insurance Company. Corey then sought coverage under a policy issued by State Farm to his mother, Linda Donovan (“Linda”), under which he was insured as a resident relative. Linda’s Auto Policy insured three automobiles but not Corey’s motorcycle. Linda’s policy had a UIM coverage limit of $100,000 per person, and Linda signed a waiver of stacked UIM coverage on her policy which complied with the waiver form mandated by Section 1738(d) of the MVFRL. First, the Pennsylvania Court considered whether an insured’s signature on the waiver form mandated by 75 Pa.C.S. 1738(d) resulted in the insured’s waiver of inter-policy stacking of UIM coverage where the relevant policy insured multiple vehicles. To this, the Supreme Court held the waiver invalid as applied to inter-policy stacking for multi-vehicle policies in light of its decision in Craley v. State Farm Fire and Casualty Co., 895 A.2d 530 (Pa. 2006). The Court then determined whether the policy’s household vehicle exclusion was enforceable following its decision in Gallagher v. GEICO Indemnity Company, 201 A.3d 131 (Pa. 2019). Finally, after concluding that the household vehicle exclusion was unenforceable absent a valid waiver of inter-policy stacking, the Court addressed the third question posed by the Court of Appeals regarding the applicability of the policy’s coordination of benefits provision for unstacked UIM coverage. After review, the Supreme Court held that the policy’s coordination of benefits provision for unstacked UIM coverage did not apply absent a valid waiver of inter-policy stacking. Having answered these questions of law, the matter was returned to the Third Circuit. View "Donovan, et al. v. State Farm Mutual Ins. Co." on Justia Law
Munden v. Stewart Title Guaranty Co.
The Mundens own ranching property in Bannock County, Idaho. They purchased 768 acres in 2012 and 660 acres in 2014 and purchased title insurance for the first purchase through Stewart and for the second purchase through Chicago Title. The property contains a gravel road. A 2019 ordinance amended a 2006 ordinance that closed specified snowmobile trails, including that gravel road, to motor vehicles except snowmobiles and snow-trail-grooming equipment during winter months. The 2019 ordinance deleted the December-to-April closure, giving the County Public Works Director the discretion to determine when to close specified snowmobile trails, and increased the maximum fine for violations. The Mundens sought an injunction. The county asserted that the road had been listed as a public road on county maps since 1963 and that the Mundens purchased their property expressly subject to easements and rights of way apparent or of record.The Mundens filed a federal complaint, seeking declaratory relief, indemnification, and damages. The district court granted the insurance companies summary judgment. The Ninth Circuit reversed as to Chicago Title, finding that the county road map is a “public record” within the meaning of its policy so that coverage applied. Stewart has no duty to indemnify or defend; its policy disclaims coverage for damages “aris[ing] by reason of . . . [r]ight, title and interest of the public in and to those portions of the above-described premises falling within the bounds of roads or highways.” View "Munden v. Stewart Title Guaranty Co." on Justia Law
United Services Automobile Association v. Pickens
After sustaining injuries in a vehicle driven by her son, Kevin Simms, Petitioner Belinda Pickens sought UM coverage through her policy with Respondent United Services Automobile Association (USAA). At the time of the accident, Pickens's policy covered five vehicles, including the 1997 Chevrolet involved in the accident. The policy included liability, personal injury protection (PIP), UM, and underinsured motorist (UIM) coverage. Pickens also executed a named driver exclusion. Pickens's declarations page also contained a provision that stated, "***COVERAGES EXCLUDED WHEN ANY VEHICLE OPERATED BY KEVIN SIMMS***." USAA denied Pickens's claim and initiated a declaratory judgment action asserting she was not entitled to UM coverage because Simms, the excluded driver, was operating the vehicle at the time of the accident. Pickens sued USAA and lost. The issue this case presented for the South Carolina Supreme Court's review centered on whether Section 38-77-340 of the South Carolina Code (2015) permitted a named driver exclusion that precluded uninsured motorist (UM) coverage to a passenger injured in an accident involving an unknown driver. The Court held that it did. "As the circuit court noted, no liability coverage would have been afforded to a third party had Simms been at fault, and thus, it would violate public policy to allow Pickens to recover UM when she was the person who executed the exclusion yet knowingly allowed Simms to drive her vehicle." View "United Services Automobile Association v. Pickens" on Justia Law