Justia Contracts Opinion Summaries

This appeal required the Pennsylvania Supreme Court to determine whether a “household vehicle exclusion” contained in a motor vehicle insurance policy violated Section 1738 of the Motor Vehicle Financial Responsibility Law (“MVFRL”), 75 Pa.C.S. 1738, because the exclusion impermissibly acted as a de facto waiver of stacked uninsured and underinsured motorist (“UM” and “UIM,” respectively) coverages. In 2012, Appellant Brian Gallagher was riding his motorcycle when William Stouffer ran a stop sign in his pickup truck, colliding with Gallagher’s motorcycle, causing Gallagher to suffer severe injuries. At the time of the accident, Gallagher had two insurance policies with GEICO; one included $50,000 of UIM coverage, insured only Gallagher’s motorcycle; the second insured Gallagher’s two automobiles and provided for $100,000 of UIM coverage for each vehicle. Gallagher opted and paid for stacked UM and UIM coverage when purchasing both policies. Stouffer’s insurance coverage was insufficient to compensate Gallagher in full. Consequently, Gallagher filed claims with GEICO seeking stacked UIM benefits under both of his GEICO policies. GEICO paid Gallagher the $50,000 policy limits of UIM coverage available under the Motorcycle Policy, it denied his claim for stacked UIM benefits under the Automobile Policy. GEICO based its decision on a household vehicle exclusion found in an amendment to the Automobile Policy. The exclusion states as follows: “This coverage does not apply to bodily injury while occupying or from being struck by a vehicle owned or leased by you or a relative that is not insured for Underinsured Motorists Coverage under this policy.” According to Gallagher, by denying him stacked UIM coverage based upon the household vehicle exclusion, GEICO was depriving him of the stacked UIM coverage for which he paid. The Pennsylvania Supreme Court held the household vehicle exclusion violated the MVFRL, and vacated the Superior Court’s judgment, reversed the trial court’s order granting summary judgment in favor of GEICO, and remanded to the trial court for further proceedings. View "Gallagher v. GEICO" on Justia Law

Defendant Metropolitan Property and Casualty Insurance Company (Metropolitan), appealed a superior court order partially granting and partially denying its summary judgment motion as well as a cross-motion filed by plaintiff Joseph Santos. Santos held a personal excess liability policy with Metropolitan that included excess underinsured motorist (UIM) coverage. After Metropolitan denied a claim made by Santos for excess UIM benefits after Santos was hurt in a motorcycle accident, he brought this declaratory judgment action. The trial court ruled that Metropolitan was liable to Santos for excess UIM benefits. Metropolitan argued the trial court erred in so holding because Santos’s policy required, as a precondition to receiving excess UIM benefits, that he carry a certain amount of underlying insurance coverage, and Santos did not do so. Santos argued his lack of sufficient underlying coverage allowed Metropolitan to reduce its excess UIM liability but not escape it altogether. Finding no error in the superior court's judgment, the New Hampshire Supreme Court affirmed partial summary judgment. View "Santos v. Metropolitan Property & Casualty Ins. Co." on Justia Law

Dennis Woolman, former president of The Clemens Coal Company, challenged a district court’s determination that Liberty Mutual Fire Insurance Company didn’t breach a duty to him by failing to procure for Clemens Coal an insurance policy with a black-lung disease endorsement. Clemens Coal operated a surface coal mine until it filed for bankruptcy in 1997. Woolman served as Clemens Coal’s last president before it went bankrupt. Federal law required Clemens Coal to maintain worker’s compensation insurance with a special endorsement covering miners’ black-lung disease benefits. Woolman didn’t personally procure insurance for Clemens Coal but instead delegated that responsibility to an outside consultant. The policy the consultant ultimately purchased for the company did not contain a black-lung-claim endorsement, and it expressly excluded coverage for federal occupational disease claims, such as those arising under the Black Lung Benefits Act (the Act). In 2012, a former Clemens Coal employee, Clayton Spencer, filed a claim with the United States Department of Labor (DOL) against Clemens Coal for benefits under the Act. After some investigation, the DOL advised Woolman that Clemens Coal was uninsured for black-lung-benefits claims as of July 25, 1997 (the last date of Spencer’s employment) and that, without such coverage, Woolman, as Clemens Coal’s president, could be held personally liable. Woolman promptly tendered the claim to Liberty Mutual for a legal defense. Liberty Mutual responded with a reservation-of-rights letter, stating that it hadn’t yet determined coverage for Spencer’s claim but that it would provide a defense during its investigation. Then in a follow-up letter, Liberty Mutual clarified that it would defend Clemens Coal as a company (not Woolman personally) and advised Woolman to retain his own counsel. Liberty Mutual eventually concluded that the insurance policy didn’t cover the black-lung claim, and sued Clemens Coal and Woolman for a declaration to that effect. In his suit, Woolman also challenged the district court’s rejection of his argument that Liberty Mutual should have been estopped from denying black-lung-disease coverage, insisting that he relied on Liberty Mutual to provide such coverage. Having considered the totality of the circumstances, the Tenth Circuit Court of Appeals concluded the district court didn’t err in declining Woolman’s extraordinary request to expand the coverages in the Liberty Mutual policy. “Liberty Mutual never represented it would procure the coverage that Woolman now seeks, and the policy itself clearly excludes such coverage. No other compelling consideration justifies rewriting the agreement— twenty years later—to Woolman’s liking.” View "Liberty Mutual Fire Insurance v. Woolman" on Justia Law

The First Circuit affirmed the order of the district court dismissing Plaintiff’s contract and tort claims for lack of personal jurisdiction, holding that the federal court in Puerto Rico lacked personal jurisdiction over Defendants.Plaintiff, a Puerto Rico tour company, brought this diversity suit in the United States District of Puerto Rico, alleging that a California youth soccer organization and related defendants breached duties that the organization owed to Plaintiff under Puerto Rico contract and tort law. The allegations centered around Defendants’ acts of first requesting that Plaintiff make an offer for a potential soccer trip to Puerto Rico for some of the organization’s teams and their families and then declining after further communications to book the tour. The district court dismissed the claims for lack of personal jurisdiction. The First Circuit affirmed, holding that the exercise of specific jurisdiction in the forum over the out-of-forum defendants did not conform to the federal constitutional test. View "PREP Tours, Inc. v. American Youth Soccer Organization" on Justia Law

In 2002, in Texas, Dr. Phillips performed a laparoscopic hysterectomy on Bramlett, a 36-year-old mother. While hospitalized, Bramlett suffered internal bleeding and died. Her family filed a wrongful death lawsuit against the hospital and Dr. Phillips, who held a $200,000 professional liability insurance policy with MedPro. He notified MedPro of the lawsuit. In 2003, the hospital settled with the Bramletts for approximately $2.3 million. The Bramletts wrote to Dr. Phillips’s attorney, Davidson, with a $200,000 Stowers demand; under Texas law, if an insurer rejects a plaintiff's demand that is within the insured’s policy limit and that a reasonably prudent insurer would accept, the insurer will later be liable for any amount awarded over the policy limit. MedPro twice refused to settle. The family won a $14 million verdict. The Supreme Court of Texas capped Dr. Phillips’s liability. The family sued MedPro, which settled. MedPro was insured by AISLIC, which declined to cover MedPro’s settlement. The district court granted AISLIC summary judgment, concluding that coverage was excluded because MedPro should have foreseen the family’s claim. An exclusion precluded coverage for “any claim arising out of any Wrongful Act” which occurred prior to June 30, 2005, if before that date MedPro “knew or could have reasonably foreseen that such Wrongful Act could lead to a claim.” The Seventh Circuit reversed in part, finding genuine issues of material fact regarding whether MedPro’s failure to settle was a Wrongful Act and whether MedPro could have foreseen a "claim" before the malpractice trial. View "Medical Protective Co. of Fort Wayne, Indiana v. American International Specialty Lines Insurance Co." on Justia Law

The Supreme Court affirmed the judgment of the district court granting Defendants’ motion to compel arbitration and dismiss the case, holding that the district court did not erroneously compel arbitration.Plaintiff entered into a construction contract that contained an arbitration agreement. Plaintiff later filed a complaint against Defendants, asserting claims for breach of contract, negligence, and other torts. Defendants filed a motion to compel arbitration and dismiss. The Supreme Court granted the motion to compel arbitration and dismissed the action. The Supreme Court affirmed, holding that the district court did not err (1) in concluding that the arbitration agreement required arbitration of matters within its scope rather than merely authorizing it as a matter of discretion upon timely demand; (2) in failing to conclude that Defendants equitably waived the right to arbitrate; (3) in compelling arbitration without consideration of Plaintiff’s proposed declaratory judgment claim challenging the validity of the arbitration agreement; (4) in concluding that Plaintiff’s asserted non-contract claims were subject to arbitration; and (5) in failing to conclude that, as a non-party to the agreement, one defendant lacked standing to enforce the arbitration agreement. View "Peeler v. Rocky Mountain Log Homes Canada, Inc." on Justia Law

In this contract interpretation case, the Supreme Court reversed the portion of the court of appeals decision ruling that a critical paragraph in a commercial real estate lease was ambiguous and that, as a result, interpretation of the contract was a matter for a jury to resolve, holding that the pertinent provisions of the lease served as a complete bar to Plaintiff lessees’ negligence-based claims against Defendants, one of which was the lessor.At issue was the operation of the lease provisions regarding insurance and liability when the lessees sought damages allegedly caused by the lessor’s negligence. The trial court granted summary judgment in favor of Defendants, concluding that the pertinent lease provision was not ambiguous and was a complete defense to the claims raised in the complaint. The court of appeals reversed, concluding that the provision was ambiguous in that it did not clearly reflect the intent of the parties to bar negligence claims against each other. The Supreme Court reversed, holding (1) the language of the lease arrangements reflected the clear intent of the parties to discharge each other from all claims and liabilities for damages resulting from hazards covered by insurance; and (2) the damages claims by the lessees resulted from a hazard that was subject to their insurance coverage. View "Morrell v. Hardin Creek, Inc." on Justia Law

The Supreme Court reversed the circuit court’s judgment against Defendants as to Plaintiff’s claims for tortious interference and statutory business conspiracy, holding that the circuit court erred in ruling that Defendants were liable for tortiously interfering with their own contract and in therefore finding that their tortious interference could serve as the predicate unlawful act for statutory business conspiracy.Plaintiff, Read Properties, LLC, filed a complaint against Defendants, Francis Hospitality, Inc. and Delta Educational Systems, Inc., alleging breach of contract, intentional interference with contract, and statutory business conspiracy. The circuit court found in favor of Plaintiff on all claims. The Supreme Court affirmed as to the breach of contract claim and otherwise reversed, holding (1) Defendants could not tortiously interfere with their own contract; and (2) because Plaintiff’s underlying claims of tortious interference with a contract against Defendants failed, its claims of statutory business conspiracy must also fail. View "Francis Hospitality, Inc. v. Read Properties, LLC" on Justia Law

Plaintiff-petitioner Charissa Schultz was injured in a 2015 car accident in which the other driver failed to stop at a stop sign. The other driver’s insurance company settled for its $25,000 policy limit, and Schultz made a demand on her own uninsured/underinsured motorist benefits under her GEICO policy, which also had a $25,000 limit. In April 2017, after months of correspondence and apparent review of an MRI performed on Schultz in April 2015, GEICO offered Schultz its full policy limit, and it did so without requesting that she undergo an independent medical examination (“IME”). Indeed, GEICO’s claim logs reveal that at the time GEICO decided to offer Schultz its policy limits, it “concede[d] peer review wouldn’t be necessary,” indicating an affirmative decision not to request an IME. A few months later, Schultz filed the present lawsuit asserting claims for bad faith breach of an insurance contract and unreasonable delay in the payment of covered benefits. GEICO denied liability, disputing the extent and cause of Schultz’s claimed injuries and asserting that causation surrounding the knee replacement surgeries was “fairly debatable” because Schultz had preexisting arthritis, which GEICO claimed may independently have necessitated her surgeries. To establish its defense, GEICO ordered the IME and the district court granted that request. The Colorado Supreme Court concluded GEICO’s conduct had to be evaluated based on the evidence before it when it made its coverage decision and that, therefore, GEICO was not entitled to create new evidence in order to try to support its earlier coverage decision. The Court also concluded the district court abused its discretion when it ordered Schultz to undergo an IME over three years after the original accident that precipitated this case and a year and a half after GEICO had made the coverage decision at issue. View "Schultz v. GEICO Casualty Company" on Justia Law

At issue in this case was when Appellees’ claims for negligence, constructive fraud, and fraudulent concealment accrued and whether they were time-barred.Appellees were the Estate of Steven Schmitz and Yvette Smith, individually and as fiduciary of the Estate. Steven died before age sixty after being diagnosed with chronic traumatic encephalopathy, a degenerative brain disease, and dementia. Appellees alleged that Steven’s diagnoses were caused, aggravated, and/or magnified by repetitive head impacts Steven sustained while playing football for the University of Notre Dame du Lac. The trial court dismissed the claims pursuant to Ohio R. Civ. P. 12(B)(6). The Supreme Court affirmed the Eighth District’s judgment reversing the dismissal of Appellees’ claims for negligence, constructive fraud, and fraudulent concealment, holding (1) Rule 12(B)(6) did not warrant the dismissal of Appellees’ claims because the amended complaint did not show conclusively that the claims were time-barred; and (2) Appellees’ fraud-related claims were subject to the same two-year statute of limitations contained in Ohio Rev. Coe 2305.10(A) as Appellees’ negligence claim. View "Schmitz v. National Collegiate Athletic Ass’n" on Justia Law