Articles Posted in Insurance Law

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Jessica Huckins filed a complaint against Barry Van Sickle and his real estate agent alleging several causes of action related to Van Sickle’s failure to disclose previous basement flooding problems in the sale of his home. At all relevant times, Van Sickle held three insurance policies through United Services Automobile Association (USAA). USAA denied coverage for the claims stated in the underlying complaint. Van Sickle settled the underlying litigation with Huckins by way of a consent judgment and Van Sickle’s assignment of all claims under his insurance policies to Huckins in exchange for a covenant not to execute. Huckins then brought this case against USAA, alleging, inter alia, breach of duty to defend Van Sickle. The district court concluded that USAA had not breached its duty to defend under any of the policies because the claim did not constitute an “occurrence” as defined by the policies. The Supreme Court reversed, holding (1) USAA had a duty to defend Van Sickle, at least until a ruling was obtained declaring there was no coverage; and (2) by failing to defend Van Sickle, USAA breached its duty to defend. View "Huckins v. United Services Automobile Ass’n" on Justia Law

Posted in: Insurance Law

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While employed by a company now known as Asurion Services, LLC, Christy Harris filed industrial injury claims for two different incidents. Lumbermens Mutual Casualty Company adjusted Harris’s workers’ compensation claims until it was declared insolvent. Montana Insurance Guaranty Association (MIGA) subsequently assumed the handling of Harris’s claims. Thereafter, MIGA notified Asurion that it would seek reimbursement for the benefits it paid to Harris pursuant to Mont. Code Ann. 33-10-114(2). Asurion filed a declaratory judgment action against MIGA. The district court granted motion for Asurion based on the exclusivity provision of the Montana Workers’ Compensation Act (Act), concluding that because Asurion met its obligation to obtain workers’ compensation insurance, it had no payment obligations to Harris, and therefore, Mont. Code Ann. 33-10-114(2) did not afford MIGA relief. The Supreme Court affirmed, holding that because Asurion provided workers’ compensation coverage in accordance with the Act, Asurion was not required to reimburse MIGA for benefits paid to Harris. View "Asurion Services, LLC v. Montana Insurance Guaranty Ass’n" on Justia Law

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After Robert Fitte burned tree branches on his property, a fire rose from the ashes of the burn and erupted into a wildfire known as the Corral Fire. At the time of the fire, Fitte carried two insurance policies issued by Mountain West Farm Bureau Mutual Insurance Company, including the commercial automobile policy at issue in this appeal. Fitte stipulated to entry of a judgment in favor of Associated Dermatology and Skin Cancer Clinic of Helena, P.C. Profit Sharing Plan and Trust for the benefit of Stephen D. Behlmer, M.D. (Behlmer). Fitte and Behlmer subsequently entered into an agreement wherein Fitte assigned his rights in the Mountain West policies to Behlmer. Behlmer then filed this action seeking a declaration that the automobile policy provided coverage for the Corral Fire damages. The district court ruled in favor of Behlmer and directed that the insurance proceeds be deposited into the district court. The Supreme Court reversed, holding that the district court erred in holding that there was coverage for the Corral Fire damage under Mountain West’s commercial automobile policy. View "Associated Dermatology & Skin Cancer Clinic of Helena, P.C. Profit Sharing Plan & Trust for the Benefit of Stephen D. Behlmer v. Mountain West Farm Bureau Mutual Insurance Co." on Justia Law

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Charlotte Suzor injured her knees in a workplace accident in 1982 and settled her workers’ compensation claims in 1987 with her self-insured employer, reserving the right to seek future medical benefits for ongoing complications from her injury. In 2009, Suzor broke her hip after her knees gave out. Suzor’s physical filed a claim with Sedgwick Claims Management Services (Sedgwick), the third-party administrator for the workers’ compensation plan now funded by her employer’s successor in interest, International Paper Company (International). After Sedgwick denied the claim, Suzor sued International, Sedgwick, and two of Sedgwick’s employees (collectively, Defendants), alleging bad faith and breach of fiduciary duty. The district court entered judgment in favor of Defendants. The Supreme Court affirmed, holding (1) Defendants did not owe Suzor a fiduciary duty; (2) the district court did not abuse its discretion in denying Suzor’s jury instruction on causation; (3) the mistaken association of a wrong juror questionnaire with a juror was not a structural error necessitating a new trial; (4) the jury’s award of no damages was supported by sufficient evidence; and (5) the district court did not abuse its discretion in its award of attorney’s fees. View "Suzor v. International Paper Co." on Justia Law

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Appellants attempted to execute judgments obtained against Robert Fitte in their respective underlying lawsuits by attaching the proceeds of a commercial liability policy issued to Fitte by joined party Mountain West Farm Bureau Mutual Insurance Company (Mountain West). In a separate declaratory proceeding, a federal court determined that the commercial policy covered Fitte’s actions. Thereafter, Mountain West filed a motion to deposit the proceeds of the commercial policy into an existing interpleader action. The underlying proceedings filed by Appellants were consolidated. The district court granted summary judgment to Fitte and Mountain West, concluding that Appellants were not entitled to execute judgments secured outside the pending interpleader action and attach the proceeds of the commercial policy. The Supreme Court affirmed, holding (1) the district court did not err in concluding that the proceeds from the commercial policy must be distributed through the interpleader; and (2) deposit of the commercial policy proceeds was not required at the time of the interpleader proceeding to establish the interpleader court’s jurisdiction. View "Associated Dermatology & Skin Cancer Clinic of Helena, P.C. Profit Sharing & Trust Benefit of Stephen D. Behlmer, M.D. v. Fitte" on Justia Law

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J & C Moodie Properties, LLC hired Haynie Construction, owned by Kyle Haynie, as general constructor to construct a building for Moodie’s farm equipment dealership. Scottsdale insured Haynie under a policy that was in effect when the building project was completed. Moodie later sued Haynie, asserting construction defect claims regarding the construction project. Scottsdale denied coverage. Haynie and Moodie subsequently filed a stipulated settlement, under which Haynie assigned its rights and interest in the Scottsdale policy to Moodie. The district court then entered judgment in the case against Haynie. Thereafter, Moodie filed a fourth amended complaint requesting a declaratory judgment against Scottsdale, claiming that Scottsdale had breached its duty to defend, Haynie had entered a stipulated judgment due to Scottsdale’s failure to defend, the stipulated judgment was reasonable, and Scottsdale was liable for the stipulated judgment. The district court ruled in favor of Moodie on all issues. The Supreme Court affirmed in part, reversed in part, and remanded, holding that the district court (1) correctly found that Scottsdale breached its duty to defend Haynie; (2) erred by ruling that there were no grounds for a reasonableness hearing regarding the stipulated judgment; and (3) erred by ruling that Scottsdale was not entitled to discovery regarding the reasonableness determination. View "J & C Moodie Properties, LLC v. Deck" on Justia Law

Posted in: Insurance Law

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Plaintiffs were both insured by USAA Casualty Insurance Company under auto insurance policies that provided medical payments coverage. Plaintiffs filed a complaint against USAA arguing that USAA’s practice of sending medical claims to Auto Injury Solutions (AIS) for review was an improper cost containment scheme designed to deprive Montana consumers of their first-party medical pay benefits. Plaintiffs subsequently filed a motion to certify a proposed class. The district court issued its order certifying the class, concluding “all members of the proposed class were subject to the same claims processing procedure of outsourcing claims to AIS. USAA appealed from the certification order. The Supreme Court reversed, holding that the district court abused its discretion by certifying the class under Mont. R. Civ. P. 23(a) and under Mont. R. Civ. P. 23(b)(3). Remanded. View "Byorth v. USAA Casualty Insurance Co." on Justia Law

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Peter Lee and three other passengers were injured in a single vehicle accident. The driver held an insurance policy issued by USAA Casualty Insurance Company and United States Automobile Association (collectively, USAA), and all of the passengers were covered by TRICARE. TRICARE paid medical benefits for the passengers and asserted medical payment liens for the passengers’ combined medical expenses. Lee made a settlement demand on USAA for Perez’s $100,000 policy limits. USAA offered to pay the policy limits provided that Lee first secure lien releases from TRICARE. TRICARE eventually waived its liens, and USAA issued a check for the policy limits of $100,000. Lee continued his suit against Perez after receiving the policy limits payment from USAA. Perez agreed to a consent judgment and assigned his claims against USAA to Lee. Elizabeth West, acting as guardian ad litem for Lee, filed suit asserting that USAA acted in bad faith by conditioning payment on resolving the TRICARE liens. The district court granted summary judgment for West, holding USAA liable to Lee for the consent judgment. The Supreme Court reversed, holding that USAA’s grounds for conditioning its payment of policy limits upon resolution of the TRICARE liens were reasonable under existing law, and therefore, USAA was entitled to judgment as a matter of law. View "West v. United Services Automobile Ass’n" on Justia Law

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In Tidyman’s I, the Supreme Court affirmed the district court’s finding that National Union Fire Insurance breached its duty to defend its insured, David and Maxwell. The Court, however, reversed the district court’s entry of summary judgment to the extent it approved a stipulated judgment of $29 million. The Court remanded for the district court to hold a hearing to assess the reasonableness of the settlement amount. On remand, after a reasonableness hearing, the district court again approved the stipulated settlement. The Supreme Court remanded the case to the district court for a second reasonableness hearing, holding (1) the district court erred in using a “reliable evidence” test to assess the reasonableness of the stipulated judgment; and (2) the district court erred in holding that Plaintiffs were entitled to prejudgment interest. View "Tidyman’s Mgmt. Servs., Inc. v. Nat’l Union Fire Ins. Co." on Justia Law

Posted in: Insurance Law

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In 2014, a large boulder dislodged from a hillside and fell into J. Russell Parker’s unoccupied vacation cabin, causing substantial damage. Parker submitted a claim to his insurer, Safeco Insurance Company. Safeco denied the claim, determining that rockfall is considered “earth movement from landslide,” which was specifically excluded under Parker’s policy. Parker sued Safeco, claiming breach of contract and seeking damages under the Unfair Trade Practices Act. The district court granted summary judgment in favor of Safeco. The Supreme Court affirmed, holding that Safeco property denied Parker’s claim based upon an express coverage exclusion in the policy. View "Parker v. Safeco Ins. Co. of America" on Justia Law

Posted in: Insurance Law