Justia Montana Supreme Court Opinion Summaries

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

This case arose out of claims asserted by multiple people against Blue Cross and Blue Shield of Montana, now known as Caring for Montanans, Inc. (CFM) and Montana Comprehensive Health Association (MCHA). The claimants asserted that while they were insured by CFM or MCHA, they submitted claims that the insurers denied based upon exclusions contained in their health insurance policies. These exclusions generally provided that the insurer would not pay for health care costs of the injured insureds if the insureds received, or were entitled to receive, benefits from any automobile liability policy. These exclusions were subsequently disapproved by the Montana Commissioner of Insurance, and the insureds sought the previously-denied benefits. The district court certified a class of claimants for settlement purposes only. The court then held a fairness hearing on a proposed settlement agreement and approved the settlement. Several class members objected to the settlement and appealed to the Montana Supreme Court, arguing they should have been allowed to conduct further discovery to ascertain the fairness of the settlement agreement. The Supreme Court agreed with the objectors and remanded the case to the district court for further discovery and a second fairness hearing. The district court allowed further discovery, held a second fairness hearing, and determined that the same settlement agreement was fair, reasonable, and adequate. The Objectors again appealed. Finding no reversible error, the Supreme Court affirmed. View "Pallister v. BCBS" on Justia Law

In the underlying litigation, the Estate of Ronny Groff filed suit against Jake Weitzel alleging that Weitzel wrongful absconded with Ronny’s property and assets, causing economic loss to the Estate. Weitzel tendered this litigation to Fire Insurance Exchange (FIE) under a homeowner’s insurance policy covering claims for personal and bodily injury and property damage. FIE accepted responsibility for the litigation under a reservation of rights. FIE then filed suit in district court seeking declaratory relief, claiming that it owed no duty to defend Weitzel against the Estate under the terms of the policy. The district court granted summary judgment in favor of Weitzel. The Supreme Court reversed, holding that the district court erred by concluding that FIE had a duty to defend Weitzel under the terms of the insurance policy. View "Fire Ins. Exchange v. Weitzel" on Justia Law

Mark Ibsen, Inc., the owner and operator of the Urgent Care Plus medical clinic in Helena, purchased health insurance coverage for its employees from Blue Cross and Blue Shield of Montana (BCBSMT) through a Chamber of Commerce program. Health Care Corporation (Health Care) subsequently acquired BCBSMT’s health insurance business and changed its name to Caring for Montanans, Inc. (Caring). Less than one year later, Ibsen filed a complaint and class action against Caring and Health Care claiming that they had violated the Unfair Trade Practices Act (UTPA). Health Care filed a motion to dismiss and Caring filed a motion for summary judgment. The district court granted the motions, concluding that the legislature did not provide private citizens with the right to bring a cause of action to enforce the UTPA. The Supreme Court affirmed, holding (1) Ibsen may not maintain a private right of action for violation of Mont. Code Ann. 33-18-208 and -212 of the UTPA; and (2) in the alternative, Ibsen’s claims cannot be sustained as common law claims. View "Mark Ibsen, Inc. v. Caring for Montanans, Inc." on Justia Law

Roger and Carrie Peters and Daggin’ Y Cattle Company (collectively, Peters) filed a complaint against Junkermier, Clark, Campanella, Stevens, P.C. and Larry Addink (collectively, Junkermeir) alleging multiple counts stemming from tax services Junkermier performed for Peters. New York Marine, which insured Junkermier under a professional liability policy, defended Junkermeir subject to a reservation of rights. Peters and Junkermeir eventually entered into a settlement agreement and stipulation for entry of judgment without New York Marine’s participation, and the district court scheduled a hearing on the stipulated settlement’s reasonableness. The district court allowed New York Marine to intervene. After a hearing, the district court found that the stipulated settlement amount was reasonable, entered judgment in Peters’s favor, and ordered that Junkermier was not liable for the stipulated settlement. New York Marine appealed, asserting for the first time that the district court judge erred by not disclosing an apparent conflict of interest. The Supreme Court dismissed the appeal without prejudice pending referral to a district judge for hearing on New York Martine’s request for disqualification for cause, holding (1) New York Marine did not waive its disqualification claim; and (2) the presiding judge should have disclosed circumstances that could potentially cause the judge’s impartiality reasonably to be questioned. View "Draggin’ Y Cattle Co. v. Addink" on Justia Law

Jerry and Karen Slack hired Jeffrey Fisher and his construction company, Fisher Builders, to build a remodeled home. During the project, the deck collapsed, and the Slacks’ construction permit was revoked. The Slacks filed a negligence action against Fisher and his company. Fisher had a commercial general liability insurance policy with Employers Mutual Casualty Company (EMC). EMC filed a declaratory action alleging that there was no coverage and that it had no duty to defend or indemnify any party in the negligence action. Fisher and Fisher Builders ultimately settled with the Slacks and assigned their rights under the EMC insurance policy to the Slacks. The district court granted summary judgment in favor of EMC, ruling that Fisher’s conduct was clearly intentional and did not fit within the meaning of “occurrence” under the policy, regardless of whether Fisher intended the consequences. The Supreme Court reversed, holding that the district court (1) erred by concluding that, in the context of general liability insurance, the term “occurrence,” defined by the policy as “an accident,” categorically precludes coverage for any intentional conduct on the part of the insured with unintended results; and (2) erred when it granted summary judgment in favor of EMC, as issues of material fact precluded summary judgment. Remanded. View "Employers Mut. Cas. Co. v. Slack" on Justia Law

Plaintiff was seriously injured while working for Employer. Plaintiff’s injury was caused by the use of her personal vehicle. Plaintiff was able to recover benefits under her auto insurance policy but also sought benefits under Employer’s commercial auto policy. Employer’s insurer (Insurer) denied coverage. Plaintiff brought a claim for coverage, arguing that she was a named insured under Employer’s policy and that she was occupying a temporary substitute for an insured vehicle at the time of her injury. The district court granted summary judgment in favor of Insurer. The Supreme Court (1) affirmed the grant of summary judgment on the issue of whether Plaintiff was a named insured under Employer’s commercial auto policy; but (2) reversed the district court’s order granting Insurer’s motion for summary judgment on the issue of whether Plaintiff’s pickup was a temporary substitute for a covered auto and directed the district court to enter judgment in favor of Plaintiff on her coverage claim, as the evidence was sufficient to establish that Plaintiff’s pickup was a temporary substitute for an insured vehicle, entitling her to judgment on her coverage claim.. View "Stonehocker v. Gulf Ins. Co." on Justia Law

Keller Transport, Inc. leased a tanker truck from Wagner Enterprises, LLC to transport gasoline. The truck’s trailer overturned and spilled 6,380 gallons of gasoline, which flooded several homeowners’ properties. Keller and Wagner were both insured under a commercial transportation policy. Westchester Surplus Lines Insurance Company insured both Keller and Wagner under an excess liability policy. Homeowners initiated suit against Keller and Wagner. Westchester undertook defense of the suit on behalf of Kohler and Wagner pursuant to a reservation of rights and defended Keller and Wagner until the limit of its excess coverage had allegedly been exhausted. Westchester sought a declaration that the limit under its excess policy was $4 million in total and that the limit had been exhausted. As relevant to this appeal, the district court granted summary judgment against Westchester. The Supreme Court affirmed in part and reversed in part, holding that the district court (1) did not err by determining that Westchester’s policy was ambiguous and that it provided an additional $4 million in coverage under the “general aggregate” limit; but (2) erred by holding that Westchester breached its duty to defend the insureds under its policy. View "Westchester Surplus Lines Ins. Co. v. Keller Transport, Inc." on Justia Law

When Kent Roose was injured in an automobile crash his wife was an employee of Lincoln County, which provided health benefits via a group health plan (the Plan) that was part of Joint Powers Trust (JPT). Employee Benefit Management Services, Inc. (EBMS administered the Plan. The Plan contained an exclusion stating that medical benefits would not be paid when any automobile or third-party liability insurance was available to pay medical costs. EBMS denied Roose’s request for reimbursement for medical expenses he paid out of the liability insurance payment he received from the tortfeasors’ insurer. Roose subsequently brought suit against EBMS and JPT. The Supreme Court held that the exclusion violated Mont. Code Ann. 2- 18-902(4). Appellants subsequently reimbursed Roose the requested amount. In 2014, Roose filed a motion for partial summary judgment and class certification, arguing that Appellants violated section 2-18-902 through systematic practices that amounted to seeking subrogation against the tortfeasor’s liability carrier before Roose was made whole. Roose also sought class certification on behalf of every member of Appellants’ plans subject to Montana law that contained the coverage exclusion. The district court granted Roose’s motion. The Supreme Court affirmed, holding that the district court did not abuse its discretion in certifying the class or in defining the class. View "Roose v. Lincoln County Employee Group Health Plan" on Justia Law

Plaintiff was involved in a vehicle collision with another driver, who admitted fault. At the time of the accident, Plaintiff’s vehicle was insured with Farmers Insurance Exchange under a policy that included underinsured motorist (UIM) coverage. After Plaintiff received medical treatment, Plaintiff filed a complaint requesting “all sums due and owing” under her insurance policy with Farmers. During the course of the litigation, Farmers extended settlement offers to Plaintiff, but the case did not settle. The jury returned a verdict in favor of Plaintiff. Thereafter, Plaintiff moved for attorney fees and nontaxable costs under the insurance exception to the American Rule. The district court denied Plaintiff’s motion, concluding that the insurance exception did not apply to Plaintiff’s attorney fees and related costs. The Supreme Court reversed, holding that the district court incorrectly interpreted Montana law when it relied on only the circumstances surrounding the filing of Plaintiff’s complaint to conclude that Plaintiff did not meet the insurance exception. Remanded for further proceedings to determine whether Farmers forced Plaintiff to assume the burden of legal action to obtain the full benefit of her UIM policy, thus entitling her to attorney fees under the insurance exception. View "Mlekush v. Farmers Inc." on Justia Law