Articles Posted in Insurance Law

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This appeal stemmed from a dispute between Summit Park Townhome Association and its insurer, Auto-Owners Insurance Company, over the value of property damaged in a hail storm. To determine the value, the district court ordered an appraisal and established procedural requirements governing the selection of impartial appraisers. After the appraisal was completed, Auto-Owners paid the appraised amount to Summit Park. But the court found that Summit Park had failed to make required disclosures and had selected a biased appraiser. In light of this finding, the court vacated the appraisal award, dismissed Summit Park’s counterclaims with prejudice, and awarded interest to Auto-Owners on the amount earlier paid to Summit Park. Summit Park appealed, raising six issues of alleged error with the proceedings. The Tenth Circuit affirmed, however, finding that in the absence of a successful appellate challenge to the disclosure order, Summit Park was obligated to comply and did not. The court was thus justified in dismissing Summit Park’s counterclaims. In addition, Summit Park’s failure to select an impartial appraiser compelled vacatur of the appraisal award under the insurance policy. View "Auto-Owners v. Summit Park" on Justia Law

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This appeal grew out of a dispute between an insured (Summit Park Townhome Association) and its insurer (Auto-Owners Insurance Company) over the value of property damaged in a hail storm. To determine the value, the district court ordered an appraisal and established procedural requirements governing the selection of impartial appraisers. After the appraisal was completed, Auto-Owners paid the appraised amount to Summit Park. But the court found that Summit Park had failed to make required disclosures and had selected a biased appraiser. In light of this finding, the court vacated the appraisal award, dismissed Summit Park’s counterclaims with prejudice, and awarded interest to Auto-Owners on the amount earlier paid to Summit Park. Summit Park appealed, but the Tenth Circuit affirmed. “In the absence of a successful appellate challenge to the disclosure order, Summit Park was obligated to comply and did not. The court was thus justified in dismissing Summit Park’s counterclaims. In addition, Summit Park’s failure to select an impartial appraiser compelled vacatur of the appraisal award under the insurance policy. Finally, Summit Park obtained due process through the opportunity to object to the award of interest.” View "Auto-Owners v. Summit Park" on Justia Law

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In this appeal, the issue before the Tenth Circuit Court of Appeals was whether the district court correctly held that ACE American Insurance Company (ACE) had no duty to defend and indemnify DISH Network (DISH) in a lawsuit alleging that DISH’s use of telemarketing phone calls violated various federal and state laws. The primary question centered on whether statutory damages and injunctive relief under the Telephone Consumer Protection Act were “damages” under the insurance policies at issue and insurable under Colorado law, or were uninsurable “penalties.” The Court concluded they were penalties under controlling Colorado law, and affirmed the district court’s grant of summary judgment in favor of ACE. View "ACE American Insurance Company v. Dish Network" on Justia Law

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At issue in this case was whether Aspen Insurance (UK) Ltd. And Lloyd’s Syndicate 2003 (collectively, “Aspen”) had to reimburse Black & Veatch Corporation (“B&V”) for costs B&V incurred due to damaged equipment a subcontractor made for power plants in Ohio and Indiana. The district court held Aspen did not have to pay B&V’s claim under its commercial general liability (“CGL”) insurance policy because B&V’s expenses arose from property damages that were not covered “occurrences” under the Policy. Because the only damages involved here were to B&V’s own work product arising from its subcontractor’s faulty workmanship, the court concluded that the Policy did not provide coverage and granted Aspen’s motion for partial summary judgment. B&V appealed. The Tenth Circuit found that the Policy contained a choice-of-law clause, making the Policy subject to New York law. The Court also found a trend among state supreme courts that supported the contention that construction defects could constitute “occurrences” under CGL policies, and that contractors have coverage for the unexpected damage caused by defective workmanship done by subcontractors. The Tenth Circuit predicted the New York Court of Appeals would decide that the damages here constituted an “occurrence” under the Policy, and as such, vacated the district court’s summary judgment decision and remand for further proceedings. View "Black & Veatch Corp. v. Aspen Insurance" on Justia Law

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Life Insurance Company of North America’s terminated plaintiff-appellant Carl Van Steen’s long-term disability benefits under Lockheed Martin’s ERISA Plan. Life Insurance Company of North America (LINA) appealed the district court’s finding that its decision to terminate Van Steen’s benefits was arbitrary and capricious. Van Steen, in turn, appealed the district court’s denial of his attorney’s fees request. Van Steen was physically assaulted during an altercation while walking his dog. The assault resulted in a mild traumatic brain injury (mTBI) that impacted Van Steen’s cognitive abilities that prevented him from returning to full time work; Van Steen was eventually allowed to return to part-time work on a daily basis roughly six weeks later. Even on a part-time schedule, Van Steen experienced cognitive fatigue and headaches that required him to frequently rest. Due to his inability to stay organized and keep track of deadlines after the assault, Van Steen received poor feedback on his job performance. Van Steen’s claim for partial long-term disability benefits was approved on March 30, 2012. Roughly a year later, LINA reviewed Van Steen’s file, contacted his doctors, and confirmed that Van Steen’s condition and restrictions were permanent as he was “not likely to improve.” Despite this prognosis, LINA sent Van Steen a letter one week later terminating his long-term disability benefits, explaining that “the medical documentation on file does not continue to support the current restrictions and limitations to preclude you from resuming a full-time work schedule.” Having exhausted his administrative appeals under the Plan, Van Steen next sought relief before the district court. The district court reversed LINA’s decision to terminate Van Steen’s partial long-term disability benefits on the grounds that it was arbitrary and capricious, but denied Van Steen’s request for attorney’s fees. The Tenth Circuit agreed with the district court’s reversal of LINA’s decision to terminate Van Steen’s coverage. The Court also found that Van Steen was not eligible for attorney fees: “Van Steen’s arguments fail to convince us that the district court’s decision was based on a clear error of judgment or exceeded the bounds of permissible choice.” View "Van Steen v. Life Insurance Company N.A." on Justia Law

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The Tenth Circuit addressed whether the federal district court in Colorado may exercise specific personal jurisdiction over out-of-state defendant Continental Motors, Inc. based upon its contacts with Colorado through its website. Continental Motors’ website allows airplane repair businesses known as fixed- base operators (“FBOs”) to obtain unlimited access to its online service manuals in exchange for an annual fee. Arapahoe Aero, a Colorado-based FBO participating in the program, accessed and consulted the manuals in servicing an airplane that contained engine components manufactured by Continental Motors. The airplane later crashed in Idaho on a flight from Colorado. After the crash, Old Republic Insurance Company, the airplane’s insurer, paid the owner for the property loss and filed a subrogation action against Continental Motors in Colorado federal district court, seeking reimbursement. Old Republic alleged that Continental Motors’ online service manuals and bulletins contained defective information, thereby causing the crash. Continental Motors moved to dismiss the lawsuit for lack of personal jurisdiction, arguing that it did not purposely direct its activities at Colorado. Old Republic conceded that Continental Motors did not maintain sufficient contacts with Colorado to support jurisdiction for all purposes. The district court granted the motion to dismiss, ruling that it did not have specific jurisdiction over Continental Motors. On appeal, Old Republic maintains that Continental Motors was subject to specific personal jurisdiction in Colorado for purposes of this case. Finding no reversible error in dismissal, the Tenth Circuit affirmed. View "Old Republic Insurance Co. v. Continental Motors" on Justia Law

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Plaintiff Greggory Owings sustained an on-the-job injury, for which he received long-term disability benefits by defendant United of Omaha Life Insurance Company (United), under the terms of a group insurance policy issued by United to Owings’ employer. Owings disagreed with, and attempted without success to administratively challenge, the amount of his disability benefits. He then filed suit against United in Kansas state court, but United removed the action to federal district court, asserting that the federal courts had original jurisdiction over the action because the policy was governed by the Employee Retirement Income Security Act of 1974 (ERISA). The district court ultimately granted summary judgment in favor of United. Owings appealed. The Tenth Circuit concluded after review of this matter that United was arbitrary and capricious in determining the date that Owings became disabled and, in turn, in calculating the amount of his disability benefits. Consequently, the Court reversed the district court’s grant of summary judgment in favor of United and remanded with directions to enter summary judgment in favor of Owings. View "Owings v. United of Omaha Life" on Justia Law

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In 2007, undercover producers from NBC Universal, Inc., attended and surreptitiously recorded a seminar presented by plaintiff-appellant Brokers’ Choice of America, Inc. to teach insurance agents how to sell annuities to seniors. NBC used excerpts and information from the seminar in a “Dateline NBC” episode. Brokers’ Choice and its founder Tyrone Clark (collectively, “BCA”) sued for defamation. This appeal concerned the district court’s dismissal of the amended complaint after it compared the seminar recording with the episode and concluded the Dateline program was substantially true. After review, the Tenth Circuit Court of Appeals affirmed because the Dateline episode was not materially false. View "Brokers' Choice of America v. NBC Universal" on Justia Law

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Philadelphia Indemnity Insurance Company (“Philadelphia”) and Lexington Insurance Company (“Lexington”) insured the same school building that suffered fire damage. In a declaratory judgment action, they disputed their relative responsibilities to pay for the loss. The district court ordered Philadelphia to pay 54 percent and Lexington to pay 46 percent of the approximately $6 million loss. Lexington appealed, arguing it should have no obligation to pay. Philadelphia cross-appealed, arguing Lexington should have paid more. Finding no reversible error, the Tenth Circuit affirmed the district court's allocation between the insurers. View "Philadelphia Indemnity v. Lexington Insurance" on Justia Law

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This appeal arose out of a property damage claim filed by the Hayes Family Trust with its insurer, State Farm Fire & Casualty. When the parties could not agree on the amount of loss, Hayes invoked an appraisal process provided by the policy to calculate the loss incurred. After Hayes sought the district court's assistance with the appointment of an umpire, the parties participated in the appraisal process, which resulted in a unanimous award. State Farm paid the balance of that award, and Hayes accepted payment. But despite State Farm's payment, at Hayes's request, the district court confirmed the award and entered judgment in favor of Hayes. Hayes promptly moved for an award of prejudgment interest, attorney's fees, and costs under a prevailing party statute. In response, State Farm moved to vacate or amend the judgment. Finding that the parties settled any dispute over the amount of loss, the court agreed with State Farm and vacated its order confirming the appraisal award and the judgment. Hayes appealed the order vacating judgment in an attempt to recover prejudgment interest, fees, and costs. Finding no reversible error, the Tenth Circuit affirmed. View "In re: Hayes Family Trust" on Justia Law