Articles Posted in Insurance Law

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Plaintiff were a class of state employees and retirees who were enrolled in an Anthem Insurance group health insurance plan at the time of the 2001 demutualization of Anthem Insurance Companies. Plaintiffs brought suit against former Governor John Rowland, the State, Anthem Insurance, and other insurance company defendants alleging that their participation in the plan entitled them to membership in Anthem Insurance and a share of the demutualization proceeds. Plaintiffs claimed that Anthem Insurance and the other insurance company defendants breached their contractual obligations by not paying Plaintiffs for their membership interests and instead distributing their share of the proceeds to the State. The Supreme Court concluded that Plaintiffs’ claims against Rowland and the State were barred by the doctrine of sovereign immunity or otherwise should have been dismissed. After a trial, the trial court rendered judgment for the remaining defendants. The Supreme Court affirmed, holding that the trial court correctly concluded that the relevant contract provisions were ambiguous as to Plaintiffs’ eligibility for membership in Anthem Insurance and their entitlement to a share of the demutualization proceeds and properly considered extrinsic evidence to determine their meaning. View "Gold v. Rowland" on Justia Law

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Child Doe brought a civil action against Mark Tully, alleging that Tully negligently sexually assaulted Doe while he was intoxicated. State Farm Fire and Casualty Company previously issued a homeowners insurance policy to Tully providing that State Farm would defend Tully from claims resulting from an “occurrence” but not from claims resulting from Tully’s intentional actions. State Farm brought this action seeking a declaratory judgment that it owed no duty to defend Tully under the policy. The trial court granted summary judgment for State Farm, concluding that Tully’s actions fell outside the scope of the policy and, therefore, State Farm had no duty to defend him under the presumption of intent established in United Servs. Auto. Ass’n v. Marburg. Tully and Doe appealed, arguing that the evidence that Tully was intoxicated at the time of the incident created a genuine issue of material fact as to whether his actions were intentional. The Supreme Court affirmed, holding that evidence of voluntary intoxication may not negate intent in duty to defend cases such as the case here. View "State Farm Fire & Cas. Co. v. Tully" on Justia Law

Posted in: Insurance Law

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A truck being driven by an employee of Tony’s Long Wharf Transport, LLC was on an intrastate trip entirely within Connecticut when the truck collided with a car being driven by Renee Martinez, causing Martinez injuries. Martinez sued Tony’s for negligence and obtained a judgment that remained unpaid. Martinez sought to collect the unpaid judgment from Tony’s insurer, Empire Fire and Marine Insurance Company, but Empire denied it was responsible for Tony’s liability under its policy with Tony’s. In dispute between the parties was whether a federally mandated insurance endorsement included in the policy, known as an MCS-90 endorsement, applies only to liability arising during interstate transportation or applies even if the accident occurs during an entirely intrastate trip. The trial court rendered summary judgment in favor of Empire, concluding that the MCS-90 endorsement applies only to accidents occurring while the motor carrier’s vehicle was traveling in interstate commerce. The Appellate Court affirmed on an alternative ground. The Supreme Court affirmed, holding (1) the MCS-90 endorsement applies only to liability arising from the transportation of property in interstate commerce, and (2) the particular trip at issue in this case did not qualify as the transportation of property in interstate commerce. View "Martinez v. Empire Fire & Marine Ins. Co." on Justia Law

Posted in: Insurance Law

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Decedent was a passenger in his own vehicle when the vehicle was involved in an automobile accident, killing Decedent. The vehicle was being driven by Decedent’s friend (Driver) at the time of the accident and was insured by Insurer. Driver was a covered permissive driver under the policy. The executrix of Decedent’s estate (Estate) filed a wrongful death action against Driver. Insurer subsequently filed this declaratory judgment action against Estate and Driver seeking a ruling that the policy did not provide coverage for Estate’s claims against Driver and that Insurer had no duty to defend Driver. The trial court rendered summary judgment in favor of Insurer, concluding that an exclusion in the policy unambiguously barred Estate’s claims against Driver. The Supreme Court reversed, holding that the exclusion at issue was void and unenforceable due to its failure to comply with the clear and unambiguous requirements of Conn. Gen. Stat. 38a-335(d). Remanded. View "Dairyland Ins. Co. v. Mitchell" on Justia Law

Posted in: Insurance Law

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Recall Total Information Management, Inc. (Recall) contracted with IBM to transport and store computer tapes containing personal information of IBM employees. Recall subcontracted with Executive Logistics Services, LLC (Ex Log) to provide transportation services for the tapes. In connection with the agreements, Federal Insurance Company (Federal) issued a commercial general liability policy and Scottsdale Insurance Company (Scottsdale) issued an umbrella liability policy to Ex Log. Both policies named Recall as an additional insured. When Ex Log lost the computer tapes, IBM spent large sums providing identity theft services. In informal negotiations, IBM sought reimbursement of those sums from Recall and Ex Log (together, Plaintiffs). Defendants - Federal and Scottsdale - refused to participate in the negotiations or to provide coverage to Plaintiffs under the policies. Plaintiffs commenced this action alleging breach of the insurance contracts. The trial court rendered summary judgment in favor of Defendants. The Appellate Court affirmed. The Supreme Court affirmed, holding that the Appellate Court did not err in concluding that (1) Defendants did not waive coverage defenses by breaching their duty to defend Plaintiffs in settlement negotiations; and (2) the policy provisions at issue did not afford coverage for claims made against Plaintiffs by a third party. View "Recall Total Info. Mmgt., Inc. v. Fed. Ins. Co." on Justia Law

Posted in: Insurance Law

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At the time that Claimant suffered a compensable work-related injury to his left knee, Liberty Mutual Insurance Group (Liberty Mutual) was the workers’ compensation insurance carrier for Claimant’s employer (Employer). Claimant subsequently suffered a compensable work-related injury to his right knee. At the time, Chubb & Son (Chubb) was the workers’ compensation insurance carrier for Employer. Claimant was scheduled to have bilateral knee replacement surgery, but the two insurance carriers disagreed about who would pay for Claimant’s temporary total disability benefits. After a hearing, the Workers’ Compensation Commissioner required Liberty Mutual to reimburse Chubb for one half of Claimant’s temporary total disability benefits. The Workers’ Compensation Review Board and the Appellate Court affirmed. Liberty Mutual appealed, claiming that the Commissioner lacked the statutory authority to order the reimbursement to Chubb. The Supreme Court affirmed, holding that, given the unique factual circumstances of this case, the Commissioner had the authority to order the reimbursement pursuant to the relapse statute, Conn. Gen. Stat. 31-307b. View "Gill v. Brescome Barton, Inc." on Justia Law

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Plaintiff, who worked for United Parcel Service, Inc. (UPS) for thirty-two years, was diagnosed with diabetes in 1987 and with diabetic neuropathy in 1998. The diabetic neuropathy caused impairment to his arms and hands. In 2003, Plaintiff suffered injuries to his upper arms and hands in a work-related accident. After Plaintiff retired in 2008 he filed a claim for benefits. The Workers’ Compensation Commissioner apportioned the payment so that Defendants, UPS and its insurer, paid only for the proportion of disability attributed to Plaintiff’s occupational injuries rather than pay the entirety of Plaintiff’s permanent partial disability to his upper extremities and hands. The Workers’ Compensation Board affirmed. The Appellate Court reversed. The Supreme Court affirmed, holding that a disability arising from a progressive nonoccupational condition - such as Plaintiff’s diabetes and diabetic neuropathy - that manifests prior to an occupational injury and that further disables the same body part is a compensable preexisting injury rather than a noncompensable concurrently developing disease under the apportionment rule established in Deschenes v. Transco, Inc. View "Sullins v. United Parcel Serv., Inc." on Justia Law

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Plaintiff, the administratrix of the estate of Georgette Dufresne, settled actions against two motorists whose negligence Plaintiff alleged caused Dufresne’s death. Plaintiff brought this action against Allstate Property and Casualty Insurance Company, Dufresne’s underinsured motorist carrier, alleging that she was entitled to recover underinsured motorist benefits under Dufresne’s policy. Allstate moved for summary judgment, asserting that Plaintiff was not entitled to underinsured motorist benefits because she had received payments from her settlements in an amount that exceeded Dufresne’s policy limit. The trial court agreed with Allstate and rendered judgment in its favor. The Supreme Court affirmed, holding that “an underinsured motorist carrier is entitled to judgment as a matter of law when all alleged tortfeasors settle the insured’s claims against them for the injuries giving rise to the underinsured motorist claim in an aggregate sum in excess of the policy limits.” View "Guarino v. Allstate Prop. & Cas. Ins. Co." on Justia Law

Posted in: Insurance Law

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Plaintiffs, insurance producers who conduct business within the state and licensees of the Department of Insurance (department), filed a declaratory judgment action against the Commissioner of Insurance seeking declaratory rulings with respect to the legality of their conduct in the sale of life insurance policies. The trial court dismissed the action, concluding (1) Plaintiffs failed to exhaust their administrative remedies before bringing this declaratory judgment action pursuant to Conn. Gen. Stat. 4-175; and (2) Plaintiffs failed to establish their standing to bring this declaratory judgment action. The Supreme Court reversed, holding (1) the trial court improperly determined that Plaintiffs were not aggrieved parties with standing to bring this declaratory judgment action; and (2) the trial court improperly dismissed this declaratory judgment action on the ground that Plaintiffs had failed to exhaust their administrative remedies. View "Fin. Consulting, LLC v. Comm’r of Ins." on Justia Law

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This case concerned a dispute between an insurance carrier (Plaintiff) and its insured (Defendant) regarding Plaintiff’s obligation to pay underinsured motorist benefits. An arbitration panel concluded that the issue of whether the relevant policy provisions provided coverage for the claim should be resolved under the choice of law rules governing claims sounding in tort, rather than claims sounding in insurance and contract, and therefore, that New Jersey law rather than Connecticut law governed Defendant’s claim for uninsured motorist benefits under the policy. The trial court vacated the arbitration award, and the Appellate Court affirmed. The Supreme Court affirmed, holding that the Appellate Court, in its opinion adopting the decision of the trial court, properly applied sections 6(2), 188 and 193 of the Restatement (Second), contract choice of law, to determine that Connecticut law governed the claim. View "Gen. Accident Ins. Co. v. Mortara" on Justia Law