Justia U.S. 1st Circuit Court of Appeals Opinion Summaries

Articles Posted in Insurance Law
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The First Circuit affirmed the judgment of the district court dismissing Plaintiffs' breach of contract action against Defendant, their insurer, holding that the district court properly dismissed for failure to state a claim Plaintiffs' claim that Defendant failed to defend and indemnify them in a state court action. Newton Covenant Church (NCC) was comprised of members of the Newton Presbyterian Church (NPC) who withdrew from the Presbyterian Church (USA) and affiliated with a non-Presbyterian organization. NPC and the Presbytery of Boston sued the NCC in the state superior court seeking, among other things, a declaratory judgment that NPC owned church property at 75 Vernon Street in Newton, Massachusetts. NCC submitted a notice to the Great American Insurance Company (GAIC) requesting a defense in the state court action under a Director and Officers insurance policy. GAIC denied coverage on the grounds that the named insured under the policy was NPC, not NCC. After the parties reached a settlement NCC and its individual officers (collectively, Plaintiffs) brought this action against GAIC for breach of contract. The district court dismissed the complaint. The First Circuit affirmed, holding that Plaintiffs' allegations were not reasonably susceptible of an interpretation that would state a claim covered under the policy. View "Newton Covenant Church v. Great American Insurance Co." on Justia Law

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In this diversity case, the First Circuit affirmed the district court's entry of summary judgment against Clarendon National Insurance Company's claim that Philadelphia Indemnity Insurance Company breached its contract with Lundgren management Group, Inc. when Philadelphia declined to tender a defense to Lundgren, holding that the district court did not err in granting summary judgment against Clarendon. Clarendon provided indemnity insurance to Lundgren, a building management corporation, from 2004 to 2005. Philadelphia insured Lundgren from 2007 to 2008. In 2009, Denise Doherty, a resident in a Lundgren-managed building, filed the underlying complaint against Lundgren after mold was discovered in her residence. Lundgren tendered the defense of the underlying complaint to Philadelphia. Philadelphia denied coverage, and Clarendon financed the defense of Lundgren. After the case settled, Philadelphia denied Clarendon's claim for contribution. Clarendon received an assignment from Lundgren of the claim arising in the Doherty matter and then filed the instant suit. The district court entered summary judgment dismissing Clarendon's complaint. The First Circuit affirmed, holding that the district court (1) did not err by granting summary judgment on the duty to defend issue; and (2) properly entered summary judgment dismissing the claims alleging violations of Mass. Gen. Laws ch. 93A and 176D. View "Clarendon National Insurance Co. v. Philadelphia Indemnity Insurance Co." on Justia Law

Posted in: Insurance Law
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In this insurance dispute, the First Circuit affirmed the judgment of the district court granting summary judgment in favor of Defendants and dismissing Plaintiff's suit to recover unreimbursed defense costs that a former investment advisory firm (Firm) incurred in connection with a Securities and Exchange Commission (SEC) investigation of the Firm, holding that the Firm was not entitled to coverage. Plaintiff, in his capacity as trustee of a trust established during the bankruptcy proceedings of the Firm, filed this suit against Defendants, two of the Firm's excess insurers, seeking to recover defense costs that the Firm incurred in connection with the SEC investigation. The district court granted summary judgment for Defendants, concluding that an SEC order issued before the start of Defendants' coverage period initiated the investigation of the Firm, and this order triggered the policy's "deemed-made" clause, meaning that the claim was deemed first made prior to Defendants' policy taking effect. The First Circuit affirmed, holding (1) the SEC investigation was a claim that was deemed to have been made when the SEC order issued prior to the inception of Defendants' policies; and (2) accordingly and the claim was outside of the policies' coverage period, and Defendants were not obligated to reimburse the Firm for its defense costs. View "Jalbert v. Zurich Services Corp." on Justia Law

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In this appeal concerning whether a settlement contract under Rhode Island law was formed after a personal injury lawsuit was filed the First Circuit certified to the Rhode Island Supreme Court the question of what is the definition of 'civil action' in R.I. Gen. Laws 27-7-2.2. Horace Johnson was the driver and Carlton Johnson was the sole passenger in a car accident. The accident occurred in Rhode Island. Both men were seriously injured. Horace was insured by Arbella Mutual Insurance Company. Arbella accepted Carlton's demand to settle for the policy limit of $100,000. Thereafter, Carlton filed a lawsuit against Horace, Arbella, and other defendants. A federal district court granted summary judgment for Defendants. The district court rejected Carlton's argument that Rhode Island's Rejected Settlement Offer Interest Statute, section 27-7-2.2, applied to the case. Carlton appealed, arguing that the statute rendered the settlement contract unenforceable because Arbella failed to accept his settlement offer within the timetable set forth by the statute. At issue was whether the court correctly determined that the statute's "[i]n any civil action" language requires that a legal proceeding in court needs to be underway to trigger the statute's application. The First Circuit certified to the Rhode Island Supreme Court a question concerning the definition of "civil action." View "Johnson v. Johnson" on Justia Law

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In this insurance dispute, the First Circuit affirmed the judgment of the district court ruling for Plaintiff on her action brought under Mass. Gen. Laws ch. 93A and ch. 176D and awarding trebled damages in the amount of $5.4 million but reversed and remanded for calculation of prejudgment interest based on actual damages and not the treble damages figure of $5.4 million, holding that Plaintiff's measure of damages was her "actual damages" because there was no "judgment" in her case. Plaintiff, who was injured in a car accident at age twenty after drinking at a nightclub, sued the nightclub's insurer (Defendant), alleging that Defendant violated chapters 93A and 176D. The federal district court ruled for Plaintiff and assessed actual damages of $1.8 million against Defendant. The court then trebled the award after concluding that Defendant's violations were willful. The First Circuit affirmed on the whole but reversed as to the calculation of prejudgment interest, holding that the district court did not err in finding Defendant's violation of chapter 93A and 176D but erred when it calculated prejudgment interest on the trebled damages award instead of the single damages award. View "Capitol Specialty Insurance Corp. v. Higgins" on Justia Law

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In this insurance dispute, the First Circuit directed entry of summary judgment for Zurich American Insurance Company, holding that Zurich's decision to deny the insured's claim was supported by substantial evidence. Denise Arruda filed a claim for death benefits following the death of her husband, Joseph Arruda, in a car accident. Zurich denied the claim, concluding that Joseph's death was not within the coverage clause of the policy because the death was not independent of all other causes and that it was caused or contributed to by his pre-existing health conditions. Denise brought this action under 29 U.S.C. 1132(a)(1)(B) alleging that Zurich violated ERISA by denying the insurance benefits. The district court entered summary judgment in favor of Denise, concluding that substantial evidence did not support Zurich's decision. The First Circuit reversed, holding that Zurich's conclusion that Joseph's death was caused or contributed to by pre-existing medical conditions was not arbitrary or capricious and was supported by substantial evidence. View "Arruda v. Zurich American Insurance Co." on Justia Law

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The First Circuit affirmed the judgment of the district court in favor of Sun Life Assurance Company of Canada finding that Sun Life properly permitted an offset of Appellant's benefits under tis employer-sponsored long-term disability insurance policy (the Plan) by the amount of Appellant's service-connection disability compensation (Veterans' Benefits), holding that the district court did not err. Specifically, the First Circuit held (1) Appellant's Veterans' Benefits fell squarely within the definition of "Compulsory Benefit Act or Law"; (2) that the district court did not err by concluding as a matter of law that Veterans' Benefits unambiguously qualify as a form of "Other Income Benefit" covered by the Plan's offset provision; and (3) the district court did not err by rejecting as a matter of law Appellant's assertion that Sun Life's offset determination was motivated, at least in part, by Appellant's military service in violation of the Uniformed Services Employment and Reemployment Rights Act. View "Martinez v. Sun Life Assurance Co. of Canada" on Justia Law

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The First Circuit affirmed the judgment of the district court granting summary judgment for Insurer and dismissing Insured's complaint alleging breach of contract and violations of Massachusetts General Laws chapters 93A and 176D, holding that Insured failed to produce evidence in support of its assertions. In the complaint, Insured claimed that Insurer breached the parties' contract and violated chapters 93A and 176D in the way that Insurer handled Insured's claim for residential property damage. The district court granted summary judgment in favor of Insurer. The First Circuit affirmed, holding (1) the district court did not err in concluding that no reasonable jury could find that Insurer had violated chapter 176D; and (2) there was no breach of the contract. View "River Farm Realty Trust v. Farm Family Casualty Insurance Co." on Justia Law

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In this insurance dispute, the First Circuit remanded the case for additional factfinding, holding that where the record was conflicted as to whether there was complete diversity of citizenship when the action was commenced, remand was required. Appellants were two affiliated insureds who owned and operated a commercial bakery in Pittsfield, Massachusetts. Appellee, their insurer, had in effect a commercial business insurance policy covering the bakery. When a pipe erupted in the bakery, causing covered losses, the parties were unable to settle the ensuing insurance claims. Appellants commenced a civil action against Appellee in the United States District Court for the District of Massachusetts, invoking federal diversity jurisdiction and alleging that complete diversity existed between the parties. The magistrate judge ultimately granted Appellee's motion for summary judgment. The First Circuit noted a jurisdictional hurdle and remanded the case, holding that remand was required for the district court to determine whether there was complete diversity between the parties at the time the action was commenced. View "Bearbones, Inc. v. Peerless Indemnity Insurance Co." on Justia Law

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The First Circuit affirmed the judgment of the district court granting summary judgment in favor of Insurers in this action brought by Appellants claiming that Insurers' refusal to cover certain legal disputes constituted a breach of their insurance contract, holding that the clear and unambiguous language of the specific litigation exclusion barred coverage of the disputed litigation matters. Appellants filed suit against their primary insurance provider and their secondary insurance providers alleging that Insurers breached their contractual duty to reimburse Appellants for defense costs incurred in connection with the disputed matters. The primary insurer argued that the legal disputes fell under a "specific litigation exclusion" clause in the insurance policy that excepted from coverage claims related to prior matters specified therein. The district court granted summary judgment for Insurers, holding that the prior and disputed matters were sufficiently related such that the exclusion clause applied. The First Circuit affirmed, holding that the specific litigation exclusion barred coverage of the disputed matters because they all involved facts, circumstances, or situations alleged in the prior matters. View "UBS Financial Services Inc. v. XL Specialty Insurance Co." on Justia Law