Articles Posted in Insurance Law

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The First Circuit affirmed the district court’s denial of Plaintiffs’ motion for reconsideration of the district court’s grant of summary judgment dismissing all of their claims against various insurance companies and certain of those companies’ employees under 42 U.S.C. 1981 and Puerto Rico law. The complaint alleged that Defendants unlawfully interfered with Plaintiffs’ right to “make or enforce” existing and prospective contracts with Defendants’ insureds or third-party claimants. The district court granted summary judgment on all claims against Defendants. The First Circuit affirmed, largely on waiver grounds, holding (1) Plaintiffs expressly waived certain issues on appeal by failing to raise them in their opening brief; and (2) Plaintiffs’ remaining claims on appeal were unavailing. View "Best Auto Repair Shop, Inc. v. Universal Insurance Group" on Justia Law

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This case was once again before the First Circuit after the court certified to the Massachusetts Supreme Judicial Court (SJC) some state-law questions arising from this diversity-based declaratory-judgment action governed by Massachusetts substantive law. The case was brought by Mount Vernon Fire Insurance Company, the employment-practices liability insurer of VisionAid, Inc., seeking a declaratory judgment that it had no duty to prosecute VisionAid’s embezzlement counterclaim in litigation brought against VisionAid alleging age discrimination. The federal district court ruled that Mount Vernon did not have to foot the bill for VisionAid’s affirmative counterclaim. On appeal, the First Circuit certified three questions to the SJC, two on the duty-to-defend issue and one on a conflict-of-interest issue, which was the only question left for the court to decide in the instant appeal. At issue was whether a conflict of interest existed between the parties that permitted VisionAid to choose the attorney to defend the suit brought against it by the ex-employee, with Mount Vernon paying for that defense. The First Circuit answered in the negative, holding that the presence of the embezzlement counterclaim did not generate a conflict of interest entitling VisionAid to separate counsel to defend against the ex-employee’s suit at Mount Vernon’s expense. View "Mount Vernon Fire Insurance Co v. VisionAid, Inc." on Justia Law

Posted in: Insurance Law

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The First Circuit affirmed in part and reversed in part a district court order dismissing claims brought by Ironshore Specialty Insurance Company, the entity that paid the clean-up costs after a large military vessel spilled over 11,000 gallons of fuel next to Boston Harbor, against American Overseas Marine Company, LLC (AMSEA) and the United States. Ironshore sought cleanup costs and damages under the Oil Pollution Act (OPA) of 1990, a declaratory judgment finding AMSEA and the United States to be strictly liable under the OPA, and damages sounding in general admiralty and maritime law as a result of AMSEA’s and the United States’ alleged negligence. The district court dismissed all claims. The First Circuit (1) affirmed the dismissal of all of Ironshore’s claims against AMSEA; (2) affirmed the district court’s dismissal of Ironshore’s OPA claims against the United States; but (3) reversed the district court’s dismissal of Ironshore’s general admiralty and maritime negligence claims brought against the United States under the Suits in Admiralty Act because these claims were not foreclosed by the OPA. View "Ironshore Specialty Insurance Co. v. United States" on Justia Law

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This case concerned defects in the execution of two life insurance annuity polices that the decedent purchased through National Western Life Insurance Co. Plaintiffs, the decedent’s wife and children, sued National Western seeking a declaration that the policies were void and a return of the premiums paid by the decedent. National Western filed a motion to dismiss because Plaintiffs failed to join a necessary party - the decedent’s brother, who was named under both policies as the sole beneficiary - even though National Western had already paid him. The district court denied the motion, ruling that the beneficiary at issue was not “required to be joined if feasible” under Fed. R. Civ. P. 19(a). The court then granted summary judgment for Plaintiffs. The First Circuit vacated the judgment of the district court, holding that the sole beneficiary of the annuities was required to be joined if feasible under rule 19(a). The court remanded the case to the district court to determine whether it was equitable for the case to proceed without him. View "Maldonado-Vinas v. National Western Life Insurance Co." on Justia Law

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Gerardo Salvati died from injuries he sustained while doing maintenance work. Gerardo’s wife, Lucia (hereinafter referred to as Salvati) filed a lawsuit seeking damages for wrongful death and loss of consortium. The underlying defendants had a primary policy through Western World Insurance Company in the amount of $1 million and an excess policy through the American Insurance Company (AIC) in the amount of $9 million. AIC refused to provide coverage to the underlying defendants. Salvati and the underlying defendants eventually reached a $6 million settlement agreement. In exchange for tendering the full $1 million of the Western World primary insurance policy, the agreement released Western World and the underlying defendants from any further liability and assigned all rights held by the underlying defendants against AIC to Salvati. Thereafter, Salvati filed a complaint against AIC, alleging, inter alia, breach of contract and seeking a declaratory judgment that she was entitled to collect $5 million from AIC under the excess policy. The district court dismissed the complaint for failure to state a claim. The Supreme Court affirmed, holding (1) Salvati failed to show that the settlement agreement triggered AIC’s duty to indemnify; and (2) Salvati may not bring a claim under Mass. Gen. Laws ch. 176D, and therefore, none of her causes of action survived. View "Salvati v. American Insurance Co." on Justia Law

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Plaintiffs brought a lawsuit against their insurance carrier (Defendant), claiming that Defendant had incorrectly denied coverage. The case proceeded to a jury trial. The jury’s unanimous verdict was for Defendant. Thereafter, Plaintiffs filed a motion for a new trial after learning that the jury foreperson had a prior felony conviction, arguing that the juror was not qualified to serve on the jury under 28 U.S.C. 1865(b)(5). The district court denied the motion for a new trial, concluding that Plaintiffs had not shown that the juror’s service deprived them of a fundamentally fair trial. The First Circuit affirmed, holding that the juror’s inclusion was not fatal to the jury’s verdict, and therefore, the district court properly denied Plaintiffs’ new-trial motion. View "Faria v. Harleysville Worcester Insurance Co." on Justia Law

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While working at a subsidiary of General Dynamics Corporation (GDC), Plaintiff participated in GDC’s long-term disability (LTD) plan, which was funded and administered by Aetna Life Insurance Company. Plaintiff became disabled in 2003 and applied for plan benefits. Aetna approved her claim until 2010, when it began offsetting Plaintiff’s monthly LTD benefits by her gross Social Security income. Plaintiff sued Aetna and GDC, alleging that Aetna breached its fiduciary duty and seeking a declaration that her past and future LTD benefits should be offset against the Social Security Disability Insurance (SSDI) benefits she was awarded minus any income taxes she was assessed on those benefits. The district court granted summary judgment in favor of Defendants, thus affirming Aetna’s interpretation of the plan’s offset provision. The First Circuit affirmed, holding (1) the plan permits Aetna to offset LTD benefits by the gross amount of SSDI benefits; and (2) the district court did not err in denying discovery. View "Troiano v. Aetna Life Insurance Co." on Justia Law

Posted in: ERISA, Insurance Law

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The Phoenix Insurance Company refused to defend and/or indemnify its named insured, an attorney referred to as “John Doe,” against claims advanced by Harry Sanders. Suing in his capacity as executor of the estate of Nancy Andersen and as Doe’s assignee, Sanders brought this diversity suit alleging primarily that Pheonix forsook its duty to defend Doe against the claims advanced by Sanders. The district court dismissed Sanders’s complaint for failure to state a claim. The First Circuit affirmed, holding (1) under the circumstances of this case, Pheonix’s duty to defend was never triggered and, thus, never breached; and (2) Sanders’s other theories of liability were unavailing. View "Sanders v. Phoenix Insurance Co." on Justia Law

Posted in: Insurance Law

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Defendant was a tenant of condominium unit (Unit 1801) when unit’s bathtub overflowed and leaked into the condominium units below, causing damage. Pacific Indemnity Company, which insured Unit 1601, brought an action seeking to recover the amount it had paid to the owners of Unit 1601. As the unit’s subrogee, Pacific sought to recover damages in the amount of $351,159 as well as pre-judgment interest and costs. The district court granted summary judgment in favor of Deming, determining that Pacific’s rights to subrogation were waived based on a clause in the bylaws of the condominium trust that unit owners “shall carry insurance,” and that “all such policies shall contain waivers of subrogation.” The First Circuit reversed, holding (1) the plain language of the condominium’s Bylaws, Master Deed, and Declaration of Trust is that the required waivers of subrogation do not apply to tenants; and (2) even if the Bylaws did require unit owners to purchase insurance that contains waivers of subrogation as to claims against tenants, because Defendant presented no evidence that Unit 1601’s owners actually waived their insurer’s subrogation rights against tenants, Pacific can pursue its claims. View "Pacific Indemnity Co. v. Deming" on Justia Law

Posted in: Insurance Law

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Gary Sullivan filed suit against VisionAid, Inc., his former employer and a Massachusetts-based company, in Massachusetts state court alleging that he was terminated as the result of illegal age discrimination. In its defense, VisionAid alleged that it terminated Sullivan because it discovered that he had misappropriated several hundred thousand dollars of corporate funds. VisionAid sought to have its insurer, Mount Vernon Fire Insurance Company, cover not only the defense against the age discrimination claim but also the prosecution of the state-court misappropriation counterclaim. VisionAid then filed the underlying suit for a declaratory judgment, arguing that it was not required to pay for the prosecution of VisionAid’s proposed misappropriation counterclaim. The district court entered judgment in Mt. Vernon’s favor, concluding that, according to the plain language of the policy, Mt. Vernon was not required to fund an affirmative counterclaim. The First Circuit certified three dispositive state law questions to the Massachusetts Supreme Judicial Court regarding when an insurer may owe a duty to its insured to prosecute and fund the insured’s counterclaim for damages. View "Mount Vernon Fire Ins. Co. v. Visionaid, Inc." on Justia Law

Posted in: Insurance Law