Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts

Tuesday, May 8, 2007

Lorraine v. Markel American Ins. Co. (U.S.D.C. MD)

Filed May 4, 2007--Opinion by Judge Paul Grimm

In an action brought to enforce a private arbitrator’s award for damage to a yacht, the court determined that the motion by the boat owners was properly considered as a motion to modify the award under the Federal Arbitration Act, while the motion by the insurance company sought to enforce the award rather than have it increased as requested by the boat owners. The court denied both motions without prejudice because counsel for both sides had failed to establish the authenticity of their exhibits, to resolve potential hearsay issues, to comply with the original writing rule, and to demonstrate the absence of unfair prejudice to the extent that their exhibits were inadmissible.

In its 101 page opinion, the court dedicated at least 90 pages to providing extensive and detailed analysis and guidance on the interrelated evidentiary issues governing the admissibility of electronically stored evidence (ESI), including: analysis under Rule 104, relevance under Rule 401, authentication as required by Rule 901(a), effect of hearsay as defined by Rule 801 and any applicable exceptions, consideration of the form of the ESI being offered under the original writing rule and the admissibility of any secondary evidence to prove its content, and the probative value of the ESI considering potential unfair prejudice or one of the other factors identified by Rule 403.

The full opinion is available in PDF.

Wednesday, April 18, 2007

Moscarillo v. Professional Risk Management Services, Inc. (Ct. of Appeals)

Filed April 16, 2007. Opinion by Judge Clayton Greene.

From the official headnote:
PROFESSIONAL LIABILITY INSURANCE– DUTY TO DEFEND– To establish a potentiality of coverage, an insured can refer to extrinsic evidence, however, the extrinsic evidence must relate to a cause of action actually alleged in the complaint and can not create a new, unasserted claim. An insurer’s duty to defend is not triggered when the professional liability insurance policy at issue does not provide coverage for fraud and the gravamen of the complaint in the underlying action alleges only fraud.
On appeal from a decision of the Court of Special Appeals affirming the decision below that the insurer had no duty to defend the insured ("Moscarillo") for intentional rather than negligent conduct, the Court of Appeals AFFIRMED the decisions below.

The opinion is available in PDF format.

Wednesday, April 11, 2007

Erie Insurance Exchange v. Heffernan, II, et al. (Court of Appeals)

Filed April 10, 2007 --Opinion by Judge Clayton Greene

The parents of a child killed in an automobile accident when the driver fell asleep sued for benefits, pursuant to two policies of insurance issued to them by Erie Insurance Exchange. The Court of Appeals held that, in a breach of contract action for benefits, pursuant to the uninsured/underinsured provisions of an automobile insurance contract executed in Maryland, what the parents were "entitled to recover" was determined by Delaware substantive law because the law of the situs of the accident controlled the tort aspects of the claim, including questions of liability and damages raised in an uninsured motorist claim.

Prior to filing the contract action, the parents had settled the underlying tort claim against the underinsured tortfeasor. Because Erie approved the settlement with the tortfeasor, the Court noted that Erie was bound by that settlement and, therefore, liability was not at issue. The Court also concluded that Maryland's public policy exception to the doctrine of lex loci delicti does not require the application of Maryland's statutory cap on non-economic damages or application of Maryland's contributory negligence principles.

The opinion is available in PDF.

Sunday, April 1, 2007

Palm v. Wausau Benefits, Inc. (U.S.D.C. Maryland)(Not approved for publication)

Filed March 26, 2007—Opinion by Judge Andre Davis

Plaintiff Anthony Palm, a beneficiary under a group long term disability income policy sponsored by his former employer, sued under the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001, et. seq., to challenge a denial of benefits.

The Court considered it undisputed that Palm suffered from numerous impairments, including chronic lumbalgia, acute chronic lumbosacral paravertebral muscle spasm, bilaterally, and degenerative dessication with dorsal disc bulging at L4 - 5, L5 - S1 and C5 - 6, that are, collectively, disabling. On the ultimate issue, however, of whether the evidence was sufficient to establish that Palm was "totally disabled" from working in "any occupation," the Court determined that a physician’s opinion that Palm cannot perform sedentary or light duty work was rather conclusory and wholly undercut by other evidence in the record, including surveillance videos of Palm engaged in physical activity inconsistent with his claims.

On cross-motions for summary judgment, the Court found that Palm failed to show by a preponderance of the evidence that he is "totally disabled" within the definition of the relevant policy. At best, the Court said, the evidence was in equipoise (and parenthetically added that it was not), but in any event Palm failed to satisfy his burden to show “total disability” under the Policy.

The opinion is available in PDF.

Friday, March 16, 2007

Bolton Partners Investment Consulting Group, Inc. v. The Travelers Indemnity Company of America (Maryland U.S.D.C.) (Not approved for publication)

Signed March 15, 2007. Memorandum Opinion by Judge Richard D. Bennett (not approved for publication)

In a case arising from the denial of coverage under comprehensive business insurance issued to the parent company of the plaintiff ("Bolton Partners") by the defendant ("Travelers"), and upon consideration of the parties' cross motions for summary judgment, the judge DENIED Bolton Partners' motion for partial summary judgment and GRANTED Travelers' motion for summary judgment.

In the course of providing consulting services to a client, an employee of Bolton Partners made allegedly defamatory statements about one of the companies being evaluated, which resulted in that company filing suit against Bolton Partners. Travelers declined to defend or indemnify under the insurance policy, citing the Designated Personal Services Exception. Bolton Partners eventually settled the suit, and sought indemnification from Travelers in this action.

Upon cross motions for summary judgment, the judge first addressed Travelers' claim that it had no duty to defend because Bolton Partners was not an "insured", since the policy was issued to the parent corporation of Bolton Partners. The judge found the structure of the policy to contemplate coverage of the subsidiary, and also because the issue had not been previously raised by Travelers in declaring its intent not to defend, and Travelers was thus estopped to raise that issue now.

Turning to the professional services exception, the judge noted that, unlike many other states, Maryland does not construe insurance contracts against the drafter, but rather uses normal principles of interpretation. Looking to cases in other jurisdictions, the judge found that such exceptions had been interpreted broadly. Turning to the facts here, the judge found the claimed defamation to have been within the context of Bolton Partners' performance of their professional services. Thus, the suit fit within the Professional Services Exception, and Travelers was not required to defend under its policy. Accordingly, the judge GRANTED Travelers' motion for summary judgment.

The Memorandum Opinion is available in PDF format.

Western World Insurance Company, Inc. v. Greene (Maryland U.S.D.C.) (Not approved for publication)

Signed March 13, 2007. Memorandum and Order and Declaration of Judgment by Judge Catherine C. Blake (not approved for publication)

On motion for summary judgment made by the plaintiff ("Western"), the judge GRANTED summary judgment in favor of Western and DECLARED the amounts due under certain insurance policies.

This case arose from a claim made by a tenant (Greene") for lead paint exposure over four years' occupancy in a residence insured by the landlord's insurance company ("Western World") in a series of four one-year policy periods. The first three years, the policy limit was $50,000 per year per occurence, while the policy limit was raised to $300,000 approximately half-way through the final year, one month after Greene had vacated the premises. Western World had offered Greene a total of $200,000, while Greene demanded $450,000, and Western World sought a declaratory judgment and summary judgment.

The judge had little difficulty finding that there was no dispute over any material fact, since the increase in policy limit in the final year did not occur until after Greene had vacated the premises, and the increase in the insurance premium was proportional to the roughly one-half year of enhanced coverage. The judge also did not find that the claim, raised for the first time on appeal, of in utero lead exposure in the last year, thus raising the total claim to $250,000, created a dispute as to a material fact. Consequently, the judge granted Western World's motion for summary judgment, and declared the policy limit for occurances prior to the endorsement date was limited to $50,000 per occurance, and thus the limit for Greene was $50,000 for that year, and $200,000 in total for all four years.

The Memorandum and Order and Declaration of Judgment are available in PDF format.

Friday, February 23, 2007

Guttman v. Liberty Mutual Fire Insurance Co. (Maryland U.S.D.C.) (Not Approved for Publication)

Signed February 22, 2007. Memorandum opinion and order by Judge J. Frederick Motz. (Not approved for publication.)

The defendant ("Liberty Mutual") had issued an insurance policy to a homeowner ("Proctor"). After the end of the policy period, Proctor was sued by an individual ("Robinson") who claimed Proctor's daughter had shot him in the eye with a BB pistol during the policy period. Proctor failed to notify Liberty Mutual as required by the terms of the policy, and a default judgment was subsequently entered against Proctor. Almost nine months after the default judgment, Proctor finally notified Liberty Mutual, who disclaimed coverage based on the untimely notice.

Proctor then filed for Chapter 7 protection, and this action was brought by Proctor's trustee in bankruptcy ("Guttman") against Liberty Mutual, asserting "insurance bad faith," based upon Liberty Mutual's failure to defend Proctor and to settle the claim in the Robinson suit, and seeking compensatory and punitive damages on the bad faith claim and the policy limit in a breach of contract claim.

Liberty Mutual filed a motion for partial judgment on the bad faith claim. The judge found Maryland law to be clear that a bad faith claim does not lie when an insurer erroneously takes the position it has no contractual liability as to a particular claim, but only when it has proceeded on the basis that the contractual obligation exists, and has undertaken the obligation in violation of the appropriate standard of care, citing Mesmer v. MAIF.

In this case, notwithstanding Guttman's claim that Liberty Mutual had in fact assumed the responsibility for providing a defense, Guttman's pleadings included a statement that this was not in fact so, and the several contacts between Liberty Mutual and counsel for Robinson were evidently initiated by counsel for Robinson in order to extend an offer to vacate the default judgment if Liberty Mutual would appoint counsel, which Liberty Mutual declined to do. Consequently, the judge granted judgment on the pleadings to Liberty Mutual on Guttman's "insurance bad faith" claim, and struck Guttman's request for punitive damages.

The opinion and order are available in PDF.

Tuesday, January 9, 2007

Centre Insurance Co. v. J.T.W. (Ct. of Appeals)

Filed January 9, 2007--Opinion by Judge Dale R. Cathell.

Issue: When, under Title 2 of Maryland's Insurance Article does the 30-day filing period for a petition for judicial review of an administrative decision begin?

Held: The plain language of the pertinent statutes provides that, in the context of the relevant sections of the Insurance Article, the 30-day filing period for a petition for judicial review of an administrative decision under §§2-204(c) and 2-215(d)(1) begins when the order resulting from a relevant administrative hearing is mailed.

Not considered in opinion: The effect of Maryland Rule 1-203(c)

Full opinion available in PDF.

Tuesday, January 2, 2007

Ohio Casualty v. Chamberlin (Ct. of Special Appeals)

Filed January 2, 2007--Opinion by Judge Robert Karwacki.

Ohio Casualty Insurance Company paid $20,000 to Sara Chamberlin, pursuant to Md. Insurance Code Art. §19-511, when Ohio Casualty (as the uninsured motorist carrier) rejected a $20,000 settlement offer from the defendant. After a jury awarded Chamberlin only $5,445 on her claim, Ohio Casualty moved to compel the return of the $20,000. The Court of Special Appeals held that, when a UIM carrier chooses to thwart a proposed settlement between a plaintiff and an alleged tortfeasor by substituting its payment of the settlement amount, it bears the risk that a jury might return a verdict in an amount less than the amount advanced or in favor of the defendant(s) and it is not entitled to a refund of any amount paid. The Court also rejected the argument by Ohio Casualty that language in Chamberlin's insurance policy required the money to be returned, finding such language vague and unenforceable.

The full opinion is available in WordPerfect and PDF.