Articles Posted in Insurance Law

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Scott and Dawn Smith (together, Insureds) filed an insurance claim with Erie Insurance Company (Insurer) seeking uninsured-motorist coverage as a result of injuries suffered by Scott in a no-contact accident allegedly caused by an unidentified vehicle. Insurer denied the claim. The trial court granted summary judgment to Insurer, concluding that a provision in the policy requiring Insureds to provide “independent corroborative evidence” that the unknown driver caused the injury meant that Insureds had to submit evidence, independent of Scott’s own testimony, corroborating that the accident was caused by an unknown motorist, and this they failed to do. The court of appeals reversed. The Supreme Court affirmed, holding that the policy’s requirement of independent corroborative evidence could be met using evidence derived from the insured’s testimony. View "Smith v. Erie Insurance Co." on Justia Law

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Plaintiffs sued World Harvest Church (WHC) for claims arising from an incident involving Plaintiffs’ two-year-old son, who attended WHC’s daycare. Plaintiffs alleged that WHC’s employee had beaten their son with a knife. Final judgment was entered in favor of Plaintiffs in the amount of $2.87 million. The court of appeals affirmed. WHC subsequently filed suit against Grange Mutual Casualty Company, which insured WHC under a commercial liability insurance policy and an umbrella policy and had defended the matter but reserved its right to deny coverage. Plaintiffs alleged that Grange improperly refused to indemnify it for any portion of the judgment awarded to Plaintiffs. The trial court entered judgment in favor of WHC, finding that Grange was obligated to indemnify WHC in the amount of $1.47 million but that Grange was not responsible to indemnify WHC for the punitive damages awarded to Plaintiffs. The Supreme Court reversed, holding (1) the abuse or molestation exclusion in the commercial liability insurance policy barred coverage for an award of damages based on WHC’s vicarious liability for intentional infliction of emotional distress arising from WHC’s employee’s abuse of Plaintiff’s son while in WHC’s care and custody; and (2) the policy did not provide coverage for an award of attorney fees and postjudgment interest. View "World Harvest Church v. Grange Mut. Cas. Ins. Co." on Justia Law

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Appellees damaged their vehicle when they collided with a deer in the roadway. Appellant insured the vehicle. Appellees had their vehicle repaired using aftermarket replacement parts that were not produced by the original equipment manufacturer (OEM). Appellant, however, refused to pay for OEM parts after providing an estimate that was based on the use of non-OEM parts. Appellees filed a complaint alleging eight causes of action related to Appellant’s estimate and its refusal to pay for OEM parts. The trial court granted summary judgment to Appellees on their claim that Appellant violated the Consumer Sales Practices Act by failing to obtain one of Appellees’ signatures on the bottom of the estimate, and Appellees voluntarily dismissed the remainder of their claims. The trial court awarded Appellees actual damages, statutory treble damages, attorney fees, and expenses. The court of appeals modified and affirmed the trial court’s award of damages. The Supreme Court vacated the judgment of the court of appeals and dismissed the cause, holding that Appellant’s provision of a repair estimate to Appellees was not in connection with a consumer transaction and, therefore, was not an “unfair or deceptive act or practice” pursuant to Ohio Rev. Code 1345.02. View "Dillon v. Farmers Ins. of Columbus, Inc." on Justia Law

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Insurer issued an automobile policy to Philip Laboy as the named insured. The policy provided that Insurer would pay “any negotiated reduced rate accepted by a medical provider.” Three members of Laboy’s family, also insureds under the policy, were involved in an automobile accident. The Laboys submitted some of their medical bills both to Insurer and to their health-insurance provider. The Laboys later reached a settlement with the third-party tortfeasor. When Insurer exercised its contractual right to subrogation against the Laboys, the Laboys objected, arguing that Insurer had overpaid the medical providers. As evidence, the Laboys showed that Insurer had paid discounted rates to medical providers totaling $1,441 in medical expenses but that their own health insurer paid only $648 for those same medical expenses. The Laboys filed a class-action lawsuit against Insurer, alleging claims for breach of contract and breach of good faith and fair dealing. The trial court entered summary judgment for Insurer. The Supreme Court agreed with the trial court’s judgment, holding that the only reasonable interpretation of the policy is that “any negotiated reduced rate accepted by a medical provider” means a negotiated reduced rate that Insurer was contractually entitled to pay and does not include the reduced rates negotiated by the Laboys’ health-insurance provider. View "Laboy v. Grange Indem. Ins. Co." on Justia Law

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This case stemmed from alleged acts of pre-leasing housing discrimination that resulted in alleged emotional distress. At the relevant time, the defendants in the underlying case (“Insureds”) were covered under an umbrella insurance policy issued by Insurer. After Insureds settled the underlying case, Insureds sued Insurer for breach of contract for failing to defend Insureds pursuant to the umbrella policy. A federal trial court granted summary judgment in favor of Insurer on its duty to defend and indemnify Insureds under the umbrella policy. The federal court of appeals reversed. At issue before the Supreme Court was whether the umbrella policy’s intentional-acts exclusion - through application of the inferred-intent doctrine - obviated Insurer’s duty to defend in this case. The Supreme Court affirmed, holding (1) the umbrella policy at issue here arguably provides coverage for emotional-distress damages through its coverage for humiliation; and (2) emotional-distress damages are not inherent in a claim for discrimination, and therefore, the inferred-intent doctrine was inapplicable. View "Granger v. Auto-Owners Ins." on Justia Law

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Appellee was injured when he fell from a ladder-jack scaffold while working as a carpenter on a construction project for his Employers. Appellee sued his Employers, alleging claims of employer intentional tort. The Cincinnati Insurance Company (“CIC”), which insured the Employers under a commercial general liability policy, intervened and filed a complaint seeking a declaration that it had no obligation to indemnify the Employers should Appellee prevail on his employer-intentional-tort claims. The policy contained a provision that excluded coverage for acts committed with the deliberate intent to injure an employee. The trial court granted summary judgment for CIC. The Court of Appeals reversed, concluding that liability may be imposed without a finding of deliberate intent under the policy. The Supreme Court reversed the Court of Appeals, holding that an insurance provision that excludes from coverage liability for an insured’s act committed with the deliberate intent to injure an employee precludes coverage for employer intentional torts. View "Hoyle v. DTJ Enters., Inc." on Justia Law

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In 2002, Ruth McCormick slipped and fell while working at a McDonald’s restaurant. McCormick received temporary total disability (TTD) compensation until 2010, when the Industrial Commission terminated McCormick’s benefits based on a doctor’s opinion that McCormick had reached maximum medical improvement. McCormick filed a complaint for a writ of mandamus, alleging that the Commission's decision to terminate benefits was not supported by the evidence, was contrary to law, and was an abuse of discretion because the doctor’s opinion that she had reached maximum medical improvement was factually inaccurate. The court of appeals denied the writ. The Supreme Court affirmed, holding that the doctor’s report that McCormick had reached maximum level improvement was valid evidence supporting the Commission’s decision to terminate TTD compensation. View "State ex rel. McCormick v. McDonald’s" on Justia Law

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WTS Acquisition Corporation purchased Ameritemps, Inc. and then transferred the assets to its wholly owned subsidiary, RFFG, LLC. RFFG continued operating the business under the Ameritemps name. The Ohio Bureau of Workers’ Compensation notified RFFG that it had determined that RFFG was a successor employer for workers’ compensation purposes and that it intended to calculate RFFG’s workers’ compensation premium rate based on Ameritemps’ experience rating. RFFG filed a complaint for a writ of mandamus alleging that the Bureau had abused its discretion when it determined RFFG to be the successor in interest to Ameritemps. The court of appeals denied the writ. The Supreme Court affirmed, holding that the court of appeals did not err in concluding that the decision of the Bureau was supported by the evidence and was not an abuse of discretion. View "State ex rel. RFFG, LLC v. Ohio Bureau of Workers' Comp." on Justia Law

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Appellee, a home health nurse who provided in-home health-care services to clients of Visiting Nurse Association of Mid-Ohio (VNA), was injured in a vehicle collision while she was traveling to the home of a patient. Appellee had decided to transport her children and two friends to a mall on her way to the patient’s home. The Industrial Commission allowed Appellee’s claim for a neck sprain. VNA appealed. The trial court granted summary judgment for VNA, concluding that Appellee was on a personal errand at the time she was injured. The court of appeals reversed, concluding that the accident and injury arose out of and occurred in the course of Appellee’s employment. Specifically, the court determined that although Appellee had intended to drop her passengers off at the mall, she had the dual intent to travel to her patient’s home, and when she was injured, she had not yet diverted from that path. The Supreme Court reversed, holding that the doctrine of dual intent or dual purpose is not recognized in Ohio for purposes of determining eligibility for workers’ compensation benefits. Remanded. View "Friebel v. Visiting Nurse Ass’n of Mid-Ohio" on Justia Law

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Miles Cobrun was killed after he was struck by a vehicle driven by Robert Shill. Peggy Spaeth, Cobrun’s wife, filed a wrongful-death action against Robert and his insurer. Robert sought additional coverage under the liability policy of his parents issued by Cincinnati Insurance Company (CIC). CIC denied coverage. Robert then filed this declaratory-judgment action seeking a declaration that CIC owed him a duty of indemnification in the wrongful-death case. The trial court consolidated the declaratory-judgment and underlying wrongful-death actions. The trial court granted summary judgment for CIC. The appellate court reversed. At issue before the Supreme Court was the meaning of the term “domicile,” the crucial policy term at issue in regard to coverage for Robert under his parents’ CIC umbrella policy. The Supreme Court reversed, holding (1) in accordance with this Court’s previous jurisprudence, the definition of domicile is where a person resides, where he intends to remain, and where he intends to return when away temporarily; and (2) under this definition, Robert was not an insured “resident relative” under the umbrella policy at issue. View "Schill v. Cincinnati Ins. Co." on Justia Law