Articles Posted in Insurance Law

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An insured sued her auto insurer and one of its adjusters, alleging that the insurer breached the insurance contract and committed tortious bad faith by withholding underinsured motorist benefits and that the adjuster negligently handled her claim for those benefits. The insurer then paid all available underinsured motorist benefits to the insured, including interest. The insured continued her tort claims, alleging additional financial and emotional harm from the delayed benefits payment. The insured proposed a jury instruction addressing the effect of the insurer’s belated payment, but the superior court rejected that instruction. After trial the jury determined that: (1) the insurer had acted in bad faith, but its conduct was not a substantial factor in causing the insured’s asserted harm; and (2) the adjuster had not been negligent. The superior court subsequently ordered the jury to award the insured nominal damages. The jury then awarded the insured $2 in nominal damages and later awarded $450,000 in punitive damages. The superior court awarded the insured prevailing party costs and attorney’s fees against the insurer. The court also awarded the adjuster prevailing party attorney’s fees against the insured. The court rejected the insured’s request that judgment against the insurer be entered nunc pro tunc to the date of the jury verdict so that post-judgment interest on the punitive damages award would start earlier. The insurer appealed the nominal and punitive damages awards and the prevailing party determination. The insured cross-appealed the adjuster’s attorney’s fees award, the jury’s failure to award compensatory damages, the court’s rejection of the insured’s proposed jury instruction, and the court’s refusal to enter judgment effective from the jury verdict date. The Alaska Supreme Court affirmed in all respects save the adjuster’s attorney’s fees award: that was remanded for further proceedings. View "Government Employees Insurance Co. v. Gonzalez" on Justia Law

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An employee continued to work for over ten years after a job-related knee injury but had multiple surgeries on her injured knee. Over time, her employer made several permanent partial impairment payments, and she was eventually determined to be permanently and totally disabled because of the work injury. She began to receive Social Security disability at about the same time she was classified as permanently and totally disabled for workers’ compensation. Her employer asked the Alaska Workers’ Compensation Board to allow two offsets to its payment of permanent total disability (PTD) compensation: one related to Social Security disability benefits and one related to the earlier permanent partial impairment (PPI) payments. The Board established a Social Security offset and permitted the employer to deduct the amount of previously paid PPI. The employee appealed to the Alaska Workers’ Compensation Appeals Commission, arguing that the Board had improperly applied one of its regulations in allowing the PPI offset and had incorrectly calculated the amount of the Social Security offset. She also brought a civil suit against the State challenging the validity of the regulation. The State intervened in the Commission appeal; the lawsuit was dismissed. The Commission reversed the Board’s calculation of the Social Security offset and affirmed the Board’s order permitting the PPI offset. The employer appealed the Commission’s Social Security offset decision to the Alaska Supreme Court, and the employee cross- appealed the PPI offset. The Court affirmed that part of the Commission’s decision reversing the Board’s calculation of the Social Security disability offset and reversed that part of the Commission’s decision permitting an offset for permanent partial impairment benefits. The case was remanded back to the Commission for further proceedings. View "Alaska Airlines, Inc. v. Darrow" on Justia Law

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A driver lost control of his truck and crashed into a cabin, causing property damage and personal injuries to the cabin owner. The cabin owner brought suit against both the driver and the driver’s insurance company, alleging in part that the insurance company subsequently took charge of and negligently handled the fuel spill cleanup on the cabin owner’s property. The superior court granted the insurer summary judgment, concluding as a matter of law that the insurer could not owe the cabin owner an actionable duty. The cabin owner appealed, arguing that Alaska case law did not preclude a duty in this context. The Supreme Court agreed with the cabin owner and therefore reversed the superior court’s grant of summary judgment. View "Burnett v. Government Employee Ins. Co." on Justia Law

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Floyd Cornelison injured his back at work in 1996 while shoveling dirt. He had back surgery later that year, but it did little to improve his condition. The Board found he was permanently and totally disabled (PTD) in 2001 under the "odd-lot doctrine." TIG Insurance, the workers’ compensation insurer for Floyd’s employer, did not contest that he was PTD; it reclassified his workers’ compensation benefits as PTD in 2000. Floyd also received Social Security disability payments, and the employer received an offset for those payments. The employer and TIG challenged Cornelison's continuing eligibility for workers’ compensation, relying on surreptitious video surveillance and a doctor’s report issued after the doctor viewed an edited surveillance video. Cornelison and his wife sued TIG and a number of others involved in the attempt to terminate benefits; they alleged several causes of action, contending that the video had been purposely edited to provide a false picture of the employee’s physical abilities and that the defendants had participated to varying degrees in a scheme to defraud the Alaska Workers’ Compensation Board. The trial court granted summary judgment or dismissal as to all of the defendants on all counts. After review of the matter, the Supreme Court affirmed in part, and reversed in part. The Court concluded the Cornelisons provided enough evidence to show that a material factual dispute existed about the accuracy of the edited videos and the manner in which the videos were created. They also presented more than generalized claims of emotional distress. Because the superior court failed to address the issues in dispute in the IIED claim against certain persons involved with the making of the videos, we reverse the grant of summary judgment on this claim and remand to the superior court. The case was remanded for further proceedings. View "Cornelison v. TIG Insurance" on Justia Law

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The Ninth Circuit federal Court of Appeals certified two questions of Alaska law to the State Supreme Court. Ingaldson Fitzgerald was an Alaska law firm. Attorneys Liability Protection Society, Inc. (ALPS) was a Montana insurance company and risk-retention group. From April 29, 2007, to April 29, 2008, ALPS insured Ingaldson Fitzgerald. Ingaldson Fitzgerald’s insurance policy with ALPS insured the firm against claims arising from “an act, error or omission in professional services that were or should have been rendered by [Ingaldson Fitzgerald].” The policy expressly excluded from coverage any claims arising from conversion or disputes over fees. The policy also contained a provision providing that Ingaldson Fitzgerald would reimburse ALPS for fees and costs ALPS incurred in defending non-covered claims. In 2008 the bankruptcy trustee for the bankrupt estate of a former client of Ingaldson Fitzgerald, in conjunction with a separate former client of the firm, brought a claim against the firm arising out of Ingaldson Fitzgerald’s actions in disbursing from and withdrawing fees and costs against a retainer. The former client and the trustee sought recovery of that retainer, and asserted claims against Ingaldson Fitzgerald for, among other things, restitution, disgorgement, and conversion. The Ninth Circuit asked: (1) whether Alaska law prohibited enforcement of a policy provision entitling an insurer to reimbursement of fees and costs incurred by the insurer defending claims under a reservation of rights, where (a) the insurer explicitly reserved the right to seek such reimbursement in its offer to tender a defense provided by independent counsel, (b) the insured accepted the defense subject to the reservation of rights, and (c) the claims were later determined to be excluded from coverage under the policy; and (2) if yes, then did Alaska law prohibit enforcement of a policy provision entitling an insurer to reimbursement of fees and costs incurred by the insurer defending claims under a reservation of rights, where (a) the insurer explicitly reserved the right to seek such reimbursement in its offer to tender a defense provided by independent counsel, (b) the insured accepted the defense subject to the reservation of rights, and (c) it is later determined that the duty to defend never arose under the policy because there was no possibility of coverage? The Alaska Supreme Court answered both certified questions “yes.” View "Attorneys Liability Protection Society, Inc. v. Ingaldson Fitzgerald, P.C." on Justia Law

Posted in: Insurance Law

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Lee Stenseth was injured at work many years ago. He and his employer, the Municipality of Anchorage, entered into a compromise and release agreement (C&R) in August 1996 in which Stenseth waived all future benefits except medical benefits in exchange for $37,000. Stenseth retired from the Municipality in 1996, but he continued to receive medical benefits for his work-related injury, including narcotic pain medication. Ten years later, Stenseth was charged with multiple felonies related to selling or delivering narcotics that he had acquired, some from forged prescriptions modeled on the prescriptions for his work-related injury. Stenseth pleaded guilty to a number of felonies and served time in jail. He was released in June 2010. The Municipality sought to terminate future workers’ compensation benefits and be reimbursed for the benefits it paid out, alleging that Stenseth obtained those benefits by making a false statement or misrepresentation. The Alaska Workers’ Compensation Board dismissed the Municipality’s fraud petition after deciding that the parties had reached an enforceable settlement. The Municipality appealed the dismissal, arguing that any settlement of its fraud petition was void because the settlement did not meet the requirements set out in the Alaska Workers’ Compensation Act and the Board’s regulations. The Alaska Workers’ Compensation Appeals Commission affirmed the Board’s decision. The Municipality appealed to the Alaska Supreme Court, arguing that the Commission’s interpretation of the statute was incorrect and that the Commission incorrectly interpreted our decisions about estoppel. Finding no reversible error, the Supreme Court affirmed the Commission’s decision. View "Municipality of Anchorage v. Stenseth" on Justia Law

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A man working at a concrete-pouring job was assaulted by another worker at the job site. The injured man filed a lawsuit against the assailant and both the concrete-pouring company and its owner. Although the company’s commercial general liability insurer initially provided a defense attorney in the negligence action, the insurer later brought a declaratory judgment action alleging that the incident fell within the policy’s employee-exclusion clause. The superior court granted summary judgment to the insurance company. The Supreme Court affirmed. "[B]ecause courts look to workers’ compensation law to give meaning to the phrase 'arising out of and in the course of employment' in workers’ compensation/employers’ liability policies, and because commercial general liability policies are designed to avoid the existence of an overlap or a gap between workers’ compensation/employers’ liability and commercial general liability policies, sister jurisdictions interpret the same phrase in employee-exclusion clauses in commercial general liability policies in light of the identical language in workers’ compensation statutes. We have found no case law holding that the contractual phrase 'arising out of and in the course of employment' in commercial general liability exclusions should be interpreted differently from the identical phrase in workers’ compensation statutes. For purposes of this appeal, we will use workers’ compensation case law to interpret the meaning of the commercial general liability policy’s exclusion of coverage for bodily injury "arising out of and in the course of employment.'" The employer did not purchase workers' compensation coverage. And in reading the general liability policy in question, the Supreme Court concluded the superior court did not err in determining that the incident here fell within the employee-exclusion claim. View "Devine v. Great Divide Insurance Company" on Justia Law

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Appellant Tommie Patterson was injured in a hit-and-run accident and sued his car insurance company claiming it had breached his insurance contract by failing to reasonably compensate him for his injuries. He later moved to amend his complaint to include racketeering, embezzlement, mail fraud, and bad faith claims, but the superior court denied the motion. A jury returned a liability verdict that was smaller than the insurance company's offer of judgment. The superior court ruled that the insurance company was the prevailing party and awarded attorney's fees and costs. Patterson appealed the denial of his motion to amend, the awarding of attorney's fees and costs, and several of the court's other procedural and evidentiary rulings. Finding no abuse of discretion in the court's rulings, the Alaska Supreme Court affirmed the judgment. View "Patterson v. GEICO General Insurance Company" on Justia Law

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An adult passenger in a car was injured in a single-car accident. The passenger and his family brought suit against the vehicle’s unlicensed minor driver, the minor’s mother, the owner of the car, the insurance policy holder, the insurer, and the insurance adjuster who handled the claims arising from the accident. The passenger’s father attempted to raise a contractual interference claim, but the superior court concluded that the complaint did not state such a claim on his behalf. The superior court dismissed the father’s only other claim (intentional infliction of emotional distress), removed the father’s name from the case caption, and ordered the father to cease filing pleadings on behalf of other parties. After the superior court judge dismissed him from the action, the passenger’s father attempted to file a first amended complaint, which expressly stated his contractual interference claim on the theory that he was a third-party beneficiary of the contracts between his son and his son’s doctors. But the superior court denied the father leave to amend the complaint because the father had already been dismissed from the case. Following a settlement among all of the other plaintiffs and defendants (which the father did not join) the superior court granted final judgment to the insurer. The insurer moved for attorney’s fees against the father under Alaska Civil Rule 82, but the father never responded to that motion. The superior court granted the award without soliciting a response from the father, and the father appealed. After review, the Supreme Court affirmed the superior court’s order dismissing the father’s claims and denying leave to amend the complaint because the proposed first amended complaint was futile. But because the superior court had barred the father from filing any further pleadings in the case and had removed his name from the caption, the superior court had a responsibility to inform the self-represented father that he was permitted to file an opposition to the motion for attorney’s fees. Therefore, the Court vacated the fee award and remanded the case to the superior court to afford the father an opportunity to respond to the insurer’s motion for reasonable attorney’s fees. View "Bush v. Elkins" on Justia Law

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A worker was left a paraplegic after a 1976 work-related motor vehicle accident. He suffered a number of medical complications related to his injuries. In 2007, his employer controverted some aspects of his medical care, and he filed a written workers’ compensation claim. Shortly before the hearing on the claim, the employer withdrew most of its controversions. The Alaska Workers’ Compensation Board decided that some of the controversions were frivolous, unfair, or in bad faith. It imposed a statutory penalty and reported its findings about frivolous or unfair controversions to the Alaska Division of Insurance. The employer appealed, and the Alaska Workers’ Compensation Appeals Commission reversed the Board in part, deciding as a matter of law that the Board could not impose a penalty for some of the controversions. The Commission decided that other appeal points were moot. The worker appeals the Commission’s decision reversing the penalties and some attorney’s fees; the employer cross-appeals the Commission’s decisions about preservation of the controversion issues and mootness. Upon review, the Supreme Court affirmed the Commission's decision that the controversion issue was properly before the Board, but reversed regarding the penalties issue. View "Harris v. M-K Rivers" on Justia Law