Insurance Law

Resident at facility for developmentally disabled adults suffered injury upon choking on food, and was transported to hospital the next day. The incident was not first reported during the policy period, as insuring agreement required, but instead was first reported after lawsuit was filed, which was after policy had already expired. Thus, duty to defend was never properly triggered and thus the estoppel doctrine does not apply. (CUNNINGHAM and CONNORS, concurring.)

Insurer filed declaratory judgment action claiming that it owed no duty to defend or indemnify day care or its owner as to lawsuit for negligent supervision filed against them by mother of minors who were alleged to have been sexually abused by husband of day care owner. No specific factual allegations in underlying complaint would trigger the expected injury exclusion. Insurer failed to show that it owes no duty to defend its insureds. (JORGENSEN and SCHOSTOK, concurring)

Medical providers filed suit against workers compensation insurer for its alleged failure to fully pay for their services to an injured employee.Plaintiffs failed to state a cause of action for breach of contract implied in law or implied in fact, and failed to adequately allege the element of consideration. Providers are not 3rd-party beneficiaries of the policy, and they have no remedies under Section 155 of Insurance Code, as those remedies extend only to insured party and assignees of insurance policy, and not to 3rd parties.(PUCINSKI and HYMAN, concurring.)

Plaintiff, who was injured while a passenger in van owned and operated by Defendant PTI,alleged that PTI failed to obtain required limits of uninsured (UM) and underinsured (UIM) coverage. Court should have dismissed Plaintiffs suit because Section 8-101(c ) of Illinois Vehicle Code does not give rise to or imply a private right of action. (HYMAN, concurring; PUCINSKI, specially concurring.)

Insurer, which issued auto liability policy, filed complaint for declaratory judgment against insured's employee, who was driving semitruck and lost control, flipping truck over. Insurer had denied coverage, and driver filed demand for arbitration. Court's finding, after bench trial, that accident was not caused by a 2nd vehicle and that therefore the uninsured coverage under the policy did not apply, was not against manifest weight of evidence.(McDADE and SCHMIDT, concurring.)

Illinois Director of Insurance filed action against 3 insurance companies, seeking to liquidate their assets. Guarantee Association objected on grounds that petition improperly required it to reimburse itself from funds held in a special deposit. The funds held in special deposits are not general assets of the insurance companies' estate.The funds in question are held in a special deposit as security for payment of workers' compensation claims in California, and are, per statutory language, expressly excluded from general assets of the insurance companies' estate. Thus, because these funds were "deposited as security" for special benefit of local policyholders in California, they are not "general assets" of the companies' estate. (CUNNINGHAM and DELORT, concurring.)

(Court opinion corrected 6/5/18.) Former employee sued employer for injuries suffered due to long-term exposure to asbestos. Insurance policies which Plaintiff insurer issued to employer for 1977 to 1985 imposed on employer a duty to notify plaintiff insurer of every occurrence, regardless of whether potential liability exceeded employer's self-insured retention (SIR), and policies established insurer's duty to defend claims that appeared likely to exceed the SIR. Contemporary documents show that insurer and empoyer understood that policies at issue provided primary insurance subject to a SIR. Court properly granted employer's motion for summary judgment and declared that insurer's policies provided primary coverage. (PUCINSKI and MASON, concurring.)