Insurance Law

Dominick’s Finer Foods v. Indiana Insurance Company

Illinois Appellate Court
Civil Court
Insurance
Citation
Case Number: 
2018 IL App (1st) 161864
Decision Date: 
Thursday, March 1, 2018
District: 
1st Dist.
Division/County: 
Cook Co., 4th Div,
Holding: 
Affirmed in part and reversed in part; remanded.
Justice: 
ELLIS

(Court opinion corrected 3/14/18.) Dispute over insurance coverage, after a woman was killed and a man was injured in a shooting in parking lot outside Dominick's on northwest side of Chicago. Dominick's was sued by decedent's estate and tendered its defense for 2 other insurers, and later sought indemnification. Those 2 insurers denied coverage, and Dominick's filed suit for declaration of coverage and damages for insurers' alleged bad-faith conduct. Netherlands Insurance (CGL insurer of shopping plaza where Dominick's was located) owed Dominick's a duty to defend and indemnify under relevant language of policy. Court properly granted summary judgment in favor of Netherlands on bad faith claims, as their position was not unreasonable, and a bona fide dispute over coverage existed. Complaint alleged that Dominick's failed to keep its premises safe for its patrons and invitees. Case law does not require a defect in the premises before a suit can be interpreted as alleging liability arising out of the premises.(BURKE and McBRIDE, concurring.)

Witcher v. State Farm Fire and Casualty Company

Illinois Appellate Court
Civil Court
Insurance
Citation
Case Number: 
2018 IL App (5th) 170001
Decision Date: 
Tuesday, March 6, 2018
District: 
5th Dist.
Division/County: 
Madison Co.
Holding: 
Vacated; reversed and remanded.
Justice: 
CATES

A fire rendered the home of Plaintiffs a total loss, but Plaintiffs and their insurer could not agree on loss valuation. Policy provided for an appraisal process in the event of disagreement as to amount of loss. Insurer failed to notify Plaintiffs of its appraiser, and parties did not select a neutral appraisal umpire. Plaintiffs then filed petition for judicial appointment of appraisal umpire in circuit court, which court granted on same date petition was filed, and without notice of or service upon insurer. Order appointing appraisal umpire is vacated, as insurer was entitled to notice and an opportunity to be heard prior to court ruling on petition. (WELCH and MOORE, concurring.)

Busch v. Country Financial Insurance Company

Illinois Appellate Court
Civil Court
Insurance
Citation
Case Number: 
2018 IL App (5th) 140621
Decision Date: 
Thursday, February 22, 2018
District: 
5th Dist.
Division/County: 
Madison Co.
Holding: 
Reversed and remanded with directions.
Justice: 
MOORE

Plaintiff driver was killed by speeding hit-and-run driver. Antistacking provision in Plaintiff’s policy is not ambiguous. The “other vehicle insurance with us” provision applies where 2 or more vehicles belonging to same insured are covered by policies issued by Plaintiff’s insurer, and “other insurance” provision refers only to a situation where a different policy issued by a different company applies. Thus, court erred in granting summary judgment for Plaintiff.  (CATES, concurring; GOLDENHERSH, dissenting.)

Dragus v. Reliance Standard Life Ins. Co.

Federal 7th Circuit Court
Civil Court
ERISA
Citation
Case Number: 
No. 17-1752
Decision Date: 
February 14, 2018
Federal District: 
N.D. Ill., E. Div.
Holding: 
Affirmed

Dist. Ct. did not err in granting defendant-insurance company’s motion for summary judgment in plaintiff-insured’s ERISA action alleging that defendant wrongfully denied his application for long-term disability benefits based on plaintiff’s claim of severe neck pain. Instant group insurance policy conferred discretionary authority on defendant to determine eligibility for such benefits, such that defendant was entitled to arbitrary and capricious standard of review, even though defendant failed to render timely decision under 29 CFR section 2560.503-1(f)(3). Moreover, plaintiff failed to show that denial of benefits was either arbitrary or capricious, where defendant relied on medical opinions from four independent individuals, who took into consideration plaintiff’s medical records, complaints and medication regiment in finding that plaintiff was not eligible for said benefits and whose compensation did not depend on outcome of their opinions. Fact that plaintiff received fully favorable decision on his application for SSDI benefits did not require different result under instant standard of review.

HR 828

Topic: 
Malpractice insurance

(Demmer, R-Dixon) urges the ARDC to look into further amending Supreme Court Rule 756 to require Illinois attorneys to disclose to prospective and current clients if and when the attorney's malpractice insurance has lapsed. This is a legislative resolution. It has just been introduced. 

Thorne v. Member Select Ins. Co.

Federal 7th Circuit Court
Civil Court
Insurance
Citation
Case Number: 
No. 17-1377
Decision Date: 
February 12, 2018
Federal District: 
N.D. Ind., Hammond Div.
Holding: 
Affirmed

Record contained sufficient evidence to support jury’s $87,000 verdict in favor of plaintiff-insured in action seeking to collect proceeds of fire-insurance policy on plaintiff’s home issued by defendant, even though defendant argued that plaintiff did not reside at said home as required by terms of policy. While plaintiff spent significant amounts of time away from said home, there was sufficient evidence to demonstrate that plaintiff had subjective intent to reside at said home, where: (1) plaintiff owned home, had free access to it, and kept his personal belongings there; and (2) plaintiff did not cook, shower or clean clothes at his home or any other place where plaintiff spent significant time. Also, record supported jury’s assessment of loss at $87,000 by using “broad evidence rule,” where: (1) plaintiff could properly testify to such value without resort to other lay or expert testimony; (2) policy lacked definition for term “actual cash value,” and policy otherwise was ambiguous as to whether there should be deduction for depreciation; and (3) plaintiff obtained $20,000 line of credit at time when there was $67,000 mortgage, and plaintiff further testified that his personal belongings were destroyed in fire.

Newman v. Metropolitan Life Ins. Co.

Federal 7th Circuit Court
Civil Court
Insurance
Citation
Case Number: 
No. 17-1844
Decision Date: 
February 6, 2018
Federal District: 
N.D. Ill., E. Div.
Holding: 
Reversed and remanded

Dist. Ct. erred in dismissing for failure to state cause of action plaintiff’s breach of contract action alleging that defendant-insurance company wrongfully increased her premiums on long-term care policy when she turned 65, after plaintiff had previously signed up for “reduced-pay at 65” option that allowed her to pay half of “amount of your pre-age 65 premiums thereafter.” Plaintiff alleged sufficient allegations to support judgment in her favor, where instant policy was at least ambiguous about whether policy fixed her premium after she turned 65, and where plaintiff could reasonably have understood that purchasing reduced-pay option took her outside of class of policyholders who were at risk of having their premiums increased after their post-age 65 anniversary. Moreover, plaintiff stated viable cause of action under Ill, Consumer Fraud and Deceptive Business Practices Act, where: (1) language in defendant’s long-term care brochure and policy did not necessarily support defendant’s act of linking plaintiff’s post-age-65 premium to premiums paid by its general policyholders; (2) defendant intended for customers to rely on language in its brochure that arguably misled them with respect to defendant’s treatment for post-age-65 premiums under reduced pay option; and (3) plaintiff alleged that defendant engaged in bait and switch strategy when marketing reduced-pay at 65 option.

City of Park Ridge v. Clarendon American Insurance Company

Illinois Appellate Court
Civil Court
Insurance
Citation
Case Number: 
2017 IL App (1st) 170453
Decision Date: 
Wednesday, October 18, 2017
District: 
1st Dist.
Division/County: 
Cook Co., 3d Div.
Holding: 
Reversed and remanded.
Justice: 
LAVIN

(Court opinion corrected 2/5/18.) Insurance dispute arising out of monies paid in survival and wrongful death action filed by mother of 15-year-old boy who died after a drug overdose; mother alleged that City's paramedics failed to provide any treatment to boy, who was unresponsive upon their first arrival at  family home; several hour later, paramedics were again summoned to the home and boy was found unresponsive and blue, later declared dead at hospital.Court erred in granting summary judgment to defendant insurer. "Products-Completed Operations Hazard" provision of policy is specifically included in aggregate coverage, and it relates to construction operations by City, and does not relate to failure of treatment and transport by City's EMTs and paramedics. (COBBS and HOWSE, concurring.)

Cherry v. Elephant Insurance Company

Illinois Appellate Court
Civil Court
Insurance
Citation
Case Number: 
2018 IL App (5th) 170072
Decision Date: 
Wednesday, January 31, 2018
District: 
5th Dist.
Division/County: 
Massac Co.
Holding: 
Reversed.
Justice: 
WELCH

Plaintiffs (driver and passenger) were injured when driver's vehicle was struck by underinsured (UIM)driver. Plaintiffs filed declaratory judgment action, asking court to find that policy provides $300,000 in UIM motorist coverage to both Plaintiffs, as policy allowed aggregation of liability limits of UIM coverage on 4 vehicles. Listing multiple limits on declarations page creates an ambiguity that is not cured by antistacking clause, which prohibits combining of coverages, as opposed to prohibiting the combining of the limits of liability. (CATES and MOORE, concurring.)

Vivify Construction, LLC v. Nautilus Insurance Co.

Illinois Appellate Court
Civil Court
Duty to Defend
Citation
Case Number: 
2018 IL App (1st) 170192
Decision Date: 
Wednesday, January 24, 2018
District: 
1st Dist.
Division/County: 
Cook Co., 3rd Div,
Holding: 
Affirmed.
Justice: 
LAVIN

Court found insurer had no duty to defendant Plaintiff construction company in underlying action filed by employee of its subcontractor, which had procured insurance coverage with insurer on company's behalf. Court found that policy excluded bodily injury to subcontractor's employees. As injured plaintiff in underlying action was employee of subcontractor, the broad employee exclusion applied, negating any duty of insurer to defend subcontractor in underlying action.(FITZGERALD SMITH and HOWSE, concurring.)