Illinois Allows Subrogating INsurer to Recover Section 155 Fees

Illinois law makes no express provision for awarding attorney’s fees to prevailing parties. However, Section 155 does allow recovery of such fees in cases where the insurer has acted vexatiously or unreasonably. A recent opinion of the Illinois Appellate Court has broadened this remedy to include insurers who pursue equitable contribution claims on behalf of their insureds.
 

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SJC To Consider Bad Faith Claims Against Guaranty Fund

The Supreme Judicial Court is due to hear oral argument on January 4, 2010 in the matter of Wheatley v. Mass. Insurers Insolvency Fund, SJC-10510. At issue is whether the state guarantee fund can be held liable under M.G.L. c. 176D for the sort of unfair claims settlement practices that would ordinarily subject a domestic insurer to liability under M.G.L. c. 93A. Wheatley has appealed from a ruling in the Superior Court that the fund was not "in the business of insurance" and was therefore outside the purview of Chapter 176D. The claim in question arises out of serious personal injuries that a special needs student suffered on October 26, 2001 while attending a public elementary school in the Town of Duxbury. At the time, the Town was insured by Legion Insurance, which was put into insolvency the Pennsylvania Insurance Commissioner in July 2003. As a result, when Wheatley made a claim against the Town in August 2003, responsibility for the investigation and disposition of her liability claim was undertaken by the Massachusetts Insurers Insolvency Fund. Wheatley alleges that the Fund never responded to her various demands, including a demand presented pursuant to M.G.L. c. 93A, ยง 9 and that it had a legal responsibility to do so as Wheatley contends that the liability of the Town of Duxbury was reasonably clear. Her bad faith claims against the MIIF were dismissed in 2008 in light of earlier rulings such as Barrett v. MIIF, 412 Mass. 774 (1992) and Poznik v. Mass. Medical Professional Ins. Assn., 417 Mass. 48 (1994) in which Massachusetts courts had declared that only conventional insurers were meant to fall within the jurisdiction of Chapter 176D. On appeal to the Supreme Judicial Court, Wheatley has argued that 1996 amendments to Chapter 176D, which amended the definition of "person" to include the MIIF and certain joint underwriting associations, evidence an intent on the part of the legislature to treat the Guaranty Fund and JUAs as being in the "business of insurance" for purposes of Chapter 176D. Wheatley further argued that the timing of these legislative amendments clearly indicated an intent on the part of the legislature to reverse the Supreme Judicial Court's holdings in Barrett and Poznik. In light of subsequent cases in which courts have ruled that JUAs may be held liable for unfair claims practice prohibited by Chapter 176D, Wheatley argues that the same should be true as regards the MIIF. In response, the MIIF has argued that the legislature plainly never intended to subject it to the same range of liabilities as actual insurance companies and that the Supreme Judicial Court has itself made clear that it views the MIIF as the "insurer of last resort." The MIIF emphasized in its brief that it has limited financial resources and is dependent on assessments from admitted carriers that are, in turn, passed along to policyholders. As a result, it argues that such a radical expansion of its potential liabilities should not be implied and should only result from a direct action of the legislature. A ruling should be received from the SJC by May or June of 2010. Note that the issue in Wheatley is whether the MIIF can be held liable for its own claimed misconduct in handling claims of a policyholder. It is far less likely that the SJC would impose liability if the issue was whether 176D liability could be imposed based on the claimed misconduct of an insurer prior to being declared insolvency.

Georgia Supreme Court Clarifies Bad Faith "Safe Harbor"

One of the more nagging problems in bad faith litigation is failure to settle cases in which more than one insurance company is involved. In such circumstances, where the insurer does not have full control as to whether the case can settle or not, may a liability insurer be liable for bad faith where the failure of the settlement owes to the intransigence of an excess insurer or other parties.  It was with some relief, therefore, that we received a ruling from the Georgia Supreme Court earlier this decade that created a "safe harbor" for primary insurers that had done everything in their power to effect a settlement within the overall limits.  Last month, however, the Georgia Supreme Court took a disturbingly narrow view of its earlier ruling in Brightman and declared that any sort of condition imposed by the insurer in offering its limits vitiates this protection.
 

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California Court: Insurer Objectively Reasonable in Reversing Course on Coverage Where No Clear Precedent and Insured Not Damaged

California appellate court opinions on insurance coverage matters are very often lengthy, but rarely entertaining.  Here is a long but well-written one that it is not only intellectually well-done, but humorous in the delivery. And, the result was for the insurer.

In Griffin Dewatering Corp. v. Northern Ins. Co. of N.Y. (2009) 176 Cal.App.4th 172 (2009 WL 2344762), the California Court of Appeal, Fourth Appellate District, reversed the trial court’s $10 million judgment of attorneys fees and punitive damages against the insurer. The court concluded the insurer breached its duty to defend; however, the insurer acted reasonably in, after denying any duty, defending and paying the claim, all while the law was in flux as to application of the policy’s “Total Pollution Exclusion.”  The court found the insurer’s conduct was objectively reasonable under the circumstances. The decision demonstrates an insurer can reconsider and, in doing so, avoid being found in bad faith. 

Procedurally the case is also interesting, not only in its convoluted and extensive history, but in that the Court in denying a petition for rehearing issued a supplemental (unpublished) opinion directly addressing the additional “facts” and arguments raised by the insured. See 2009 WL 2659463. There is much that could be discussed about the case, but only a short synopsis is provided here.

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Ratio Wars Continue on Punitive Damages

It appears that Chief Justice Roberts recent sabre rattling about punitive damage awards is having some impact.

In the years since the court’s seminal decision in State Farm v. Campbell, which had suggested in dicta that punitive damage awards should generally not exceed the amount of compensatory damages in most cases, only the Eighth Circuit has consistently applied a 1:1 ratio. By contrast, most state and federal appellate courts ignored this language as dicta and have generally sustained punitive damage awards so long as they are less than ten times the size of the compensatory award.

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The Increasing Trend to "Set Up" Carriers (and the Inability (or Unwillingness) of Courts to Do Much About It)

Efforts by policyholder lawyers to "set up" a carrier to make a decision which will enable the lawyer to prosecute a bad faith claim are nothing new.   The trend, however, seems to be increasing across the country as some policyholder lawyers resort to such tactics with more frequency than in prior years.  Frustration among the insurance industry has also been growing as courts across the country fail to recognize a "set up" for what it is and, instead, find the facts giving rise to the set up simply create a "fact issue" that must be resolved by a jury at trial instead of by summary judgment.  A federal court judge in Texas recently decided a bad faith summary judgment issue against a carrier who was "set up" illustrating how easily the "set up" can occur and the limits on a trial court to do much about it once the bad faith suit is filed.

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Hurricane Ike Insurance Litigation: Will It Be As Bad As Katrina?

It didn’t take long for the first bad faith suits arising from Hurricane Ike to be filed in Texas.  Last week, the first two Ike bad faith lawsuits that I am aware of were filed in Galveston and Ft. Bend Counties. In Fort Bend County, a breach of contract suit was filed last week titled Gatesco Inc. v. Steadfast Insurance Company in which plaintiffs claim the insurer failed to pay policy benefits after its property sustained damages during Ike. On November 7th, an Ike bad faith lawsuit was filed in Galveston County titled Williamson v. Brown & Brown Insurance Services of Texas and Chubb Lloyds Insurance Company of Texas for alleged failures to pay Ike-related damages.  These are first of several thousand Ike lawsuits expected to be filed across Southeast Texas over the next several years. There doesn’t appear to be anything uniquely significant about them other than their apparently quick filing so soon after the storm.  The big question being asked by carriers across the country is whether Hurricane Ike will generate the type and volume of litigation generated by Hurricane Katrina. 

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PIP Insurer Required to Defend Process for Denying Claims

Oregon courts have consistently held that an insurance company may only be liable for tortuous bad faith in situations where it is defending its insured.  In Ivanov v. Farmers Insurance Company of Oregon, the Oregon Supreme Court addressed an insurer’s obligations under personal injury protection (PIP) coverage.  The decision itself addresses an insurer’s obligation to pay medical payments under Oregon’s PIP coverage statutes.  Ivanov sought certification of a class and summary judgment regarding denial of PIP benefits “solely on the basis of generalized criteria not specific to claimants’ injuries” and that PIP benefits may not be denied “unless [the] determination is based on a contemporaneous physical examination of the insured by a physician selected by Farmers.”  The trial court granted summary judgment in favor of Farmers on Farmers’ corresponding motion for summary judgment on the ground that the PIP statute does not require an IME prior to denial of the claim and that the insured bears the burden of proving that medical expenses were reasonable and necessary.  The Court of Appeals affirmed the trial court decision, but held that plaintiff had failed to produce evidence from which a trier of fact could infer that the claimed expenses were necessary.
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Minnesota Senate Trims Back Proposed Bad Faith Legislation

The Minnesota Senate has approved bad faith legislation albeit only after significant insurance industry lobbying ameliorated some of the more onerous provisions of the original proposal.

As originally drafted, SF 2822, an insurer would be deemed to be acting in good faith unless the policyholder could prove the absence of a reasonable basis for denying benefits and that the insurer knew of the lack of a reasonable basis or acted in reckless disregard of the lack of a reasonable basis. A claimant must give written notice 60 days before bringing any such action during which time an insurer may avoid liability by acting to cure the violation.

The revised bill expands the definition of what constitutes good faith, caps the amount of economic damages and attorney’s fees that a prevailing insured may recover, and expressly limits the scope of the legislation to first party insurance (which is defined as precluding claims under liability insurance policies).  The amended version caps attorneys fees at $40,000 while providing consumers up to $100,000 if insurers are found to have acted in “bad faith.”

 

More on the Oregon Supreme Court's Opinion in Goddard

As reported earlier by Mike Aylward below, the Oregon Supreme Court ruled on Thursday that the maximum constitutionally acceptable punitive damages award is four times the amount of compensatory damages. The case, Goddard v. Farmers Insurance Co. of Oregon, concerns Farmers’ claims handling with respect to a car accident that occurred in 1987and the resultant wrongful death action filed against Farmers’ insured. Farmers undertook the insured’s defense but failed to settle Goddard’s wrongful death action within policy limits, after which a jury returned a verdict that resulted in a judgment against the insured for $863,274. The insured, who asserted that Farmers’ failure to settle was an act of bad faith, assigned his bad faith claim to Goddard who prosecuted the action and obtained an $863,274 compensatory damages award at trial along with an award of $20,718,576 in punitive damages. The Court of Appeals reduced the punitive damages award finding that the punitive damages award was grossly excessive and therefore unconstitutional under the Due Process Clause. As Mike outlines below, the Oregon Supreme Court affirmed the Court of Appeals finding that a ratio of 4:1 was constitutionally acceptable.





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Oregon Supreme Court Revisits Constitutionality of Punitive Damage Bad Faith Award

Only weeks after its opinion in Williams v. Philip Morris upholding a punitive damage award that was nearly 100 times the amount of punitive damages (and largely ignoring the U.S. Supreme Court's directions through its application of state law to jury instructions),  the Oregon Supreme Court issued a new opinion discussing the constitutionallity of punitive damages yesterday in the context of a bad faith claim against an insurer.

 

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New York Approves Extra-Contractual Damages for First-Party Bad Faith

In a 5-2 decision, New York’s high court holds that consequential damages resulting from delay in payment of business interruption losses are recoverable in an action for breach of a commercial property policy. In Bi-Economy Market, Inc. v. Harleysville Ins. Co. of New York (N.Y. Feb. 19, 2008), the court found that claims for consequential damages, including the demise of the insured’s business, were reasonably foreseeable and contemplated by the parties, and could not be dismissed on summary judgment. Resolving conflicting decisions among New York's appellate courts, the court opens the door to extra-contractual claims in the first-party context. Continue Reading...

Texas Supreme Court Reverses Itself on Contractual Indemnity Coverage

Last Friday, the Texas Supreme Court withdrew its 2006 opinion in Evanston Ins. Co. v. Atofina Petrochemicals, Inc., 2006 WL 1195330 (Tex. May 5, 2006) (where the high court found the additional insured provisions of the liability policy were not broad enough to indemnify the third-party's own acts of negligence, but it failed to decide whether the scope of this coverage is limited in any way by the separate indemnity agreement between the third-party and the policy's named insured). Last Friday, the Texas Supreme Court reversed itself and closely examined the interplay between a contractual indemnity agreement and the scope of coverage afforded to additional insureds. In Evanston Ins. Co. v. Atofina Petrochemicals, Inc., 2008 WL 400394 (Tex. February 15, 2008), the court specifically addressed three specific issues: 1) “whether a commercial umbrella insurance policy that was purchased to secure the insured's indemnity obligation in a service contract with a third party also provides direct liability coverage for the third party;” 2) “whether the insurer is bound to pay the amount of an underlying settlement between the additional insured;” and  3) “whether article 21.55 (now Chapter 542) of the Texas Insurance Code, the “Prompt Payment of Claims” statute, authorized the imposition of penalties and attorney's fees for the insurer's failure to pay the claim timely.”

Addressing the first issue involving the breadth of additional insured coverage, the court focused on the policy language defining who is an insured, the provision discussing the named insured’s duty to indemnify the additional insured, and a separate provision defining an insured to include “A person or organization for whom you have agreed to provide insurance as is afforded by this policy; but that person or organization is an insured only with respect to operations performed by you or on your behalf, or facilities owned or used by you.” The court reasoned that each “who-is-an-insured” clause served to grant coverage independently and, therefore, it held the policy provided the broader scope of coverage and did not exclude liabilities arising out of the additional insured’s sole negligence.  

Addressing the second issue of “whether the insurer was bound to pay the amount of an underlying settlement between the additional insured,” the court revisited related decisions and held the insurer’s “denial of coverage barred it from challenging the reasonableness” of the settlement and the insurer was thus bound to pay the $5.75 million settlement. Addressing the third issue of whether article 21.55 of the Texas Insurance Code applied in this context, however, the court observed the claim in this case was a third-party claim involving the insured’s liability to another and not a first-party claim falling within the statute. Accordingly, the court held that the additional insured was not entitled to attorney fees or damages under article 21.55.

The high court’s treatment of the 21.55 penalty provision is interesting in light of the court’s ruling last month in Lamar Homes where it addressed the same statute in a liability claim involving the duty to defend.   Last Friday’s decision in Atofina Petrochemicals properly ruled the penalty provision does not apply to indemnity benefits under a liability policy.   It still leaves claims for previously tendered defense benefits subject to the 18% statutory penalty pursuant to last month’s decision in Lamar Homes, despite the obvious inconsistency between the two decisions.  A majority of the Texas Supreme Court apparently doesn’t have any problems with applying the 18% statutory penalty to defense benefits under a liability policy when coverage is later determined to exist, but it does have problems applying the same penalty provision to the same claim under the same policy as it relates to indemnity benefits. Friday’s decision in Atofina Petrochemicals is simply a good illustration of why the 21.55 holding in Lamar Homes last month was terribly wrong.  

New Michigan Proposal Would Permit Treble Damage Awards

Although insurers have fared relatively well in recent years in contesting law suits alleging  bad faith, they have recently lost ground in state legislatures.  In addition to the new administrative regime for adjusting bad faith claims in Maryland and the Oregon referendum reported on earlier this week by Diane Polscer, legislation has now been proposed in Michigan that would permit policyholders to recover treble damages if an insurer unreasonably denied a claim to sue for damages (including costs).   Senate Bill 866, which was introduced on November 1 and referred to the Committee on Economic Development and Regulatory Reform, would require insureds to give 20 days notice before such claims could be made.

While the fate of SB 866 is unclear, a proposal of this sort would have a dramatic impact on Michigan law.  Michigan is among the few states that do not recognize claims for breach of an impllied covenant of good faith and fair dealing against insurers.   As a result, bad faith damages are, for the most part, limited to penalty interest.

SB 866 also highlights the growing trend of plaintiffs and policyholder to obtain remedies and rights through the legislative process that they've heretofore been unable to secure in court.

 

Washington State Voters Approve the Insurance Fair Conduct Act

The Seattle Times is reporting this morning that Referendum 67 was approved by voters by a margin of 57% to 43% in Tuesday’s election. As we have previously reported, the Referendum allows the unprecedented remedy of uncapped treble damages awarded at the discretion of the trial court for “unreasonable” denials of claims for coverage or payment of benefits, or violations of the Washington Administrative Code regulations concerning improper claims handling. The National Association of Mutual Insurance Companies issued a statement this morning indicating that passage of the Referendum will likely lead to increased rates for Washington consumers and that the organization will work with lawmakers to repeal the IFCA during the next legislative session.


A Cautionary Tale of Bad Faith for Coverage Counsel

The Washington Supreme Court released its opinion this week in Mutual of Enumclaw Ins. Co. v. Dan Paulson Const. Inc., No. 79027-2, 2007 Wash. LEXIS 788 (Wa. Oct. 11, 2007), finding that an insurer acted in bad faith by subpoenaing an arbitrator in an underlying case involving its insured for his mental impressions of the underlying arbitration and sending two letters to the arbitrator setting forth its coverage position with regard to the underlying case. The court further found that the insurer, Mutual of Enumclaw (“MOE”) failed to rebut the resulting presumption of harm to its insured. 

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