Justia Class Action Opinion Summaries

Articles Posted in Insurance Law
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The plaintiff, after her vehicle was declared a total loss in a collision, received a payment from her insurer based on the “actual cash value” of her car, as determined by a third-party valuation system. This system used comparable vehicle listings and, when actual sales prices were unavailable, applied a “Projected Sold Adjustment” to estimate market value. The plaintiff accepted the insurer’s offer, paid her deductible, and did not contest the valuation or invoke the policy’s appraisal process. Despite this, she filed suit alleging breach of contract, claiming the insurer’s use of the adjustment resulted in underpayment, and sought to represent a class of similarly situated South Carolina policyholders.The United States District Court for the District of South Carolina certified a class of individuals who received total loss payments calculated using the Projected Sold Adjustment. The court found that the plaintiff’s claims were typical of the class and that common questions predominated, thus meeting the requirements for class certification under Federal Rule of Civil Procedure 23.On interlocutory appeal, the United States Court of Appeals for the Fourth Circuit reversed the class certification order. The Fourth Circuit held that the plaintiff lacked standing because she did not suffer a concrete injury—she accepted the insurer’s payment, was not out-of-pocket beyond her deductible, and never demonstrated that her vehicle’s value exceeded the amount paid. The court further held that, even if standing existed, class certification was improper because determining whether the insurer breached its obligation to pay actual cash value would require individualized inquiries into each class member’s vehicle and circumstances. Thus, the requirements of commonality and predominance under Rule 23 were not met. The district court’s order certifying the class was therefore reversed. View "Freeman v. Progressive Direct Insurance Company" on Justia Law

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Plaintiffs initiated a class action against National General Insurance Company and Integon National Insurance Company, alleging that the defendants improperly denied their car accident claims and rescinded their automobile insurance policies. The plaintiffs claimed that the defendants retroactively denied insurance claims and rescinded policies based on the plaintiffs' failure to disclose household members. The plaintiffs sought class certification for 1,032 insureds who had their policies rescinded under similar circumstances.The Superior Court of San Bernardino County denied the plaintiffs' motion for class certification, citing the lack of a palpable trial plan for resolving damages. The court noted that the plaintiffs admitted most of the available damages were inherently individualized and expressed concern that the plaintiffs wanted to make the case more manageable by forfeiting certain categories of damages. The court concluded that class treatment would not be a substantial benefit to the litigants.The California Court of Appeal, Fourth Appellate District, Division Three, reviewed the case. The appellate court disagreed with the defendants' contention that common questions of law and fact did not predominate on the issue of liability. The court found that the trial court had relied on improper legal criteria by denying certification based on individualized damages and by not considering the potential benefits of class certification. The appellate court held that individualized proof of damages does not preclude class certification when common issues of liability predominate. The court reversed the order denying class certification and remanded the case, directing the trial court to certify, at minimum, a liability-only class and to consider whether any subclasses are necessary. View "Cobos v. National General Insurance Co." on Justia Law

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Heather Schroeder and Misty Tanner, representing a class of Indiana car owners insured by Progressive Paloverde Insurance Company and Progressive Southeastern Insurance Company, filed a lawsuit claiming that Progressive breached its contractual duty by applying "Projected Sold Adjustments" to the list prices of comparable cars when determining the actual cash value of totaled cars. The insurance policy in question specifies that the actual cash value is determined by the market value, age, and condition of the vehicle at the time of the loss.The United States District Court for the Southern District of Indiana, Indianapolis Division, recognized that whether Progressive paid each class member the actual cash value of their car is not susceptible to classwide proof. However, it concluded that common evidence could establish that Progressive employed an unacceptable method for calculating actual cash value payments by applying Projected Sold Adjustments. The court certified a class on this basis.The United States Court of Appeals for the Seventh Circuit reviewed the case and concluded that Progressive’s policy does not preclude the use of Projected Sold Adjustments in calculating actual cash value payments, as long as the insureds are ultimately paid the actual cash value of their totaled cars as defined under the policy and Indiana law. The court found that individual questions about whether Progressive failed to pay each class member the actual cash value of their car would overwhelm any common ones. Consequently, the Seventh Circuit reversed the district court’s class certification decision and remanded the case for further proceedings. View "Schroeder v. Progressive Paloverde Insurance Co." on Justia Law

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Plaintiffs, limited liability companies, filed class action lawsuits in the United States District Court for the District of Maryland seeking relief under the Medicare Secondary Payer (MSP) provisions. These provisions make Medicare a secondary payer when a beneficiary has other insurance coverage. Plaintiffs obtained assignments from Medicare Advantage Organizations and other secondary payers to seek reimbursement from primary payers like the defendants, Government Employees Insurance Company and its affiliates (GEICO). Plaintiffs had no preexisting interest in the claims and were compensated on a contingency basis.The United States District Court for the District of Maryland denied GEICO's motion to dismiss the case, which argued that the assignments were void as against Maryland public policy based on the doctrines of maintenance, champerty, and barratry. The court found no clear statement of Maryland law on this issue and certified questions to the Supreme Court of Maryland.The Supreme Court of Maryland held that Plaintiffs did not violate Maryland’s barratry statute, which prohibits soliciting another person to sue for personal gain without an existing relationship or interest. Plaintiffs did not solicit secondary payers to file lawsuits but obtained the right to sue in their own names through assignments. The court also held that the common law doctrines of maintenance, champerty, and barratry, to the extent they still apply, do not invalidate Plaintiffs’ assignments. The court concluded that the assignments are not void as against public policy and did not address the enforceability of choice-of-law provisions in the agreements. View "GEICO v. MAO-MSO Recovery II" on Justia Law

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Plaintiffs, representing a class of drivers, alleged that Progressive Specialty Insurance and Progressive Advanced Insurance systematically underestimated the actual cash value (ACV) of their totaled vehicles, thereby breaching their insurance agreements. The plaintiffs claimed that Progressive's method of calculating ACV, which included a "Projected Sold Adjustment" (PSA) to account for the fact that used cars often sell for less than their listed prices, was improper and resulted in underpayment.The United States District Court for the Eastern District of Pennsylvania certified two damages classes, finding that the plaintiffs' claims centered on the legitimacy of the PSAs and that this issue could be resolved on a class-wide basis. The court held that the plaintiffs had standing and rejected Progressive's arguments against commonality, predominance, superiority, and adequacy.The United States Court of Appeals for the Third Circuit reviewed the case and concluded that the District Court had abused its discretion in certifying the classes. The Third Circuit held that proving whether Progressive undercompensated each class member was an individual issue that could not be resolved on a class-wide basis. The court emphasized that the key issue was whether each class member received less than the true ACV of their vehicle, which would require individualized inquiries. As a result, the court found that common issues did not predominate over individual ones, and the District Court's certification of the classes was reversed and remanded for further proceedings. View "Drummond v. Progressive Specialty Insurance Co." on Justia Law

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Towers Watson & Co. (Towers Watson) was insured under a directors and officers (D&O) liability policy by National Union Fire Insurance Company of Pittsburgh, PA (National Union) and had excess coverage from other insurers. Following a merger with Willis Group Holdings plc (Willis), Towers Watson shareholders filed class actions alleging that the merger consideration was inadequate due to a conflict of interest involving Towers Watson’s CEO. The shareholders settled for $90 million, and Towers Watson sought indemnity coverage under the D&O policy. The insurers denied coverage, citing the policy’s “bump-up exclusion,” which excludes coverage for settlements that effectively increase the consideration paid for an acquisition.The United States District Court for the Eastern District of Virginia initially granted summary judgment in favor of Towers Watson, finding that the merger did not involve an acquisition within the meaning of the bump-up exclusion. The insurers appealed, and the United States Court of Appeals for the Fourth Circuit vacated and remanded, clarifying that the merger did involve an acquisition. On remand, the district court held that the bump-up exclusion applied, barring indemnity coverage for the settlement, and granted summary judgment in favor of the insurers.The United States Court of Appeals for the Fourth Circuit reviewed the case and affirmed the district court’s decision. The court held that the settlements represented an effective increase in the consideration paid for the merger, thus triggering the bump-up exclusion. The court also upheld the district court’s application of the common fund doctrine, concluding that the entire settlement amount, including the portion allocated to attorneys’ fees, fell within the exclusion. Consequently, Towers Watson was not entitled to indemnity coverage under the D&O policy. View "Towers Watson & Co. v. National Union Fire Insurance Co." on Justia Law

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In August 2023, a devastating fire in Lahaina, Maui, caused significant damage, destroying over 3,000 structures and resulting in at least 102 fatalities. Numerous lawsuits were filed by individual plaintiffs and class action plaintiffs against various defendants, including Hawaiian Electric Industries and others. Additionally, several insurance carriers filed subrogation actions to recover benefits paid to their insureds for damages caused by the fires. A global settlement agreement was reached among the plaintiffs and defendants, but the settlement required either a release of all subrogation claims by the insurance carriers or a final judgment that the insurers' exclusive remedy would be a lien against the settlement under Hawai‘i Revised Statutes (HRS) § 663-10.The Circuit Court of the Second Circuit reserved three questions for the Hawai‘i Supreme Court. The Supreme Court of the State of Hawai‘i reviewed the case and issued an opinion. The court held that the holding in Yukumoto v. Tawarahara, which limited subrogation remedies for health insurers to reimbursement from their insureds under HRS § 663-10, extends to property and casualty insurance carriers. Therefore, under HRS § 431:13-103(a)(10)(A), the lien provided for under HRS § 663-10(a) is the exclusive remedy for property and casualty insurers to recover claims paid for damages caused by a third-party tortfeasor in the context of a tort settlement.The court also held that a property and casualty insurer’s subrogation right of reimbursement is not prejudiced by its insured’s release of any tortfeasor when the settlement documents and release preserve those same rights under HRS § 663-10. Finally, the court declined to apply the made whole doctrine to the statutory lien-claim process established by HRS §§ 431:13-103(a)(10) and 663-10 under the circumstances of this mass tort case. View "In re: The Petition for the Coordination of Maui Fire Cases. S.Ct. Order" on Justia Law

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Christopher Meek purchased a universal life insurance policy from Kansas City Life Insurance Company, which combined a standard life insurance policy with a savings account. Meek alleged that Kansas City Life improperly included profits and expenses in the cost of insurance, which was not mentioned in the policy, leading to a lower cash value in his account. Meek filed a federal lawsuit for breach of contract and conversion, and the district court certified a class of about 6,000 Kansans with Meek as the lead plaintiff.The United States District Court for the Western District of Missouri found that Meek's lawsuit was timely for payments going back five years under Kansas’s statute of limitations. The court granted partial summary judgment in favor of Meek on the breach-of-contract claim, interpreting the policy against Kansas City Life. The conversion claim was dismissed. A jury awarded over $5 million in damages, which was reduced to $908,075 due to the statute of limitations. Both parties appealed.The United States Court of Appeals for the Eighth Circuit reviewed the case. The court affirmed the district court’s class certification, finding that common questions of law and fact predominated. The court also upheld the application of Kansas law for both the conversion claim and the statute of limitations. The court agreed with the district court’s interpretation of the insurance policy, concluding that the cost of insurance should not include profits and expenses. The court found that the jury’s damages award was supported by reasonable evidence and did not warrant an increase.The Eighth Circuit affirmed the district court’s judgment, including the class certification, the application of Kansas law, the partial summary judgment in favor of Meek, and the damages award. View "Meek v. Kansas City Life Ins. Company" on Justia Law

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Christopher Meek purchased a universal life insurance policy from Kansas City Life Insurance Company, which combined a standard life insurance policy with a savings account. Meek alleged that Kansas City Life improperly included profits and expenses in the cost of insurance, which was not mentioned in the policy, leading to a lower cash value in his account. Meek filed a federal lawsuit for breach of contract and conversion, and the district court certified a class of about 6,000 Kansans with Meek as the lead plaintiff.The United States District Court for the Western District of Missouri found that Meek's lawsuit was timely under Kansas’s five-year statute of limitations for breach-of-contract claims. The court granted partial summary judgment in favor of Meek on the breach-of-contract claim, concluding that the policy's cost-of-insurance provision was ambiguous and should be construed against Kansas City Life. The jury awarded over $5 million in damages, which was reduced to $908,075 under the statute of limitations. Both parties appealed the decision.The United States Court of Appeals for the Eighth Circuit reviewed the case and affirmed the district court's judgment. The appellate court held that the cost-of-insurance provision in the policy did not include profits and expenses, as these were not listed factors. The court also upheld the class certification, finding that common questions of law and fact predominated over individual issues. Additionally, the court agreed with the district court's application of Kansas law for the conversion claim and the statute of limitations for the breach-of-contract claim. The court found that the jury's damages award was supported by sufficient evidence and did not warrant an increase. View "Meek v. Kansas City Life Ins. Company" on Justia Law

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In April 2013, Michael Riste applied for a bail bond for his son, Michael Peterson, and signed an Indemnity Agreement and a Premium Agreement with Bad Boys Bail Bonds (Bail Agent). The agreements required Riste to pay a $10,000 premium in installments. Peterson signed identical documents after his release. The Bail Agent executed a $100,000 bail bond on behalf of The North River Insurance Company (Surety), ensuring Peterson's appearance at future court proceedings. Peterson failed to appear, leading to the forfeiture of the bail bond and a summary judgment against the Surety in October 2015.The Superior Court of Los Angeles County denied appellants' previous motions to set aside the summary judgment, vacate the forfeiture, and exonerate the bond. Two different panels of the Court of Appeal affirmed these denials. In October 2020, a class action cross-claim was filed against BBBB Bonding Corporation (doing business as the Bail Agent), arguing that their bail bond premium financing agreements were subject to Civil Code section 1799.91 and thus unenforceable. The trial court agreed, and the Court of Appeal upheld this finding, affirming a preliminary injunction against BBBB.In September 2022, appellants filed a third motion to set aside the summary judgment, citing the Caldwell decision. They argued that the premium was part of the consideration for the bail bond, making the bond void and the summary judgment invalid. The trial court denied the motion.The California Court of Appeal, Second Appellate District, Division Three, affirmed the trial court's order. The court held that the bail bond was not void because the consideration for the bail bond was Peterson's release from custody, not the premium financing agreement. Therefore, the trial court had jurisdiction, and the summary judgment was valid. View "P. v. North River Ins. Co." on Justia Law