Justia U.S. 11th Circuit Court of Appeals Opinion Summaries

Articles Posted in Insurance Law
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In the United States Court of Appeals for the Eleventh Circuit, the Court reviewed a case involving the estates of two patients who passed away after undergoing liposuction procedures at CJL Healthcare, LLC in Georgia. After the patients' deaths, their estates filed lawsuits against the clinic and its doctor. The clinic's insurer, Prime Insurance Co., defended the clinic under a reservation of rights but ultimately withdrew its defense after the costs of defending the lawsuits exhausted the insurance coverage.The estates of the patients and the clinic then filed a lawsuit against the insurers, Prime Insurance Co., Prime Holdings Insurance Services, and Evolution Insurance Brokers, claiming they had breached their duties, contract, and acted negligently. They also claimed the insurers had unlawfully sold surplus lines insurance. The district court dismissed the case, and the plaintiffs appealed.The Court of Appeals affirmed the district court's decision. The Court held that the policy unambiguously provided a $50,000 limit for a single professional liability claim and a $100,000 aggregate limit for all claims. The Court further held that the insurers' duty to defend the clinic ended when the policy limits were exhausted by payment of damages and claim expenses. The Court also affirmed the district court's finding that the Georgia Surplus Lines Insurance Act did not provide a private cause of action for the unauthorized sale of surplus lines insurance. View "Jumlist v. Prime Insurance Co." on Justia Law

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The United States Court of Appeals for the Eleventh Circuit ruled in a dispute between Travelers Property Casualty Company of America and Talcon Group LLC. Talcon, an underground utility contractor, had an insurance policy with Travelers. Two residential homes under construction and connected to Talcon were destroyed by fire. Talcon filed a claim with Travelers, which was denied on the grounds that the policy only covered their underground utility operations and related site development work, not home construction. Talcon argued that the policy was ambiguous and should cover the homes as they were newly constructed during the policy period. The Court of Appeals, affirming the district court's summary judgment in favor of Travelers, held that the policy unambiguously did not cover the construction of the two homes. The court noted that when viewed together with Talcon's insurance application, the policy clearly restricts coverage to Talcon's underground utility and site development work. The court also stated that the policy's exclusion of pre-existing buildings did not imply coverage for all new construction, only buildings related to Talcon's specified operations. View "Travelers Property Casualty Company of America v. Talcon Group LLC" on Justia Law

Posted in: Insurance Law
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The Eleventh Circuit certified the following two questions to the Florida Supreme Court:(1) does Fla. Stat. § 559.921(1) grant an insurance company a cause of action when a repair shop does not provide any written repair estimate?(2) Do the violations here under the repair act void a repair invoice for completed windshield repairs and preclude a repair shop from being paid any of its invoiced amounts by an insurance company? View "Government Employees Insurance Company, et al v. Glassco, Inc., et al" on Justia Law

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These appeals are about a pending insurance contract dispute between Positano Place at Naples I Condominium Association, Inc., and Empire Indemnity Insurance Company, which issued an insurance policy (the “Policy”) to Positano for coverage of five buildings that Positano owns in Naples, Florida. Following Hurricane Irma, Positano filed a first-party claim for property insurance benefits under the Policy, claiming that Hurricane Irma damaged its property and that the damage was covered by the Policy. Empire determined that there was coverage to only three of the five buildings covered by the Policy but disagreed as to the amount of the loss. Positano sought to invoke appraisal based on the Policy’s appraisal provision. Positano sued Empire in Florida state court, and Empire removed the case to federal court based on diversity jurisdiction. Positano moved to compel appraisal and to stay the case pending the resolution of the appraisal proceedings, which Empire opposed. The magistrate judge issued a report recommending that the district court grant Positano’s motion, and, over Empire’s objection, the district court ordered the parties to appraisal and stayed the proceedings pending appraisal. Empire timely appealed the district court’s order.   The Eleventh Circuit dismissed the appeal. The court concluded that the district court’s order compelling appraisal and staying the proceedings pending appraisal is an interlocutory order that is not immediately appealable under 28 U.S.C. Section 1292(a)(1). The court concluded that the order compelling appraisal and staying the action pending appraisal is not immediately appealable under the Federal Arbitration Act (“FAA”). View "Positano Place at Naples I Condominium Association, Inc. v. Empire Indemnity Insurance Company" on Justia Law

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After Plaintiff sustained serious injuries from a hot-soup spill at Noodle College Park, an Atlanta-area restaurant, she and her spouse sued Shou & Shou, Inc., which owned and operated the restaurant. Shou & Shou tendered the defense to and sought coverage from AmGuard Insurance Company. But AmGuard denied coverage on the ground that the policy named “Noodle, Inc.”—an entity that did not exist—as insured. Shou & Shou settled the suit and assigned the Lowerys its rights under the policy. Plaintiffs, as assignees, then sued AmGuard for equitable reformation of the policy. The district court granted partial summary judgment in favor of Plaintiffs and later entered a final judgment.   The Eleventh Circuit affirmed, holding that reformation of the policy was proper under Georgia law. The court explained that the district court correctly equitably reformed the 2016–17 policy to insure the true owner of the restaurant. The court explained that AmGuard insists that it could not have shared Shou & Shou’s mistake because it did not know the “identity” of the intended insured and could not have intended to “name” Shou & Shou as an insured. But Georgia law does not demand that degree of specificity in defining a mutual mistake. Further, the court held that Plaintiffs claim of breach of contract merges with reformation of the policy. View "Hee Lowery, et al v. AmGuard Insurance Company" on Justia Law

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CSX Transportation, Inc. is a freight railroad company. General Mills, Inc. operates a cereal processing plant in Georgia near one of CSX’s rail lines. A small connecting railroad connects CSX’s main rail line to General Mills’s plant. A contract between CSX and General Mills governs the use of the sidetrack.A General Mills employee suffered severe injuries while working on the sidetrack and then sued CSX for negligence. A jury found CSX liable, and CSX sought indemnification from General Mills, citing a contractual provision providing General Mills was required to indemnify CSX—regardless of whether CSX alone was responsible. The district court dismissed one of CSX’s breach-of-contract claims and granted General Mills summary judgment on the other.The Eleventh Circuit found that, under the parties’ agreement, General Mills was not required to indemnify CSX if CSX was solely negligent. However, the court disagreed with the district court that Georgia's vouchment doctrine barred CSX from litigating the issue of General Mills’s negligence. Thus, the Eleventh Circuit remanded for the district court to determine if General Mills was at least partially at fault for the injury. If so, then General Mills must indemnify CSX for at least a portion of the settlement and related expenses. View "CSX Transportation, Inc. v. General Mills, Inc." on Justia Law

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Continental Casualty Company and Valley Forge Insurance Company (collectively, “the insurers”) and Winder Laboratories, LLC and Steven Pressman (collectively, “the insureds”) appeal and cross-appeal from the district court’s judgment in this insurance coverage dispute. In short, the parties’ insurance agreements required the insurers to defend the insureds against certain third party lawsuits. After being sued by non-party Concordia Pharmaceuticals Inc., S.A.R.L. (“Concordia”), the insureds sought coverage under the policies. The insurers agreed to defend the insureds against Concordia, subject to a reservation of rights, including the right to seek reimbursement of defense costs incurred for claims not covered by the policies. The insurance agreements themselves, however, did not provide for reimbursement.   The Eleventh Circuit affirmed. First, the court agreed that the insurers did not have a duty to defend the insureds in the underlying action. To supplement this analysis, the court held that the duty to defend was extinguished when the district court’s ruling was issued. Second, the court agreed that the insurers do not have a right to reimbursement because the reservation of rights letters did not create a new contract, the insurers’ unjust enrichment argument is untenable, and the court wrote that it does not believe the Supreme Court of Georgia would upend the State’s insurance law framework by establishing a right to reimbursement for an insurer who has no contractual right to recoupment. View "Continental Casualty Company, et al v. Winder Laboratories, LLC, et al" on Justia Law

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This appeal arose out of an insurance dispute between Plaintiff and Safeco Insurance Company of Illinois. After an accident in which her vehicle suffered substantial damage, Plaintiff made a claim under her Safeco-issued insurance policy for the damage. Safeco declared her vehicle a total loss and paid her what it deemed to be the actual cash value of her vehicle. The district court granted summary judgment to Safeco.   The Eleventh Circuit affirmed. The court explained that as proof that a policyholder is reasonably likely to need to incur dealer fees, Plaintiff pointed to the facts that (1) she incurred dealer fees in purchasing both the Lexus that was totaled and her Subaru replacement vehicle, (2) approximately 50-70% of Safeco policyholders are likely to purchase a vehicle from a dealer, and (3) approximately 85-95% of dealerships charge dealer fees. These facts, viewed in the light most favorable to Plaintiff, do not give rise to a genuine dispute of material fact. Plaintiff’s three data points show a reasonable likelihood that a policyholder will incur dealer fees if she chooses to purchase her replacement vehicle from a dealer. And they show that a policyholder is reasonably likely to purchase a replacement vehicle from a dealer. But they do not show that a policyholder is reasonably likely to need to purchase a replacement vehicle from a dealer. Plaintiff has failed as a matter of law to satisfy the Mills standard; therefore, the district court correctly awarded Safeco summary judgment on this issue. View "Gina Signor v. Safeco Insurance Company of Illinois" on Justia Law

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The case arose following an insurance dispute between Travelers Property Casualty Company of America (“Travelers”) and Ocean Reef Charters LLC (“Ocean Reef”), a Florida Limited Liability Company. On cross-motions for summary judgment, the district court granted summary judgment for Travelers, agreeing with it that federal law applied and that Ocean Reef, therefore, forfeited its insurance coverage. On appeal, the Eleventh Circuit reversed, holding that under Wilburn Boat Co. v. Fireman’s Fund Insurance Co., Florida law applied. At issue is whether, under Florida’s anti-technical statute, the insurance company must prove that the breach of the Captain Warranty “contribute[d] to” the specific accident. Further, in meeting its burden of proof under Florida law, Travelers needed to introduce expert testimony in its case-in-chief about what would have been different if Ocean Reef had complied with the applicable warranties.   The Eleventh Circuit affirmed on remand. The court held Travelers offered no expert witness— such as a licensed captain competent to speak to the issue—to prove that the lack of a full-time captain and crew played a role in the destruction of the yacht during Irma. The court explained that the Captain—whom Travelers did not disclose as an expert witness—could not provide his opinion on what would have happened to the My Lady if a licensed, professional captain were employed full-time. He could discuss the weather forecasts he observed. But those facts would leave the jury to speculate about what a captain would have done differently to avoid the storm under the specific circumstances of this case. View "Travelers Property Casualty Company of America v. Ocean Reef Charters LLC" on Justia Law

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E.G. fell from a roof and became paralyzed from the waist down, never to walk again. Within months, his medical bills climbed past $400,000, and future costs projected into the millions. Three insurance companies potentially provided coverage for the man. This appeal is a battle between the two of them. The primary insurer for E.G.’s company was Southern-Owners Insurance Company. E.G. was performing subcontracting work for Beck Construction, which had a policy with American Builders Insurance Company and an excess policy with Evanston Insurance Company. Southern-Owners refused to pay any amount to settle the claim, and American Builders and Evanston ponied up a million dollars apiece instead. American Builders then sued Southern-Owners for common law bad faith under Florida’s doctrine of equitable subrogation. Southern-Owners moved for summary judgment, but the district court denied the motion. A federal trial jury heard the case and found in favor of American Builders.  Southern-Owners sought judgment as a matter of law or, in the alternative, a new trial. The district court denied those motions, too. On appeal, Southern-Owners challenges the denials of its summary judgment and post-trial motions.   The Eleventh Circuit affirmed. The court held that the evidence is not “so overwhelmingly in favor of [Southern-Owners] that a reasonable jury could not” have ruled for American Builders on bad faith and against Southern-Owners on breach of contract. Further, the court held that the jury’s verdict was not against the clear weight of the evidence, and the district court did not abuse its discretion in denying Southern-Owners’ Rule 59 motion. View "American Builders Insurance Company v. Southern-Owners Insurance Company" on Justia Law