Case Law » Civil Law
Insurance Law
Parsons v. State Farm Mutual Automobile Insurance Company, Del. Super. C.A. No. 09C-01-029 JTV, December 30, 2011.
Upon considering the parties’ cross-motions for summary judgment, the Court denied plaintiff’s motion and granted defendant’s. The issue was whether a policy of insurance for PIP benefits, created though the Delaware Assigned Risk, contained a valid PIP deductible. The Court found the defendant was not required comply with 10 Del. C. §2118(a)(2)(f), in demonstrating the existence of a valid PIP deductible. The Court extended Berg v. American Casualty Co., 597 A.2d 4 (Del. 1991), which dealt with UM/UIM benefits, to include policies issued for PIP benefits. In Berg, the court found no duty on the insurer to offer UM/UIM coverage in an amount equal to the insured’s liability coverage, where the insured applied under the Assigned Risk Plan. Specifically, the court distinguished the circumstance presented when a policy is issued pursuant to an Assigned Risk Plan because there is no contact between the insurer and the insured, prior to the issuance of the insurance policy. This is unlike the traditional circumstances under which insurance policies are issued, involving direct contact between an insurer and insured. In this case, the Court found persuasive the reasoning in Berg, emphasizing the very different insured-insurer relationship presented in the context of an Assigned Risk Plan.
McAlley v. Selective Ins. Co. of America, 2011 WL 601662 (Del. Super.)
This case arises from an underlying complaint naming plaintiff as a defendant, alleging that plaintiff, in her official capacity as a teacher, sexually abused a minor student. This declaratory judgment sought a defense to the underlying complaint under a policy of liability insurance issued to the school district, plaintiff's employer. Plaintiff argued that coverage was triggered because she was an agent of the school district acting in the course of her employment at all relevant times. Defendant denied coverage on the basis that none of the allegations against plaintiff in the underlying complaint constituted an “occurrence” under the insurance policy, triggering coverage. The policy defined an “occurrence” as an accident. In granting defendant's motion for summary judgment, the court declined to accept that the count of negligence contained in the underlying complaint triggered coverage, finding that rape was intentional conduct. Therefore, the underlying complaint could not manufacture an “accident” in order to implicate coverage where the facts alleged did not support such a claim.
Purnell-Charleston v. State Farm Fire and Casualty Co., 2011 WL 3812564 (Del. Super.)
After a bench trial, the Court held that defendant State Farm met its burden to show that it had made a "meaningful offer" of UM/UIM insurance coverage to plaintiff. Plaintiff alleged that no meaningful offer had been made by State Farm, and therefore, sought reformation of her insurance policy to reflect UM/UIM coverage equal to her bodily injury liability limits. The Court found that neither the plaintiff, nor the State Farm representative who issued the policy to plaintiff, had a clear memory of the discussion during which the various coverage options were reviewed with plaintiff. However, the Court found that, more likely than not, State Farm made a meaningful offer based upon the language contained in State Farm's Form A and the State Farm representative's testimony it was his standard practice to review with automobile insurance customers all available coverages, including UM/UIM coverage. For this reason, the Court did not reform the UM/UIM coverage contained in plaintiff's insurance policy.
Irene Sivakoff v. Nationwide Mut. Ins. Co. 2011 WL 1877610 (Del. Supr.)
Irene Sivakoff appealed the Superior Court's grant of Nationwide's motion to dismiss. The appeal arose from a motor vehicle accident caused by Jessica F. Talley, from which Sivakoff alleged serious injury. The vehicle being operated by Talley at the time of the accident was insured by Traveler's Indemnity Company of America (Travelers). Travelers offered the full liability limits of its policy, $15,000, to settle Sivakoff's claims. Sivakoff executed a "Release in Full" in settlement of her claims against Talley in exchange for the $15,000 Travelers policy limits. Sivakoff thereafter discovered that Talley was also insured under a policy of insurance issued to her mother, because Talley resided at her mother's home. Sivakoff filed a complaint against Talley, which was dismissed based upon Sivakoff's execution of the release. Sivakoff also proceeded against her own insurance company, Nationwide, for underinsured motorist coverage. The Delaware Supreme Court affirmed the grant of Nationwide's motion to dismiss, holding that Sivakoff was not entitled to seek UIM coverage because she had failed to "exhaust all bodily injury bonds and insurance policies available" to her, as required by 18 Del. C. § 3902(b)(3).
National Union Fire Ins. Co. of Pittsburg v. Fisher, 692 A.2d 892 (Del. Supr. 1997)
Police officer sued insurer that had issued business automobile insurance policy covering his patrol vehicle, seeking uninsured/underinsured motorist (UM/UIM) and personal injury protection (PIP) coverage for injuries that occurred when he exited his patrol vehicle to investigate suspicious vehicle in parking lot and was struck by that vehicle. In the context of triggering entitlement to UM/UIM and/or PIP coverage, the insurance policy defined the term "occupying" to mean "in, upon, getting in, on, out or off." In determining whether the police officer was an "occupant" of the vehicle, thus triggering UM/UIM or PIP coverage, the Court utilized the following test "a person is considered an occupant of the covered vehicle is he or she is either: a) within a reasonable geographic perimeter of the vehicle or 2) engaged in a task related to the operation of the vehicle." The Court held that to meet the "within a reasonable geographic perimeter" prong of the test the claimant must be "in, entering, exiting, touching or within reach of the covered vehicle." The Court found that this prong was not met because the police officer was between 10 to 25 feet from his patrol vehicle when the accident occurred. Further, the Court found that the police officer was not "engaged in a task related to the operation of the vehicle," at the time of the accident, because he was not "using his patrol car for communication, for apprehension, detention or transportation of suspects, for protection from small arms fire, or for chasing the suspicious vehicle." In summary, the Delaware Supreme Court held that police officer was not "occupant" of patrol vehicle when collision occurred, and thus he was not entitled to UM/UIM or PIP coverage under policy at issue.
Campbell v. State Farm Mutual Automobile Insurance Company 2011 WL 143238 (Del. Supr.).
This case involved Plaintiff's claim of entitlement to Personal Injury Protection (PIP) benefits for injuries suffered as a result of being hit in the shoulder by a closing garage door. The record reflected that the garage door was caused to be closed by pressing a button on a device located inside the insured vehicle. The Supreme Court affirmed the Superior Court's grant of summary judgment to Defendant/Appellee State Farm, finding that Plaintiff's bodily injury did not arise out of the ownership, maintenance or use of the vehicle, nor did Plaintiff qualify as a pedestrian under Delaware's PIP statute. In affirming, the Supreme Court reasoned that Plaintiff's injuries were not caused by the insured vehicle, as the injury could have occurred just as easily without the vehicle's involvement. Further, the Court held Plaintiff was not a pedestrian, as defined under 10 Del. C. § 2118(a)(2)e, as she was not "injured by an accident with any motor vehicle."
State Farm Mutual Auto Ins. Co. v. O'Neal, 2008 WL 4194006 (Del.Super.).
This case arose from a motor vehicle accident resulting in the death of driver of an employer's van. The employee was found to be under the influence of cocaine and alcohol when driving on Interstate 495. The employee was killed when she exited and walked behind the van which rolled backwards and hit her. At issue was whether the employee's use of the van at the time of the accident in a highly intoxicated state constituted a "major deviation" from the permission given to her by her employer. The Superior Court held that the employee's use of the van to pick up personal belongings was within the scope of permission. However, her driving at around midnight while intoxicated constituted a "major deviation" from the scope of permission. The employer was therefore not obligated to provide coverage under the "omnibus provision" contained in the policy insuring the van.
McKnight v. USAA, 871 A.2d 446 (Del.Super.Ct. 2005).
This case involved a claim for coverage under a homeowners' insurance policy issued by USAA. Plaintiffs experienced a water accumulation in the basement of their home resulting in the development of mold and fungi in the residence. Plaintiffs argued entitlement to damages to the full extent of the liability coverage under the policy. USAA relied on the mold and fungus coverage provision of the policy specifically limiting property damage to $2,500 and loss of use to $2,000, as well as a related policy exclusion, in denying Plaintiffs' claim in excess of those limits. The Superior Court held that the coverage policy unambiguously provided mold related coverage, with specific limits, while at the same time adding a clear exclusion for just the type of loss at issue. The Plaintiffs were therefore entitled to the limits in the policy related to coverage caused by or consisting of mold or fungus. Further, the policy excluded coverage for loss caused by microbial organisms, and the limits of the additional coverage were not in addition to the limits for dwelling and personal property coverage.
Dunlap v. State Farm Fire and Casualty Co., 878 A.2d 434 (Del 2005).
In this case the Plaintiff, a car passenger, was injured during a collision with a bus. Plaintiff brought this action with her parent against their automobile insurer to recover for bad faith by refusing to consent to settlement with the bus owner for less than its liability coverage limits. The Superior Court dismissed the complaint and the Plaintiffs appealed. Plaintiffs argued that the insurer was informed and could easily verify that the passenger was not responsible for the accident and that her severe, permanent injuries would far exceed the total of all available policy limits. The insurer contended that a claimant had to exhaust liability coverage before UIM coverage was available. The Delaware Supreme Court held that the insurer's alleged refusal to cooperate and agree to car passenger's settlement with bus owner for less than its liability coverage limits could be a breach of the implied covenant of good faith and fair dealing. It was noted by the Supreme Court that the implied covenant of good faith and fair dealing does not require an insurer to risk financial exposure in order to assist the insured. However, it does obligate the insurer not to take advantage of the unequal positions in order to become a second source of injury to the insured.
Deptula v. Horace Mann Insurance Co., 842 A.2d 1235 (Del. 2004), Berger, J.
This case addressed UIM stacking. The Delaware Supreme Court held that the stacking of coverage provided by multiple automobile insurance policies is permitted once the statutory threshold for UIM coverage has been satisfied by any one policy. The court found that nothing in the UIM statute prohibits stacking, and that stacking enables innocent claimants to be more fully compensated for their injuries.
Kent v. Nationwide Property & Casualty Insurance Co., 844 A.2d 1092 (Del. Super. 2004), Del Pesco, J.
A Delaware resident, who was injured in an automobile accident that occurred in New Jersey and involved a New Jersey resident, sought to recover from her automobile insurer for non-economic damages, under the uninsured motorist provisions of the policy. The Superior Court determined that injured Delawareans could seek recovery from their uninsured motorist policies when another state's insurance statute exempts resident drivers from liability for non-economic damages.
