Case Summaries

Insurance Law

[09/03] McMillan v. Stroud
In a challenge to a probate court order directing plaintiff to pay a lien issued by defendant State Department of Health Care Services under the Medi-Cal California Medical Assistance Program, court order is affirmed where plaintiffs: 1) did not establish how much of the initial settlement constitutes reimbursement for medical expenses; 2) presented no contemporaneous evidence of discussions at the time of settlement on the subject; and 3) failed to provide defendant with the name of purported medical carrier which would have allowed defendant to attempt to determine the true value of medical expenses in this case. Given this record, the court was satisfied that $83,837.43 constituted a fair determination of the amount of reimbursable medical expenses due to defendant.

[09/03] Officer v. Chase Ins. Life & Annuity Co.
In a suit to recover the face amount of plaintiff's wife's life insurance policy, denial of summary judgment for plaintiff is affirmed, and request for certification of questions to the Indiana Supreme Court is denied, where: 1) the policy's suicide provision was unambiguous, valid and enforceable, and not a disproportionate forfeiture or illegal penalty; and 2) the doctrine of substantial performance did not apply to a time-limited suicide exclusion.

[09/02] Adams v. Monumental Gen. Cas., Co.
In a lawsuit filed by plaintiff-insured truck owner against defendant-insurer for a refund of portion of her premium because she paid the loan early, appeal of grant of motion to compel arbitration is dismissed where: 1) court has no jurisdiction over this appeal because the district court compelled arbitration; and 2) when a district court compels arbitration of a dispute under one contract and is silent about whether another contract provides for arbitration of the same dispute, section 16(a)(1)(B) is not implicated.

[08/29] Spangle v. Farmers Ins. Exchange
In claim to seek recovery against a "garage operations" liability policy issued by used car dealership, summary judgment against plaintiff is reversed and remanded where: 1) there are triable issues of material fact regarding title to the automobile and consequently whether minor was a permissive user of the automobile; and 2) it cannot be established as a matter of law that minor was not covered by the policy if he was a permissive user.

[08/29] Ulico Cas. Co. v. Allied Pilots Ass'n
In a suit seeking a declaratory judgment that plaintiff-insurer did not have coverage and did not owe defendant's defense costs for a suit against defendant-insured, judgment notwithstanding a jury verdict in favor of defendant is affirmed in part and reversed in part where: 1) an insurer's contractual coverage under a claims-made policy can be expanded by the doctrines of waiver and estoppel to cover a risk not otherwise within the policy coverage, namely a suit against the insured that was not reported until after the policy expired; but 2) the doctrines of waiver and estoppel cannot be used to re-write the contract of insurance and provide contractual coverage for risks not insured.

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