Justia U.S. 8th Circuit Court of Appeals Opinion Summaries

Bonnie, a Trinity Health employee, enrolled her family in a Blue Cross group health plan. Trinity served as plan administrator. Bonnie took FMLA leave and then short-term disability leave, which expired June 8, 2011. Bonnie requested long-term disability benefits from Unum, which provisionally paid medical care claims under a “Reservation of Rights.” In October 2011 Unum denied Bonnie’s request but did not seek repayment. June 8, 2011 was the last day Bonnie qualified for benefits and was considered an employee. Her termination was not processed, so the family received benefits until Trinity deemed them retroactively terminated. The Coles were first alerted to their loss of insurance on June 1, 2012 by husband’s physician. They obtained insurance through husband’s employer, retroactively effective June 1, 2012. Blue Cross did not seek a refund of claims paid between January 1, and April 30, 2012. The Coles claimed violation of the Consolidated Omnibus Budget Reconciliation Act by failing to notify them of their right to continuing health care coverage. The district court declined to award statutory damages, reasoning that unreimbursed medical bills from May 2012 were less than the COBRA premiums they would have had to pay to maintain insurance. The Eighth Circuit affirmed. View "Cole v. Trinity Health Corp." on Justia Law

After Hot Stuff recalled mislabeled sandwiches containing MSG, Hot Stuff sought indemnification from HCC for losses sustained due to the recall. HCC denied coverage on the ground that the claim did not involve an "Accidental Product Contamination" as defined by the policy. The district court granted Hot Stuff's motion for partial summary judgment. The court disagreed with the district court's interpretation of the policy term "may likely result." The court concluded that whether the consumption of the mislabeled sandwiches "may likely result" in physical symptoms of sickness or disease is a genuine dispute of material fact that cannot be answered by a summary judgment record that consists of inconclusive government reports and scientific studies and the dueling opinions of experts far removed from the relevant marketplace. Unless the district court determines on remand that summary judgment is appropriate based on the full trial record, the coverage question must be submitted to the jury. However, as the damages issues appear to be distinct and separable from the question of coverage, damages need not be retried. Further, the court concluded that the district court did not err when it denied HCC's motion for judgment as a matter of law in regards to the loss gross profit award, and the district court did not clearly err in denying an award of attorney's fees. View "Hot Stuff Foods, LLC v. Houston Casualty Co." on Justia Law

Hudson filed suit seeking a declaratory judgment that the Hired and Non-Owned Auto Liability endorsement to an insurance policy's Commercial General Liability Coverage Form provides no coverage to any defendant in the underlying lawsuit. The district court granted summary judgment to defendants. Hudson appealed. Defendants cross-appealed an earlier ruling that Hudson is not collaterally estopped to contest coverage by the state court judgment. In appeal No. 13-1688, the court concluded that Hudson is entitled to summary judgment on the coverage issue where, at the time of the accident, defendant Tyler Roush was not acting in the course of defendant Brash Tygr's business within the meaning of the Policy's Hired and Non-Owned Auto Liability endorsement. In appeal No. 13-1742, the court affirmed the judgment and dismissed the cross-appeal, concluding that defendants' cross-appeal is an alternative argument in support of the district court's decision. On the merits, the district court correctly ruled that defendants are not entitled to summary judgment on the basis of collateral estoppel.View "Hudson Specialty Ins. Co. v. Tygr, LLC, et al." on Justia Law

Annex, Stuart Lind, and Tom Janas filed suit challenging HHS' contraceptive mandate under the Religioous Freedom Restoration Act (RFRA), 42 U.S.C. 2000bb-1(a). Lind, a controlling shareholder of Annex, opposed insurance coverage of contraceptives for Annex's employees. The district court denied Annex and Lind's motion for a preliminary injunction respecting the contraceptive mandate's enforcement. The court concluded that Janas lacks standing to appeal because he did not join the preliminary injunction motion which forms the basis of the appeal; the mandate does not apply to Annex because Annex has fewer than fifty full-time employees and has no government-imposed obligation to offer health insurance of any kind; the only alleged injury is that independent third parties - private health insurance companies not involved in this case - are unable to sell Annex a health insurance plan that excludes healthcare inconsistent with Lind's religious relief; and, ultimately, it is unclear whether Annex's alleged injury is caused by the government defendants and redressable by the federal courts. Accordingly, the court vacated the district court's denial and remanded for the district court to conduct more fact-finding to determine whether subject matter jurisdiction exists. View "Annex Medical, Inc., et al. v. Sebelius, et al." on Justia Law

Thomas Hipp was driving a semi-tractor and trailer on a two-lane road when the trailer collided with a vehicle driven by Amy Soczynski. Amy died as a result of the collision and this appeal concerns the subsequent insurance coverage dispute. The court affirmed the district court's determination that a bobtail policy issued by Hipp's Trucking provided coverage for damages arising out of the collision and that the bobtail policy provided $1 million in coverage.View "Occidental Fire & Casualty Co. v. Soczynski" on Justia Law

Plaintiff filed suit against Mid-Continent, alleging that Mid-Continent breached the insurance contract by denying coverage to plaintiff in an underlying lawsuit arising from a subcontractor's faulty workmanship during construction of a home. The court affirmed the district court's dismissal of the claim because faulty workmanship on the home was not an "occurrence" within the meaning of the policy under Essex Ins. Co. v. Holder. The district court did not err by denying plaintiff leave to amend because plaintiff seeks to extend coverage to subcontractor negligence through a claim of estoppel. Under Arkansas law, the doctrine of waiver of estoppel cannot be given the effect of enlarging or extending the coverage as defined in the contract. View "J-McDaniel Construction Co v. Mid-Continent Casualty Co., et al." on Justia Law

Plaintiff appealed the district court's grant of summary judgment in favor of Encompass in this insurance coverage dispute. Plaintiff's home was damaged from a broken drain pipe in the basement shower stall and she sought to recover repair costs for the damage. The court concluded that Encompass failed to satisfy its burden of proving the applicability of the policy's exclusion and the district court erred when it determined as a matter of law that the water damage resulted from seepage. Further, the district court erred when it determined the "seepage or leakage" exclusion for mold remediation barred all of plaintiff's claims. Accordingly, the court reversed and remanded for further proceedings. View "Syfco v. Encompass Indemnity Co." on Justia Law

Starr Indemnity filed suit seeking a determination of their rights and obligations under Continental Cement's insurance policies after the Mark Twain, a cement barge owned by Continental Cement, sank in the Mississippi River. Continental Cement counterclaimed for breach of contract and vexatious refusal to pay under Missouri law. Determining that Continental Cement did not waive its appeal, the court concluded that the district court did not err by applying the federal doctrine of utmost good faith, a judicially established federal admiralty rule, instead of Missouri state law; Continental Cement waived its appeal of the denial of its motion for judgment as a matter of law on Starr Indemnity's utmost good faith defense; and, apart from the issue of waiver, the district court did not abuse its discretion in submitting the utmost good faith instruction. Accordingly, the court affirmed the judgment of the district court. View "New York Marine & General Ins., et al. v. Continental Cement Co., et al." on Justia Law

Plaintiffs filed suit to recover losses sustained after a fire damaged their home. On appeal, plaintiffs challenged the district court's grant of summary judgment to Allstate. Plaintiffs claimed that the jury instructions misstated Missouri law and the elements of the claims and defenses. The court concluded that the jury instruction was not obviously erroneous and that any imprecision in this instruction was not the sort of egregious error that might warrant relief on plain error review in a civil case. Accordingly, the court affirmed the judgment of the district court. View "Young, et al. v. Allstate Ins. Co." on Justia Law

Baum filed suit against Twin City, its insurer, over a dispute regarding coverage of an IRS investigation. Reviewing the choice of law question in light of sections 188 and 187 of the Restatement (Second) of Conflict of Laws, the court predicted that the Missouri Supreme Court would apply New York law to this dispute; the court concluded that the policy provided coverage where Twin City's insurance agreement was ambiguous regarding any timely notice requirement applicable to later liabilities arising from a timely original claim; although the district court erred by applying Missouri law, the court affirmed the judgment of the district court; and the court affirmed the district court's declaration that a $3 million self-insured retention applied to the derivatives litigation because the litigation was sufficiently related to Baum's business underwriting and selling municipal bonds. View "George K. Baum & Co. v. Twin City Fire Ins. Co." on Justia Law