Justia Georgia Supreme Court Opinion Summaries

Articles Posted in Insurance Law
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The issue before the Supreme Court was whether an employee who filed an injury claim against his employer under the State Workers' Compensation Act and receives compensation in exchange for a "no liability" settlement with his employer that is approved by the State Board of Workers' Compensation may then turn around and sue the co-employee who caused the injury in a tort action. Ten years ago, the Court of Appeals answered this question no, holding that the Act's exclusive remedy provision bars such a lawsuit based on the same injury for which the employee has already received a remedy. In this appeal, however, the Court of Appeals was equally divided as to whether the underlying case law should be overruled, and the case was sent to the Supreme Court for resolution. Upon review, the Supreme Court held that "Ridley" was correctly decided. Thus, appellant Joseph Smith, having previously entered a Board-approved settlement with his employer in exchange for compensation, would be barred from suing appellee John Ellis for the same injury in tort if Ellis qualified as an "employee of the same employer" as Smith, rather than a "third-party tort-feasor," as those phrases are used in the applicable statutory authority. However, the evidence did not establish that Ellis was acting as "an employee of the same employer" in the course of his employment, at the time he injured Smith. The trial court therefore erred in granting summary judgment to Ellis, and that judgment was reversed. View "Smith v. Ellis" on Justia Law

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The Supreme Court granted certiorari to the Court of Appeals in "Glass v. Gates" to answer whether the definition of "any motor vehicle" in OCGA 33-24-51(a) continued to be the broader definition of the term provided for in prior case law, notwithstanding the 2002 passage of OCGA 36-92-1. As inmates at the Troup County Correctional facility, Jonathan Glass and Tony Smith were operating tractors when Smith's tractor got stuck in a ditch. Donrell Gates, Glass' detail supervisor, instructed the men to attach a chain to the tractors so Glass could use his tractor to pull Smith's from the ditch. As Glass did so, Smith engaged his tractor's bush hog, causing a rock to take flight and pierce Glass' throat. Glass bled profusely and died later that day. Plaintiffs, Glass' minor son and the executor of his estate, brought a wrongful death and survivor action against Troup County and Gates. The county sought summary judgment, claiming plaintiffs' claims were barred by sovereign immunity. The County asserted that by revising OCGA 33-24-51 (b) in 2002 (effective 2005), the legislature demonstrated its intent to apply the more narrow definition of "motor vehicle" found in OCGA 36-92-1 (6) in determining whether a local government waived sovereign immunity by purchasing liability insurance on a motor vehicle. The trial court agreed and granted summary judgment in favor of the County, concluding that the county did not waive sovereign immunity because neither a tractor nor a bush hog could be deemed a "motor vehicle" under OCGA 36-92-1. The Court of Appeals reversed, holding that the broader definition of "motor vehicle" should have been applied under 33-24-51, and that therefore, the County waived its sovereign immunity as long as it purchased insurance for the tractor and bush hog used by Smith. The Supreme Court agreed with the Court of Appeals' reasoning, and affirmed by answering the appellate court's original question in the affirmative. View "Gates v. Glass" on Justia Law

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The United States Court of Appeals for the Eleventh Circuit certified two questions to the Georgia Supreme Court: "(1) Did the Georgia Insurance Commissioner act within his legal authority when he promulgated Ga. Comp. R. & Regs. 120-2-20-.02, such that a multiple-line insurance policy providing first-party insurance coverage for theft-related property damage must be reformed to conform with the two-year limitation period provided for in Georgia's Standard Fire Policy, Ga. Comp. R. & Regs. 120-2-19-.01?; and, (2) is this action barred by the Policy's one-year limitation period?" These questions arose from a dispute over Petitioner Ricardo White's purchase of a homeowner's insurance policy from Respondent State Farm Fire and Casualty Company. The insurance policy was a first-party insurance contract that provided multiple-line coverage, including coverage for loss or damage caused by both fire and theft. The policy contained a limitation provision stating that a lawsuit against State Farm must be brought "within one year of the date of loss or damage." After his home was burglarized in January 2008 (within the period of coverage), Petitioner filed a claim for the loss of more than $135,000 in personal property. State Farm denied the claim based on its determination that Petitioner misrepresented material information in filing his claim. Waiting more than one year after his date of loss, Petitioner filed a June 2009 complaint against State Farm in state court alleging claims for breach of contract, bad faith, and fraud. Upon review of the facts of this case, the Supreme Court found that: (1) the Georgia Insurance Commissioner did not act within his legal authority and (2) this action was barred by the one-year limitation period in his insurance policy. View "White v. State Farm Fire & Casualty Co." on Justia Law

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Plaintiff sustained a serious brain injury when he fell while climbing down from the roof of a residence while working for EWES. At the time of the accident, EWES held a commercial liability insurance policy issued by Maxum. Maxum denied coverage and refused to defend, citing the policy's Employer Liability Exclusion. After plaintiff obtained a negligence judgment against EWES, he filed suit against Maxum pursuant to an assignment of claims from EWES, asserting breach of the duty to defend and seeking indemnification. The court reversed as to the notice issue, finding that Maxum waived its right to assert a defense based on untimely notice because it did not properly alert EWES that the lack of timely notice would be a potential bar to coverage. The court also reversed the Court of Appeals' decision regarding Maxum's duty to defend, finding that since Maxum waived its right to assert a defense related to EWES' failure to give timely notice of the occurrence, timely notice of the occurrence was not a prerequisite to Maxum's duty to defend. View "Hoover v. Maxum Indemnity Co." on Justia Law

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The United States Court of appeals asked the court to answer a question that stemmed from a dispute over the proper interpretation under Georgia law of a contract insuring real property. The primary issue presented was whether the court's ruling in State Farm Mut. Auto. Ins. Co. v. Mabry, a case involving an automobile insurance policy wherein the court held that a provision requiring the insurer to pay for loss to the insured's car required the insurer to also pay for any diminution in value of the repaired vehicle, was applicable. The court held that its ruling in Mabry was not limited by the type of property insured, but rather spoke generally to the measure of damages an insurer was obligated to pay. View "Royal Capital Dev., LLC v. Maryland Casualty Co." on Justia Law

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Appellee, as executrix of the estate of her father, and her sister, brought a breach of contract action in which they asserted that their father's second wife, appellant, contractually waived her right to retain the proceeds of their deceased father's employer-provided 401K plan and life insurance policy by entering a settlement agreement incorporated into an order of separate maintenance executed approximately a year prior to the father's death. At issue was whether the court of appeals erred in finding that decedent's children could maintain a state law action against the decedent's surviving spouse to recover proceeds distributed to the spouse as the beneficiary of the decedent's ERISA-governed benefits plans, 29 U.S.C. 1001 et seq., where the state law claims were based on a contention that the spouse waived her rights to such proceeds. The court answered in the negative, concluding that, in this case, since the proceeds of the ERISA-covered plans were paid out to appellant and were no longer in the control of the plan administrator, the trial court erred when it dismissed appellees' breach of contract claim against appellant. View "Appleton v. Alcorn, et al." on Justia Law

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Lisa Krebs sued Carmen McReynolds and GM for serious injuries she received when McReynold's car struck the GM vehicle in which Krebs was a passenger. McReynolds subsequently appealed the trial court's rulings. The court granted certiorari to consider two questions: (1) Did the Court of Appeals correctly construe OCGA 51-12-33 to require a trier of fact to apportion an award of damages among multiple defendants when the plaintiff was not at fault?; and (2) Did the Court of Appeals correctly find that McReynolds's insurer made a counteroffer in response to Krebs's settlement demand? The court answered both questions affirmatively. The court held that in applying section 51-12-33, the trier of fact must "apportion its award of damages among the persons who were liable according to the percentage of fault of each person" even if the plaintiff was not at fault for the injury or damages claimed. In light of this holding, there was no error in the dismissal of McReynolds's cross-claims for contribution and set-off against GM. The court construed the response by McReynolds's insurer to Krebs's settlement offer, proposing to resolve the hospital and other liens "as part of this settlement," as a counteroffer rather than an unconditional and unequivocal acceptance. Accordingly, no binding settlement was formed. View "McReynolds v. Krebs" on Justia Law

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This case arose from an automobile collision in which a police officer employed by the City of Newman was driving a City police car when it was struck by a motor vehicle owned and operated by the insured, who had $25,000 of motor vehicle liability coverage. The City had a Member Coverage Agreement (Agreement) with the Georgia Interlocal Risk Management Agency (GIRMA), established under OCGA 36-85-1 et seq. The officer subsequently sued the insured in tort and served a copy of the complaint on GIRMA to notify GIRMA that it might be held responsible as an uninsured motorist carrier pursuant to OCGA 33-7-11. The court subsequently granted a writ of certiorari to the court of appeals to consider whether that court properly determined that a municipality's motor vehicle liability coverage secured through an interlocal risk management agency was not statutorily obligated to satisfy the requirements for uninsured and underinsured motorist coverage that were applied to commercial insurance policies and private self-insurance plans. The court held that the district court reached the correct conclusion when it determined that there was no authority for the conclusion that an interlocal risk management program such as that offered by GIRMA must include uninsured motorist coverage pursuant to OCGA 33-7-11. Therefore, the Agreement was limited to its express terms and did not include the underinsured motorist protection that the police officer sought. Accordingly, the judgment was affirmed.