Justia Iowa Supreme Court Opinion Summaries
Articles Posted in Insurance Law
Dostart v. Columbia Insurance Group
John and Deena Dostart were awarded $182,408.30 in compensatory damages and $17,591.70 in exemplary damages by a jury for consumer fraud claims against their general contractor, Tyler Custom Homes, Ltd., and its owner, James Harmeyer. Columbia Insurance Group, which provided a commercial-general-liability (CGL) insurance policy to Tyler Custom Homes, declined to indemnify the judgment, arguing that consumer fraud is excluded from coverage under the CGL policy. Unable to collect directly from Tyler Custom Homes or Harmeyer, the Dostarts filed a suit seeking payment of the unsatisfied judgment from Columbia.The Iowa District Court for Polk County granted Columbia's motion for summary judgment regarding the exemplary damages but found that fact questions existed as to whether the consumer fraud was an "occurrence" under the CGL policy, whether the jury's award was for "property damage," and whether the intentional acts exclusion applied. The Iowa Court of Appeals affirmed the district court's decision, noting the lack of evidence about the underlying dispute beyond the verdict form and jury instructions.The Iowa Supreme Court reviewed the case and concluded that the consumer fraud involved in the underlying action is not a covered "occurrence" under the CGL policy and that the alleged harm does not include covered "property damage" as defined in the policy. The court vacated the decision of the Court of Appeals, reversed the district court's ruling, and remanded the case for entry of summary judgment in favor of Columbia. The court emphasized that defective workmanship or failure to complete construction does not constitute an "occurrence" under a CGL policy and that the damages sought were not for "property damage" as contemplated by the policy. View "Dostart v. Columbia Insurance Group" on Justia Law
Posted in:
Consumer Law, Insurance Law
Heartland Co-Op v. Nationwide Agribusiness Insurance Company
Heartland Co-op, an agricultural cooperative, purchased a property and casualty insurance policy from Nationwide Agribusiness Insurance Company. The policy included earnings and extra expense coverage with a $3 million limit for "any one loss" at "all covered locations." In August 2020, a derecho caused significant damage to Heartland's operations across 48 locations. Nationwide paid Heartland approximately $131 million for the losses, including $3 million for earnings and extra expense coverage. Heartland claimed that the $3 million limit should apply to each location individually, while Nationwide argued that the limit applied to the total loss across all locations.The Iowa District Court for Polk County granted Nationwide's motion for summary judgment, concluding that the policy unambiguously limited the earnings and extra expense coverage to $3 million in total for the derecho-related loss. The Iowa Court of Appeals affirmed the district court's decision, agreeing that the policy language was clear and that the $3 million limit applied to the aggregate loss across all covered locations.The Iowa Supreme Court reviewed the case and affirmed the decisions of the lower courts. The court held that the insurance policy was unambiguous and provided coverage for the total loss of net income and extra expense to Heartland as an entity, not on a per-location basis. The $3 million limit applied to the total loss resulting from the derecho at all covered locations. The court emphasized that the policy's plain language and the premium paid supported this interpretation, and it declined to rewrite the contract to provide the coverage Heartland sought. View "Heartland Co-Op v. Nationwide Agribusiness Insurance Company" on Justia Law
Posted in:
Agriculture Law, Insurance Law
Waterloo Community School District v. Employers Mutual Casualty Company
A school district insured its buildings through a policy that covered abrupt collapses caused by perils, including the weight of snow and ice. After a heavy snowstorm, part of the roof of an aged elementary school building collapsed into a second-floor classroom. The collapse and subsequent investigations revealed that load-bearing walls throughout the building had deteriorated, and the entire building was declared unsafe for occupancy. The school district demanded that the insurer pay to restore the load-bearing walls for the entire building, but the insurer agreed to pay only for the area of the collapse. The school district sued for the larger amount.The Iowa District Court for Polk County granted summary judgment for the insurer. The court concluded that the school district could only recover for the damage physically caused by the collapse. It also applied the policy’s “ordinance and law” provision exception for pre-existing code violations, finding that the deterioration within the load-bearing walls pre-dated the partial roof collapse and violated local building codes. The school district appealed the decision.The Iowa Supreme Court reviewed the case and affirmed the district court’s judgment. The court held that the insurer must only pay to repair the damage from the partial roof collapse but not the cost to remedy the longstanding deterioration in other areas of the building unaffected by the collapse. The court found that the policy’s exception for pre-existing code violations was unambiguous and applied regardless of whether the insured was aware of the deterioration before the collapse. The court emphasized that a contrary holding would convert the insurance policy into a general maintenance contract. View "Waterloo Community School District v. Employers Mutual Casualty Company" on Justia Law
Posted in:
Insurance Law
Burton v. West Bend Mutual Insurance Company
Jessenia Burton, a student driver, was involved in a car accident during a drivers' education course on April 30, 2017. Burton and her parents sued several defendants, including West Bend Mutual Insurance Company, which provided coverage for the vehicles used in the course. Burton retained neuropsychologist Dr. Daniel Tranel, who conducted an evaluation and diagnosed her with a concussion, postconcussion syndrome, PTSD, and major depressive disorder. Dr. Tranel's report included summaries of psychological and neuropsychological tests administered to Burton.The Iowa District Court for Polk County granted West Bend's motion to compel the production of Dr. Tranel's psychological test material and test data. The court reasoned that since Burton made her mental condition an element of her claim, the information was discoverable under Iowa Code section 228.6(4)(a). The court ordered the information to be produced to West Bend and its attorneys, issuing a protective order to limit further disclosure.The Iowa Supreme Court reviewed the case and reversed the district court's decision. The court held that Iowa Code section 228.9 explicitly prohibits the disclosure of psychological test material and test data in a judicial proceeding to anyone other than a licensed psychologist designated by the individual. The court emphasized that the statute's language is clear and unambiguous, and the only exception to this prohibition is disclosure to another licensed psychologist. The court concluded that the district court erred in granting the motion to compel and vacated the protective order. The case was remanded for further proceedings consistent with this interpretation. View "Burton v. West Bend Mutual Insurance Company" on Justia Law
Mid American Construction LLC v. Sandlin
Marshall Sandlin, a laborer at Mid American Construction LLC, suffered an injury to his left foot during work. After an initial medical examination conducted by a physician chosen by Mid American's insurance carrier, Grinnell Mutual, Sandlin underwent another independent medical examination (IME) by a physician of his choosing. Sandlin sought reimbursement for the full cost of this second examination, as he believed the first examination's evaluation was too low.The Supreme Court of Iowa had to decide whether an amendment to Iowa Code section 85.39(2) in 2017 limited an employee's reimbursement for an IME to only the cost of the impairment rating or included the full cost of the examination. The court held that the employee is eligible for reimbursement of the reasonable cost of the full examination to determine the impairment rating, not merely the cost of the impairment rating itself. The court interpreted the term "examination" as used in the statute to include review of medical records, physical examination, testing, and written report.However, the court found that the commissioner's analysis of the physician's fee as reasonable was incomplete. While the commissioner considered the physician's written opinion about the reasonableness of his fee, the commissioner failed to analyze the typical fee charged for such an examination in the local area where the examination was conducted, as required by the 2017 amendment to the statute. Consequently, the court remanded the case for further fact-finding on the issue of the reasonableness of the fee based on the typical fee charged in the local area.Thus, the Supreme Court of Iowa affirmed in part and vacated in part the decision of the Court of Appeals and affirmed in part, reversed in part, and remanded the judgment of the District Court. View "Mid American Construction LLC v. Sandlin" on Justia Law
Posted in:
Insurance Law, Labor & Employment Law
Hagen v. Serta/National Bedding Co., LLC
In a workers' compensation case, an employee was injured and sought compensation from her employer and its insurance carrier. The employee failed to provide her expert witness's evidence in a timely manner, serving them only two weeks before the arbitration hearing began. The employer and its insurance carrier objected, arguing that this late submission of evidence was unfairly prejudicial. The deputy workers’ compensation commissioner agreed with the employer and excluded the evidence. This decision was affirmed by the commissioner, but was later reversed on judicial review by the district court. The court of appeals affirmed the district court’s ruling. However, the Supreme Court of Iowa held that the commissioner’s decision to exclude untimely evidence was entitled to deference. The court found that the commissioner did not abuse his discretion by excluding the untimely evidence since the employee had disregarded multiple deadlines and submitted the reports only about two weeks before the hearing. Moreover, the reports were not from the employee’s treating physicians and the vocational report reached a conclusion that no other expert in the case shared. Therefore, the supreme court vacated the court of appeals decision, reversed the district court decision, and remanded the case back to the district court to enter a judgment affirming the commissioner's decision to exclude the untimely evidence. View "Hagen v. Serta/National Bedding Co., LLC" on Justia Law
Nationwide Mutual Insurance Co. v. Polk County Board of Review
The Supreme Court vacated the decision of the court of appeals reversing the decision of the district court affirming the Polk County assessor's original tax valuation of two large corporate office buildings in downtown Des Moines at $87,050,000 and $44,910,000, holding that the district court did not err by relying on the Board's expert appraisers when it affirmed the assessor's valuation.Nationwide Mutual Insurance Co., the owner of the buildings at issue, protested the valuation, and the Polk County Board of Review upheld the valuation. The district court affirmed the assessment after hearing appraisers appointed by both the Board and Nationwide as expert witnesses and finding the Board's experts more reliable. The court of appeals reversed and reduced the assessments. The Supreme Court vacated the appellate court's decision and affirmed the judgment of the district court holding (1) there was no basis to reject the district court's determination about the relative reliability of the expert witness testimony; and (2) the Board met its burden to prove that the valuation was not excessive. View "Nationwide Mutual Insurance Co. v. Polk County Board of Review" on Justia Law
Posted in:
Insurance Law, Real Estate & Property Law
American Home Assurance v. Liberty Mutual Fire Insurance Co.
Pursuant to an arbitration award, American Home paid workers’ compensation benefits to an employee injured in 2008. American did not file a notice before the arbitration that, pursuant to Iowa Code 85.21, it was paying the claim subject to a potential coverage issue. By 2013, American paid all the benefits owed under the arbitration award. In 2016, the employee sought to reopen the case. American then filed a section 85.21 notice seeking reimbursement of benefits paid to the employee, claiming that on the date of injury Liberty Mutual was providing the employer with workers’ compensation coverage.The workers’ compensation commissioner concluded that in order to be entitled to reimbursement, American was required to file section 85.21 notice before the arbitration proceeding and could not, years later, seek to be reimbursed. The district court reversed, reasoning that section 85.21 gave the commissioner broad power to order reimbursement, not time-limited in the statute. The court of appeals, agreeing with the commissioner, reversed. The Iowa Supreme Court agreed. The commissioner may require that insurance carriers obtain a section 85.21 reimbursement order before an evidentiary hearing in order to seek indemnity or contribution from another carrier. The procedural question is not controlled by the substantive provisions of section 85.21. The commissioner has simply established a rule of procedure for handling section 85.21 claims. View "American Home Assurance v. Liberty Mutual Fire Insurance Co." on Justia Law
Posted in:
Government & Administrative Law, Insurance Law
Jesse’s Embers, LLC v. Western Agricultural Insurance Co.
The Supreme Court affirmed the order of the district court granting summary judgment in favor of Insurer in this insurance dispute, holding that summary judgment was properly granted.Insured, which operated a bar and restaurant, made a claim under its commercial property insurance policy for business interruption coverage for the period it closed its business in response to the order of the West Virginia Governor that bars and restaurants shut down in response to the COVID-19 pandemic. Insurer denied the claim. The Supreme Court affirmed, holding (1) the language "direct physical loss of or damage to Covered Property" requires a physical aspect to the property loss before coverage is triggered; and (2) Insured's claim failed under the provision that required actual damage to nearby property. View "Jesse’s Embers, LLC v. Western Agricultural Insurance Co." on Justia Law
Posted in:
Insurance Law
Wakonda Club v. Selective Insurance Co. of America
The Supreme Court affirmed the order of the district court granting summary judgment in favor of an Insurer in this insurance dispute, holding that the mere loss of use of business property did not constitute "direct physical loss of or damage to property" to trigger coverage in this case.Insured, which operated a private golf and country club, made a claim under its all-risk commercial property insurance policy for income it lost during the time it temporarily closed its facilities in compliance with the Governor's 2020 proclamation restricting in-person services at bars and restaurants in response to the COVID-19 pandemic. Insurer denied the claim, and Insured sued. The district court granted Insurer's motion for summary judgment. The Supreme Court affirmed, holding that the mere loss of use of business property does not constitute “direct physical loss of or damage to property” to trigger coverage under the business interruption endorsement to an all-risk commercial property insurance policy like the one at issue in this case. View "Wakonda Club v. Selective Insurance Co. of America" on Justia Law
Posted in:
Insurance Law