Justia Wisconsin Supreme Court Opinion SummariesArticles Posted in Insurance Law
5 Walworth, LLC v. Engerman Contracting, Inc.
The Supreme Court affirmed the decision of the court of appeals in this insurance dispute over damages allegedly caused by the poor construction of an in-ground pool, holding that this Court overrules the portions of Wisconsin Pharmacy Co. v. Nebraska Cultures of California, Inc., 876 N.W.2d 72 (Wis. 2016), stating that "property damages" must be to "other property" for purposes of determining an initial grant of coverage in a commercial general liability (CGL) policy.Due to the damages caused by the cracking of Homeowner's pool, Homeowner was forced to demolish the entire pool structure and construct a new one. Two insurers on appeal had issued CGL policies to the pool's general contractor, and a third insurer issued a CGL policy to the supplier of the pump mix used for the pool's construction. All three insurers sought a declaration that their policies did not provide coverage to Homeowner. The Supreme Court held, under the circumstances of this case, that none of the insurers were entitled to summary judgment and accordingly remanded the cause back to the circuit court for further proceedings. View "5 Walworth, LLC v. Engerman Contracting, Inc." on Justia Law
ACUITY v. Estate of Michael Shimeta
The Supreme Court affirmed the judgment of the court of appeals reversing the decision of the circuit court granting declaratory judgment for Acuity, a mutual insurance company, in this insurance dispute arising from a fatal automobile accident, holding that the court of appeals did not err.When Douglas Curley lost control of his vehicle and crossed the center line he hit another vehicle, killing Michael Shimeta and seriously injuring Terry Scherr. After Curley's insurer paid Shimeta's estate and Scherr $250,000 each both parties sought additional recovery under a policy that Acuity had issued to Shimeta before the accident. At issue was whether Acuity's underinsured motorist coverage entitled Shimeta's estate and Scherr to an additional $250,000 each from Acuity or whether the payments the parties received from Curley's insurer reduced their recovery to $0. The Supreme Court held that Acuity owed Shimeta's estate and Scherr $250,000 each, thus affirming the court of appeals. View "ACUITY v. Estate of Michael Shimeta" on Justia Law
Banuelos v. University of Wisconsin Hospitals and Clinics Authority
Banuelos claimed that she was unlawfully charged per-page fees for copies of her UW Hospitals medical records which were provided in an electronic format. UW Hospitals argued that section 146.83(3f) is silent as to fees for electronic copies of patient healthcare records and does not prohibit a healthcare provider from charging fees for providing such copies. Banuelos argued that because fees for electronic copies are not enumerated in the statutory list of permissible fees that a healthcare provider may charge, the fees charged here are unlawful under state law. The court of appeals agreed with Banuelos and determined that Wis. Stat. 146.83(3f) does not permit a healthcare provider to charge fees for providing copies of patient healthcare records in an electronic format.The Wisconsin Supreme Court affirmed. Although section 146.83(3f) provides for the imposition of fees for copies of medical records in certain formats, it does not permit healthcare providers to charge fees for patient records in an electronic format. Although Wisconsin statutes previously permitted a charge for the provision of electronic copies of patient health care records, that language has been repealed. View "Banuelos v. University of Wisconsin Hospitals and Clinics Authority" on Justia Law
Secura Supreme Insurance Co. v. Estate of Huck
The Supreme Court affirmed the decision of the court of appeals affirming the order of the trial court granting judgment to the Estate of Daniel Keith Huck in this insurance dispute, holding that there was no error.Huck was killed by a motorist while he performed his job duties for the Village of Mount Pleasant. The Estate first received worker's compensation from Huck's employer's worker's compensation insurer (WC insurer) and then a settlement from the tortfeasor's insurer. By receiving the settlement from the tortfeasor the Estate was statutorily obligated to reimburse the WC insurer from the settlement. The Estate did as required and reimbursed the WC insurer $9,718.73 (the disputed amount). The Supreme Court affirmed, holding that Secura Supreme Insurance Company, from whom Huck had purchased an automobile insurance policy, was not statutorily authorized to reduce its liability limits by the total worker's compensation and tortfeasor settlement payments the Estate initially received but was obligated in part to reimburse. View "Secura Supreme Insurance Co. v. Estate of Huck" on Justia Law
Dostal v. Strand
The Supreme Court reversed the decision of the court of appeals affirming the circuit court's grant of summary and declaratory judgment in favor of State Farm in this insurance dispute, holding that issue preclusion did not bar Lindsey Dostal from seeking insurance coverage for her claims against Curtis Strand.The daughter of Dostal and Strand died as a result of head trauma that occurred while she was in Strand's care. Strand was convicted of second-degree reckless homicide. Dostal subsequently brought this civil action against Strand for negligence and wrongful death. Strand tendered the matter to his homeowner's insurer, State Farm, seeking defense and indemnification. The circuit court granted summary and declaratory judgment in favor of State Farm. The court of appeals affirmed, determining that Strand's conduct did not constitute an "occurrence" covered by the policy at issue because Defendant's criminal conviction established that the death was not the result of an accident. The Supreme Court reversed, holding (1) the issue of whether Strand's conduct was an "accident" was not actually litigated in the prior criminal proceeding; and (2) there were genuine issues of material fact such that summary judgment was inappropriate. View "Dostal v. Strand" on Justia Law
Posted in: Insurance Law
Brey v. State Farm Mutual Automobile Insurance Co.
The Supreme Court reversed the decision of the court of appeals reversing the circuit court's grant of summary judgment in favor of State Farm Mutual Automobile Insurance Company and instead granting summary judgment in favor of Elliot Brey, holding that Wis. Stat. 632.32(2)(d) does not bar an insurer from requiring that an insured sustain bodily injury or death in order to trigger underinsured (UIM) coverage under an automobile liability insurance policy.The circuit court determined (1) the State Farm automobile liability insurance policy issued to Brey's mother and her husband did not provide uninsured motorist (UIM) coverage to Brey for the death of his father in an automobile accident because Brey was an insured under the policy but his father was not; and (2) Brey could not recover under the policy because he did not sustain bodily injury. The court of appeals reversed, concluding that sections 632.32(1) and (2)(d) bar an insurer from limiting UIM coverage to only those insureds who sustain bodily injury or death. The Supreme Court reversed, holding that section 632.32(2)(d) does not require insurers to extend UIM coverage to an insured for bodily injury or death suffered by a person who was not insured under the policy. View "Brey v. State Farm Mutual Automobile Insurance Co." on Justia Law
Emer’s Camper Corral, LLC v. Western Heritage Insurance Co.
The Supreme Court affirmed the decision of the court of appeals affirming the judgment of the circuit court directing a verdict in favor of Defendant, an insurance agent, on Plaintiff's claim that Defendant was negligent because he procured an insurance policy that did not conform to Plaintiff's requirements, holding that Plaintiff must prove that it would have qualified for an insurance policy with better terms than the policy it actually obtained.Plaintiff sold new and used camper trailers. Plaintiff asked Defendant, an insurance agent, to acquire a policy to cover its camper inventory. Plaintiff thought Defendant had acquired a policy with a deductible for $1,000 per camper in the event of hail damage with a $5,000 aggregate deductible limit, but the policy actually required a $5,000 deductible per camper, with no aggregate limit. After a hailstorm damaged many of the campers on its lot, Plaintiff sued Defendant. The circuit court directed a verdict due to Plaintiff's failure to introduce evidence that an insurer would have insured Plaintiff with the deductible limits it thought it had. The Supreme Court affirmed, holding that Plaintiff must not only prove that an insurance policy with the requested deductibles was commercially available but that Plaintiff would actually have qualified for that policy. View "Emer's Camper Corral, LLC v. Western Heritage Insurance Co." on Justia Law
Pulkkila v. Pulkkila
The Supreme Court reversed the decision of the court of appeals applying a constructive trust to proceeds Lynnea Landsee-Pulkkila collected from a life insurance policy maintained by her late husband, James Pulkkila, holding that the court of appeals erred in imposing a constructive trust absent findings of fact that would support such an imposition.In 2009, James and Joan Pulkkila divorced. In their marital settlement agreement (MSA) that was incorporated into the judgment of divorce James and Joan were required to maintain life insurance with their children as beneficiaries. In 2013, James and Lynnea were married. The following year, James submitted a beneficiary name change asking that Lynnea be made the sole beneficiary of the life insurance policy. After Lynnea was paid the proceeds of the policy, Joan asserted that James breached the MSA agreement and that a constructive trust should be placed on the proceeds. The circuit court denied Joan's motion for a constructive trust. The court of appeals reversed, concluding that equity required the imposition of a constructive trust. The Supreme Court reversed, holding that the court of appeals erroneously exercised its discretion because it determined that a constructive trust was appropriate in the absence of an evidentiary hearing and resulting relevant factual findings. View "Pulkkila v. Pulkkila" on Justia Law
Choinsky v. Germantown School District Board of Education
In this insurance coverage duty-to-defend dispute the Supreme Court affirmed the decision of the court of appeals affirming the circuit court's judgment denying the motion for attorney fees filed by the Germantown School District Board of Education and Germantown School District (collectively, the School District), holding that the School District's insurers (Insurer) did not breach the duty to defend the School District in a lawsuit brought by retired employees.In seeking attorney fees, the School Board argued that its Insurer should pay all of the attorney fees incurred by the School District in the underlying lawsuit as a remedy for its breach of the duty to defend the School District. The Supreme Court held (1) the Insurer's initial denial of the School District's tendered claim did not breach its duty to defend when the Insurer followed a judicially preferred method for determining coverage; (2) a delay in payment of liability attorney fees alone does not mean an insurer breached its duty to defend; and (3) the four-corners rule applies in determining whether a duty to defend exists but does not preclude a court's consideration of certain factors in assessing whether an insurer breached its duty to defend. View "Choinsky v. Germantown School District Board of Education" on Justia Law
Posted in: Insurance Law
Enbridge Energy Co. v. Dane County
The Supreme Court reversed the decision of the court of appeals reversing the judgment of the circuit court striking two insurance conditions from a conditional use permit (CUP) Dane County issued to Enbridge Energy Company as unenforceable under 2015 Wisconsin Act 55, holding that because Enbridge carried the requisite insurance, Act 55 rendered Dane County's extra insurance conditions unenforceable.The two conditions at issue required Enbridge to procure additional insurance prior to Enbridge expanding its pipeline pump station. Dane County approved the CUP with these insurance conditions. Thereafter, the Wisconsin Legislature passed Act 55, which prohibits counties from requiring an interstate pipeline operator to obtain additional insurance when the pipeline operating company carries comprehensive general liability insurance with coverage for "sudden and accidental" pollution liability. Dane County issued the CUP with the invalid insurance conditions. The circuit court struck the two conditions from the CUP as unenforceable under Act 55. The court of appeals reversed on the ground that Enbridge failed to show it carried the requisite coverage triggering the statutory prohibition barring the County from imposing additional insurance procurement requirements. The Supreme Court reversed, holding that Enbridge carried the requisite insurance, and therefore, Dane County's extra insurance conditions were unenforceable. View "Enbridge Energy Co. v. Dane County" on Justia Law