Justia South Dakota Supreme Court Opinion Summaries

A fire damaged a malt beverage store owned by A Maxon Company, LLC (AMC). Acuity Insurance Company sought a declaratory judgment to determine coverage under an insurance policy listing Greg and Tammy Weatherspoon as additional loss payees. The Weatherspoons counterclaimed for breach of contract. The circuit court granted Acuity’s motion for judgment as a matter of law on the Weatherspoons’ counterclaim, determining that the insurance policy terms prevented the Weatherspoons from recovering damages unless AMC successfully asserted a claim. The jury found that AMC principal, Russel Maxon, had intentionally started the fire, excluding coverage under AMC’s policy. The Weatherspoons appealed.The Circuit Court of the Fourth Judicial Circuit, Corson County, South Dakota, initially denied the Weatherspoons’ motion for summary judgment, ruling that the insurance contract was unambiguous and that the Weatherspoons’ claim was dependent on AMC’s claim. The court also denied Acuity’s motion for summary judgment, finding that there were factual disputes suitable for a jury. At trial, the court granted Acuity’s motion for judgment as a matter of law, concluding that the Weatherspoons could not recover under the policy because AMC’s claim was excluded due to Russel’s intentional act.The Supreme Court of the State of South Dakota affirmed the circuit court’s decision. The court held that the insurance policy’s Loss Payable Clause only allowed the Weatherspoons to collect if AMC could collect, and since the jury found that Russel intentionally started the fire, AMC was precluded from recovering. The court also found no abuse of discretion in admitting expert testimony from Special Agent Derek Hill and allowing the impeachment of Tracy Maxon with prior inconsistent statements. The court concluded that the Weatherspoons’ arguments regarding ambiguity and third-party beneficiary status were unavailing. View "Acuity Insurance V. A Maxon Company" on Justia Law

Acuity issued a commercial auto policy to Terra-Tek, LLC, which included John Waba and Sheila Foreman as additional named insureds. Waba was injured in an auto accident with an underinsured motorist while driving a vehicle not listed under Terra-Tek’s policy. Acuity denied Waba’s claim for underinsured motorist (UIM) benefits, arguing that the vehicle he was driving was not covered under the policy. Acuity then sought a declaratory judgment to confirm that Waba was not entitled to UIM benefits.The Circuit Court of the First Judicial Circuit in Brule County, South Dakota, reviewed the case. The court found that the UIM endorsement in Terra-Tek’s policy unambiguously provided coverage to Waba for the injuries sustained in the accident, despite the vehicle not being listed as a covered auto. The court granted summary judgment in favor of Waba, determining that the policy’s language did not require Waba to be occupying a covered auto to receive UIM benefits. Acuity appealed this decision.The Supreme Court of the State of South Dakota affirmed the lower court’s decision. The court held that the UIM endorsement’s language did not limit coverage to injuries sustained while occupying a covered auto. The court noted that the policy’s definition of an insured for UIM coverage did not include such a limitation, unlike the liability coverage section, which explicitly required the insured to be occupying a covered auto. The court concluded that the policy provided UIM coverage to Waba for the accident, affirming the circuit court’s judgment in favor of Terra-Tek and Waba. View "Acuity V. Terra-Tek" on Justia Law

In this case, a group of healthcare providers (Providers) sued the insurer Sanford Health Plan, Inc. (SHP) for excluding them from participating in some of its health benefit plans. The Providers argued that according to South Dakota’s “Any Willing Provider” law (SDCL 58-17J-2), they had the right to participate as panel providers in all of SHP's plans. The law stipulates that a health insurer cannot block patient choice by excluding a willing and qualified healthcare provider from its panel of providers if the provider is within the geographic coverage area of the health benefit plan. The circuit court determined that the law did not permit SHP to exclude a qualified and willing healthcare provider from participating in every health benefit plan it offered, granting summary judgment in favor of the Providers.The Supreme Court of the State of South Dakota affirmed the circuit court's decision. It interpreted the law as plan-specific, meaning an insurer may not exclude any willing and fully qualified provider from any of its plans or from any tier within a plan. It also clarified that an insurer may still exclude providers from plans if they do not meet the statutory requirements for participation as a panel provider. The court concluded that, according to the law, SHP could not exclude the Providers from participating in its TRUE Plan or Tier 1 of the PLUS Plan, thus affirming the circuit court's granting of summary judgment in favor of the Providers. View "Orthopedic Institute v. Sanford Health Plan, Inc." on Justia Law

The Supreme Court affirmed the decision of the circuit court granting summary judgment in favor of State Farm Mutual Automobile Insurance Company in this lawsuit it brought seeking a declaration that it had no duty to defend or indemnify its insureds under the circumstances, holding that the circuit court did not err.Agtegra Cooperative brought the underlying lawsuit alleging that Mike Grunewaldt and Nancy Grunewaldt were liable to Agtegra for damages related to its delivery of wheat contaminated with fertilizer to Agtegra's elevator. State Farm, the Grunewaldts' insurance company, then commenced a separate lawsuit arguing that it had no duty to defend or indemnify the Grunewaldts to pay any judgment arising from the allegations in Agtegra's action. The circuit court granted summary judgment for State Farm. The Supreme Court affirmed, holding that the circuit court properly held that State Farm had no duty to defend or indemnify the Grunewaldts in the lawsuit initiated by Agtegra. View "State Farm v. Grunewaldt" on Justia Law

The Supreme Court reversed the judgment of the South Dakota Life and Health Guaranty Association denying the protests brought by the South Dakota Bankers Benefit Plan Trust as to the Association's assessment schedule it established to cover an insolvent insurer's obligations, holding that the Trust was not liable to pay the contested assessments.In 2017, the Association, which covers impaired and insolvent insurers' obligations to their insureds by assessing Association members, assumed liability for the insolvent insurer at issue and established a five-year assessment schedule. The Trust paid three years of the five-year schedule but protested the requirement to pay the remaining two because they were assessed after the insolvent insurer's membership in the Association ended. The Association denied the protests. The South Dakota Division of Insurance's Office of Hearing Examiners reversed, determining that the Association lacked authority to assess the Trust for the last two assessments. The circuit court reversed. The Supreme Court reversed, holding that the Trust was not liable to pay the Association's 2020 and 2021 assessments. View "S.D. Life & Health Guaranty Ass'n v. S.D. Bankers Benefit Plan Trust" on Justia Law

The Supreme Court affirmed the judgment of the circuit court affirming the decision of the Office of Hearing Examiners (OHE) reviewing the decision of the South Dakota Department of Labor and Regulation Division of Insurance (DOI) relating to captive insurance companies domiciled in South Dakota, holding that there was no error.Appellant requested information from the South Dakota Department of Labor and Regulation Division of Insurance (DOI) relating to captive insurance companies domiciled in the state of South Dakota. The DOI denied the request, explaining that the information was confidential. The OHE upheld the decision, and the circuit court affirmed. The Supreme Court affirmed, holding that the circuit court and the OHE properly determined that certificates of authority for captive insurance companies may not be disclosed under S.D. Codified Laws 58-46-31. View "Schupp v. Division of Insurance" on Justia Law

The Supreme Court reversed the judgment of the circuit court in favor of Liberty Mutual Fire Insurance Company in this insurance dispute, holding that the circuit court improperly dismissed the complaint for failure to state a claim upon which relief can be granted.An agent of Kaiser Trucking was in an automobile accident with Liberty Mutual's insured. The circuit court granted default judgment for Kaiser Trucking and its agent. After the judgments were returned unsatisfied, Kaiser and its agent brought this action against Liberty Mutual seeking indemnification of the judgments against its insured. Liberty Mutual filed a motion to dismiss under S.D. Codified Laws 15-6-12(b)(5), arguing that Plaintiffs failed to plead a condition precedent to coverage under the policy. The circuit court agreed and dismissed the complaint. The Supreme Court reversed, holding that Kaiser Trucking, Inc. was not required to plea satisfaction of conditions precedent in the relevant insurance policy sufficiently to state a claim upon which relief could be granted and avoid a Rule 12(b)(5) dismissal of its complaint. View "Kaiser Trucking, Inc. v. Liberty Mutual Fire Insurance Co." on Justia Law

The Supreme Court held that S.D. Codified Laws 58-29B-56 provides a state insurance liquidator an additional 180 days to provide a notice of a claim under a claims-made professional liability policy.The South Dakota Director of Insurance filed a petition for an order of liquidation of ReliaMax Surety Company (RSC), a subsidiary of ReliaMax Holding Company (RHC). The circuit court declared RSC to be insolvent and directed the company's liquidation. The state insurance liquidator (Liquidator) later commenced the underlying action against the directors and officers (D&O) of RSC and RHC. Under a settlement agreement, the Liquidator was granted a final judgment, agreeing not to execute upon and instead receiving an assignment of the D&Os' claims for coverage under a policy issued by SL Specialty. The Liquidator then brought this action against XL Speciality. At issue was the timeliness of the Liquidator's claim seeking D&O coverage. The district court certified questions of law to the Supreme Court. The Court held that section 58-29B-56 provides a state insurance liquidator an additional 180 days to provide notice of a claim under a claims-made professional liability policy. View "Deiter v. XL Specialty Insurance Co." on Justia Law

The Supreme Court held that the circuit court did not err when it granted Nationwide's motion for summary judgment on its complaint seeking a declaratory judgment regarding its duty to indemnify and defend Defendants against a personal injury lawsuit stemming from an accident on their farm.Nationwide issued a farm liability insurance policy for Defendants' farm and cattle ranch operation. After an accident resulted in permanent injuries to a relative, the relative filed a personal injury action against Defendants and their business entities. Nationwide then commenced this declaratory judgment action to determine the extent of its obligation to defend or indemnify Defendants. The circuit court granted summary judgment for Nationwide, concluding that a "Recreational Vehicle Liability Coverage Endorsement" in the policy operated to exclude coverage for the accident. The Supreme Court affirmed, holding that the circuit court properly granted summary judgment based on the language in the Recreational Vehicle Endorsement. View "Nationwide Agribusiness v. Fitch" on Justia Law

The Supreme Court affirmed the judgment of the circuit court denying Plaintiffs' declaratory judgment action against State Farm seeking payment of $2 million under Florida's uninsured motorist (UM) statute, holding that Florida law did not require State Farm to provide UM coverage.State Farm denied Plaintiffs UM coverage under their personal liability umbrella insurance policy after a motorcycle accident with an uninsured vehicle in South Dakota because the policy did not include UM coverage. Thereafter, Plaintiffs, who resided in Florida at the time of the accident, filed this declaratory action. The circuit court concluded that Florida law applied to the dispute, that State Farm did not violate Florida's UM statute, and that Plaintiffs were not entitled to UM coverage. The Supreme Court affirmed, holding that Florida law did not require State Farm to provide UM coverage. View "Payne v. State Farm Fire & Casualty Co." on Justia Law