Justia South Dakota Supreme Court Opinion Summaries
Articles Posted in Insurance Law
Hass v. Wentzlaff
Defendant Paul Wentzlaff, an insurance agent, stole thousands of dollars from Harvey Severson, an elderly man who asked Defendant to help manage his financial affairs. Plaintiff Donald Hass, as personal representative for Severson’s estate, sued Defendant and two insurance companies who appointed Defendant as an agent, North American Company for Life and Health Insurance (North American) and Allianz Life Insurance of North America (Allianz). Hass and North American each moved for summary judgment and Allianz joined North American’s motion. After a hearing, the circuit court denied Plaintiff's motion and granted the insurance companies’ motion. Plaintiff appealed, arguing that the insurance companies were vicariously liable for Defendant's acts. Based on undisputed material facts on the record in this case, the Supreme Court found that Defendant Wentzlaff was not acting within the scope of his employment when he stole money from Severson, and thus, as a matter of law, North American and Allianz were not vicariously liable for his acts. The Court affirmed the circuit court's grant of summary judgment in favor of the insurance companies. View "Hass v. Wentzlaff" on Justia Law
Cornelius v. Nat’l Cas. Co.
James Cornelius initiated a declaratory judgment action against National Casualty Company to determine whether a policy of insurance issued by National Casualty to Cornelius's employer, Live Line Maintenance, provided uninsured motorist coverage to Cornelius for injuries he sustained while occupying a vehicle owned by Live Line. The circuit court granted National Casualty's motion for summary judgment, finding that Cornelius could not recover uninsured motorist benefits. The Supreme Court reversed, holding that the circuit court erred in granting summary judgment for National Casualty because Cornelius presented evidence to support his claim that there was a casual connection between Live Line and Live Line's proprietor's alleged negligent maintenance of the work vehicle and the accident that caused Cornelius's injuries. View "Cornelius v. Nat'l Cas. Co." on Justia Law
Kendall v. John Morrell & Co.
Patrick Kendall suffered a work-related injury while working at John Morrell and Company, a self-insured employer. Morrell initially accepted Kendall's workers' compensation claim, but because Kendall later missed a number of physical therapy and doctor's appointments, Morrell later denied all further benefits relating to the injury. Almost three years later, Kendall filed a petition with the state Department of Labor requesting additional benefits for the injury. The Department granted summary judgment in favor of Morrell, concluding that the petition was barred by the statute of limitations. The circuit court affirmed. The Supreme Court affirmed, holding that all of Kendall's claims for benefits were procedurally barred by the statute of limitations in S.D. Codified Laws 62-7-35. View "Kendall v. John Morrell & Co." on Justia Law
McQuay v. Fischer Furniture
Employee received workers' compensation benefits for a neck and back injury he suffered in 2002 while working for Employer. After his benefits were discontinued in 2004, Employee sought treatment for a low back condition and petitioned the Department of Labor for workers' compensation benefits. The Department denied the petition, ruling that Employee did not prove his low back condition was related to his original 2002 work injury. The circuit court affirmed. The Supreme Court affirmed, holding that the Department correctly denied workers' compensation benefits where Employee failed to establish by a preponderance of the evidence that the 2002 injury was a major contributing cause of his current low back condition. View "McQuay v. Fischer Furniture" on Justia Law
Thyen v. Hubbard Feeds, Inc.
Employee submitted a workers' compensation claim to his Employer after suffering a reaction that some doctors attributed to work-related exposure. Employee petitioned the Department of Labor for a hearing on his workers' compensation claim. The Department denied Employee's claim, concluding that Employee failed to demonstrate that he sustained a compensable injury arising out of and in the course of his employment. The circuit court affirmed. At issue on appeal was whether Employee's efforts to prove causation were thwarted by Employer's refusal to allow collection of samples of various materials in areas around the plant and its later destruction of potential samples. The Supreme Court reversed, holding that the Department failed to properly consider the spoliation question and Employee was entitled to a new hearing before the Department. View "Thyen v. Hubbard Feeds, Inc." on Justia Law
S.D. Public Assurance Alliance v. Aurora County
The South Dakota Public Assurance Alliance (SDPAA), a local government risk pool, negotiated with Aurora County to provide what was essentially insurance coverage. After coverage was finalized, a local dairy farm sued the County over a pre-existing zoning dispute. The County was found liable for damages. SDPAA then sought a declaration that it did not have a duty to defend or indemnify, arguing, inter alia, that the County failed to disclose material facts relating to the claim. In a jury trial, the circuit court excluded as parol evidence the parties' pre-contract communications regarding coverage for zoning issues, including communications that could be interpreted as having disclosed the dairy farm zoning dispute. The jury found for SDPAA. The Supreme Court reversed and remanded for a new trial, holding that because the excluded coverage communications were not offered to alter or contradict any written terms of the agreement, their admission would not have violated the parol evidence rule. View "S.D. Public Assurance Alliance v. Aurora County" on Justia Law
Jennings v. Rapid City Reg’l Hosp., Inc.
After self-insured Employer filed for bankruptcy, it continued to take payroll deductions from Employees for medical coverage but stopped paying the provider hospital for the covered charges. The hospital then directly billed Employees for services that should have been paid by Employer. Employees filed suit to stop the hospital's attempts to collect payment, seeking relief under the theories of declaratory judgment, injunction, breach of contract, negligent infliction of emotional distress, and bad faith breach of contract. The circuit court granted summary judgment in favor of the hospital on all of Employees' claims. The Supreme Court reversed, holding (1) Employees had standing as third party beneficiaries to enforce the provisions of the hospital agreement and payer agreement; and (2) Employees were not obligated to pay for covered medical services under the agreements. Remanded. View "Jennings v. Rapid City Reg'l Hosp., Inc." on Justia Law
De Smet Ins. Co. v. Pourier
Tabitha Pourier was seriously injured in an automobile accident and suffered damages in excess of $250,000. After receiving $25,000 from the tortfeasor's liaility carrier and $100,000 in underinsured motorist coverage from her primary insurer, Pourier sought an additional $100,000 in underinsured coverage from her excess carrier, De Smet Insurance Company. De Smet denied coverage, asserting that an exclusion in the policy precluded coverage. On cross motions for summary judgment, the circuit court granted summary judgment in favor of De Smet, ruling that the policy exclusion was valid and enforceable. At issue on appeal was whether De Smet's owned-but-not-insured exclusion was void as against public policy because it prohibited Pourier, who was riding in a vehicle owned by her but insured by another company, from recovering for uncompensated damages by De Smet as the secondary insurer. The Supreme Court affirmed, holding that the policy exclusion was not against public policy. View "De Smet Ins. Co. v. Pourier" on Justia Law
Demaray v. De Smet Farm Mutual Ins. Co.
Appellees Floyd Demaray and James Hagemann were sued for repeated tortious activity in discharging of pollutants into lakes and streams of a nearby property. Appellees, who owned separate but identical insurance policies with De Smet Farm Mutual Insurance, notified De Smet of the lawsuit. De Smet declined defense of the suit, asserting it owed no duty to defend under the insurance contract. Appellees obtained their own defense counsel and defended the matter through trial, where a jury ruled in their favor. Appellees then sued De Smet, alleging that the company breached its duty to defend them in the previous lawsuit and seeking indemnification for all costs and fees incurred as a result. The trial court granted Appellees' motion for summary judgment, holding that De Smet owed Appellees a duty to defend because the alleged claim, if true, fell within policy coverage. On appeal, the Supreme Court reversed, holding that the policy language was unambiguous and the complaint asserted no claim that would arguably invoke coverage. Remanded with directions to grant summary judgment for De Smet. View "Demaray v. De Smet Farm Mutual Ins. Co." on Justia Law
Batiz v. Fire Ins. Exchange
After a fire damaged Oscar Batiz's residential rental property, Batiz filed a claim with his carrier, Fire Insurance Exchange. Exchange initially tendered to Batiz $33,182 representing the actual cash value of the damaged property, later raising that amount to $8,415 after both parties chose an impartial appraiser and an umpire determined the cost to repair the property was $43,921. Batiz did not cash the payment and brought a declaratory action against Exchange. Both parties filed cross motions for summary judgment. The circuit court granted Exchange's motion for summary judgment, dismissing Batiz's action without prejudice. On appeal, the Supreme Court affirmed, holding that (1) the circuit court did not err in determining that a declaratory judgment against Exchange was unwarranted because the insurance policy unambiguously provided what rights and obligations the parties had; and (2) the circuit court was correct in ruling that Batiz's assertion that the vast difference between his appraiser's and the umpire's valuations presented a justiciable issue requiring the court to determine the amount of loss was premature as Batiz had not yet repaired or replaced the damaged property. Remanded. View "Batiz v. Fire Ins. Exchange" on Justia Law