Justia Kentucky Supreme Court Opinion Summaries

Hospital purchased from Assurance Company of America a "builder's risk" insurance policy and contracted with Wehr Constructors for installation of subsurfaces and floors as part its project. After installation, a portion of the floors and subsurface done by Wehr was damaged. Hospital sought recompense under the builders risk policy. Assurance denied the claim. Meanwhile, Wehr and Hospital settled on Wehr's breach of contract claim. As part of the settlement, Hospital assigned to Wehr any claim Hospital had against Assurance arising out of the policy. Wehr, as Hospital's assignee, then sued Assurance in federal district court. Assurance moved for judgment on the pleadings, invoking the policy's anti-assignment provision and arguing that it had not consented to the assignment. The district court requested certification to answer a question of Kentucky law. The Supreme Court concluded that under Kentucky law, a clause in an insurance policy that requires the insured to obtain the insurer's prior written consent before assigning a claim for an insured loss under the policy is not enforceable or applicable to the assignment of a claim under the policy where the covered loss occurs before the assignment, and that such a clause would, under those circumstances, be void as against public policy. View "Wehr Constructors, Inc. v. Assurance Co. of Am." on Justia Law

Hospital purchased from Insurer a "builders risk" insurance policy which included a provision requiring Hospital to obtain Insurer's written consent before assigning a claim for an insured loss. Hospital contracted with Constructors for floors and subsurface work, which was later damaged. Hospital claimed a loss and sought recompense under the builders risk policy, but Insurer denied the claim. Hospital later assigned Constructors any claim or rights Hospital had against Insurer arising out of the insurance policy. Constructors, as Hospital's assignee, brought suit in federal court against Insurer seeking to recover payment due under the builder's risk policy. The Supreme Court granted the certification request of the federal court to answer a question of state law and concluded that, under Kentucky law, a clause in an insurance policy that requires the insured to obtain the insurer's prior written consent before assigning a claim for an insured loss under the policy is not enforceable or applicable to the assignment of a claim under the policy where the covered loss occurs before the assignment, and that such a clause would, under those circumstances, be void as against public policy. View "Wehr Constructors, Inc. v. Assurance Co. of Am." on Justia Law

Appellant appealed from an opinion of the court of appeals which affirmed an order of the circuit court dismissing Appellant's petition for review of a decision of the Kentucky Unemployment Insurance Commission (KUIC). In addition to denying Appellant unemployment benefits, the KUIC ordered Appellant to reimburse $12,785 in benefit payments he had already received. The circuit court dismissed Appellant's petition for review because it did not comply with the verification requirement contained in Ky. Rev. Stat. 341.450(1), and thus the court concluded that its jurisdiction was not invoked within the twenty-day limitations period provided for filing such an action. The Supreme Court affirmed, holding (1) because Appellant failed to comply with the verification provision of section 341.450(1), the circuit court lacked jurisdiction over the controversy; and (2) Appellant did not comply with the verification requirement, as his attorney's signature on the petition did not constitute "certification." View "Taylor v. Ky. Unemployment Ins. Comm'n" on Justia Law

Appellee pled guilty to fraudulent insurance acts by complicity. Pursuant to a plea agreement, the circuit court sentenced Appellee to a five-year probated sentence and ordered restitution to Amica Mutual Insurance Company in the amount of $48,597 - the full amount distributed by Amica after Appellee's house burned down. The court of appeals vacated the order of restitution and remanded to the trial court to make specific findings of the monetary damages suffered as a result of the insurance fraud, without regard to the proceeds distributed as a result of the property damage or alternate housing and living expenses. The Supreme Court reversed, holding (1) a trial court is authorized to order restitution for damages not suffered as a direct result of the criminal acts for which the defendant has been convicted when, as part of a plea agreement, the defendant freely and voluntarily agrees to the restitution condition; and (2) therefore, the trial court did not abuse its discretion when it ordered Appellee to reimburse Amica for the entire $48, 597. View "Commonwealth v. Morseman" on Justia Law

Appellee was injured during the course of his employment. When his workers' compensation benefits ceased, Appellee applied for and received unemployment insurance benefits. The Kentucky Unemployment Insurance Commission determined that Kan. Rev. Stat. 341.090, which permits the use of an "extended base period" that captures earnings leading to equitable unemployment benefits, required that the extended base period may include only the four calendar quarters that immediately precede the base period. Pursuant to this extended base period, Appellee was awarded benefits of $149 per week. The circuit court reversed. The court of appeals affirmed, concluding that the extended base period need not be limited to the four quarters that immediately precede the base period. The Supreme Court reversed, holding that the Commission properly applied the statute in calculating Appellee's unemployment benefits. View "Unemployment Ins. Comm'n v. Hamilton" on Justia Law

This appeal concerned the method for excluding impairment from a non-compensable disability when calculating a worker's permanent disability benefit under the post-1996 version of Kan. Rev. Stat. 342.730(1)(b). The ALJ calculated a benefit based on the claimant's entire post-injury permanent impairment rating and then subtracted an amount equal to a benefit based on his pre-existing active impairment rating. The workers' compensation board reversed, determining that the present version of section 342.730(1)(b) requires the calculation of income benefits to be based only on the permanent impairment rating caused by the injury being compensated. The court of appeals affirmed. The Supreme Court affirmed, holding that pre-existing impairment must be excluded when calculating a total disability award under section 342.730(1)(b). View "Tudor v. Indus. Mold & Mach. Co." on Justia Law

Appellants James Baldwin and Ronda Reynolds allegedly sustained injuries in separate highway incidents after objects came loose from unidentified vehicles and collided with their vehicles. Both Appellants sought uninsured motorist (UM) coverage for hit-and-run accidents through their automobile insurance policies. Baldwin's State Farm policy provided coverage when an uninsured motor vehicle "strikes" the insured vehicle, and Reynolds's Safeco policy covered damages when an uninsured motor vehicle "hits" the insured vehicle. The Supreme Court accepted review in these consolidated cases to focus on whether Appellants' accidents satisfied the impact requirements contained in the UM clauses of their insurance policies. The Supreme Court held that the impact requirements of the UM clauses of Baldwin's and Reynolds's insurance policies were not met, and therefore, UM coverage was not applicable to Appellants' hit-and-run accidents. View "State Farm Mut. Auto. Ins. Co. v. Baldwin" on Justia Law

Claimant sustained a work-related injury in 2003, for which he was awarded temporary total disability (TTD) benefits followed by 425 weeks of permanent partial disability benefits. In 2007 Claimant sustained another injury. After finding the effects of the 2003 injury caused Claimant's 2007 injury, an ALJ increased Claimant's partial disability benefit at reopening and tripled the entire income benefit awarded for his injury. The workers' compensation board and court of appeals affirmed. The Supreme Court affirmed, holding (1) substantial evidence supported the finding of increased impairment as well as the finding that Claimant lacked the physical capacity at reopening to perform the type of work performed at the time of his injury; and (2) the combined effects of the impairment present at the time of the initial award and the additional impairment present at reopening entitled Claimant to triple benefits based on the whole of his disability for the balance of the compensable period. View "James T. English Trucking v. Beeler" on Justia Law

An ALJ determined that Claimant sustained a work-related hearing loss and that Kan. Rev. Stat. 342.7305(4) placed the entire liability for income and medical benefits with Appellant, the last employer with whom Claimant was last injuriously exposed to hazardous noise. The workers' compensation board and court of appeals affirmed. The Supreme Court affirmed, holding (1) the record contained substantial evidence that testing revealed a pattern of hearing loss compatible with that caused by hazardous noise exposure and contained substantial evidence that Claimant sustained repetitive exposure to hazardous noise in the workplace, including his final employment with Appellant; and (2) Kan. Stat. Rev. 342.7305(4) does not permit apportioning liability among employers in such cases. View "Greg's Constr. v. Keeton" on Justia Law

This appeal concerned an ALJ's decision to award the claimant temporary total disability (TTD) benefits for his work-related shoulder injury from the date he left work, May 10, 2007, until May 8, 2009. The ALJ also awarded permanent income and medical benefits for the injury but denied claims for cervical and lumbar spine injuries. A court of appeals majority reversed, concluding that the opinion and award failed to contain findings adequate to make clear whether the ALJ considered and understood all of the evidence relevant to the date when TTD began. The Supreme Court (1) reversed to the extent that the ALJ made the finding of fact required by Kan. Rev. Stat. 342.0011(11)(a); but (2) affirmed to the extent the Court was unable to determine whether the ALJ simply misstated May 10, 2007 as being the date the claimant testified he stopped working due to the effects of his injury, misunderstood the evidence concerning his reason for missing work on May 10, 2007, or chose May 10, 2007 based on other evidence. Remanded to the ALJ to clarify that portion of the decision. View "Arnold v. Toyota Motor Mfg." on Justia Law