Justia Kentucky Supreme Court Opinion Summaries
Articles Posted in Insurance Law
Bidwell v. Shelter Mut. Ins. Co.
This case presented the question of whether an automobile insurance policy's permissive user step-down provision was valid and enforceable. Specifically, the Supreme Court addressed whether the particular provision at issue was sufficiently conspicuous, plain, and clear to satisfy the doctrine of reasonable expectations. The circuit court entered summary judgment in favor of the insurance company, declaring the permissive user step-down provision enforceable. The court of appeals affirmed. The Supreme Court reversed, holding that the policy's permissive user step-down provision was insufficiently plain and clear to defeat the reasonable expectations of the insureds, and therefore, the provision violated the doctrine of reasonable expectations. Remanded. View "Bidwell v. Shelter Mut. Ins. Co." on Justia Law
UPS Airlines v. West
At issue in this appeal was whether Ky. Rev. Stat. 342.730(6) entitled UPS Airlines to receive credit against its liability under section 342.730(1) for the payment of loss of license benefits that were the product of a collective bargaining agreement between UPS Airlines and the Independent Pilots Association (IPA), of which Claimant was a member. Claimant, a UPS pilot, sustained a work-related injury and underwent surgery. UPS paid the entire premium for the loss of license insurance plan. UPS subsequently sought leave to credit Claimant's loss of license benefits against its liability for income benefits. Reversing an ALJ's decision, the workers' compensation board found that section 342.730(6) did not entitle UPS to a dollar-for-dollar credit against Claimant's past due and future income benefits for all benefits paid under the loss of license plan. The Supreme Court (1) affirmed to the extent that UPS was not entitled to a dollar-for-dollar credit; but (2) reversed with respect to the conclusion that loss of license benefits were not funded exclusively by the employer for the purposes of section 342.730(6) because they were bargained-for benefits, holding that section 342.730(6) does not entitle UPS to credit the overpayment of voluntary benefits against future income benefits. Remanded. View "UPS Airlines v. West" on Justia Law
Ky. Unemployment Ins. Comm’n v. Hamilton
On April 1, 2005, Employee was injured during the course of his employment. Due to the injury, Employee never returned to work. Employee received workers' compensation benefits from April 2, 2005 through April 14, 2007. When the workers' compensation benefits ceased, Employee applied for unemployment insurance benefits. The Unemployment Insurance Commission based Employee's unemployment benefits on an extended base period comprised of the first three quarters of 2005 and the fourth quarter of 2006. Employee appealed, arguing that the extended base period should be based upon the four calendar quarters of the year 2004 because those were the most recent four quarters which fairly reflected the wages he earned prior to his injury. The circuit court reversed. The court of appeals affirmed. At issue on appeal was the proper interpretation of "extended base period" as defined in section 341.090(2). The Supreme Court reversed the court of appeals and reinstated the decision of the Commission, holding that the Commission properly applied the statute as written by the General Assembly in calculating Employee's unemployment benefits.
View "Ky. Unemployment Ins. Comm'n v. Hamilton" on Justia Law
Doctors’ Assocs. v. Uninsured Employers’ Fund
Doctors' Associates, Inc. (DAI) owns the "Subway" trademark and franchises the right to operate Subway sandwich shops nationwide. A claimant sought workers' compensation benefits for a work-related injury sustained while working for an uninsured Subway franchisee. The DAI and Uninsured Employers' Fund (UEF) were later joined as parties. The sole issue submitted for a decision by the ALJ was whether DAI was a contractor and, thus, liable to the employee of its uninsured subcontractor. The ALJ dismissed the UEF's claim against DAI, ruling that Ky. Rev. Stat. 342.610, which provides that a contractor can be liable to the employee of its uninsured subcontractor, imposed no liability on DAI because the statute did not encompass franchise relationships. The workers' compensation board affirmed. The court of appeals reversed, holding that the ALJ committed by legal error by concluding that the legislature did not intend for section 34.610 to encompass the franchisor-franchisee relationship simply because the statute failed to mention the relationship. The Supreme Court reversed, holding (1) the ALJ erroneously interpreted section 342.610, but (2) the error did not require reversal of the ALJ's ruling because the ALJ properly analyzed the facts of the case under the statute. View "Doctors' Assocs. v. Uninsured Employers' Fund " on Justia Law
Blackstone Mining Co. v. Travelers Ins. Co.
Travelers Insurance Company brought suit in circuit court alleging that Blackstone Mining Company had underpaid premiums under two separate workers' compensation policies issued by Travelers. Blackstone counterclaimed, alleging that it had overpaid the premiums due under the policies and was entitled to a refund. The circuit court granted summary judgment to Blackstone. The court of appeals reversed. The Supreme Court reversed the court of appeals and reinstated the judgment of the circuit court, holding (1) the court of appeals incorrectly applied well-established burden of proof principles applicable to summary judgment motions; and (2) the circuit court correctly determined that Blackstone was entitled to summary judgment. View "Blackstone Mining Co. v. Travelers Ins. Co." on Justia Law
Interlock Indus., Inc. v. Rawlings
Charles Rawlings suffered injuries as he was rolling straps beside his tractor-trailer while it was being unloaded. Thirteen months after the accident, Rawlings filed an action against Defendants, his employer and the companies involved in loading and unloading the trailer. The trial court granted summary judgment in favor of Defendants and dismissed the action based on the one-year statute of limitations for personal injury claims in Ky. Rev. Stat. 413.140(1)(a). The court of appeals reversed, applying the two-year statute of limitations in the Motor Vehicle Reparations Act. At issue on appeal was whether Rawlings was in fact unloading his truck at the time of the accident, which would determine whether the one- or two-year statute of limitations applied. The Supreme Court reversed, holding (1) Rawlings's activity in releasing the straps and rolling them qualified him as a participant in the unloading process; and (2) therefore, the trial court correctly applied the one-year personal injury statute of limitations found in section 413.140(1)(a). Remanded. View "Interlock Indus., Inc. v. Rawlings" on Justia Law
Cincinnati Ins. Co. v. Motorists Mut. Ins. Co.
Five years after Homeowners contracted for the construction of their home, Homeonwers sued Elite Homes, the construction company that built their home, and Motorists Mutual Insurance, the insurance company that provided commercial general liability (CGL) insurance to the construction company while the home was under construction, claiming the house was so poorly built it was beyond repair. Motorists settled Homeonwers' claims against itself and Elite. Under the terms of the settlement, Homeowners and Elite assigned to Motorists all claims they may have had against Cincinnati Insurance, which was a successor to Motorists as Elite's CGL insurer. Motorists then filed a third-party complaint against Cincinnati. The trial court granted summary judgment to Cincinnati, holding that Homeowners' claims of intangible economic loss did not qualify as an "occurrence" causing property damage under Cincinnati's CGL policy. The court of appeals vacated the grant of summary judgment. At issue on appeal was whether faulty construction-related workmanship, standing alone, qualifies as an "occurrence" under a CGL policy. The Supreme Court reversed the court of appeals and reinstated the judgment of the trial court, holding that the trial court's conclusion that the claims were not an "occurrence" was correct. View "Cincinnati Ins. Co. v. Motorists Mut. Ins. Co." on Justia Law
State Farm Ins. Co. v. Honorable Brian C. Edwards,
Appellant appealed from an order denying its petition for a writ of prohibition where appellant sought to prohibit appellee, a Jefferson Circuit Court judge, from referring its default judgment motion to the circuit court Master Commissioner for certain factual determinations. At issue was whether appellants were entitled to a writ where appellants alleged that the Jefferson Circuit Court's routine practice of referring default judgments to the commissioner did not comport with the role of commissioners as contemplated by the Kentucky Rules of Civil Procedure and that the Jefferson Circuit Court's alleged practice was unique among Kentucky's circuit courts and was at odds with the equal protection guarantees of both the Kentucky and United States Constitutions. The court held that appellant was not entitled to a writ prohibiting the reference to the commissioner because appellant could obtain ordinary appellate review of its objection.
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