Justia Government & Administrative Law Opinion Summaries

The issue in this case concerned a challenge to a trial court's order denying a motion to compel arbitration of an insurance coverage dispute. James River Insurance Company issued two "surplus line" insurance policies under which the Washington State Department of Transportation (WSDOT) claimed coverage. James River sought to compel arbitration of the coverage dispute pursuant to the insurance policies' arbitration clauses. WSDOT opposed arbitration and filed a motion for declaratory judgment, arguing that the arbitration clauses are unenforceable under RCW 48.18.200(1)(b), which prohibits insurance contracts from "depriving the courts of this state of the jurisdiction of action against the insurer," and under RCW 48.15.150(1), which requires that "an unauthorized insurer must be sued in the superior court of the county in which the cause of action arose." In addition, WSDOT argued that the McCarran-Ferguson Act (15 U.S.C. 1012), shields the statutes from preemption by the Federal Arbitration Act (9 U.S.C. secs. 1-14). The trial court agreed with WSDOT and denied James River's motion to compel arbitration. James River appealed and the Supreme Court granted direct review. The Court affirmed: "RCW 48.18.200(1)(b) is not merely a forum selection provision as James River maintain[ed], but rather a provision prohibiting binding arbitration agreements in insurance contracts. As such, we hold that this provision regulates the 'business of insurance' because it is aimed at protecting the performance of an insurance contract by ensuring the right of the policyholder to bring an action in state court to enforce the contract." The Court concluded that RCW 48.18.200(1)(b) was shielded from preemption by the FAA under the McCarran-Ferguson Act. View "Dep't of Transp. v. James River Ins. Co." on Justia Law

Relator, a sales manager for Takeda, brought a qui tam action against his employer under the False Claims Act, 31 U.S.C. 3729-3733, alleging that Takeda violated the Act by causing false claims to be presented to the government for payment under Medicare and other federal health insurance programs. The district court dismissed relator's claims under Rule 12(b)(6). The court held that the district court did not err in dismissing the third amended complaint because relator failed to plausibly allege that any false claims had been presented to the government for payment. The court also held that the district court did not abuse its discretion in denying relator leave to file a fourth amended complaint. Accordingly, the court affirmed the judgment. View "US ex rel. Noah Nathan v. Takeda Pharmaceuticals" on Justia Law

The Superintendent of Insurance found that a Bankers Life and Casualty Company agent engaged in deceptive insurance sales practices in multiple transactions with an elderly woman. Bankers Life and its agents functioned as insurance producers at the relevant time. The Superintendent ordered Bankers Life to pay restitution and a civil penalty of $100,000. The business and consumer docket affirmed the Superintendent's decision. Bankers Life appealed. The Supreme Court affirmed, holding that the Superintendent did not err in her statutory interpretation or factual findings and did not abuse her discretion by imposing restitution and a penalty on Bankers Life based on the evidence presented in the administrative record. View "Bankers Life & Cas. Co. v. Superintendent of Ins." on Justia Law

The United States District Court for the Northern District of Alabama, Southern Division certified a question to the Alabama Supreme Court: "Under Alabama law, is a 'Potentially Responsible Party' ('PRP') letter from the Environmental Protection Agency ('EPA'), in accordance with the Comprehensive Environmental Response Compensation and Liability Act ('CERCLA') provisions, sufficient to satisfy the 'suit' requirement under a liability policy of insurance?" The plaintiff in the underlying action is Alabama Gas Corporation ("Alagasco"). Defendants St. Paul Fire and Marine Insurance Company, St. Paul Surplus Lines Insurance Company, and St. Paul Mercury Insurance Company are all direct and indirect subsidiaries of defendant Travelers Casualty and Surety Company. Upon review of the applicable statutory and case law authority, the Supreme Court answered the certified question in the affirmative. View "Travelers Casualty and Surety Company et al. v. Alabama Gas Corporation " on Justia Law

This appeal by Dorothy Knight arose from a 2011 circuit court order. In it, the circuit court affirmed an administrative decision by the Public Employees Retirement System (PERS) denying disability benefits. Upon review, a majority of the Supreme Court concluded that Knight met her burden, and that PERS' decision to deny her claim was not supported by substantial evidence. Accordingly, the Court reversed the appellate and circuit courts' rulings and remanded the case for further proceedings. View "Knight v. Public Employees' Retirement System of Mississippi" on Justia Law

Petitioner Vincent James Hogg, Sr. sought review of a Workers' Compensation Court order which denied his workers' compensation benefits based upon the court's interpretation of 85 O.S. 2011, section 312 (3). Petitioner was employed by the Oklahoma County Juvenile Detention Center when in late 2011, he sustained an injury to his right shoulder and neck while subduing an unruly and combative juvenile. Petitioner was given a post-accident drug screen and a follow-up screen the next day. Both screens showed a "positive" result for the presence of marijuana in his system. Petitioner did not dispute the test results but Petitioner denied ever smoking marijuana. The trial court ultimately found there was no evidence presented to establish Petitioner was "high," nor was there any evidence to establish the marijuana in his system was the "major cause" of the accidental injury. The trial court did, however, deny Petitioner's eligibility for workers' compensation benefits by reason of its interpretation of the newly created 85 O.S. 2011, section 312 (3). The dispositive issue presented to the Supreme Court was whether the trial court erred in its interpretation of the statute. The trial court found the last sentence of paragraph 3 expressed the legislative intent of the entire paragraph without giving any weight to the other sentences in the same paragraph. In its order, the trial court indicated this sentence created an irrebuttable presumption. Upon review, the Supreme Court disagreed. The Court concluded that Petitioner overcame the rebuttable presumption of ineligibility for workers' compensation benefits. The case was reversed and remanded for further proceedings. View "Hogg v. Oklahoma Cty. Juvenile Bureau" on Justia Law

Brendan Muldoon appealed a district court judgment that affirmed an order from an administrative law judge ("ALJ") which: affirmed an order of Workforce Safety and Insurance ("WSI") finding Muldoon was an employer under N.D.C.C. 65-01-02(17); that Muldoon wilfully failed to secure workers' compensation coverage for his employees; and that Muldoon was personally liable for past premiums and penalties owed to WSI. Upon review of the ALJ's record, the Supreme Court affirmed, concluding the ALJ's findings were supported by a preponderance of the evidence. View "Muldoon v. WSI" on Justia Law

In this appeal, the Supreme Court was asked to determined whether Ohio Const. art. XII, 5a permits the use of motor vehicle and gas tax (MVGT) funds to pay those costs of a county's joint self-insurance pool attributable to covering the risk of liability and loss resulting from the operations of a county engineer's highway department. The Supreme Court concluded that Ohio Const. art. XII, 5a authorizes the use of MVGT funds to pay a county's cost of participating in a joint self-insurance pool attributable to covering the risk of liability and loss resulting from the operations of a county engineer's highway department. In so holding, the Court reversed the judgment of the court of appeals and remanded. View "Stockberger v. Henry" on Justia Law

Petitioner suffered an injury while in the course and scope of his employment. The employer's workers' compensation insurance carrier paid medical benefits but contested the extent of Petitioner's entitlement to impairment income benefits. The Department of Insurance's Workers' Compensation Division determined that Petitioner had an impairment rating of twenty percent. The trial court reversed the agency's decision, ruling that Petitioner had no valid impairment rating. The court of appeals affirmed. While Petitioner's appeal to the Supreme Court was pending, the Court held in American Zurich Insurance Co. v. Samudio that the absence of a valid impairment rating that had been submitted to the agency did not deprive a reviewing court of subject matter jurisdiction. In light of its decision in Samudio, the Court then reversed and remanded to the trial court with instructions that the court remand the case to the Division in light of its determination that Petitioner had no valid impairment rating. View "DeLeon v. Royal Indem. Co." on Justia Law

The Supreme Court accepted the petition of Harleysville Mutual Insurance Company (Petitioner) in its Original Jurisdiction to assess constitutional challenges to Act No. 26 of the South Carolina Acts and Joint Resolutions, which regulates coverage provided by commercial general liability (CGL) insurance policies for construction-related work. Upon review, the Supreme Court held that the retroactivity clause of Act No. 261 violated the Contract Clauses of the state and federal Constitutions, and that the statute may only apply prospectively to CGL insurance contracts executed on or after its effective date of May 17, 2011. View "Harleysville Mutual v. South Carolina" on Justia Law