Articles Posted in Insurance Claims

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In a case that involved a “duty to settle” claim, the Illinois Appellate Court affirmed a decision dismissing a claim made by the insured, Randy Powell against his auto insurance company, American Service Insurance Co. (ASI).  It was alleged in the lawsuit by Randy Powell that Katie Linares broadsided his van when he stopped in front of her vehicle and started turning left to make a U-turn.  Powell demanded the $20,000 limit of the auto policy that Linares had purchased from ASI.

ASI rejected the demand and Powell continued on to a jury trial, which returned a verdict of $47,951.  Linares assigned her rights against the insurer to Powell who then sued for breach of duty to settle against ASI.

According to paragraph 6 of the complaint, “Linares was operating her vehicle on northbound Medline Drive, a private street or corporate driveway, in Mundelein, Illinois, behind the van being operated by Powell, saw him make a left turn attempting to make a U-turn and stopping in front of the Linares vehicle either perpendicular or at a northwest angle to the northbound roadway, and, rather than apply her brakes or attempt to veer behind the van driven by Powell, veered directly into the van striking it broadside with a strong impact.”

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James Werner, who was also the defendant in this case, was the insurer producer for Office Furnishings Ltd. and Brathan Property LLC. Brathan Property owned a commercial building at 725 S. 25th Avenue in Bellwood, Ill., where Office Furnishings maintained a warehouse for its office furniture business.  Werner obtained insurance coverage for Office Furnishings and Brathan Property with American Family Insurance.

American Family required its own application to be signed by the insureds, in this case Office Furnishings and Brathan Property, which was done in a meeting on Dec. 17, 2002.

On Jan. 31, 2003, the roof of the warehouse shattered due to extreme cold weather and high winds, which caused serious property damage to the building and its contents. Office Furnishings and Brathan Property submitted a claim for their losses, including $1,349,872 in estimated roof replacement costs, $729,295 for inventory damage and $88,074, which represented the cost of a temporary roof.

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On Aug. 10, 2009, Dolores Trujillo was a passenger in a vehicle driven by Adam Delgado.The Delgado vehicle was involved in a collision.  Allstate Property and Casualty Insurance insured Delgado and his car.  The other car involved in the collision was insured by American Access Insurance Co.

Trujillo settled her claim against American Access for $20,000, which was the policy limit, and then settled her claim against Delgado for the $100,000 insurance policy limit on his Allstate policy. 

Trujillo also claimed $80,000 from Allstate as under-insured motorist coverage. The $80,000 represented the difference between Allstate’s maximum under-insured coverage $100,000 and the $20,000 she received from American Access.

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In December 2007, the plaintiffs, Brothers Future Holding LLC and Custom Gourmet Concepts LLC purchased a vacant meat packing plant located at 2684 N. 900 East Road in Ashkum, Ill.  The plaintiffs planned to use the property to start up a new custom contracting cooking company. The plaintiffs hired Assurance Agency, which was an insurance brokerage firm to procure insurance for any loss or damage to the property, and the brokers were to obtain a policy through Indiana Insurance Co.

Between Nov. 27, 2009 and Dec. 7, 2009, the real property was severely damaged by vandals and thieves who broke into the premises, cut and removed copper pipes, stripped copper from all of the electrical wiring and refrigeration systems and stole other fixtures and equipment for a total property loss of $2,272,168. However, the defendants — the insurance brokers — chose not to obtain ongoing vacancy coverage for the property, causing plaintiffs’ insurance claim for the loss to be denied by the insurer, Indiana Insurance Co.

The plaintiffs’ lawsuit asserted that the defendants knew that the building was vacant and that the plaintiffs had specifically requested vacancy insurance coverage.

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Ana Reyes was the owner of a motor vehicle and was the sole named insured.  She purchased auto insurance from American Access Casualty Co., and  the policy specifically said there would be no liability coverage for any accident in which she was operating a motor vehicle.

On Oct. 30, 2007, Reyes allegedly drove the Chrysler sedan she owned and hit two pedestrians, killing a 4-year-old boy and injuring his mother.

The Jasso family, who were the injured mother and fatally injured child, had uninsured motorist coverage with State Farm Insurance Co.  The question for the Illinois Supreme Court in this case was the dispute between American Access and State Farm as to whether public policy as established under §7-317(b)(2) of the Illinois Vehicle Code serves to block insurance companies from excluding coverage for a policy’s sole named insured. With Justice Thomas Kilbride dissenting, the Illinois Supreme Court concluded “an automobile liability insurance policy cannot exclude the sole named insured since such an exclusion conflicts with the plain language of Section 7-317(b)(2) and, therefore, violates public policy.”

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Illinois law provides for losses suffered when an Illinois insurance company goes bankrupt, is liquidated or cannot meets its obligations.  The Illinois Insurance Guarantee Fund is available to step in when an insurance company fails.

In this case, the Illinois Supreme Court reversed and remanded a decision written by the Fifth District Appellate Court in the case of Roy Dean Rogers II. Rogers, age 18, was struck by a car driven by John Winterrowd in 2009.  Roy died as a result of this incident and his injuries.

Winterrowd was intoxicated at the time.  Rogers’s parents received in settlement two insurance payouts.  One was for $26,550 from Winterrowd’s insurance company and another $80,000 was received from the Rogers’s own automobile insurance company.

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Phusion Projects Inc. manufactures and distributes the alcoholic beverage Four Loko. The product contains alcohol in addition to caffeine, guarana, taurine and wormwood. Guarana is a plant that has one of the highest concentrations of caffeine in any plant. It’s often used as a supplement to energy drinks, including this one. Taurine is an organic acid or an amino acid that some research shows may be a contributing factor to improved athletic performances. Wormwood is an herb. Some uses of wormwood are said to be for digestive disorders and to increase sexual desires and stimulate the imagination.  Wormwood is also used for healing wounds and countering insect bites. It is also used in some alcoholic beverages, such as vermouth and absinthe. 

Phusion purchased insurance coverage from two members of the Liberty Mutual Group. Both of the insurance policies contained clauses that excluded coverage for bodily injury or property damage when Phusion could be held responsible by reason of causing or contributing to intoxication.

Phusion was sued by five separate plaintiffs. All of them alleged that the consumption of Four Loko caused their injuries in whole or in part.

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In October 2007, John Walls suffered a work injury at I-Maxx Metalworks Inc. when “a stair stringer and/or perimeter cable protection failed.”

Walls filed suit against I-Maxx, Turner Construction, Frontier Construction and against Waukegan Steel Sales. The lawsuit alleged that Waukegan Steel negligently chose not manage, operate and maintain the work premises in a safe way, failed to inspect, failed to provide a safe workplace or provide proper fall protection.

By the contract with subcontractors, I-Maxx was solely responsible for the “means, method and safety of employees while on the job site.”

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Cathy Stackhouse obtained a $4.5 million jury verdict against Lakemoor Golf Course and Royce Realty for an accident that took place on Lakemoor’s golf course. The golf course and Royce Realty were insured by Indiana Insurance Co.

Royce Realty was the manager of several golf courses, shopping centers and apartment buildings. Because of the need for protection, it purchased a commercial general liability policy from Indiana Insurance Co. But Indiana Insurance Co. attempted to severely restrict its own liability by attaching an endorsement that limited the policy’s coverage to claims “arising out of the ownership, maintenance or use of Royce’s headquarters in Oak Brook and operations necessary or incidental to those premises.”  After the Stackhouse verdict against Lakemoor and Royce, Indiana Insurance sued in the Chancery court for a declaratory judgment that the Stackhouse judgment was not covered. 

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Atlantic Casualty Insurance Co. insured Paszko Masonry as it worked on the construction of an apartment building in Downers Grove, Ill., along with three other companies, Prince Contractors Inc., Chicago Masonry Construction and 4929 Forest LLC..

Robert Rybaltowski was an employee of the waterproofing company, Raincoat Solutions, which had submitted a bid to the general contractor, Prince Contractors, to perform caulking work on the building. 

On the condition that Raincoat bring its employee to the jobsite to show that Raincoat’s employee was competent, the general contractor would approve the submitted bid for the caulking work. 

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