Articles Posted in Insurance Law

by
The United States District Court for the District of New Mexico certified a question of New Mexico law to the state Supreme Court. The question centered on whether a worker injured in the course of employment by a co-worker operating an employer owned motor vehicle was a person “legally entitled to recover damages” under his employer’s uninsured/underinsured motorist coverage. Andrew Vasquez was killed at the workplace after being struck by a steel beam that fell off of a forklift during the course of his employment at Coronado Wrecking and Salvage. A coworker operating the forklift had jumped off to check whether the steel beam being lifted was secure, leaving the forklift unattended as the steel beam slid off of the forks, striking and killing Vasquez. Plaintiff, Vasquez’s estate, subsequently collected workers’ compensation benefits from Coronado’s workers’ compensation carrier. Related to the forklift accident, Plaintiff also collected uninsured motorist benefits under Vasquez’s own automobile insurance policy.The certified question from the district court arose from an alleged discontinuity among the plain language of New Mexico’s Workers’ Compensation Act (WCA), the Uninsured Motorist statute, and the New Mexico Court’s case law. Because the WCA provided the exclusive remedy for an employee injured in a workplace accident by an employer or its representative, the employee was not legally entitled to recover damages from the uninsured employer tortfeasor under the Uninsured Motorist statute. The Court therefore answered the certified question in the negative. View "Vasquez v. American Cas. Co. of Reading" on Justia Law

by
A trucking company purchased a liability insurance policy covering its tractors and trailers. The policy stipulated that liability coverage would be limited to "$1,000,000 each ‘accident.’" A tractor-trailer rig insured under the policy was involved in a single accident. The question this case presented for the New Mexico Supreme Court's review centered on whether $1,000,000 was the limit per accident for both vehicles (the tractor and the trailer) or whether each vehicle has liability coverage in the amount of $1,000,000. The district court interpreted the policy to limit its coverage to $1,000,000; the Court of Appeals disagreed and reversed. Because this dispute affects not only the parties to this lawsuit but arguably New Mexico’s place among the many jurisdictions that have grappled with similar policy language, the New Mexico Court granted certiorari. The Supreme Court disagreed with the Court of Appeals and reversed. The Supreme Court found that the Declarations page of the policy at issue provided that the dollar limit was $1,000,000 each accident. Section II(C) of the policy then said the same thing in terms of a "per accident" outside limit on what the insurer would pay: "Regardless of the number of covered ‘autos’ . . . or vehicles involved in the ‘accident’," the most Northland will pay "for the total of all damages . . .resulting from any one ‘accident’ is the Limit of Insurance for Liability Coverage shown in the Declarations [$1,000,000 each accident]." Therefore, the argument advanced by plaintiffs, the Luceros, that the policy provided $1,000,000 in coverage for "'each covered auto in each accident' simply does not find support in the language of the policy. The policy limits Northland’s exposure to $1,000,000 per accident regardless of the number of covered autos involved in any one accident." View "Lucero v. Northland Ins. Co." on Justia Law

by
The issue this case presented for the Supreme Court's review stemmed from a worker's compensation claim. Specifically, the issue the Court had to determine was whether a “wet floor” sign was a safety device and whether a nurse who slips on a recently mopped floor at work is entitled to a 10% increase in benefits when a “wet floor” sign was not posted near a mopped floor. The Court held that a “wet floor” sign is a safety device and that the nurse’s injury resulted from the negligence of the employer in failing to supply reasonable safety devices in general use. View "Benavides v. Eastern N.M. Med. Ctr." on Justia Law

by
Plaintiff Thomas P. Whelan, Jr.'s decedent father, Thomas P. Whelan, Sr., was in Plaintiff's parked truck when it was hit by a moving vehicle. The collision allegedly resulted in severe injuries and medical costs in excess of $100,000 and ultimately in the decedent's death a few years later. At the time of the accident, occupants of Plaintiff's truck were insureds under the terms of a $50,000 liability policy issued by State Farm, facially providing no UM/UIM coverage. In the Supreme Court's decision in "Jordan v. Allstate Ins. Co.," the effective rejection of an insured's statutory rights to UM/UIM coverage equal to liability limits had to be made in writing and as part of the insurance policy delivered to the insured. Because the result in "Jordan" was foreshadowed by other precedents, the Supreme Court declined to make Jordan applicable only to cases arising in the future, and held that policies that failed to comply with Jordan's rejection requirements would be judicially reformed to provide full statutory coverage. In 2011, following the 2010 issuance of Jordan, Plaintiff made a demand on his insurer State Farm for reformation of his policy that was in effect at the time of the accident. Relying on a clause in the policy that purported to bar UM/UIM claims made more than six years after the date of the underlying accident, State Farm rejected the claim. Plaintiff then instituted a declaratory judgment action against State Farm for reformation of the policy. Upon review of this matter, the Supreme Court held that a limitations clause based solely on the date of the accident without consideration of the actual accrual of the right to make a UM/UIM claim was unreasonable and unenforceable as a matter of law. But addressing the merits of Plaintiff's action, the Court also held that judicial reformation under Jordan did not extend to historical insurance contracts formed before another precedential opinion was issued in 2004. Because the policy in this case was issued before that date, it was not subject to retroactive reformation of its facial lack of UM/UIM coverage. View "Whelan v. State Farm Mutual Auto Ins. Co." on Justia Law

by
While working for Vista Care (Employer), appellant Sherrie Fowler suffered a back injury. Appellant began receiving TTD and subsequently underwent back surgery. Several years later, a physician determined that appellant reached maximum medical improvement (MMI). This case began when appellant filed a complaint with the Workers' Compensation Act (WCA) in 2010, for reinstatement of her TTD benefits and for an increase in her PPD rating. The Court of Appeals held that the Act limited appellant's eligibility for TTD benefits to 700 weeks of benefits and reversed a contrary decision of the Workers’ Compensation Administration judge. Upon review of the matter, the Supreme Court concluded that the Act imposed no such limitation; TTD benefits are payable during any period of total disability for the remainder of a worker’s life. View "Fowler v. Vista Care" on Justia Law

by
This appeal concerned the construction of a single word, "sudden," within a pollution exclusion clause in a series of liability insurance policies barring coverage for certain damages unless the events causing those damages were "sudden and accidental" (an issue of first impression in New Mexico). Concluding that "sudden" lacks a single clear meaning, the Supreme Court reversed the Court of Appeals' holding that the word unambiguously signifies "quick, abrupt, or a temporarily short period of time. . . .Under well-established principles of insurance law," the Court construed this ambiguity in favor of the insured, Petitioner United Nuclear Corporation, and interpreted the term "sudden" in the insurance policies at issue in this dispute to mean "unexpected." the case was remanded to the district court for further proceedings. View "United Nuclear Corp. v. Allstate Ins. Co." on Justia Law

by
The questions certified to the Supreme Court by the Court of Appeals pursuant to NMSA 1978, Section 34-5-14(C) (1972), required the Court to determine whether the primary or the secondary underinsured motorist (UIM) insurer, if either, should be given the statutory offset for the tortfeasor’s liability coverage. "[T]he short answer to the certified question is that neither the primary nor the secondary insurers are directly awarded the offset because under existing case law, the offset is applied before any UIM insurer is required to pay UIM benefits." View "State Farm v. Safeco Ins. Co." on Justia Law

by
Through its opinion in this case, the Supreme Court addressed an exception in the New Mexico Workers' Compensation Act (the Act) that permitted compensation for injuries incurred in travel by employees when those injuries "[arose] out of and in the course of employment." Eloy Doporto, Jr., Mike Lucas, Jose Turrubiates, and Pete Rodriguez (collectively, the Workers), employed by Permian Drilling Corporation (Permian) and insured by American Home Assurance, were involved in an automobile accident while traveling to their work site, resulting in the death of Doporto and injuries to the others.  Upon review, the Supreme Court concluded that the injuries suffered by the Workers arose out of and in the course of their employment because the travel was mutually beneficial to employees and employer and the Workers encountered special hazards unique to their employment while traveling, thus rendering the Workers "traveling employees" whose injuries are compensable under the Act. View "Rodriguez v. Permian Drilling Corp." on Justia Law