Source: http://cclegalupdate.com/
Timestamp: 2015-03-31 03:15:31
Document Index: 292888668

Matched Legal Cases: ['§ 631', '§ 345', '§ 632', '§ 632', '§ 101', '§ 893']

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Claims-Made-And-Reported Insurance Policies Not Subject to Statutory Notice Requirements
March 4, 2015 By Sara Mills, Esq. in insurance, insurance coverage	Leave a comment
In a decision I previously reported on, Anderson v. Aul, the Court of Appeals was asked to examine the reporting requirements of a claims-made-and-reported policy of insurance, which is a common type of policy in the context of errors and omissions and professional liability coverage. Claims-made-and-reported policies differ from “occurrence” policies, because occurrence policies generally provide coverage for injuries that “occur” during the policy period even if the claim for the resulting injury is not filed until after the policy expires. In contract, claims-made-and-reported policies contain two requirements to trigger coverage: 1) the claim must be made during the policy period; and 2) the insured must give written of the claim within the policy period.
The appellate court examined a claims-made professional liability policy written by Wisconsin Lawyers Mutual Insurance Company with a policy period of April 1, 2009 to April 1, 2010. However, WLMIC did not receive notice of the claim of malpractice against the insured attorney until March 9, 2011. Despite this delay and despite the language of the policy requiring notice to be made during the policy period, the appeals court held that a “finding of untimeliness is not solely dispositive” of the coverage question and that the circuit court must also determine whether the untimely notice prejudiced the insurer. In its published opinion, the Court of Appeals looked to the reasonableness standard set forth in Wisconsin statutes and held that unreasonably late notice is not per se prejudicial to an insurer. The appellate court’s decision was a blow to insurers who relied on the claims-made-and-reported type of policy to limit their exposure and to keep premiums low.
On review of the Court of Appeals’ decision, the Wisconsin Supreme Court reversed. The court noted that Wisconsin’s notice-prejudice statutes, Wis. Stat. §§ 631.81(1) and 632.26(2) provide that an insured’s failure to furnish timely notice of a claim as required by the terms of a liability policy will not bar coverage unless timely notice was “reasonably possible” and the insurance company was “prejudiced” by the delay. ¶ 4. However, the court held that these statutes do not supersede the policy’s notice requirements. ¶ 7.
Personal Knowledge Necessary to Establish Impermissible Purpose in Age Discrimination Claims
November 26, 2014 By Sara Mills, Esq. in Age Discrimination, Civil Rights, Evidence, Litigation	Leave a comment
The Seventh Circuit recently reiterated the rule that admissible testimony must be based on personal knowledge in a case alleging age discrimination. See Widmore v. Sun Chemical Corporation, No. 13-2313 (7th Cir., Nov. 19, 2014). Being blamed for problems that were not your fault is not sufficient to establish that your employer was motivated by an impermissible purpose, and speculation as to the employer’s state of mind does not create a material factual dispute about whether the reason for termination was pretextual.
George Widmar worked for Sun Chemical Corporation as a Plant Manager for sixteen years. Sun Chemical terminated Widmar’s employment in 2009, claiming that the company was unsatisfied with Widmar’s performance. “The gist of his case is that Sun Chemical falsely blamed Widmar [for many of the problems involving its products] to cover up for the fact that it was firing him because of his age.”
However, the court was quick to note that, at first blush, this case did not seem as if it was appropriate for summary judgment disposition: “Generally, when the fact sections of the opposing briefs read like two unrelated stories, that is a clue for a court to look for material facts that require a trial to resolve. …That certainly seemed to be the case here.”
Although the two sides’ stories were dissimilar, the court could not simply end its analysis on a cursory review of the facts. The district court and the court of appeals examined the briefs and record carefully and found that much of the disagreement was created by deficiencies in Widmar’s recitation.
Widmar’s declaration and deposition were “not only self-serving, but also irrelevant in establishing that age was a motivating factor in his termination.” (R. 201, p. 6). Self-serving affidavits can indeed be a legitimate method of introducing facts on summary judgment.
Additionally, Widmar failed to comply with Federal Rule of Civil Procedure 56(e) and Federal Rule of Evidence 602, “both of which require that testimony be based on personal knowledge. Personal knowledge can include reasonable inferences, but it does not include speculating as to an employer’s state of mind, or other intuitions, hunches, or rumors.”
Whether Property is “Wholly Destroyed” is Determined Solely by Statutory Formula
November 12, 2014 By Sara Mills, Esq. in insurance, insurance coverage	Leave a comment
The Court of Appeals recently confirmed that when determining whether a building cannot be repaired and is therefore wholly destroyed, application of the statutory formula in Wis. Stat. 66.0413 is conclusive. See Haynes v. American Family Mutual Insurance Company, 2014AP000395. Tracy Haynes home burned down on May 29, 2012. The City of Milwaukee issued a Raze Order on July 10, 2012 stating that the home was “now unfit for human habitation, further occupancy or use, and is unreasonable to repair.”
American Family insured the home for $244,800. As a result of the fire, the home was assessed at $23,300 per the Raze Order. The Order stated that it was unreasonable to repair the home pursuant to Wis. Stat. 66.0413(1)(c). When a property is “wholly destroyed,” the insurance company must pay the “full value” of the policy. See Wis. Stat. 632.05(2). Accordingly, Haynes argued that her home was wholly destroyed because the Raze Order said it could not be repaired and was unfit for human habitation. But American Family disagreed.
American Family obtained a repair estimate for $146,906 and sent Haynes a Total Actual Cash Value Settlement offer listing the Replacement Cost Value as $130,947.62. Days later, American Family increased the amount slightly and then paid Haynes $131,578 on October 9, 2012. American Family had the contractor from whom it obtained an estimate to pull a repair permit, but Haynes objected and the City revoked the permit. Haynes’ home was ultimately razed.
Haynes sued, arguing that American Family owed her the full value of the home. American Family argued that a City inspector told both Haynes and American Family that she had the option of repairing or razing the property and that if she chose to repair it, the Raze Order would be withdrawn. The inspector also allegedly told American Family that the cost of repairs “was in the range of at least $75,000 to $1000,000.” But the Raze Order never mentioned the option of repair, and neither Haynes nor anyone else ever appealed the Raze Order. Further, the informal estimate offered by the inspector still exceeded the statutory formula in section 66.0413 used to determine whether repair is reasonable.
The court of appeals reversed the trial court and held that Haynes was entitled to the full value of her home: $244,800.
Of course, [Wis. Stat. 66.0413’s] command trumps any contrary analysis or post-hoc assessment by [the inspector] that he sets out in his affidavit. Simply put, the focus is on whether repairs are reasonable under the statutory formula, not whether elements of the structure survived the fire. The unappealed Raze Order, which, as we have seen, applied the mandated statutory formula, is conclusive.
UIM Coverage Determined by Entitlement, Not Recoverability
October 22, 2014 By Sara Mills, Esq. in insurance, insurance coverage, municipal law, policy exclusions Tags: State Farm	Leave a comment
The Court of Appeals recently examined a case involving a car accident with a municipally-owned vehicle being operated by a municipal employee. There is a statutory cap on recoverable damages applicable to municipalities, Wis. Stat. § 345.05(3), and State Farm argued that its insured was not an underinsured motorist because he was not “legally entitled to recover” any amount above the $250,000 statutory cap. In its analysis, the appellate court focused on whether the insured was entitled to recover and not whether the amounts were actually recoverable. Ultimately, it reversed the circuit court and held that the insured was an underinsured motorist.
In State Farm Mutual Automobile Ins. Co. v. Hunt, 2013AP002518, Mr. Hunt was seriously injured in an accident with a Dane County snow plow. His damages exceeded $250,000, and it was not disputed that the accident was caused by the County employee’s negligence. Hunt had insurance through State Farm, and his policy was issued on October 10, 2011. At that time, Wis. Stat. § 632.32(1), (4)(a)2m required all policies of insurance to include underinsured motorist coverage. The statute defined UIM coverage as:
coverage for the protection of persons insured under that coverage who are legally entitled to recover damages for bodily injury, death, sickness, or disease from owners or operators of underinsured motor vehicles.
Wis. Stat. § 632.32(2)(d) (2011-12).
October 7, 2014 By Richard Orton in Evidence, Litigation Tags: Daubert	Leave a comment
September 30, 2014 By Sara Mills, Esq. in Civil Rights, municipal law Tags: Seventh Circuit	Leave a comment
School District Not Liable For One Student’s Bullying of Another
September 24, 2014 By Sara Mills, Esq. in Civil Rights, deliberate indifference, School Law	Leave a comment
A recent Seventh Circuit case reiterated the high burden to impose liability on a school for one student’s mistreatment of another. In Doe v. Galster, et al., No. 13-2551, a girl sued the Elmbrook School District and several school administrators after severe bullying resulted in criminal charges against her tormentors. She asserted claims against the district under Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, and a section 1983 claim for violations of the Equal Protection Clause.
The girl, “Jane Doe,” was born in Russia and adopted at the age of two by American parents. The events that gave rise to her claim began during the sixth and seventh grade, a period of time that even the most gregarious and graceful pre-teens know to be painfully awkward if not constantly mortifying. During those years, several of Doe’s male classmates bullied her and she claims they used gendered and ethnic insults. The bullying even turned violent, at which point three of the boys were charged with criminal battery.
The thought of a girl being bullied so viciously that criminal charges ensued is heartbreaking. The Seventh Circuit used language suggesting that they too understood how reprehensible the bullies’ actions were, calling the classmates’ actions “inexcusable.” However, the frequent thoughtlessness and cruelty of children, which regrettably is not unique to this instance, must color a court’s interpretation of the standards of Title VI and Title IX when determining a school’s liability. In order to hold the school and its administrators liable,
School officials must have had “actual knowledge” of harassment “so severe, pervasive, and objectively offensive that it can be said to deprive the victims of access to the educational opportunities or benefits provided by the school.” To have actual knowledge of an incident, school officials must have witnessed it or received a report of it. To impose liability, school officials’ response to known harassment also must have been “clearly unreasonable in light of the known circumstances.” p. 2-3, quoting Davis v. Monroe County Board of Education, 526 U.S. 629 (1999) and citing Gabrielle M. v. Park Forest–Chicago Heights, Illinois School Dist. 163, 315 F.3d 817, 823–24 (7th Cir.2003).
September 15, 2014 By Sara Mills, Esq. in Litigation, municipal law, Vicarious Liability	Leave a comment
Supreme Court Explains What Evidence is Necessary to Prove Constructive Notice in Safe Place Claims
August 5, 2014 By Sara Mills, Esq. in Litigation, Safe Place, Torts	Leave a comment
One of the supreme court’s recently issued decision should prove helpful in defending against slip-and-fall cases, especially those that are alleged to be the result of snow and ice. See Kochanski v. Speedway SuperAmerica, 2014 WI 72. While the Kochanski decision was prompted by an erroneous use of the absent witness jury instruction, the court’s analysis necessarily required an application of its rationale to the facts: a plaintiff who slipped and fell on snow as he walked into a convenience store. The result is a decision full of useful points about what types of evidence will and will not support a Safe Place claim under Wis. Stat. § 101.11. Especially in cases relying on constructive notice, this decision should help solidify defenses when a plaintiff offers nothing more than weather records or evidence of post-fall remedial measures.
In Kochanski, the plaintiff requested and was given the absent witness instruction because Speedway relied only on surveillance video and did not call any former employees as witnesses. The absent witness instruction provides:
If a party fails to call a material witness within [its] control, or whom it would be more natural for that party to call than the opposing party, and the party fails to give a satisfactory explanation for not calling the witness, [the jury] may infer that the evidence which the witness would give would be unfavorable to the party who failed to call the witness.
Wis JI——Civil 410. Kochanski’s attorney used the instruction to argue that Speedway didn’t call any witnesses because the testimony would have been unfavorable. He asked, “Why didn’t [Speedway] call anybody? What would that unfavorable testimony have been? Other evidence that’s missing in this case.” ¶ 7. The jury returned a verdict in favor of Kochanski.
On appeal, Speedway argued that the circuit court erroneously gave the absent witness instruction, and the court of appeals and the supreme court both sided with Speedway. In its analysis, the supreme court discussed the implications of a lack of evidence in support of claims of negligence and of violation of the Safe Place Statute. The court said there was no indication in the record that any current Speedway employees could provide information about the store’s snow removal methods, and the plaintiff did not establish that Speedway had any control over its former employees. Furthermore, Speedway provided the employees’ names and addresses to Plaintiff, but Plaintiff made no showing that he could not compel their appearance at trial by subpoena. “The safe-place claim was Kochanski’s to prove; it was not Speedway’s obligation to disprove it.” ¶ 26.
Reversals Abound As Wisconsin Supreme Court Term Comes to a Close
August 4, 2014 By Sara Mills, Esq. in supreme court	Leave a comment
Throughout the month of July, the Wisconsin Supreme Court has been issuing the last of its decisions for the 2013-2014 term. While plenty of decisions affirm in whole or in part the decisions of the lower courts, a barrage of reversals has also been released within the last 30 days. The following opinions reversed the lower courts:
Madison Teachers, Inc. v. Scott Walker, 2014 WI 99: This suit challenged four aspects of the controversial budget bill, often referred to simply as “Act 10,” as violating the constitutional associational and equal protection rights of employees. The aspects were the collective bargaining limitations, the prohibition on payroll deductions of labor organization dues, the prohibition of fair share agreements, and the annual recertification requirements. In Dane County Circuit Court, the provisions relating to collective bargaining limitations, union recertifications, and the prohibitions on fair share agreements and payroll deductions of labor organization dues were all invalidated. Upon certification by the court of appeals, the supreme court reversed the decision of the circuit court and upheld Act 10 in its entirety.
Milwaukee Branch of the NAACP v. Scott Walker, 2014 WI 98: 2011 Wis. Act 23 is Wisconsin’s voter photo identification act. It requires voters to present photo identification, and it was challenged under the argument that it would “severely burden a significant number of qualified voters but [is] not reasonably necess[ary] or designed to deter fraud or otherwise effect an important government interest.” The Dane County Circuit Court granted declaratory and injunctive relief and concluded that the act was unconstitutional. The supreme court reversed, holding that “the burdens of time and inconvenience associated with obtaining Act 23-acceptable photo identification are not undue burdens on the right to vote and do not render the law invalid.” ¶3. The court also held that the DOT could not require electors to produce documents for which an elector must pay a fee to a government agency (e.g. birth certificates) in order to obtain a photo identification card for voting.
Legue v. City of Racine, 2014 WI 92 (see Remzy Bitar’s earlier post discussing this decision): In another certification to the supreme court, the justices reviewed the Racine County Circuit Court’s decision dismissing the plaintiff’s action arising from a car accident in which she was hit by a Racine police car that was responding to an emergency dispatch call. The circuit court held that the officer was immune from liability under § 893.80, but the supreme court reversed. It held that the immunity statute did not apply to the facts of the case, which demonstrated that the police officer violated his duty to operate the vehicle “with due regard under the circumstances.”
What we’re saying	Claims-Made-And-Reported Insurance Policies Not Subject to Statutory Notice Requirements