Justia Civil Rights Opinion Summaries

Articles Posted in Insurance Law
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Plaintiff appealed the district court's grant of summary judgment in a class action suit alleging that Broward County's employee wellness program violated the Americans with Disabilities Act of 1990 (ADA), 42 U.S.C. 12101 et seq. Plaintiff alleged that the wellness program's biometric screening and online Health Risk Assessment questionnaire violated the ADA's prohibition on non-voluntary medical examinations and disability-related inquiries. The court held that the district court did not err in finding as a matter of law that the wellness program was a "term" of Broward County's group health insurance plan, such that the wellness program fell within the ADA's safe harbor provision.

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This appeal arose from an insurance coverage dispute where the City sought coverage from Genesis for 42 U.S.C. 1983 claims in the nature of malicious prosecution. Genesis filed suit against the City, seeking a declaratory judgment that its policies provided no coverage for the underlying actions. The district court granted summary judgment to Genesis and the City appealed, arguing that the district court erred in ruling as a matter of law that the policies did not provide the City insurance coverage for the claims. Because Genesis did not have an insurance contract with the City in 1977, when the underlying charges were filed, it did not have a duty to defendant and indemnify the city in the suits. Accordingly, the court affirmed the judgment.

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In 1989 Dominguez was arrested and in 1990 he was convicted of home invasion and sexual assault. In 2002 he was exonerated by DNA; in 2005 he received a pardon. Under Illinois law, his claim for malicious prosecution accrued in 2002. Under federal law, constitutional claims (42 U.S.C. 1983) accrued in 1989 and 2002. Wrongful arrest claims accrue on the date of arrest, but wrongful conviction claims accrue when conviction is invalidated. The Seventh Circuit affirmed an award of about $9 million for malicious prosecution and concealment of exculpatory evidence. The city has been insured by different companies and each asserted that the policy for another year applied. None provided a defense. The district court held that the issuer of the "occurrence" policy in force at exoneration must defend and indemnify. The Seventh Circuit affirmed. The city's misconduct occurred in 1989 and 1990, but the policy does not define the "occurrence" as misconduct by a law-enforcement officer. It defines the occurrence as the tort under state or federal law, and, in both, the tort occurs witn its last element, exoneration. Until then, Dominguez could not establish "malicious prosecution" or "violation" of section 1983.

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Main & Associates, Inc., d/b/a Southern Springs Healthcare Facility, filed an action in the Bullock Circuit Court, on behalf of itself and a putative class of Alabama nursing homes, against Blue Cross and Blue Shield of Alabama (BCBS), asserting claims of breach of contract, intentional interference with business relations, negligence and/or wantonness, and unjust enrichment and seeking injunctive relief. BCBS removed the case to the the federal court, arguing among other things, that Southern Springs' claims arose under the Medicare Act and that the Medicare Act, as amended by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (the MMA) completely preempted Southern Springs' state-law claims. Southern Springs moved the federal court to remand the case to the circuit court, arguing that the federal court did not have jurisdiction over its claims. The federal court granted the motion and remanded the case to the Bullock Circuit Court. After remand, BCBS moved the circuit court for a judgment on the pleadings, arguing that Southern Springs had not exhausted its administrative remedies and that the circuit court did not have subject-matter jurisdiction over the case. The circuit court denied BCBS's motion, and BCBS petitioned the Supreme Court for a writ of mandamus to direct the circuit court to dismiss Southern Springs' claims. Upon review, the Court concluded that Southern Springs' claims were inextricably intertwined with claims for coverage and benefits under the Medicare Act and that they were subject to the Act's mandatory administrative procedures and limited judicial review. Southern Springs did not exhaust its administrative remedies, and the circuit court did not have jurisdiction over its claims. Therefore, the Court granted BCBS's petition and issue a writ of mandamus directing the circuit court to dismiss the claims against BCBS.

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A federal jury awarded Fortin $125,000 in damages against a police officer after finding that the officer negligently used force in arresting Fortin in 2007. In a post-judgment ruling, the district court reduced the award to $10,000, the maximum set by the Maine Tort Claims Act for the personal liability of government employees, Me. Rev. Stat. tit. 14, 8104-D. On appeal, Fortin argued that the MTCA cap is inapplicable here because the officer was covered by an insurance policy that triggered a higher limit under the Act. The First Circuit determined that the issues were unresolved under state law and certified two questions to the Maine Supreme Court. Whether Fortin is limited to recovery of $10,000 depends on the unexplored relationship among several provisions of the MTCA governing damage awards against government employees. Analysis may also require determining what interpretive rule should be applied to ambiguous insurance policies providing MTCA liability coverage.

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This case involved Commonwealth Care, a state-initiated program that provided structured premium assistance for low-income Massachusetts residents. In 2009, the Legislature made certain changes to the eligibility requirements of Commonwealth Care, enacted in a two-part supplemental appropriation for fiscal year 2010. Section 31(a) of the appropriation excluded all aliens who were federally ineligible under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), 8 U.S.C. 1601-1646, from participation in Commonwealth Care. Plaintiffs were individuals who either have been terminated from Commonwealth Care or have been denied eligibility solely as a result of their alienage. The court held that section 31(a) could not pass strict scrutiny and that the discrimination against legal immigrants that its limiting language embodied violated their rights to equal protection under the Massachusetts Constitution.

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Plaintiffs-Class Representatives sought summary judgment in favor of numerous others similarly situated arising out of the failure of Louisiana Citizens Property Insurance Corporation (Citizens) to timely initiate loss adjustment on the enumerated members' insurance claims. The District Court granted summary judgment in plaintiffs' favor and awarded penalties for each compensable claim, totaling $92,865,000. The Court of Appeal reversed, finding a factual determination of whether the insurer breached its duty of good faith was required before assessing penalties. This litigation presented two issues of first impression for the Supreme Court: (1) whether an insurer is subject to the penalties imposed by former La. Rev. Stat. 22:658(A)(3) for its untimely initiation of loss adjustment in the absence of a showing of bad faith; and (2) whether the provisions of former La. Rev. Stat. 22:1220(C) capped those penalties at five thousand dollars when damages were not proven. Upon review, the Supreme Court found the plain language of La. Rev. Stat. 22:2658(A)(3) does not require a showing of bad faith by the insurer, but simply requires proof of notice and inaction for over thirty days. Furthermore, the Court found that the provisions of La. Rev. Stat. 22:1220(C) capped the penalties for such inaction at five thousand dollars when damages are not proven. Finding no error in the district court's award of the statutory cap for each failure to timely initiate, the Court reversed the judgment of the Court of Appeal and reinstated the district court's judgment.

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In 1995 Puerto Rico enacted a law mandating minimum liability insurance for drivers and created the Asociación de Suscripción Conjunta del Seguro de Responsabilidad Obligatorio to provide compulsory liability insurance to those otherwise unable or unwilling to obtain insurance; the Association insures about 80 percent of vehicles in Puerto Rico. In 2008 the Association challenged regulations that limit its distribution of profits to members (insurance companies) and require that other revenue be kept in a reserve. The district court dismissed a "taking claim" under 42 U.S.C. 1983. The First Circuit affirmed. Facial claims were time-barred; other claims were not properly raised.

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The State of Arizona appealed the district court's order granting a preliminary injunction to prevent a state law from taking effect that would have terminated eligibility for healthcare benefits of state employees' same-sex partners. The district court found that plaintiffs demonstrated a likelihood of success on the merits because they showed that the law adversely affected a classification of employees on the basis of sexual orientation and did not further any of the state's claimed justifiable interests. The district court also found that plaintiffs had established a likelihood of irreparable harm in the event coverage for partners ceased. The court held that the district court's findings and conclusions were supported by the record and affirmed the judgment.

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Plaintiffs, a class of economically vulnerable Arizonians who receive public health care benefits through the state's Medicaid agency, sued the U.S. Secretary of Health and Human Services (Secretary) and the Director of Arizona's medicaid agency (director)(collectively, defendants), alleging that the heightened mandatory co-payments violated Medicaid Act, 42 U.S.C. 1396a, cost sharing restrictions, that the waiver exceeded the Secretary's authority, and that the notices they received about the change in their health coverage was statutorily and constitutionally inadequate. The court affirmed the district court's conclusion that Medicaid cost sharing restrictions did not apply to plaintiffs and that Arizona's cost sharing did not violate the human participants statute. The court reversed the district court insofar as it determined that the Secretary's approval of Arizona's cost sharing satisfied the requirements of 42 U.S.C. 1315. The court remanded this claim with directions to vacate the Secretary's decision and remanded to the Secretary for further consideration. Finally, the court remanded plaintiffs' notice claims for further consideration in light of intervening events.