Justia Arbitration & Mediation Opinion Summaries

Articles Posted in Insurance Law
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The NECA-IBEW Health and Welfare Fund provides health benefits to members of a local union of electrical workers. The Fund negotiated a Local Agreement with Sav-Rx, a provider of prescription-drug benefits, under which Sav-Rx reimburses pharmacies for dispensing medication and then invoices the Fund for some of its costs. The Local Agreement does not call for arbitration. A few months later, Sav-Rx negotiated a different agreement with the national organization of the IBEW, with which the local is affiliated. The National Agreement offers locals reduced charges and more services than the Local Agreement and contains a mandatory arbitration clause. Local unions and funds could opt into the National Agreement, but the Fund's trustees never voted on the matter. Over the next eight years the Fund accepted from Sav-Rx services provided by the National Agreement. The Fund sued Sav-Rx for invoicing the Fund at rates not authorized by either the Local or National Agreement. The district court dismissed, finding that Fund had accepted the benefits of the National Agreement and was bound to it; Sav-Rx established that the Fund knew it was accepting benefits under the National Agreement. The Seventh Circuit affirmed. View "NECA-IBEW Rockford Local Union 364 Health & Welfare Fund v. A&A Drug Co." on Justia Law

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The parties disputed ownership of life insurance policies and, according to their contract, submitted the dispute to a rabbinical arbitration panel. The arbitration panel appointed by the parties entered an award mandating the immediate transfer of the insurance policies at issue to Kolel and appellants subsequently appealed. The court concluded that the district court properly denied vacatur based on claims of bias and corruption; properly denied vacatur based on claims of premature decision and failure to consider evidence; and properly denied appellants' motion for reconsideration. Therefore, appellants have not presented any evidence that meets the high burden of proof necessary to vacate an arbitration award, and therefore the district court properly denied their motion for vacatur and granted Kolel's motion for confirmation of that same arbitration award. View "Kolel Beth Yechiel Mechil v. YLL et al." on Justia Law

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The Providence School Board (Board) provided health insurance to active employees and retirees. In 2006, the Providence Teachers Union (Union) filed a grievance protesting a difference in the increase of premium costs for retirees compared with a more modest increase in premium costs for active employees. The Union argued that the Board's action violated three provisions of the collective bargaining agreement (CBA) between the board and the union. An arbitrator ruled in the Union's favor, concluding that the Board violated the CBA by failing to include retirees and active employees in a single group when it calculated the healthcare premium rates. The trial justice vacated the arbitration award, concluding (1) the Union did not have standing to pursue a grievance on behalf of retirees, and (2) the issue of the calculation of the group premium rate was not arbitrable. The Supreme Court affirmed, holding (1) pursuant to Arena v. City of Providence and City of Newport v. Local 1080, the Union could not pursue this grievance on behalf of the retirees; and (2) because the Union had no standing to pursue this particular grievance, the grievance was not arbitrable. View "Providence Sch. Bd. v. Providence Teachers Union, Local 958" on Justia Law

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This case arose out of the payment of benefits pursuant to an Aflac accident insurance policy. Defendant and the decedent's siblings challenged the district court's entry of summary judgment and order compelling arbitration of defendant's claims against Aflac and its agents. At issue was whether defendant's affidavit, which included her opinion that the signature on the arbitration acknowledgment form was a forgery, was sufficient to create a genuine issue of material fact. The court concluded that defendant's affidavit was never made part of the summary judgment record before the district court and therefore failed to create a genuine issue of material fact on the authenticity of the decedent's signature. Accordingly, the court affirmed the district court's judgment. View "American Family Life Assurance Co. of Columbus v. Biles, et al" on Justia Law

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AEGIS, an insurer, appealed from the district court's denial of its motion to compel alternative dispute resolution in its dispute with UEC. The court agreed with the district court that by agreeing in the endorsement of the contract to submit to the jurisdiction of Missouri state courts, AEGIS agreed to have any dispute relating to the insurance or to the claim resolved in those courts. Thus, the endorsement entirely supplanted the condition's mandatory arbitration provision. Even if the policy as a whole were ambiguous as to the mandatory arbitration, the court concluded that UEC would still prevail because it would be entitled to have the ambiguity resolved in its favor. Accordingly, the court affirmed the judgment. View "Union Electric Co. v. AEGIS Energy Syndicate 1225" on Justia Law

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Plaintiffs filed a claim with their insurer (Insurer) for underinsured motorist benefits after a car accident. Pursuant to a provision of the insurance policy, the parties submitted the dispute to an arbitration panel. Prior to the arbitration hearing, Insurer sought broad discovery under Wis. Stat. 804. Plaintiffs refused to comply with such discovery on the grounds that Wis. Stat. 788.07 controlled and permitted only the taking of certain depositions. The arbitration panel decided that Insurer was entitled to chapter 804 discovery. The circuit court reversed and directed that arbitration discovery would proceed as allowed by section 788.07. The court of appeals reversed, holding that Plaintiffs were not allowed to seek an interlocutory appeal, and that full chapter 804 discovery was available to Insurer. The Supreme Court affirmed as modified, holding (1) because no unusual circumstances justified an interlocutory appeal, Plaintiffs' action in the circuit court was premature; and (2) because Insurer failed to include an explicit, specific, and clearly drafted arbitration clause stating otherwise, discovery in this case was limited to that provided for in section 788.07. Remanded. View "Marlowe v. IDS Prop. Cas. Ins. Co." on Justia Law

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Second Chance Investments, LLC (SCI) purchased a fire insurance policy from Auto-Owners Insurance Company (Auto-Owners) that covered a building with the limit of insurance set at $2,095,500. The building subsequently suffered extensive fire damage. SCI filed a proof of loss claiming the building was a total loss. Auto-Owners rejected the proof of loss, contending that it did not state the actual cash value of the loss as required by the policy or provide a written estimate of repair to support the claim. After a continued dispute over whether the property was a total loss, Auto-Owners ultimately filed a complaint in district court seeking an order compelling SCI to submit the issue of whether the building was a total loss to a binding determination by an appraisal panel. The district court denied Auto-Owners' motion to compel appraisal and dismissed its complaint. The court of appeals affirmed, concluding that a court, rather than an appraisal panel, is the appropriate forum to determine whether the property suffered a total loss. The Supreme Court affirmed, holding that a party to a fire insurance policy does not have the statutory right to have an appraisal panel decide whether a claim involves a total loss. View "Auto-Owners Ins. Co. v. Second Chance Invs., LLC" on Justia Law

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This insurance coverage dispute arose from charges of sexual harassment brought by a one-time employee against Appellant, the former president of Jasmine Company, Inc. Appellant sought a defense to and indemnity for the harassment claims from Appellee, Jasmine's liability insurance provider. The district court ruled that Appellant was not entitled to coverage from Appellee because, under the doctrine of issue preclusion, a prior arbitration between Appellant and the purchaser of his business conclusively established that Appellant's conduct fell within an exclusion to Appellee's insurance policy. The First Circuit Court of Appeals affirmed, holding (1) the arbitration presented Appellant with the full and fair opportunity for adjudication on the issue at hand; and (2) therefore, the district court was correct to bar Appellant from disputing the applicability of the exclusion based on the doctrine of issue preclusion. View "Manganella v. Evanston Ins. Co." on Justia Law

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This case stemmed from a dispute over annuity payments. Counter Defendants, RSL, appealed the district court's decision to abstain based on the doctrine of Colorado River Water Conservation District v. United States. Under the Colorado River doctrine, a court could abstain from a case that was part of parallel, duplicative litigation under "exceptional circumstances." The court examined the six relevant factors under Colorado River and reversed and remanded for further proceedings. On remand, the district court should determine whether RSL was entitled to compel arbitration under 9 U.S.C. 3. The district court must determine in the first instance whether any issues or claims decided by the state court were entitled to preclusive effect. View "Saucier v. Aviva Life and Annuity Co." on Justia Law

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Under the terms of a collective-bargaining agreement, the City of Newport provided health insurance benefits to its retired firefighters. After the City decided to modify those benefits, Local 1080, International Association of Firefighters, ALF-CIO (Union) filed grievances and sought arbitration. The City responded by seeking relief in the superior court to determine the arbitrability of disputes over changes to these benefits. The superior court determined that this dispute was not arbitrable. The Union disagreed and petitioned the Supreme Court for a writ of certiorari. The Court affirmed the judgment of the superior court, holding that the parties did not intend to arbitrate disputes regarding retiree healthcare, and therefore, such disputes must be resolved, if at all, judicially rather than through arbitration. View "City of Newport v. Local 1080, Int'l Ass'n of Firefighters, AFL-CIO" on Justia Law