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Sizemore v. United Physicians Ins. Risk Retention Group, 1997 Tenn. App. LEXIS
253 (1997). Policyholder’s proof of claim failed to be timely filed under the
Tennessee Insurance Rehabilitation and Liquidation Act (Act) and was denied by
the receiver of the insurance company. The chancery court held that it had no
more authority under the Act to have excused the late filing than had the
receiver. The appellate court held that the chancery court applied an
unnecessarily restricted interpretation of its powers under the Act.
The Terminix Int'l. Co. v. Tennessee Ins. Guar. Ass’n., 845 S.W.2d 772 (Tenn. Ct.
App. 1992). The court held that the term "covered claim, " as used in the
Tennessee Insurance Guaranty Association Act, includes medical expenses and
lost wages actually incurred but does not include future medical expenses or
loss of earning capacity.
Texas
Utah
Global Santa Fe Corp. v. Tex. Prop. & Cas. Ins. Guar. Ass’n, 153 S.W.3d 150 (Tex.
App. 2004). The court held that the Texas Property and Casualty Insurance
Guaranty Association (“TPCIGA”) is not required to apportion a payment made
on behalf of multiple insureds covered under a single insurance policy in order
to seek recoupment from a net worth insured under the TEX. INS. CODE ANN. art.
21.28‐C, § 11(b) (Supp. 2004‐05). The TPCIGA sought recoupment from a
corporation based on a contribution the TPCIGA made to settle a suit filed
against the corporation after its insurance provider became impaired. The
corporation refused to pay arguing that there was no evidence of how much
contribution was paid solely on behalf of the insured, because the TPCIGA failed
to properly apportion its contribution among the multiple insureds. The court
held that if the legislature wanted such a requirement, it would have included
the relevant language in TEX. INS. CODE ANN. art. 21.28‐C, § 11(b) (Supp. 2004‐05).
R&R Indus. Park, L.L.C. v. Utah Prop. & Cas. Ins. Guar. Ass’n, 199 P.3d 917 (Utah
2008). A fire was caused by material stored by CDR, the insured, at an industrial
park. CDR’s insurance company entered receivership and the Utah Property
and Casualty Insurance Guaranty Association (“UPCIGA”) assumed the role of
insurer of CDR. Other parties, R&R and AlumaTek, were damaged by the fire
caused by CDR, and each collected insurance from their own (third party)
insurance carriers. R&R collected insurance for both lost profits and property
damage. R&R, AlumaTek, and UPCIGA attended a mediation to resolve what
portions of the claims UPCIGA would pay. The three parties sought a
declaratory judgment to determine whether, in settling the claims, UPCIGA
would only be required to pay “one covered claim per claimant” and whether
UPCIGA would be entitled to offset the amounts that R&R and AlumaTek’s own
insurers had paid for the damages suffered. The supreme court held that the
Guaranty Act in Utah applies to multiple claims because to allow for only one
claim out of a single occurrence would defeat the remedial nature of the Act.
The court further held that UPCIGA could not offset amounts that R&R and
AlumaTek recovered from third‐party insurers.
Virginia Universal Life Ins. Co. v. Binford, 76 Va. 103 (1882). It was held that a
policyholder is entitled to be restored to the status quo‐‐the amount necessary
to purchase the same coverage from a solvent company.
Washington Seattle‐First National Bank v. Washington Insurance Guaranty Association, 972
P.2d 1282 (Wash. Ct. App. 1999). Where out‐of‐state insurer became insolvent,
WIGA was required to cover claims that became due within 30 day of the
insurer’s insolvency and refund unearned premiums.
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