When Insurer Settles Claim Against Insured for Less Than Policy Limits it Fulfills its Obligations Under the Policy
Post 4916
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Raymond Kvalvog challenged the dismissal of his claims against his insurer, Secura Supreme Insurance Company. Kvalvog argued that his complaint states a claim upon which relief can be granted because it alleges Secura (1) breached its duty of good faith by failing to inform Kvalvog of his right to withdraw from the liability coverage he invoked and take over his defense, (2) breached its duty of good faith by failing to properly evaluate the claims against Kvalvog, and (3) failed to pay Kvalvog $17,500 in uninsured-motorist benefits.
In Raymond Kvalvog v. Secura Supreme Insurance Company, No. A24-0226, Court of Appeals of Minnesota (October 14, 2024) the Court of Appeals resolved the allegations.
FACTS
After a tragic automobile accident where Kvalvog’s son was driving an automobile as part of a high school athletic trip. The passengers in the automobile included Kvalvog’s other son and Mark Schwandt. As a result of the accident, Kvalvog’s sons died and Schwandt was injured. At the time of the accident, Secura provided automobile insurance coverage to Kvalvog that included liability coverage.
Kvalvog brought a wrongful-death action against, among others, the school and a coach who was driving a different vehicle as part of the school trip only to lose.
Schwandt later commenced a separate action against Kvalvog, the school, the coach, and Schwandt’s own insurer (the underlying action), asserting in part that Kvalvog was liable for Schwandt’s substantial injuries. Kvalvog tendered the defense of the underlying action to Secura, which appointed a lawyer to defend Kvalvog. The case settled with Secura paying less than the policy limits in exchange for a release of all claims against Kvalvog.
The district court granted Secura’s motion reasoning that Secura had the right to settle the claims against Kvalvog, did so within his policy limits.
Kvalvog asserts that his complaint supports three theories of liability, the first two of which are premised on Secura’s claimed breach of its duty of good faith.
The district court granted Secura’s motion to dismiss, determining that Secura did not breach their duty of good faith by settling the claims at mediation within policy limits and that the complaint did not state a viable claim for $17,500 in uninsured-motorist benefits.
DECISION
A complaint is subject to dismissal if it fails to state a claim upon which relief can be granted. Kvalvog’s complaint fails to state a legally sufficient claim that Secura breached its duty of good faith.
An insurance policy, like other contracts, is governed by its terms. But Minnesota law imposes an additional duty of good faith on a liability insurer that assumes control of the right of settlement of claims against its insured. This duty arises because an insured and insurer may have conflicting interests, with an insurer being obligated to represent an insured’s best interests and to defend and indemnify while also wanting settlement at the lowest possible figure. An insurer’s right to control the negotiations for settlement must be subordinated to the purpose of the insurance contract-to defend and indemnify the insured within the limits of the insurance contract
Secura Did Not Have A Duty To Inform Kvalvog That He Could Withdraw From The Coverage He Invoked.
A liability insurer’s duty of good faith springs from the purpose of the insurance contract-to defend and indemnify the insured within the limits of the insurance contract. If an insured is clearly liable the insurer must attempt to settle with the injured party. A liability insurer’s obligations are tethered to a purpose: protecting an insured’s financial interests and ensuring that the insured receives the full benefits it is entitled to under the policy.
Creating the duty advanced by Kvalvog would do the opposite. Such a duty would run counter to an insurer’s other rights and obligations.
Secura Is Not Liable For Any Failure To Investigate.
Kvalvog has not stated a claim for a breach of the duty of good faith on which relief can be granted. Kvalvog’s theories of liability, failing to advise him that he could fire the appointed lawyer, are not viable under Minnesota law.
Kvalvog’s Complaint Fails To State A Legally Sufficient Claim For Uninsuredmotorist Benefits.
Without an identified liability theory, the complaint does not provide fair notice of the basis for Kvalvog’s uninsured motorist claim. It was appropriately dismissed.
ZALMA OPINION
Liability insurance provides for a defense of the insured. It does not, nor should it, provide for the insured’s attempt to gain a judgment against a third party or UM coverage when the responsible party is insured. No good deed was punished – Secura settled the claim against Kvalvog only to be sued for doing what the policy required it to do.
(c) 2024 Barry Zalma & ClaimSchool, Inc.
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Notice of Claim Later than 60 Days After Expiration is Too Late
Post 5089
Injury at Massage Causes Suit Against Therapist
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Hiscox Insurance Company (“Hiscox”) moved the USDC to Dismiss a suit for failure to state a claim because the insured reported its claim more than 60 days after expiration of the policy.
In Mluxe Williamsburg, LLC v. Hiscox Insurance Company, Inc., et al., No. 4:25-cv-00002, United States District Court, E.D. Missouri, Eastern Division (May 22, 2025) the trial court’s judgment was affirmed.
FACTUAL BACKGROUND
Plaintiff, the operator of a massage spa franchise, entered into a commercial insurance agreement with Hiscox that provided liability insurance coverage from July 25, 2019, to July 25, 2020. On or about June 03, 2019, a customer alleged that one of Plaintiff’s employees engaged in tortious ...
ZIFL – Volume 29, Issue 11
The Source for the Insurance Fraud Professional
Posted on June 2, 2025 by Barry Zalma
Post 5087
See the full video at and at
Read the full article and the full issue of ZIFL June 1, 2025 at https://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-06-01-2025.pdf
Zalma’s Insurance Fraud Letter – June 1, 2025
See the full video at https://lnkd.in/gw-Hgww9 and at https://lnkd.in/gF8QAq4d, and at https://zalma.com/blog plus more than 5050 posts.
ZIFL – Volume 29, Issue 11
The Source for the Insurance Fraud Professional
Read the full article and the full issue of ZIFL June 1, 2025 at https://lnkd.in/gTWZUnnF
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at ...
No Coverage if Home Vacant for More Than 60 Days
Failure to Respond To Counterclaim is an Admission of All Allegations
Post 5085
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In Nationwide Mutual Insurance Company v. Rebecca Massey, Civil Action No. 2:25-cv-00124, United States District Court, S.D. West Virginia, Charleston Division (May 22, 2025) Defendant Nationwide Mutual Insurance Company's (“Nationwide”) motion for Default Judgment against Plaintiff Rebecca Massey (“Plaintiff”) for failure to respond to a counterclaim and because the claim was excluded by the policy.
BACKGROUND
On February 26, 2022, Plaintiff's home was destroyed by a fire. At the time of this accident, Plaintiff had a home insurance policy with Nationwide. Plaintiff reported the fire loss to Nationwide, which refused to pay for the damages under the policy because the home had been vacant for more than 60 days.
Plaintiff filed suit ...
ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional
See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:
Health Care Fraud Trial Results in Murder for Hire of Witness
To Avoid Conviction for Insurance Fraud Defendants Murder Witness
In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...
Professional Health Care Services Exclusion Effective
Post 5073
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This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.
In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:
Insurance Coverage Dispute:
Travelers issued a Commercial General Liability ...
A Heads I Win, Tails You Lose Story
Post 5062
Posted on April 30, 2025 by Barry Zalma
"This is a Fictionalized True Crime Story of Insurance Fraud that explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help everyone to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime."
Immigrant Criminals Attempt to Profit From Insurance Fraud
People who commit insurance fraud as a profession do so because it is easy. It requires no capital investment. The risk is low and the profits are high. The ease with which large amounts of money can be made from insurance fraud removes whatever moral hesitation might stop the perpetrator from committing the crime.
The temptation to do everything outside the law was the downfall of the brothers Karamazov. The brothers had escaped prison in the old Soviet Union by immigrating to the United...
