Around the PIA Western Alliance States – Week of September 8, 2025

Idaho  –

Masterpiece Floors faces $380k liability as Idaho court reopens case

Idaho's top court puts insurers on notice

Masterpiece Floors faces $380k liability as Idaho court reopens case

Legal Insights

By Matthew Sellers

Sep 08, 2025

An Idaho Supreme Court ruling has clarified when employers and their insurers can face civil lawsuits - even with a workers’ compensation claim already in play.

The decision, handed down on September 4, 2025, centers on Cameron Demott Tyler, who lost his right index finger while working for Masterpiece Floors, Inc. Tyler claimed the injury happened because he was required to use a table saw without a safety guard – a practice he said was standard at the company.

After the accident, Tyler filed for workers’ compensation and received some benefits. But he also took his case to civil court, arguing that his employer’s actions were so egregious they fit a rare exception in Idaho law, allowing employees to sue for damages outside the usual workers’ comp system.

When Masterpiece Floors failed to respond to the lawsuit, Tyler secured a default judgment for more than $380,000. Months later, the company challenged the judgment, arguing that the district court didn’t have the authority to decide the case until Idaho’s Industrial Commission weighed in on whether the exception applied. The district court agreed, put the judgment on hold, and sent the question to the Commission, which ultimately sided with the employer.

Tyler appealed, and the state’s highest court reversed course. The justices ruled that the district court did, in fact, have the power to decide whether the exception to the exclusive remedy rule applied – even if the workers’ comp claim was still pending. The Supreme Court ordered the lower court to reinstate the original default judgment in Tyler’s favor.

The court didn’t delve into the details of any specific insurance policy language, but the outcome sends a clear message to insurers and employers: strong claims management and a proactive legal approach are essential. The case serves as a reminder that lapses in workplace safety, slow legal responses, or misunderstandings about exceptions to workers’ comp rules can lead to significant - and sometimes unexpected – liability.

This case is squarely about workplace insurance and employer risk, making it especially relevant for those managing or underwriting workers’ comp policies. With the Idaho Supreme Court’s decision now on the books, the boundaries between workers’ comp and civil liability in Idaho are a little clearer - at least until the next challenge comes along.

Source link: Insurance Business America — https://bit.ly/46eK8Rg

Montana — Montana State Auditor James Brown Elected by peers to the National Association of Insurance Commissioners Government Relations Leadership Council: Montana State Auditor and Commissioner of Securities and Insurance James Brown announced he has been elected to the Government Relations Leadership Council (GRLC) of the National Association of Insurance Commissioners (NAIC)—a key policymaking body that helps shape the nation's insurance regulatory landscape.  Brown was elected by his peers in the Western region of the United States to serve on this important national policy setting board.

The GRLC coordinates the NAIC’s government relations efforts at both the federal and state levels, advising on critical legislative and regulatory priorities. Council members, such as Auditor Brown, help guide the Association’s response to federal actions that could impact consumers, insurers, and state regulatory authority — ensuring that the voice of state-based regulation remains strong in Washington, D.C.

“It’s an honor to represent Montana and Montana’s interests on the GRLC,” said Auditor Brown. “My position within this council gives Montanans a seat at the table when national insurance policy matters are discussed and adopted.  By giving voice to those living in rural areas of the United States and to those living throughout the Rocky Mountain region, I will protect the interests of insurance consumers and aggressively challenge ongoing federal and international efforts to undermine the sovereignty of individual states to regulate insurance markets and companies operating within their borders.

Brown’s election comes as no surprise to those familiar with his public service career. Prior to serving as Montana’s State Auditor, Brown held the position of Chair of the Montana Public Service Commission (PSC), where he oversaw regulation of electric, gas, water, and telecommunications utilities across the state. in that capacity, Brown also served on the government relations committee for the National Associate of Regulatory Utility Commissioners (NARUC).  Brown’s prior experience in consumer protection and promoting competition in the insurance marketplace closely parallels the GRLC’s mission at the national level.

“Whether it’s utility rates, federal overreach, or insurance policies, the fundamental principle of putting Montana’s first is always my to priority.  In the end, that is all that matters,” Brown noted. “The GRLC provides me a platform to ensure that Montana’s needs and perspectives are part of the national conversation.”

Brown joins a select group of commissioners nationwide entrusted with steering the NAIC’s engagement with Congress and federal agencies on a wide variety of issues.

Montana — State Farm & Subrogation: The Montana Supreme Court has clarified when insurers can seek subrogation. A case of property loss where State Farm paid for the losses of some items that the company says were not covered.

Once it paid the losses, State Farm then went after GEICO, the insurer for the at-fault driver. The couple with the losses said State Farm violated the law by seeking compensation from GEICO before GEICO had fully compensated them for their losses.

A lower court ruled that State Farm’s seeking compensation from GEICO before the couple were fully compensated is legal under Montana law. The Supreme Court agreed.

Source link: Insurance Business America — https://bit.ly/4nkmauP

Nevada — Ransomware Attack Shuts Down Insurance Division Website: On August 24th a ransomware attack caused the Nevada Division of Insurance to take its website offline. It has been determined that some data was stolen by the thieves. The state says it will let those whose information was compromised know what happened and cover the costs to make them whole.

Source link: Insurance Business America — https://bit.ly/4gmCGZg

Oregon — SAIF Declared $50 Million Dividend: For the 16th consecutive year, Oregon’s work comp system, SAIF will share a $50 million dividend with its over 50,000 policyholders

Source link: Insurance Journal — https://bit.ly/4mSRu3X

Oregon — FBI seeks information from potential victims in health care fraud; Oregon issued order against company, partial owner in 2024: The FBI is seeking information from potential victims as part of a health care fraud investigation against Bene Market Group or any of the companies it operates, one of which the Oregon Division of Financial Regulation (DFR) issued a cease-and-desist order against in 2024.

The division revoked the licenses of Seguro Medico LLC (doing business as Quick Health) and Arthur Walsh, who was Seguro’s partial owner, for violations of the Oregon Insurance Code. The order also permanently barred Walsh, Seguro Medico, and any related entities from getting an insurance license in Oregon.

DFR’s investigation found that Seguro enrolled consumers in insurance plans without their knowledge, sent inappropriate and inaccurate text communications, used false statements in sales scripts, used Walsh’s credentials to submit applications for other agents, and forged a former employee’s signature to submit applications. Seguro and Walsh also failed to report to DFR on orders against them in other states, did not reply truthfully to division inquiries, and did not update their address with DFR.

In May, the United States Attorney’s Office in the Eastern District of Pennsylvania charged Walsh and three others, as well as corporate defendants Seguro Medico LLC and Bene Market LLC with conspiracy and wire fraud offenses in connection with their execution of a nationwide telemarketing fraud scheme.

The FBI asks that anyone victimized by the Bene Market Group or any of the companies it operated (Seguro Medico, Nation Insurance Brokers of America [NBOA], Benefits Now LLC, Bene Market LLC, Quickhealth, Q Health, and Express Benefits) or who has information relevant to the investigation to complete a short form at https://bit.ly/4pfiLPV

To help with the investigation, the FBI also asks consumers to email a copy of any documents they received from the Bene Market Group, as well as any prior complaints they made, to phhcft@fbi.gov and include their first and last name in the subject line.

The DFR order against Seguro Medico LLC and Walsh is available on the DFR website.

Oregon — With students headed back to school, review your insurance policies: There is a lot of excitement and trepidation this time of year as students go off to college. As your student heads out on their adventure, be sure to review your insurance policies to give yourself peace of mind and help protect your family from financial disaster.

The Oregon Division of Financial Regulation (DFR) reminds Oregonians that having proper insurance coverage can provide greater peace of mind and protect your family. Here are some insurance tips to help your back-to-school season go smoothly.

Homeowner and renters insurance

If your student is moving into a dorm room, your homeowners policy will likely cover their personal property in case of a loss. Ask your child to tell you if they buy a new computer or other pricey items, and have them keep receipts. Check with your agent or insurance company to make sure these items are covered.

Students living off campus should consider renters insurance. This coverage will protect students' personal property and provide liability coverage if someone is injured on the property. Premiums for renters insurance are reasonable, depending on the location, size of the rental unit, and the value of the possessions. A home inventory is always a good idea, whether they live on or off campus. This list of items will make a future insurance claim much quicker and easier to settle.

Auto insurance Oregon requires every vehicle on the road to have auto liability coverage. Auto liability insurance pays – up to your policy’s limits – for property damage and bodily injury to someone else if you are found responsible for an accident. If the title to the vehicle is in your student's name, they must have their own policy. If your college student is driving a vehicle you own, your child can likely stay on your policy and be listed as a driver.

Tell your insurance agent or company where the vehicle will be stored if the address differs from what is on your policy.

Health insurance Students have several options for health insurance coverage while away at college. If your children are covered under your insurance now, they will still be covered while at school. Any insurance plan that offers dependent coverage must make that available until the dependent is 26. If you are currently enrolled in a health maintenance organization (HMO), your child may need to return to your home area for routine care and may have emergency care only while at school.

Many colleges and universities also offer their own student health insurance plans. The premiums and features vary widely by school. Check with your student's school health center to see available coverage options.

Denied insurance claims If your family experiences a claim denial or settlement disagreement, and you are unable to resolve the issue with your insurance company, you can file a complaint on the DFR website. The division's advocates are also available to help answer general questions. Call 888-877-4894 (toll-free) or email dfr.insurancehelp@dcbs.oregon.gov. The division's website also has resources available at Division of Financial Regulation : Oregon