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Ask Tim - Got an insurance technical question on your mind?

Blogs Home >> Ask Tim - Got an insurance technical question on your mind? >> 'Order in the Court: It Was the Collision That Caused the Injury, Not the Sudden Stop'
Order in the Court: It Was the Collision That Caused the Injury, Not the Sudden Stop

On April 25, 2009, Jacob Hymes was operating his 2005 Harley Davidson motorcycle when he collided with a 2001 Chevrolet Malibu operated by Robert Meyer. Meyer was subsequently determined to be at fault for the accident. However, Meyer's liability insurance proved to be insufficient to fully compensate Jacob for the injuries he sustained in the accident.

Jacob had not elected to have underinsured motorist coverage from his primary insurer, GEICO, and therefore turned to his parents' policy with Allstate. Allstate denied Jacob's claim for underinsured motorist coverage, relying on the policy's "household exclusion." Allstate subsequently initiated this proceeding via complaint for declaratory judgment against the Apellants, seeking a determination that the policy did not cover Jacob's injuries in this case. The Appellants filed an answer and new matter, and thereafter filed a motion for judgment on the pleadings. The trial court granted Allstate's motion and dismissed Jacob's complaint. This timely appeal followed.

On appeal, the Appellants raise one issue for our review:

Did the lower court err in granting declaratory relief to Allstate and determining that a "Household Exclusion" barred recovery by Jacob Hymes of underinsured motorist benefits under his parents' insurance policy when Hymes suffered serious injuries while not "in, on, getting into or out of" his motorcycle and instead suffered those injuries after being thrown from the motorcycle and into the windshield and onto the ground some twenty feet away from the point of impact?

via scholar.google.com

This is sad. A young man, through no fault of his own, suffers serious injuries in an auto accident. The at-fault driver doesn't have enough liability insurance to fully cover the injuries. The injured person had chosen not to buy Uninsured/Underinsured Motorist Coverage. Because he doesn't want to start out life with both a serious disability and medical bankruptcy, he desperately tries to find UM/UIM coverage under his parents' insurance. The Pennsylvania court rightly said no:

As explained by the trial court, our review should not result in an absurd construction of the policy. Words of "common usage" in an insurance policy are to be construed in their natural, plain, and ordinary sense, and a court may inform its understanding of these terms by considering their dictionary definitions...

Although we have, on occasions, admired good lawyering on behalf of a client and zealous advocacy, we cannot conclude that there is any plausible argument that the injures complained of here are not the direct result of Jacob's operation of his motorcycle while "on" it. Therefore, we conclude that recovery for UIM benefits is properly excluded under the pertinent policy provision.

This is why it is so important for consumers to at least consider buying the maximum Supplemental Uninsured/Underinsured Motorist limits available, as well as the maximum Personal Injury Protection limits. I understand why this man and his parents went to court on this; it sounds like his injuries may have been life-altering. Unfortunately, they had no control over the amount of insurance the other driver carried. They could control only the amount that they bought.

I encourage all you insurance producers out there to remember this story the next time a client only wants to talk about price. Easier said than done, I know, but it's an important discussion to have.

Posted on Thursday, Nov 17, 2011 13:04:00 CST by tdodge

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