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Insurance - General

June 10, 2007

News Flash: Study shows insureds don't understand their homeowner's insurance policies! Duh! Many lawyers, judges, and court decisions confirm that point every day.

Here is a post from Insurance Coverage Law Blog that tells us something we don't already know, but noone is going to do anything about it - folks don't read or understand their insurance policies!  However, the law does not stop assuming they read them, understand them, and are bound by them since all are presumed to know the law in spite of the fact that it takes four years of college, three years of law school, and a bar examination before we can practice law!

If you have any doubts, then take a look at Nationwide v. Abney  2004-SC-000937-DG.pdf when the claimant should have known the release he signed released the whole wide world of tortfeasors and not just the one for whom Nationwide was writing the check for the simple reason that is what he signed - "all other persons". 

It makes no difference that many plaintiffs' lawyer's jaws may have collectively dropped on reading this, and every insurance adjuster in the state "licked their lips" and started scrutinizing and asking for those liability releases to try and extend it to joint tortfeasors, indemnitees, and UIM/UM carriers.

And it makes no never-mind, that the Abney decision was a TORT decision which focused on KRS 411.182 and the abolition of joint and several liability applicability to release of tortfeasors which questions its applicability to the CONTRACTUAL claim represented by underinsured motorist benefits.

See, eg.:

Kentucky Farm Bureau  Mut. Ins. Co. v. Ryan, 177 S.W.3d 797, 801 (Ky. 2005).
[W]e are of the opinion that the legislature was quite clear in its intent to exclude contract actions, including those for UM and UIM coverage, from the scope of KRS 411.182. And while we certainly agree that UM and UIM actions involve aspects of tort law, in that the allocation of fault is a necessary prerequisite to coverage, our case law firmly establishes that the contractual nature of the claims is procedurally controlling.

And;

True v. Raines, 99 S.W.3d 439 (Ky.,2003)
Nor do we write without recognizing that the claimant may execute a release recognizing he intends to release not only the tortfeasor, but his own UIM carrier, specifying he has been “fully compensated for all damages and the release constitutes payment in satisfaction of all claims.” Richardson v. Eastland, Inc., Ky., 660 S.W.2d 7, 9 (1983).

Here is the post:

Survey finds homeowners have badly mistaken beliefs about coverage

This doesn't surprise me much [eg., insurance coverage blogger who wrote the post]. The National Association of Insurance Commissioners did a survey of homeowner beliefs about what their policies cover, and found huge percentages have mistaken ideas. Here's one example from the NAIC report:

The survey found that 33 percent of U.S. heads of household, who own a home and have homeowners insurance, incorrectly believe flood damages would be covered by a standard homeowners or property and liability policy, despite extensive media coverage on Hurricane Katrina victims whose claims were denied because they lacked flood insurance.

Here are some other findings:

  • 68 percent think vehicles such as cars, boats and motorcycles stolen from or damaged on their property are covered.
  • 51 percent think damages from a break in the water line on their property supplying water to their home are covered.
  • 37 percent think damages due to a break in the sewer line on their property that connects to their municipal sewer system are covered.
  • 35 percent think damages from earthquakes are covered.
  • 34 percent think damages from mold are covered.
  • 31 percent think damages from termites or other infestation are covered.
  • 22 percent think pets stolen from or injured on their property are covered.
  • Actually, I'm [insurance coverage blogger] surprised these percentages aren't higher.

    Click here, read the rest of his post, and be amazed how the reality of the insureds falls short of the expectations of our judicial decisions and presumptions.

    March 07, 2007

    Anthem's loss of confidential information on 300,000 customers a breach of confidentiality?

    Anthem has just reported a theft of personal information on their insureds that occurred on Oct. 26, 2006. Yesterday, I had received a form letter of the announcement.

    So, mine (and 300,000 others) have personal information on the loose, and the company that lost it takes 4 1/2 months to share that with me?  Well, it could have been worse since my VA records were taken last year (with a lot more folks affected too) and keep silent for even longer than this.

    Insurance is a business, but its a relationship based on trust and a breach of an obligation to protect and keep my personal information confidential.  Else why would I want to be in the good hands of a good neighbor on my side?

    Insurance customer records stolen
    Computer tapes containing Social Security numbers and other personal information about more than 300,000 insurance company customers -- including Anthem health plan members in Kentucky and Indiana -- were stolen late last year from a Massachusetts office.

    A recent decision, published, comes to mind:

    JOHNS V. FIRSTAR BANK
    TORTS - Invasion of privacy and breach of confidentiality
    2004-CA-001558
    PUBLISHED   
    AFFIRMING IN PART, REVERSING IN PART, AND REMANDING (DYCHE)
    DATE:  3/24/2006

    CA affirms in part, reverses in part and remands this invasion of privacy/breach of contract case.

    Johns sought financing through Firstar to establish a juvenile detention facility. He requested complete confidentiality because his father, superintendent of the school board, had recently come under public scrutiny. Someone at the bank leaked his involvement, torpedoing the deal. He sued for invasion of privacy, breach of implied contract, breach of fiduciary duty and negligence. A jury awarded him $250,000 for lost profits. CA affirms in part, reverses in part, and remands, holding that jury award did not distinguish whether award was for invasion of privacy, which did not apply, or breach of confidentiality.

     

    February 08, 2007

    Another car dealer sale and no insurance on buyer case puts strong burden on dealer to shore up insurance at sale

    GAINSCO COMPANIES  V. GENTRY
    INSURANCE - Owner of vehicle upon transfer for liability insurance purposes
    2004-SC-000276-DG.pdf
    PUBLISHED
    AFFIRMING (JOHNSTONE)
    DATE:  3/23/2006

    Gainsco, H&H Auto and David Holder appeal Barren Circuit Court's entry of Summary Judgment for Gentry, Booth and Ky Farm Bureau. COA affirmed the TC's ruling, and the Supreme Court granted review.

    The case involves the sale of an auto on 4/15/00 by H&H Auto to Joe Booth. The auto in question had been purchased just 9 days prior from Philip Duke Motors in Alabama, although Duke was unable to immediately transfer the auto's certificate of title. Holder, president of H&H Auto, personally negotiated the sale to Booth, but was unable to immediately assign title to Booth. Booth nevertheless took possession of the auto on 4/15/00 without title. Booth's son lost control of the vehicle and caused an accident on 4/20/00 that resulted in his passenger Gentry sustaining permanent, disabling injuries. Gentry initiated suit against Booth, KFB, H&H Auto, Holder and Gainsco (Holder's insurer). Gentry filed a MSJ asserting that H&H Auto was the owner of the auto on the accident date for purposes of insurance coverage, which the TC granted. Gainsco was therefore deemed to have primary coverage while KFB (Booth's insurer) was held secondarily liable. This appeal followed.

    In a 4-3 decision, the Supreme Court upheld the COA's ruling that affirmed the entry of Summary Judgment. Justice Johnstone wrote the majority opinion, and identified the sole issue on appeal as whether H&H Auto was the owner of the auto for insurance purposes at the time of the accident. The opinion discusses KRS 186.010(7)(c) and the requirements placed on a licensed auto dealer in order to effectively transfer ownership of the auto in those instances where the title is not immediately transferred to the buyer at the time of purchase. Those requirements as set forth in KRS 186A.220 are two-fold: 1) the dealer must obtain the purchaser's consent to file the certificate of title on his behalf; and 2) he must verify that the purchaser has obtained insurance on the auto before relinquishing possession. The majority felt that H&H Auto failed to satisfy the second prong since Holder did not request any form of proof of insurance from Booth on 4/15/00 (a Saturday) even though he did verbally verify coverage with Booth's insurance agent on 4/17/00, the next business day. Of importance was the fact that the title documents were not signed by Booth until 4/24/00. Also of importance is the fact that KFB conceded that Booth had valid insurance coverage on 4/15/00 and 4/20/00. The majority side-stepped this fact by ruling that this alone is not enough in that the statute also requires the dealer to obtain proof of insurance. The court then proceeded to reject Holder's argument that his course of prior dealing with Booth (by having sold him vehicles in the past, most recently within a year of the subject sale) satisfies the "proof" requirement by way of his knowledge that Booth was insured with KFB in the recent past, noting that the statute requires verification beyond mere assumption or prior knowledge. Justices Lambert, Roach and Winterheimer joined Johnstone in the majority.

    Justice Graves issued the dissenting opinion during which he discusses the legislative intent behind KRS 186A.220, which is to prevent uninsured vehicles on the roadways. He felt that the majority too narrowly reviewed the proof of insurance requirement, and questioned what effect a discussion about insurance coverage at the time of sale (that the majority repeatedly noted Holder had failed to do) would have on the ultimate question of ownership at the time of the accident. He felt that almost any form of proof carries an assumption, the exception being proof obtained directly from the buyer's insurance representative. He emphasizes the difficulty dealers would face if required to obtain this form of absolute proof, especially on weekends, and felt that the statute did not require it. Graves points out that even if there was a technical deficiency at the time of sale, Holder had nevertheless cured it by obtaining verbal proof of insurance from Booth's agent on 4/17/00 - 3 days before the accident. In this regard, he declares that the harm the statute seeks to prevent - uninsured motorists - did not exist in this particular case since KFB had admitted coverage existed on all relevant dates at issue. He concludes by conceding that a prior course of dealing is certainly not a preferable means to obtain proof of insurance, but nevertheless felt that there was evidence sufficient in favor of Holder to at least survive a MSJ. Justices Cooper and Scott joined in the dissent.

    Commentary: The majority's decision appears to place a burden of strict compliance on the dealer to obtain proof of insurance pursuant to KRS 186A.220, presumably on the basis that the dealer is in the best position to prevent the harm of uninsured vehicles hitting the roadways. However, the majority doesn't go far enough by offering some guidance on what actions constitute verification of "proof" of insurance. Is verbal assurance from the buyer enough? What about obtaining a copy of the most current insurance card? Of course, as Graves notes this carries with it an assumption that the policy has not lapsed or been canceled since the date the card was printed. The majority flatly rejected Holder's argument that knowledge of coverage by Booth less than a year prior was satisfactory, so would an insurance card printed up to 6 months before the sale nevertheless be okay? Or was the majority's ruling simply a way of providing as much insurance coverage as possible to a claimant who apparently sustained significant damages and would have otherwise been limited to Booth's policy limits (though never identified, it's safe to assume that they were a fraction of the dealer's liability limits). Certainly, Holder's failure to even hint at the topic of insurance coverage during the transaction with Booth gave the majority an opportunity to issue its ruling without having to adjudge what action(s) a dealer must take in order to satisfy the proof of insurance requirement.

    The court's minority instead focuses on the big picture by weighing the benefits of requiring strict compliance against the costs placed on the dealer in doing so. Their opinion is that the latter outweighs the former, and suggests that the logistics of obtaining actual proof of insurance at the time of sale would adversely impact commerce in light of the volume of sales that occur outside the regular business hours of insurance companies and agencies. The dissenting opinion seems to suggest that the ultimate determination on liability of the dealer is not the sufficiency of proof obtained at the time of sale, but instead is whether the buyer did in fact have valid insurance coverage at the time of loss. If the dealer has a reasonable basis for assuming coverage exists at the time of sale, and the assumption turns out to be correct (as in the present case), then the court's minority would seemingly relieve the dealer of liability since the vehicle is not uninsured and the situation contemplated by the statute is therefore avoided. However, this approach ignores the fact that the statute speaks to who is deemed the legal "owner" of the vehicle and not whether the vehicle is insured at the time of loss.

    While this decision does not resolve all potential issues that may arise when a dealer transfers possession of a vehicle to a buyer without the accompanying title, it certainly suggests that the dealer must make some affirmative inquiry into the buyer's insurance status before the buyer drives the vehicle off the lot. Needless to say, it would be wise for the dealer to have some documentation in his file supporting the existence of insurance such as a copy of the buyer's current insurance card or a letter from his insurer or agent or maybe a written ledger entry confirming verbal proof received from the insurer or agent. One thing that is clear -- obtaining proof after the date of sale but before the date of loss will not be held sufficient in light of the majority's decision.

    See, KRS 186 .010(7)(a); KRS 186A.220 .

    September 06, 2006

    Releases: Is there a law allowing a claimant to rescind a release? No.

    The recent letter to the editor in the Courier-Journal claiming predatory insurance practices regarding approaching claimants to settle cases prompted a citation to a recent Supreme Court case affirming the settlement and release obtained by an adjuster and dismissing the personal injury claim.

    Here is an extract of that editorial again by William Adkins of Williamstown, Kentucky, as well as the link and extracts from the Kentucky decision.

    Insurers 'more predatory' [letter to editor in 9/5/2006 Courier-Journal]

    Is there a statute that would prohibit an insurance company or defendant in a civil case from preying upon grieving relatives by having them agree to lesser settlements than they might receive with counsel?

    The answer to this question is a simple "no".   And within the last year, a claimant has tried in vain to rely upon the Kentucky Unfair Claims Settlement Practices Act to protect herself following a release signed just one day after a car accident.

    In Margaret Coomer v. Charlie Phelps and Progressive Northern Ins. Co., the Kentucky Supreme Court affirmed summary judgment dismissing a claim in which the injured party signed a settlement and release the day after the accident.  Coomer settled for $500 thinking she only bruised her knee, but learned later that week that the emergency room misdiagnosed the injury, and the bruised knee was in reality a fractured patella. 

    The majority opinion was authored by Justice John Roach affirming the Court of Appeals decision denying Coomer her attempt to invalidate the release due to mutual mistake, constructive fraud, incapacity, and the Kentucky Unfair Claims Settlement Practices Act.

    Here are the facts: 

    Continue reading "Releases: Is there a law allowing a claimant to rescind a release? No." »