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Posts Tagged ‘insurance claims’

Noteworthy Insurance Coverage Case

Thursday, June 3rd, 2010

In the Supreme Court of Mississippi; Corban v. USAA, Case No. 2008-IA-00645-SCT

Dr. and Mrs. Corban owned a home in Long Beach, Mississippi which was damaged as a result of Hurricane Katrina on August 29, 2005.  The Corbans had purchased a homeowner’s policy from USAA which afforded protection from windstorm damages.  The Corbans properly notified USAA of their claim for damages.  USAA conducted an inspection of the Corbans’ residence and made the determination that the majority of physical damage was a result of flooding from storm surge which was excluded by the homeowner’s policy.  As such, USAA refused to pay for damages it alleged were the result of water or damages which resulted from wind and water acting together.  The Corbans filed suit. (more…)

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Noteworthy Insurance Coverage Case

Tuesday, April 27th, 2010

Florida Farm Bureau Casualty Insurance Company v. Mathis —So.3d—, 35 Fla. L. Weekly D868a,  2010 WL 1542631 (Fla. 1st DCA April 20, 2010)

Mr. and Mrs. Mathis suffered damage to their two story home in Navarre Beach following Hurricane Ivan.  The Mathis’ were insured under a flood policy and a separate homeowners policy which covered windstorm coverage.  The home was deemed a total loss by the county and in order to rebuild or repair, the Mathis’ would need to comply with current building codes requirements with regards to elevation heights.  The expense to repair as well as the unsafe nature of the structure left  the Mathis’ with no choice but to demolish their home.  (more…)

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Noteworthy Insurance Coverage Cases

Tuesday, April 13th, 2010

State Farm v. Menendez, So.3d, 35 FLW D133 (Fla. 3d DCA 1-6-2010)

In this case, Gilda Menendez allowed her granddaughter, Fabiola, to use a vehicle insured by State Farm.  Ms. Menendez and her granddaughter’s parents were passengers in the car while Fabiola was driving.  Fabiola negligently operated the vehicle and caused an accident resulting in injuries to everyone.  At the time of the accident, Fabiola lived in her parents’ home and Ms. Menendez lived at a separate address.

State Farm considered Fabiola an “insured” under the policy because she had permission to operate her grandmother’s vehicle.  However, State Farm denied her parents’ bodily injury claims because of a “household exclusion” provision.  The provision excluded “any insured or any member of an insured’s family residing in the insured’s household.”  State Farm concluded that the parents were members of their daughter’s “household” and not eligible for bodily injury coverage under the policy. (more…)

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Noteworthy Insurance Coverage Cases

Tuesday, April 13th, 2010

Lloyds Underwriters v. Keystone Equipment Finance Corp., 25 So3d 89 (Fla. 4th DCA 2009)

In this case, Keystone Equipment (the “insured”), purchased insurance coverage from Lloyds Underwriters (the “insurer”) for a commercial tractor trailer.  The insurance policy had an effective date of November 30, 2004.  On December 18, 2004, the tractor trailer was stolen.  The insurer denied the claim although the policy provided coverage for theft.  The written policy contained a “Garaging or Secured Yard Warranty” which required the insured to keep the tractor trailer in a closed garage, a guarded enclosed parking lot, or parked beside the insured’s residence.  Because the insured had failed to store the tractor trailer in either of these ways, Lloyds found that Keystone was in breach of this warranty and was not entitled to recover damages for the stolen tractor trailer.  At the time of the loss, Keystone had not yet received a copy of the insurance policy and was unaware of the warranty provision. (more…)

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Bittersweet Victory for Mississippi Homeowners with Katrina Damage

Thursday, November 12th, 2009

The Mississipppi Supreme Court ruled in a 9-0 landmark decision that “all-risk” home insurance policies may cover wind damage from hurricanes even where the loss is later exacerbated by water damage from storm surge.  Insurers had argued that such damage is excluded by the anti-concurrent cause (ACC) in their policies.  The Court decided that the ACC Clause in not applicable because the wind and water losses were separate or in sequence, and not “indivisible.”  Justice Randolph wrote in part, “… An insurer may not abrogate its duty to idemnify for such loss by the occurrence of a subsequent, excluded cause or event.”  In effect, once the wind loss occurs, the insured is entitled to the policy coverage and the burden is shifted to the insurer to prove what part of the loss was caused by the excluded peril, like water.  Unfortunately, thousands have already negotiated their Katrina claims for less than the value of their losses.

http://www.insurancejournal.com/news/national/2009/10/09/104428.htm

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Think You’re Insured? Maybe Not.

Wednesday, September 30th, 2009

Money Magazine’s Special Report by Walter Updegave and Kate Ashford explores how insurance companies use tactics to deny and delay legitimate claims.  While premiums are more expensive and insurance companies are paying out less in claims, these companies are taking a hard-nosed approach with their insured.  Learn how to take preventative measures to ensure that you get the benefits that you are entitled to receive.

http://money.cnn.com/magazines/moneymag/moneymag_archive/2007/03/01/8400877/index.htm

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