Articles Posted in Term Definitions

Buying a car usually entails walking around a car dealership, spotting a car you potentially want to buy, and then test driving the car to see if satisfies what you are looking for in a vehicle. However, one aspect that you may not take into consideration, is what happens if you get into a car accident while driving the car dealership’s vehicle? Who is is liable? Who ultimately has to pay? This all depends on the insurance contract the car dealership has, and whether or not you, as the test driver of the vehicle that has been damaged, is insured. Oftentimes, there is a limiting provision commonly found in insurance contracts called a “garage policy”, it excludes customers of an automobile dealership unless the customer does not have liability insurance of his/her owner is statutorily uninsured. But what exactly does this mean?

A garage policy is a provision designed to limit coverage under certain circumstances. For instance, the recent case of Chretien v. Thomas, the Louisiana Second Circuit Court of Appeal explored garage policies in depth due to the existence of one in a service station’s insurance policy. The course of events in the Chretien case involved the defendant, Thomas, bringing in a vehicle for repair. He was provided with a vehicle to drive while his vehicle was being serviced. Significantly, the car being serviced was his girlfriends and was listed as a covered vehicle under a policy issued by Allstate Insurance Company. The service station lent the vehicle to Thomas in hopes his employer would purchase the vehicle. The service station was insured by Stonington Insurance Company, which had the infamous garage coverage provision included in the insurance agreement. The garage policy excluded coverage for customers of the service station IF the customer had other insurance available. Shortly after being provided the “loaner” vehicle, Thomas was involved in an accident with the Plaintiff, who sued Thomas, the service station, as well as both insurance companies, Stonington and Allstate. The dilemma the court faced was determining who is ultimately responsible for coverage, and for how much. Under the garage policy, one would assume that Thomas would be responsible, since the vehicle he brought in for service was covered by insurance, thus, preventing him from relying on the service station’s coverage. However, the issue is not so easily resolved.

Both insured parties have a burden to meet, and a burden to prove in order to avoid liability. When determining whether or not a policy affords coverage for an incident, it is the burden of the insured to prove the incident falls within the policy’s terms. On the other hand, the insurer bears the burden of proving the applicability of an exclusionary clause within a policy, such as the “garage policy” provision found in Stonington’s agreement with the service station. To begin with, an insurance policy is a contract, as such, the party’s intent is reflected by the words of the policy, this determines the extent of the policy’s coverage. When looking at the policy’s language, one cannot read too much into the words, phrases and words are to be construed using their plain, ordinary, and generally prevailing meaning. Thus, interpretation or paraphrasing is not encouraged when exploring insurance policies, to put it simply, just look to the four corners of the document, and to nothing else, in order to understand what the policy means.

Lake Charles resident Ginger Hinch Durio sued her Insurer, Horace Mann, over the extent of payments she received for the damages she sustained during Hurricane Rita. Durio’s house was severely damaged, including her garage where her family’s belongings were being stored while they were in talks to sell the house. The ceiling inside the garage collapsed onto their stored belongings. Additionally, an engineering report obtained by Durio four months after the hurricane indicated the structural and mechanical integrity of the house was compromised, and the HVAC, electrical, and plumbing systems had failed.

Durio’s policy with Horace Mann provided for several categories of damages for which the Insurer would pay her up to their respective policy limits: Structure ($173,300), Adjacent Structures ($17,330), Contents ($103,980), and Additional Living Expenses ($103,980). After Durio submitted a claim in September of 2005, Horace Mann made several payments to her that fell far below the category policy limits. Despite Durio’s submission of re-evaluation materials, Horace Mann ultimately honored in full only her Contents claim (for all the belongings contained in the garage) of $47,061.44. This, however, was after the Insurer issued her a “sarcastic” check for $6.90 for a broken flowerpot.

The Third Circuit Court of Appeal affirmed the damages awarded by the Trial Court for a total in excess of $1.5 million. Durio received Contractual damages for the difference between what she was paid by Horace Mann and the policy limits for Structure and Adjacent Structure damages. In addition, the Court affirmed an award of $39,000 for thirty-eight months of living expenses based on Durio’s own estimation for the period in which the Insurer worked on the claim.

By the terms of most mortgage agreements, homeowners are required to maintain adequate insurance on their houses. In New Orleans and other coastal areas, this requirement can include both a standard homeowner’s policy as well as flood insurance. Mortgage lenders insist on insurance coverage to help protect their financial interest in the properties for which they issue mortgages. If a borrower fails to purchase or maintain adequate coverage, the lender is permitted to “force-place” a policy–that is, to purchase an insurance policy on the property for its own benefit. A force-placed policy allows the lender to protect its exposure on a home up to the then-owed amount of mortgage on the date of issuance.

When Hurricane Katrina hit New Orleans, the home of Latisha Williams sustained significant flood damage. Williams had purchased the house with a mortgage issued by Homecomings Financial, the terms of which required her to maintain a flood insurance policy on the property. In June of 2005, Williams let the flood policy lapse, at which point Homecomings Financial force-placed a new policy on the property that was issued by Lloyd’s of London. Following the Katrina disaster, a Lloyd’s adjuster inspected the property and issued a loss estimate that Williams believed was below the true amount of loss on the property. Williams sued Lloyd’s seeking to recover for the full amount of flood damage to the house. At trial in the district court, Lloyd’s filed a motion to dismiss Williams’s claim, arguing that she lacked standing to bring the action. Standing is the right to initiate a lawsuit which arises from the plaintiff’s direct connection with or involvement in a legal dispute. The district court granted Lloyd’s motion, and Williams appealed.

The Fifth Circuit of the U.S. Court of Appeals examined the facts to determine whether Williams had standing to sue Lloyd’s. The issue centered around the question of whether the insurance policy, which was an agreement between Lloyd’s and Homecomings Financial, was intended to benefit Williams in any way. Without this intent to benefit Williams, she would have no standing to bring suit. Under Louisiana law, which the federal court applied, a contract for the benefit of a third party is called a “stipulation pour autrui.” See Paul v. Louisiana State Employees’ Group Benefit Program, 762 So.2d 136, 140 (La. App. 1st Cir. 2000). According to the court, “[t]he most basic requirement of a stipulation pour autrui is that the contract manifests a clear intention to benefit the third party; absent such a clear manifestation, a party claiming to be a third party beneficiary cannot meet his burden of proof.” The court found ample evidence that Homecomings Financial and Lloyd’s did not intend to benefit Williams in any way. The court noted that the policy specifically stated that Homecomings Financial was the “sole insured” under the policy, notwithstanding “the insurable interests of the owner,” (Williams). Furthermore, the policy specified that Homecomings was Lloyd’s “sole insured under this policy” and that benefits paid would be “made directly to [Homecomings].” Thus, the court affirmed the district court’s dismissal of Williams’s action.

The lesson from this case is that a homeowner should always maintain the appropriate level of insurance for his or her property. Because a mortgage issuer is able to force-place a policy only up to the value of the outstanding balance on the mortgage, any equity the homeowner may have in the property is left unprotected in the event of a catastrophe. It is no stretch to imagine that a mortgage issuer would be happy to accept a settlement offer that covers its exposure without regard to any equity loss the homeowner may personally sustain.

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For those Louisiana residents, whether you live in Lake Charles, Shreveport, Baton Rouge, New Orleans, Kentwood or any other of the great cities across this state, looking for more information on their possible personal injury claim, check out our blog dedicated to these legal matters:

Louisiana Personal Injury Blog

This blog discusses the legal issues relating to Admiralty/Maritime law, Animal/Dog Bites, Car Accidents, Chemical/Industrial Spills, the intricacies of Expert Testimony, Insurance Disputes, employee rights under the Jones Act, Legal Duty, Civil Lawsuits, Criminal prosecution, Medical Malpractice, Mesothelioma/Asbestos, Motorcycle Injury, Negligence, Offshore Accidents, Product Defects, Chinese Drywall, Strict Liability, Workers’ Compensation and Wrongful Death. All of these issues are crucial to citizens rights and residents of Louisiana.

In a very well written and important Times-Picayune article, writer Rebecca Mowbray reports that the recent problems being caused by Chinese drywall in courtrooms goes beyond simple construction or building code and law and into the depths of federal laws regarding international products. Because of this faulty imported wallboard, Mowbray points out, huge problems in the law and remedy for faulty products have been exposed. While many have followed this matter for its importance to builders and homeowners, business and legal experts now see it as a crucial, highly important matter that demonstrates work needs to be done on the United States’ federal legal system.

The article explains

International trade agreements treat health and safety standards as barriers to commerce, and make it possible for manufacturers to hawk products that fall short of the importing country’s standards. Meanwhile, foreign companies that sell products in U.S. markets aren’t required to participate in litigation in American courts, and even if they did, there’s no means of enforcing U.S. legal judgments against them.

In order to be best prepared for hurricanes or to better understand your hurricane insurance provisions, having a glossary of key terms used in hurricane reports is a good idea. Courtesy of the Texas Department of Insurance and the National Oceanic and Atmospheric Administration, here is a list of helpful terms used commonly and their definitions:

Tropical disturbance: A moving area of thunder storms in the Tropics that maintains its identity for 24-hours or more. A common phenomenon in the tropics.

Tropical depression: Rotary circulation at surface highest constant wind speed 38 miles per hour (33 knots).

The San Francisco Gate features an article that helpfully and articulately describes the difference between property and disaster insurance. Embedded within the article are links to other articles that help outline the grey area that can often exist on the issue. While this blog has tried to explain this in the past, every article an insurance policyholder in the Gulf Coast can read on the topic is worthwhile as recent years have shown insurance nightmares can easily spring up.

An EXCERPT:

The key today, with so many options, is to first assess exactly what you need and then work with an insurance agent to figure out the best package: one that covers your most significant risks. It’s not an either/or scenario that you want, but a combination of policies that provides protection without duplicating coverage. It is common for business owners to fail to look closely at what is covered by their property insurance and buy another policy that covers many of the same risks. Conversely, many policyholders mistakenly assume disasters such as flooding are covered under one of their policies and don’t discover until they’re underwater that neither their property insurance nor their disaster insurance covers flooding.

When going about shopping for the right policy or making sure your policy protects you in the ways you need, it is important to understand insurance terms used. In educating yourself about the legal jargon employed by the insurance companies, you can be better prepared to combat an unfair claim payment or prevent your policy from being hijacked by vague language.

Below, courtesy of the University of Illinois, is a wrap up of this blog’s glossary of insurance terms, ranging from the letter S to Z:

Screening. Physical examination and health history taken by an insurer before the applicant is given the policy applied for.

When going about shopping for the right policy or making sure your policy protects you in the ways you need, it is important to understand insurance terms used. In educating yourself about the legal jargon employed by the insurance companies, you can be better prepared to combat an unfair claim payment or prevent your policy from being hijacked by vague language.

Below, courtesy of the University of Illinois, is a glossary of insurance terms, ranging from the letter O to R:

Optionally renewable. An insurance policy renewable at the discretion of the company.

When going about shopping for the right policy or making sure your policy protects you in the ways you need, it is important to understand insurance terms used. In educating yourself about the legal jargon employed by the insurance companies, you can be better prepared to combat an unfair claim payment or prevent your policy from being hijacked by vague language.

Below, courtesy of the University of Illinois, is a glossary of insurance terms, ranging from the letter J to N:

Lapsed policy. A policy terminated for non-payment of premiums. Level premium life insurance. Life insurance for which the premium remains the same from year to year.

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