The victim made a claim for med pay coverage which was denied. Safeco contended its obligation to pay was conditioned on a finding that the insured had been at fault it the shooting. In the coverage litigation which followed, Safeco's demur to the complaint was sustained. App.4th 1079 conferred third party beneficiary rights upon them allowing them to sue Safeco directly without an adjudication of the insured's fault. The court disagreed.
Insurers are free to limit the class of persons to whom med pay coverage is afforded.
The policy language in Harper extended off premises med pay coverage without regard to fault. The Safeco policy was different and limited off premises med pay coverage to four specific situations. Relying on cases from other jurisdictions to consider language similar to the Safeco's, the court concluded that for injuries off the premises, the coverage contained various causative restrictions. Thus, absent a final judgment against the insured, the plaintiffs were not third party beneficiaries of the insurance contract between Safeco and its policy holder. This decision highlights the need to review the pertinent policy language when evaluating any claim.