Source: http://cbaclelegalconnection.com/tag/uninsured-motorist/
Timestamp: 2018-01-16 19:24:23
Document Index: 52601421

Matched Legal Cases: ['§ 10', '§ 10', '§ 10', '§ 10', '§ 1115', '§ 10', '§ 1115']

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Colorado Court of Appeals: District Court Erred in Concluding Injured Worker Not Entitled to UIM Benefits from Personal Insurer
The Colorado Court of Appeals issued its opinion in American Family Mutual Insurance Co. v. Ashour on Thursday, May 18, 2017.
Filed Under: Case Law Tagged With: Colorado Court of Appeals, insurance law, litigation, tort law, uninsured motorist, workers' compensation law
Colorado Court of Appeals: Insurer’s Definition of “Resident Relative” Void as Against Public Policy
September 12, 2016 By Susan Hoyt Leave a Comment
The Colorado Court of Appeals issued its opinion in Grippin v. State Farm Mutual Automobile Insurance Co. on Thursday, September 8, 2016.
Shane Grippin was seriously injured when he was hit by a truck while riding his motorcycle. After collecting the policy limits on the tortfeasor’s insurance and his motorcycle insurance, Grippin sought underinsured motorist benefits from State Farm pursuant to his grandparents’ four policies on which he was named as an “other household driver.” Although Grippin owned a home in Colorado Springs, he and his family resided approximately one week per month with his grandparents.
State Farm moved for summary judgment on the grounds that because Grippin did not reside primarily with his grandparents, he was not a “resident relative” as contemplated by the policies. Grippin responded that State Farm’s definition of “resident relative” was void as against public policy because the qualifier “primarily” diluted the statutory definition of resident relative. He alternatively argued the contracts were ambiguous because he was listed as an “other household driver” and therefore had a reasonable expectation of coverage. The trial court granted summary judgment in favor of State Farm, and Grippin appealed.
On appeal, the Colorado Court of Appeals evaluated Colorado’s statutory mandate of uninsured/underinsured motorist (UM/UIM) coverage and noted that insurance policy provisions that attempt to dilute, condition, or limit statutorily mandated coverage are void and unenforceable. The court of appeals evaluated the definition of resident relative under C.R.S. § 10-4-601(13) and found no qualifying language as to the insured’s primary residence. The court of appeals agreed with Grippin that a person can have multiple residences under Colorado law and the statute’s plain language does not restrict the definition of “resident relative” to a single, “primary” residence. State Farm argued that Grippin’s reading would render some statutory language superfluous, but the court of appeals disagreed, finding the statutory definition cohesive.
The court of appeals disagreed with Grippin’s alternative contention that the contracts were ambiguous, since the policies at issue unambiguously failed to list Grippin as a covered insured. The court also determined that Grippin could not rely on the doctrine of reasonable expectations because that doctrine would only apply after coverage was determined.
The court of appeals reversed the trial court’s grant of summary judgment and remanded for further proceedings.
Filed Under: Case Law Tagged With: Colorado Court of Appeals, insurance law, litigation, personal injury law, uninsured motorist
Colorado Court of Appeals: “Resident Relative” Insurance Coverage Does Not Apply to Estranged Husband
March 7, 2016 By CBA-CLE Staff Leave a Comment
The Colorado Court of Appeals issued its opinion in GEICO Casualty Co. v. Collins on Thursday, February 25, 2016.
Summary Judgment—Resident of the Same Household for Purposes of Insurance Coverage—Boatright Factors—Intent of the Parties.
Collins lived in a house with his wife and their children until a petition for dissolution of marriage was filed in January 2013, at which point Collins moved out of the home. Collins and his wife co-owned a motorcycle and a Jeep. Upon separation, Collins took possession of the motorcycle and his wife took possession of the Jeep. In February 2013, Collins’s wife purchased a new policy from GEICO to cover only the Jeep, informing the GEICO representative that she and Collins were separated and she did not consider him to be a member of her household for purposes of the policy. He was not rated or considered for coverage under the policy.
In May 2013, Collins was injured in a motorcycle accident with an underinsured motor vehicle. In July 2013, the divorce became final. In September 2013, Collins filed a claim with GEICO for underinsured motorist coverage. GEICO denied the claim on the ground that Collins was not a resident relative because he did not reside in his former wife’s household at the time of the accident and therefore was not an insured under the policy. Collins and GEICO each sought declaratory relief on the issue of whether he was a resident of his former wife’s household at the time of the accident. The district court granted summary judgment in favor of GEICO, and Collins appealed.
Whether a person is a resident of a household for purposes of insurance coverage is determined by the facts and circumstances of each case. The fact that Collins lived apart from his wife at the time of the accident does not foreclose the possibility that he was a resident of her household, nor is the fact that they were married dispositive. The critical questions are (1) whether the spouses’ separation was intended to be permanent and (2) whether the contracting parties intended the insurance policy to cover both spouses. Given the dissolution petition, the permanent protection order barring Collins from the house where his wife lived, the undisputed evidence that the couple did not discuss or contemplate reconciliation, and their lack of contact after the dissolution petition, the Court concluded that Collins’s absence from the residence at the time of the accident was intended to be permanent. Moreover, the undisputed facts show that neither GEICO nor the wife intended Collins to be covered under the underinsured motorist provisions of the policy. Hence, under the totality of the circumstances, Collins was not a resident of his former wife’s household at the time of his motorcycle accident.
Filed Under: Case Law Tagged With: Colorado Court of Appeals, domestic relations law, family law, insurance law, litigation, personal injury law, uninsured motorist
Colorado Court of Appeals: No Requirement of Exhaustion of Tortfeasor’s Liability Policy Prior to Collecting UIM Benefits
The Colorado Court of Appeals issued its opinion in Tubbs v. Farmers Insurance Exchange on Thursday, May 21, 2015.
Uninsured/Underinsured Motorist Coverage—Exhaustion Clause.
Tubbs was involved in a car accident in California with another driver. The accident was the other driver’s fault, and Tubbs suffered damages. The other driver’s auto insurance had a $100,000 liability limit. Tubbs was insured by Farmers Insurance Exchange (Farmers), and his policy included uninsured/underinsured motorist (UIM)coverage with a limit of $500,000. Tubbs accepted a $30,000 settlement from the other driver. He then sought to recover under his Farmers policy’s UIM provision, claiming that his total damages exceeded $100,000. Farmers refused to pay benefits, stating that Tubbs did not meet the conditions of the UIM clause, which required him to exhaust the limits of the liable party’s policy before making a UIM claim. The trial court entered summary judgment in favor of Farmers.
On appeal, Tubbs argued that the exhaustion clause in the UIM policy was void and unenforceable. UIM policies are required to cover the difference between the damages the insured party suffered and the limit of any liable party’s legal liability coverage, regardless of whether the insured party’s recovery from the liable party exhausted that limit. As applied to the facts of this case, CRS § 10-4-609(1)(c) requires that Farmers cover Tubbs for damages he sustained in excess of $100,000 (the other driver’s legal liability limit), in an amount up to $500,000 (the limit of Tubbs’s UIM coverage), regardless of how much, if any, he actually recovered under the other driver’s legal liability coverage. Because the exhaustion clause imposes a condition precedent on coverage mandated by the statute, the clause was void and unenforceable. The summary judgment was reversed and the case was remanded for further proceedings.
Filed Under: Case Law Tagged With: Colorado Court of Appeals, insurance law, litigation, personal injury law, tort law, uninsured motorist
Colorado Court of Appeals: Insurer Not Entitled to Directed Verdict Because Medical Benefit Payment Unreasonably Delayed
May 13, 2015 By CBA-CLE Staff Leave a Comment
The Colorado Court of Appeals issued its opinion in Fisher v. State Farm Mutual Automobile Insurance Co. on Thursday, May 7, 2015.
Underinsured Motorist Coverage—Delayed Payment—Directed Verdict—Exclusion of Expert’s Testimony.
In February 2010, Fisher was injured in a collision between the vehicle he was driving and another vehicle. The other vehicle’s driver carried $25,000 in automobile liability insurance. Fisher was insured under several automobile insurance policies with defendant (State Farm) that had a combined underinsured motorist (UIM) coverage limit of $400,000. The trial court found in favor of Fisher in his claims against State Farm for unreasonably delaying and denying payment of UIM benefits.
On appeal, State Farm argued that the trial court erred in denying its motion for a directed verdict on Fisher’s statutory claim. State Farm contended that Fisher’s medical expenses were not, as a matter of law, benefits owed to Fisher at the time he initiated the lawsuit, and therefore, it could not have unreasonably delayed payment of owed UIM benefits. CRS § 10-3-1115(2) provides that “an insurer’s delay or denial was unreasonable if the insurer delayed or denied authorizing payment of a covered benefit without a reasonable basis for that action” (emphasis added). State Farm was precluded from relying on any policy language that purports to prevent Fisher from establishing a claim under CRS § 10-3-1115 until the amount of compensatory damages to which he is legally entitled to collect from the underinsured motorist has been determined. Accordingly, under the plain language of § 1115, State Farm had a duty to not unreasonably delay or deny payment of Fisher’s medical expenses. Fisher offered evidence that he had presented medical bills to State Farm totaling $61,125 at the end of September 2010, and State Farm had not paid any of those bills by the time the lawsuit was filed in July 2011. Therefore, there was sufficient evidence introduced at trial to support the jury’s verdict that State Farm unreasonably delayed paying Fisher’s medical expenses.
State Farm also argued that the trial court abused its discretion in excluding the testimony of its insurance industry standard expert. CRS § 10-3-1115(2) defines “unreasonableness” for the purpose of a claim under §§ 1115 or 1116, and State Farm was not harmed by excluding testimony contrary to Colorado law. The judgment was therefore affirmed.