Oklahoma Schools Destroyed by Tornado Lacked ‘Safe Rooms’
Connecticut Court Rules That Lawyers Can’t Be Sued for Fraud
Wage and Hour Claims Among Top Threats to U.S. Employers
Cyber Attacks On Banks More Serious Than Public Realizes
E&O Insights: Restaurant and Tavern Risks
CEA’s First CIO Reflects C-Suite Trend
Golf and Country Clubs Weather the Storm
Midwest AGs Go After Storm-Chasing Roofing CompaniesFree Newsletters
Sign up to receive insurance news alerts!Most Popular
Current Issue
Editors and Contributors
-
Andrea WellsAgency Compensation Playbook: 2013 Agency Salary Survey -
Andrew G. SimpsonHow Process Improvement Drives Agency Profitability -
Stephanie JonesThe Acquisition Cycle -
Don JerglerIndustry Predictions -
Chris BurandReasonable Compensation -
Andrea WellsPersonal Lines: How Technology is Changing the Way Agents Do Business
“The court’s conservative majority”….why do we never see “The court’s liberal majority” or “ZZZ is a liberal think tank?”
Just wondering.
You don’t see “the court’s liberal majority” because most of the current Justices were appointed by Republicans.If there was a liberal majority, we would have never been cursed with the Citizens United decision.
Because few of the courts that come up with crazy results these days have liberal majorities. And few of the think tanks are liberal. They are mainly creatures of the conservative-moneied complex, used as tools for world domination (or at least domination of the “liberal” media), and funded by monies that lapdog politicians have thoughtfully allowed the ultra-wealthy to retain rather than pay in taxes.
There, no need to wonder anymore.
I found and read the actual decision in this case. I wanted to know a few more details about DeFrain’s medical condition since it was described as a head injury. The Court does not talk about it much. If DeFrain was incapable of giving notice within 30 days of the accident, then it seems a bit Draconian ignore that fact and foreclose his ability to make a claim. (Ordinarily I would praise a decision like this where the Court actually reads and applies the policy language, but this ones seems somewhat unfair for some reason…)
I thought that the only benefits that were denied in this case were for UM because the 30 day requirement was only contained within the UM portion of the policy.
Maybe I’m missing something but it seems like the IJ article is incomplete.
I wonder how much State Farm spent defending this position. Likely more than the policy limits. Shame on all involved including the State Insurance Department that approved that language in the policy, which in my opinion, is against the public interest. It is more than “unfair”, this person paid premium for a coverage, taking responsibilty for himself due to the numerous uninsured motorists on our roads, and due to no fault of his own was denied the benefit. This is particulary offensive since as the lower court ruled,there was no prejudice to State Farm for the delayed report. Sometimes, insurers need to do the right thing even when there is a good defense!
The little guy pays the bills & the big guys get away with murder.
Does the agent ever compare these clauses when placing a client with a carrier?
State Farm agents have nothing to compare it to since they are captive.
Good point. Plus I thought this “30 day” requirement in the language was common to most policies.
I certainly understand the intent of the language is to encourage timely reporting so that investigations aren’t jeopardized. SF probably suffered no additional loss becuase of the delay but so often it seems that the courts “read between th lines” and interpret coverage that just doesn’t apply. We’ve all seen big judgements that don’t make sense. Right or wrong, this language is straight forward.
State Farm agents are “captive.” They can only write one policy – State Farm’s. It is not the agents fault as they have no choice regarding policy language. Because this insured was incapacitated during the filing period it seems to me that State Farm should have done the “right thing,” and paid out on the claim.
This article is a good example of why compassionate conservatism is an oxymoron. You can bet that the conservative majority is all Republicans, and you can also bet that Republicans will put business interests above the interests of the every day person every time.
Yeah, Jim. We want everyone to die so that we can keep a bigger piece of the pie for ourselves. Lib.
Nice to see an honest republican. Thanks Ralph.
Yeah, because liberal progressives are sooo trust-worthy…riiiight.
Way to generalize, Jim! Glad you received your latest talking points instead of reviewing the facts. The contract had specific timeframes (approved by the state DOI!), the mother failed to meet it. The court agreed and didn’t try to legislate from the bench or rule on emotions. Also, if State Farm would have paid this despite the claim being made 2 months late, then how do they reject future claims on the same basis?
It should be pointed out that State Farm paid the medical expenses….the mother was remiss in meeting the 30 day deadline for her “pain and suffering” claim:
William DeFrain’s mother, who lives in the Detroit suburb of Redford Township, had an uninsured motorist policy with State Farm at the time of the May 2008 accident. Her 50-year-old son had gone to Florida to find work when he was struck by an unidentified driver in a parking lot.
Because auto insurance covers “resident relatives” of the policy holder, State Farm covered his medical expenses under the no-fault policy. It refused to pay other damages such as pain and suffering, though, because it was not notified within 30 days of the accident – as required for hit-and-runs under her uninsured motorist policy.
DeFrain, who alerted the insurer nearly two months too late, sued. The high court majority on Wednesday ruled that unambiguous contracts must be enforced as written and DeFrain’s lawyers failed to show it was not possible to comply with the 30-day notice provision
Sgal, you think that just because you repeat the same specious argument that the conservative majority used to render this unjust decision that you have somehow offered something new to the discussion. The point here is that justice is supposed to be about fairness. The only way that a just decision would have been reached here is if were established that the insurer was somehow prejudiced because of the late reporting, and according to the facts in this case, no prejudice was shown. Instead, the conservative majority relied on the technicality of the arbitrary, but unambiguous, 30 day deadline in a policy that only insurance professionals have any real understanding of, hopefully! In typical smug Republican, pro-big business fashion, you champion the strict application of unambiguous policy language over compassion and a just result. Of course, you have no problem with the fact that the ordinary insurance consumer is not privy to all the exclusions and conditions that insurers are allowed to put in their policies by a DOI that puts the foxes in charge of the hen house and results in big insurers being able to skirt their obligations to pay legitimate claims. And I bet that if you had it your way, there would be no such thing as awards for pain and suffering; just give them the medicals and a big corporate brush off. And don’t forget to call them slackers because they are disabled by their injuries. We can only hope that what goes around comes around for you and like minded individuals.
Jim, this isn’t the time or place for “justice”. This is a contractual issue. The contract is the contract, and you can’t just go changing the terms of the contract after the fact. If you do, why bother with a contract to begin with?
“Justice” would be the hit and run driver being brought to account for his actions. Justice would be civil and criminal penalties for the person that caused the injury.
Shame on you Mark. How dare you say that determining whether a contract is interpreted in a way that either an insured gets the benefit of the insurance contract that was purchased, or whether the insurer gets to avoid making payments that are contractually owed – the non-payment of which increases its profits- is not about justice. Especially here where the “contract” is one sided and in no way negotiated by two parties of somewhat equal power. Well, maybe not in your “insurance” world, but to the injured party here who was left without a recovery, first by the uninsured driver who was liable, and then by the conservative court that determined that insurer profits trumped the injured insured’s right to a recovery, I’d say the claimant views that as an injustice, as in adding insult to injury, literally. And from a legal standpoint, considering that the injured party is likely looking at a two year statute of limitations for pursuing a claim against the uninsured driver, it appears that the DOI by allowing this contractual provision has usurped the legislative mandate of a much more reasonable statutory limitation. In effect, it has allowed State Farm (and other insurers) to impose a 30 day statute of limitations of sorts on the only recovery available to the injured party that is backed by insurance. Again, in progressive states not dominated by conservative majorities whose leaders are more concerned with fairness and justice than in protecting business profits, the key here would have been to require State Farm to establish prejudice due to the lack of notice, as this is the basis behind the 30 day time frame to report the UM claim. Courts always maintain the power to assert equitable jurisdiction to arrive at a just result. The only real contractual certainty is that there is no such thing as a guaranteed unambiguous contract, because by their vary nature, all contracts are subject to interpretation. You and those of your mindset appear to support the “unambiguous contract” justification when it gives you the result you want, which is to protect the insurer’s profits. Admit it. I would therefore add to your list of what I agree would constitute justice is for the legislature – since I am not sure the DOI can be trusted to protect the insurance consumer in this state – to require that the insurer must establish that it has been prejudiced by a “late” reporting if it wants to play this game of requiring that the UM claim be reported within this very short and unreasonable time frame. State Farm could have done the right thing on its own and only denied the claim if it had been prejudiced, as I am sure other carriers have done in this type of case, but it chose not to do so. I suspect that State Farm did so because it was emboldened by what it knew would be a conservative majority hearing the case, just as we now see happening with the U.S. Supreme Court. I hope insurance consumers are watching and understand they should avoid State Farm, knowing it will pursue every avenue available to avoid making payments on legitimate claims if they can find a technical loophole to avoid making payment. They owed it, plain and simple, and a conservative majority undid the just ruling of a lower court judge.
Well stated Jim! Just to let you, hakadjuster has been a life-time registered Republican, although this year things may change. Incredibly, State Farm paid some of the claim so they must have either had proper notice of the accident or accepted bills within the reasonable time frame for submitting medical bills. Why shouldn’t the UM claim have the same standard. Ultimately, it comes down to fairness, as you say. I am glad to hear there are others who support fainess over “technicality of arbitrary, but unambigous deadline in a policy”.
Thanks hakadjuster, and you prove why generalizing is a slippery slope. Since you are sharing, I have over 20 years experience in casualty claim, and I was fortunate enough to be employed by carriers who would not have wanted to make these headlines with this kind of decision that establishes such shabby treatment toward an insured.
my first conclusion, is there anyone else who knew him? if he had insurance was it paid in full or had the insurance ran out because of payment…. the agent might have called to find out if everything was ok…. i think if he was incapacitated, you would think the insurance folks would obliged to take care of him…
If the information about this being the mother’s policy is correct, I would expect that State Farm contested the claim because the mother was not incapacitated. Without that information, this is bad publicity for State Farm. They pride themselves on ‘being dependable’ when it comes to claims. If they paid the medical expenses, is that the obligation in this case? In Michigan, the coverage for the other person not having insurance is really meant for ‘drivers’ to be covered.
Oh, I should say, I’m an entreprenuerial, Democrat, educated in the Detroit public school system, now living in Oakland County.
“unambiguous contract language has meaning”
Conservatism/liberalism aside, we can be grateful there are still courts in the land capable of rendering the above.
I can’t “like” that comment enough times.
you know, i can see this going to the US Supreme court…
State Farm boasts Your in a better State. That sure is not true.
The initial headlines of this case sound bad… but hearing the facts, I agree with the decision.
#1 It was the Mothers’ policy and She was the one who wanted to make the claim. She bought the policy with that language…She wasn’t incapacitated
#2 Get to a better state…
Ignorance of the law excuses no man, an unambiguous contract is what is is. In your rantings Jim, you make your liberal slant the basis of your argument. This has nothing to do with politics. The choice to read and understand and ask questions of what is bought is always up to the individual. The fact that they may not doesn’t change the nature of a contract.
Tim, you could not have provided a more ignorant cliche to support your smug right wing opinion, which explains why you have such a narrow minded outlook. You would have had fun back in Roman times watching the peasants being thrown to the lions, since you clearly favor the powerful over the vulnerable.