WK – she clearly was forced to do this. And what’s worse is that it was the insurance company that forced her.
In any event, what I want to know is why the defendant had his parent’s insurance cover the claim? How old was this guy? Were they minors? Or is this guy some deadbeat living at home with his parents? Either way, if she was drinking, and using drugs why does she get a handout for the lack of self control?
Another example of the “excellent” use of our court system. This lawsuit is ridiculous. This person should take responsibility for her own actions. I hope the jury does the right thing. I do, however, agree that the insurance company should defend their insured. I wish there was a way they could countersue to recoup their expense, but, they owe a defense even if the lawsuit is ridiculous.
“reasoning that the insurer could not rely on the exclusion because the experts were unable to attribute the injuries to either the drugs or the alcohol and that Cardiello was entitled to the benefit of an inference that the injuries were caused by a covered risk.”
There’s your horse your honor. Keep it murky and they will buy it every time.
I certainly agree that it’s a ridiculous claim. The only area that could POSSIBLY be ambiguous is the claim that the injury was due to not getting medical attention in time. If that is what caused the injury, coverage would apply. I agree that all of the other theories would fall under the exclusion. It’s a tough one for the insurance co to swallow. Personally, I think the claim is ridiculous, and, as I said, I sincerely hope the jury does the right thing and throws this BS claim out.
I sure am glad that I matured. Otherwise, I’d still be basing our Party Punch on ethanol and besides melting the “once and done” coolers, my buds and budettes would now be able to sue The Usual Gang of Idiots because we were subjecting the partygoers to drugs.
this reporter does not make clear the legal loophole: damages “were caused by ingesting multiple drugs AND alcohol AND were worsened by a delay in treatment”.
Because the exclusion is for “dangerous and controlled substances”, admitting expert testimony that alcohol MAY have also contributed, along with the “delay in treatment”, the wording of the exclusion leaves room for a court to rule that there were other factors aside from the excluded “danngerous and legal substances”. Because alcohol + delay MAY have also contributed, the tight wording of the exclusion becomes ambiguous and nullified. One lesson: As long as you LOCK up the alcohol, it is ok if the medicine cabinet is raided, AND you call the ambulance fast. Sad.
this claimant, per the article is imputing her injury and permanent hearing loss (!) to drugs OR alcohol OR a combo of the two OR overserving OR failure to render timely medical attention. Wouldn’t you think that she would have to prove…or at least perfect, her suit to count out drugs or a combo? She makes a poorly worded suit which is ambiguous as to cause of injury but that is honored and yet only the insuror clause is ambiguous? Shouldn’t she have to prove up…or at least pick… what caused her injury and permanency before the carrier would pay or defend? Is there contrib negligence in the state?
Some pertinent facts were omitted from the IJ summary. Here is a more complete version with more details surrounding this case:
TRENTON — Insurance companies that provide homeowners policies don’t get an automatic pass when party guests sue after overdosing on alcohol and illegal drugs, the state Supreme Court said today.
Ruling unanimously in a Somerset County case, the court said that because its policy language was ambiguous, Pennsylvania General Insurance Co. must defend Matthew Cardiello of Warren Township in a suit brought by Wendy Flomerfelt, who was a 21-year-old Warren Township resident when she overdosed at his house in 2003.
“It’s a victory for the homeowner in that it forces insurance companies … to stand up and prove that drug use caused, in some way, the alleged injuries,” said attorney Anthony D’Elia, who represents Cardiello and his parents. “I think it’s good for the homeowners and fair to insurance companies.”
That’s not how insurers are likely to see it, said Loretta Worters, a spokeswoman for the New York-based, nonprofit Insurance Information Institute.
“I don’t think an insurer has a duty to defend something that’s criminal,” Worters said. Noting the policy wording is standard, she added, “the language is clear and unambiguous.”
Flomerfelt was a guest at a party Cardiello, then 20, threw in July 2003, while his parents were away. She lost consciousness at some point and was found on a porch the following day, according to court documents.
After trying to rouse Flomerfelt and then to get her sister to bring her to the hospital, Cardiello called rescuers, the decision says.
Flomerfelt was treated for kidney and liver failure at Overlook Hospital in Summit, court and newspaper accounts said. She said she was left with permanent partial hearing loss.
According to a hospital toxicology report, Flomerfelt had alcohol, marijuana, opiates and cocaine in her system.
She sued Cardiello, saying he waited too long to call for help. Cardiello said he didn’t know Flomerfelt was in trouble.
During discovery, doctors for both sides said drugs and alcohol were in Flomerfelt’s urine, but it could not be determined to what extent any of the substances might have hurt her.
Pennsylvania General refused to defend or cover Cardiello, citing an exclusion clause that said coverage would not apply to bodily injury “arising out of the use … of a controlled substance(s).”
The Supreme Court found the language ambiguous and that the company could only refuse to defend Cardiello if it could prove the injuries were actually caused by illegal drugs.
“If the terms are not clear, but instead are ambiguous, they are construed against the insurer and in favor of the insured, in order to give effect to the insured’s reasonable expectations,” Justice Helen Hoens wrote.
The decision reverses an appellate ruling in favor of the insurer and sends the case back to the trial court.
Of course Wendy is not responsible because it is unreasonable to take responsibility for your own actions right? Just say no.
This decision is from the same Court that said a pedestrian getting shot in a random drive by shooting was a PIP claim.
WK – she clearly was forced to do this. And what’s worse is that it was the insurance company that forced her.
In any event, what I want to know is why the defendant had his parent’s insurance cover the claim? How old was this guy? Were they minors? Or is this guy some deadbeat living at home with his parents? Either way, if she was drinking, and using drugs why does she get a handout for the lack of self control?
Another example of the “excellent” use of our court system. This lawsuit is ridiculous. This person should take responsibility for her own actions. I hope the jury does the right thing. I do, however, agree that the insurance company should defend their insured. I wish there was a way they could countersue to recoup their expense, but, they owe a defense even if the lawsuit is ridiculous.
Maybe I’m missing something here but what part of the phrase “arising out of” is ambiguous?
The slippery slope we are going down sure seems to be getting steeper.
I’m with you, plymn – I’m no lawyer, but I don’t find anything ambiguous about the exclusion. Seems pretty clear to me.
“reasoning that the insurer could not rely on the exclusion because the experts were unable to attribute the injuries to either the drugs or the alcohol and that Cardiello was entitled to the benefit of an inference that the injuries were caused by a covered risk.”
There’s your horse your honor. Keep it murky and they will buy it every time.
I certainly agree that it’s a ridiculous claim. The only area that could POSSIBLY be ambiguous is the claim that the injury was due to not getting medical attention in time. If that is what caused the injury, coverage would apply. I agree that all of the other theories would fall under the exclusion. It’s a tough one for the insurance co to swallow. Personally, I think the claim is ridiculous, and, as I said, I sincerely hope the jury does the right thing and throws this BS claim out.
I sure am glad that I matured. Otherwise, I’d still be basing our Party Punch on ethanol and besides melting the “once and done” coolers, my buds and budettes would now be able to sue The Usual Gang of Idiots because we were subjecting the partygoers to drugs.
this reporter does not make clear the legal loophole: damages “were caused by ingesting multiple drugs AND alcohol AND were worsened by a delay in treatment”.
Because the exclusion is for “dangerous and controlled substances”, admitting expert testimony that alcohol MAY have also contributed, along with the “delay in treatment”, the wording of the exclusion leaves room for a court to rule that there were other factors aside from the excluded “danngerous and legal substances”. Because alcohol + delay MAY have also contributed, the tight wording of the exclusion becomes ambiguous and nullified. One lesson: As long as you LOCK up the alcohol, it is ok if the medicine cabinet is raided, AND you call the ambulance fast. Sad.
this claimant, per the article is imputing her injury and permanent hearing loss (!) to drugs OR alcohol OR a combo of the two OR overserving OR failure to render timely medical attention. Wouldn’t you think that she would have to prove…or at least perfect, her suit to count out drugs or a combo? She makes a poorly worded suit which is ambiguous as to cause of injury but that is honored and yet only the insuror clause is ambiguous? Shouldn’t she have to prove up…or at least pick… what caused her injury and permanency before the carrier would pay or defend? Is there contrib negligence in the state?
Some pertinent facts were omitted from the IJ summary. Here is a more complete version with more details surrounding this case:
TRENTON — Insurance companies that provide homeowners policies don’t get an automatic pass when party guests sue after overdosing on alcohol and illegal drugs, the state Supreme Court said today.
Ruling unanimously in a Somerset County case, the court said that because its policy language was ambiguous, Pennsylvania General Insurance Co. must defend Matthew Cardiello of Warren Township in a suit brought by Wendy Flomerfelt, who was a 21-year-old Warren Township resident when she overdosed at his house in 2003.
“It’s a victory for the homeowner in that it forces insurance companies … to stand up and prove that drug use caused, in some way, the alleged injuries,” said attorney Anthony D’Elia, who represents Cardiello and his parents. “I think it’s good for the homeowners and fair to insurance companies.”
That’s not how insurers are likely to see it, said Loretta Worters, a spokeswoman for the New York-based, nonprofit Insurance Information Institute.
“I don’t think an insurer has a duty to defend something that’s criminal,” Worters said. Noting the policy wording is standard, she added, “the language is clear and unambiguous.”
Flomerfelt was a guest at a party Cardiello, then 20, threw in July 2003, while his parents were away. She lost consciousness at some point and was found on a porch the following day, according to court documents.
After trying to rouse Flomerfelt and then to get her sister to bring her to the hospital, Cardiello called rescuers, the decision says.
Flomerfelt was treated for kidney and liver failure at Overlook Hospital in Summit, court and newspaper accounts said. She said she was left with permanent partial hearing loss.
According to a hospital toxicology report, Flomerfelt had alcohol, marijuana, opiates and cocaine in her system.
She sued Cardiello, saying he waited too long to call for help. Cardiello said he didn’t know Flomerfelt was in trouble.
During discovery, doctors for both sides said drugs and alcohol were in Flomerfelt’s urine, but it could not be determined to what extent any of the substances might have hurt her.
Pennsylvania General refused to defend or cover Cardiello, citing an exclusion clause that said coverage would not apply to bodily injury “arising out of the use … of a controlled substance(s).”
The Supreme Court found the language ambiguous and that the company could only refuse to defend Cardiello if it could prove the injuries were actually caused by illegal drugs.
“If the terms are not clear, but instead are ambiguous, they are construed against the insurer and in favor of the insured, in order to give effect to the insured’s reasonable expectations,” Justice Helen Hoens wrote.
The decision reverses an appellate ruling in favor of the insurer and sends the case back to the trial court.
Thank you Compliance Guy. Why couldn’t the IJ put that in their column? Or at least a better description of what happened.
Still a BS lawsuit. Seems to me this woman had been doing drugs and drinking long before this party.