In a recent case before the Louisiana Second Circuit Court of Appeal, the court addressed the reach of an automobile insurance policy’s underinsured/uninsured motorist coverage. The daughter of a woman fatally injured in a motor vehicle accident in Texas sought to recover benefits from her own policy, due to her own emotional pain and suffering. The court reviewed the terms of the insurance policy and analyzed whether the underinsured/uninsured coverage extended to the daughter of the deceased.
Lori Marshall sought to recover uninsured/underinsured motorist (“UM”) benefits under her husband’s insurance policy with Louisiana Farm Bureau Casualty Insurance. Ms. Marshall had received policy benefits in the amount of $30,000 from Safeco Insurance Company after her mother was killed in a vehicle accident while riding as a guest passenger in a car owned by Tana Roy. Ms. Roy maintained automobile liability through Safeco at the time of the accident.
Ms. Marshall sought UM benefits on the grounds that, since the car in which her mother was riding was underinsured, she was entitled to UM benefits as an insured under the Farm Bureau policy. The Farm Bureau policy provided for UM benefits in the amount of $50,000/$100,000 per insured claim.
After Farm Bureau denied her request, Ms. Marshall filed a lawsuit against them, seeking damages, penalties, and attorney fees. Farm Bureau moved for summary judgment, seeking the dismissal of Ms. Marshall’s claim. The insurer contended that, since Ms. Marshall’s mother was not insured under their policy, Ms. Marshall was not entitled to UM benefits. The trial court granted Farm Bureau’s summary judgment and dismissed Ms. Marshall’s demands with prejudice. She appealed the summary judgment.
The appellate court began their analysis by stating that interpreting an insurance contract is a usually a legal question that can be resolved in a summary judgment motion. The court looks to the parties’ intent when entering the contract. Any doubts in an insurance policy are construed in favor of the insured and against the insurer.
Louisiana UM coverage is set forth by statute and incorporates a strong public policy. If there is an exclusion of coverage, it must be clear and unmistakable. The law requires that the insurer prove that an insured named in the policy rejected coverage in writing. The UM statute states that coverage is an implied amendment to an automobile liability policy, and it will be read into the policy unless it is clearly rejected.
The court set forth a two-step analysis to evaluate the UM coverage at issue. First, the automobile policy was examined to determine whether UM coverage is contractually provided under the policy. Second, if UM coverage was not found, the UM statute is applied to determine whether coverage is mandated.
Turning to the insurance policy, the court stated there are four provisions to consider. First, Ms. Marshall was in fact an “insured” under the policy, since she was a resident of her husband’s household, the named insured. Next, the court turned to the term “bodily injury” and the subject of “death” as addressed in the Insuring Agreement.
Here, since Ms. Marshall asserted a wrongful death benefit claim, the policy reference to “death” must be analyzed. The Insuring Agreement made clear that the uninsured motorist must have caused, by their negligence, the damages or death sustained by the insured. The UM benefit flowed from the insured decedent for her pain and suffering before death to her wrongful death beneficiaries.
The court stated that damages from a wrongful death are covered by the policy only when they arise from a bodily injury that caused the death of an insured under the policy. Since Ms. Marshall’s mother was not insured under the policy, Ms. Marshall was not entitled to benefits. The court affirmed the lower court’s judgment.
Here, the court interpreted the automobile insurance contract strictly, and the insurance company prevailed in this lawsuit involving uninsured motorist coverage. At the Lavis Law Firm – Personal Injury & Accident Attorney, we help clients in need of guidance or representation for their insurance disputes. Contact our office at 866-558-9151 for a free consultation.
More Blog Posts:
Louisiana Court Affirms Judgment in Favor of Car Accident Victim Receiving Maximum Coverage From Insurance Company, Louisiana Insurance Lawyer Blog, November 24, 2015
Louisiana Appeals Court Holds Plaintiff Has Burden of Proving His Entitlement to Recovery Under Uninsured Motorist Coverage, Louisiana Insurance Lawyer Blog, August 25, 2015