Louisiana Appellate Court Allows Family Member Injured While Crossing Street to Recover Insurance Benefits Despite Being Named Excluded Operator on Policy

Recently, the Louisiana Second Circuit Court of Appeal addressed the DSC_0694 (1)uninsured/underinsured motorist (UM) coverage provided by an automobile insurance policy as it applied to a family member of the named insured.  In this case, the court turned to the specifics of the insurance policy in order to determine whether a family member specifically excluded from liability coverage could recover under the UM portion of the policy.

Alcender Williams, Jr. was walking on foot, attempting to cross the intersection of Gralyin Lane and Hawes Street in Monroe, Louisiana.  He was struck by a vehicle owned by Sharon Davis, and operated by Eric Davis, as he crossed the street.  Mr. Williams was injured, and Ms. Davis’ liability insurance policy was not enough to cover his entire claim.

Mr. Williams brought a lawsuit against his mother’s automobile insurer, USAgencies Casualty Insurance Companies. He claimed that since Ms. Davis’ insurance could not cover his claim, USAgencies needed to pay the remaining damages.

In response, USAgencies moved for summary judgment on the issue of policy coverage. They argued Mr. Williams was excluded from UM coverage because Ms. Hubbard did not pay a premium that would have covered him.  Additionally, they argued he was an excluded driver under the liability provision of the policy.

In response, Mr. Williams argued that he was covered under the policy, and he was a pedestrian and not a driver when the accident occurred.  The excluded driver endorsement, he argued, did not apply.   The trial court initially found that Mr. Williams was excluded from UM coverage but allowed coverage under the medical payment portion of the policy, in which a covered person was defined as a family member struck by a motor vehicle.  Upon a rehearing on the issue of UM coverage, the court stated the policy provisions were ambiguous, and Mr. Williams was entitled to coverage.  USAgencies appealed.

On appeal, USAgencies claimed that Mr. Williams’ status as a “named excluded operator” excluded him from UM coverage.

The appellate court stated that interpreting an insurance contract is a legal question to be resolved according to general contract law under the Louisiana Civil Code.  Louisiana law provides UM coverage by statute, making clear that any exclusions from insurance coverage must be clear.

Here, USAgencies contended that whether Mr. Williams was a driver, a non-driver occupant, or a pedestrian, the UM coverage definition stated that coverage does not include a named excluded driver.  This created a complete exclusion of any UM benefits under the policy for Mr. Williams.  The policy defined “named excluded operator” as someone listed as excluded.  Mr. Williams’ name was listed as a named excluded operator.

Looking closely at the provisions within the insurance policy, the court stated that Mr. Williams was both a “family member” and a “named excluded operator.” Simply because Mr. Williams was a named excluded operator did not bar him from policy coverage.  In fact, the court stated he was afforded coverage as a family member.

The appellate court held that Mr. Williams’ coverage was not withdrawn by the language in the exclusionary section of the policy.  Specifically, the court stated that Mr. Williams is a “named excluded operator” when he is acting within the policy definition of a named excluded operator.  During the rest of the time, he remains a family member, entitled to coverage.  As a pedestrian injured in an accident, his conduct did not define him as a named excluded operator.

To hold otherwise, the court made clear, would provide that family members who are also named excluded operators will not receive UM coverage, whether or not they are driving an insured vehicle.   The USAgencies benefit here extended to an insured family member who was not covered for liability under the policy.

The court affirmed the trial court judgment finding USAgencies’ policy provided UM coverage to Mr. Williams.

At Lavis Law, our personal injury attorneys provide dedicated legal representation and advice to Louisiana car accident victims.  If you or a loved one has suffered injuries due to a negligent driver, contact our office for a free consultation. We can be reached by calling 866-558-9151 or using our online form.

More Blog Posts:

Louisiana Appellate Court Holds Injured Plaintiff Failed to Show Department of Transportation Had Notice of Failed Stop Sign After Intersection Car Accident, Louisiana Injury Lawyer Blog

Louisiana Appeals Court Reverses Award in Favor of Defendant, Finding that Both Parties were Equally at Fault in Intersection Collision, Louisiana Injury Lawyer Blog

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