Car insurance companies are notorious for finding loopholes in policy language with which to deny coverage.
One that Boston car accident injury lawyers have seen with greater frequency is the denial of coverage to non-married, cohabiting spouses, even when they are technically on the same plan. Coverage in these cases can be a minefield, as evidenced in the recent case of Bell v. Progressive Direct Insurance.
This was a case that recently made its way all the way to the South Carolina Supreme Court for review. Ultimately the court sided with the insurance company, illustrating why policy language must be read very carefully. Many policies grant coverage to “household members,” but the definition of that may in fact be quite narrow.
Given the facts of the case, however, it’s completely understandable that the plaintiff believed he was covered.
This case stems from a serious car accident in the spring of 2006. The plaintiff was a passenger in a vehicle driven by his co-worker. The other driver was at-fault, but he was under-insured. This happens a lot where a driver has insurance, but the policy limits aren’t enough to cover the damage caused.
This is why it’s beneficial for all individuals to have uninsured motorist coverage or underinsured motorist coverage on their own policy, which will help make up the difference.
Here, there was no underinsured motorist coverage on the vehicle in which he was riding. Therefore, the plaintiff sought benefits under the underinsured motorist coverage of his on-again-off-again fiancee, with whom he shared at a child and, at the time, resided. Both the plaintiff’s name and that of his fiancee appeared on the policy as “drivers and household residents,” although the fiancee was listed as the “named insured.”
The policy was intended to include spouses and relatives residing in the same household. However, these two weren’t technically spouses or relatives. The plaintiff would later testify, however, that when the pair moved in together, they sought to consolidate many of their bills. One of those was car insurance. He relinquished his own coverage, and became an “additional driver” on his fiancee’s policy. In doing so, he legally had the minimum amount of insurance necessary were he to cause an accident. However, that didn’t necessarily mean his injuries would be covered in the event he was injured by an uninsured motorist.
Both the trial court and appellate court relied heavily on the fact that while the two were engaged, they had not set a date, were not common-law spouses and marriage was for an “undetermined” point in the future. Therefore, the plaintiff could not be considered a “spouse” under the policy guidelines, and nor was he a named insured.
This is the kind of loophole that can end up costing an injured party dearly. It’s important that any time you switch insurance policies you know the exact extent of your coverage.
If you are injured in an accident in Massachusetts, call Jeffrey Glassman Injury Lawyers for a free and confidential appointment — (617) 777-7777.
Bell v. Progressive Direct Insurance, April 9, 2014, South Carolina Supreme Court
More Blog Entries:
Massachusetts DOT to Bostonians: “Use Yah Blinkah”, May 13, 2014, Boston Auto Accident Lawyer Blog