The Insureds Have Failed To Cooperate In The Investigation Of The Insureds In Insurance Case Analysis

One of the principal grounds for rejecting insurance claims is that the claim is not covered by the terms of the policy, or is specifically excluded. The rule that coverage provisions should be interpreted broadly and exclusion clauses should be interpreted narrowly is really just a corollary of the Contra Proferentem rule which applies in the event of ambiguity i.e. it is the insurer who likely drafted the insurance contract and construing coverage provisions broadly, or exclusion clauses narrowly, will be to the detriment of the insurer as the party who drafted the contract. The construction of exclusion clauses and coverage provisions helps justify the objective intention of the contract. This is the intention which the court considers, a reasonable person in the position of the contracting parties, would have had. It is submitted that coverage provisions should be broad and encompassing and exclusion clauses should be narrow. However, before such a conclusion is reached, this paper will aim to justify the reasoning behind such a claim analysing arguments for and against such a proposition, drawing upon the landmark case Darlington Futures Ltd v Delco Australia Pty Ltd to help relate the discussion to issues raised by such considerations.

Plaintiff held onto the safety bar located just outside of the shower with her left hand, reached backwards with the right arm to grasp the right armrest of the wheelchair, which had been left in the same spot as when she entered the shower, and began to feel the wheelchair roll backwards away from her. With one hand still on the safety bar and the other on the armrest of the wheelchair, Plaintiff was unable to upright herself and instead, began to fall towards the floor. Plaintiff lost grip of the safety bar and fell on the floor at which time, Plaintiff suffered immediate pain in her back and lower bottom. Plaintiff, screaming in pain, was unable to get up and because of Plaintiff’s location on the floor, the nurse call button was out of reach. Plaintiff was eventually found by medical staff on the floor of the bathroom approximately 8:33am. See Defendant’s Response to Plaintiff’s Request for Admissions No. 15.

Brohawn, supra, 276 Md. at 399. Subsequently, the other party to the altercation filed an action against Brohawn seeking damages for intentional torts and negligence. Id. at 399-400. Transamerica, Brohawn’s insurer, refused to defend Brohawn on the grounds that her coverage contained a policy exclusion whereby Transamerica was not responsible for intentional conduct. Id. at 400. Thereafter, Transamerica initiated a declaratory judgment action, in the same court, seeking to have the court declare that Brohawn’s conduct was intentional, and, therefore, fell within the policy exclusion. Id. at 401. The circuit court dismissed the declaratory judgment action because “the question of coverage would be ‘determined by the jury’s verdict in the tort suits]. . . .” Id. at

In Maryland, insurance policies are generally construed in the same manner as contracts. Collier v. MD-Individual Practice Ass 'n, Inc., 327 Md. 1, 5, 607 A.2d 537 (1992). An insurance contract, like any other contract, is measured by its terms unless a statute, a regulation, or public policy is violated thereby. Pac. Indem. Co. v. Interstate Fire & Cas. Co., 302 Md. 383, 388, 488 A.2d 486 (1985). We do not follow the rule, adopted in other jurisdictions, that an insurance policy is to be construed most strongly against the insurer. Collier, 327 Md. at 5; Cheney, 315 Md. at 766. We construe the instrument as a whole in order to determine the parties’ intent. Pac. Indem., 302 Md. at 388; Collier, 327 Md. at 5; Aragona v. St. Paul Fire & Marine Ins. Co., 281 Md. 371, 375, 378 A.2d 1346 (1977). In order to determine the intention of the parties, “Maryland courts should examine the character of the contract, its purpose, and the facts and circumstances of the parties at the time of execution.” Pac. Indem., 302 Md. at 388 (citations omitted). In doing so, we give the words their usual, ordinary, and accepted meanings. Id.; Mut. Fire Ins. Co. v. Ackerman, 162 Md. App. 1, 5, 872 A.2d 110 (2005) (citing Nationwide Mut. Ins. Co. v. Scherr, 101 Md. App. 690, 695, 647 A.2d 1297 (1994)). The test is what meaning a reasonably prudent layperson would attach to the term. Pac. Indem., 302 Md. at 388.

In Pennsylvania, a plaintiff claiming negligent infliction of emotional distress must establish one of these four situations: “1) that the defendant had a contractual or fiduciary duty; 2) plaintiff suffered a physical impact; 3) plaintiff was in a “zone of danger” and at risk of an immediate physical injury; or 4) plaintiff had a contemporaneous perception of tortious injury to a close relative.” Doe v. Phila. Cmty. Health Alternatives AIDS Task Force, 754 A.2d 25, 27 (Pa. Super. Ct. 2000). The first element does not apply to our client because there was no fiduciary or contractual duty relationship. Secondly, it could be argued that Nordlund suffered a physical impact because after Sumner’s accident, Nordlund could not eat, could not

David A. Goldmeier and Terry C. Goldmeier v. Allstate Insurance Company 337 F.3d 629 (6th Cir 2003) case supports our

Although all accidents and injuries can be unique in their own way, we do utilize a professional, structured process that is designed to protect your rights and attain a positive resolution for you. We assemble your claim alleging the negligence of the responsible party, using police reports, medical observations, photographs, witness accounts, and your own testimonial account. While we do all of the work, you can concentrate on healing and recovering, while anticipating the normalcy returning back to your

State Farm has asked whether it has a duty to defend the insured pursuant to the insured’s homeowners policy. It is our opinion that State Farm has no duty to defend the insured under the insured’s homeowners policy. The insured’s homeowners policy entitled the insured to a defense for “a suit brought against an insured for damages because of bodily injury or property damage to which this coverage applies, caused by an occurrence.” In this case, these elements initially triggering the insured’s homeowners policy are likely satisfied. Nevertheless, the SECTON II – Exclusions section provides that the liability coverage does not apply to any of the fifteen exclusions specifically enumerated therein.

More significantly, the witnesses said they were knowledgeable that the claimant was involved in a recent automobile accident when he injured his “spinal cord” during the car crash where he was transported to a local emergency room for his injuries. They said the accident occurred in November

“An insurance company has a duty to act in good faith in settling claims and a breach of that duty will give rise to a cause of action by the insured. That duty, however, runs only from the insurer to the insured, not to third parties.” Id. at page 5.

Ms. Almanza claimed she researched and provided the claimant’s entire personnel file for this investigation and stated she was not aware of any industrial-related injuries associated with the claimants said injuries, by noting that no treating physicians ever provided any causation or the implied injuries. She provided proof with the claimant’s personnel file taken into as evidence by stating there was no medical evidence, doctors note or request of modified work duties to suggest any medical

As a result of the Defendant’s Actions, Mrs. Summers has a medical injury that entitle her to damages.

On review in the appellate court, after the trial court granted a no-evidence summary judgment for the defendant, were three testimonies submitted by the defendant. Id. at *2. The court held that the testimonies did not sufficiently establish the appropriate standard of care because while each testimony stated the applicable standard of care, none of them stated how the standard was or was not met. Id. at *9. In addition, the plaintiff submitted expert testimony by a veterinarian who stated,

Ms. Yu claimed during her interview that she had no information to give as to the claimant’s evaluation, attendance and her past employment history. Furthermore, she had no information about the claimant’s medical history, injuries at previous employers, or any other work related injuries with this employer.

The claimant is a 45-year-old female who sustained a work-related injury on 11/25/2016 while working as a social worker. She stated that she was backing out of a parking space when her vehicle collided with another car that was backing out of a space across from her. On an impact, she was jerked forward and back.