Insurance policies define “Occurrence.” Generally, policies define an “occurrence” as an “accident” or “repeated exposure to the same or similar” conditions. Liability policies require an occurrence for coverage and require an insured to give prompt notice of any “occurrence” that could result in a claim. First-party coverage, however, often does not rely on the word “occurrence.” Most policies require an insured to give prompt notice of a “loss.” Recently, the United States District Court for the Western District of Virginia determined if “occurrence” and “loss” meant the same thing and what impact the use of each word had on an insured’s duty to timely report a first-party claim. In Wheeler v. Standard Fire Ins. Co., 2016 U.S. Dist. LEXIS 38255, Wheeler suffered damage to her barn when trees fell on the porch of the barn. Thinking that the barn repair cost would be less than her deductible, Wheeler had unidentified day laborers repair the damage. She did not notice any other damage at the time. Several months after the repair, Wheeler heard rumbling noises and then the foundation basement wall of the barn collapsed on the same side of the barn where the trees fell. Wheeler reported the earlier damage and the wall collapse to her insurer. Experts determined that the trees falling months earlier led to the wall collapsing. Despite that, the insurer denied coverage for several reasons, the first that Wheeler did not “promptly” report her “loss” to the insurer. The insurer claimed that Wheeler should have reported her claim when the trees fell on the barn. The Honorable Norman K. Moon first noted that “occurrence” is...
Written by Gary Reinhardt, Esq. Glass Companies are battling insurers throughout the country claiming that the insurers’ glass claim programs amount to improper “steering.” One particularly active group filed a petition titled “National Right to Fair Trade Petition.” This petition argues that insurers’ glass programs may violate antitrust laws. In order to be ready for such claims, the insurer needs to act consistently and adhere to its insurance policy. A recent skirmish between a glass repair company and insurers resulted in an early win for the insurers. In Clear Vision Windshield Repair, LLC, as assignee of Star Davis v. Elephant Insurance Company (numerous companion cases accompanied this ruling involving Erie Insurance and First Liberty), the Henrico Circuit Court granted the insurers’ demurrer and dismissed Clear Vision’s cases, with prejudice. Clear Vision alleged that it performed windshield chip repair on windshields of each insured. Clear Vision attempted to gain an assignment of insurance benefits from each insured. As part of its contract for services, Clear Vision sought this assignment of insurance policy benefits and agreed not to pursue the insured personally for the cost of its services (costs were also disputed but the Court never reached that issue). All of this took place, including the alleged repairs, prior to the claim being reported to the insurer. Neither the insured nor Clear Vision obtained consent from the insurer for this attempted assignment. The insurers refused Clear Vision’s demand for payment under the policy. In response, Clear Vision sued each insurer in General District Court seeking not only $150 per insured for chip repair(s) but also bad faith double damages, costs and...
Written by Gary Reinhardt, Esq. Have you used a Transportation Network Company (TNC) yet? That is the fancy, statutory name for “ride share” companies such as Uber and Lyft. As most are aware, a TNC relies on its drivers to use their personal vehicle. The prospective passenger contacts a TNC driver through the use of a smartphone app. From there, the driver acts as a typical taxicab although personal experience has shown these cars to be cleaner and the driver to be nicer. Payment for the ride is made via credit or debit card already entered into the TNC’s digital platform. The TNC concept is fairly new and courts have yet to sort out the morass of legal and insuring issues these ride shares cause. State statutes set out a comprehensive regulatory framework for these companies, including requirements that essentially label these TNC vehicles and require minimum insurance limits. Starting with Va. Code Ann. § 46.2-2099.48, the Virginia legislature sets out what a TNC and its driver must do to operate in the Commonwealth. This statute requires that all TNC drivers carry “proof of coverage under each in-force TNC insurance policy, which may be displayed as part of the digital platform, and each in-force personal automobile insurance policy covering the vehicle.” This same statute limits a driver from driving more than 13 hours during any 24 hour period. The statute also requires that a TNC vehicle have a different color decal on the license plate, the year decal that shows you have renewed the vehicle registration. Virginia TNC vehicles will have a black decal with yellow “VA” letters and...
Managing Partner of KPM LAW’s Coverage & Fraud division, Gary Reinhardt considers Coverage implications following a Biohazard on an insured’s premises in this episode of...
KPM LAW’s Gary Reinhardt, Managing Partner of KPM’s Coverage & Fraud Department, will present at The Property & Liability Resource Bureau’s Eastern Regional Adjusters Conference in Atlanta, Georgia, on November 10-11, 2015. An AV-rated attorney who serves as General Counsel to the International Association of Special Investigation Units, Gary is speaking on the latest trends and strategies in property fraud claims. Gary and the team at KPM LAW hope to see you at this valuable two-day conference. More information can be found at http://www.plrbregionalconferences.org/. ...
