My update on Alabama Department of Insurance Regulation 482-1-125-.07(4) and what it means for claims handlers dealing with pro se claimants can be found in the October 2019 edition of CLM magazine: here.
Sometimes business and people make misrepresentations to their clients or during the course of a transaction. You buy a car that you were told hadn't had any prior problems, only to determine that it has flood damage. A business owner sells his company and remembers to disclose all his assets so he can get top dollar, but fails to mention all his debts and liabilities. When these businesses have insurance, there is sometimes an exclusion carved out of the policy that disallows the insurer from defending or indemnifying its insured for intentional acts, like are alleged in fraud and misrepresentation...
A Not Uncommon Scenario in Obtaining Life Insurance A person wants to obtain a life insurance policy and goes to an insurance agent's office. The person and the insurance agent discuss his needs and complete the application. The application is a computerized form, so the insurance agent types in responses or clicks buttons as they discuss the various questions on the life insurance application. Once they've gone through everything, the insurance agents prints off the application and hands it to the potential insured. He either glances over it and doesn't read it at all and signs his name. Sometime later,...
McNamara v. Benchmark Ins. Co.: An indemnity action that arises from an underlying claim of medical malpractice is time-barred if commenced more than four years after the medical injury is incurred, pursuant to Alabama Code (1975) § 6-5-482. Facts of the Matter In December 2009, Ricky Avant's doctor prescribed him to take Tobramycin for two weeks. Southern Medical was assigned to fill the prescription but discovered that Medicare would not pay for Tobramycin. At Southern Medical's suggestion, Avant's prescription was changed to gentamicin, which Avant was to take for only one week (rather than two). Avant's doctor relayed the new order...
I enjoyed the opportunity today to speak to the group attending the "Insurance Coverage Litigation" seminar in Birmingham. Like my previous two speaking opportunities at NBI events, this group was engaged and inquisitive, which is always nice at CLEs. The topics I covered were "Recent Insurance Coverage Decisions in Alabama" and" Creatively Framing Your Coverage Position." In December I'm scheduled two speak at another NBI seminar called, "Truck Accident Litigation from A to Z." The topics I'll be presenting are "Using FMCSRs and Other Trucking Laws/Regs to Support Your Case" and "Investigation, Authentication and Admissibility of Truck Accident Evidence." I will...
Once an insured is aware of the existence of a claim, she has a reasonable time to put the insurer on notice of the claim, and if she fails to do so, any potential coverage may be extinguished. Compliance with the notice requirements in an insurance policy is a condition precedent to recovery [or defense.[1] An insured's failure to give notice "within a reasonable time with such conditions precedent in an insurance policy requiring the insureds to give notice of an accident or occurrence releases the insurer from obligations imposed by the insurance contract.”[2] Alabama courts have interpreted the term as soon as practicable to mean that "notice must be given...
Warren Grimes and Johanna Grimes v. Alfa Mutual Ins. Co.: Where there is not an omnibus or other clause requiring it in an automobile liability policy, neither Alabama law nor public policy require an insurer to provide coverage for the driver of a motor vehicle who did have not the express permission of the owner or drivers covered by the policy. Facts and Procedural History In May 2010, Teresa Boop added liability and UM/UIM coverage on a truck to her auto policy with Alfa. Boop also added her minor son as a driver under the policy, and as the primary...
GEICO v. Sharon Bell, administratrix of the estate of Kaysha Bell: An insurer’s denial of liability coverage to an individual because of an applicable liability exclusion (i.e., household exclusion) or definition does not trigger the availability of uninsured motorist coverage to the individual under the same policy. Pertinent Facts In June 2013, Kaysha Bell was killed in a single-vehicle accident. She was a passenger in a 2012 Honda, of which she was the co-owner with Shandarius Steiner, who was driving at the time of the accident. Steiner and Bell purchased an insurance policy from GEICO, that included uninsured motorist ("UM")...
Delores Aderholt v. Sandra R. Aderholt McDonald: The general rule in Alabama is that the named beneficiary of a life insurance is entitled to the proceeds from the policy, and the general rule is not usually interrupted by divorce and has only two exceptions. The Facts of the Matter In 1993, Alfa Life Insurance Corporation issued a $150,000.00 life insurance policy to Bobby Aderholt. The policy provided that upon Bobby's death, the beneficiary would be the person named in the application. Bobby wrote in the name of his then-wife Sandra as the sole beneficiary. Bobby and Sandra divorced in 2004....
Under Alabama Code (1975) § 27-14-1, an insurance policy is comprised of a “written contract of, or written agreement for, or effecting, insurance, by whatever name called, and includes all clauses, riders, endorsements, and papers attached, or issued and delivered for attachment thereto and made a part thereof.” In order for an endorsement to be effective, it must be either (1) attached to the policy, or (2) sufficiently referenced in either the policy or the endorsement to be identified as related to the policy.[1] Signing the Insurance Policy Endorsement (or Not) An insurance policy endorsement does not have to be...
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