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 Posted: Thu Sep 17, 2009 1:02 pm Post subject: |
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Just like any adjuster that's been at this for any length of time, I've handled a ton of these claims. They have ALWAYS been covered..(to the state min. on PD and BI), and if collision (or comp) on the vehicle it has been paid (in all the claims I've seen or worked) each and every time.
Tell ya' what let's see what a MO policy has to say.
Under coverages A and B
| Quote: | (Subject to the limits of our liability)
We will pay damage fo an insured, if:
1) that insured is legally obligated to pay those damages; and
2)the accident that caused those damages arose out of the ownership or use of the described auto or a non-owned auto |
well, looks to me like both of those apply to this situation.
Now I'm skipping thru all the different definitions of an 'insured' under these coverages, and posting only the one that applies
| Quote: | Category 4
Individuals who have permission or general consent to use the described auto are insureds for claims resulting from that use. The limit of their coverage is the min. amount required by the financial responsiblity law appliciable to the accident, regardless of the amount stated in the Declarations. With respect to these insureds, we provide only those coverages required byt he applicable financial responsiblity law. |
The following words are defined in the policy as follows:
| Quote: | | PERMISSION: means the prior authorization of the owner of an item of personal property for another to use it on a specified occasion and for a specified purpose. The specified occasion can be more than one day in duration. Permission exists only on that specified occasion and only while the item is being used for the specified purpose. Permission can be expressed or implied. An individual who is expressly authorized to use a vehicle by a person in possession of that vehicle will be treated as having permission to use it, if he or she reasonably believes that the permission extends from its owner. |
| Quote: | | GENERAL CONSENT: means the authorization of the owner of an auto for another to use it on one or more occasions without the necessity of obtaining permission for each use. General consent can be expressed or implied. |
Now under F & G (coll/comp)
| Quote: | INSURED means the person defined as an insured by the specific coverage or dendorsement under which coverage is sought.
YOU means any person listed as a named insured in the Declaarations and, if that person is an individual her or her spouse.
PERSON means an individual, a corp, or an entity that has separate legal existence under the laws of the state where this policy was issued or a claim is made.
INDIVIDUAL means a human being |
In MO, he's covered. Unless there is some wacky policy (private) that I've not seen..possible, but unlikely. They are all written pretty much the same. But of course we don't have a copy of the OP's policy to check the language.
IMO, the OP needs to file the claim with his carrier (did, and denied? really? get it in writing the file a complaint with your states Dept of Ins. AFTER requesting your adjusters superiors review this), file a claim with sisters insurance carrier, and with drivers parents insurance carrier. I find it VERY hard to believe that this claim would be denied...
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"Never, never be afraid to do what's right, especially if the well being of a person or animal is at stake. Society's punishments are small compared to the wounds we inflict on our soul when we look the other way." Martin Luther King Jr. |
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Lori
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Joined: 10 Sep 2007
Posts: 8173
Location: Missouri
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| Posted: Thu Sep 17, 2009 3:33 pm Post subject: |
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| In the case of the dealer, the insurer cited that they had abused the confines of the policy. The vehicle was not being used/operated under ther terms of the policy. Vehicle was being used outside of business purposes. Coll and liab was denied. The dealer is suing the vendor for damages. This is a MO claim. |
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Trench
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Joined: 16 Sep 2009
Posts: 911
Location: Kansas City
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| Posted: Thu Sep 17, 2009 3:50 pm Post subject: |
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| Quote: | | In the case of the dealer... |
That is a GK form, not a PAP. Definitions as well as coverage is different. |
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tcope
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| Posted: Fri Sep 18, 2009 10:48 am Post subject: |
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| Quote: | | In the case of the dealer, the insurer cited that they had abused the confines of the policy. |
Agreed, the policy wording is totally different. I'd fully expect that claim to be denied. I've only been involved in claims with a few of those policys, and the difference is night and day.
_________________
"Never, never be afraid to do what's right, especially if the well being of a person or animal is at stake. Society's punishments are small compared to the wounds we inflict on our soul when we look the other way." Martin Luther King Jr. |
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Lori
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Posts: 8173
Location: Missouri
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| Posted: Thu Feb 24, 2011 9:40 am Post subject: Claim denial |
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There is one aspect to this claim that might be missed on a denial for collision coverage. Certain insurance insuring agreements exclude coverage and will deny collision coverage based on the fact that the driver who caused the accident was not licensed! Some companies have such exclusion within the insurance contract.
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Jack Thomas
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