New Jersey Appellate Court Prohibits Unlicensed Drivers From Collecting PIP Benefits

The New Jersey Appellate Division has ruled that an unlicensed driver may not recover PIP benefits for their own medical expenses sustained in an auto accident, even if they had permission from the vehicle’s owner to drive the vehicle.

In Blanco-Sanchez v. Personal Service Insurance Company, A-5393-16 (Feb. 28, 2019), plaintiff, who was the daughter of the named insured, was injured in an accident that occurred while the plaintiff was moving her mother’s car to avoid getting a parking ticket. Her mother had asked …

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New York Appellate Court Permits Use of Extrinsic Facts to “Clarify Ambiguous Pleadings” and Establish the Applicability of a Policy’s Auto Exclusion

On October 23, 2018, our Global Insurance Services group hosted an interactive webinar discussing states’ varying interpretations of what is considered “loading and unloading” in the context of a liability policy’s “Aircraft, Auto or Watercraft” exclusion. During that presentation, we identified inconsistencies in the courts’ application of this provision when assessing an insurer’s duty to defend, particularly in New York. Ironically, that same day, a New York Appellate Court analyzing the application of a the “Aircraft, Auto or Watercraft” exclusion relied on facts extrinsic to …

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Use of Uninsured Vehicle To Transport Victim To Site of Assault Does Not Trigger UM Coverage

On August 14, 2018, in a case of apparent first impression in New Mexico, the New Mexico intermediate appellate court in Crespin v. Safeco Ins. Co. of Am., 2018 (N.M. Ct. App. 2018) upheld a lower court’s ruling that transporting a minor in an uninsured motor vehicle to another location in order commit a sexual assault does not trigger uninsured motorist (UM) coverage because the assault did not arise out of the use of the uninsured vehicle. The decision rebuffs a novel attempt to …

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The ALI’s Recently Adopted “Restatement of the Law of Liability Insurance” Receives Mixed Reviews from Courts and Legislatures

The much-anticipated Restatement of the Law of Liability Insurance (RLLI) was recently approved by the American Law Institute (ALI) during its Annual Meeting in May 2018. Since its adoption, the RLLI has been met with mixed reviews from courts as well as at least one state legislatures.

As discussed in previous blogposts, the RLLI is the ALI’s first publication in the field of insurance law and touches upon nearly every legal issue frequently faced by insurance professionals. Prior to its adoption, the RLLI had been …

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Illinois Supreme Court Puts the Brakes on Named Driver Exclusion

The Illinois Supreme Court held in Thounsavath v. State Farm Mutual Automobile Insurance Co., 2018 IL 122558, that an insurer cannot rely on a named driver exclusion to deny underinsured motorist coverage to its insured because the exclusion is unenforceable under Illinois’ mandatory automobile insurance statutory scheme and the state’s public policy.

State Farm provided automobile liability and uninsured motorist (UM)/underinsured motorist (UIM)coverage to Thounsavath, which contained a named driver exclusion stating no liability shall attach “while any motor vehicle is operated by …

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Changes to New York State Insurance Law Affect Auto Policies, Neonatal Intensive Care Coverage, and Exposures for Mortgage Guaranty Insurers

Frederick J. Pomerantz, a partner in Goldberg Segalla’s Global Insurance Services and Insurance Regulatory Practice Groups, has authored three alerts on changes to New York State insurance regulations in the November 2017 edition of the Federation of Regulatory Counsel (FORC) Alerts. In the alerts, Fred details notable recent changes pertaining to private passenger auto policies, neonatal intensive care services, and exposures for mortgage guaranty insurers.

Analysis of Non-Renewals of Private Passenger Auto Policies

Effective October 23, 2017, Section 1, Paragraph 2 of Subsection (l) …

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No Sympathy: Injured Claimant Without Auto Insurance Due to Fraud Barred From Bringing Personal Injury Claim

In Bencosme v. Kannankara, no. A-1672-14T3 (App. Div. Mar. 22, 2016), the New Jersey Appellate Division concluded that the apparent harshness of the decision was not a sufficient basis for it to refuse to affirm a trial court’s ruling that dismissed a personal injury lawsuit against a claimant who failed to carry statutorily required auto insurance, even though the claimant was uninsured as a result of fraud.

Federico Bencosme was involved in an auto accident with Joseph Kannankara in which Bencosme allegedly sustained injury. …

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Location, Location, Location: Michigan PIP Benefits Awarded to Illinios Claimant Where Location of Accident is Only Connection to Michigan

Michigan’s no-fault insurance benefits, especially Personal Injury Protection (PIP) benefits, are among the most favorable to claimants. Michigan law requires no-fault insurance for every vehicle owner. This insurance pays for medical expenses, wage loss benefits, replacement services, and damages to other people’s property, no matter who caused the accident. These provisions make Michigan’s no-fault coverage attractive to injured claimants when insurance coverage may not otherwise be available or fault may be difficult to establish, as shown by a recent case decided by Michigan Court of …

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Supreme Court of Illinois Limits Liability of Self-Insured Car Rental Company

On October 8, 2015, in DeShaw Nelson v. Donald Artley, the Illinois Supreme Court overturned a ruling by the First District Appellate Court  that ordered a car rental company to pay an accident victim $600,000 as a result of damages allegedly sustained in an automobile accident involving a car owned by the rental company and driven by an operator without his own insurance. At issue in DeShawn was the extent of financial liability that a self-insuring rental car company faces where a default judgment …

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Attorney-Negotiated Medical Discounts Reduce Tort Victim’s Recovery

The Louisiana Supreme Court has issued the first ruling from a state’s highest court on the issue of whether a tort victim’s potential recovery in a lawsuit is diminished when her attorney negotiates medical discounts on her behalf. The court ruled that tort victims can only recover the lower rate for medical services they actually pay.

The case, Hoffman v. 21st Century N Am. Ins. Co., No. 14-2279, 2015 La. LEXIS 1962 (La. Oct. 2, 2015), dealt with the collateral source rule. Under the …

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