Insurance contracts can be confusing. Often, the party purchasing the insurance only reads the “declarations” page, which is only a very brief overview of what their coverage entails. However, the actual insurance contract itself is often much longer and much more complicated, and it may even contain seemingly contradictory clauses.
When an insurance contract contains a clause that seems contradictory, the court system often must step in to resolve the conflict if the insured and the insurance company cannot agree. In most cases, if the court determines that there are contradictory terms, the conflict will be resolved in favor of the insured. However, the plaintiff does have the initial burden to prove that a contradiction exists. If no contradiction exists, the court will likely interpret the contract as it was written, even if this seems unfair because the insured thought that they were entitled to more coverage. A recent case decided by a federal court of appeals illustrates how a court may be asked to make a final interpretation of an insurance policy.
ACE Fire Underwriters v. Romero
Romero was the executor of an estate belonging to a man who was killed after he was involved in a tractor-trailer accident. There was no dispute that the operator of the tractor-trailer was at fault. However, since the accident was caused when the tractor became disconnected from the trailer, the issue arose of what the insurance pay-out limit was. Specifically, Romero claimed that it was $2 million, $1 million for each of the two vehicles involved. The insurance company, on the other hand, claimed that the policy maximum was $1 million, regardless of how many vehicles were involved.
The parties could not come to an agreement as to which limit applied, and they asked a court to decide what the insurance contract’s limit was. Prior to asking the court to interpret the contract, the parties agreed that the insurance company would pay $1 million if its interpretation was adopted and $1.55 million if Romero’s interpretation was adopted.
The court ended up deciding the case in favor of the insurance company. In making its decision, the court looked at the entire contract and took the whole document in context. Romero attempted to convince the court that there was a contradiction contained in several clauses of the contract, but the court was able to reconcile the alleged conflict so that the document made sense as a whole. As a result of the court adopting the insurance policy’s interpretation, the estate will receive the $1 million agreed-upon amount.
Have You Been Injured in a South Florida Truck Accident?
If you or someone you care about has recently been involved in a serious auto accident in the South Florida area, you may be entitled to monetary compensation. It is important for all accident victims to realize, however, that they will likely have to deal with insurance companies along the way. This may mean meeting resistance where none was expected. The skilled personal injury attorneys at Cecere Santana have decades of experience assisting their clients in seeking the damages they deserve, including dealing with difficult insurance companies. Call 800-753-5529 today to set up a free consultation.
More Blog Posts:
State Supreme Court Rules for Defendant in Boating Accident Case, Cecere Santana Injury Lawyers Blog, published July 21, 2016.
Appellate Court Broadly Interprets Landowner’s Duty to Protect Visitors, Cecere Santana Injury Lawyers Blog, published July 28, 2016.