| Insurer's Duty to Fully Investigate an Insured's Claim |
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| An insurance company has a duty to fully investigate an insured's claim for benefits before denying it. A thorough investigation and fair evaluation of an insured's claim requires an insurance company to examine the insured's proof of loss statement and supporting documents. Further, the insurance company cannot ignore evidence that is available to it which supports the claim. That is, the insurance company cannot focus only on the facts that would justify its denial of the claim. More... |
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| "Escape Clauses" in Automobile Insurance Policies |
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| An automobile insurance policy may have a provision for "other insurance." When more than one insurance policy provides coverage for a loss, the "other insurance" clause can limit an insurance company's liability by defining the priority in which the policy should pay an insured's claim. There are three types of "other insurance" clauses: (1) pro rata; (2) excess; and (3) escape. More... |
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| Overview of Automotive Products Liability Law |
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| The everyday operation of millions of cars and trucks on the streets and highways of the United States, and the massive resulting toll in deaths, personal injuries, and property damage caused by motor vehicle accidents, have inevitably created a situation in which the manufacturers and sellers of motor vehicles are implicated as potential defendants in legal actions seeking compensation for the losses arising from such accidents. Products liability law, a subset of the branch of the legal system called tort law, provides the legal standards for determining the potential liability of motor vehicle manufacturers and their dealers in such cases. (The principles of products liability law also apply to non-automotive products, but our discussion here will focus on the law of products liability as it relates to motor vehicles.) More... |
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| Setoff Provisions in No-fault Insurance Policies |
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| When an insured files a lawsuit against an insurance company, the insurance company can file a counter claim against the insured to reduce the amount of the insured's claim by an amount that the insurance company claims that the insured owes to it. The amount owed can be unpaid premiums or funds received by the insured from other sources that would exceed the amount of the insured's loss. This is called a setoff, an offset provision, or a benefit-set off provision. In the case of no-fault insurance, setoffs exist for a number of benefits that an insured could obtain due to an automobile accident. More... |
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| Insurer's Right to Subrogation |
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| When one person pays to another person an amount due to the second person by a third person, the first person has a right to recover from the third person the amount paid to the second person. This right of payment is called a subrogation. Subrogation is a doctrine of equity. It is the substitution of the first person in the place of the second person, who had a claim upon the third person. When an insurance company pays its insured for a loss under an insurance policy that was caused by a third party, the insurance company acquires the right of subrogation against the third party. More... |
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