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Insurer Read Your Policy | Zalma on insurance



Owners Insurance Company (Owners) appealed against the introduction of a final summary judgment in favor of Allstate Fire and Casualty Insurance Company (Allstate) in an action brought by Allstate against owners and Allstates insured, James M. Horne, Jr. (Horne) in Owners Insurance Company v. Allstate Fire And Casualty Insurance Company and James M. Horne, Jr. Case No. 2D18-2309, District Court of Appeal of Florida Second District (June 19, 2020) to decide whether the owners should provide UM benefits to Horne.

FACTS

Horne was living with her mother and stepfather, who had a car insurance with the owners. The owner policy provided UM insurance (UM) but only gave it to relatives who did not own a car. Horne had an accident while driving his own car. Allstate sought an explanation that Horne was covered by the owner's policy for injuries he suffered in the accident.

Because the owner policy provided basic liability insurance to resident relatives, the trial court held that the owners were required to provide UM coverage to Horne.

ANALYSIS

The owners claimed that "the basic liability insurance under the owner policy only extends to relatives who do not own a car." However, upon closer examination of the policy, these relatives are only excluded from the extended liability insurance of unlisted cars. Section II of the policy, entitled "Liability Insurance", contains the following:

We will pay damages for bodily injury and property damage for which you become legally liable for or arising out of the ownership, maintenance or use of your car (it is not a trailer ) as a car. We will pay such damages. . . on behalf of some relative who uses your car (it is not a trailer ).

This provision gives Horne, a relative as the term defined in the policy, coverage of basic liability when driving one of the listed cars. Neither the owner nor Allstate referred to Section II Liability Insurance provision in their summaries, but the Court of Appeal found that provision.

Allstate claimed that Horne was entitled to UM coverage because "he is insured for basic liability coverage" under the disregarded Section II Liability Insurance. However, if a court reaches the right result, as it did here, that decision will be upheld if there is any basis that could support the judgment in the minutes.

According to Florida law, if an auto liability insurance policy provides liability insurance, then it must also provide UM coverage to the insured under the insurance. Uninsured motorist protection does not attract a particular motor vehicle but protects the said insured or insured family members from bodily injury caused by the negligence of any insured motorist under the conditions, locations or circumstances that such insured happens to be at that time.

An insurance policy may contain specific provisions that exclude certain insured persons from UM coverage if the said insured knowingly accepts such a limitation and the insurer offers a reduced contribution.

In order to limit coverage, the insurer must meet the statutory mandated termination requirement of the insured and obtain a recognized approval of the limited coverage and must submit revised, reduced premium rates for such insurance. Owners did not receive the informed approval or provide the reduced tax rates required by insurance companies that include the statutory exemptions from the UM coverage mandate in their insurance policies.

Because the ownership policy gives Horne basic liability, Florida requires the law to provide UM coverage to him as well. As such, the trial fairly granted a summary judgment in favor of Allstate.

Had the owner read the full policy (RTFP), it would have seen that it owed UM coverage to Horne and would have avoided the trial and appeal. According to Florida law, because the ownership policy gave Horne liability as a member of its named insured's household, it was also required to provide UM benefits to Horne.


© 2020 ̵

1; Barry Zalma

Barry Zalma, Esq., CFE, now limits his practice to an insurance consultant specializing in insurance coverage, insurance claim management, insurance bad faith and insurance fraud insurance. policyholder. He also acts as arbitrator or mediator for insurance-related disputes. He practiced law in California for more than 44 years as an insurance coverage and insurance service and more than 52 years in the insurance industry. He is available at http://www.zalma.com and zalma@zalma.com.

Mr. Zalma is the first recipient of the first annual Claims Magazine / ACE Legend Award.

Over the past 52 years, Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to enable insurance companies and their claims staff to become professional insurance claims.

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