Articles Tagged with insurance

Most personal injury lawsuits involve accidents, i.e. unintentional but negligent conduct, but sometimes a personal injury arises from criminal activity. When this is the case, the criminal party can be held liable in a personal injury lawsuit–but their insurance company probably will not cover any award of damages. That is because insurers typically include criminal activity from the scope of their policy coverage.

Marcus v. Country Mutual DO-013 Insurance Company

A recent decision from the Georgia Court of Appeals, Marcus v. Country Mutual DO-013 Insurance Company, provides a helpful illustration of this principle. This case unfortunately began with a scenario that has become all too common in Georgia — a white person reporting “suspicious” African-Americans to the police. According to court records, the woman repeatedly complained to law enforcement in Macon about several African-American youths. When questioned, the juveniles explained that the woman had repeatedly shouted racial epithets at them. The police advised the youths to “stay on the other side of the street when passing by her house, knowing that [she] was upset and hostile.”

If you are injured in an auto accident, you naturally assume that your insurance policy will help cover your damages. As with any contract, you need to carefully review and understand the terms of your policy. You may need to comply with a number of conditions before the insurer is legally obligated to provide you with coverage. Your failure to comply can–and will–be strictly held against you by the courts.

Geico General Insurance Company v. Breffle

A recent decision from the Georgia Court of Appeals, Geico General Insurance Company v. Breffle, provides a cautionary example. This case involves an insured driver (the plaintiff) who was injured in an April 2016 auto accident with another vehicle. The plaintiff sought medical treatment for his injuries a few days after the accident. In December 2016, about eight months after the accident, the plaintiff underwent a surgical procedure as part of his treatment. Later, in March 2017, the plaintiff’s doctors advised him that he would need a second surgery.

As a general rule, you cannot directly sue an insurance company for a personal injury caused by someone they insure. In other words, if you are in a car accident caused by a negligent driver, you cannot name that driver’s insurance company as a defendant. Such “direct action” is not permitted under Georgia law.

Daily Underwriters of America v. Williams

But there are exceptions. Georgia law includes two separate provisions that permit direct action against insurance companies that insure motor carriers, i.e. semi-trucks. In a recent decision, Daily Underwriters of America v. Williams, the Georgia Court of Appeals explained how these two provisions can be applied in practice.

Insurance companies will often file what are known as “declaratory judgment” lawsuits following an auto accident. Basically, the insurer wants a judge to declare that it is not responsible for defending or indemnifying its policyholders against any personal injury lawsuits that arise from the accident. These actions normally turn on the language of the specific policy at issue, as well as any exclusions allowed under Georgia insurance law.

Progressive Mountain Insurance Company v. Middlebrooks

But can an insurer obtain a declaratory judgment before anyone has even filed a personal injury claim? The U.S. 11th Circuit Court of Appeals in Atlanta recently confronted this question. This case, Progressive Mountain Insurance Company v. Middlebrooks, deals with a September 2017 auto accident in Albany, Georgia. A man was driving a Ford to a local dealership for repair when it collided with a bus. Both the driver and the owner of the Ford held separate insurance policies from Progressive Mountain.

In many successful personal injury cases, the defendant’s insurance company ends up paying most of the judgment. You might therefore think it would “save a step” just to sue the insurance company directly. In most cases, such “direct action” is not permitted under Georgia law. The legal theory behind this is that an insurance policy is a contract between the insurer and the insured, and the injured person is a third party who is not “privy” to this agreement.

However, Georgia law makes an exception to the prohibition on “direct action” when the insured party is a “motor carrier.” That is to say, if you are injured in an accident caused by a motor carrier, you may file directly sue both the carrier and its insurance company for damages.

Mitchell v. Dixie Transport, Inc.

In most cases, damages arising from a car accident are covered by the negligent driver’s auto insurance policy. But what if the accident occurred while the car was still in the owner’s driveway? Would homeowner’s insurance actually cover such damages?

Wilkinson v. Georgia Farm Bureau Mutual Insurance Company

The Georgia Court of Appeals recently addressed these questions in Wilkinson v. Georgia Farm Bureau Mutual Insurance Company. This case began when a man named Buchanan purchased a used Ford F350 truck. One of Buchanan’s co-workers, a man named Wilkinson, asked to take a look at the truck. Wilkinson and his wife subsequently went to Buchanan’s house.

When you file a personal injury lawsuit against a negligent driving following an auto accident, in most cases this means you are really seeking compensation from the driver’s insurance company. Unfortunately, insurance companies are quite adept at asserting their own legal rights. This includes taking legal action to void a policy if they believe the policy holder–i.e., the negligent driver–did not strict comply with its terms.

American Family Insurance Company v. Almassud

A recent case before a federal judge in Atlanta, American Family Insurance Company v. Almassud, offers a cautionary example. This case involves a 2012 accident in Cumming, Georgia. The defendant was driving his Jeep. According to court records, the Jeep “veered into oncoming traffic and struck a vehicle driven” driven by a woman who sustained serious injuries.

When it comes to personal injury lawsuits, many plaintiffs do not only need to contend with the negligent defendant. They also need to deal with the negligent defendant’s insurance company. Even where the insurer has a contractual duty to indemnify and defend a policyholder, you can rest assured that the company will make every legal effort to avoid providing coverage.

ACCC Insurance Company v. Walker

Take this ongoing lawsuit, ACCC Insurance Company of Georgia v. Walker. This case involves a 2015 auto accident. The defendant was one of the parties involved in the accident. He subsequently filed a personal injury lawsuit against two men, who were insured by the plaintiff, ACCC Insurance.

When a person is seriously injured in a motor vehicle accident, the responsible insurance company may face conflicting obligations under Georgia law. On the one hand, the insurer must settle a valid claim in good faith. For example, if an insurer knows its policyholder is responsible for causing an accident, a refusal to settle with the victim can make the insurer liable for any excess personal injury award against the negligent driver.

On the other hand, an insurer may also be responsible to any medical provider that files a lien after providing services to the accident victim. That is to say, if the insurer simply cuts a check to the victim without first checking to see if there are any hospital liens, the hospital could turn around and sue the insurer for the amount owed (plus additional damages).

Kemper v. Equity Insurance Company

One of the biggest mistakes a person can make following a serious accident is to not contact a lawyer. In some cases, the negligent party who caused the accident will try and convince the victim that it is unnecessary to speak with an attorney. The negligent party may even make promises to “take care of” the victim’s damages without the need for them to file a personal injury lawsuit.

Golden Isles Cruise Lines, Inc. v. Lowie

Unfortunately, such promises may be nothing more than a delaying tactic. The negligent party may simply be trying to keep the victim from filing a claim until it is too late–i.e., after the statute of limitations has expired.

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