A South Carolina man was a passenger in a co-worker’s vehicle when an automobile accident occurred. There was insufficient insurance coverage and the victim did not have under-insured motorist coverage. To obtain much-needed compensation for injuries, he submitted a claim under a separate insurance policy that had been issued to his fiancé and that listed both the man and his fiancé as residents. The policy did not have the injured man listed on the declaration’s page as the “named insured.”
The insurance company denied the claim and said he wasn’t eligible for underinsured motorist coverage because under the policy language, he was not related to the owner of the policy. The couple never did become related because they broke off the engagement. However, Insurance News Net reports the victim pursed compensation all the way to the state Supreme Court.
Ultimately, he did not prevail in the case, with the appeals court ruling against him and the Supreme Court upholding the ruling. However, the Supreme Court did make a fundamental change that could help customers going forward to get the insurance coverage they deserve. Insurance disputes, and the laws governing them, can be complicated. An experienced Rock Hill injury lawyer should be consulted for assistance when dealing with any insurer.
Insured Victims Get More Leverage in Supreme Court Ruling
South Carolina has long had a strict interpretation of insurance policies based solely on the language and wording of the contract. It was this strict interpretation that resulted in the victim being ineligible for coverage due to the narrow definition of family member.
The Supreme Court changed all of that going forward. While the judge did not adopt broad, consumer-friendly protections to give policyholders the complete edge in insurance disputes as some other jurisdictions have, it did go a long way towards helping injured victims get the compensation.
The courts may now use the “doctrine of reasonable expectations” when deciding on an insurance dispute over policy coverage. The doctrine indicates that under any circumstances when the insurance policy is vague or the terms are unclear, the dispute should be resolved according to what the consumer who purchased the policy believes.
This does not give customers free reign to make up whatever insurance terms they want, since the court will still review policies and apply the consumer’s interpretation only in cases where the terms are legitimately ambiguous. However, it does mean that individuals who are hurt or who suffer losses will not be deprived of coverage they thought they had as a result of unclear insurance contract language that favors the insured.
The doctrine reflects a major policy shift in the handling of insurance disputes. However, the court made clear that the reasonable interpretation policy should be used sparingly as just another “interpretative tool,” because the doctrine cannot be used to alter an insurance policy’s plain language.
If you have been injured, contact the Lee Law Offices at 800-887-1965.
More Blog Entries:
Protecting Carolina Children from Deadly Everyday Risks, Jan. 12, 2014, Rock Hill Child Injury Lawyer Blog