Articles Posted in Insurance

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Any time you enter into a contract, it is crucial that you understand all of the terms and conditions of the agreement you are entering into. This is of especially high importance for agreements such as insurance policies on major purchases in your life, such as your car or your home.

Although many insurance policies or similar contractual agreements can often be long and tedious to read through, it is essential that you, as the policyholder, understand the obligations that you are bound to by entering into the agreement, as well as what the other party has agreed to. This way, you are more likely to know when you can invoke specific clauses of an agreement and defend yourself when issues arise.

In a recent Rhode Island Supreme Court opinion, the court considered whether a couple was entitled to receive a subsequent appraisal of damage to their property in addition to compensation for damage incurred. The plaintiffs, who were insured by the defendant, notified the defendant of water damage to their home that was the result of snow that had accumulated on the roof. The plaintiffs submitted a claim to the defendant, which detailed the damage. Shortly after, the plaintiffs received a check for $14,549, which they cashed. More than a year later, the plaintiffs requested an appraisal for the original loss, which was rejected by the defendants because the plaintiffs failed to dispute the scope of payment, more than a year had elapsed, and the claim was categorized as resolved. The plaintiffs sued the defendant, claiming that the denial of the claim constituted a breach of their insurance contract.

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Pursuing a Rhode Island homeowners or property insurance claim can be much more difficult than it should be. Although insurance companies are paid by their clients for the express purpose of providing coverage against a covered loss, once a claim is filed, an insurance company often treats their client as a hostile party. Claims adjusters and the legal teams behind them have a duty to their employers to weed out fraudulent claims; however, incentive programs used by insurance companies often result in all claims initially being treated as if they are unreasonable or fraudulent.

As an insured person who has recently suffered a devastating loss that would result in a property insurance claim, the client is often in an extremely vulnerable and unfavorable position to express their rights under the insurance policy and demand what they are entitled to. Insurance companies know this and will often deny coverage unjustly or make extremely reduced offers to vulnerable clients who need a payout immediately. While the ethics of this practice is certainly questionable, when taken to its extreme, insurance company tactics can have legal implications that all their clients should be aware of.

When the insurance company game of hardball goes from unkind to unethical or illegal, is when a Rhode Island bad faith insurance claim can come into play. Insurance companies have a fiduciary duty to act in the insured’s best interests, which includes a duty to seriously consider a plaintiff’s reasonable settlement demand. An insurance company that wrongfully denies a claim can be sued by their client for acting in bad faith. Insurers can be held accountable for declining to settle a valid claim or for otherwise failing to adequately perform their duties under the insurance contract. A plaintiff who successfully pursues a bad faith claim against their insurance company may be entitled to the original damages under the claim, as well as punitive damages against the insurance company as well as attorney’s fees.

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Most Rhode Island personal injury and insurance disputes must be filed with the court within the statute of limitations that is set by the state legislature. Because plaintiffs are often overwhelmed and or unaware of the potential for a claim for damages, lawsuits are often dismissed when plaintiffs fail to file suit within the statute of limitations. Some exceptions exist, allowing a plaintiff’s suit to proceed even when it is filed after the statute of limitations. A recent decision by the Rhode Island Supreme Court serves as an example. In that case, an appellate court reversed a lower court’s decision in favor of an insurance company in a personal injury insurance dispute.

According to the court’s opinion, the plaintiff was injured in a slip and fall accident while at a restaurant that was insured by the defendant. He filed an initial lawsuit against the restaurant owner within the three-year statute of limitations. The plaintiff’s initial complaint was eventually dismissed because the plaintiff failed to have the defendant properly served under the state requirements. Although the defendant insurance company was not officially a party to the plaintiff’s initial lawsuit, the restaurant owner defendant was represented in the proceedings by attorneys retained by the insurance company.

After his initial complaint was dismissed, the plaintiff refiled his lawsuit against the restaurant owner, and ultimately joined the insurance company in the suit. However, this was not until after the three-year statute of limitations had expired. The plaintiff justified the timing of the filing based on a Rhode Island law that the courts refer to as the” savings statute,” which gives a plaintiff an additional year to refile a complaint after it has been dismissed on specific procedural grounds. The second trial court rejected the plaintiff’s justification, holding that because the insurance company was not a party to the original suit, the savings statute did not apply. As a result of this ruling, the plaintiff’s second suit was dismissed, leading him to appeal the ruling to the Rhode Island Supreme Court.

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New England property owners generally owe members of the public a legal duty of care to maintain safe premises for people using or visiting their property. This responsibility can result in financial liability for injuries suffered by a person while on the premises as a result of the negligence of the property owner. Landlords have a similar duty to maintain safe and habitable premises for their tenants, however, a recently published opinion by the Massachusetts Supreme Court demonstrates that tenants may face an uphill battle when seeking damages for an injury sustained as a result of premises that are negligently maintained by their landlord.

The plaintiff in the recently decided case was severely injured after slipping and falling while crossing an icy pathway outside the home he rented from the defendant. Claiming that the landlord negligently failed to maintain the surroundings, the plaintiff sued for damages on two theories. First, the plaintiff argued that the landlord negligently caused his injuries by failing to safely remove the snow and ice from the driveway and access to the home. After a jury trial on this issue, it was found that that the plaintiff’s own negligence in failing to avoid the fall outweighed the landlord’s negligence, and that the plaintiff was not entitled to relief.

In addition to the negligence claim, the plaintiff made other claims based on contract law, alleging that the landlord violated the implied warranty of habitability of the premises by failing to safely remove the snow and ice from the premises. In a pretrial ruling, the trial judge found that the plaintiff would be unable to pursue this cause of action against the landlord, and the plaintiff was denied relief before the jury addressed the claim. The plaintiff appealed the pretrial rulings to the Massachusetts Supreme Court.

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When searching for a homeowner’s insurance policy, many Rhode Island homeowners seek out the lowest premium or highest policy limits without paying much attention to the details of what types of losses are covered or excluded from a particular policy. In the event of an incident involving damage or loss, a homeowner may be denied coverage for some type of loss that they thought or assumed would be included in their policy. A recent decision by the Rhode Island Supreme Court demonstrates this scenario.

According to the court’s opinion, the plaintiff was a homeowner who purchased an insurance policy from the defendant. In May of 2017, the plaintiff’s water heater ruptured and caused flood damage to their home. Believing that the damage was covered by the homeowner’s policy, the plaintiff made a claim with the defendant which was denied. The plaintiff sued the defendant in district court, alleging that the policy included coverage for damage from the incident. The district court reviewed the insurance policy and determined that the text of the policy included an exclusion for water damage caused by a malfunctioning appliance in the dwelling and determined that the defendant was justified in denying the plaintiff’s claim.

The plaintiff appealed the ruling to the Rhode Island Supreme Court, pointing to language in the policy providing coverage for sudden, accidental, and direct physical loss caused by fire, explosion, or theft resulting from a flood or other water-related incident. The plaintiff claimed that the damage caused to their home should be covered under this provision, as the water heater exploded prior to the flooding. The high court denied the plaintiff’s arguments, finding that the clear and unambiguous language within the policy excluded any water damage resulting from a defective or malfunctioning appliance, and that the provision affording coverage to damage incident to flooding did not afford coverage for the type of damage reflected in the plaintiff’s claim.

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Most Rhode Island homeowner’s insurance policies insure the policyholder from personal liability for injuries and property damage that may occur both on the insured property as well as in other places. The personal liability protection is broad, but not unlimited, and many exclusions apply, depending on the specific homeowner’s insurance policy. In a recently decided appeal, the Supreme Judicial Court of Massachusetts ruled against an insurance company in their attempt to enforce an exclusion against a policyholder whose children and others were killed in an accident while vacationing at a cabin in Maine.

Prior to the filing of the recently decided case, a tragedy occurred when the two children of a Massachusetts property owner and two of their friends were celebrating a birthday at a Maine cabin that was also owned by the father. While in the cabin, the children and their friends used a gasoline-powered generator to run a small refrigerator inside the cabin. The generator was used inside the cabin and there was not adequate ventilation for the exhaust, resulting in the four individuals succumbing to carbon monoxide poisoning and dying.

The estates of the two deceased friends notified the insurance company supplying homeowners insurance to the father’s Massachusetts primary residence that they would be seeking damages under that policy for the deaths of the two friends. The insurance company then filed suit in district court seeking a judgment that the incident was not covered under the policy because of an exclusion for incidents arising out of liability from another premises, as the Maine cabin was not an insured premises under the Massachusetts homeowner’s policy.

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A Massachusetts woman was mauled to death in a tragic dog attack that occurred less than 20 miles from Providence, Rhode Island last month. According to a local news report, the woman was having a seizure when she was attacked by her family’s eight-year-old pit bull. Medical crews and police were called to the scene to subdue the dog and render aid, and the woman was taken to a nearby hospital, where she died as a result of the injuries that she sustained. According to the woman’s family, she had owned the dog since it was a puppy, and the dog had not exhibited aggressive behavior toward the woman in the past, although her seizure may have caused the dog to panic and bite its owner.

Rhode Island dog bites cause serious injuries each year, and they often result in the hospitalization of the bite victim. Dog owners can be held accountable in a civil claim for the damages that result from their dog’s actions. Attacks that occur at the dog owner’s home, or possibly elsewhere, may be covered by a Rhode Island homeowner’s insurance policy, even in situations in which the bite victim is the owner of the home. Some insurance policies contain exclusions for dog or animal attacks, and homeowners should be sure to have the correct policy in effect and notify their insurance company if they intend to purchase a pet.

Homeowner’s insurance policy exclusions are not always black-and-white, and insurance companies have been known to deny coverage for an incident or injury based on a supposed exclusion in the policy, which may not be applicable or enforceable under state law. Insurance policies are sometimes written to benefit the insurance company and encourage denials of claims that are actually covered under the policy if someone takes a closer look. Dog bites aren’t the only type of injury that may be covered under a homeowner’s policy, and injuries that occur far from the property may also be covered. Any injuries that occur as a result of negligence by a homeowner or their dependent should be evaluated by a legal expert to determine if there is a possible claim under the homeowner’s insurance policy to recover damages.

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When someone is injured in a serious Rhode Island car accident, they will likely incur significant medical expenses, miss time away from work, and may also experience pain and suffering as a result of the accident. Rhode Island accident victims can pursue a claim against an at-fault driver to recover compensation for these damages.

While a Rhode Island personal injury lawsuit is technically filed against the at-fault driver, the claim will most likely be defended by that driver’s insurance company. In Rhode Island, all drivers and owners must be financially responsible, meaning they must obtain a certain amount of car insurance to cover the costs of a potential accident. Rhode Island uses a fault-based system, under which drivers will obtain insurance coverage to pay for the damages that they cause. This is referred to as liability coverage.

Most Rhode Island car insurance policies contain three parts: liability for bodily injury, liability for property damage, and un/underinsured motorist protection (UIM). As mentioned above, bodily injury liability coverage protects the insured against damages to other people they cause. Similarly, property damage liability coverage pays for damage to property caused by the insured. Notably, both bodily injury and property damage liability will cover damages caused by the insured, up to the policy limit. However, neither covers injuries suffered by the insured.

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The purpose of car insurance is to provide a way for accident victims to receive compensation for the injuries they sustain in a Rhode Island car accident. Indeed, without the existence of insurance, Rhode Island car accident victims would not be able to recover adequate compensation for their injuries unless the at-fault party happened to have sufficient assets to cover the expenses.

Despite the requirement that all drivers maintain insurance on their vehicles, the reality is that in many Rhode Island car accidents, the victim’s injuries far exceed the policy maximum of the at-fault driver’s insurance policy. In these situations, an accident victim can obtain underinsured/uninsured motorist (UIM) benefits under their own policy.

Under Rhode Island law, all insurance companies must offer UIM insurance when they write a policy. Additionally, all motorists must obtain a certain level of UIM insurance. Only in situations where a motorist obtains the minimum amount of liability insurance can they entirely waive UIM coverage.

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In Rhode Island, all motorists are required by law to maintain a certain amount of auto insurance on their vehicles. Under Rhode Island General Laws section 31-31-7, motorists must obtain liability insurance of $25,000 per person and $50,000 per accident. In addition, motorists must obtain $25,000 worth of insurance per accident for property damage. Liability and property damage insurance protects the policyholder in the event that they cause a Rhode Island car accident by covering the costs incurred by victims of the accident. However, it is estimated that 17% of Rhode Island drivers do not maintain sufficient insurance on their vehicles.

If someone is involved in an accident that was caused by another motorist’s negligence, the at-fault motorist will be responsible for any injuries suffered by the accident victims. However, if the at-fault motorist does not have insurance, the accident victim will only be able to pursue a claim against the driver, who may not have the assets to compensate the injury victim adequately. This is where uninsured/underinsured motorist (UIM) protection comes into play.

Underinsured/Uninsured Motorist Protection in Rhode Island

Under a UIM policy, a policyholder is protected from accidents caused by an at-fault motorist who either has no insurance or does not have sufficient insurance to fully compensate the policyholder for the damages caused by the accident.

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