Another insured driver denied PIP benefits because purchased policy listed her as a driver but did not identify her as an "insured"
William Stone sought PIP survivor's loss benefits from Auto-Owners Insurance Company after his wife was killed in a car accident. His in-laws had added the car he and his wife owned to their insurance policy and paid the premium for coverage. Nevertheless, when she was killed, Auto-Owners refused to pay medical or three years of wage loss and domestic services because the policy did not list Stone or his wife, Linda, as a "Named Insured."
Linda's mother testified that she discussed the coverage issue with her insurance agent and understood that a new policy would be issued, showing both couples as insureds. Since she got the policy and didn't understand that under the technical language her daughter wasn't covered, the Court ruled that she was stuck with the "clear" language of the policy--which was so clear that the trial judge had rejected Auto Owners argument...
Unfortunately for Stone, his unfortunate choice of insurance companies and agents was compounded by drawing Judge Saad and Kirsten Kelly to consider his claim. Both judges routinely reject all injury claims and rubber-stamp virtually any decision an insurer makes. In this case, even though the Stones were "listed in the policy" as insured drivers, the Judges held that "persons designated merely as drivers under a policy...are neither named insureds nor 'person[s] named in the policy'." And the poor insured is supposed to be able to discern this fact "clearly" when the 20-page policy arrives a month later in the mail...
The Judges go on to reason that the Stone "has failed to identify policy language evidencing an intent to include Stephanie as an insured," even though she is expressly recognized as an insured driver! These judges then go on to hold that Stone could not "equitably estop" the insurer from interpreting the policy in this manner, because any unfairness or negligent inducement by Auto-Owners was made to Stone's mother-in-law and not to him. And since there is "only one way to reasonably interpret" the insurance contract (?--not including the way the trial judge interpreted it, we guess) the "clear" language will be enforced against the insureds. All this, despite the fact that the insureds went to the agent, added the Stones and their vehicle to the policy, identified them as insured "drivers" in the policy, and paid the increased premium.
Keep this case in mind if you question the influence of insurance "special interest" money on judicial elections.