Insurance: 1 Claim or 2
I have a nursing home case where we plead two separate incidents. Insurance company takes the position that we have only one claim for coverage purposes, regardless of how many separate incidents or injuries. Carrier relies on policy language that "Related Claims Deemed Single Claim," that then recites policy language stating that basically everything that happens to the person is a related claim.
Answer: Not sure I know enough about your case to intelligently respond but be aware Oklahoma follows a “cause” analysis of whether multiple claims constitute one occurrence or multiple occurrences. There are two cases applying Oklahoma law on the issue. See: Business Interiors, Inc. v. Aetna Cas. and Sur. Co., 751 F.2d 361 (10th Cir. 1984): Oklahoma will adopt the “cause” analysis, so embezzlement by 39 checks over 7 months was a single loss; Transport Ins. Co. v. Lee Way Motor Freight, Inc., 487 F.Supp. 1325 (N.D. Tex 1980) (Multiple claims of discrimination arising from a single employment practice gave rise to only one occurrence). See also: Anno. 64 ALR4th 688 What Constitutes Single Accident or Occurrence Within Liability Policy Limiting Insurer’s Liability to a Specified Amount Per Accident or Occurrence.
Posted on Mon, February 22, 2010
by Sharon Coleman filed under