Insurance Coverage – Forcing the Insurer’s Hand (Part 1)

When dealing with liability coverage, for example through your homeowner’s policy, you are faced with a seemingly mass of confused wording of here is what you get, then later on, what you don’t.  It gets really confusing when you are sued and the allegations in the Statement of Claim allege claims that are both covered and not covered by your policy.

For example, your homeowner’s policy will cover for injuries or damages arising to others as a result of your negligence.  It will not cover for those same injuries or damages if they were caused intentionally by you.

I am in the middle (actually hopefully near the end) of dealing with such a case where I am trying to get the insurer to except that it has a “duty to defend” a civil action brought against my clients (and others).  The “duty to defend” is extremely important because it means that the insurer pays for the lawyer who is defending you.  In exchange, the insurer gets to hire the lawyer.  Believe me, it is not unheard of for the legal fees to be enough to bankrupt an individual, and sometimes can outstrip what is the amount the plaintiff would get awarded by a court.

In simple terms, the plaintiff was hurt in what he says was an assault.  The problem is, he does not know who did it (if in fact it was an assault).  He does not remember either due to his own intoxication, or as a result of a head injury.  So he sues everyone there at the time. The allegations as against my clients are either they assaulted him, but if not them it was one or more of the other defendants,  and my clients were negligent (for a variety of reasons not necessary to outline here).

Those part of the allegations that accuse my clients of assault would not be covered under the policy, thus there would be no duty to defend on the part of the insurer.  But what about the “negligence” allegations?

…..more to come……..

John Barzo
205-60 Collier Street,
Barrie, Ontario, Canada
L4M 1G8

#: 705-733-6245

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