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Policy Language Stops California Widow’s Claim Against Insurer in Fatal Drunk Driving Crash

In many auto accident injury cases, insurance companies are central figures in the process. In a recent California Court of Appeal case involving a drunk driver, the drunk driver’s employer and a fatally injured motorcyclist, the court decided that the motorcyclist’s wife was not entitled to recover payment under her and her husband’s auto insurance policy, because the insurers for the drunk driver and the employer each had already paid the wife, and the sum of those payments exceeded the limit of the couple’s policy.

The tragic events that ended Greg Elliott’s life began when Lesa Shaffer, a worker at Peterson’s Corner, a restaurant and bar, decided to drive home at the end of her shift despite being drunk. Shaffer’s truck crossed the center line of Route 49 in Nevada County and collided with Elliott’s motorcycle, killing the man.

Elliott’s wife sued the restaurant’s owners, as well as Shaffer, for wrongful death. The restaurant’s insurer paid $250,000, with Shaffer’s insurance company adding $15,000. Elliott’s wife also filed an underinsured motorist claim with the couple’s insurance company, Geico.

Elliott had sought only $85,000, acknowledging that the $15,000 Shaffer’s insurer paid was validly applicable against the policy limit. She claimed, however, that the money paid by the restaurant’s insurance company should not count against her policy limit. Geico rejected the claim and Elliott sued for breach of contract. Elliott used a document Geico gave her that was designed to explain how her underinsured motorist coverage worked as proof supporting her version of how the policy functioned.

Both before the trial court and the appeals court, the wife’s case was unsuccessful. The problem was the way that the couple’s insurance policy was written. The explanatory document carried no weight with the courts because it was not a part of the actual policy. The only language that mattered was the wording of the policy itself. That document allowed the Elliotts to pursue underinsured motorist claims up to a policy limit of $100,000, but also allowed the insurance company to deduct from that $100,000 limit any amounts paid to the Elliotts “by or for any person or organization that may be held legally liable for the injury.” Geico had based its payout offset language allowing for deductions due to payments made by legally liable third parties, on Cal. Ins. Code §11580.2.

Both Shaffer and the restaurant were legally liable for the fatal accident. Both Shaffer and the restaurant, through their insurers, paid. Those payments totaled more than $100,000, so Geico was entitled to deny the claim.

If you or a loved one has been injured in an auto accident, dealing with insurance companies is likely to be an inevitable part of pursuing compensation for your damages. For knowledgeable advice and strong representation in dealing with both the court system and the insurance companies, contact the Oakland injury law attorneys at the Law Offices of Stephen M. Fuerch. Contact us through our website or call our office at (925) 463-2575 to schedule your confidential initial consultation today.

More Blog Posts:

Family Able to Sue Restaurant Owner for Dangerous Parking Lot, Even When Injury Occurred Offsite, Oakland Personal Injury Attorney Blog, Dec. 31, 2014

Trucker Potentially Liable for Teen Driver’s Injuries Due to Illegal Parking Stop, Oakland Personal Injury Attorney Blog, June 13, 2014

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