Articles Posted in Insurance Claims

Illinois Tool Works purchased commercial liability policies many years ago from Travelers Casualty Surety Co. and Century Indemnity Co. They were purchased by Illinois Tool Works for the years 1971 through 1987.The policies were designed to have the insurance companies defend Illinois Tool Works against toxic-tort injury complaints that did not allege dates or exposure or injury.

The insurance companies reportedly declined to defend Illinois Tool in thousands of toxic-tort cases in which the plaintiffs alleged that their injuries were caused by exposure to hazardous substances, which included asbestos, benzene and manganese in welding supplies and other products distributed by other companies Illinois Tool started buying in 1993. According to the facts in the case, Illinois Tool did not enter the welding product market until 1993, while the last insurance policy that was issued expired in 1987.

A Cook County judge granted Illinois Tool’s request for summary judgment. On appeal, the tort complaints were characterized this way: Continue reading

The Illinois Appellate Court dismissed an appeal taken from the Circuit Court of Cook County. This case involved Isaiah DeLaCruz, who was hit by a car while crossing a Chicago street. An uninsured motorist was driving the vehicle that struck DeLaCruz. However, it was determined that the vehicle was used as a weapon to run over DeLaCruz, who later died of his injuries.

The plaintiff, Universal Casualty Co., had issued an insurance policy to Ana Ocampo, who was a relative of DeLaCruz. Universal claimed that because this incident was not an accident, but rather an intentional criminal act on the part of the motorist who struck DeLaCruz, it would not be responsible under its uninsured motorist coverage. 

Universal filed a declaratory judgment action in Cook County against the estate of DeLaCruz.In December 2011, the estate moved to dismiss the complaint pursuant to §2-615 of the Illinois Code of Civil Procedure. In March 2012, the trial judge in the Circuit Court granted the motion to dismiss. In that decision, the judge granted Universal’s motion for leave to file an amended complaint and the court’s order noted that the dismissal was entered without prejudice.

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The Illinois Third District Appellate Court has held  that the large hardware chain Menards was entitled to insurance coverage under the automobile insurance policy issued to the insured, the customer, who was injured while a Menards employee loaded her car. 

In this case, Ruby Bohlen purchased gravel and bricks from a Menards store in Champaign, Ill.  She brought her car around to the loading area where her car was to be loaded by an employee of Menards. While the Menards employee was loading the bricks, Bohlen tripped and fell on debris near her car and was injured. 

Bohlen filed a lawsuit against Menards claiming that Menards was negligent in failing to provide a safe place for its customers.  As part of the complaint, Bohlen claimed that Menards chose not to remove debris from the aisles, sidewalks and other areas of the store. 

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The Illinois Appellate Court has ruled in favor of a motorcycle rider who lost a leg in an accident and sought a $1 million judgment against Allstate Insurance Co. This decision might have gone differently for Allstate, but the insurer made several very serious errors in its handling of the case.

This case was reported in the Chicago Daily Law Bulletin.

The accident occurred on June 30, 2006, when the driver, E.H., allegedly drove a truck through a stop sign and smashed into the side of a motorcycle driven by S.K., whose leg later had to be amputated. The truck was owned by a third party, L.S.

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Eleven-year-old A.J. was injured in an automobile crash and was taken for treatment to St. Alexius Medical Center in Hoffman Estates. The bills that were sent by the hospital to the boy’s parents featured the crest of Alexian Brothers Catholic order and, in large font, the name “Alexian Brothers.” Below that was smaller print, which showed the name “St. Alexius Medical Center.”
A lawsuit was brought by the boy’s family that settled the auto accident for $30,000. The hospital hired a law firm in Deerfield to notify the family attorney that it was asserting a hospital lien for $11,638.

The family attorney then moved the court under §30 of the Hospital Lien Act to adjudicate the hospital’s lien. Section 30 calls for the hospital to receive “written notice,” which the boy’s family attorney did by certified mail, return receipt requested.

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In this case the parties fought over the insurance policies arising out of the wrongful death of Daniel Zacha, an employee of S&S Service Co. Mr. Zacha was driving a tractor-trailer owned by Coca-Cola Enterprises back to the S&S garage for repairs; in the process, he caused a head-on crash with the driver of a minivan, which resulted in that driver’s death.

Under the Illinois Vehicle Code, insurance companies are generally required to extend protection under liability policies to persons who are driving insured vehicles with express or implied permission of the owners.

The Illinois Supreme Court explained the statutory requirement of the Illinois Vehicle Code naming it “omnibus coverage,” which means “primary liability is generally placed on the insurer of the owner of an automobile rather than on the insurer of the operator” – unless a statutory exception applies.

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An Illinois employee who was involved in a car accident during the course of his employment sought to recoup payments from both his employer’s workers’ compensation policy and its car insurance policy. When the insurance company denied his claims, the employee filed a lawsuit in order to recoup those costs. And while the Illinois Appellate Court allowed some of the plaintiff’s claims, it denied others in Burcham v. West Bend Mutual Insurance Co., 2011 IL App (2d) 101035.

In 2007, the plaintiff, Curtis Burcham, was driving a truck for his employer, P&M Mercury Mechanical Corporation (P&M), when he was struck by an uninsured motorist. Burcham sustained multiple injuries from the truck accident and had to undergo several surgeries. Because the accident occurred while Burcham was working, his employer, P&M, paid for his medical expenses and lost wages out of its workers’ compensation policy. To date, P&M has paid $490,000 for medical expenses, more than $100,000 for temporary-total incapacity, and continues to pay $925 per week based on Burcham’s 2/3 weekly wage.

P&M also had an uninsured and underinsured motorist policy through West Bend Mutual Insurance Company. Since the other driver involved in Burcham’s truck accident was not insured, he sought to receive additional payments from West Bend under P&M’s truck insurance policy. However, West Bend denied the claim, citing a provision in its policy that it “will not pay for any element of loss if a person is entitled to receive payment for the same element of loss under any worker’s compensation, disability benefits or similar law.” West Bend’s position was that since Burcham was already receiving workers’ compensation payments for the truck accident that he was not entitled to any money from West Bend’s uninsured motorist policy.

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The Illinois Appellate Court recently ruled on a spoliation claim in a product liability lawsuit arising out of a 2004 car accident. The trial court had ruled that the insurer for the defendant vehicle salvage company did not have to contribute to any settlement that might arise out the salvage company’s inappropriate destruction of the relevant vehicle. However, the appellate court reversed this ruling and found that the salvage company’s insurance policy did in fact cover any claims arising out of spoliation of evidence. As a result of the appellate court’s decision, the defendant’s insurance company will now have to pay any reasonable damages arising out of the spoliation claim. Universal Underwriters Insurance Company v. LKQ Smart Parts, Inc., et al., No. 1-10-1723 (December 16, 2011).

The product liability lawsuit was based on a 2004 SUV rollover accident. Michael Widawski’s Nissan Pathfinder SUV rolled over, ejecting Monika Gramacki, its only passenger, from the vehicle as it rolled over. Gramacki died and her family brought a product liability lawsuit against Nissan for an alleged defect in the Pathfinder’s rear door.

The main piece of evidence in a product defect claim is the alleged damaged product, which in this case would Widawski’s Nissan Pathfinder. It is not enough for a party to simply allege that a product is defective; it must also be examined by experts to determine the source of the defect and whether that defect caused harm to the party. However, in the present case, no experts were able to examine Widawski’s vehicle because it was destroyed before they could do so.

Following the rollover accident, Widawski’s insurer, Farmers Insurance, handled the preservation of the Pathfinder. Farmers hired LKQ Smart Parts, Inc., a vehicle salvage and storage firm, to store the damaged Nissan and keep it in its current condition. However, LKQ failed to follow these instructions and somehow ended up destroying the Nissan Pathfinder shortly after it arrived. And with its destruction went Gramacki’s family’s hope of a fair and successful product defect claim against Nissan.

In order to rectify this dilemma, Gramacki’s father filed two lawsuits: the first was a product liability lawsuit against Nissan for the allegedly faulty door latch, the second was a spoliation of evidence claim against Farmers for the destroyed Pathfinder. In its claim against Farmers, Gramacki alleged that the “destruction of the subject Nissan Pathfinder deprived Plaintiff of the key piece of evidence necessary to prove an otherwise valid product liability/negligence lawsuit” against Nissan. Farmers then filed a third party lawsuit against LKQ for its role in destroying the Pathfinder.

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Cell phones have made it easier for people to stay connected and to access data while on the go. However, cell phones can cause car accidents, whether the driver is using them to talk or to text. And while many states, including Illinois, have passed bans on the use of cell phones while driving, doing so has not been able to halt the use of cell phones while driving.

Consequently, the National Transportation Safety Board (NTSB) is looking for other strategies to halt the use of cell phones while driving. Last week it suggested that insurance companies could help limit this widespread problem if they simply refused to pay out for accident claims caused by drivers texting or talking on their cell phones.

And while the NTSB’s idea makes sense and even seems like it could work, insurance companies are not jumping on board. To explain their reluctance to adopt the NTSB’s suggestions, insurance companies explained that one of the main reasons to have insurance is that insurance companies will cover the cost of injuries even if the auto accident is caused by careless or even reckless behavior. And as an insurance specialist and spokesperson for the Consumer Federation of America said, “An accident is an accident.”

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It is common knowledge that insurance companies tend to drag their feet when it comes to paying out on insurance policies. Therefore, there are laws in place to prevent insurance companies from acting in bad faith and requiring them to uphold their end of the bargain. However, in the lawsuit of Kevin Pryor v. United Equitable Insurance Company, No. 1-11-0544 (2011), the appellate court found that the insurance company had actually not acted in bad faith. Rather, it was the insured client who had jumped the gun and filed an unnecessary lawsuit.

The case arose out of a claim the plaintiff, Kevin Pryor, filed after being involved in a 2009 car crash. While Pryor had car insurance, the other driver did not. Therefore, Pryor filed an uninsured motorist claim with his own insurance company, United Equitable Insurance Company.

On January 21, 2010, Pryor entered into a binding arbitration agreement with United Equitable for an award of $9,775. On January 27, 2010, Pryor signed a release and trust agreement regarding that award. On February 5, 2010, Pryor signed a release of the physician’s lien, thereby completing his part of the arbitration agreement. United Equitable was to pay out Pryor’s award within 30 days of receiving his release. However, when it had still failed to pay out by March 2, 2010, Pryor brought an insurance malpractice lawsuit against United Equitable.

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