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An insurer must defend an insured passenger when concurrent causes include non-excluded negligent acts.
Coachman Insurance Company sought a declaration that it had no duty to defend or indemnify its insured, Barry Kelley, under a homeowner's policy for a negligence claim arising from an all-terrain vehicle (ATV) accident.
The policy contained a 'motorized vehicle' exclusion.
The court found the exclusion ambiguous and, construing it narrowly, determined it applied to allegations of Kelley's direct physical interaction with the ATV causing it to flip over.
However, the exclusion did not apply to distinct allegations that Kelley impeded the driver's escape or was intoxicated, as these were considered separate concurrent causes not solely 'due to' the use of the motorized vehicle.
Consequently, Coachman was found to have a duty to defend Kelley for the claims not falling under the exclusion.
Attendant care benefits awarded at $649.52 per month; claim for 24-hour care rejected.
The applicant was injured in a motor vehicle accident in 1998, sustaining a traumatic brain injury.
She applied for arbitration after a dispute with her insurer over the quantum of attendant care benefits.
The applicant claimed she required 24-hour care due to cognitive impairments and safety concerns, while the insurer argued she only required limited assistance.
The arbitrator found that while the applicant suffered from executive functioning impairments caused or exacerbated by the accident, she did not require around-the-clock care.
The arbitrator accepted the insurer's occupational therapist's assessment, awarding attendant care benefits of $649.52 per month, plus interest on overdue payments.
