insurance coverage denied in BUI case

Home Cookin'

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May 26, 2009
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9,715
A recent court opinion in Virginia should make you reconsider your insurance coverage.

a drunk boater (call him DB) crashed into a moored sailboat (SB) and did $50,000 damage. When SB sued DB, DB's insurance company denied coverage, saying that insurance does not cover his liability occurring while DB was engaged in an illegal act (boating under the influence), per the insurance policy. The court agreed; it was a simple matter of contract and the contract controls.

So DB has no coverage and has to cough up $50,000. And you can't discharge that debt in bankruptcy. Not that we feel sorry for drunk boaters (who by the way also had a small quantity of pot on board), but....

And SB, assuming DB has no money, has to pay the repair himself. Hopefully he has insurance to cover it, and luckily a claim like this won't affect his rates, but still. And I doubt his policy will give him a "loaner" while his boat is in the shop for the rest of the summer--damages you might be able to recover from DB's policy.

Some things to consider:

If the damages had been worse, including injury to SB himself, that extra insurance would have been needed.

SB better have "uninsured/underinsured boater" coverage--do you?

Here's the "but" and why hard cases make bad law:

What if DB were you, but you weren't drunk; the "illegal act" was really ordinary negligence that happens also to be illegal: you go just a little above "no wake" under a bridge or in a NW zone, illegally close to another boat and something happens (steering breaks), turn to port and not starboard, you have an extra passenger on board, one bulb in your running lights doesn't work (even in daytime), you are operating with expired registration. You hit a moored boat while not paying attention--and you have one more fish in the box over the limit. There are dozens of laws you can violate that "just aren't that bad." You expect to have coverage anyway.

Think of it in the context of cars--as SB we expect the other guy's insurance to cover us if DB hits our car. And as SB, we all know that insurance doesn't cover us for a wreck occurrung during an illegal act like drag racing, driving a stolen car or the getaway car from the bank robbery. But if we get in a wreck for running a red light or stop sign, or while speeding (4 mph over is speeding and illegal) or driving on expired registration, we expect our insurance to protect us (perfect people who never do these things, please do not comment--we humans don't like your type nor do we believe in your existence).

Also keep in mind that if you call your agent today to ask about your coverage for ssomething like this, and his advice is wrong (and often is) you have no recourse. You have to read your own policy. Further, some state laws may require insurance coverage for something like this; it' starting to come up in DUI cases and some states and courts say "public policy" requires coverage. But not all.

Have a nice day.
 
Joined
Oct 22, 2007
Messages
2,598
Re: insurance coverage denied in BUI case

It all comes down to the fact that insurance companies make more money by not paying, so they'll do everything in their power to deny claims (and they've got a lot more lawyers working for them than most of us do).
 

Opnine99

Petty Officer 3rd Class
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Re: insurance coverage denied in BUI case

Very interesting....gets the ol' wheels a turnin'
 

wgl333

Petty Officer 2nd Class
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Re: insurance coverage denied in BUI case

Metric....Me thinks you paint with an awfully broad brush. Insurance coverage is a contract....contracts which are not unilateral. Had the individual not been operating illegally, coverage would not have been denied. A court of law upheld the decision....and believe me, the courts would much rather rule against the insurance company. You seem so willing to jump all over the insurance industry, but, what about the boater that broke several laws....you ok with that?
 

H20Rat

Vice Admiral
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Mar 8, 2009
Messages
5,204
Re: insurance coverage denied in BUI case

You are jumping to conclusions... Both in marine and auto, it is common practice (and legally upheld) to deny coverage for person who receives a DUI as part of the act. If you are not physically able to drive a vehicle in the legal sense, you probably don't have coverage, at least if alcohol is a contributing factor. The rest of your reasons are simple fallacy, insurance companies pay every day for stupid human error on the the part of the insured. (used to work in insurance, I saw it all! Stupid things like if you intentionally set your house on fire, its arson and insurance fraud, but the dumb (smart) ones openly admit they had 20 candles burning and one tipped over, burning the house down. That is a perfectly valid and legal claim! The vast majority of claims were for preventable human error.

But the short answer is read your policy. NOBODY reads the policies, but everyone gets their feathers ruffled when the insurance company actually enforces the legal document. As WGL mentioned above, courts love to rule against insurance companies, especially in the lower courts, so if there is any hint of wrongdoing, the insurance company looses.

Lastly, since a court case in 2009, a DUI conviction is required for the insurance company to engage those clauses. (at least in the auto world) Having an officer state that alcohol is a contributing factor but not getting a DUI conviction is not grounds for denying coverage any more. May or may not apply to the boating world...


(disclaimer, I said you don't have coverage if alcohol is a contributing factor, that isn't always true, only for actual physical control. If you have a party guest get sloppy drunk and then fall and break their arm on your boat, your liability covers it. No actual physical control of the boat.)
 

MH Hawker

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Re: insurance coverage denied in BUI case

I have uninsured coverage in my state boat insurance isnt required and I doubt most have any.
 

Home Cookin'

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Re: insurance coverage denied in BUI case

Ironically, then, if a drunk boater hits yours, you don't want him to be convicted!

Best advice ever: read your contract. as in: (a) read. (b) your. (c) contract. Don't ask the agent or a friend what it says; not someone else's; not the dec page or summaries.

But I will tell you this from experience: they aren't all that clear, and the closer you look when the stakes are high, the less clear they are. I was indirectly involved in the legal proceedings over a boat collision with three fatalities, and the smartest guys in the world couldn't agree for certain what the policies and laws meant.

I have also found insurance companies typically cooperative when the obligation to pay is relatively certain. But as this case shows, there are exceptions.
 

BRICH1260

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Re: insurance coverage denied in BUI case

I current work in the Insurance industry as a sales agent. We cover drunk drivers for their actions in automobiles everyday. I have never heard of a coverage denial based on alcohol as it relates to cars in 26 years. Now with regards to boats, I have never heard of a company using this defense as a means of denial and would say that it is probably not typical of most boatowners policy`s legal language. Generally most liability exclusions with boats are centered around racing/speed contests or intentional acts by the owner.

I would suggest that each boatowner read and understand their policy and only do business with well known, highly rated, reputable companies. I do not think that denials like this are the customary, but know your policy.
 

Dam2009

Seaman
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Messages
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Re: insurance coverage denied in BUI case

I find it unreal.. I would like to see what they classify as 'illegal activity'. What it comes down to is bureaukracy....
 

Quit It

Petty Officer 1st Class
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Messages
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Re: insurance coverage denied in BUI case

I'd like to see a link to the ruling, but it sounds like it could be based in truth, but I think there also could be more to it. It seems to be the way some businesses are headed, anything they can do prevent coverage they will do.

I look at the Progressive (and others) Plug-In that monitors your driving and :facepalm: - of course they say it's not being used to deny coverage :rolleyes:
 

Home Cookin'

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Re: insurance coverage denied in BUI case

also check your umbrella policy, or your homeowner's if that's the source of your liability coverage. Umbrella policies are there for your major screw-ups, and this would be one.

Dam2009, it's not a matter of "what they classify as 'illegal activity'." I was describing the case generally. It isn't "they" it's what the contract says.

I would also like to think that there has to be some causal connection between the illegal activity (say fishing over the limit) and the casualty (hit another boat on the way home) but again, when the stakes are high, the microscopes come out.
 

UncleWillie

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Messages
3,995
Re: insurance coverage denied in BUI case

Every Policy has the Illegal Activity Clause, even yours!

ANYTHING that you do that causes damage is an Illegal activity. Just causing the damage is Illegal.
If that were the case, Insurance companies would NEVER pay for anything.

Illegal activity is more often interpreted a something like, Robbing a Bank, Fleeing and Evading the Police,
Getting into a Gun Battle, and then filing a claim to get the bullet holes in your car repaired. Denied!
Or your car is destroyed in the process of finding all the heroin you were smuggling into the country. Denied!

There is more to that story than was revealed.
Like, DB had 3 prior BUI convictions, a Suspended Auto License for DUI and was under house arrest with a Drive to work only Permit, and wasn't even allow to be on a boat, much less operating one!
 

Dam2009

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Messages
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Re: insurance coverage denied in BUI case

Dam2009, it's not a matter of "what they classify as 'illegal activity'." I was describing the case generally. It isn't "they" it's what the contract says.

Unless appealed this will most likely become a case law in that state, meaning every other (likely non-reputable) insurance company can use that ruling in similar cases spripping the judge of any discretion.
 

Home Cookin'

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Re: insurance coverage denied in BUI case

Every Policy has the Illegal Activity Clause, even yours!

ANYTHING that you do that causes damage is an Illegal activity. Just causing the damage is Illegal.
If that were the case, Insurance companies would NEVER pay for anything.

There was this law professor once who would say, "you could say that--but you would be wrong."
 

TilliamWe

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Re: insurance coverage denied in BUI case

.. Both in marine and auto, it is common practice (and legally upheld) to deny coverage for person who receives a DUI as part of the act. ...)

NEVER have I experienced that with ANY insurance company I worked, for or on their behalf, (about 20 companies) in close to 10 years of claims. Never had any carrier deny liability to one of our insureds in a DUI case.

This ruling will get overturned. And if you all want me to show you how, it's simple. EVERY "accident" is the direct result of an illegal activity. EVERY one. I have yet to see any accident on land or water in which someone doesn't get a citation. Therefore, they were committing an illegal act, and NO ACCIDENT would ever be covered. I think if we dig harder into this VA case, the word "Intentional" will come into play. But even then it doesn't apply. He intentionally drove the boat while drunk (as do people drive cars when they know they're drunk) but he didn't INTND to have an accident and cause damage. Fact is BUI and DUI liability claims ARE covered and paid every day. This won't hold up.

(Uncle Willie gets it!)
 

Home Cookin'

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Re: insurance coverage denied in BUI case

Unless appealed this will most likely become a case law in that state, meaning every other (likely non-reputable) insurance company can use that ruling in similar cases spripping the judge of any discretion.

This was a US District Court opinion (yes, they made a Federal case out of it!) ruling on Virginia law, upon finding first no applicable admiralty law. The court found no precedent in Virginia and relied on a similar case out of Michigan. It did not mention automobile cases, but the plaintiff (insurance company) cited a similar DUI case and--this is a killer--a case where a guy's accidental death benefit of his life insurance was not paid, b/c he died in a single vehicle wreck while driving drunk!

The policy said, it "excludes coverage for any loss, damage injury or expense that occurs while the insured is engaged in any illegal act, regardless of whether the insured is convicted of such act by a criminal court." That's the definition; that's the law of the case.

This guy was convicted; he blew .137 (.08 is the presumption here). Nothing in the opinion about his priors; his ban from operating was part of the sentence for this conviction (plus 15 days served, 5 1/2 months suspended, restitution of $10,000). He was driving a 46 foot Silverton, he was from Florida (and later filed bankruptcy there). There is also a Federal statute prohibiting BUI on navigable waters but USCG did not charge him. Sailboat was ovr 40'. Clear calm conditions on a summer night.

It has precedental value but does not "strip judges of discretion."
 

Home Cookin'

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Re: insurance coverage denied in BUI case

Um, you are driving along in your boat at a safe speed and hit a submerged log; the boat sinks and your passengers are injured. Accident? yes. Illegal? no. Insured loss? most likely.
You are driving along in your car, have a blow-out and hit the car next to you. Accident? yes. Illegal? no. Insured loss? most likely.
Your golf ball hits my window. Accident? yes. Illegal? no. Insured loss? probably.

you are confusing civil and criminal law. One can be civilly liable without a criminal violation (aka illegal). It is not illegal to not pay your rent; it is not always illegal to accidentally injure another person or his property.

If you would like to read about reported cases where coverage was denied for damages caused while BUI/DUI, read the plaintiff's brief in support of summary judgment in this case, Standard Fire Insurance v. Armstrong, US DCt EDVA 3:12-cv-181.

You may not have seen it, and it may not happen much, but it does happen and that's the reason I posted this--it's both surprising and disconcerting.
 

slag

Chief Petty Officer
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471
Re: insurance coverage denied in BUI case

It all comes down to the fact that insurance companies make more money by not paying, so they'll do everything in their power to deny claims (and they've got a lot more lawyers working for them than most of us do).

That's not entirely true. Insurance companies will deny coverage if they think they are in the right (as was this case), but every insurance company I've ever had to deal with was professional and handled the problems as they should. It's the people who try to scam insurance companies who are the real thieves who raise the premiums for everyone.
 

Dam2009

Seaman
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Messages
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Re: insurance coverage denied in BUI case

Insurance fraud is a huge problem, no question about it, however, that does not warrant a "guilty until found innocent" attitude towards any claim. About 10 years ago i was rear-ended while stopped at a red light. Not at fault at all, but the grief I got from my insurance company was unreal. Not to mention that my premium went up regardless.
 
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