Zalma on Insurance
Education • Business
Insurance Claims professional presents articles and videos on insurance, insurance Claims and insurance law for insurance Claims adjusters, insurance professionals and insurance lawyers who wish to improve their skills and knowledge. Presented by an internationally recognized expert and author.
Interested? Want to learn more about the community?
March 22, 2022
Exclusion for Operating an Automobile Without a Reasonable Belief that he or she is Entitled to do So

Exclusion for Operating an Automobile Without a Reasonable Belief that he or she is Entitled to do So

Read the full article at https://www.linkedin.com/pulse/violating-term-graduated-license-eliminates-auto-zalma-esq-cfe and https://zalma.com/blog plus more than 4100 posts.

Posted on March 22, 2022 by Barry Zalma

United Equitable Insurance Company (UEI) sought and received a finding that it had no duty to defend, indemnify, or provide coverage in relation to an October 4, 2018, automobile accident. A defendant injured in the accident attempted to obtain benefits from the auto policy issued by UEI.

In United Equitable Insurance Company v. Cicely Calhoun, Individually and as Mother and Next Friend of Jadis Baker, a Minor; et al, No. 1-21-0525, 2022 IL App (1st) 210525, Court of Appeals of Illinois, First District, Third Division (March 9, 2022) the Court of Appeal resolved the dispute.
FACTS

On September 22, 2018, Cicely Calhoun was issued an automobile insurance policy by UEI, which covered her Chevrolet Impala. The policy listed both Calhoun and her 16-year-old son, Jadis Baker, who had been issued a graduated driver’s license days earlier, as operators of the vehicle. Less than two weeks later, on October 4, 2018, Baker was driving five passengers in the Impala, which had seatbelts for only a driver and four passengers, when Baker collided with a light pole.

Andre Robinson-Dock, one of the passengers in the vehicle at the time of the accident sued for personal injuries. Thereafter, UEI sued seeking declaratory judgment against Robinson-Dock and the other alleged passengers. UEI claimed that Baker held a graduated driver’s license and the graduated licensing statute prohibited Baker from operating a motor vehicle with more than one passenger under the age of 20, excluding siblings, step-siblings, children, or stepchildren of the driver. There were five passengers in Baker’s vehicle at the time of the collision, all of whom were under the age of 20 and not related to Baker. UEI further alleged that the Impala seated a driver and four passengers, and Baker was driving the vehicle in violation of the graduated licensing statute and the Illinois Vehicle Code, both of which prohibited him from operating the vehicle with more than one passenger in the front seat and more passengers in the back seats than the number of available safety belts.

Robinson-Dock generally admitted UEI’s allegations regarding Baker’s age and that he possessed a graduated license. Robinson Dock also admitted that the Impala seated a driver and four passengers and that Baker had five passengers in the Impala at the time of the accident. Additionally, Robinson-Dock admitted that the five passengers were under age 20 and that they were not related to Baker’s.

Robinson-Dock alleged that Baker was named in the policy as an operator, that he had a valid driver’s license, and that he had given Robinson-Dock permission to be present as a passenger at the time of the accident. Robinson-Dock claimed that, as a permissive user of the vehicle, he was an insured under the policy. He further alleged that denying coverage to him as a permissive passenger would violate public policy and, therefore, the reasonable belief exclusion was unenforceable against him.

UEI filed a motion for “prove-up,” requesting a default judgment against the defendants who had failed to appear, and further requesting summary judgment against Robinson-Dock. UEI argued that Robinson-Dock had admitted the facts necessary to find that Baker could not have had a reasonable belief that he was entitled to drive at the time of the accident, as he was driving in violation of the conditions placed on his graduated license.

The trial agreed with UEI and found “that … Jadis Baker was a 16-year-old driving a vehicle with a graduated driver’s license, subject to the driving restrictions contained in [the graduated driver’s license statute], and was driving 5 passengers all under the age of 20 years old, in a vehicle that only contained seatbelts for 4 passengers.”

The court entered summary judgment on the complaint in favor of UEI and against all defendants.

The policy provision at issue in this case is exclusion (h) of the policy’s liability coverage. It provides that the policy does not apply to provide liability coverage to “any person operating the owned automobile or a non-owned automobile without a reasonable belief that he or she is entitled to do so.”
DISCUSSION

Irrespective of whether a person owns the vehicle, or is a permissive user, without a valid license, a person cannot have a reasonable belief that he or she is entitled to drive in Illinois. Robinson-Dock argued, first, that summary judgment in favor of UEI should be reversed because “driving outside the parameters of a graduated driver’s license is not the equivalent of driving with no driver’s license.”

The graduated licensing statute provides conditions for the operation of a motor vehicle by a graduated license holder. The provisions in the graduated licensing statute are mandatory. The Court of Appeal concluded that the graduated licensing statute is a limited license that gives graduated license holders the right to drive, but only under the conditions outlined in the statute.

Since Robinson-Dock did not provide any factual support from which it could be determined that it would have been reasonable for Baker to believe that he could operate the vehicle at the time of the accident. Although Baker had a graduated license when Baker drove in violation of the conditions of his graduated driver’s license, he could not have had a reasonable belief that he was entitled to operate the vehicle.

The public policy at issue is explicitly set out by the Illinois legislature in the Graduated Licensing statute. Specifically, that “[t]he purpose of the Graduated Licensing Program is to develop safe and mature driving habits in young, inexperienced drivers and reduce or prevent motor vehicle accidents, fatalities, and injuries…” The graduated licensing program is intended to prevent young, graduated license holders from operating motor vehicles under conditions that increase the risk of accidents, like the one that occurred here. Had sixteen-year-old Baker complied with the statute the injuries would not have happened and, at best only he and one other would have been in the car when it hit a pole, proving the wisdom of the graduated license statute.

In sum, Baker held a graduated driver’s license, which provides conditions for the operation of a motor vehicle by a graduated license holder and he was operating the vehicle in violation of those conditions. Summary judgment was properly granted, and the policy’s reasonable belief exclusion barred coverage.
ZALMA OPINION

Illinois allowed Baker to have a limited license to operate an automobile in the graduated license statute. He knew, or should have known, that the license limited the right to drive an automobile. Since he was only entitled to move one passenger, not five, he could not reasonably believe he had a right to drive with five passengers. Six teenagers in a large vehicle are a priori unsafe as the public policy of the state. UEI did not agree to take such a major risk and that is why it wrote the exclusion into its policy.

(c) 2022 Barry Zalma & ClaimSchool, Inc.

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance related disputes. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business. He is available at http://www.zalma.com and [email protected].

Over the last 54 years Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat insurance fraud. He has created a library of books and other materials to make it possible for insurers and their claims staff to become insurance claims professionals.

Subscribe to Zalma on Insurance at locals.com https://zalmaoninsurance.local.com/subscribe. Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome. Write to Mr. Zalma at [email protected]; http://www.zalma.com; http://zalma.com/blog; I publish daily articles at https://zalma.substack.com.

Go to the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; Follow Mr. Zalma on Twitter at https://twitter.com/bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ Read posts from Barry Zalma at Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/

Interested? Want to learn more about the community?
What else you may like…
Videos
Posts
May 01, 2026
Zalma’s Insurance Fraud Letter – May 1, 2026

Happy Law Day

ZIFL – Volume 30, Issue 9 – May 1, 2026

Read the full article at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-may-1-2026-barry-zalma-esq-cfe-2tywc, see the video at at and at https://zalma.com/blog plus more than 5300 posts.

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

ZIFL – Volume 30, Issue 9 – May 1, 2026

Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year and is written by Barry Zalma.

DOJ Creates National Fraud Enforcement Division

Will the Feds Take on Insurance Fraud? Possibly as Part of a National Anti-Fraud Effort

On April 7, 2026, the Acting Attorney General, Todd Blanche, issued a memorandum establishing the Department of Justice National Fraud Enforcement Division (NFED). The memo describes an ambitious, but perhaps redundant, vision for this ...

00:08:23
placeholder
April 30, 2026
The Efficient Proximate Cause Doctrine Saves a Claim

When Abalone Died As a Result of Multiple Causes The Efficient Proximate Cause Requires Payment

Post number 5345

Read the full article at https://www.linkedin.com/pulse/efficient-proximate-cause-doctrine-saves-claim-barry-zalma-esq-cfe-yndlc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.

In American Abalone Farms, LLC v. Star Insurance Company et al., H052643, California Court of Appeals, Sixth District (April 27, 2026) the Court of Appeals dealt with an insurance coverage issue that required application of the efficient proximate cause doctrine.

FACTS

American Abalone Farms, LLC ("American Abalone" ) operates an aquaculture farm in Santa Cruz County, California, raising abalone in tanks. In August 2020, the CZU Lightning Complex Fires led to a prolonged power outage and road closures near the farm. As a result, the farm’s water pumps failed, causing the death of most of the ...

00:08:38
placeholder
April 29, 2026
Breach of a Specific Condition Precedent Is a Complete Defense

Breach of a Specific Condition Precedent Is a Complete Defense

See the video at and at and at https://zalma.com/blog plus more than 5300 posts.

In United Services Automobile Association and State Farm Mutual Automobile Insurance Company v. Anthony Wenzell, 2026 CO 25 (Colo. Apr. 27, 2026) Anthony Wenzell was rear-ended in a car accident. He had a significant prior 2014 accident that required back surgery.

Wenzell claimed underinsured-motorist (UIM) benefits under three policies: (1) the tortfeasor’s liability policy, (2) his own primary UIM policy with State Farm, and (3) an excess UIM policy issued by USAA (under his brother’s policy, which contained an “other insurance” clause making USAA’s coverage excess over any collectible insurance).

After receiving the claims, both USAA and State Farm repeatedly requested that Wenzell execute comprehensive medical-release authorizations so they could obtain his full medical records and ...

00:11:27
placeholder
12 hours ago

It is Fraud to Make the Same Claim Twice

Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.

Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages

Post number 5347

No One is Entitled to be Paid for the Same Loss Twice

In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.

BACKGROUND

In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.

PROCEDURAL HISTORY

State Farm filed motion for summary...

post photo preview
12 hours ago

It is Fraud to Make the Same Claim Twice

Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.

Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages

Post number 5347

No One is Entitled to be Paid for the Same Loss Twice

In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.

BACKGROUND

In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.

PROCEDURAL HISTORY

State Farm filed motion for summary...

post photo preview
April 30, 2026
Investigation of First Party Property Claims

What Must be Done after Notice of a Claim is Received by the Insurer

Read the full article at https://lnkd.in/gzvvdkMZ and at https://zalma.com/blog.

Below you will read from this post until you reach the the end of this blog post as the free part of an Excellence in Claims Handling post. To read the full article and receive all articles for members of Excellence in Claims Handling you should consider joining as a paid member to get full access to articles for members only, to our news, analysis, insurance coverage, claims, insurance fraud and insurance webinars, by clicking at the subscription link below.

A first party property policy does not insure property: it insures a person, partnership, corporation or other entity against the risk of loss of the property. Before an insured can make a claim for indemnity under a policy of first party property insurance the insured must prove that there was damage to property the risk of loss of which was insured by the policy. The obligation imposed on the insured ...

post photo preview
See More
Available on mobile and TV devices
google store google store app store app store
google store google store app tv store app tv store amazon store amazon store roku store roku store
Powered by Locals