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/
Jury’s Findings Interpreting Insurance Contract Affirmed
Post 5105
See the full video at https://lnkd.in/gPa6Vpg8 and at https://lnkd.in/ghgiZNBN, and at https://zalma.com/blog plus more than 5100 posts.
Madelaine Chocolate Novelties, Inc. (“Madelaine Chocolate”) appealed the district court’s judgment following a jury verdict in favor of Great Northern Insurance Company (“Great Northern”) concerning storm-surge damage caused by “Superstorm Sandy” to Madelaine Chocolate’s production facilities.
In Madelaine Chocolate Novelties, Inc., d.b.a. The Madelaine Chocolate Company v. Great Northern Insurance Company, No. 23-212, United States Court of Appeals, Second Circuit (June 20, 2025) affirmed the trial court ruling in favor of the insurer.
BACKGROUND
Great Northern refused to pay the full claim amount and paid Madelaine Chocolate only about $4 million. In disclaiming coverage, Great Northern invoked the Policy’s flood-exclusion provision, which excludes, in relevant part, “loss or damage caused by ....
Failure to Name a Party as an Additional Insured Defeats Claim
Post 5104
Read the full article at https://lnkd.in/gbcTYSNa, see the full video at https://lnkd.in/ggmDyTnT and at https://lnkd.in/gZ-uZPh7, and at https://zalma.com/blog plus more than 5100 posts.
Contract Interpretation is Based on the Clear and Unambiguous Language of the Policy
In Associated Industries Insurance Company, Inc. v. Sentinel Insurance Company, Ltd., No. 23-CV-10400 (MMG), United States District Court, S.D. New York (June 16, 2025) an insurance coverage dispute arising from a personal injury action in New York State Supreme Court.
The underlying action, Eduardo Molina v. Venchi 2, LLC, et al., concerned injuries allegedly resulting from a construction accident at premises owned by Central Area Equities Associates LLC (CAEA) and leased by Venchi 2 LLC with the USDC required to determine who was entitled to a defense from which insurer.
KEY POINTS
Parties Involved:
CAEA is insured by Associated Industries Insurance Company, Inc. ...
Exclusion Establishes that There is No Duty to Defend Off Site Injuries
Post 5103
Read the full article at https://lnkd.in/geje73Gh, see the full video at https://lnkd.in/gnQp4X-f and at https://lnkd.in/gPPrB47p, and at https://zalma.com/blog plus more than 5100 posts.
Attack by Vicious Dog Excluded
In Foremost Insurance Company, Grand Rapids, Michigan v. Michael B. Steele and Sarah Brown and Kevin Lee Price, Civil Action No. 3:24-CV-00684, United States District Court, M.D. Pennsylvania (June 16, 2025)
Foremost Insurance Company (“Foremost”) sued Michael B. Steele (“Steele”), Sarah Brown (“Brown”), and Kevin Lee Price (“Price”) (collectively, “Defendants”). Foremost sought declaratory relief in the form of a declaration that
1. it owes no insurance coverage to Steele and has no duty to defend or indemnify Steele in an underlying tort action and
2. defense counsel that Foremost has assigned to Steele in the underlying action may withdraw his appearance.
Presently before the Court are two ...
ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional
See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:
Health Care Fraud Trial Results in Murder for Hire of Witness
To Avoid Conviction for Insurance Fraud Defendants Murder Witness
In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...
Professional Health Care Services Exclusion Effective
Post 5073
See the full video at https://lnkd.in/g-f6Tjm5 and at https://lnkd.in/gx3agRzi, and at https://zalma.com/blog plus more than 5050 posts.
This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.
In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:
Insurance Coverage Dispute:
Travelers issued a Commercial General Liability ...
A Heads I Win, Tails You Lose Story
Post 5062
Posted on April 30, 2025 by Barry Zalma
"This is a Fictionalized True Crime Story of Insurance Fraud that explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help everyone to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime."
Immigrant Criminals Attempt to Profit From Insurance Fraud
People who commit insurance fraud as a profession do so because it is easy. It requires no capital investment. The risk is low and the profits are high. The ease with which large amounts of money can be made from insurance fraud removes whatever moral hesitation might stop the perpetrator from committing the crime.
The temptation to do everything outside the law was the downfall of the brothers Karamazov. The brothers had escaped prison in the old Soviet Union by immigrating to the United...