Potential of Coverage is Enough to Require an Insurer to Defend
Post 4765
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When two or more insurance companies issue When two or more insurance companies issue policies with a potential for coverage of a claim of bodily injury they should work together to protect their mutual insured rather than litigate with the insured and the other insurers. Litigation is expensive and may result in a case and result they did not wish to have.
In Admiral Insurance Co. v. Track Group, Inc. f/k/a Securealert, Inc., and Jeffrey Mohammed Abed, and Certain Underwriters At Lloyd’s, London Subscribing To Policy No. CJ10028219, No. 1-23-1210, 2024 IL App (1st) 231210-U, Court of Appeals of Illinois, First District, Third Division (March 27, 2024) the Illinois Court of Appeals looked to protect the interests of the insured other than the interest of the insurers.
FACTS
This appeal concerned an insurance coverage dispute between a general liability carrier and a professional liability carrier. Certain Underwriters at Lloyd’s, London Subscribing to Policy No. CJ10028219 (Underwriters) and Admiral Insurance Co. (Admiral) both insured Track Group, Inc., a company in the business of electronically monitoring individuals using ankle monitors. Track Group was sued after a person wearing the ankle monitor sustained severe injuries while driving his vehicle. Underwriters had paid the costs of Track Group’s defense up to the time of the decision but it argued that Admiral should share in the costs, as it believes both insurance policies provide coverage in this case. The circuit court held that Admiral did not owe coverage under the terms of its insurance policy with Track Group.
BACKGROUND
Underwriters issued Track Group a general liability insurance policy, while Admiral issued a professional liability insurance policy. Track Group sought coverage under both policies in connection with a personal injury lawsuit filed against it in Los Angeles, California. The plaintiff in that suit, Jeffrey Mohamed Abed, alleged that his leg was torn from his body after his foot, on which he was wearing the ankle monitor, became lodged between the gas and brake pedals in the vehicle he was driving. Admiral denied coverage and filed a declaratory action, contending that it does not owe coverage under these circumstances.
The circuit court granted Admiral’s motion for summary judgment and denied Underwriters’ motion for summary judgment.
ANALYSIS
On appeal, Underwriters argued that the circuit court erred in granting summary judgment in favor of Admiral, contending that the court’s interpretation of the Admiral policy was overly narrow. Underwriters argued that Admiral policy covers the injury at issue.
Where policy language is susceptible to more than one reasonable interpretation, it is considered ambiguous and will be construed strictly against the insurer. Courts construe the policy as a whole, giving effect to each provision where possible because the court must assume that the provision was intended to serve a purpose.
According to the plain language of the policy Admiral is potentially liable for wrongful acts arising out of the provision of “professional services” and “technology products.” The policy includes a general exclusion for bodily injury and property damage. However, that exclusion does not apply to bodily injury arising out of the provision of “professional services.” In other words, Admiral’s policy could potentially cover bodily injury arising out of the provision of “professional services.”
One of the four components of the ankle monitor is an internal central processing unit. The ankle monitor can make and receive calls, generate alarms, receive radio frequency transmissions, and communicate movements to Track Group. Because the ankle monitor is an electronic device that can store, retrieve, and process data it is potentially a computer. Moreover, the ankle monitor likely constitutes “hardware.” Because the ankle monitor is potentially computer hardware, the Court of Appeals held that it is potentially covered by Admiral’s policy and potential coverage is all that is required to trigger an insurer’s duty to defend its insured.
Because the facts of Abed’s lawsuit against Track Group potentially fell within the terms of the policy the decision of the Circuit Court was reversed.
ZALMA OPINION
The court did what the insurers should have done – it read the policy which covered claims resulting from professional services or technology products. Since the ankle monitor was clearly a technology product and was claimed to be the cause of the injury that ripped off Mr. Abed’s leg, there was a potential of coverage and all of the insurers owed Track Group a defense. Working together both insurers could have saved money and served their insured fairly.
(c) 2024 Barry Zalma & ClaimSchool, Inc.
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Amended Complaint Provides Escape from Anti-Assignment Condition
Post number 5345
Read the full article at https://www.linkedin.com/pulse/proper-inconsistent-pleading-defeats-policy-condition-barry-mrugc, shttps://www.linkedin.com/pulse/proper-inconsistent-pleading-defeats-policy-condition-barry-mrugc and at https://zalma.com/blog plus more than 5300 posts.
State Farm’s Responsive Pleading Defeated Motion on Anti Assignment Condition
In Tyra Caire Treadway v. State Farm Fire And Casualty Company, Civil Action No. 23-6834, United States District Court, E.D. Louisiana (April 28, 2026) Plaintiff Tyra Caire Treadway owned property at 7000-02 Jeannette Street, New Orleans, Louisiana, which was insured under a State Farm homeowners’ policy.
Hurricane Ida struck Louisiana on August 29, 2021, causing damage to the property. Nearly two years later, on August 9, 2023, Treadway sold the property to M1SRJT Jeanette, LLC and assigned her State Farm insurance claim, including the right to pursue additional damages and penalties for ...
Amended Complaint Provides Escape from Anti-Assignment Condition
Post number 5345
Read the full article at https://www.linkedin.com/pulse/proper-inconsistent-pleading-defeats-policy-condition-barry-mrugc, shttps://www.linkedin.com/pulse/proper-inconsistent-pleading-defeats-policy-condition-barry-mrugc and at https://zalma.com/blog plus more than 5300 posts.
State Farm’s Responsive Pleading Defeated Motion on Anti Assignment Condition
In Tyra Caire Treadway v. State Farm Fire And Casualty Company, Civil Action No. 23-6834, United States District Court, E.D. Louisiana (April 28, 2026) Plaintiff Tyra Caire Treadway owned property at 7000-02 Jeannette Street, New Orleans, Louisiana, which was insured under a State Farm homeowners’ policy.
Hurricane Ida struck Louisiana on August 29, 2021, causing damage to the property. Nearly two years later, on August 9, 2023, Treadway sold the property to M1SRJT Jeanette, LLC and assigned her State Farm insurance claim, including the right to pursue additional damages and penalties for ...
BACKGROUND
See the video at https://rumble.com/v79dts2-crime-doesnt-pay.html and at https://youtu.be/dw0f4goCbxA, and at https://zalma.com/blog plus more than 5300 posts.
Plaintiff:
Andrew J. Mitchell, an incarcerated individual proceeding pro se sued Pandit Law Firm, LLC, on behalf of a corporation that was controlled by Mitchell who had operated Mitchell Adjusting International LLC (MAI), a Texas limited liability company.
According to the US Attorney:
A Texas man (Mitchell) acting as an insurance adjuster who cheated an Albany church out of millions of dollars paid out by its insurance company to repair its facilities heavily damaged by Hurricane Michael in 2018 was sentenced to serve more than 19 years in prison and ordered to pay nearly $4 million in restitution to victims in several states.
Andrew Mitchell, formerly Andrew Aga, 46, of Houston, Texas, was sentenced to serve 235 months in prison to be followed by three years of supervised release and was ordered to pay $2,895,903.01 in restitution to the Brotherhood ...
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...
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...
What Must be Done after Notice of a Claim is Received by the Insurer
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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 ...