When a UTV is not a Motor Vehicle
Post 4915
See the full video at https://rumble.com/v5jjnc5-umuim-coverage-requires-accident-with-a-motor-vehicle.html and at https://youtu.be/FjWX4e8Nv7g
In Shaun and Jennifer Lopez, et al v. Erie Insurance, No. 23-ICA-338, West Virginia Intermediate Court of Appeals (October 16, 2024) agreed that a UTV is not a "motor vehicle."
FACTUAL BACKGROUND
The petitioners, Shaun and Jennifer Lopez, and Keith and Melissa Chapman (“Petitioners”), appealed the Order Granting Summary Judgment. Petitioners contended that the circuit court erred in applying contractual terms from the insurance policy’s general definitions section of a utility-terrain vehicle (“UTV”) to the uninsured and underinsured motorists endorsement finding it did not fit the definition of “motor vehicle.”
In Shaun and Jennifer Lopez, individually, and as Next Friends and Legal Guardians of S.L., G.L., and J.L., minors; and Keith and Melissa Chapman, individually, and as Next Friends and Legal Guardians of H.C., a minor, Plaintiffs Below v. Erie Insurance, No. 23-ICA-338, West Virginia Intermediate Court of Appeals (October 16, 2024) agreed that a UTV is not a “motor vehicle.”
Petitioners made a claim for uninsured/underinsured motorists (“UIM”) benefits under Mr. Cox’s Erie Policy on October 22, 2020. The Erie Policy includes UIM bodily injury limits of $100,000 per person and $300,000 per accident.
Erie denied coverage for the Petitioners’ UIM claims by finding that Mr. Kidd’s UTV did not qualify as a “motor vehicle” as defined under the Erie Policy. Erie filed a motion for summary judgment and the circuit court ruled in Erie’s favor.
RELEVANT POLICY LANGUAGE
The policy defined “Motor vehicle” as “any vehicle that is self-propelled and is required to be registered under the laws of the state in which “you” reside at the time this policy is issued.” (Emphasis Added)
DISCUSSION
The primary issue in this case is whether, under the Erie Policy, the UTV meets the general definition of “motor vehicle.”
Each exclusion category is predicated upon the subject of the exclusion being a “motor vehicle,” which is written in quotations and bolded. Each and every exclusion for “underinsured motor vehicle” begins with an explicit reference to a “motor vehicle,” which is modified in some way. The Court needed to determine whether the UTV is a “motor vehicle” under the Erie Policy.
In the Erie Policy’s general policy definitions, “motor vehicle” is defined as “any vehicle that is self-propelled and is required to be registered under the laws of the state in which ‘you’ reside at the time this policy is issued.” (Emphasis added.)
It is well-settled that contracts should be read as a whole. To be considered an “underinsured motor vehicle” pursuant to the UIM Endorsement, a vehicle must first be considered a “motor vehicle” under the Erie Policy’s general definitions section.
Coverage as an “underinsured motor vehicle” can only apply to the UTV if it is a “motor vehicle” as defined by the general definitions section of the Erie Policy. However, it is undisputed that the UTV here does not meet the second prong of the Erie Policy’s “motor vehicle” definition, the legal requirement that the vehicle be registered.
A claim for underinsured motorists coverage for injuries caused by an off-roading vehicle not subject to West Virginia’s registration and licensing requirements the UTV was not legally required to be registered (and thus be insured) and was being driven on a road that was closed off to normal traffic, the denial of underinsured motorists coverage does not conflict with West Virginia Code.
ZALMA OPINION
People often forget that insurance is a contract whose terms and conditions control the obligations of the insurer and its insureds. In this case the accident was caused by the a person operating an UTV which was neither licensed nor registered in accordance with the law of the state of West Virginia and, therefore, did not fit the definition of “motor vehicle” and there was no coverage under the UIM coverage of the policy.
(c) 2024 Barry Zalma & ClaimSchool, Inc.
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Notice of Claim Later than 60 Days After Expiration is Too Late
Post 5089
Injury at Massage Causes Suit Against Therapist
Read the full article at https://lnkd.in/gziRzFV8, see the full video at https://lnkd.in/gF4aYrQ2 and at https://lnkd.in/gqShuGs9, and at https://zalma.com/blog plus more than 5050 posts.
Hiscox Insurance Company (“Hiscox”) moved the USDC to Dismiss a suit for failure to state a claim because the insured reported its claim more than 60 days after expiration of the policy.
In Mluxe Williamsburg, LLC v. Hiscox Insurance Company, Inc., et al., No. 4:25-cv-00002, United States District Court, E.D. Missouri, Eastern Division (May 22, 2025) the trial court’s judgment was affirmed.
FACTUAL BACKGROUND
Plaintiff, the operator of a massage spa franchise, entered into a commercial insurance agreement with Hiscox that provided liability insurance coverage from July 25, 2019, to July 25, 2020. On or about June 03, 2019, a customer alleged that one of Plaintiff’s employees engaged in tortious ...
ZIFL – Volume 29, Issue 11
The Source for the Insurance Fraud Professional
Posted on June 2, 2025 by Barry Zalma
Post 5087
See the full video at and at
Read the full article and the full issue of ZIFL June 1, 2025 at https://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-06-01-2025.pdf
Zalma’s Insurance Fraud Letter – June 1, 2025
See the full video at https://lnkd.in/gw-Hgww9 and at https://lnkd.in/gF8QAq4d, and at https://zalma.com/blog plus more than 5050 posts.
ZIFL – Volume 29, Issue 11
The Source for the Insurance Fraud Professional
Read the full article and the full issue of ZIFL June 1, 2025 at https://lnkd.in/gTWZUnnF
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 ...
No Coverage if Home Vacant for More Than 60 Days
Failure to Respond To Counterclaim is an Admission of All Allegations
Post 5085
See the full video at https://lnkd.in/gbWPjHub and at https://lnkd.in/gZ9ztA-P, and at https://zalma.com/blog plus more than 5050 posts.
In Nationwide Mutual Insurance Company v. Rebecca Massey, Civil Action No. 2:25-cv-00124, United States District Court, S.D. West Virginia, Charleston Division (May 22, 2025) Defendant Nationwide Mutual Insurance Company's (“Nationwide”) motion for Default Judgment against Plaintiff Rebecca Massey (“Plaintiff”) for failure to respond to a counterclaim and because the claim was excluded by the policy.
BACKGROUND
On February 26, 2022, Plaintiff's home was destroyed by a fire. At the time of this accident, Plaintiff had a home insurance policy with Nationwide. Plaintiff reported the fire loss to Nationwide, which refused to pay for the damages under the policy because the home had been vacant for more than 60 days.
Plaintiff filed suit ...
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...
