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October 22, 2024
UM/UIM Coverage Requires Accident With a “Motor Vehicle”

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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00:08:07
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Dr. Segun Patrick Adeoye, a medical doctor, filed a lawsuit against the United States of America, seeking damages for alleged violations during his criminal prosecution. He was acquitted by a jury but claims to have suffered significant harm, including financial losses, damage to his professional reputation, and personal distress.

In Dr. Segun Patrick Adeoye v. The United States Of America, Civil Action No. 4:25-cv-83, United States District Court, E.D. Texas, Sherman Division (July 23, 2025) the USDC dismissed Adeoye’s suit.

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Dr. Adeoye was indicted on charges of conspiracy to commit wire fraud and money laundering. The indictment alleged that he and his co-conspirators obtained at least seventeen million dollars through various fraudulent schemes. Despite being acquitted, Dr. Adeoye claims that his ...

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Amount of Loss Set by Appraisal Award

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Post 5163

Read the full article at https://lnkd.in/dNpKKcYx, see the full video at https://lnkd.in/dNgwRP8q and at https://lnkd.in/dA9dvd-D, and at https://zalma.com/blog plus more than 5150 posts.

Hurricane Damage to Dwelling Established by Appraisal Award

In Homeowners Of America Insurance Company v. Emilio Menchaca, No. 01-23-00633-CV, Court of Appeals of Texas, First District (July 31, 2025) after a hurricane Homeowners of America Insurance Company (“HAIC”) estimated that the cost of covered repair to Menchaca’s house was $3,688.54, which was less than his deductible, and therefore no payment would be made.

FACTS

After Menchaca retained counsel HAIC advised that, under the terms of the policy, Menchaca was required to first invoke the appraisal process prior to filing suit, and that HAIC reserved the right to request that Menchaca and any adjuster hired on his behalf submit to an Examination Under Oath (“EUO”).

On August 23, 2018, Menchaca’s counsel ...

00:08:45
August 07, 2025
Amount of Loss Set by Appraisal Award

Payment of Appraisal Award Defeats Claim of Bad Faith
Post 5163

Read the full article at https://lnkd.in/dNpKKcYx, see the full video at https://lnkd.in/dNgwRP8q and at https://lnkd.in/dA9dvd-D, and at https://zalma.com/blog plus more than 5150 posts.

Hurricane Damage to Dwelling Established by Appraisal Award

In Homeowners Of America Insurance Company v. Emilio Menchaca, No. 01-23-00633-CV, Court of Appeals of Texas, First District (July 31, 2025) after a hurricane Homeowners of America Insurance Company (“HAIC”) estimated that the cost of covered repair to Menchaca’s house was $3,688.54, which was less than his deductible, and therefore no payment would be made.

FACTS

After Menchaca retained counsel HAIC advised that, under the terms of the policy, Menchaca was required to first invoke the appraisal process prior to filing suit, and that HAIC reserved the right to request that Menchaca and any adjuster hired on his behalf submit to an Examination Under Oath (“EUO”).

On August 23, 2018, Menchaca’s counsel ...

00:08:45
July 16, 2025
There is no Tort of Negligent Claims handling in Alaska

Rulings on Motions Reduced the Issues to be Presented at Trial

Read the full article at https://lnkd.in/gwJKZnCP and at https://zalma/blog plus more than 5100 posts.

CASE OVERVIEW

In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.

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Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.

Prior to trial Bernier had three remaining claims against State Farm:

1. negligent and reckless claims handling;
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3. award of punitive damages.

Both Bernier and State Farm dispositive motions before ...

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May 15, 2025
Zalma's Insurance Fraud Letter - May 15, 2025

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 ...

May 15, 2025
CGL Is Not a Medical Malpractice Policy

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 ...

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