Consider the case of Elsie Fossum. Fossum was 95-years-old when she checked herself into as assisted living facility. Instead, she died and her family has been waiting for seven long years to find out what happened. All they know is that she died as a result of injuries sustained at the assisted living facility. In fact, the home’s administration suggested Fossum had fallen.
As it turned out, the real cause of her death was revealed by the home’s former nursing director, who stated her injuries did not come about as the result of a fall, but because she was punched. The former director described the woman’s injuries as miserable: swollen eyes, knuckle shaped bruises, and damaged eyes. Apparently, no one knew who inflicted such horror on Fossum and there have been no charges filed.
This case is just the tip of the iceberg. According to the Center for Investigative Reporting, abuse complaints are steadily increasing, but many of those complaints are in limbo or on hold. In fact, it appears state regulators created cold/hold files for over 900 incidents, even files that included death under suspicious circumstances. It seems the Department of Public Health has hundreds of uninvestigated and unassigned cases waiting for attention, which they may never get.
With a change of department management in 2011, things have begun to slowly turn around, with screening within two days. Unfortunately, it also appears that many current investigations are being done only by phone, not by going to the scene, a situation that may result in missing vital information and leaving vulnerable seniors at risk.
Elsie Fossum’s case, now deemed a homicide, is now in the hands of the Los Angeles County Sheriff’s Department for a closer look. If you have concerns about a loved one in care, contact an experienced nursing home abuse lawyer. Do not wait.
While the popular impression of the flammability of motor vehicles may be exaggerated due to such things as the manner in which they are portrayed on television and in the movies, cars and trucks do contain flammable materials, and they obtain their motive power through the use of flammable fuel. As a result they occasionally catch fire, causing damage to themselves and to objects around them. Fire coverage under policies of motor vehicle insurance has been devised in order to reimburse vehicle owners for the loss and damage sustained in such incidents.
Fire coverage under a policy of motor vehicle insurance, which is sometimes contained within the comprehensive coverage provisions of the policy, generally provides coverage for accidental loss of or damage to a covered vehicle caused by fire. Questions may sometimes arise over coverage of fire damage associated with a collision involving a covered vehicle. Similarly, because of the great variety of ways in which fires can start and propagate themselves, incidents resulting in motor vehicle fires may raise other coverage issues related to causation. While negligence or carelessness of an insured will normally not preclude coverage, intentional acts of the insured that bring about a fire can cause an insurer to deny coverage for a loss. Because of the destructive nature of fire and the manner in which it can obliterate the evidence of how it was ignited, insurers have an incentive to carefully analyze claims of damage or loss involving fires of suspicious origin.
The business of insurance in the United States, including that of motor vehicle insurance, has traditionally been governed by the separate laws of each of the states rather than by a single unified body of federal law. As a result, the answers to questions concerning coverage of fire damage under auto insurance policies will vary from state to state, and will be found in the state statutes regulating the business of insurance and in the decisions of courts dealing with matters of insurance law.
Some motorist insurance policies contain an exclusion of liability and uninsured coverage for members of an insured’s household or family. Where these exclusions are enforceable, they would prohibit, for example, a husband, who was a passenger in a car driven by his wife, from recovering benefits under her insurance policy for injuries he suffered in an auto accident that she caused. One reason given for denying insurance coverage for members of an insured’s household or family is a perceived difficulty of defending a lawsuit brought by an insured’s household or family member against the insured.
Whether household and family exclusions are valid and enforceable in a particular state depends upon the decisions of the state’s courts. Some courts have upheld the validity of these exclusions because they do not violate the state’s public policy or state insurance laws. Other states have ruled that the exclusions are invalid because they do violate public policy and insurance laws. Some states enforce the exclusions as to liability coverage but not uninsured coverage.
Even though a state court finds these exclusions valid, it might conclude that they do not apply to the parties in a particular case. The court must decide whether the injured person is a family or household member of the insured under the motorist insurance policy. In one case, a court would not expand the definition of the term household to include unrelated roommates. In another case, a court found that a college student, who was injured in an auto accident caused by her father, the insured, was not a resident of his household. The student had become a resident of the state in which she attended college and only returned to her father’s house for holidays.
Therefore, exclusions in a motorist insurance policy that deny coverage to members of an insured’s family or household may or may not be valid in a particular case. Further, several factors must be considered before an injured party may be found to be a member of an insured’s family or household. It is best to check current case law before accepting that these exclusions in a motorist insurance policy bar an injured person’s recovery from the insured’s policy.
Some automobile insurance policies have clauses that specifically exclude the payment of punitive or exemplary damages against an insured. Punitive or exemplary damages do not pay for bodily injuries or property damage. They are awarded over and above payment for those items. Punitive or exemplary damages are intended to punish the person who caused the injuries or damage or to make that person an example to deter others from such conduct.
So long as the punitive or exemplary exclusion is not ambiguous and does not violate a state’s public policy or statutes, most courts will uphold the exclusion and enforce it. Most states agree that an insurer does not have to provide insurance coverage for an award of punitive or exemplary damages against an uninsured or underinsured person.
Several states have statutes that prohibit the punishment of intentional wrongdoers through punitive damage awards. In such states, insurance coverage for punitive or exemplary damages would not exist unless that coverage is specifically included in the insurance policy. Therefore, no punitive or exemplary damages exclusion is needed for the insurance companies in those states to avoid paying awards for punitive damages.
State laws regarding punitive or exemplary damage exclusions can vary in other ways. Some states do not permit an insurance company to provide insurance coverage for punitive damages awarded due to the acts or omissions of an insured’s employees or agents, if the insured did not know of those acts or omissions. Other states permit insurance coverage for punitive damages that arise out of a person’s death or injury due to an insured’s negligence.