In the vast majority of personal injury cases, the injured person seeks to recover from the at-fault party's insurer. Most people usually do not have the financial resources to pay for the injuries and medical care they cause. That is unfortunate but true. That is the reason that most people try to collect against the at-fault party through the person's insurance.
In order to collect against the person that caused injuries through the person's insurance, the injury and the cause of the injury must be covered by the terms of the insurance policy. In almost every type of insurance policy, there are certain exclusions from coverage. The exclusions are used by insurers to limit their “exposure to risk”. “Exposure to risk” is really the amount of help that they will give to injured people.
One of the most significant limitations upon the ability of injured people to recover for injuries caused by others is the “Criminal Act Exclusion”. The “Criminal Act Exclusion” was recently addressed in a case by the Georgia Court of Appeals.
At some point, Welker submitted a claim to Trustgard to recover her medical expenses resulting from the shooting. Trustgard denied coverage under three exclusions from personal liability protection expressly set forth in the Policy. The pertinent sections of the Policy provide that Trustgard's coverage for personal liability and for medical payments to others does not include:
6. Bodily injury … caused by the willful, malicious, or intentional act of any person.****
8. Bodily injury … expected or intended by any insured person. This includes bodily injury …:a. caused intentionally by or at the direction of an insured person; orb. which results from any occurrence caused by an intentional act of any insured where the results are reasonably foreseeable.(collectively, the “Intentional Acts Exclusions”).****
18. Bodily injury … arising from a criminal act or omission which is committed by … an insured person. This exclusion applies regardless of whether the insured person is actually charged with, or convicted of a crime.(the “Criminal Act Exclusion”).
Trustgard Ins. Co. v. Herndon, No. A16A0585, 2016 WL 3854710, at *2 (Ga. Ct. App. July 14, 2016).
If you have questions about a personal injury that occurred while you were on another person's property, contact the injury attorneys at The Sessions Law Firm today.
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