May 08, 2012

Med-Pay Barred by Regular Use Exclusion

In Vann v. Mercury Indemnity Co. of Amer., the New Jersey Superior Court, Appellate Division, in an unpublished decision 1, held that the regular use exclusion in the plaintiff’s personal automobile policy of insurance precluded him from recovering “med-pay” benefits when he was involved in a motor vehicle accident while operating a work vehicle that was furnished or available for his regular use. In that case, the exclusion at issue provided:

The company will pay medical expenses benefits not to exceed the total aggregate amount stated in the schedule with respect to bodily injury sustained by an insured person, caused by an accident occurring during the policy period anywhere in the world and arising out of the ownership, maintenance or use, including loading and unloading, of an insured automobile or of a highway vehicle not owned by or furnished or available for the regular use of the named insured or any relative of the named insured.

In holding that the regular use exclusion applied, the court reasoned that the plaintiff testified that he normally drove the truck involved in the accident about 90% of the time he was at work, which was about three to five days per week. Notably, the court stated that the plaintiff had an unrestricted right to use the truck for business purposes. Thus, the court concluded that the truck was “furnished or available for the regular use” of the plaintiff.

What It Means to You

When considering whether there is coverage under a personal policy, pay close attention to the circumstances of the accident. If the insured is not operating a vehicle insured under the policy, potentially applicable exclusions must be carefully evaluated in order to determine whether coverage is available under the policy in question.

”No unpublished opinion shall constitute precedent or be binding upon any court. Except for appellate opinions not approved or publication that have been reported in an authorized administrative law reporter, and except to the extent required by res judicata, collateral estoppel, the single controversy doctrine or any other similar principle of law, no unpublished opinion shall be cited by any court. No unpublished opinion shall be cited to any court by counsel unless the court and all other parties are served with a copy of the opinion and of all contrary unpublished opinions known to counsel. New Jersey Rules of Court, R. 1:36-3.

Sources

Vann v. Mercury Indemnity Co. of Amer., A-4264-10T4 (N.J. App.Div. April 25, 2012)