by Ed Sneneh, Illinois Auto Insurance Agent, Chicago
Liability Insurance & Negligence
Liability insurance policies are designed to pay for property damages and bodily injuries that are caused because of the negligence of the insured. In order to establish negligence four elements have to be present for the liability insurance policy to consider any claim. To prove negligence the four elements that must be present are Duty to Protect, Failing to Exercise a Reasonable Standard of Care, Proximate Cause, and presence of Actual Injury.
In other words, there has to be some sort of proof that the person claiming actual injury or damage was under the care of the insured, and that the insured failed to take reasonable measure to protect the claimant from injury, and that the cause of damage/ injury was the failure to take proper care. If either one of those elements could not be established, liability may not exist. In that case no lawsuits can be brought against the insured.
Medical Payments in Commercial General Liability
Commercial general liability policies (CGL) includes a coverage called Medical Payment. Limits range between $1,000 to $10,000 bodily injury per person. The coverage pays for bodily injuries that occur on the insured premises, without a need to prove negligence. Basically the coverage is there to meet the ethical or moral obligations of the insured business towards its customers that get hurt on the premises, not for any fault of the business. Example: A customer decides to climb the tall shelves in a department store to remove a bike, causing the bike to fall on the man causing injury. The store can argue that a prudent person would not have climbed the tall shelves, and therefore it was not the fault of the store that the man was injured. But to meet its ethical and moral obligation the store insurance may pay for emergency treatment under the
Medical Payment coverage.
Medical Payment in Homeowners Insurance
Similar coverage exists in homeowners insurance, called Medical Payment to Others. Some home policies call it 'Guest Insurance.' The coverage ranges between $1,000 to $5,000 pays for injuries that are suffered by guests (not household members), with no need to sue under liability. For example, if your friend was helping you washing dishes, suddenly the suffered very bad cut in the hand that required emergency treatment then the
Medical Payment in the homeowner policy that you own will pay up to the limit of the coverage. This coverage also exists on renters insurance and condo insurance policies.
Medical Payment in Auto Insurance
Medical Payment in Auto Insurance is a limited coverage that is found as optional coverage in many states. The coverage ranges from $500 to $5,000 per person per accident. The coverage pays for
medical and funeral expenses that the insured person or any household members suffer because of any auto related accidents, even as a pedestrian. Auto insurance in Illinois does not mandate this coverage and several companies offer no more than $1,000 coverage. Some companies offer higher limits, such as $10,000.
Making claims under
medical payment coverage is easy. First verify that the coverage exists on your policy, then make sure that you have the proper documentation of the injury time, place, and bills. Call the claim department for further details. There are always time limits for filing claims.