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Insurance Coverage – The Insurer’s Duties

Nov 28th, 2019

Video Transcript

THOMAS NEVILLE: An insurance policy is a contract. But it’s a contract unlike an ordinary commercial contract. It’s not a contract that is negotiated between two parties with equal bargaining power. Instead, it’s a contract that one party, the insured, enters into to obtain protection against future damage.

The insurance company is making a promise that it will be there for its insured when its insured is at his or her weakest point, most vulnerable. That it will be there to defend the insured that it will be there to absorb the liability, the financial hit, from whatever the lawsuit is. And because this contract is so different than an ordinary contract, insurance companies have additional responsibilities, additional duties.

There are two types of relationships that an insurer can have with its insured. In what we call a first party context which most people are familiar with from their health insurance or their homeowner’s insurance, the insurance company agrees to pay the insured money for damages the insured suffers either from an act of nature or the conduct of another person.

In the third party context, which most people also know about through their auto insurance, what happens is the insurance company agrees to defend and indemnify or pay any judgment for damages that are caused by the insured’s negligent conduct.

Your insurance company makes a promise to you that they will be there to protect you, that when everything has gone sideways, they will step up and they will help make you whole.

The problem is all too often they break that promise. And for me, holding the insurance company accountable for leaving the insured high and dry in the worst time of their life is really important.