THE REASONABLE EXPECTATIONS DOCTRINE APPLICATION TO THE
CONSTRUCTION OF AMBIGUOUS POLICY LANGUAGE
By: David A. Gauntlett of Gauntlett & Associates,
Irvine, California
Research Assistant: Erik Brent
The Doctrine of Reasonable Expectations governed the
construction of insurance contracts in nearly 20 states.
Footnote1 The "reasonable expectations doctrine
means that '[t]he objectively reasonable expectations of the
applicants and intended beneficiaries regarding the terms of
insurance contracts will be honored, even though a
painstaking study of the policy provision would have negated
those expectations'."
Footnote2 Lately, many courts, rather than adopting
wholesale a reasonable expectations doctrine, have expanded
the ambit of terms found to be unambiguous in the context of
the policy as a whole.
Footnote3 The most progressive application of the
reasonable expectations doctrine has been the courts in
Minnesota. As the Minnesota Supreme Court held in Atwater
Creamery Co. v. Western National Mutual Ins. Co., 366 N.W.2d
271, 276-277 (Minn. 1985) ("objectively reasonable
expectation applicants and intended beneficiaries regarding
the terms of insurance contracts will be honored even though
painstaking study of the policy provisions would have negated
those expectations." Id. at 277.) Commenting upon the
scope of this doctrine, the court in Wessman v. Massachusetts
Mutual Life Ins. Co., 929 F.2d 402 (8th Cir. 1991)
stated:
Of course, the doctrine does not "remove from the
insurer the responsibility to read the policy but at the same
time it does not hold the insured to an unreasonable level of
understanding of the policy." Hubred v. Control Data
Corp., 442 N.W.2d 308, 311 (Minn. 1989) (citing Atwater
Creamery, 366 N.W.2d 278). It does this by enforcing the
insured's expectations of coverage where those expectations
are reasonable under the circumstances of the policy's
negotiation and purchase. Hubred, 442 N.W.2d at 311; Atwater
Creamery, 366 N.W.2d 278. The actual terms of the policy are
but one factor to be considered in determining the insured's
reasonable expectations.
Other factors to be considered are the "presence of
ambiguity, language which operates as a hidden exclusion,
oral communications from the insurer explaining important but
obscure conditions or exclusions, and whether provisions in a
contract are known by the public generally." Hubred, 442
N.W.2d at 311 (citing Atwater Creamery, 366 N.W.2d 278). The
question of whether or not the insured's expectations were
"reasonable" is ordinarily an issue of fact before
the jury. Atwater Creamery, 366 N.W.2d at 278." Id. at
404-405.
In Western, the court found that in the circumstances of
that case the most perspicacious reader would not have
understood that the "statement of insurability" was
part of or a supplement to the application for life
insurance. Clearly the context involving an individual
seeking life insurance is distinct from a business procuring
a commercial liability policy. Application of the reasonable
expectations doctrine therefore may differ in some instances
based on the nature of the insured and its prior relationship
with the insurer. In this context, the applicable standard
for evaluating ambiguous terms in a policy is often critical
to the result reached in coverage cases.
In Westman v. Massachusetts Life Ins. Co., for instance,
the court found that there were multiple levels of ambiguity
which required an interpretation of the policy provisions
related to and which terms were included within the
application for insurance against the insurer. As the court
noted:
Ambiguity may result from terms in a policy that are
susceptible to more than one meaning. Ambiguity may also
result from irreconcilable conflict between terms or
provisions within the contract. Morris v. Weiss, 4914 N.W.2d
483 (Minn.App. 1987).
Id. at 406.
The court there also found that the nature of the
ambiguous terms required their submission to a jury for
determination. It reasoned that:
The rule is well established that ordinarily the
construction of a writing which is unambiguous is for the
court, particularly when the intention of the parties is to
be gained wholly from the writing. However, if the language
is ambiguous, resort may be had to intrinsic evidence, and
construction then becomes a question of fact, unless such
evidence is conclusive. . . . Ordinarily, the question
whether the language of the contract is ambiguous is one of
law for the court . . . The extrinsic facts which may be
considered an aid of construction are ordinarily questions
for the court . . . It is also true that when the parties do
a contract if given in a practical construction by their
conduct, as by acts in performance thereof, such construction
may be considered by the court in determining its meaning and
in ascertaining the mutual intent of the parties. . . . Where
such extrinsic evidence is conclusive and undisputed and
renders the meaning of the contract clear, its construction
again becomes a question of law for the court.
Id. at 407.
The standard rule regarding ambiguity is that it
exists when a provision is susceptible to more than one
reasonable interpretation.
Footnote4 Thus, if there is doubt or uncertainty as to
the policy's meaning and it is fairly susceptible of two
interpretations, one favorable to the insured and the other
favorable to the insurer the former will be adopted.
Footnote5
The critical inquiry is whether ambiguity arises in the
first instance requiring the application of this rule. The
question of at what point in the analysis the ambiguity of a
given term becomes relevant has been aggressively dealt with
by the California Supreme Court in a manner so as to
eliminate any resort to the ambiguity doctrine in a majority
of cases. In La Jolla Beach & Tennis Club v. Ind.
Indemnity Co., 36 Cal.Rptr.2d 100 (Cal. 1994) the court
summarized applicable coverage law principles applied in
California to insurance policies. It stated:
While insurance contracts have special features, they are
still contracted to which the ordinary rules of contractual
interpretation apply." (Bank of the West v. Superior
Court [1992] 2 Cal.4th 1254, 1264, 10 Cal.Rptr.2d 538, 833
P.2d 545; see AIU Ins. Co. v. Superior Court, [1990] 51
Cal.3d 807, 821-822, 274 Cal.Rptr. 820, 799 P.2d 1253.)
"The fundamental goal of contractual interpretation is
to give effect of the mutual intention of the parties.
Civ.Code § 1636.
Bank of the West v. Superior Court, supra, 2 Cal.4th at
p. 1264, 10 Cal.Rptr.2d 538, 833 P.2d 545 ("Such intent
is to be inferred, if possible, solely from the written
provisions of the contract"); AIU Insurance Co. v.
Superior Court, supra, 51 Cal.3d at p. 22, 274 Cal.Rptr. 820,
799 P.2d 1253 ("If contractual language is clear and
explicit, it governs. Civ.Code § 1638.") Bank of
the West v. Superior Court, 2 Cal.4th at p. 1264, 10
Cal.Rptr.2d 538, 833 P.2d 545. Moreover, if the policy's
terms are "used by the parties in a technical sense or a
special meaning is given to them by usage, 'this use or
meaning' controls judicial interpretation." AIU
Insurance Co. v. Superior Court, supra, 51 Cal.3d at p. 822,
274 Cal.Rptr. 820, 799 P.2d 1253.
"An insurance policy provision is ambiguous if it is
capable of two or more constructions, both of which are
reasonable." Bay Cities Paving & Grading, Inc. v.
Lawyers Mutual Ins. Co., [1993] 5 Cal.4th 854, 867, 21
Cal.Rptr.2d 691, 855 P.2d 1263 [italics omitted]; Producers
Dairy Delivery Co. Inc. v. Sentry Ins. Co., supra, 41 Cal.3d
at p. 912, 226 Cal.Rptr. 668, 718 P.2d 920 ("courts will
not adopt a strained or absurd interpretation in order to
create an ambiguity where none exists.") Reserve Ins.
Co. v. Pisciotta [1983] 30 Cal.3d 800, 807, 180 Cal.Rptr.
628, 640 P.2d 764 ("[L]anguage in a contract must be
construed in the context of that instrument as a whole, and
in the circumstances of that case, it cannot be found to be
ambiguous in abstract.") Bank of the West v. Superior
Court, supra, 2 Cal.4th at p. 1265, 10 Cal.Rptr.2d 538, 833
P.2d 545 [italics omitted] . . . If an asserted ambiguity is
not eliminated by the language in context of the policy,
courts that invoke the principle that ambiguities are
generally construed against the party who caused the
uncertainty to exist (i.e., the insurer) in order to protect
the insured's reasonable expectations of coverage . . . Id.
at 105.
Specially addressing the reasonable expectations of the
insured, the court noted that in Bank of the West v. Superior
Court the analysis of the undefined "advertising
injury" offense of unfair competition was rejected where
its application would have encompassed unfair business
practices whose remedy was limited to disgorgement of
ill-gotten gains rather than compensatory damages as the
policy also required that coverage was limited to recovery in
the form of damages.
Similarly in La Jolla v. Industrial, the court noted that
the policy language in a workers' compensation policy
provides that there will be a defense owed in any claim
proceeding a suit . . . for benefits payable by this
insurance. The court ruled that a workers' compensation
proceeding may lead to a benefit payable by the workers'
compensation insurance but a civil action in which a workers'
compensation claim was erroneously asserted could not give
rise to benefits payable by the workers' compensation policy
so that an interpretation requiring a defense of the civil
action under the workers' compensation policy was not within
the insured's reasonable expectations.
The reasonable expectations doctrine has also been
applied where a finding of estoppel or waiver against an
insurer is appropriate because its interpretation of the
policy is inconsistent with other representations made to the
insured or aspects of the policy on which the insured may
properly rely. In Romano v. New England Mut. Life Ins. Co.,
362 S.E.2d 334, 339 (W.Va. 1987) the court noted that:
Where advertisements, sales brochures, or similar
materials are provided as an inducement to insurance, cases
uniformly hold that the insurer's are bound by the provisions
contained therein.
The court noted:
Other courts, applying a variance analysis, have held
that representations continued in promotional materials must
be looked at so as to construe the policy in accord with the
insured's reasonable expectations (e.g., Sparks v. Republic
Nat'l Life Ins. Co., 132 Ariz. 529, 647 P.2d 1127 cert.denied
459 U.S. 1070, 74 L.Ed.2d 632, 103 S.Ct. 490 (1982). Id. at
339.
Thus, in Sparks the Arizona Supreme Court concluded that
in light of the insurer's brochure, the policy would be
deemed to provide benefits beyond the termination of
insurance coverage. See, also, Crawford v. Mid-American Ins.
Co., 488 S.W.2d 255 (Mo. 1972); 13 A.J. Appleman, Insurance
Law & Practice Section, 7534 (1976) (citing cases).
This view is in accord with collected cases. See,
Annotation 6 ALR4th 835 (1981) (Effective Policy Limitations
or Exclusions Not in Materials Provided to Insureds);
Annotation 36 ALR3d 541 (1971) (Estoppel Based Upon
Promotional or Explanatory Materials Provided to Insurers).
The same arguments about the need to look in context to
representations made to the insured appropriately requires
reference of the drafting history of the particular form of
policy at issue. Weyerhauser Co. v. Aetna Casualty &
Surety Co., 123 Wash.2d 891, 874 P.2d 142 (Wash. 1994). A
reasonable expectation doctrine even as adopted by states,
like California, therefore, provides a basis for looking
beyond the policy to emphasize the insured's reasonable
expectations objectively considered as coverage in light of
all representations by the insurer. Not only prior to
issuance of policy in advertising materials but as to the
scope of coverage under the policy form adopted.
The scope and meaning of the reasonable expectations
doctrine in modern jurisprudence has been the subject of much
critical commentary.
Footnote6 Although the ambiguity doctrine as it relates
to the reasonable expectations doctrine is most readily
applied in interpreting exclusions to policy coverage for
basic principle of ambiguity, it would apply for both
coverage clauses, conditions and exclusions.
50 STATES: REASONABLE EXPECTATIONS DOCTRINE SYNOPSIS BY
STATE
AMBIGUITY DOCTRINE(S) - 5 ELEMENTS APPLIED BY STATES:
Footnote7
1. Plain meaning of insurance contract terms not
apparent;
2. Terms susceptible to more than 1 reasonable
interpretation (if so, reasonable interpretation favorable to
insured is adopted);
3. No plain meaning when terms viewed in context of
policy as a whole;
4. Terms (undefined) viewed from layperson's perspective;
and
5. Reasonable expectations of insured.
StateElements |
Rule |
Case |
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Alabama1, 2, 4 |
Meaning of policy term must
reflect intent of parties and be one that persons with a
usual and ordinary understanding would give to the terms when
used to express one purpose for which they were
employed. |
St. Paul Fire & Marine
Ins. Co v. Veal, 377 So.2d 9102 (Ala. 1979); Ho Bros
Restaurant Inc. v. Aetna Cas. & Sur. Co., 492 So.2d 603
(Ala. 1986); Cashatt v. State Farm Mutual Auto Ins. Co., 510
So.2d. 831, 833 (Ala.Civ.App. 1987) |
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Ambiguity exists where a term is
reasonably subject to more than one interpretation looking to
the plain, ordinary meaning or popular sense of the word
.
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Cannon by and Through Cannon v. State
Farm Mut. Auto. Ins. Co., 590 So.2d 191 (Ala. 1991).
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Alaska2, 3, 4
|
Insurance contracts are to be construed
so as to provide that coverage which a lay person would have
reasonably expected from a lay interpretation of the policy
terms. An ambiguity exists when the contract as a whole and
the extrinsic evidence support differing reasonable
interpretations.
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Stordahl V. Government Employees Ins.
Co., 564 P.2d. 63, 66 (Ak. 1977); Allstate Ins. Co. v.
Ellison, 757 F.2d 1042 (9th Cir. 1985) (Applying Alaska Law);
Serradell v. Hartford Acc. And Indem. Co., 843 P.2d 639 (Ak.
1992).
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Arizona1, 2, 3, 4, 5
|
Doctrine of reasonable expectations
applies. Ambiguity exists where language is unclear and can
be reasonably construed in more than one sense; policy must
be read as a whole using plain and ordinary language for all
terms; policy clauses limiting benefits are strictly
construed in favor of the insured. Arizona courts will not
enforce even unambiguous boilerplate terms in standardized
insurance contracts in a limited variety of situations:
1. Where the contract terms, although not ambiguous to the
court, cannot be understood by the reasonably intelligent
consumer who might check on his or her rights, the court will
interpret them in light of the objective, reasonable
expectations of the average insured.
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Sparks V. Republic Nat'l Life Ins. Co.,
132 Ariz. 529, 6476 P.2d 1127, 1135 Cert.denied 459 U.S.
1070, 103 S.Ct. 490, 74 L.Ed.2d 632 (Az. 1982); Standardized
Agreements and the Parole Evidence Rule: Defining and
Applying the Expectations Principle 26 Ariz.L.Rev. 793,
834-35 (1984); Coconino County v. Fund Administrators Ass'n,
Inc., 149 Az. 427, 719 P.2d 693 (Az. 1986).
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2. Where the insured did not receive full
and adequate notice of the term in question, and the
provision is either unusual, or one that emasculates apparent
coverage.
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3. Where some activity which can be
reasonably attributed to the insurer would create an
objective impression of coverage in the mind of a reasonable
insured. 4. Where some activity reasonably attributable
to the insurer has induced a particular insured reasonably to
believe that he/she has coverage although such coverage is
expressly and unambiguously denied by the policy.
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Arkansas1, 2
|
An ambiguity exists, however, only when a
provision is susceptible to one or more reasonable
interpretations. If there is doubt or uncertainty as to the
policy's meaning and it is fairly susceptible of two
interpretations, one favorable to the insured and the other
favorable to the insurer the former will be adopted.
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Norton v. St. Paul Fire and Marine Ins.
Co., 902 F.2d 1355 (8th Cir. 1990) (Applying Arkansas
Law);Arkansas Farm Bureau Ins. Fed. v. Ryman, 309 Ar,. 283,
831 S.W.2d 133 (1992); Keller v. Safeco Ins. Co., 317 Ark.
308, 877 S.W.2d. 90 (Ar. 1994); State Farm Fire & Cas.
Co. v. Midgett, 892 S.W.2d 469 (Ar. 1995).
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California1, 2, 3, 5
|
Ambiguity exists, 4-part rule: 1) look to
plain meaning of terms; 2) interpret the language in context,
with regard to its intended function in the policy,
attempting to be consistent with the insured's objectively
reasonable expectations; 3) if neither 1 or 2 resolves the
ambiguity then it is resolved against the insured; 4) an
insurance policy provision is ambiguous when it is capable of
two or more constructions both of which are reasonable.
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AIU Insurance Co. v. Superior Court, 51
Cal.Rptr.3d 807, 274 Cal.Rptr. 820, 799 P.2d. 1253 (Cal.
1990); Bank of the West v. Superior Court, 2 Cal.4th 1254,
833 P.2d 545, 10 Cal.Rptr.2d. 538 (Cal. 1992) ; Shell Oil Co.
v. Winterthur Swiss Ins. Co., 12 Cal.App.4th 715, 15
Cal.Rptr.2d 815 (Cal.App. 1993);Bay Cities Paving &
Grading Inc. v. Lawyer's Mut. Ins. Co., 5 Cal.4th 854, 2161
Cal.Rptr.2d 691, 855 P.2d 1263 (Cal. 1993).
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Colorado1, 2, 3, 4
|
An insurance company has an obligation to
write the critical portions of its policies in plain english
and with such precision that a reasonable lay person can, by
reading the policy, understand the coverage provided.
Ambiguity exists if the language is susceptible to more than
one reasonable interpretation; policy must be evaluated as a
whole using the generally accepted meaning of words.
|
Travelers Insurance Co. v.
Geffries-eaves, Inc., 166 Colo. 220, 442 P.2d. 822 (1968);
Union Ins. Co. v. Huntz, 883 P.2d 1057 (Colo. 1994)
;Travelers Indem. Co. v. Howard Elec. Co., 879 P.2d 431
(Colo.App.1994).
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Connecticut4, 5 |
Policy language will be
construed as laypersons would understand it. The
policyholders expectations should be protected as long as
they are objectively reasonable from the layperson's point of
view. |
Marcolini v. Allstate Ins.
Co., 160 Conn. 280, 278 A.2d 796 (Conn. 1971); Hammer v.
Lumberman's Mutual Casualty Co., 214 Conn. 573, 583-84, 573
A.2d 699 (Conn. 1990); Ceci v. Nat'l Indem. Co., 225 Conn.
165, 622 A.2d 545 (Conn. 1993); |
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Delaware2
|
When the language of an insurance policy
is clear and unambiguous, Delaware applies ordinary
principles of contract law . . . An ambiguity exists only
when the language is subject to two or more reasonable
interpretations. An ambiguity does not exist merely because
two conflicting interpretations may be suggested; the insured
must proffer more than a "possible construction of the
policy." Because ambiguity lurks in every word,
sentence, and paragraph in the eyes of a skilled advocate,
absent a showing that the term has acquired a special
meaning, the question is not whether there is an ambiguity in
the metaphysical sense, but whether the language has only one
reasonable meaning when constructed, not in a hyper technical
fashion, but in an ordinary common sense manner.
|
Cheseroni v. Nationwide Mut. Ins. Co.,
402 A.2d 1215, 1217 (Del.Super. 1979) aff'd 410 A.2d 1015
(Del. 1980); Hallowell v. State Farm Auto Ins. Co., 443 A.2d
925 (Del. 1982); Aetna Casualty & Surety Co. V. Kenner,
570 A.2d 1172, 1174 (Del. 1990). New Castle County v.
Hartford Acc. & Indemnity Co., 970 F.2d 1267 (3d Cir.
1992).
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District of Columbia2, 4
|
When confronted with an integrated
insurance agreement which contains ambiguous terms, the court
must examine and interpret the policy 'through the eyes of a
reasonable purchaser' . . . in interpreting ambiguous
provisions, there must be resort to parol evidence and an
exploration of extrinsic circumstances . . . particularly
significant is extrinsic evidence concerning the parties'
negotiations prior to and contemporaneous with the formation
of the agreement, as well as their course of conduct under
the contract.
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Old American Ins. Co. v. Tucker, 223 A.2d
334 (D.C.Ct. App. 1966);1901 Wyoming Avenue Cooperative
Association v. Lee, 345 A.2d 456, 461, N. 9 (D.C.App. 1975);
Intern Broth, Etc. v. Hartford Acc. & Indemnity Ins. Co.,
388 A.2d 36 (D.C.App. 1978).
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Ambiguity exists where language has more
than one clear meaning when words are given the meaning which
common speech imparts.
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Florida2
|
Although an ambiguity is not invariably
present when analysis is necessary to interpret a policy,
when the terms make the contract subject to different
reasonable interpretations, one of coverage and one of
exclusion, as in this case, an ambiguity does exist.
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Blue Shield of Florida, Inc. v. Woodlief,
359 S.2d 833 (Fla.App.Dist. 1978); Ellsworth v. Ins. Co. of
N. Am., 508 So.2d 395 (Fla. Ct. App. 1987); Weldon v. All
American Life Ins. Co., 605 So.2d 911 (Fla.App.Dist.
1992).
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Ambiguity exists when more than one
interpretation may be fairly given to a policy provision.
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Georgia1, 2, 3
|
Ambiguity is duplicity, indistinctness,
an uncertainty of meaning or expression. A word or phrase is
ambiguous when it is of uncertain meaning and may be fairly
understood in more ways than one. Further, words in a
contract have their usual and common meaning.
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Kusuma v. Metametrix, Inc., 191 Ga. App.
255, 381 S.E.2d 322 (Ga.Ct.App. 1989); Major v. Allstate Ins.
Co., 207 Ga.App. 805, 429 S.E.2d 172 (Ga.App. 1993).
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Hawaii2, 3, 4, 5
|
In the field of comprehensive general
liability insurance, the supreme court has stated that
insurance policies are to be construed in accordance with the
reasonable expectations of a layperson. Ambiguity exists only
where the contract taken as a whole is reasonably subject to
differing interpretation; only after ambiguity is found will
the policy be construed in accordance with the reasonable
expectations of the insured.
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Sturla, Inc. v. Fireman's Ins. Co., 67
Haw. 203, 684 P.2d 690 (Haw. 1984);Lee v. Insurance Co. of
North America, 7 Haw.App. 338, 762 P.2d 809 (Haw.App.
1988).
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Idaho2, 4, 5
|
Where there is ambiguity, the test is
what a reasonable person in the position of the insured would
have understood the language of the contract to mean.
Ambiguity exists if a term is reasonably subject to
conflicting interpretation; meaning of terms is what a
reasonable person in the position of the insured would
attribute; exclusionary provisions are strictly construed
against the insurer.
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Foremost Ins. Co. v. Putzier, 102 ,138,
142, 627 P.2d 317, 321 (Id. 1981); City of Boise v. Planet
Ins. Co., 878 P.2d 750 (Id. 1994).
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Illinois2, 3
|
While ambiguities in an insurance policy
will be construed in favor of the insured, the mere absence
of a definition does not necessarily render a policy term
ambiguous, nor is an ambiguity created simply because the
parties disagree about the meaning of the policy language.
All the provisions of an insurance policy should be read to
interpret it and to determine whether an ambiguity exists. A
provision in an insurance policy is ambiguous if, considering
the policy as a whole, it is subject to more than one
reasonable interpretation.
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Dolan v. Welch, 123 Ill.App.3d 277, 78
Ill.Dec. 675, 462 N.E.2d 764 (Ill.App. 1984); De Los Reyes v.
Travelers Insurance Co., 135 Ill.2d 353, 142 Ill.Dec. 787,
553 N.E.2d 301) (Ill. 1990) A. Miller & Co. v.
Cincinnati, 217 Ill.App.3d 572, 160 Ill.Dec. 560, 577 N.E.2d
885 (Ill. 1991); Allstate Insurance Co. v. Gonzalez-loya, 226
Ill. App.3d 446, 968 Ill. Dec. 482, 589 N.E.2d 882 (Ill. Ct.
App. 1992) .
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Indiana1, 2
|
Under Indiana law, if an insurance policy
exclusion is susceptible to more than one reasonable
interpretation, it is ambiguous and must be given the meaning
most favorable to the insured. However, clear and unambiguous
policy language must be given its plain meaning.
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Freeman v. Commonwealth Life Ins. Co.,
259 Ind. 237, 286 N.E.2d 396, 397 (Ind. 1972); State Farm
Fire & Cas. Co. v Miles, 730 F.Supp. 1462, 1465 (S.D.Ind.
1990) aff'd 930 F.2d 25 (7th Cir. 1991); American Family Mut.
v. National Ins. Ass'n, 577 N.E.2d 969 (Ind.Ct.App. 1991);
Allstate Insurance Company v. Brown, 16 F.3d 922 (7th Cir.
1994).
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Iowa1, 2, 3, 4, 5
|
When words are left undefined in a
policy, we do not give them a technical meaning. Rather, we
give them their ordinary meaning, one that a reasonable
person would understand them to mean.
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Farm & City Ins. v. Potter, 330
N.W.2d 263 (Iowa 1983); A.y. Mcdonald Indus., Inc. v.
Insurance Co. Of N. Am., 475 N.W.2d 607 (Iowa 1991); AMICO
Ins. Co. v. Rossman, 518 N.W.2d 333 (Iowa 1994).
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Ambiguity exists if, after the
application of pertinent rules of interpretation to the
policy, a genuine uncertainty exists as to which one of two
or more meanings is the proper one; court may refer to the
dictionary and the interpretation favoring the insured must
be adopted.
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Kansas1, 2, 3, 4, 5
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If there is a genuine uncertainty as to
meaning of terms in an insurance contract, the policy is
ambiguous and will be construed to mean what a reasonable
person in the position of the insured would have understood
them to mean.
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Farm Bureau Mut. Ins. Co. v. Old Hickory
Ins. Co., 248 Kan. 657, 810 P.2d 283 (Kan. 1991); Levier v.
Koppenheffer, 879 P.2d 40 (Kan.App. 1994); House v. American
Fam. Mut. Ins. Co., 251 Kan 419, 837 P.2d. 391 (Kan.
1992).
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Ambiguity exists if after application of
pertinent rules of interpretation to the face of the
instrument it is generally uncertain which of two or more
meanings is the proper meaning.
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Kentuck2, 4
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Ambiguity exists where language is
reasonably susceptible to more than one meaning using plain
language; two cardinal rules of Kentucky insurance law: 1)
contracts are to be liberally construed with all doubts
resolved in favor of the insured's; 2) exceptions and
exclusions should be strictly construed to make insurance
effective; terms of an insurance policy are to be given their
ordinary meanings as persons with ordinary and usual
understanding would construe them, and the terms of an
insurance policy are to be enforced as written.
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National Insurance Underwriters v.
Lexington Flying Club, Inc., 603 S.W.2d 490, 493 (Ky.App.
1979); City of Louisville V. Mcdonald, 819 S.W.2d 319 (Ken.
Ct. App. 1991); See also Kentucky Farm Bureau Mut. Ins. Co.
v. McKinley 831 S.W.2d 164 (Ken. 1992); Foster v. Kentucky
Housing Corp., 850 F.Supp. 558 (5th Cir. 1994) (Applying
Kentucky Law).
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Louisiana1, 2, 3
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When the language of an insurance policy
and its endorsements are clear and unambiguous, a reasonable
interpretation consistent with the obvious meaning and intent
of the policy must be given.
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Maggio v. Manchester Insurance Co,. 292
So.2d 644 (La.App. 1974); Duplantis V. State Farm Fire &
Cas. Co., 606 So.2d 51 (La.App.992); Herbert v. Hartford Ins.
Co. Of the Midwest, 649 So.2d 631 (La.Ct.App. 1994).
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Ambiguity exists where language is
susceptible to two or more equally reasonable
interpretations; the meaning of a word is determined solely
on its face without necessity of extrinsic evidence.
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Maine1, 3, 4, 5
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Contrary to the rule adopted in other
jurisdictions, the rule in Maine is firmly embedded that a
contract of insurance, like any other contract, is to be
construed in accordance with the intention of the parties,
which is to be ascertained, when there is ambiguity from an
examination of the whole instrument. All parts and clauses,
including exceptions and conditions, must be considered
together in order to perceive if and how far one particular
clause is explained, modified, limited or controlled by
another clause. And, in applying these rules of construction
to, and interpreting the meaning of, the instant insurance
contract, the language used in the policy should be viewed
from the standpoint of the average ordinary person who is
untrained in either one law of the insurance field "in
light of what a more casual reading of the policy would
reveal to an ordinarily intelligent insured." The
objectively reasonable expectations of an insured will be
honored even though painstaking study of the policy
provisions would have negated those expectations.
|
Baybutt Construction Corp. v. Commercial
Union Ins. Co., 455 A.2d 914 (Me. 1983); Brackett v.
Middlesex Ins. Co., 486 A.2d 1188 (Me. 1985).
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Maryland1, 4
|
Unless there is an indication that the
parties intended to use words in the policy in a technical
sense, we accord the words their usual, ordinary and accepted
meaning. A words' ordinary signification is tested by what
meaning a reasonably prudent lay person would attach to the
term. In the event of ambiguity, courts may consider
extrinsic evidence as to the meaning of policy language.
|
Pacific Idem. v. Interstate Fire &
Cas., 302 Md. 383, 388, 488 A.2d 486 (Md. 1985); Mitchell v.
Maryland Casualty; 324 Md.44, 56, 595 A.2d 469 (Md. 1992);
Bausch & Lomb Inc. v. Utica Mut. Ins. Co., 330 Md.758,
625 A.2d 1021 (Md. 1993); .Nationwide Mut. Ins. Co. v.
Scherr, 101 Md.App. 690, 647 A.2d 1297 (Md.Ct.Spec.App. 1994)
.
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Absent evidence that parties intended
special or technical meaning, words in an insurance contract
are accorded their usual, ordinary and accepted meaning;
Maryland does not follow the rule that an insurance policy is
to be construed most strongly against the insurer.
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Massachusetts2, 5
|
When construing language in an insurance
policy, we consider what an objectively reasonable insured,
reading the relevant policy language, would expect to be
covered.
|
Hazen Paper Co. v. United States Fidelity
& Guar. Co., 407 Mass. 689, 700, 555 N.E.2d 576 (Mass.
1990); Atlantic Mut. Ins. Co. v. Mcfadden, 413 Mass. 90, 595
N.E.2d 762 (Mass. 1992); Lumbermans Mut. Cas. Co. v. Office
Unlimited, Inc., 419 Mass. 462, 645 N.E.2d 1165 (Mass. 1995).
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Ambiguity exists in an insurance contract
when language contained therein is susceptible to more than
one meaning using plain and ordinary meaning.
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Michigan2, 3, 4, 5
|
Where insurer fails to provide otherwise,
the commonly understood meaning, which a typical lay person
might reasonably expect to apply to policy term, must
prevail.
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Taylor v. Blue Cross/Blue Shield of
Michigan, 205 Mich.App. 644, 517 N.W.2d 864 (Mich.Ct.App.
1993); Michigan Mut. Millers Mut. Ins. Co. v. Bronson Plating
Co., 445 Mich. 558, 519 N.W.2d 864 (Mich. 1994).
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Ambiguity exists if, after reading the
entire contract as a whole, its language can reasonably be
understood in different ways; exclusions in insurance
policies are to be read with the insuring agreement and
independent of other exclusions; exclusionary clauses are
strictly construed against the insurer.
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Minnesota1, 2, 3, 5
|
Ambiguity exists in an insurance contract
if it is susceptible to more than one meaning or if there
exists an irreconcilable conflict between its terms or
provisions, after reading the entire contract; language must
be given its plain and ordinary meaning; the reasonable
expectations of the insured must be determined; insurer has
the burden of proving a policy exclusion applies.
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Canadian Universal Insurance Co., Ltd. v.
Fire Watch, Inc., 258 N.W.2d 570, 572 (Minn. 1977);
Progressive Cas. Ins. Co. v. Kraayenbrink, 370 N.W.2d. 455
(Minn.App. 1985); Hubred v. Control Data Corp., 442 N.W.2d
308 (Minn. 1989).
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Mississippi1, 2, 3
|
When the language is ambiguous, insurance
policies are to be construed in a manner most favorable to
the insured. Under Mississippi jurisprudence words, terms,
phrases, and clauses in insurance contracts to be given their
everyday meanings not hyper technical or esoteric
definitions, but their plain and common meaning.
|
Lumbermen's Mutual Casualty Ins. Co. V.
Randle, 370 F.2d 68, 72 (5th Cir. 1966);Aetna Casualty &
Surety Co. v. Steele, 373 S.2d 797 (Miss. 1979); Employers
Ins. Of Wausau v. Trotter Towing Corp., 834 F.2d 1206 (5th
Cir. 1988) (Applying Mississippi Law); Mcfarland V. Utica
Fire Ins. Co. Of Onedja County Ny, 814 F.Supp. 518 (S.D.MISS.
1992) Aff'd 14 F.3d 55 (5th Cir. 1992).
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Ambiguity exists when a policy is
susceptible to more than one reasonable interpretation after
all provisions are construed, if possible, to give effect to
each.
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Missouri1, 2, 4, 5
|
In construing an insurance policy, the
words must be given their plain meaning, consistent with the
reasonable expectations, objectives and intent of the
parties. The language of an insurance policy is ambiguous
when it is reasonably and fairly open to different
constructions. The words will be tested in light of the
meaning which would normally be understood by the average lay
person. The lay person's definition will be applied unless it
plainly appears that the technical meaning is intended.
|
Canadian Universal Insurance Co., Ltd. v.
Fire Watch, Inc., 258 N.W.2d 570, 572 (Minn. 1977); Standard
Artificial Limb, Inc. v. Alliance Ins. Co., 895 S.W.2d 205
(Mo. 1989); Krombach v. Mayflower Ins. Co., Ltd., 785 S.W.2d
728, 731 (Mo.App. 1990) Chase Resorts, Inc. v. Safety Mut.
Cas. Corp., 869 S.W.2d 145 (Mo.App. 1993).
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Montana2, 3
|
Looking to the Kansas rule which we have
adopted, we find that the test is not what the insurer
intended the words of the policy to mean but what a
reasonable person in the position of an insured would
understand them to mean.
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St. Paul Fire & Marine Ins. Co. v.
Thompson, 150 Mont. 182, 187, 433 P.2d. 795, 798 (Mont.
1968); Alpha Real Estate Development, Inc. v. Aetna Life
& Casualty Company, 570 P.2d 585 (Mont. 1977); Conal Ins.
Co. v. Bunday, 249 Mont. 100, 813 P.2d 974 (Mont. 1991).
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Ambiguity exists in an insurance contract
only when the contract taken as a whole in its wording or
phraseology is reasonably subject to two different
interpretations; language is ambiguous when different persons
looking at it in the light of its purpose cannot agree on its
meaning.
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Nebraska2, 5
|
An insurance policy should be interpreted
in accordance with the reasonable expectations of the insured
at the time of the contract. A contract of insurance should
be given a reasonable construction so as to effectuate the
purpose for which it was made. In cases of doubt, it is to be
liberally construed in favor of the insured.
|
Modem Sounds & Systems Inc. v.
Federated Mut. Ins. Co., 200 Neb. 46, 49, 262 N.W.2d 183, 186
(1978); Decker v. Combined Ins. Co. of America, 244 Neb. 281,
505 N.W.2d 719 (Neb. 1993); Union Ins. Co. v. Land and Sky,
Inc., 247 Neb. 696, 529 N.W.2d 773 (Neb. 1995).
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Ambiguity exists in an insurance contract
when it can be fairly interpreted in more than one way, and
the word, phrase or provision in question is susceptible to
at least two conflicting meanings; the dictionary meaning of
terms may be used.
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Nevada1, 2, 3, 4
|
An insurance policy is to be judged from
the perspective of one not trained in law or in insurance,
with the terms of the contract viewed in their plain,
ordinary and popular sense. A reading of the provision must
include reference to the entire policy and must be read as a
whole in order to give reasonable and harmonious meaning to
the entire policy.
|
Transamerica Ins. Group v. State Farm
Mut. Auto Ins. Co., 492 F.Supp. 283 (D. Nev. 1980) (Applying
Nevada Law); Nat'l Union Fire Ins. Co. v. Reno's Executive
Air, 100 Nev.360 364, 682 P.2d 1380, 1392 (Nev. 1984);
Siggelkow v. Phoenix Insurance Co., 109 Nev. 42, 846 P.2d 303
(Nev. 1993).
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Ambiguity exists if the court determines
language is reasonably susceptible to more than one meaning
by plain language; exclusionary clauses are strictly
construed against the insurer.
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New Hampshire1, 2, 3
|
Courts look to the plain and ordinary
meaning of words in their context and construe terms of the
policy as would a reasonable person in the position of the
insured based on more than a casual reading of the policy as
a whole.
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Concord General Mut. Ins. Co. v.
Mitchell, 138 N.H. 229, 637 A.2d 903 (N.H. 1994);High Country
Associates v. New Hampshire Ins. Co., 648 A.2d 474 (N.H.
1994); Niedzielski v. St. Paul Fire & Marine Ins. Co.,
134 N.H. 141, 146, 589 A.2d 130, 133 (N.H. 1991).
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Ambiguity exists that will be construed
in favor of the insured and against the insurer if the
language of the policy reasonably may be interpreted more
than one way and one interpretation favors coverage.
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New Jersey1, 4, 5
|
Insurance contracts are to be construed
in accordance with the reasonable expectations of the average
policyholder. In the absence of a specific definition in an
insurance policy, the words must be interpreted in accordance
with their ordinary, plain and usual meaning. Ambiguity
exists if the phrasing of the policy is so confusing that the
average policyholder cannot make out the boundaries of
coverage; at this point the courts can resort to the doctrine
of reasonable expectations.
|
Killeen Trucking Inc. v. Great American
Surplus Lines Ins. Co., 211 N.J.Super. 712, 715, 716, 512
A.2d 490 (App.Div. 1986); Daus v. Marble, 207 N.J.Super. 241,
636 A.2d 1091 (N.J.Super. A.D. 1994); Nunn v. Franklin Mut.
Ins. Co., 274 N.J.Super. 543, 644 A.2d 1111 (N.J. 1994).
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New Mexico2, 3 |
The well established test in
New Mexico is that where terms used are ambiguous, the test
is not what the insurer intended its words to mean, but
rather what a reasonable person in the position of the
insured would understand them to mean. Ambiguity exists if
language is reasonably and fairly susceptible to different
constructions; policy should be construed as a whole;
exclusions are enforced so long as they are clear and do not
conflict with public policy expressed by statute. |
Williams v. Herrera, 83 N.M.
680, 496 P.2d 740 (N.M.App. 1972); Curtis v. Aetna Life Ins.
Co., 560 P.2d 169 (N.M.App. 1976); New Mexico Physicians Mut.
Liability Co. v. Lamure, 116 N.M. 92, 860 P.2d 734 (N.M.
1993). |
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New York1, 3, 4 |
Clear and unambiguous terms
should be understood in their plain, ordinary, popular and
non-technical sense and they should be given the meaning of
an ordinary business person in applying for insurance and
reading the language of the policies when submitted. In
order to determine whether contract of insurance is
ambiguous, all provisions must be construed as one entire
contract and must be read and interpreted in light of each
other. |
Vanminos v. Merkley, 48 A.D.2d
281, 369 N.Y.S. 246 (N.Y. 1975); United States Fid. &
Guar. Co. v. Annonizata, 67 N.Y.2d 299, 232, 501 N.Y.S.2d
790, 492 N.E.2d 1206 (N.Y.Ct.App. 1993). |
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North Carolina1,
2 |
An undefined term is given its
ordinary meaning unless the context in which the term is used
in the policy requires that it be given a different meaning.
In addition, an insurance contract is to be construed as a
reasonable person in the position of the insured would have
understood it. Ambiguity exists when the language used in a
policy is susceptible to different and conflicting
interpretations, the policy being construed as a reasonable
person in the position of the insured would have understood
it. |
Grant v. Ins. Co., 295 N.C.
39, 243 S.E.2d 894 (N.C. 1978); West American Insurance Co.
v. Tufco Flooring East, 104 N.C. App. 312, 409 S.E. 692 (N.C.
Ct. App. 1991); United Services Auto Ass'n v. Gambino, 114
N.C.App. 701, 443 S.E.2d 368 (N.C.App. 1994). |
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North Dakota1, 2,
4 |
A term in an insurance policy
should be construed to mean what a reasonable person in the
position of the insured would think it meant. When a contract
uses words that have an ordinary meaning, extrinsic evidence
should not be used to show that the words were used in some
other sense. Moreover, an insurance policy must be
interpreted to give effect to the mutual intention of the
parties. Custom cannot be used to prove the meaning of words
and phrase unless all parties are chargeable with knowledge
of the custom. Ambiguity exists if a contract can be
reasonably construed as having at least two alternate
meanings considering whether a person not trained in the law
or in the insurance business can clearly understand the
language. |
Haugen v. Auto-Owners Ins. Co.
of Lansing, 191 N.W.2d 274, 279 (N.D. 1971); Wal v. Penn Life
Ins. Co., 274 N.W.2d 208, 216-17 (N.D. 1979); Northwest G.f.
Mutual Insurance Co. v. Norgard, 518 N.W.2d 179 (N.D.
1994). |
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Ohio1, 2, 4 |
The words used in policy of
insurance must be given their ordinary meaning to an average
person, not the meaning such words might have to the very
wary or to someone skilled in the law. Interpretation of
words used in an insurance contract and words used in
advertising brochures of the insurance company will be
considered as they affect the thinking of ordinary person as
to the meaning of the words in the insurance policy.
Ambiguity exists if language is reasonably susceptible to
more than one interpretation after giving words and phrases
used their plain, ordinary, natural or commonly accepted
meaning. |
Craver v. Union Fidelity Life
Ins. Co., 298 N.E.2d 918 (Ohio App. 1973); King v. Nationwide
Ins. Co., 35 Ohio St.3d 208, 519 N.E.2d 1380 (Ohio
1988). |
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Oklahoma1, 2, 3 |
Under Oklahoma law related to
insurance contracts, the terms of the parties contract, if
unambiguous, clear, and consistent, are accepted in their
plain and ordinary sense, and the contract will be enforced
to carry out the intention of the parties as it existed at
the time of the contract. Ambiguity exists where meaning of a
contract term is uncertain, or the term can bear more than
one reasonable interpretation; contract construed as a whole
with all words and phrases taken in context; insurance
contracts are liberally construed consistent with the object
sought to be accomplished so as to give a reasonable effect
to all of its provisions. |
Dodson v. St. Paul Ins.Co.,
812 P.2d 372 (Okla. 1991); American Cas. Co. v. FDIC, 958
F.2d 324 (10th Cir. 1992). |
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Oregon4 |
We interpret the terms of an
insurance policy according to what we perceive to be the
understanding of the ordinary purchaser of insurance. Also
any ambiguity in any exclusionary clause is strictly
construed against the insurer. Ambiguity does not
automatically arise when one clause provides coverage and
another excludes the coverage under certain
circumstances. |
Stanford v. American Guaranty
Life Ins. Co., 280 Or. 525, 527, 571 P.2d 909 (1977); Botts
v. Hartford Acc. & Indem. Co., 284 Or.95, 100, 585 P.2d
657 (1978); Totten v. New York Life Ins. Co., 696 P.2d 1082
(Or. 1985); Schutt v. Farmers Ins. Group of Companies, 129
Or.App. 401, 879 P.2d 1303 (Or.Ct.App. 1994). |
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Pennsylvania1 + Majority
Rule Factors re Construc-tion |
If words of policy are clear
and unambiguous, court must give words their plain and
ordinary meaning. When term of policy is ambiguous, however,
and intention of parties cannot be discerned from face of
policy, then the Court, in its attempt to arrive at
reasonable construction of policy that is in accord with
parties apparent intention, may look to extrinsic evidence of
purpose of insurance, its subject matter, situation of
parties, and circumstances of contract. |
Pacific Indemnity Co. v. Linn,
766 F.2d 754 (3d Cir. 1984); Musisko v. Equitable Life
Assurance Soc'y, 344 Pa.Super. 101, 496 A.2d 28 (Penn. 1985);
Safeguard Scientifics v. Liberty Mut. Ins. Co., 766 F.Supp.
324 (E.D.Pa. 1991). |
|
Rhode Island1, 5
|
The Terms should be given their plain,
ordinary and usual meaning. If there remains any doubt, the
terms should be read in the same sense that the insurer had
reason to believe would be the way they would be interpreted
by the ordinary reader and purchaser. The test to be applied
is not what the insurer intended by the words, but what the
ordinary reader and purchaser would have understood them to
mean.
|
Elliott Leases Cars Inc. v. Quigley, 118
R.i. 721, 326 373 A.2d 810, 812 (R.I. 1977); Hughes v.
American Universal Ins. Co., 423 A.2d 1171 (R.I. 1981);
Pressman v. Aetna Cas. & Sur. Co., 574 A.2d 757 (R.I.
1990).
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South Carolina2, 3, 4
|
In the absence of a prescribed definition
in the policy, the term should be defined according to the
ordinary and usual understanding of the term's significance
to the ordinary person. Ambiguity exists when language used
is reasonably susceptible to more than one meaning when the
contract is read as a whole giving words used their plain,
ordinary meaning; exclusions are strictly construed against
the insurer.
|
Green v. United Ins. Co. of America, 254
S.C. 202, 174 S.E.2d 400 (1970); Mcpherson v. Michigan Mut.
Ins. Co., 412 S.E.2d 445 (S.C. 1991); USAA Property &
Cas. Ins. Co. v. Rowland, 435 S.E.2d 879 (S.C.App. 1993).
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South Dakota1, 2,
3 |
An insurance policy is
ambiguous when it is fairly susceptible to two constructions.
Ambiguity in an insurance policy is determined with reference
to the policy as a whole and the plain meaning and effect of
its words. If the language of the policy is ambiguous, the
policy should be construed liberally in favor of the insured
and strictly against the insurer. If the policy is
unambiguous however, its terms are to be construed according
to the plain and ordinary meaning. |
Mcgraff v. U.S. Fire Ins. Co.,
436 N.W.2d 859) (S.d. 1989); Sunshine Ins. Co. v. Sprung, 452
N.W.2d 782, 784 (S.D. 1990); American Family Mut. Ins. Co. v.
Elliott, 523 N.W.2d 100 (S.D. 1994). |
|
Tennessee1, 2, 3
|
In determining whether the meaning of a
contract is clear or ambiguous courts apply the following
principles. The language in dispute must be examined in the
context of the entire agreement. Words must be given their
usual and ordinary interpretation. The language of a contract
is ambiguous when its meaning is uncertain and when it can be
fairly construed in more than one way. Insurance policies
almost always being written by the insurance company, are
strictly construed in favor of the insured.
|
Cockle County Bd. Of Highway Commrs. v.
Newport Utilities Bd., 690 S.W.2d 231, 237 (Tenn. 1985); Moss
v. Golden Rule Life Insurance Co., 724 S.W.2d 367
(Tenn.Ct.App. 1986) ; Gredig v. Tenn. Farmers Mut. Ins. Co.,
891 S.W.2d 909 Tenn.App. 1994).
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Texas1, 2, 3, 4
|
What controls is not the interpretation
of individual words which are not defined in the policy
itself, but the interpretation, which the ordinary person
would give to the phrase as a whole, taken in the context of
the whole policy. Ambiguity exists where language is
susceptible to more than one reasonable interpretation;
contract language is given its ordinary and generally
accepted meaning; insurer must be reasonable in the amounts
it gives to parties to settle claims when multiple claims
have been filed and there is only a limited amount of
insurance.
|
Security Mut. Cas. Co. v. Johnson, 584
S.W.2d 703 (Tex. 1979); Freeman v. Crown Life Ins. Co., 480
S.W.2d 897 (Tex.App.-Texarkana, 1979) reh.den.;Prudential
Ins. Co. of America v. Uribe, 595 S.W.2d 554 (Tex.App.-San
Antonio, 1980) reh.den.; Nationwide Prop. & Cas. Ins. v.
Mcfarland, 887 S.W.2d 487 (Tex.App.-Dallas, 1994)
reh.overruled; Texas Farmers Ins. Co. v. Soriano, 881 S.W.2d
312 (Tex. 1994)
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Utah2, 3 |
Because insurance policies are
intended for sale to the public, the language of an insurance
contract must be interpreted and construed as an ordinary
purchaser of insurance would understand it. Ambiguity exists
if language is fairly susceptible to different
interpretations as a matter of law, excluding any reasonable
expectations of the insured. |
Am. Casualty Co. v. Eagle Star
Ins. Co., 568 P.2d 731 (Utah 1977); Fuller v. Director of
Finance, 694 P.2d 1045, 1047 (Utah 1985); U.S. Fidelity &
Guar. Co. v. Sandt, 854 P.2d 519 (Utah 1993). |
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Vermont2, 3 |
Terms of liability policy will
be construed in accord with the policy's intended purpose
such that the language will be given an appropriate breadth
of meaning. Ambiguity exists if language is reasonably or
fairly susceptible to different constructions based on plain
meaning; contract must be construed as a whole for the
purpose of giving force and effect to each clause, if
possible; a dictionary can be used to define terms. |
Fish v. Nationwide Mutual Ins.
Co., 236 A.2d 658 (Vt. 1967); Town of Troy v. American
Fidelity Company, 120 Vt. 410, 143 A.2d 469 (Vt. 1958).
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Virginia1, 2, 3 |
Ambiguity exists if language
is reasonably or fairly susceptible of different meaning with
plain reading and intent of the parties, even if different
jurisdictions have reached different results in construing
similar policy language; each clause and phrase should be
construed together when it can be reasonably done, so as to
effectuate the intention of the parties as expressed therein;
reasonable policy exclusions not in conflict with a statute
will be enforced. |
Virginia Farm Bureau Mut. Ins.
Co. v. Hodges, 238 Va. 692, 696, 385 S.E.2d 196, 198 (Va.
1988); Cuna Mutual Ins. Society v. Norman, 375 S.E.2d 724
(Va. 1989); Floyd v. Northern Neck Ins. Co., 245 Va. 153, 427
S.E.2d 193 (Vir. 1993); Wool v. National Bank of Virginia,
N.a., 448 S.E.2d 613 (Va. 1994). |
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Washington2, 4
|
The language of the policy is to be
interpreted in accordance with the way it would be understood
by the average person, rather than in a technical sense. An
ambiguity exists in an insured contract if the language is
fairly susceptible to two different reasonable
interpretations. 3-part process: 1) ambiguity exists if
language is fairly susceptible to two different reasonable
interpretations interpreted as understood by the average
person rather than in a technical sense; 2) if ambiguity
exists, then the court may attempt to determine the parties
intent by examining extrinsic evidence; 3) if the policy
remains ambiguous after the application of extrinsic evidence
the court will apply the rule that ambiguities in insurance
contracts are construed against the insurer; the rule
strictly construing ambiguities in favor of the insured
applies with added force to exclusionary clauses which seek
to limit policy coverage.
|
Weyerhauser Co. v. Aetna Casualty and
Surety Co., 123 Wash.2d 891, 874 P.,2d 142 (Wash. 1994);
Santos v. Sinclair, 76 Wash. App. 320, 884 P.2d 941 (Wash.Ct.
App. 1994).
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West Virginia1, 2, 3,
5 |
It is well settled law in West
Virginia that ambiguous terms in insurance contracts are to
be strictly construed against the insurance company and in
favor of the insured. The doctrine of reasonable expectations
is that the objectively reasonable expectations of applicants
and intended beneficiaries regarding the terms of insurance
contracts will be honored even though painstaking study of
the policy provisions would have negated those expectations.
Ambiguity exists if after three rules are applied reasonably
prudent and intelligent people could honestly differ as to
the interpretation of the contract language: 1) contract read
as a whole; 2) policy language given its plain, ordinary
meaning; 3) policy should receive a reasonable interpretation
consistent with intent of the parties. |
Soliva v. Shand, Morahan &
Co. Inc., 176 W.Va. 430, 345 S.E.2d 33 (W.V. 1986); National
Mutual Insurance Co. v. Mcmahon & Sons, Inc., 177 W.Va.
734, 356 S.E.2d 488 (W.Va. 1987); Marcum Trucking v U.S.
Fidelity & Guaranty Co., 438 S.E.2059 (W.Va.
1993). |
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Wisconsin1, 2 |
Ambiguity exists when language
is fairly or reasonably susceptible to more than one
construction using plain language; not all insurance policies
are contracts of adhesion; in the case of insurance
contracts, the words are to be construed in accordance with
the principle that the test is not what the insurer intended
the words to mean, but what a reasonable person in the
position of an insured would have understood the words to
mean. Whatever ambiguity exists in a contract of insurance is
resolved in favor of the insured. |
Katze v. Randolph & Scott
Mut. Fire Ins. Co., 341 N.W.2d 689 (Wis. 1983); School Dist.
Of Shorewood v. Wausau Ins., 488 N.W.2d 82 (Wis. 1992); City
of Egerton v. General Cas. Co. of Wisconsin, 184 Wis.2d 750,
517 N.W.2d 463 (Wis. 1994). |
|
Wyoming1, 2, 3, 5
|
This court utilizes a standard of
interpretation for insurance policies which declares that the
words used are given the plain meaning that a reasonable
person, in the position of the insured, understands them to
mean. Ambiguity exists when language is capable of more than
one reasonable interpretation using the plain meaning of
words so that a reasonable person, in the position of the
insured understands them; contract read as a whole; extrinsic
evidence may not be admitted to contradict plain meaning.
|
Worthington v. State, 598 P.2d 796, 806
(Wyo. 1979); Doctors Co. v. Ins. Corp. of America, 864 P.2d
1018 (Wyo. 1993).
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|
against the insurer. If the policy is unambiguous
however, its terms are to be construed according to the plain
and ordinary meaning. </P>... <P>Mcgraff v. U.S.
Fire Ins. Co., 436 N.W.2d 859) (S.d. 1989); Sunshine Ins. Co.
v. Sprung, 452 N.W.2d 782, 784 (S.D. 1990); American Family
Mut. Ins. Co. v. Elliott, 523 N.W.2d 100 (S.D.
1994).</P>... <P><BR> </P>"...
<P>Tennessee1, 2, 3</P>... <P>In
determining whether the meaning of a contract is clear or
ambiguous courts apply the following principles. The language
in dispute must be examined in the context of the entire
agreement. Words must be given their usual and ordinary
interpretation. The language of a contract is ambiguous when
its meaning is uncertain and when it can be fairly construed
in more than one way. Insurance policies almost always being
written by the insurance company, are strictly construed in
favor of the insured.</P>... <P>Cockle County Bd.
Of Highway Commrs. v. Newport Utilities Bd., 690 S.W.2d 231,
237 (Tenn. 1985); Moss v. Golden Rule Life Insurance Co., 724
S.W.2d 367 (Tenn.Ct.App. 1986) ; Gredig v. Tenn. Farmers Mut.
Ins. Co., 891 S.W.2d 909 Tenn.App. 1994).</P>...
<P><BR> </P>"... <P>Texas1, 2,
3, 4</P>... <P>What controls is not the
interpretation of individual words which are not defined in
the policy itself, but the interpretation, which the ordinary
person would give to the phrase as a whole, taken in the
context of the whole policy. Ambiguity exists where language
is susceptible to more than one reasonable interpretation;
contract language is given its ordinary and generally
accepted meaning; insurer must be reasonable in the amounts
it gives to parties to settle claims when multiple claims
have been filed and there is only a limited amount of
insurance.</P>... <P>Security Mut. Cas. Co. v.
Johnson, 584 S.W.2d 703 (Tex. 1979); Freeman v. Crown Life
Ins. Co., 480 S.W.2d 897 (Tex.App.-Texarkana, 1979)
reh.den.;Prudential Ins. Co. of America v. Uribe, 595 S.W.2d
554 (Tex.App.-San Antonio, 1980) reh.den.; Nationwide Prop.
& Cas. Ins. v. Mcfarland, 887 S.W.2d 487
(Tex.App.-Dallas, 1994) reh.overruled; Texas Farmers Ins. Co.
v. Soriano, 881 S.W.2d 31
ar. Co. v. Sandt, 854 P.2d 519 (Utah 1993).VermontTerms
of liability policy will be construed in accord with the
policy's intended purpose such that the language will be
given an appropriate breadth of meaning. Ambiguity exists if
language is reasonably or fairly susceptible to different
constructions
Footnote1
American Jurisprudence, 20 Proof of Facts 2d 59, 68-71
(1979).
Footnote2
Keeton, Insurance Law Rights at Variance with Policy
Provisions, 83 Harv.L.Rev. 91, 967 (1970); Perrine v.
Prudential Ins. Co., 56 N.J. 120, 265 A.2d 521, 524-525
(1970); Dairyland Ins. Co. v. Wyant, 474 N.W.2d 514, 516
(S.D. 1991).
Footnote3
Dairyland Ins. Co. v. Wyant, 474 N.W.2d 514, 516 (S.D.
1991) ("This policy confines its coverage, in plain and
unmistakable terms, in compensatory damages arising from car
accidents, and it would be unreasonable to expect that
punitive damages might be covered merely because they were
not expressly excluded.")
Footnote4
Keller v. Safeco Ins. Co., 317 Ark.308, 877 S.W.2d 90
(1994).
Footnote5
Arkansas Farm Bureau Ins. Fed'n v. Ryman, 309 Ark.283,
831 S.W.2d 133 (1992).
Footnote6
North Dakota Law Review, Vol. 64:423 (1986)
("Insurance-Contracts-the Ambiguity in the Doctrine
of Reasonable Expectations"); Maine Law Review, Vol.
36:179 (1984); Baybutt Construction Corp. v. Commercial Union
Ins. Co.: a question of ambiguity in comprehensive general
liability insurance policy; Valparaiso University Law Review,
Vol. 21:361 ("Intentional Injury Exclusionary Causes:
The Question of Ambiguity"); Columbia Law Review,
Vol. 88:1849 ("Insurance Contract: The Argument for
Abandoning the Ambiguity Doctrine.")
Footnote7
This chart does not purport to be an exhaustive treatment
of the issue referenced.
© 1995, 1996 American Bar Association. All Rights
Reserved.
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