Question: I have a complaint coming in against a carrier for a situation that is actually quite common, except for the way the insurance carrier is acting. Mother and adult daughter are residing in same home, but each has her own auto policy. Adult daughter backs into mother's vehicle. Mother files the claim with her own carrier. Because the Property Damage portion of the personal auto policy (PAP) prevents it from paying for damage to another resident relative's vehicle, the daughter's carrier will not reimburse the mother's carrier for the cost of those damages. Now the mother's carrier is subrogating directly to the adult daughter. Since a PAP defines a resident relative, such as a child, also as an "Insured", they are essentially subrogating against their own insured. Have you heard of the Anti-Subrogation rule?

— Virginia Subscriber

Answer: There is no such exclusion in the property section of the ISO form. Under liability, coverage is excluded only for vehicles, "other than your covered auto" (and) owned by a family member. If daughter has a separate car on a separate insurance policy with a different carrier, then her policy should cover this. If it's a separate policy through the same carrier, it should still provide coverage. If the mom and daughter are on the same policy then the insurer can't subrogate against itself, but otherwise it should be covered. The statute Va. code Ann.§ 38.2-207 states that: "Except for contracts or plans subject to § 38.2-3405 or § 38.2-2209, when any insurer pays an insured under a contract of insurance which provides that the insurer becomes subrogated to the rights of the insured against any other party the insurer may enforce the legal liability of the other party. This action may be brought in its own name or in the name of the insured or the insured's personal representative." The two sections referenced apply only to hospital, surgical, medical insurance, and not auto coverage. |

Covering accident damage to a prosthetic

Question: We have a named insured driver who has a prosthetic leg that was damaged in an auto accident. The prosthetic leg now needs to be replaced. Would the cost of the new prosthetic leg be covered under the medical pay coverage portion of the personal auto policy?

— Illinois Subscriber

Answer: It is true that medical pay applies to reasonable expenses for necessary medical services but the coverage is based on bodily injury. Replacing a prosthetic leg is actually a property damage claim, however, and med pay only applies to bodily injury. |

Who pays for first responder accident cleanup?

Question: It is my understanding that the expenses incurred by a fire department to clean up hazardous substances in the roadway, which were caused by an auto accident, should be covered under the personal auto policy. However, we are reviewing a complaint where the carrier is stating that the town that had its fire department perform the clean-up did not sustain bodily injury or property damage and so, the insurer is denying the claim. I would greatly appreciate your insight.

— Vermont Subscriber