Medical Payments for Preventive Medical Care?

Our insured operates a small retail store and she always kept her pet dog on the premises. The dog had the run of the store and was friendly and would always interact with the customers. Recently, the dog died and it was suspected that the dog may have had rabies. Tests were to be done on the dog but they were delayed due to bad weather effectively closing down the area. The insured notified her recent customers about the dog and some of them went to receive anti-rabies vaccinations. The customers received two or three of the vaccinations in the series before the tests on the dog showed that it did not have rabies.

The insured wants to pay for the vaccinations under the medical payments section of her CGL policy, but the insurer denied coverage, saying that there was no bodily injury suffered here. We think there ought to be coverage because the vaccinations were taken to prevent bodily injury and perhaps even death, and med pay coverage is supposed to be for goodwill purposes. What is your opinion?

Wisconsin Subscriber

The costs incurred in this case are not covered by the medical payments section of the CGL form. The policy states that medical payments are covered if they result from an accident causing bodily injury. Bodily injury is a defined term, and bodily injury did not occur here. Although preventive vaccinations were thought by some customers to be necessary, and may have even been medically justifiable, the insuring agreement of the medical payments section of the CGL form was not met. Unless the dog actually bit one of the customers, there was no bodily injury and that is what med pay covers. Med pay can be used as a goodwill tool for a business, but the insuring agreement still has to be met for medical payments to be made.

 

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