Medical Payments Coverage for Guest on

Tenant Homeowners Policy

Q

Our insured has a tenant homeowners policy. His mother was visiting him, and, while there, was assaulted by the insured's estranged wife. The mother filed charges against the wife, and as a result of the action the wife was ordered to pay $500 to cover the medical bills. As it turned out, the bills amounted to around $1400. A claim for the additional bills was turned in to the insured's carrier. The carrier denied payment, stating the insured's mother would be indemnified twice for the same injury, and that the insurer had been precluded from subrogating against the wife because of the insured's mother's actions.

What is your opinion?

Virginia Subscriber

A

The insured's mother will not recover more than the total amount of her loss. The limit of liability on the insured's medical payments is $1,000. She has been reimbursed $500, so the amount remaining is $900. This is recoverable under the insured's policy.

The fact that the insurer was not party to the mother's filing charges is immaterial, since the section I and II conditions subrogation clause states “Subrogation does not apply under section Ii to medical payments to others or damage to property of others.”

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