Q
The business auto coverage form has an exclusion that reads 'we will not pay for loss caused by or resulting from any of the following unless caused by other loss that is covered … blowouts, punctures, or other road damage to tires.' I understand that the policy would not pay for road damage to the tires, but the phrase 'loss caused by or resulting from' is confusing. Does this mean if the tire has a blowout and the car then veers into a tree, that the resulting damage is not covered?
Kansas Subscriber
A
If the phrase 'resulting from' were the end of the exclusion, then any loss that came about due to wear and tear or tire blowouts would be excluded from coverage. However, the extension of the exclusion's wording — 'unless caused by other loss that is covered' — limits the scope of the exclusion. For example, if the exclusion read 'we will not pay for loss caused by or resulting from blowouts or other road damage to tires,' then if the insured's car ran into a wall because a tire blew out, that collision damage could and probably would be excluded by some insurer. That would be a difficult thing for some courts to accept since the insured purchased collision insurance, and who is to say that the tire caused the damage and not the collision with the wall? This would strike many courts as illusory coverage and it would not be allowed.
So, by adding the phrase 'unless caused by other loss …' the insurer is saying that the tire blowout exclusion will not be used to deny coverage, if the car is damaged by some other cause of loss that the insured has purchased. Using the above example, the insured collided with a wall and that caused the damage. The fact that the tire blowout may have caused the car to veer off the road and may have eventually led to the car crashing into the wall is going to be considered as too remote, too far removed from the eventual damage to be considered as the cause of the damage.
The wording of insurance policies can be confusing, but that can work for the insured's benefit. If people can look at policy language and offer different but reasonable and logical interpretations as to the meaning of the language, then a judgment of ambiguity can be made against the policy. And of course, ambiguities are interpreted in favor of the insured.
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