The question I have is regarding a loss which occurred in IL and is looking at the ISO HO-3 10/00 for coverage. The named insured's (NI) live in girlfriend falls off the deck due to the railing not being maintained appropriately by the NI. She dies as a result of her injuries. Our NI is looking to his HO3 to respond to the suit he has received from her family. I say there is coverage because she is not considered an “insured” by definition and Section II exclusion F.6. does not apply. My co-worker says the policy will not respond because she is a resident of the household.

Illinois Subscriber

You are correct that she is not an insured by definition. She is not related to the insured by blood, and was not in the care of the insured or another resident relative. The definition does not change under Section II other than for persons having custody of the insured's animals or watercraft, neither of which is the case here.

Medical payments provides coverage for people on the “insured location” with permission of the “insured”, which fits this situation.

However, under G. Coverage F Medical Payments to Others 4. coverage does not apply to any person “regularly residing on any part of the “insured location”. So there is no coverage under medical payments.

Remember that Coverages E and F are separate coverages; Coverage E pays for injury caused by an occurrence to which the coverage applies. Under the personal liability coverages and exclusions, the exclusion for injury to “insured” does not apply as she was not an “insured” by definition. There is coverage under personal liability, but no coverage under medical payments. There is a duty to defend and coverage under coverage E Personal Liability.