In a case handed down last week, the Missouri Supreme Court sent a clear message to the insurance company defendant--that the insurance company is responsible for using clear, unambiguous language in their insurance policies. If the insurance company fails to use language that an ordinary person of average abilities would understand, then any ambiguity is construed in favor of the person who is insured under the policy. The case is Burns v. Smith and Farmers Alliance Mutual Insurance Company of Kansas, (Mo banc SC90041, Jan. 26, 2010)
Eric Burns recovered a judgment in excess of $2 million against Lynn Smith for damages he received when a weld that Mr. Smith had placed on a cement mixer failed, causing the truck to explode and seriously injure its driver, Mr. Burns. Mr. Smith was insured under a policy of insurance issued by Farmers Alliance Mutual Insurance Company. Farmers denied coverage, claiming that language contained within a policy exclusion for "business pursuits" precluded insurance coverage under the policy. Although the insurance company argued strongly that the word "and" sometimes means "or" and should be read that way in their policy, the Supreme Court wasn't persuaded. In a 7-0 ruling, the court stated that at best, accepting Farmers' argument would mean only that the use of the word "and" is sometimes ambiguous and was in this case.
It is well settled Missouri law that any such ambiguity must be construed against the insurance company.
If your insurance denies a claim that you feel should be paid, consult with attorneys who are familiar with insurance company tactics. Who among us hasn't been confused by policy language that seems to grant coverage in one place, only to exclude it in another? The team of insurance lawyers at Tatlow, Gump, Faiella and Wheelan, LLC, of Moberly, Missouri, has the expertise and experience to tackle your insurance denials.
