Insurance companies often go to great lengths to avoid paying
benefits, if they can get away with it. Here's a brief summary of a case
that just ended last year, after appeals, in which Hartford Insurance
Company did all it could to get out of paying the widow of a dead
diver.
Larry Fuller, an Arkansas resident, was diving in Mexico with the
Snorkel Center, aboard the dive boat El Magnifico, with 18 other
divers. He motioned the dive boat for assistance after experiencing
trouble with his regulator, but drowned after grabbing the dive
boat's ladder in an attempt to board the boat.
Fuller had common carrier travel insurance with Hartford,
through his membership in the Exxon Travel Club. The policy provided
coverage for injury that "occurs while [the insured] is ... a passenger
on, boarding, or alighting from a common carrier." Hartford
refused Fuller's widow's claim for $500,000 in accidental death benefits
under the policy, forcing her to sue.
Hartford argued, among other things, that Fuller's injury did
not occur while he was boarding El Magnifico, as required by the
policy. They claimed he was injured before attempting to board the
dive boat, when he first experienced trouble with his regulator and
his lungs began to fill with water.
The court slapped that silly notion down by saying, "We disagree
with Hartford's attempt to parse the undisputed facts so finely. It
appears Mr. Fuller's lungs were filling with water both before and
after he grabbed the boat's ladder and attempted to board. Thus,
his injury was an ongoing one and is not limited to the period preceding
his fateful attempt to board the dive boat. The policy neither
addresses nor excludes coverage for a continuing injury that starts
before (and is still occurring while) an insured boards a common
carrier."
Hartford also argued that there is no coverage unless both the
"accident" (the event that caused the intake of water into Fuller's
lungs) and the "injury" occur during the boarding process, because
the policy required an injury to result "directly from accident." The
court said, "the word 'directly' requires a causal relationship between
accident and injury, not a simultaneous temporal relationship.
Hartford could have written the policy in a manner that required
the accident to occur during boarding, but did not."
Ms. Fuller was awarded $500,000 by the United States Court of
Appeals, Eighth Circuit.