Download PDF - Goodmans

Case Law Digest Supplement
PROPERTY & CASUALTY GUARANTY FUNDS
Purpose & Construction of Guaranty Association Laws
Purpose & Construction of Guaranty Association Laws – In General
Nebraska Nebraska Life & Health Ins. Ass’n v. Dobias, 247 Neb. 900, 531 N.W.2d 217 (1995).
Provisions of Act requiring a liberal construction “does not grant us a license to
add words . . . .”
Ohio Lake Hospital Systems v. Ohio Ins. Guar. Ass’n, 69 Ohio St. 3d 521, 634 N.E.2d 611
(1994). “There is no need to liberally construe a statute whose meaning is
unequivocal and definite.”
Direct Insurance
Line of Business
Florida Zinke‐Smith v. Florida Ins. Guar. Ass’n, 304 So.2d 507 (Fla. Dist. Ct. App. 1974).
The insured qualified as a self‐insured, but had a policy with a large deductible.
The court held the policy was not reinsurance, but direct insurance analogous to
collision coverage with a deductible.
Oklahoma
Pennsylvania
South Carolina
Wichita National Life Ins. Co. v. State of Oklahoma, Unpublished (Ok. Civ. App.
1991). Amounts due under a reinsurance contract from an insolvent insurer are
not covered.
Garcia v. Pennsylvania Financial Responsibility Assigned Claims Plan, 455 Pa.
Super. 360, 688 A.2d 209 (1997). 15 USC 3901, et seq., specifically excludes
policies issued by Risk Retention Groups from coverage under the Model Act.
South Carolina Prop. & Cas. Ins. Guar. Ass’n v. Carolinas Roofing & Sheet Metal
Contractors Self‐Ins. Fund, 315 S.C. 555, 446 S.E.2d 422 (1994). The insured had a
policy with a large deductible and the court held the arrangement was one of
reinsurance and not direct insurance.
Excluded Lines – Health
Alabama Alabama Ins. Guar. Ass’n v. Stephenson, 514 So.2d 1000 (Ala. 1987). The
Association was denied credit for payments made by a health insurer because
the statute excluded health insurance from coverage.
Indiana
Indiana Ins. Guar. Ass’n v. Davis, 768 N.E.2d 902 (Ind. Ct. App. 2002). Under
Indiana Code § 27‐6‐8‐11’s non‐duplication of recovery provisions, the calculation
of “amount payable” does not take into account types of direct insurance
excluded under § 27‐6‐8‐4. Accordingly, the Associations’ obligations may not
be reduced by paid health insurance benefits because such insurance is
expressly excluded under § 27‐6‐8‐4.
Excluded Lines – Mortgage Guaranty
Louisiana
Commercial National Bank in Shreveport v. Louisiana Ins. Guar. Ass’n, 19th
Judicial Dist., Parish of East Baton Rouge, La. (1993). The court held the
Association liable for return premiums on policies covering loan payments,
stating that the policies were not mortgage guaranty, an excluded line, but
were for credit life.