Medical payment coverage similar to exclusions that apply to liability coverage


Medical payments coverages exclusions apply only to the medical payments coverages, several of which are substantially similar to many of the exclusions that apply only to the liability coverages.

Residence Employees Off Premises

This exclusion precludes medical payments coverage for residence employees if bodily injury occurs away from an insured premises and does not arise out of or occur within the course of employment of the residence employee by an insured. Both of these conditions must exist for this exclusion to apply. As a result, this is a narrow exclusion.

In other words, if bodily injury to a residence employee occurs off premises, but within the course of employment, the medical payments coverage applies. Similarly, if the bodily injury to a residence employee occurs at an insured location, the medical payments coverage applies even if the bodily injury did not occur within the course of employment.

Workers Compensation

As with the liability coverage, the medical payments coverage does not apply to bodily injury to any person eligible to receive benefits pursuant to any workers compensation, nonoccupational disability, or occupational disease law. As with the liability coverage, workers compensation coverage is required to be provided by homeowners policies in many states.

Nuclear

As with all other portions of the ISO HO 2 and HO 3 homeowners policies, medical payments coverage does not apply to bodily injury from nuclear reaction, radiation, or radioactive contamination, however caused.

Residents

This exclusion provides that the medical payments coverage does not apply to any person who regularly resides on any part of any insured location, except for residence employees.

Other Comments

Exclusions applicable to the liability and medical payments coverages do not vary widely from insurer to insurer. Some insurers include exclusions for punitive or exemplary damages. In most, but not all, states, the punitive damages are noninsurable as a matter of law, although there are a few states where there is no such public policy. In those states, if insurers wish to avoid coverage for punitive damages, a separate exclusion needs to be included.

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Note: This article was sent to us by: Sandra Darphs at 10062010

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