Real-life scenarios

Boating fun quickly turns serious

The claim arises out of a boating accident. The policyholders are the owners of a speedboat, which is considered a “family” boat and made available to other members of the family for recreational use.

Several family members were camping at a lake near the policyholders’ residence. One of the policyholders allowed them to use the boat during their stay. The policyholders’ 15-year-old grandson was allowed to take three other family members (all minors) out on the lake to go tubing. The 10-year-old claimant had just finished tubing. The tube and tow rope were placed in the stern of the boat and the claimant was sitting next to them.

The conditions on the lake suddenly became very choppy and windy. The claimant was ejected from the rear of the boat along with the tube and the tow rope. The tow rope wrapped around the claimant’s neck, causing a significant injury.

The occupants of the boat recovered the claimant and headed for the dock, flagging down the sheriff’s patrol boat on the way. The claimant lost consciousness and the deputy had to administer CPR several times. She was airlifted to the hospital.

The claimant suffered an injury to her neck, trachea, esophagus as well as a fracture of the second cervical vertebrae. She was on a ventilator for 96 hours and in ICU for almost one month. Later, she developed serious complications to her pancreas, colon and gall bladder and suffers from ongoing extreme hoarseness with continued troubles with her breathing.

The RLI Personal Umbrella Policy contributed $700,000 on top of the primary coverages.

Life can change in an instant

Shortly after sunset, the insured was driving her minivan on a two-lane roadway. Near an intersection, she struck a bicycle driven by a 14-year-old girl (Girl #1), who suddenly crossed in front of her. The accident occurred adjacent to a park where football and soccer practice had just let out.

There were six witnesses to the accident, including the girl’s best friend (Girl #2) who was riding next to her. Witnesses saw both girls initially start across the road, but then Girl #2 stopped. Girl #1 kept going and was struck. All witnesses agree that the insured van was traveling well within the 45 mph speed limit (the insured maintains that she was going approximately 35 mph), that the insured did not apply her brakes or take any evasive action, and that Girl #1 did not look both ways before crossing the road. With the exception of one witness, who is a close friend of Girl #1’s family, the remaining witnesses are consistent in their testimony that the insured probably did not have time to avoid the accident.

Girl #1 was thrown onto the hood, hit the windshield and was launched into the air, landing in a ditch where she was found unconscious. She was not wearing a helmet. She suffered a brain stem injury, head fracture, brain hemorrhage and multiple compound fractures of the right leg. She remained in the hospital for 90 days. She was released with weakness in all four limbs and was in minimally responsive states, requiring maximum assistance with all activities of daily living. Girl #1 remains on a feeding tube and school records show that she attends a special education program.

The insured driver is now 70 years old and initially gave a statement. She later provided a doctor’s note stating that forcing her to testify about the incident would be detrimental to her health and cause severe emotional distress. Her initial statement asserts that she never saw Girl #1 until she hit her. Girl #1 was hit by the van on the front passenger side corner, indicating that she was almost all the way across the lane when she was hit.

The defense’s position claimed the insured’s failure to act was reasonable in that she had no time to see and react to the sudden movement of the bicyclist. The final decision was that the insured should have had time to observe the plaintiff, Girl #1, and take evasive action.

The claim was ultimately closed, with the RLI Personal Umbrella Policy paying $681,000.

SEE motorcycles on the road

The 76-year-old insured pulled forward out of her driveway, making a left turn into the path of a motorcycle, which was coming out of a curve. The operator of the motorcycle applied his brakes and “laid it down,” but struck the quarter panel of the insured’s vehicle.

The insured was cited for traffic violations. The motorcycle passenger (wife of the motorcycle operator), died at the scene. She is survived by her husband, four children (ages 7 to 15), her parents, grandparents and several siblings. The motorcycle operator suffered a fractured finger and abrasions and had a valid “bystander’s claim” under state law.

The RLI Personal Umbrella Policy contributed $640,000, above the primary policies.

The day no parent wants to see

The insured, age 59, was employed to care for an 8-month-old infant. While attempting to negotiate a curve, she crossed the center line and collided head on with a pickup truck, which was pulling a trailer of construction equipment.

The only witnesses are the two 19-year-old occupants of the truck. They both state the insured vehicle appeared to be traveling too fast for road conditions. The insured has no memory of the event and there are indications the insured had experienced blood sugar level problems in the past. A hypoglycemic attack may have contributed to this accident.

The infant died later that same day at a children’s hospital of injuries received in this accident. Her medical bills were approximately $60,000. Her parents are college educated and the mother is in the insurance industry. They contend that their daughter would have obtained at least an undergraduate degree and earned at least $80,000 per year from ages 24-62.

The two occupants of the truck were injured, but their claims settled within the underlying auto policy. The claim was ultimately settled, with the RLI Personal Umbrella Policy paying $550,000.

Run a stop sign, run a risk

The insured’s 26-year-old daughter was driving the insured vehicle when she pulled away from a stop sign, striking the claimant’s vehicle. The claimant had no stop sign at the intersection.

The insured’s daughter was cited for failure to yield. Plaintiff (age 17) sustained multiple fractures to her jaw, scarring to the forehead, a severed left ear and a dental injury. She spent seven days in the hospital, where records also confirm memory loss and a combative disposition.

Underlying auto limits of $250,000 / $500,000 were in place and the insured’s daughter was listed specifically on the RLI Personal Umbrella Policy application as a driver. RLI ultimately paid $500,000 under the policy.