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Loss of Consortium Claim Treated as Bodily Injury Under New Mexico Automobile Insurance Policy

On Behalf of | Jul 15, 2019 | Insurance Bad Faith

The United States District Court for the District of New Mexico recently ruled against an insurance company, and in favor of the wife of a man who was killed when the motorcycle he was driving was hit by a car.  The motorcyclist sustained fatal physical injuries while driving down San Mateo Blvd NE in Albuquerque, New Mexico after the driver of an automobile made a left turn resulting in a collision.  The driver who struck the motorcyclist was insured, and his insurance company provided a defense when the wife of the deceased motorcyclist sued the driver in state court on behalf of her husband’s estate and on her own behalf for loss of consortium. The parties’ settlement talks allegedly hit an impasse when they could not agree on the policy limit of the automobile driver’s insurance policy, which resulted in the insurance company bringing a declaratory action in federal court to resolve the issue.

The parties agreed that the insurance policy had a limit of $100,000 per person and $200,000 per accident.  The insurance company argued that even though the wife of the deceased motorcyclist asserted claims on his behalf as well as on her own behalf for loss of consortium, there was a physical injury to one party only and the so the per person limit applied.  The wife of the deceased motorcyclist asserted in response that there were two bodily injuries, hers and her husband’s, so the higher per accident insurance policy limit of $200,000 applied.

To resolve the dispute over the extent of coverage under the insurance policy the district court applied New Mexico law, which resolves disputes over insurance policies by interpreting their provisions in accordance with the same principles that govern the interpretation of contracts.  The court explained that, under the controlling law, when policy language is clear and unambiguous, courts must give the contractual language effect and enforce the insurance policy as written.

The insurance policy defined “Bodily Injury” to mean bodily harm, sickness, disease or death.  The policy also stated: “Bodily Injury” does not include mental injuries such as emotional distress, mental anguish, humiliation, mental distress or any similar injury unless it arises out of physical injury to some person.”  The insurance company stressed that the wife’s injuries were derivative of her husband’s, rather than separate.  The court looked to the policy language and observed that the insurance company could have effectuated its stated intent by defining bodily injury to include no mental injuries or only mental injuries suffered by the “same” person physically injured, as opposed to “some” person. Or, the court observed, the insurance company could have clarified that damages sustained by anyone else as a result of a physical injury are part of the “each person” coverage.  The court agreed with the wife of the deceased motorcyclist with respect to her argument, which the court characterized as straightforward, that her loss of consortium claim was a “mental injury” that “arises out of physical injury to some person,” i.e. the deceased motorcyclist.  Concluding that two people suffered bodily injury in the accident under the terms of the driver’s insurance policy, the court ruled that the per occurrence limit of $200,000 applied.

If you or a loved one has been injured in an accident, or if you have lost a loved one in an accident, there may be grounds for a financial recovery.  An award of monetary damages can help people with out-of-pocket costs, including medical costs, lost wages, and pain and suffering.  Insurance companies are among third parties that may be responsible for paying costs resulting from an accident, depending on the circumstances.  To understand more about your case and how it can be pursued in ways that maximize your recovery, call New Mexico personal injury lawyer Matthew Vance at the Law Office of Matthew Vance, P.C.  We provide a free consultation and can be reached at 505-445-1604 or online.