No coverage for excess medical bills, Court of Appeals decides

The North Carolina Court of Appeals has held in James v. Integon National Insurance Company that a driver of a motor vehicle did not have access to the underinsured motorists (UIM) coverage of his fiance, because the driver lived with his fiance and she had not listed him on her policy. The driver was involved in an accident while driving his fiance’s car. His medical bills were more than the $50,000 coverage held by the driver who hit him. Therefore, he turned to his fiance’s policy. Integon, the insurance company that issued the policy, objected, saying it had required the fiance to list every member of her household on the policy, and while the fiance had listed her mother, she did not list her fiance, even though he also lived with her. The Court of Appeals agreed that the failure to list the fiance was a material misrepresentation by the policy holder, and coverage was denied. This was true even though the fiance did not intend to commit any fraud against the company.

Lesson: When you fill out forms given to you by your insurance company, be sure to give complete answers. You could lose coverage because of a misrepresentation.