![](https://cdn.agencyequity.com/wp-content/uploads/2013/08/insurance-newsletter_logo-2-lines-transparent-702x526.png)
Case #1
Kennebec County, Maine (31218)
The plaintiff in this action was the principal owner and operator of a painting contractor business. The defendant was an insurance agent with whom the plaintiff had dealt in obtaining various insurance policies. The plaintiff contended that he had specifically requested that the defendant obtain Workers' Compensation coverage as well as automobile and Comprehensive General Liability coverage. The plaintiff brought suit against the defendant alleging that the defendant failed to procure the Workers' Compensation coverage as promised and then misrepresented to the plaintiff that the Workers' Compensation policy was in effect, leaving the plaintiff unknowingly without coverage. The plaintiff's cause of action against the defendant insurance agent proceeded on theories of breach of contract, negligent misrepresentation and fraud.
The evidence indicated that following the plaintiff request of the defendant to place his Workers' Compensation Coverage, an employee of the plaintiff made a Workers' Compensation claim for an injury allegedly suffered on the job. The plaintiff maintained that it was not until this claim was made by his employee that the plaintiff discovered that he had no Workers' Compensation insurance. The plaintiff was forced to expend his own money in investigating and defending the claim. The plaintiff was successful in his defense of the claim made by his employee. The plaintiff then sued the defendant agent for failing to place the Workers' Compensation Coverage as requested by the plaintiff.
The defendant denied liability and asserted that he fulfilled his duties to the plaintiff by ensuring that the plaintiff's original Workers' Compensation policy with Hanover Insurance Company continued. The defendant offered evidence indicating that shortly after the plaintiff requested that the defendant place his Workers' Compensation coverage, the plaintiff received a renewal notice and a bill for payment of his premium due by January 1, 1990. The defendant maintained that the plaintiff's Workers' Compensation coverage was not renewed because the plaintiff ignored the bill. The plaintiff countered that he justifiably assumed that he would get a bill for the Workers' Compensation coverage through the defendant agency as per his other insurance policies. The plaintiff additionally testified that in January or early February of 1990, before his employee's accident, the plaintiff telephoned the defendant and asked if his Workers' Compensation coverage was in effect. The plaintiff maintained that the defendant assured him at that time that the coverage was fine.
The defendant maintained that he justifiably assumed that the plaintiff had paid his premium when he made such assurances. The defendant called a witness from Hanover Insurance who established that the plaintiff's Workers' Compensation bill was and always had been issued directly from Hanover. The defendant argued that the plaintiff, therefore, had no reason to assume that this standard procedure, of which he was aware, would change.
The plaintiff sought to recover the costs which he expended in defense of his employee's claim in the amount of $100,000. The jury found for the defendant. Bouchee vs. Lash. Case no. CV89/209; Judge Chandler, 3-91. Attorney for plaintiff: Peter Dawson; Attorney for defendant: James Roux of Skelton, Taintor & Abbott in Auburn, Me.
Commentary
The credibility of the plaintiff was a central aspect in this case brought against the defendant insurance agent for his alleged negligence in failing to procure the plaintiff's workers' comp coverage as requested. The jury apparently was unwilling to believe that the plaintiff was unaware that his coverage had lapsed in light of the fact that he had undisputedly received a renewal notice from the comp carrier advising that a premium was due by January first 1st if his coverage were to continue. The plaintiff attempted to convince the jury of his genuine confusion arising out of the fact that he received all his insurance bills directly through the agent, a practice which he maintained he assumed would apply to his comp coverage upon requesting that the agent handle this policy as well. The jury was apparently more impressed with the defendant's argument that that the plaintiff had dealt with Hanover Insurance for a number of years and was, therefore, aware of their direct billing policy.
The case(s) cited herein was(were) reprinted with the permission of the publisher Jury Verdict Review Publications, Inc. www.jvra.com
These real life claims scenarios and jury verdicts are sponsored by InsuranceNewsletters.com, the premier provider of client newsletters for Insurance Agencies. While AgencyEquity.com will feature cases that are of interest to insurance agencies, InsuranceNewsletters.com content will focus on cases that are of interest to insurance consumers. Properly educating clients on real life situations helps them better understand the need for proper liability coverage. To learn more, go to InsuranceNewsletters.com.