7th Circuit: Fatal Crash Not Covered Because Vehicle Not on Policy

By Jim Sams | April 14, 2020

An insurance carrier is not liable for a fatal crash caused by an ambulance that was not listed on its commercial policy, even though the business thought that the vehicle had been added, the 7th Circuit Court of Appeals ruled.

The appellate court affirmed a ruling by the trial court, finding that the terms of United Emergency Medical Services’ policy required any changes to the vehicles insured to be specifically listed on an endorsement issued by Markel Insurance Co. The court was not persuaded by arguments that United had been “lulled” into believing only an email was required to amend coverage.

Christopher Sofko was killed on Jan. 2, 2016 when his vehicle collided with a United EMS ambulance driven by Abraham Nadermohammadi on U.S. Highway 30 in Schereville, Indiana. His death sparked a dispute that pitted United and its driver against Markel and its agent, Insurance Service Center. Sofko’s guardian, Lilian Rau, also pursued claims against Markel and United.

Along the way, Erie Insurance Co. joined the fray as an intervenor. Sofko was covered under an uninsured motorist policy issued by Erie, so the outcome of the dispute impacted its liability.

United EMS’s administrative director, Steven Pavek, testified that he had emailed the Insurance Service Center asking agent Jack Rosen to an ambulance labeled Ford #4497 to be added to the policy and that another vehicle be removed. Pavek never followed up on that request, even though in the past the company had received written endorsements from Markel when changes were made.

United EMS did not realize Ford #4497 was not listed on the policy until after the crash that killed Sofko. Rosen said he never received the email.

The district court found Markel had no duty to defend or indemnify United or Nadermohammadi. It denied cross-motions from Rau and United for summary judgment against Markel.

The 7th Circuit said it does need to know what happened with the email sent by United to decide that Markel is not liable. It is undisputed that neither the Insurance Service Center or the carrier had accepted or responded to United EMS’s request to add Ford #4497 to the policy, the court said.

The court also rejected an argument that ambulance companies should be treated in the same way as commercial motor carriers, which regularly take vehicles in and out of service and do not list each vehicle specifically on their insurance policies. The court said under federal law, commercial motor vehicles must weigh more than 10,000 pounds. Ford #4497 weighs less, the court said.

Finally, the court was not persuaded by an argument that United EMS had been “lulled” into believing that its vehicle was covered because Markel had accommodated all of the company’s previous requests for policy changes. Rau argued that equity required coverage because the requested changes did not affect the amount of the premium.

“Markel’s amenability to past changes … did not mean that it was estopped from rejecting amendment requests,” the opinion says.

About Jim Sams

Sams is editor of the Claims Journal, a part of Wells Media Group. He can be reached at jsams@wellsmedia.com. More from Jim Sams

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