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By: Seth Kirby
In a previous blog entry we discussed the concept of “micro-language” and its relationship to insurance coverage disputes. In essence, this concept is a recognition that people ascribe different meanings to words and phrases based upon their interactions with other speakers throughout their life. For instance, if your family constantly refers to the television remote as the “clicker,” then “where is the clicker?” may be the first phrase that comes out of your mouth when searching for the remote between the cushions of the couch. This concept goes beyond slang terms and it affects the way people perceive written and spoken communication. Whether a phrase sounds like “proper” English to a listener is dependent upon the linguistic influences that person has been exposed to throughout their life.
In the insurance world, if a policy fails to clearly and unequivocally define its terms, courts will interpret the language in a manner most favorable to the policy holder. But how does a carrier define the terms of coverage, when people cannot agree on what basic phrases mean? A shining example of this difficultly was provided by the Georgia Court of Appeals this year in American Strategic Ins. Corp. V. Helm where a policy holder had been in an accident while driving his four passenger golf cart. The policy excluded coverage for injuries sustained while operating a motor vehicle, except for motorized golf carts designed to carry “up to 2 persons.” The carrier argued that the policy did not provide coverage for the accident because the golf cart at issue was designed to carry more than 2 people. The court found that the policy provision was ambiguous and refused to enforce the exclusion because the language “up to 2 persons” could be reasonably understood to impose a minimum requirement that covered golf carts must seat at least two people. Since this golf cart held more than two people, the accident was covered by the policy.
Now consider similar language in the context of mountain climbing. The rope that you are about to use as a safety device has a warning stating “This rope is designed to support weight up to 300 lbs.” Would it be reasonable to assume that you need to exceed 300 lbs. in order to safely use the rope? Perhaps you should have some other climbers join in on the rope to ensure that you exceed the 300 lbs. limit? Or perhaps not. It seems clear that we are not all speaking the same language when it comes to policy interpretation.