Contra Proferentum Does Not Apply, to a Clear and Unambiguous Policy: No Coverage Before Policy In Effect.

• Author: Zalma, Barry
• Position: [ON MY RADAR]

People who sue insurance companies seem to forget that an insurance policy is a contract - not an entitlement provided by a government. Insurance contracts must be read as a whole document and all clear and unambiguous terms must be applied as written.

In Atlantic Specialty Insurance Company v. Sergey Pastukov, No. 18-11129, United States Court Of Appeals For The Eleventh Circuit, (October 10, 2018) the Eleventh Circuit was asked to provide insurance coverage for Sergey Pastukov who was involved in a truck accident on May 14, 2015 before a policy with Atlantic Specialty Insurance Company was in effect.

Atlantic Specialty denied his claim and later sought a declaratory judgment to establish that it was not obligated to cover his accident. The district court agreed and granted judgment in Atlantic Specialty's favor.

Before the district court, Atlantic Specialty provided three reasons for which it was not obligated to provide coverage for Mr. Pastukov's accident. First, it argued that his claim was not covered because his loss occurred before coverage began. Second, it argued that he was not eligible for coverage under the policy because he did not meet the requirements of a "Contract Driver" or an "Owner-Operator." Finally, it asserted that his claim was barred by the known loss doctrine.

The district court adopted the second basis, finding that Mr. Pastukov was never eligible for coverage. It rejected Mr. Pastukov's contention that the contract's terms were ambiguous and held that there is "no interpretation of the language of the [Certificate of Insurance] under which [he] qualifies for coverage, either as a Contract Driver or an Owner-Operator."

THE POLICY

According to the insurance contract, under the provision entitled "Your Coverage Effective Date;' Mr. Pastukov's "coverage under the Policy beg[an] on the latest of:"

(1) the policy effective date

(2) the date you become a member of an eligible class as described above; or

(3) the date upon which the program administrator or its designee approves your fully completed and signed enrollment form.

Mr. Pastukov's Policy stated an effective date of May 14, 2015. His coverage began, however, when the Program Administrator approved his application on May 29, 2015.

ANALYSIS

Under Florida law, insurance contracts are construed according to their plain meaning. The policy terms should be given their plain and unambiguous meaning as understood by the man-on-the-street. If the relevant policy...