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Insurance Coverage Denials Leave Acquitted Defendants Without Insurance

There are many issues that need to be resolved when one has been accused of a crime. There are the preparations that need to be made upon arrest (everything from getting an attorney, to posting bail, receiving a hearing date, etc.), preparations that need to be made for the criminal proceedings that are about to occur, and preparations for post-criminal proceedings that may include such things as an appeal strategy, the expenses and costs of an attorney, and the expenses and costs if you are actually charged with the criminal offense. What is not considered are the additional costs that may be attributed if an injury, harm, or damage resulted from the alleged offense. For example, if you are injured as a result of the alleged activity you are being charged with, what happens if your health insurance decides to deny coverage for those issues?

Insurance Companies’ ‘Illegal Act Exclusions’

Many insurance companies have provisions within their terms and conditions that allow the insurance company to deny coverage when an injury occurs as a result of illegal activity. The purpose of the provision was to protect insurance companies for having to pay out and incentivizing illegal activities and crime. However, criminal defendants who are arrested but are ultimately acquitted may still pay the price even if they are not responsible for what occurred, and are injured or harmed as a result.

The Scope of the Exclusion

The provision, known as the “illegal act exclusion,” provides that if an injury resulted from the commission of a felony. The scope of this exclusion has been applied broadly to not only felonies, but to misdemeanors and traffic infractions. The exclusion can also touch a person who is injured as a result of a felony, misdemeanor or traffic infraction but who was not actually convicted or charged with a crime.

Applicability of the Exclusion to Misdemeanors and Traffic Infractions

What has become the center of public debate regarding this exclusion is the applicability of the exclusion to misdemeanors or traffic infractions that do not even come close to the threshold of a felony or illegal act: as a result, based on a technicality, someone may lose coverage, for example, if he or she was in a car accident but the car was unregistered, uninsured, and had not been to an inspection in a while. The court, however, disagreed with the defendant’s understanding of “illegal” to mean criminal and extended the scope of the exclusion to encompass misdemeanors and traffic violations that may just require the payment of fines.

Applicability to Acquitted Defendants

Also at the center of the issue is the exclusion applying to defendants who were never charged with or convicted of a crime, stating that the purpose of the policy’s exclusion may have different considerations than the prosecution’s decision to not convict or charge. The reasoning behind this was that a prosecutor’s decision to not convict or charge may be due to other external factors that have nothing to do with an actual acquittal of the defendant from the crime; the policy’s purpose to not cover individuals’ injuries resulting from illegal acts is independent of the prosecutor’s reasoning.

Applicability of the Exclusion to Juveniles

The courts have also declined to apply the exclusion differently when the crime was committed when the person was an adult than when he/she was a juvenile. In other words, being a juvenile at the time of the crime does not impact the applicability of the exclusion.

Experienced Criminal Defense Attorney in Fort Lauderdale

If you or a loved one has been arrested for a criminal offense, It is important to speak with an experienced criminal defense attorney like Kevin J. Kulik. Contact Kevin J. Kulik today for a free and confidential consultation in the Fort Lauderdale area.

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