Plain language mandated for Insurance EOC’s Evidence of Coverage – Policy

#Plain Meaning Rule
How to read a policy

How to read and figure out the law or Insurance Policy Provisions – Evidence of Coverage

• Read the Statute – Policy
• Read the Statute – Policy
• Read the Statute – Policy
• Then when you think you understand it, read it again
  • Then as my cousin reminded me – one needs to check Westlaw, Google or the Talmud to see how the courts have interpreted the law, their might be some jiggery pokery – malarky going on.
  • Check your Insurance Company Evidence of Coverage EOC  one big advantage of the EOC is that it’s in Plain English.
• Scroll down for more…

• Felix Frankfurther – Wikipedia

  

Plain language makes it easier for the public to read, understand, and use government communications.

Modern insurance policies, as a result of state statutes, are required to be written in plain language or easy to read language sufficient for anyone with a fourth-grade education can understand.  “Sesame Street English.” ^{Merlin Law Group}

The Plain Writing Act of 2010 was signed on October 13, 2010. The law requires that federal agencies use clear government communication that the public can understand and use.

While the Act does not cover regulations, three separate Executive Orders emphasize the need for plain language: ^{E.O. 12866, E.O. 12988, and E.O. 13563.}

• plain language.gov/law/ 
  • Training Videos
  • plain language.gov/guidelines/
• California Globe – Plain English
  • CA Government Code 11340 – 11342.4

• Contra proferentem is a rule of contract interpretation that states an ambiguous contract term should be construed against the drafter of the contract. The term contra proferentem is derived from a Latin phrase meaning “against the offeror.”

  Contra proferentem has become increasingly important with the rise of contracts of adhesion. Contracts of adhesion involve pre-written contracts which are offered on a strict take-it or leave-it basis, leaving no opportunity for a party to bargain over specific contractual terms. Because the party does not have an opportunity to negotiate, they may reasonably interpret a term in a different manner than the contract offeror intended. Contra proferentem exists to place the burden of ambiguity on the party most capable of mitigating that ambiguity – the person who wrote it.

  The doctrine of contra proferentem is also especially important in the field of insurance law due to the generalized nature of many of its terms. For example, it may be unclear if a policy that covers “water damage” will cover damage caused by a rainstorm induced mudslide. The doctrine of contra proferentem encouraged insurance providers to create enumerated lists of events that are excluded under a given policy, ultimately increasing clarity for insurance purchasers.  Source  Cornell Law * 

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More on How to read a contract – Insurance Policy 

The starting point in statutory construction is the language of the statute – Evidence of Coverage itself. The Supreme Court often recites the “plain meaning rule,”  as in, King vs Burwell Subsidies in Health Care.Gov upheld, that, if the language of the statute is clear, there is no need to look outside the statute to its legislative history in order to ascertain the statute’s meaning.

Parol Evidence Rule Wikipedia – Contract stands by itself – can’t bring up discussions or agreements that were prior to actually signing the written Contract

The plain meaning of the contract will be followed where the words used—whether written or oral—have a clear and unambiguous meaning. Words are given their ordinary meaning; technical terms are given their technical meaning; and local, cultural, or Trade Usage of terms are recognized as applicable. The circumstances surrounding the formation of the contract are also admissible to aid in the interpretation.  ^{West’s Encyclopedia of American Law},

A cardinal rule of construction is that a statute should be read as a

Harmonious Whole,

with its various parts being interpreted within their broader statutory context in a manner that furthers statutory purposes.  A provision that may seem ambiguous in isolation is often clarified by the remainder of the statutory scheme — because the same terminology is used elsewhere in a context that makes its meaning clear, or because only one of the permissible meanings produces a substantive effect that is compatible with the rest of the law.”

In Edgar v. MITE Corp., 457 U.S. 624 (1982), the Supreme Court ruled: “A state statute is void to the extent that it actually conflicts with a valid Federal statute.” In effect, this means that a State law will be found to violate the supremacy clause when either of the following two conditions (or both) exist:^[3]

1. Compliance with both the Federal and State laws is impossible, or
2. “…state law stands as an obstacle to the accomplishment and execution of the full purposes and objectives of Congress…”

Supreme Court – FINAL Ruling – Plain Meaning – No Jiggery Pokery 47 Pages, view our highlights, annotations & bookmarks

The

doctrine of privity in contract law

provides that a contract cannot confer rights or impose obligations arising under it on any person or agent except the parties to it.

The premise is that only parties to contracts should be able to sue to enforce their rights or claim damages as such. However, the doctrine has proven problematic due to its implications upon contracts made for the benefit of third parties who are unable to enforce the obligations of the contracting parties. en.wikipedia.org

 In tort law, a duty of care is a legal obligation imposed on an individual requiring that they adhere to a standard of reasonable care while performing any acts that could foreseeably harm others. It is the first element that must be established to proceed with an action in negligence. The plaintiff must be able to show a duty of care imposed by law which the defendant has breached. In turn, breaching a duty may subject an individual to liability in tort. The duty of care may be imposed by operation of law between individuals with no current direct relationship (familial or contractual or otherwise), but eventually become related in some manner, as defined by common law (meaning case law). wikipedia.org/

Elements