Repwest Ins. Co. v. Portland Adventist Medical Center

Summarized by:

  • Court: Oregon Court of Appeals
  • Area(s) of Law: Insurance Law
  • Date Filed: 04-26-2017
  • Case #: A156948
  • Judge(s)/Court Below: Tookey, J. for the Court; DeHoog, J.; & Sercombe, P.J.
  • Full Text Opinion

It is reversible error to submit questions of coverage to the jury in absence of factual questions.

Defendant-Insured (“Adventist”) appealed the trial court’s declaratory judgment that Plaintiff-Insurer (“Repwest”) was not required to cover Defendant-Insured’s excess payments it made to an employee. On appeal, Adventist claimed the denial of its motion for directed verdict was improper, arguing that the loss was covered as a matter of law, and should not have been decided by the jury. Repwest argued that it should not be bound to Adventist’s decision to process the employee’s claims as aggravations of earlier, covered injuries, because Adventist was motivated to process the claims as such to preserve coverage, against Repwest’s interests. Adopting the trial court’s interpretation of the policy language, the Court of Appeals concluded that the loss was covered and that, to contest coverage based on the insured’s motivations, Repwest would have needed to file a claim addressing the insured’s behavior. Reversed and remanded. 

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