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Tort Law Study Guide Chs. 18-19

For third-party claims, because the insured has almost no control over the processing of the claim against her, most courts impose a higher duty on the insurer, sometimes referred to as an “____ consideration” standard. Under this standard, the question is not whether the insured’s position was just “fairly debatable” but rather whether the insurer gave ____ consideration to the insured’s interests as it gave to its own interests.
Under workers’ compensation systems, the amount of compensation to be paid to an injured worker is limited by putting a cap on the monthly wage they can be paid, and the injured employee is paid only a ____ of what his or her average monthly wage was before the accident.
An ___ judgment is a judgment for more than an insurance policy's limits. The insured is liable for the amount of the judgment that exceeds policy limits.
The reasonable ____ doctrine protects the insured’s reasonable ____ that insurance coverage will be provided and not defeated by provisions that would be unanticipated by the ordinary insured and that were never negotiated between the insured and the insurance carrier. The court will reform the contract to the reasonable ____ of the insured even though a detailed review of the contract itself does not support those _____.
Workers’ compensation laws provide lost wages and medical expenses until the injury is resolved for ___ ___ , such as back injuries, where there is more variance in symptoms and expenses.
An ____ ____ ____ is the judicial figure that often presides over workers’ compensation hearings where claims are disputed.
In a ____ party bad faith case the insured demands payment from the insurer in their own right, for their own claim/injuries.
Under the “___ debatable” standard, if a claim submitted by an insured is ___ debatable, the insurer’s actions in refusing to pay the claim will not constitute bad faith. This standard is often used as the standard in first-party claims (insured v. insurer for insured’s own claim). Insurer may still be liable in a breach of contract action, but not liable in an additional tort claim for additional damages.
Where courts find there is a ____ of adhesion, typical in insurance contracts, they scrutinize such contracts to protect the insured’s contract rights as well as their “reasonable expectations.”
Intentional or self-inflicted injuries and those caused by intoxication are ____ from compensation under most states' workers’ compensation laws.
___ ____ systems were intended to provide fast and efficient relief (medical expenses and lost wages) to injured workers without regard to fault.
Pain and suffering, and emotional distress are generally ____ compensated for in workers’ compensation systems.
Workers’ compensation laws provide a fixed benefit (usually a set number of months’ compensation) for ____ ____, such as loss of a limb or an eye, without regard to actual lost wages or medical expenses.
A ___ ___ tort can occur when an insurance carrier: a. Unreasonably delays payment. b. Acts unconscionably toward its insured. c. Engages in unfair claims practices.
An insurance carrier that defends its insured under a reservation of ___ initially tells its insured it will provide a defense to the claim. but the carrier reserves its ___ to later deny that coverage exists, in which case it can withdraw the defense previously offered.
An insurer can file a ___ judgment action against its insured to determine if coverage exists and thereby avoid a bad faith claim for refusing to pay.
______ contracts are characterized by the courts as those contracts in which the party drafting the contract has superior bargaining power and the other party is typically unfamiliar with the terms of the contract and also has no real opportunity to negotiate what those terms will be.
In a ____ party bad faith claim, the insurer pays damages to not to the insured but to a ____ party who the insured or his property has injured or harmed.