Insurer refuses to pay ATV accident claim, suit says

By Kelly Holleran | Feb 19, 2010

An Ellis Grove woman has filed suit against her insurance company, alleging it would not pay for injuries her daughter sustained after an ATV accident.

Carrie Lutman claims her daugher, Geanene Lutman, was injured in an ATV accident on July 19.

According to the complaint filed Feb. 16 in Madison County Circuit Court, both Carrie Lutman and her daughter should have been covered by defendant Meritain Health, which had issued Carrie Lutman a group health plan.

However, Meritain refused to pay medical bills Geanene incurred after seeking treatment for her injuries, the suit states.

"The basis of said denial was an exclusion that occurs on page 31 of the above referenced contract of insurance and is set out as subparagraph 13," the complaint says. "It states as follows: Hazardous Hobby or Activity. Care and treatment of an injury or sickness that results from engaging in a hazardous hobby or activity. A hobby or activity is hazardous if it is an activity which is characterized by a constant threat of danger or risk of bodily harm. Examples of hazardous hobbies or activities are skydiving, auto racing, hang gliding, jet ski operating or bungee jumping."

Still, Carrie Lutman contends her daughter's injuries should have been covered.

"Defendant is aware or should be aware that such exclusion is required by specific language," the suit states. "No where in said exclusion does the writing of an ATV is mentioned."

Because of the company's refusal to pay for the injuries, Carrie Lutman has suffered damage to her credit rating and sustained undue hardship, burden and emotional distress, the complaint says.

In her two-count suit, Carrie Lutman is seeking a judgment of more than $100,000, plus other relief the court deems just.

Edward W. Unsell of East Alton will be representing her.

Madison County Circuit Court case number: 10-L-169.

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