Monday, January 23, 2006

consumer - insurance - duty of insured to cooperate in investigation of claim

Murphy v. Federal Insurance Company - ED Pa. - January 18, 2006

http://www.paed.uscourts.gov/documents/opinions/06D0056P.pdf

Defendant's motion for summary judgment granted. Plaintiff breached his contract when he unreasonably refused to cooperate in the insurer's investigation of his claim, to the prejudice of the insurer.

Interpretation of an insurance contract is a question of law. Where a policy is ambiguous, it should be construed against the insurer. If the terms are clear and not ambiguous, the court must give effect to the plain language. Here there was a clear contractual duty of the insured to cooperate in the investigation. His refusal to do so had a prejudicial effect on the insurer.

Donald Marritz
MidPenn Legal Services

UC - willful misconduct - refusal to obey ER direction - insubordination

ATM Corp. of America v. UCBR - Commonwealth Court - January 23, 2006

http://www.courts.state.pa.us/OpPosting/CWealth/out/1560CD05_1-23-06.pdf

Held, refusal of Claimant (CL) to agree to request of employer (ER) for background check was insubordination and willful misconduct.

CL had been an accounting clerk for ER for 4 years w/o incident. In February 2005, ER adopted a new policy and directed CL and all others in the accounting dept. to sign a consent for a background check. There was no ER rule at the time of CL's hire about such checks, although there was a rule about insubordination. CL refused to sign, claiming that the request was overbroad and unreasonably intrusive. ER advised CL that her continued refusal would be grounds for dismissal for insubordination. CL's job involved handling sensitive information, including credit card info, social security numbers, addresses, loan info, etc., and gave her access to large sums of money. There was a specific ER concern about identity theft.

The Court held that CL's refusal to consent to the background check violated the ER rule about insubordination, and that CL did not have good cause for her refusal, thus making her actions willful misconduct. It said that it was "beyond peradventure that Employer has a legitimate need to protect the confidential information of its customers to which accounting department employees, including Claimant, have daily access. A background check is a "reasonable way to protect that confidential information, particularly where demanded by Employer's financial partners and customers. Such background checks are not unique, which is why their occurrence must be disclosed by employers under the Fair Credit Reporting Act [15 USC sec. 1681a(h)]....[T]he Authorization Form conformed to the requirement of federal law." The court said the if a background check of the type identified in the FCRA was "too intrusive on Claimant, it is difficult to imagine for what employment positions it would ever be appropriate." The ER direction was "reasonable under the circumstances, and Claimant's refusal to cooperate was willful misconduct." In addition, the court said that the CL's failure to articulate specific reasons for her refusal "was itself a form of insubordination."

Donald Marritz
MidPenn Legal Services

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