Does a medical payment provision in a long-term disability insurance plan allow a plaintiff to sue the insurer for negligence?
California, United States of America
The following excerpt is from Harper v. Wausau Ins. Co., 56 Cal.App.4th 1079, 66 Cal.Rptr.2d 64 (Cal. App. 1997):
[56 Cal.App.4th 1089] Although there are no California cases which have addressed the specific issue raised in this appeal, a number of other authorities have concluded medical payment provisions of the type presently before us provide exceptions to the general rule barring actions against the insurer for liability. This is because the medical coverage provisions provide direct obligations on the part of the insurer to the intended beneficiaries. (See Donald v. Liberty Mut. Ins. Co. (1994)
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