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Two Small Words, One Great Divide

BY Joseph G. Grasso
September 02, 2015

Even the smallest words can carry controlling meaning. At least, that's what the Supreme Court of Pennsylvania held in Mutual Benefit Insurance Company v. Politsopoulos, where it joined the majority of other jurisdictions that have considered the issue in holding that a policy providing an exclusion for an employee of “the insured” meant an employee of the insured seeking coverage under the policy, but not of any of the other insureds under the policy, or even of the Named Insured.

This question, involving the interpretation of two seemingly straightforward words, has lingered in the insurance industry for over 50 years. In 1961, the Insurance Counsel Journal published an article by Norman Risjord and Jane Austin, titled “Who Is 'The Insured'” Revisited, which addressed just this question. Risjord and Austin explained that insurers had always intended the term “the insured” to refer only to the entity claiming coverage. However, at that time, nearly all courts that had addressed the issue had reached a different conclusion ' holding that “the insured” could mean any of the insureds under the policy. “Ironically, this is the only known situation where many of the courts persist in erring in favor of the insurance companies.” Norman E. Risjord and Jane M. Austin, “Who Is 'The Insured'” Revisited, 28 Ins. Counsel. J . 100, 101 (1961) (emphasis in original).

In order to clarify that “the insured” meant solely the insured seeking coverage, the National Bureau of Casualty Underwriters and the Mutual Insurance Rating Bureau created a new condition called the “Severability of Interests” condition. That condition states that the insurance applies separately to each insured against whom claim is made or suit is brought. Therefore, the insured seeking coverage would necessarily be considered separately from any other insured.

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