PADI getting sued over Insurance Program

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1. I suppose I ought to make it my business to spend some quality time on Rick's site and/or take him out for drinks or dinner. The one time I talked to him on the phone, I really enjoyed it.

2. Insurance law, not garden variety personal injury, is what I primarily do. So, when I say Rhone Man was right on target, that means he was. As far as the Ferrari case, I have had to advise insurers on similar kinds of things. The case raises a few points:

a. The incident described would not fall under the liability coverage of any policy. If anything, the loss would be under the "comprehensive and collision" coverage. It would not be under the liability coverage as liability coverage does not apply to damage to property owned by or in the care, custody or control of any insured person. And, as far as the "comprehensive and collision" coverage, coverage would turn on whether the person who left the car did so with the intent or expectation of it being stolen.

b. Typically, liability insurance provides coverage for sums an insured becomes legally obligated to pay resulting from an "occurrence." Definitions of "occurrence" tend to vary a bit. However the definition generally talks about "an accident neither expected nor intended by the insured."

In the case where the two fellows were horsing around, the court ruled that since the fellow doing he throwing did not expect or injure the victim, there was an "occurrence." It explained: "The following paradigms are illustrative: During a pick-up baseball game, a batter hits the ball with the intention of sending it into deep right field for a homerun. But, because of the batter’s stance and the angle of contact with the ball, the batter sends the baseball in a trajectory that breaks a window in foul territory. The batter deliberately hit the ball and intended that it move far and fast. It cannot be said that this batter intended to cause the property damage, i.e., to hit a foul ball and break the window. This was an accident because one aspect in the causal series of events -- too much force at an inadvertent angle leading to the broken window -- was unintended by the batter, and as such was fortuitous. In the second example, an intentionally speeding driver negligently hits another car. The speeding was an intentional act; but, 'the act directly responsible for the injury -- hitting the other car -- was not intended by the driver and was fortuitous. Accordingly, the occurrence resulting in injury would be deemed an accident.' [Citation.] In these examples, the conduct resulting in harm was intended but the ultimate result was not because the actor mistakenly miscalculated the physics involved. [Citation.]"

Contrast these with the case where a woman sued a male co-worker for sexually assaulting her in the workplace. In seeking coverage from his liability insurer, the man asserted that he misinterpreted the woman's statements and actions as being a "come-on." Thus, he argued there was an "occurrence" because he had not expected or intended to harm the woman. In rejecting this, the court reasoned that the acts the man performed were exactly the ones he expected and intended to do, and the result he accomplished in doing them were exactly the results he expected and intended to accomplish. His only problem was that they were all unwelcome.

I am not willing to opine on taking an OW student to 200 feet on air is or is not an "occurrence." I'd need to know a lot more about the incident.
 
Actually If I remember right, the last case Rick was involved with, and the centerpiece at the last DEMA was very close. Well it involved a DM and Discover Scuba Diving in OW at depth, and bad conditions. IMHO Standards went out the window. Still Rick not only went after the DM, The Shop, The Insurance, But also after PADI. And won on all counts. The depositions are still on Ricks site, however the transcript from DEMA was successfully blocked by PADI lawyers.

Coverage was nevertheless triggered which Peter Guy indicated to be the rule with few, if any exceptions.
 
Coverage was nevertheless triggered which Peter Guy indicated to be the rule, with few, if any exceptions.

I meant to say that it was close to sending an OW student on a 200ft dive. Not close to not being covered, sorry for not being clear.

On the contrary. That case is an example not only of the Insurance responsibility, but also because of a loop hole, and bad wording in NG DSD The Agency was also responsible for the DM that clearly did not follow the standards.

IMHO, if the litigations are true, PADI opened the loop hole wide open, And if PADI looses, and profit from insurance is proven. Than PADI will not only be responsible for the $300K (pocket change) but also millions in future judgments.
For some reason I think Rick Lesser is setting PADI up for another law suit, and the proof of insurance involvement is just a stepping stone to tie PADI in as Financially responsible. But this is just my opinion and should be taken as such.
 
Coverage was nevertheless triggered which Peter Guy indicated to be the rule with few, if any exceptions.

Originally Posted by PRL
Actually If I remember right, the last case Rick was involved with, and the centerpiece at the last DEMA was very close. Well it involved a DM and Discover Scuba Diving in OW at depth, and bad conditions. IMHO Standards went out the window. Still Rick not only went after the DM, The Shop, The Insurance, But also after PADI. And won on all counts. The depositions are still on Ricks site, however the transcript from DEMA was successfully blocked by PADI lawyers.



You may remember that at the beginning of this year that new Cue Cards were required for DSD's?

And that the True/False "quiz" had been changed?

And that the DSD skills had been changed to include a "BCD Inflate/Deflate" skill?

These changes, as well as the exlcusions to coverage that "Thalassamania" quoted on page 11 of this thread came about as a direct result of the DSD's death that was referred to by "PRL".

PADI Standards violations were covered by V&B Insurance up until then. Now they are not covered. If you want to read between the lines on that case, read these exclusions :

BB) Any claim arising out of any “occurrence” in which the
insured failed to obtain a medical history form completed by the
student involved in the claim, prior to in-water instruction; and
in the case of a minor, the failure to have obtained the minor’s
parent’s or guardian’s signature on the medical history form.
Furthermore, this insurance does not apply if the medical history
form indicated any condition contrary to safe participation in diving
activities, and the insured failed to require the student to obtain
medical approval (based on a medical examination) by a licensed
physician, who is not the student, prior to in-water instruction.

CC) Any claim arising out of any “occurrence” during a training
dive in which the insured had not first obtained from the student
involved in the claim a signed release of liability/assumption of
risk form developed or approved by the certification organization
through which the training was offered; and in the case of
a minor, the failure to have obtained the minor’s parent’s or
guardian’s signature on the form.

FF) Any claim arising out of any “occurrence” involving instruction
in which the insured instructor and/or Dive Center/Resort
Operator has not maintained records for the purpose of recording
the progress of the student involved in the claim.

GG) Any claim arising out of any “occurrence” involving
instruction in which the insured instructor and/or Dive Center/
Resort Operator has not maintained records for the purpose of
evaluating the understanding of the instructional material by the
student involved in the claim.

HH) Any claim arising out of any “occurrence” involving instruction
in which the insured instructor and/or Dive Center/Resort
Operator has not retained all records relating to the individual
student involved in a claim, for a minimum of five (5) years.

II) Any claim arising out of any “occurrence” involving the
insured’s conduct of an introductory experience program (any
program designed to introduce uncertified divers to recreational
scuba diving via a supervised, controlled open water dive
experience) that was not in accordance with Recreational Scuba
Training Council (RSTC) standards. This exclusion does not apply
to confined water-only experiences being conducted by properly
certified divemasters, assistant instructors and instructors.


Do the math and you can probably figure out what happened.

The violations were so eggregious (horrible) that the DM, who had become an Instructor, and his wife and their company are no longer PADI Members.

The one to give thanks to for these exclusions would be the DM and the Dive Company involved in the death, not Rick Lesser, who represented the family.
 
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BB) Any claim arising .......

CC) Any claim arising .......

FF) Any claim arising .......

GG) Any claim arising .......

HH) Any claim arising ........

II) Any claim arising .........


Do the math and you can probably figure out what happened.

The one to give thanks to for these exclusions would be the DM and the Dive Company involved in the death, not Rick Lesser, who represented the family.

I'm not sure where I have the notes from the DEMA seminar, But I forgot just how many standards were supposedly violated.

Actually I disagree on one point. PADI was sucked in into the suit by their own doing in that case. And That's what Rick Lesser was waiting for. If PADI kept its nose out of the case, the outcome would be much different and settlement much smaller. Until PADI started defending the DM, Lesser had no way to drag PADI into the fight. That's what he does, and that's why he is so good. He finds a way to suck in the money cow. But that's just my opinion, and should be taken as such.
 
I'm not sure where I have the notes from the DEMA seminar, But I forgot just how many standards were supposedly violated.

Actually I disagree on one point. PADI was sucked in into the suit by their own doing in that case. And That's what Rick Lesser was waiting for. If PADI kept its nose out of the case, the outcome would be much different and settlement much smaller. Until PADI started defending the DM, Lesser had no way to drag PADI into the fight. That's what he does, and that's why he is so good. He finds a way to suck in the money cow. But that's just my opinion, and should be taken as such.

IF, as Mr. Lesser asserts, PADI has to pay the first $300,000.00 ... then PADI HAD to stick its nose in that case and defend the DM! Lesser was retained by the family of the deceased DSD, and apparently was under the impression that the insurance company was V&B.

With this newly discovered evidence of PADI's "deductible", it looks like they obviously had a dog in that fight!

I think Mr. Lesser's case has some merit. IMOH.
 
IF, as Mr. Lesser asserts, PADI has to pay the first $300,000.00 ... then PADI HAD to stick its nose in that case and defend the DM!

If I remember correctly, Mr. Lesser explained it that if PADI would not intervene than the maximum settlement would be the amount insured. There was no point to go after the assets of the DM or the shop since they were not worth the time. However once PADI took on the fight, PADI obligated it self financially, and the maximum $ amount was no longer the amount insured. This had nothing to do with the current case.
However like I pointed out just above, if its proven in the current case that PADI profited from the insurance in any way than their bank roll is fair game.

I have nothing against Rick Lesser. I think he does his job very well. And I am glad that he is in my corner.

As usual, this all is just my opinion and should be taken as such.
 
I wish PADI no ill. I also do not like attorneys enriching themselves which causes all of us to pay more for our goods and services. The tone of some against PADI is a bit too gleeful. PADI has made diving accessible to many and I certainly would not want to see them fail.

As far as PADI not being upfront with their finances in regards to insurance - was this really to gouge people, or to offer insurance at a less expensive rate by having the organization responsible for their (contributing) members?

Again, we should be careful about judging others and watch our "glee" when others get into trouble. Someday the shoe could be on the other foot. My hope is that this case would get straightened out with minimal expenses and all could be sure of their coverage. But in a country which pays out thousands of dollars to attorneys and a person who spills hot coffee on themselves - well, anything can happen.
 
As far as PADI not being upfront with their finances in regards to insurance - was this really to gouge people, or to offer insurance at a less expensive rate by having the organization responsible for their (contributing) members?

Maybe someone should be asking these questions :

1. Does it matter where the $2.5 million (or more each year) went?

2. What is the difference between what it costs PADI for the Master Policy and what PADI charges its DM's, Instructors and various levels of Dive Centers ?

3. Did any of the $2.5 million (or more each year) inure/enrich any individual(s) ?

4. How about charging PADI DM's, Instructors and various levels of Dive Centers LESS MONEY for their insurance coverages ?

Inquiring minds need to know. IMHO.
 

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