Definitions in CGL Form Affect Coverage

Our insured is being sued along with the health insurance provider by a hospital because the health insurance provider has refused to pay a large hospital bill. The bill is for an employee's spouse. The CGL carrier has denied coverage for the lawsuit, but this general liability policy has a definition that has raised a question for us. This policy defines a claim as “any demand or suit made by an employee, dependent, and beneficiary”. Would this definition allow coverage for the hospital's lawsuit?

Arkansas Subscriber

The standard CGL insuring agreement applies to damages because of bodily injury or property damage, or to personal and advertising injury. These are all defined terms and even though your policy may cover any claim, that claim still has to be grounded in bodily injury or property damage or personal and advertising injury as defined. Refusing to pay a bill is not going to meet the definitions of any of these items in the standard CGL form; so if that is the sole basis for the claim, the CGL form will not afford coverage.