16.2 Coverage B Personal/Advertising Injury and Coverage C Medical Payments
Key Takeaways
- Coverage B is offense-based personal and advertising injury: false arrest, malicious prosecution, wrongful eviction, slander or libel, violation of privacy, use of another’s advertising idea, and infringing copyright, trade dress, or slogan in an advertisement.
- Coverage B exclusions remove knowing violations, insureds in media or internet-type businesses, most contractual liability, failure of goods to conform to quality statements, wrong description of prices, and intellectual property other than advertising idea, copyright, trade dress, or slogan in an ad.
- Coverage C Medical Payments is no-fault medical expense for bodily injury caused by an accident on the premises or because of operations; a $5,000 per-person limit is a common CGL declarations figure, not a statute.
- Medical payments do not apply to the insured, to employees entitled to workers compensation, or to the products-completed operations hazard.
- Supplementary payments—defense expenses, limited bail-bond cost, and limited loss of earnings to attend hearings—apply to Coverages A and B and are typically paid in addition to the limits of insurance.
16.2 Coverage B Personal/Advertising Injury and Coverage C Medical Payments
Quick Answer: Coverage B is personal and advertising injury—named offenses, not a second copy of Coverage A. Think false arrest, malicious prosecution, wrongful eviction, slander or libel, violation of privacy, use of another’s advertising idea, and infringing copyright, trade dress, or slogan in an advertisement. Coverage C Medical Payments is no-fault medical expense for bodily injury caused by an accident on premises the insured owns or rents, on ways next to those premises, or because of the insured’s operations. A $5,000 per person medical-expense limit is a common CGL declarations amount, not a law. Coverage C does not cover the insured, employees, or products-completed operations. Supplementary payments (defense costs, limited bail bonds, limited loss of earnings to attend hearings) apply to A and B and are typically in addition to limits.
Coverage B: named offenses, not “hurt feelings”
Coverage B pays sums the insured is legally obligated to pay as damages because of personal and advertising injury to which the insurance applies. The insurer also has a duty to defend suits seeking those damages. The trigger is an offense committed in the coverage territory during the policy period (occurrence form), not an occurrence of BI/PD. ISO lists the offenses. If the claimant’s theory is not on the list, Coverage B does not become a spare Coverage A.
| Listed offense (ISO idea) | Exam picture |
|---|---|
| False arrest, detention, or imprisonment | Store security holds a suspected shoplifter in a back room without a reasonable basis |
| Malicious prosecution | The insured pushes a criminal or civil case without probable cause and with malice |
| Wrongful eviction, wrongful entry, or invasion of the right of private occupancy | A landlord named insured locks out a tenant, or a property manager enters a dwelling unlawfully—this is why habitational and lessor’s risks care about Coverage B |
| Slander or libel / disparagement of goods, products, or services | A manager tells a reporter that a competitor “poisons its customers,” or a review-response post makes a false statement of fact |
| Publication that violates a person’s right of privacy | The insured publishes a customer’s medical information or a worker’s private facts |
| Use of another’s advertising idea in your advertisement | The insured copies a competitor’s campaign concept into your advertisement |
| Infringing upon another’s copyright, trade dress, or slogan in your advertisement | The insured uses a protected slogan or look in an ad—not a factory-floor patent fight |
Advertisement is a defined term: a notice broadcast or published to the general public or specific market segments about the named insured’s goods, products, or services, including internet advertising, with important limits on what counts as an ad (chat rooms and bulletin boards the insured hosts are a different problem). A salesperson’s one-off insult in a parking lot is not automatically “in your advertisement.” A website product page can be.
Coverage B is still third-party legal liability. It is not a PR budget, not a retraction fund the insured spends without the insurer, and not a cyber policy for a network intrusion.
Coverage B exclusions that kill the obvious claim
| Exclusion | What it takes out | What students confuse it with |
|---|---|---|
| Knowing violation of the rights of another | The insured knew the act would violate rights | An accidental false-arrest fact pattern that can still be a Coverage B offense |
| Knowledge of falsity | Material the insured knew was false | Negligent defamation, which may still be in play if the other elements fit |
| Material published prior to the policy period | A rumor the insured started last year and that continues to circulate | The occurrence-form idea that “the suit came in this year” |
| Criminal acts | The crime itself | Civil damages arising from a listed offense that is not a crime the insured committed |
| Contractual liability | Liability the insured has only because of a contract | Liability the insured would have without the contract |
| Breach of contract | Failure to perform a contract (with a narrow advertising-idea implied-contract exception) | A listed offense that happens to involve a customer |
| Quality or performance of goods — failure to conform to statements | “Our paint lasts 20 years” and it peels in two | Libel about a competitor, which can still be a listed offense |
| Wrong description of prices | The flyer says $19.99 and the register charges $199 | False arrest of the customer who argued about the price |
| Intellectual property other than the advertising carve-back | Patent, trademark (except trade dress/slogan in an ad), trade secret | Copyright/slogan/advertising idea in your advertisement, which the form carves back into Coverage B |
| Insureds in media and internet-type businesses | Publishers, broadcasters, websites that exist to create content, search-engine and similar operations | A hardware store’s ordinary website promoting drills |
| Electronic chatrooms or bulletin boards the insured hosts, owns, or over which the insured exercises control | User comments on the insured’s hosted forum | A paid display ad on someone else’s site |
| Unauthorized use of another’s name or product in an email address, domain name, or metatag | Cybersquatting-type conduct | Use of another’s advertising idea in a genuine advertisement |
Pollution, war, and recording and distribution of material in violation of law (TCPA, CAN-SPAM, FCRA-type statutes) also sit on Coverage B. A blast of unsolicited promotional texts is not “advertising injury” in the slogan sense; it is often a statutory exclusion. That is a common AINS/CPCU trap and a reason cyber / media products exist.
Knowing violation is the first filter on a false-arrest stem: a security guard who honestly but negligently stops the wrong customer is a different Coverage B discussion from a manager who knows the shopper paid and detains the person to make a point.
Coverage C Medical Payments: no-fault, small, and picky
Coverage C agrees to pay medical expenses for bodily injury caused by an accident:
- on premises the named insured owns or rents,
- on ways next to those premises, or
- because of the named insured’s operations.
The expenses must be incurred and reported to the insurer within one year of the accident. The grant is regardless of fault. It is first aid, necessary medical, surgical, X-ray, dental, ambulance, hospital, professional nursing, prosthetic devices, and funeral services. It is not pain-and-suffering, not lost wages as damages, and not a substitute for Coverage A when the claimant sues.
The medical expense limit is whatever the declarations show per person. $5,000 per person is a common CGL limit on those declarations. It is not a statutory medical-payments amount and not an ISO promise that every CGL prints $5,000. If the declarations show $10,000, that is the Coverage C cap for that person. If they show $5,000, a $28,000 ER bill does not become a $28,000 Coverage C claim.
Coverage C does not apply to BI:
- to any insured, except volunteer workers (a volunteer who falls while packing donation bags can be a med-pay claimant; the named insured’s owner cannot medical-pay himself);
- to a person hired to do work for an insured or a tenant;
- to a person injured on that part of premises the named insured owns or rents that the person normally occupies (a tenant injured in the tenant’s own unit is not the landlord’s Coverage C gift);
- to a person entitled to workers compensation benefits;
- to a person while taking part in athletics;
- included within the products-completed operations hazard;
- excluded under Coverage A;
- due to war.
That PCO bar is the salsa-jar sequel. The shopper who slips in the aisle can receive Coverage C medical payments (if not an insured or employee, and if reported in time) and still pursue Coverage A. The customer injured at home by the product cannot use Coverage C. Medical payments is a premises/operations courtesy, not a products guarantee.
Coverage C payments for an accident count toward the each-occurrence limit (together with Coverage A damages from that occurrence) and toward the general aggregate. They do not create a third aggregate. They also do not buy the claimant a defense; Coverage C is a medical-expense grant, not a liability defense grant.
Supplementary payments: the defense wallet
Supplementary Payments — Coverages A and B are not Coverage C and are not a hidden increase of the each-occurrence limit. They apply when the insurer defends. Typical ISO CGL supplementary payments include:
- all expenses the insurer incurs, including defense attorney fees the insurer pays to defend the insured;
- up to $250 for the cost of bail bonds required because of accidents or traffic-law violations arising out of the use of a vehicle to which bodily-injury liability coverage applies;
- the cost of bonds to release attachments;
- reasonable expenses the insured incurs at the insurer’s request to assist in the investigation or defense, including actual loss of earnings up to $250 a day because of time off from work (hearings, depositions, trial);
- court costs taxed against the insured in the suit (not including attorneys’ fees or expenses taxed against the insured);
- prejudgment interest awarded against the insured on the part of the judgment the insurer pays;
- postjudgment interest on the full amount of any judgment that accrues after entry of the judgment and before the insurer has paid, offered to pay, or deposited the amount of the applicable limit.
Those figures ($250 bail-bond cost, $250 a day loss of earnings) are ISO CGL form amounts, not state statutes. Later private-company manuscripts can print different numbers; AINS wants the ISO idea: small, specified, and extra.
In addition to limits is the exam phrase. A $1 million occurrence limit is not first eaten by the defense lawyer. When the insurer has paid judgments or settlements equal to the applicable limit, the duty to defend ends. Supplementary payments do not keep the defense alive after the indemnity limit is gone. Coverage C medical payments are not supplementary payments; they are their own coverage with their own declarations limit.
Putting A, B, C, and supplementary payments on one claim call
Harbor Grocers again:
- Shopper slips, goes to the ER, then sues. Coverage C can pay eligible medical bills up to the per-person medical-expense limit, no fault required. Coverage A defends and indemnifies the lawsuit. Supplementary payments fund the defense in addition to the occurrence limit.
- Competitor alleges Harbor’s weekly circular stole its slogan. That is a Coverage B advertising-offense analysis, not med pay and not a fall. Knowing copying, a media-business named insured, or a patent theory can take it back out.
- Salsa claimant at home wants ER bills paid “like medical payments on auto.” Coverage C does not apply to PCO. Coverage A (products-completed operations) is the liability grant.
- Employee stocking shelves herniates a disc. Workers compensation, not Coverage C and not Coverage A employer’s-liability territory.
Exam traps in this section
- Coverage B is a list of offenses. Patent, price-mistake, and “our product did not work as advertised” are the usual misses.
- Media/internet businesses lose Coverage B that a hardware store still has.
- $5,000 medical payments is a common declarations limit, not a law.
- Med pay excludes insureds (except volunteer workers), employees, and PCO.
- Supplementary payments are A and B, in addition to limits, until the limit is exhausted by judgments or settlements.
- Defense is not Coverage C, and Coverage C does not defend a suit.
Section 16.3 is the trigger (occurrence versus claims-made), the limit stack, and additional insured endorsements—the math that decides whether Harbor still has aggregate left after the slip-and-fall and the salsa suit.
A hardware store’s unendorsed ISO CGL is asked to respond to four complaints: a customer detained without reasonable basis in the stockroom; a weekly circular that uses a competitor’s copyrighted slogan; a flyer that prints the wrong sale price; and a shopper who wants emergency-room bills paid after tripping on a pallet. Which pairing is most accurate?
An unendorsed CGL named insured is a regional newspaper. A weekly column accidentally repeats a false statement about a local contractor. A hardware store with its own unendorsed CGL prints a similar false statement about the same contractor in a product circular. Which statement best reflects Coverage B?
A visitor not employed by the named insured falls in the named insured’s lobby during the policy period and submits $4,200 of emergency-room bills within two months. The CGL declarations show a $5,000 medical expense limit. The same week, a consumer injured at home by the named insured’s product submits hospital bills and asks for “medical payments.” Which statement is most accurate?
An ISO CGL insurer defends a Coverage A slip-and-fall suit. Defense counsel bills $90,000. The insured misses three days of work to attend depositions. The occurrence limit is $1 million. Which statement about supplementary payments is most accurate?