summary of responses re: Equitable Estoppel and denied claims

summary of responses re: Equitable Estoppel and denied claims

William Lifford

9/10/2009

Hello colleagues,

A number of you had asked me to post my responses. I only received two
responses that were useful:

1. Wayne Renardson provided me with a definition of estoppel:
> < <URL Redacted>>
>
> For an example of estoppel, consider the case of a debtor and a
> creditor. The creditor might unofficially inform the debtor that the
> creditor forgives the debt. Even if such forgiveness is not formally
> documented, the creditor may be estopped from changing its mind and
> seeking to collect the debt, because that change would be unfair. In
> the same way, a landlord might inform a tenant that rent has been
> reduced, for example, if there was construction or a lapse in utility
> services. If the tenant relies on this notice, the landlord could be
> estopped from collecting the full rent.
>
> ==========
> < <URL Redacted>>
>
> equitable estoppel n. where a court will not grant a judgment or
> other legal relief to a party who has not acted fairly; for example,
> by having made false representations or concealing material facts
> from the other party. This illustrates the legal maxim: he who seeks
> equity, must do equity. Example: Larry Landlord rents space to Dora
> Dressmaker in his shopping center but falsely tells her a Sears store
> will be a tenant and will draw customers to the project. He does not
> tell her a new freeway is going to divert traffic from the center.
> When she failed to pay her rent due to lack of business, Landlord
> sues her for breach of lease. Dressmaker may claim he is equitably
> estopped. (See: estoppel, clean hands doctrine)
>
> Thanks for bringing this up. I plan to read more about it.


2. Gary Cheney, CPO, posted this response:

> Equitable estoppel, sometimes referred to as promissory estoppel can
> be defined as legal principle that prevents a (first) party from
> taking advantage of another (second) party where the second party is
> injured from relying on the misrepresentations of the first party. It
> can also be defined simply as a legal principle that prevents a person
> who made a promise from reneging when someone else has reasonably
> relied on the promise and will suffer a loss if the promise is broken.
>
> Pertaining to insurance claims; the principle of estoppel could be
> claimed if your decision to provide services was based on affirmative
> coverage information received from the insurance carrier, and
> the insurance carrier then denied the claim when submitted. As your
> decision was based on the information provided, and they reneged on
> their promise to pay, you as the provider have suffered a loss.
>
> In theory this principle sounds great but what it boils down to is
> legal action would be required and most insurance companies are not
> intimidated by threats, and their ability to prolong legal action will
> normally wear down most providers. I have not had any success
> by threatening action under the estoppel principle.

Thanks for your responses!

Bill Lifford, CP