Wisconsin Supreme Court Narrows Definition of ‘Occurrence’

By Burke Coleman | August 7, 2013

  • August 7, 2013 at 3:48 pm
    Just Curious says:
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    So, if a person is knowingly driving an automobile (volition), is speeding or inattentive (volition), and a collides with a pedestrian or vehicle, the event is not an accident?

    • September 11, 2013 at 11:02 am
      JohnP says:
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      Automobile policies do not exclude liability for intentional events. By definition a liability policy covers any damage your vehicle does (thus you are legally responsible for). Note that your vehicle does. If an occupant of your vehicle assaulted another occupant would you be liable for the assault and your insurance cover it? No

      By the same token just because someone assaults someone else on your property doesn’t mean you are liable. Only your own intentional actions can make you liable for assault.

      The policy in question did not cover intentional actions of the insured only unintentional actions. So if you break the law and serve alcohol to minors then you are committing a crime and also committing intentional negligence. You are negligent by violating a legal duty.

      An insurance company has the right to refuse to sell coverage for intentional acts of negligence and the policy in question clearly did refuse to cover such actions.

      An automobile policy in constrast covers all damages caused to third parties by drivers whether they obeyed the law or not because that is the purpose of the policy.

      There are premises policies which will cover all actions that occur but they are extremely expensive.

      • September 11, 2013 at 12:25 pm
        JohnP says:
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        I left out the word necessarily. I meant to say automobile policies do not necessarily exclude intentional acts. Under the majority opinion what matters is whether the harmful act of the insured was intentional.

        If the harmful event is crashing into another vehicle then the question would be whether the crash was intentional.

        The decision holds that the occurrence is the harmful event by the insured that gives rise to coverage.

    • September 11, 2013 at 11:25 am
      JohnP says:
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      Something I forgot to mention is that your examples were invalid as well.

      Is crashing into a car or person intentional or an accident? Sometimes it is an accident sometimes it is intentional. If someone intends to strike a vehicle or person with his vehcile out of anger then it is not an accident it is aggravated assault. If no one is in the other vehicle at the time it is intentional destruction of property at minimum. Many auto policies exclude such intentional conduct. Striking someone unintentionally is an accident.

      What happened in the case at hand was not an accident but an intentional assault. The drunken guest intended to assault the victim. Likewise serving liquor to the guest was intentional. There was no accident either way. To call an assault an accident because the homeowner didn’t want the quest to commit the assault is a fallacy.

  • August 7, 2013 at 4:42 pm
    pinkie_lardo says:
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    This is a real problem. As I keep telling my children, all accidents are preventable with hindsight.

    What about driving while sleepy? What about buying a cheaper space heater? (volition to save money) Or leaving the space heater too close to some papers? (deliberately using it in a manner not proscribed in the directions.)

    What about forgetting to close the garage door before you go to bed?

    What the people did in throwing the party was wrong, but I think the court accidentally threw the baby out with the bath water. Wait, no. Not accidentally. It was volition.

    • September 11, 2013 at 12:42 pm
      JohnP says:
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      “What about driving while sleepy?”

      What about it? That alone does nothing. If someone is sleepy so inattentive and fails to break in time so crashes their car was that crashing intentional? No it was an accident. What is the occurrence? Was the occurrence? The occurrence was crashing the car not driving sleepy. The exclusion would only operate if the crash was intentional.

      “What about buying a cheaper space heater? (volition to save money)”

      The occurrence is the fire caused by the spaceheater no the decision to buy the spaceheater. Was the fire caused intentionally is the relevant question to determine whether the exclusion operates or not.

      “Or leaving the space heater too close to some papers? (deliberately using it in a manner not proscribed in the directions.)”

      Again the occurrence is the fire. Was the fire caused intentionally? Unless it could be proved that the papers were deliberately left there with the knowledge a fire would result and intent to cause such a fire (arson) then the fire was a result of negligence merely which means unintentional.

      “What about forgetting to close the garage door before you go to bed?”

      and what harm results from that? If you are robbed because you forgot to close a door that is not intentional conduct. If you hire someone to rob your house for insurance money and leave it open for them to get in then that is intentional and the exclusion operates.

      “What the people did in throwing the party was wrong, but I think the court accidentally threw the baby out with the bath water. Wait, no. Not accidentally. It was volition.”

      The court didn’t throw out anything. The court did the most rational thing- what the law requires. The court said that the occurrence is the action of the insured that gives rise to libabilty. It applies the exclusion only to the action of the insured. Thus insurance will cover injuries caused by a drunk person even if those actions are intentional where the person got drunk as a result of the negilgence of the insured.

  • August 8, 2013 at 8:31 am
    Lisa says:
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    I agree with Pinkie and Curious. It seems like it would be very easy to argue the insuring agreement is not met due to the lack of an “occurrence” any time an insured intentionally does something that might foreseeably lead to an injury. Other states where I have handled claims do not read the definition of “occurrence” this narrowly and I suspect Wisconsin will be in the minority.

    • September 11, 2013 at 12:15 pm
      JohnP says:
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      The Court opinion is the majority opinion and in fact most sensible opinion.

      If the homeowner had assaulted someone then for sure the injuries would be excluded but the homeowner would be legally liable. If a guest in general assaulted someone there would be no liability under the policy and no legal liability against the homeowner, the guest would be legally liable.

      Whether a homeowner who is negligent by illegally serving alcohol is responsible is responsible for allacts of the person who consumed the alcohol depends on state law. Assault is an action which can intervene in the chain of events and thus breaks liability. This is because in general we are not liable for the intentional actions of others. If a drunk person accidentally causes harm then a person who illegally got the person drunk would be legally liable. Legal liability for assault is less certain and depends on the jurisdiction.

      In terms of an insurance policy both the action giving potential rise to the homeowner’s legal liability and the act that caused the harm were intentional.

      To say an assault is an accident because the homeowner didn’t want the guest to commit the assault sounds nuts to a sane person. An assault is not an accident it is by definition intentional.

      At any rate the legal question at issue concerned coverage. The court held the occurrence is the action giving rise to insurance coverage which is the correct result and only reasonable result.

      Would the assault alone qualify as an occurrence? No. A guest assaulting another guest is not an occurrence covered by the policy.

      They attempted to get coverage by arguing the owner was negilgent by serving alcohol to a minor and thus resposible for the minor’s conduct. The exclusion needs to be applied to the conduct that is supposedly giving rise to the coverage which in this case was the serving of alcohol.

      Let’s look at a slightly different fact pattern and how the majority opinion operates. A homeowner leaves alcohol in the fridge and fails to supervise a teen party their son is throwing. A guest goes in the fridge, gets drunk, has an argument and then leaves. As he drives away he runs down an innocent pedestrian in the driveway who told him he was not allowed to leave because he was drunk.

      Was it conduct of the insured? No a guest. Is that the end of potential coverage? No. The proper question in terms of coverage is whether the insured did anything that gives rise to coverage. It is not enough that he didn’t commit the assault. The homeowner was negligent by leaving alcohol in grasp of teens and failing to supervise the party. Thus the damage that flowed from such negligence can in fact be covered. Was the conduct intentional? Yes the guy intended to run down the person who was trying to stop him from driving drunk. So does that mean the intentional action exclusion results in no coverage. No. Under the majority opinion the exclusion applies only if the insured’s action giving rise to the claim is intentional. The insured was negligent he did not intentionally serve alcohol. Thus the exclusion does not apply and his insurance will cover the damages.

      The exclusion is meant to prevent an insured who commits an intentional wrong from not being responsible for his actions. Hey I got insurance so I will intentially break your nose and my insurance will pay I won’t have to so it is a free shot.

      Hey I have insurance so I will throw a wind underage party and let my insurance worry about it if something happens. No you are responsible so you need to think twice before you take such risks.

  • September 11, 2013 at 10:44 am
    JohnP says:
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    This case has unique circumstances that makes the majority opinion correct.

    The party host was being sued for negligence. The host was negligent by breaking the law and serving alcohol to underage guests thus is responsible for the actions of those who became intoxicated.

    In general if a guest had simply assaulted someone at your house then that would be an intentional action of the guest and the host could not be sued for the criminal acts of another. The only reason the host was able to be sued was because the host illegally served alcohol to a guest and that drunken guest then assaulted someone.

    In this case the occurrence that brings about legal liability to the host was the serving of alcohol. Thus the question is whether the serving of alcohol was intentional. If a guest broke into a stash and had not been served that is not intentional in contrast.

    The minority opinion makes no sense. It basically would hold that insurance liability attaches anytime someone does anything in your house even if intentional so long as the ownder didn’t want it to happen. That would drastically raise premiums. It would mean if someone breaks into your house and murders a guest that your insurance must pay for it even because you didn’t intend for someone to break in and kill them. How much would premiums rise to cover that?



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