Property Claims Ethics: Adjusting In Good Faith
By Jonathan Barger | Events
March 13, 2023
Overview | Blog Posts | Extra-Contractual | Matthew Lavisky | Related | Print | Share
Automobile insurance policies specify a maximum amount the insurer will pay for a single accident. This coverage limit applies both to liability and uninsured/underinsured motorist (“UM”) coverages. Insurance policies often contain language providing that the applicable coverage limit is the most the insurer will pay in any one accident regardless of the number of vehicles involved.
This seems simple enough but “few insurance policy terms have ‘provoked more controversy in litigation than the word ‘accident.’”1 This is unsurprising since determining the number of accidents will determine the amount of coverage available under the insurance policy. Counting the number of impacts or collisions does not answer the question because “a single accident may involve more than one impact or collision.”2
In the context of liability coverage, the majority rule is that:
Collisions with multiple vehicles constitute one occurrence when the collisions are nearly simultaneous or separated by a very short period of time and the insured does not maintain or regain control over his or her vehicle between collisions. When collisions between multiple vehicles are separated by a period of time or the insured maintains or regains control of the vehicle before a subsequent collision, there are multiple occurrences.3
This test does not, however, lend itself to UM claims where the insured only was involved in a single collision. That is because in the context of liability coverage, the parties and the court generally must determine how many accidents occurred when an insured struck two different people in close succession. In UM coverage, however, the issue of the number of accident arises because a single insured has been injured but claims the injuries resulted from multiple accidents.
The court in Travelers Indem. Co. v. Garcia4 recently addressed this issue in the context of UM coverage. In Garcia, the insured tragically was killed when a dump truck crashed into the back of the insured vehicle. This collision occurred as the insured slowed his vehicle down and began to come to a stop due to a traffic backup. The traffic backup that caused the insured to slow down was the result of a collision that occurred five minutes earlier and two miles away.
The insurer paid the per accident UM coverage limit. However, the insured’s estate took the position that the insured was injured in two accidents: the collision that caused the traffic to slow and the collision with the dump truck. It was undisputed that the insured and his vehicle were not struck by any vehicle in the earlier collision that caused traffic to slow.
The court held that to determine the number of accidents, one must look at the events from the perspective of the insured. This is consistent with an opinion of another court that addressed a similar issue.5 The accident is the event that actually caused the harm. The court concluded that the insured had been involved in a single accident—the collision with the dump truck.
The court also analyzed the number of accidents under the cause theory. The court found that the focus of the cause theory is “the independent immediate acts that gave rise to the injuries.”6 The court emphasized that the focus in applying the cause theory is on “immediacy.” Turning to the facts of the case, the court concluded that the collision that caused traffic to slow was not the immediate cause of injury or the immediate injury-producing act. Accordingly, the court found there was a single accident under the cause theory. The Eleventh Circuit Court of Appeals affirmed agreeing that a single accident caused the insured’s death.7
The takeaway is that multiple collisions may be a single accident. In the context of UM coverage, where the insured is struck once, but multiple collisions may have contributed to the injuries, courts look at the events from the perspective of the insured. Where the insured was only involved in one collision there is only one accident under the policy even when a second collision contributed to the injury.8
Butler Weihmuller Katz Craig LLP represented Travelers in the Garcia case in the trial and appellate courts.
For any further questions, please contact Matthew Lavisky.
1 State Farm Fire & Cas. Co. v. CTC Dev. Corp., 720 So. 2d 1072, 1075 (Fla. 1998).
2 Safeco Ins. Co. of Am. v. Simmons, 642 F. Supp. 305, 308 (N.D. Cal. 1986).
3 Am. Family Mut. Ins. Co. v. Wilkins, 179 P.3d 1104, 1114 (Kan. 2008).
4 497 F. Supp. 3d 1218 (M.D. Fla. 2020).
5 IDS Prop. Cas. Ins. Co. v. Pickens, C15-5125 BHS, 2015 WL 6160228, at *5 (W.D. Wash. Oct. 20, 2015).
6 Garcia, 497 F. Supp. 3d. at 1225 (citing Koikos v. Travelers Ins. Co., 849 So. 2d 263, 273 (Fla. 2003)).
7 Travelers Indem. Co. v. Garcia, 20-14387, 2021 WL 2935425, at *2 (11th Cir. July 13, 2021).