Case Law Update: Injuries from assault not an “accident” and not covered by insurance

Posted Wednesday, August 16, 2017 by Christopher L. Thayer

Case Law Update: Injuries from assault not an “accident” and not covered by insurance In a recent unpublished decision, the Washington Court of Appeals (Division 1) addressed whether injuries caused by an intentional assault would be covered under an insurance policy that provided coverage for “accidents”. State Farm Fire and Casualty v. Peters, et al (No. 75705-9-I, August 14, 2017).

Belt and Peters got into an argument. Belt struck Peters several times in the face with a closed fist, breaking Peters’ jaw in three places. Belt pled guilty to fourth degree assault. Peters subsequently sued Belt for damages in Snohomish County. Belt was insured by State Farm, with a policy that covered bodily injury claims arising out of an “accident”. The term “accident” was not defined in the policy. State Farm sought a court order confirming it had no duty of defense or indemnity – and the trial court agreed.

Insurance policies are contracts and are construed as such. Insurance policies are to be interpreted "as an average insurance purchaser would understand them.” Kish v. Ins. Co. of North America, 125 Wn. 2d 164 (1994). If an insurance policy defines its terms, those definitions apply, but undefined terms "must be given their plain, ordinary, and popular meaning." Kitsap County v. Allstate, 136 Wn.2d 567 (1998).

In the present case, the policy does not expressly define "accident" and the policy's exclusionary provisions do not mention the term. The court then looked to the common law definition of “accident”:

Thus, where the insured acts intentionally but claims that the result was unintended, the incident is not an accident if the Insured knew or should have known facts from which a prudent person would have concluded that the harm was reasonably foreseeable. State Farm v. Ham & Rye, 142 Wn. App. 6 (2007).

Belt argued he lacked specific knowledge that his conduct would cause injuries to Peters and that he did not “expect or intend” to cause injuries. The Court noted Belt’s unintended result and purported subjective intent were of no consequence and that “a prudent person would have concluded that a broken jaw was a reasonably foreseeable result of punching someone in the jaw.” The Court concluded “There is no support for the proposition that a mere subjective belief that there would be no injury, or subjective lack of knowledge or appreciation of consequences, results in coverage of intentional conduct as an "accident."

The Court of Appeals affirmed the trial court’s summary judgment order – confirming State Farm had no duty to provide coverage or indemnify against any damage award.

For the average person, Belt’s arguments probably seem pretty esoteric, but the reality is this case was all about insurance coverage. With certain exceptions, the typical home or auto policy will provide coverage for “accidents” and not intentional conduct. Without insurance, Belt may not have been able to afford a lawyer, and Peters may not recover any damages for his injuries.