Dallas area life insurance attorneys will occasionally see a situations like this 1997, Dallas Court of Appeals case. The case is styled, Grant v. Group Life & Health Insurance Co.
Grant used a pry bar to break into the residence of Stokes. When Grant entered the residence Stokes shot him five times, killing him. Grant’s wife sued Group Life to recover benefits under an accident policy for the death of her husband. Group Life moved for summary judgement on the basis that Grant died while committing a burglary and, therefore, his death was not accidental. The trial court granted the summary judgment and Grant appealed.
In it’s ruling, the Court said that because Grant’s death was not accidental, the trial court correctly granted Group Life’s motion for summary judgement. Grant argues that because Group Life id not furnish her with a certificate of insurance, it is estopped from relying on undisclosed exclusions. Because the policy in question does not provide coverage for Grant’s death the policy exclusions are irrelevant.
The policy only provides for “accidental” injury. Injuries are “accidental” and therefore, covered, if the injury in not the natural and probable consequence of the action or occurrence which resulted in the injury. Grant’s wife argues that Grant did not subjectively anticipate the injury because his mode of stealing included taking precautions to break into homes that were unoccupied at the time he broke in. Grant’s subjective intent is irrelevant. The standard for determining whether an injury was reasonably anticipated is an objective standard. As a matter of law, Grant should have reasonably anticipated that breaking into someone’s home at night with a pry bar could provoke the homeowner to respond with deadly force.
As an aside from this case, it is important to realize that the vast majority of the time an insured’s beneficiary will be able to make recovery of life insurance proceeds under an accidental death policy when the insured is killed by someone who is committing a crime. A recent case where a banker was kidnapped and then killed by his assailants resulted in the accidental death policy paying over $300,000.00 in benefits.
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