Fort Worth lawyers need to be able to answer the above question properly when dealing with a coverage issue in an insurance policy.
Here is what the Texas Supreme Court said in a 1999 case. The style of the case is, MidCentury Insurance Company of Texas v. Lindsey.
Here is some relevant information.
Richard Metzer and his wife had been fishing with their nine-year-old son when the boy returned to Metzer’s pickup parked nearby to retrieve his coveralls. Finding the truck locked, the boy climbed into the bed and attempted to enter the cab through the truck’s sliding rear window, which was open a few inches. In so doing, he accidentally touched a loaded shotgun resting in a gun rack mounted over the rear window, causing the gun to discharge. The buckshot struck Richard Lindsey, who was seated in his mother’s car parked next to the pickup. Lindsey’s wife and mother, also seated in the car, were not struck by the gunshot.
Lindsey and his wife sued Metzer and settled for the $20,000 policy limits on his truck, which were far less than Lindsey’s total damages. The Lindseys then claimed the $50,000 limits of the uninsured/underinsured motorists coverage of his mother’s policy issued by the Mid-Century Insurance Company of Texas, a division of the Farmers Insurance Group. Mid-Century, who had consented to the Lindseys’ settlement with the Metzers, denied the claim on the ground that there had been no physical contact between the two vehicles. The Lindseys then sued Mid-Century for breach of contract, breach of the duty of good faith and fair dealing, breach of warranty, and violations of the Deceptive Trade Practices-Consumer Protection Act and the Insurance Code. The Lindseys and Mid-Century all moved for summary judgment on the contract claim, and the district court granted the Lindseys’ motion and severed the order, making it an appealable judgment.
MidCentury’s policy states:
We will pay damages which a covered person is legally entitled to recover from the owner or operator of an uninsured [or underinsured] motor vehicle because of bodily injury sustained by a covered person, or property damage, caused by an accident.
The owner’s or operator’s liability for these damages must arise out of the ownership, maintenance or use of the uninsured [or underinsured] motor vehicle.
The parties’ sole dispute concerning the applicability of this provision is over whether Lindsey’s injuries were caused by an accident arising out of the use of Metzer’s truck. Taking each of Mid-Century’s arguments in turn, the court considered, first, whether Lindsey’s injuries were “caused by an accident”, and second, whether Metzer’s liability for Lindsey’s injuries “[arose] out of the . . . use” of Metzer’s truck.
Mid-Century’s policy does not define “accident”, but the court has held that an injury is accidental if from the viewpoint of the insured, it is not the natural and probable consequence of the action or occurrence which produced the injury; or in other words, if the injury could not reasonably be anticipated by insured, or would not ordinarily follow from the action or occurrence which caused the injury. An injury caused by voluntary and intentional conduct is not an accident just because the result or injury may have been unexpected, unforeseen and unintended. On the other hand, the mere fact that an actor intended to engage in the conduct that gave rise to the injury does not mean that the injury was not accidental. Rather, both the actor’s intent and the reasonably foreseeable effect of his conduct bear on the determination of whether an occurrence is accidental. An effect that cannot be reasonably anticipated from the use of the means that produced it, an effect which the actor did not intend to produce and which he cannot be charged with the design of producing, is produced by accidental means.
Metzer’s son intended only to gain entry to the truck. He did not intend to cause the shotgun to discharge or Lindsey to be injured, nor was it reasonably foreseeable that either consequence would result from the boy’s trying to enter the pickup through the rear window. Metzer’s son was not playing with the gun or acting recklessly. There is no evidence that he even knew it was loaded. His injuring Lindsey was an accident.
Mid-Century argues, however, that by “accident” the policy means “auto accident” or “motor vehicle accident”, as evidenced by the use of the latter phrases throughout the policy. An auto accident, Mid-Century argues, requires a collision. Assuming that “auto accident” is a more restrictive term in the policy than “accident”, and that a fair construction of the policy as a whole requires that the restriction be implied in the uninsured/underinsured motorist provision where it does not appear, the court did not agree that the term excludes the occurrence here.
The court discussed this case at greater length in its’ opinion. What is relevant to this case is knowing that each case has its’ own facts and those facts have to be looked at in light of the insurance policy language.
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