Insurance companies have many ways of limiting liability for coverage of serious illness or injury. One of those involves arguing that injuries sustained by numerous individuals were in fact part of a single occurrence, therefore reaching the per-accident liability limits much sooner.
Our West Palm Beach personal injury attorneys know that plaintiffs who can successfully argue that an injury was one of multiple occurrences have the potential to significantly increase the potential payout.
Most often, we see this issue raised when insurance companies attempt to argue a multi-vehicle accident is part of one large crash, whereas plaintiffs argue they were the result of several smaller crashes.
Florida courts have historically applied the “cause theory” in order to determine the number of occurrences in a case. This approach involves determining whether there was one proximate, uninterrupted and continuing cause that resulted in all injuries and damages. The focus is on whatever immediate act causes the damage.
The controlling case generally cited is the 2003 Florida Supreme Court decision of Koikos v. Travelers Ins. Co., where a single gunman shot multiple people and the court found each shooting was a separate incident, for insurance purposes.
In the more recent case of Maddox v. Florida Farm Bureau, Florida’s Fifth District Court of Appeals held that dog bites sustained by both mother and son by the same dog constituted two separate occurrences under the homeowner’s insurance policy.
But injured parties should never assume this is a given. More recently, the federal appellate case of Fellowship of Christian Athletes v. Ironshore Specialty Ins. shows how challenging this argument can be. This case, before the U.S. Court of Appeals for the Eighth Circuit, stemmed from the death of two boys who drowned a pool party sponsored by the FCA.
According to the court records, the boys attended a youth sports camp that was organized and operated by the FCA. Neither child was able to swim, as the permission forms signed by their parents indicated.
One night, the organization held a party. After the party, the staffers realized the two boys were missing. They were found in the pool, their bodies side-by-side at the bottom of the deep end of the pool, near the primary drain. An autopsy report listed the boys’ deaths accidental drowning, listing the time-of-death as two minutes apart.
The families filed a complaint in state court, asserting the organization was negligent by allowing the two to enter the pool area after their parents had signed forms indicating they couldn’t swim; by failing to properly supervise them; by not properly training or supervising its counselors; by taking the boys from camp to the pool when they couldn’t swim; and by failing to use reasonable care.
The organization was insured under three policies. One of those provided $1 million coverage, with up to $5 million in aggregate payouts. Two other umbrella policies were in place. One of those offered up to $5 million in excess coverage, and the other offered up to $10 million.
The organization filed suit against its insurer, with the goal of seeking a determination of whether these deaths were the result of one or two occurrences.
The insurer with the $1 million payout limit argued there was only one occurrence, while the insurer that carried a $10 million policy argued there was more than one occurrence, which would bump up the first company’s liability to $2 million.
The court held this was part of a single occurrence, and therefore the first insurer was liable for just $1 million in damages, while the second insurer is liable for whatever was awarded to the families beyond that amount.
The second insurer appealed.
The federal appellate court cited the approach established by the Missouri Court of Appeals, which holds that a single act is “the accident from which all things flow.” Based on that logic, the court found, the boys’ drowning was part of a single occurrence.
Fortunately for the plaintiff in this instance, the original defendant, the FCA, is well insured, which, given the level of egregious negligence that gave rise to the tragic death of these two boys, will likely mean the compensation will be substantial.
Those injured in West Palm Beach should contact the Hollander Law Firm at 888-751-7777 for a free and confidential consultation. There is no fee unless we win.
Fellowship of Christian Athletes v. Ironshore Specialty Ins. , July 11, 2014, U.S. Court of Appeals for the Eighth Circut
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M.V. Transp., Inc. v. Allgeier – $4.2 Million Injury Verdict Stands, June 30, 2014, West Palm Beach Personal Injury Lawyer