In a recent opinion, the California Court of Appeal addressed whether an insurance company had a duty to defend their insured in an underlying personal injury lawsuit. Many liability policies have clauses that exclude insurance coverage for harm that is not caused in an “accident.” In other words, insurers limit liability for intentional harm. The court in this case analyzed whether the policies provided coverage for injuries suffered by a plaintiff who alleged his harm resulted from both intentional and negligent conduct.Plaintiff Christopher Miazga was injured by Giancarlo Romano, the insured of a policy issued by Mid Century Insurance Company and Fire Insurance Exchange. While Mr. Miazga was inside the home of Johnny Sebetic and his estranged wife, being intimate, both Mr. Sebetic and Mr. Romano walked in on them.
Mr. Miazga alleged that his injury met the definition of a covered bodily injury under Mr. Romano’s policies. Mr. Miazga demanded that Mr. Romano pay damages for his injury, and Mr. Romano notified his insurers of Mr. Miazga’s claims. Next, Mr. Miazga filed a lawsuit against Mr. Romano and Mr. Sebetic, asserting negligence and intentional tort claims. The allegations stated that Mr. Sebetic hit Mr. Miazga’s head with a large flashlight, and Mr. Romano punched Mr. Miazga in the face and continued to punch and choke him until the police arrived.
After Mr. Romano tendered the lawsuit to his insurers for defense and indemnification, they advised him that the policies did not cover Mr. Miazga’s injury. They denied coverage for Mr. Romano concerning damages related to Mr. Miazga’s injury.
The parties entered a stipulated judgment providing that Mr. Miazga’s damages amounted to $250,000 for past and future emotional distress, pain, suffering, and inconvenience. Mr. Miazga agreed not to execute any judgment against Mr. Romano or Mr. Sebetic personally.
Mr. Miazga then filed the current action against the insurance companies on the grounds that they breached their duty to defend and indemnify Mr. Romano and breached the implied covenant of good faith and fair dealing owed to Mr. Romano.
The insurers argued they had no duty to defend Mr. Romano in the underlying action, and they moved for summary judgment. They contended that their coverage obligation did not extend to Mr. Romano because the policies covered injuries resulting from an “occurrence,” which is an “accident.” According to the insurers, Mr. Miazga had not alleged the injury-producing actions were accidental or negligent. Instead, he had stated that Mr. Romano punched him in the face repeatedly.
Mr. Miazga then argued that Mr. Romano acted in self-defense, and his negligent conduct was accidental for insurance purposes, rather than wrongful or willful. In addition, Mr. Miazga argued that his satisfaction of judgment only released Mr. Romano and not Mr. Romano’s insurers from liability.
The trial court found that the insured, Mr. Romano, intentionally inflicted an injury on Mr. Miazga. They rejected Mr. Miazga’s claims that it was an accident. The court stated that any assault, even in self-defense, is intentional conduct, not an accident, and that the insurance companies did not have a duty to defend Mr. Romano. Mr. Miazga appealed this judgment.
Regarding whether the insurance companies had a duty to defend against claims that create a potential for indemnity, the appellate court stated that the duty to defend is broader than the duty to indemnify – and that the determination requires comparing allegations in the complaint to the language in the policy. Here, both insurance policies stated that damages would be paid when the insured is legally obligated to pay them due to a “bodily injury resulting from an occurrence.” An occurrence is further defined as an accident.
According to the appellate court, Mr. Miazga’s complaint did not reveal a possibility that Mr. Romano would be covered by the policies. The complaint alleged general negligence and intentional tort. The court stated that these allegations cannot be read to have resulted from an “accident.” They were not revealed to Mr. Romano’s insurers as an action that may be covered by the policies.
The court rejected Mr. Miazga’s contention that the negligence action disclosed a potential for insurance coverage. Stating that the labels given the causes of action do not matter, the court held that the issue is whether the facts reveal a possibility that the claim might be covered by the policy.
After examining facts extrinsic to the complaint, the court also confirmed there was no revealed potential for coverage. The injuries Mr. Romano inflicted were not accidental and did not give rise to a potential for coverage. Since an injury-producing event is not an accident when the acts accomplished their intention, the court stated that even if Mr. Romano did act in self-defense, there would not be potential coverage under the policies.
The court concluded by stating that the insurers did not owe Mr. Romano a duty to defend the underlying action, and it affirmed the lower court’s grant of summary judgment.
The Southern California personal injury attorneys at Sharifi Firm provide personalized, efficient representation to victims throughout the state. If you or a loved one has suffered injuries resulting from an accident, the attorneys at Sharifi Firm can help you seek compensation for your injuries. Contact us at 1-866-422-7222 for a free consultation.
More Blog Posts:
California Court of Appeal Holds Government Not Liable for Injuries Suffered by Escaping Psychiatric Patient, Southern California Injury Blog, May 12, 2016
California Appellate Court Reverses Dismissal of Injury Lawsuit Because Plaintiff’s Failure to Cooperate with Discovery Was Not Shown to be Willful, Southern California Injury Lawyer Blog, May 29, 2016