Denial of a liability insurance claim can deprive injury victims and wrongful death victims of a viable source of compensation for life-altering injuries or the loss of a family member.  A recent decision by the Florida 3rd DCA demonstrates the heartbreaking consequences of non-coverage when the at-fault party’s insurance coverage denies a third party claim.

In Bryant v. Windhaven Ins. Co., the parents of an infant, who served as personal representatives of the child’s estate, were denied wrongful death damages involving the tragic death of their daughter.  The infant died when she was left for seven hours in the summer heat in a van that was used to transport the child to and from a daycare facility.  The driver was an employee of the daycare center and used the van on a regular basis to transport children to the facility.  Extended exposure to the heat inside a vehicle with the windows rolled up was determined to have caused the child’s death.

The auto insurance policy was issued to cover a personal sedan owned and driven by the insured.  The policy did not list the daycare van as a covered vehicle.  The childcare center, driver, and landlord for the premises were sued by the estate of the deceased child for wrongful death.  The driver notified his insurer of the claim and requested indemnification and defense against the claim.  The insurer defended the claim under a reservation of rights based on the contention that the claim was excluded under the terms of the policy. 

The insurer alleged the claim was excluded under the “employment vehicle provision” and the “use provision”.  The employment exclusion indicated that no coverage existed for any vehicle used for or in the course of employment while the use provision excluded any vehicle other than the “covered vehicle” furnished or available for the insured’s regular use.  The parties filed cross-motions for summary judgment.  The trial court granted the insurer’s motion for summary judgment based on the “regular use” provision but ruled the employment exclusion inapplicable.

The appellate court upheld the trial court’s ruling that the claim was excluded under the use provision.  However, the court went further by finding that the claim also should have been denied under the employment vehicle exclusion.  The appellate court initially observed that the insured was clearly an employee of the childcare center at the time of the death of the child.  While the claimant did not deny the employment relationship, he argued that the van was not the “cause” of the death.  The claimant relied on a prior decision that concluded a vehicle did not constitute a cause of injury when it fell on an individual who was performing an oil change when the driveway crumbled.

The judges distinguished the prior decision based on the fact the collapse of the concrete caused injury rather than the vehicle.  In the instant case, the court found that the failure to properly unload a passenger established a direct causal connection between use of the car and the death of the infant.  The court applied a three-prong test to determine whether the accident arose out of ownership, maintenance, or use of a vehicle:

  • The injury must have arisen from the inherent nature of the vehicle as an automobile;
  • The incident must have occurred within the natural territorial limits of a vehicle, and the actual use, loading, or unloading must not have been terminated; and
  • Rather than just contributing to cause the condition producing injury, the vehicle must actually produce the injury.

The court then analyzed the facts of this case under each prong of the test.  When considering the first prong of the test, the court found that the injury occurred because of the van’s nature as a mechanism for passenger transport.  Under the second prong, the infant suffered injury because of negligence during the “unloading” process.  Because the unloading process was never completed, use of the vehicle was not terminated.  With respect to the third prong, the court reasoned the child suffered a fatal heat stroke condition because of the van’s lack of cooling or ventilation. 

This tragic example demonstrates that a denial of coverage can have a devastating impact on multiple parties.  While the insured in this case was exposed to a potential judgment against his or her personal assets, the family of the victim likely will receive no compensation or justice for their tragic loss.  These types of insurance complications are a reason that policyholders should seek legal advice promptly.  If your auto insurer or homeowner’s insurance carrier refuses to indemnify you against losses, a terrible accident based on a momentary lapse in judgment or distraction can lead to financial ruin and bankruptcy.

You can reach Miami Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].

J.P. Gonzalez-Sirgo
J.P. Gonzalez-Sirgo, P.A.
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