Texas Farm Bureau Mutual Insurance Co. v. Sturrock
Texas Farm Bureau Mutual Insurance Co. v. Sturrock
Opinion of the Court
delivered the opinion of the Court,
In this case, an insured was injured when his foot became entangled with his truck’s raised door facing while he was exiting the vehicle. We must decide whether his injury resulted from a “motor vehicle accident” for purposes of personal
I
Jeff Sturrock drove his truck to work, parked, and turned off the engine. While exiting the truck, he entangled his left foot on the raised portion of the truck’s door facing. Sturrock injured his neck and shoulder in his attempt to prevent himself from falling from the vehicle. Sturrock filed a claim for PIP benefits under his vehicle’s insurance policy, issued by Texas Farm Bureau.
The Texas Insurance Code requires that every automobile insurance policy issued within Texas provide PIP coverage, unless rejected by the insured. See Tex. Ins.Code art. 5.06-3(a). It is the public policy of Texas to provide injured occupants of the insured vehicle PIP benefits, up to the statutory maximum of $2,500, without regard to fault or nonfault of the insured. See id. art. 5.06 — 3(b), (c); Unigard Sec. Ins. Co. v. Schaefer, 572 S.W.2d 303, 308 (Tex. 1978). Sturrock’s policy provides, in pertinent part:
A. We will pay Personal Injury Protection benefits because of bodily injury:
1. resulting from a motor vehicle accident; and
2. sustained by a covered person.
(Emphasis added). Texas Farm Bureau does not dispute that Sturrock is a “covered person” under the policy, but demes that Sturrock’s injuries resulted from a “motor vehicle accident” within the policy’s PIP coverage.
Sturrock sued Texas Farm Bureau for breach of contract and violations of Article 21.21 of the Texas Insurance Code. Both parties filed motions for summary judgment. The parties then filed an “greed Statement of Facts, pursuant to Texas Rule of Civil Procedure 263,
We construe insurance policies in Texas according to the rules governing contract construction. Am. Mfrs. Mut. Ins. Co. v. Schaefer, 124 S.W.3d 154, 157 (Tex. 2003); Tex. Farmers Ins. Co. v. Murphy, 996 S.W.2d 873, 879 (Tex. 1999). If policy language can be given a certain or definite legal meaning or interpretation, then it is not ambiguous and we construe it as a matter of law. Schaefer, 124 S.W.3d at 157; Coker v. Coker, 650 S.W.2d 391, 393 (Tex. 1983). Whether a contract is ambiguous is itself a question of law. Schaefer, 124 S.W.3d at 157; Kelley-Coppedge, Inc. v. Highlands Ins. Co., 980 S.W.2d 462, 464 (Tex. 1998). An ambiguity does not arise simply because the parties offer conflicting interpretations of the policy language. Schaefer, 124 S.W.3d at 157; Kelley-Coppedge, 980 S.W.2d at 464. Rather, an ambiguity exists only if the contract is susceptible to two or more reasonable interpretations. Schaefer, 124 S.W.3d at 157; Kelley-Coppedge, 980 S.W.2d at 464.
Neither party contends that the term “motor vehicle accident” is ambiguous, although each asserts a different interpretation. We have held that the term “auto accident”
Ill
Citing our decision in Griffin, Texas Farm Bureau argues that accidents like the one Sturrock experienced do not fit within the plain meaning of “motor vehicle accident” because the term requires some involvement between the covered motor vehicle and another vehicle, person, or object. Griffin, 955 S.W.2d at 83. Because Sturrock’s accident did not involve another vehicle or person, Texas Farm Bureau contends, Sturrock’s injuries did not result from a “motor vehicle accident.” Conversely, Sturrock claims this Court has determined that a “motor vehicle accident” does not require a collision, and the incident at hand was a “motor vehicle accident” because the vehicle itself produced the injury.
As the parties’ contentions indicate, this is not the first time we have examined the meaning of the term “motor vehicle accident” in a personal automobile liability insurance policy. In Griffin, an insured, James Royal, III, drove his vehicle while two passengers fired shots that hit and
We most recently addressed the meaning of the term “automobile accident” in Mid-Century Insurance Co. of Texas v. Lindsey, 997 S.W.2d 153 (Tex. 1999). There, Lindsey, a passenger in his mother’s car, was shot by a gun that accidentally discharged from an adjacent truck when a boy attempted to enter the cab through the rear window. Lindsey filed a claim under the uninsured/underinsured motorists (UM/UIM) provision of his mother’s policy, which covered injuries resulting from “an accident” that “arise[s] out of the ... use of the uninsured [or underinsured] motor vehicle.” Id. at 155. Mid-Century denied the claim, arguing that under the policy the term “accident” meant “auto accident,” as evidenced by the latter phrase’s use throughout the policy — a more restrictive term than an accident that merely “arises out of’ a vehicle’s use. An “auto accident,” Mid-Century claimed, requires a collision. We accepted the first part of Mid-Century’s argument for purposes of our holding, but disagreed that the term “auto accident” required a collision or excluded occurrences like Lindsey’s:
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/un-derinsured motorist provision where it does not appear, we do not agree that the term excludes the occurrence here.... Nothing in [Griffin or Peck] suggests that an “auto accident” requires a collision....
Id. at 155-56. We agreed with the trial court and the court of appeals that Lindsey’s injury was caused by an “auto accident” under the policy. Id. at 156.
Recognizing that our holding in Lindsey would appear to support coverage for Sturrock’s injuries, Texas Farm Bureau seeks to distinguish this case in three respects. First, Texas Farm Bureau argues that we should reject the above-quoted language as dicta. The dissenting justices similarly try to avoid Lindsey’s holding by stating that our discussion regarding the requirement of an “auto accident” was not the primary focus of the case and declaring that the discussion was not necessary to our decision. 146 S.W.3d at 136-37 (Owen, J., dissenting). While the dissent is correct that two separate issues were raised in Lindsey — namely whether there was an accident and, if so, whether the accident arose from the use of the vehicle — that the first issue did not receive the majority of our attention does not make it any less essential to the holding. We expressly premised our holding in Lindsey on the assumption that the policy required an “auto accident.” Lindsey, 997 S.W.2d at 155-56. Thus, we did not simply determine that an accident had occurred, and our statement cannot be disregarded as
Second, Texas Farm Bureau notes that Lindsey involved UWUIM coverage, whereas the current dispute involves PIP coverage. But courts interpret both UM/ UIM and PIP insurance provisions broadly, and our discussion of the term “auto accident” in Lindsey remains applicable to our analysis of the term “motor vehicle accident” in this case. See Stracener v. United Servs. Auto. Ass’n, 777 S.W.2d 378, 382 (Tex. 1989) (holding that UM/UIM coverage “is to be construed liberally to give full effect to the public policy which led to its enactment”); Unigard Sec. Ins. Co., 572 S.W.2d at 308 (noting that it is the public policy of the State that automobile policies include PIP benefits without regard to fault); Ortiz v. State Farm Mut. Auto. Ins. Co., 955 S.W.2d 353, 356-57 (Tex.App.-San Antonio 1997, pet. denied) (stating that courts must interpret the ÜM/UIM and PIP coverage provisions broadly to give full effect to “the state’s interest in protecting conscientious and thoughtful motorists from financial loss”); see also Putkamer v. Transamerica Ins. Corp. of Am., 454 Mich. 626, 563 N.W.2d 683, 686 (1997) (“The no-fault act is remedial in nature and is to be liberally construed in favor of the persons who are intended to benefit from it.”); 8D Apple-man on Insurance Law & Practice § 5171.55 (2003 Supp.) (“The terms [of no-fault and personal injury protection] are construed liberally to extend coverage broadly.”). Additionally, we note that the Texas Department of Insurance does not contend that the meaning of “motor vehicle accident” varies from one insurance provision to another and urges the Court to find PIP coverage in this case. See Liberty Mut. Ins. Co. v. Garrison Contractors, Inc., 966 S.W.2d 482, 485 (Tex. 1998) (recognizing that the Texas Department of Insurance’s “expertise in the insurance trade is unquestionable”).
Third, Texas Farm Bureau insists that Sturrock’s injuries did not result from a “motor vehicle accident” because the accident did not involve “another vehicle, object, or person,” as Griffin and Lindsey require. According to Texas Farm Bureau, an insured who is injured by his own vehicle is not involved in a “motor vehicle accident.” In its amicus brief, the Texas Department of Insurance urges the Court to reject Texas Farm Bureau’s argument, asserting that it posits an absurd interpre
Admittedly, our statement in both Lindsey and Griffin, that the term “auto accident” refers to instances “where one or more vehicles are involved with another vehicle, object, or person,” is grammatically confusing. Lindsey, 997 S.W.2d at 155 (emphasis added); Griffin, 955 S.W.2d at 83 (emphasis added). There can be “another vehicle” because the definition first speaks of a vehicle or vehicles. But there cannot be “another object” or “another person” unless there is a first object or person. Because we did not reference a first object or person when interpreting the term, “another” can only modify the word vehicle. Thus, the definition refers to accidents where one or more vehicles are involved with another vehicle, an object, or a person.
We agree with the Texas Department of Insurance that Texas Farm Bureau’s cramped interpretation of our holding in Griffin and Lindsey would severely limit an insured’s no-fault coverage in a manner that would contravene its purpose and lead to absurd results. Under Texas Farm Bureau’s formulation, a passenger who fell from Sturrock’s truck in the same way would be covered, but Sturrock himself would not. Sturrock would be covered if he had fallen out of his car onto another person, but not if he had fallen directly onto the ground. He would be covered if a tire dislodged from another vehicle and hit his car, but not if his own tire blew out and caused his vehicle to roll over. Sturrock would be covered if he were run over by a vehicle with a faulty parking brake, but not if his own vehicle ran over him because of the same defect. Neither the policy’s language nor its context indicates a construction that would deny no-fault benefits to insureds who suffer injuries caused by their own covered vehicles.
This is not to say, however, that any accident involving another vehicle, an object, or a person constitutes a “motor vehicle accident.”
Texas Farm Bureau contends that Stur-rock’s policy contains more restrictive language than the broader policy language found in Lindsey, which merely required that the injuries “arise out of’ the “use of a motor vehicle.” Lindsey, 997 S.W.2d at 156. According to Texas Farm Bureau, the court of appeals’ conclusion that Stur-rock’s injuries resulted from a “motor vehicle accident” erroneously incorporates a broader “arising out of use” concept that does not appear in the more restrictive PIP language. The parties here did not contract for coverage of any accident that might arise out of a motor vehicle’s use, Texas Farm Bureau contends, but only for coverage in the event of a “motor vehicle accident.” In Lindsey, however, we examined the “arising out of use” language only after first construing the term “auto accident.” Id. at 155-56. As discussed earlier, we concluded that the incident in question satisfied our construction of that term. Id. at 156. Lindsey’s discussion of the term “auto accident” is not rendered inap-posite because we continued to discuss additional policy language.
Moreover, that the term “motor vehicle accident” might connote a more restrictive
(a) No automobile liability insurance policy ... covering liability arising out of the ... use of any motor vehicle shall be delivered or issued for delivery in this state unless personal injury protection coverage is provided therein or supplemental thereto.
(b) “Personal injury protection” consists of provisions of a motor vehicle liability policy which provide for payment to the named insured in the motor vehicle liability policy ... up to an amount of $2,500 for each such person for payment of all reasonable expenses arising from the accident
Tex. Ins.Code art. 5.06-3 (emphasis added). “The accident” for which PIP payments are statutorily required refers to subsection (a)’s liability “arising out of the ... use of any motor vehicle.” Other jurisdictions’ no-fault statutes also speak in terms of accidents resulting from or arising out of the vehicle’s use.
Therefore, while the court of appeals conflated Lindsey’s discussion of two separate policy terms, 65 S.W.3d at 766-67, its approach comports with the mandatory statutory provisions for PIP coverage. The court’s consideration of the vehicle’s involvement in Sturrock’s accident did not expand coverage beyond the policy’s language and is consistent with Texas case law and decisions from other jurisdictions. See cases cited supra note 8.
We find it significant that courts across the nation have found no-fault coverage to exist in similar circumstances. Generally, if a claimant sustains injuries from a slip- and-fall accident while entering into or alighting from the covered vehicle, the courts are consistent in holding there is coverage.
The dissenting justices assert that cases interpreting “arising out of’ policy language are inapposite when interpreting policy language that requires the injury to result from a “motor vehicle accident.” 146 S.W.3d at 139 (Owen, J., dissenting). The dissent then proceeds to provide a litany of cases, with no analysis, which stand for the proposition that not all accidents involving a vehicle in some manner are covered by PIP policies with potentially broader language. See, e.g., Kordell v. Allstate Ins. Co., 230 N.J.Super. 505, 554 A.2d 1, 2 (Ct.A.D. 1989) (finding no coverage when insured died from a heart attack while stopped at a red light). In citing the above cases we do not mean to suggest that policies covering injuries “arising out of the use” of the vehicle and those covering injuries resulting from “motor vehicle accidents” provide identical coverage; we simply find it notable that, nationwide, states provide no-fault PIP benefits for injuries sustained in similar incidents.
Moreover, our approach comports with other language that appears in Sturrock’s
rv
We hold that a “motor vehicle accident” occurs when (1) one or more vehicles are involved with another vehicle, an object, or a person, (2) the vehicle is being used, including exit or entry, as a motor vehicle, and (3) a causal connection exists between the vehicle’s use and the injury-producing event. Here, Sturrock was injured when his left foot became entangled with his car’s door facing while he was exiting the vehicle. We conclude that Sturrock’s injury resulted from a “motor vehicle accident” within the policy’s terms, and affirm the court of appeals’ judgment.
. Texas Rule of Civil Procedure 263, entitled "Agreed Case,” provides:
Parties may submit matters in controversy to the court upon an agreed statement of facts filed with the clerk, upon which judgment shall be rendered as in other cases; and such agreed statement signed and certified by the court to be correct and the judgment rendered thereon shall constitute the record of the cause.
. Texas Farm Bureau argues that Sturrock is bound by his response to a Request for Admissions that "I was not involved in a 'motor vehicle accident,’ but I was involved in an accident involving a motor vehicle.” However, the Agreed Statement of Facts submitted to the trial court did not mention Sturrock’s admission; rather, the parties stipulated that the Agreed Statement included "all the ultimate facts essential for determination of the claim" and that "[n]o other facts are relevant
. In this context, the terms “auto accident,” "automobile accident,” and "motor vehicle accident” are interchangeable, as the parties assume. See also Tex. Dep’t of Ins. Commissioner’s Bulletin, No. B-0004-01 (Feb. 5, 2001) (stating that “auto policies and endorsements referring to 'an accident,’ ‘the accident,' 'motor vehicle accident,’ or ‘auto accident' mean the same as if the word ‘occurrence’ were substituted for the word ‘accident.’ ”).
. The Attorney General's amicus brief, filed on the Texas Department of Insurance’s behalf, states:
[Texas Farm Bureau] unsuccessfully attempts] to distinguish Lindsey on the grounds that [Sturrock's] policy does not contain language like the policy in Lindsey, which required the injuries to “arise out of” the “use of a motor vehicle.” ... This Court, however, addressed that language only after first concluding that there was an "accident” within the definition of “motor vehicle accident.” And it is the "accident” analysis in Lindsey that is material to this case. Lindsey is not rendered inapposite simply because [Sturrock] need not shoulder the additional burden of demonstrating that his injuries "arise out of the use” of the vehicle — though obviously they did. Even under Lindsey’s definition of "motor vehicle accident,” PIP coverage exists for [Stur-rock's] claim. (Citation omitted).
. The origin of the language we used in Griffin supports this interpretation. The language originated in Farmers Insurance Co. of Washington v. Grelis, 43 Wash.App. 475, 718 P.2d 812, 813 (1986), in which the court stated that the " 'words [motor vehicle accident] evoke an image of one or more vehicles in forceful contact with another vehicle or a person causing physical injury.' ” Id. (emphasis added) (quoting Manhattan & Bronx Surface Transit Operating Auth. v. Gholson, 98 Misc.2d 657, 414 N.Y.S.2d 489, 490 (Spec. Term 1979), aff'd, 71 A.D.2d 1004, 420 N.Y.S.2d 298 (N.Y.App.Div. 1979)).
. To the extent Berry v. Dairyland County Mutual Insurance Co. of Texas, 534 S.W.2d 428 (Tex.Civ.App.-Fort Worth 1976, no writ), is inconsistent with our holding today, we disapprove it.
.We recognize that the Griffin definition was derived from Peck, 900 S.W.2d at 913, which did require a vehicle’s involvement "in some type of collision or near collision.” However, our decisions in Griffin and Lindsey firmly establish that no such requirement exists. We further note that the Texas Department of Insurance, the agency entrusted with promulgating and enforcing standard and uniform insurance policies, recognizes that the term "motor vehicle accident” is not limited to a collision unless explicitly stated in the policy. Tex. Dep’t of Ins. Commissioner's Bulletin, No. B-0004-01 (Feb. 5, 2001).
. Peck, 900 S.W.2d at 913 (denying PIP coverage because "the only nexus between the accident and the vehicle was the fact that Salazar was sitting in the vehicle when he got bit [by the dog]”); see also State Farm Mut. Auto. Ins. Co. v. Barth, 579 So.2d 154, 156 (Fla.Dist.Ct.App. 1991) ("[I]n order for a loss to 'arise out of’ the use of a motor vehicle, for the purpose of determining whether personal injury protection coverage exists, 'some nexus’ between the vehicle and the injury is all that is required.”); Gov’t Employees Ins. Co. v. MFA Mut. Ins. Co., 802 P.2d 1122, 1124 (Colo.Ct.App. 1990) ("A 'but-for’ test is to be applied in determining whether this requisite causal relationship exists between the injury and the use of an insured vehicle.”); Gray v. Allstate Ins. Co., 668 A.2d 778, 780 (Del.Super.Ct. 1995) (to constitute an "accident involving a motor vehicle” and thus qualify for PIP coverage, a causal connection is required between the use of the vehicle and the injury); Allied Mut. Ins. Co. v. Patrick, 16 Kan.App.2d 26, 819 P.2d 1233, 1236 (1991) (holding that "there must be some causal connection between the accident and the automobile allegedly involved” for coverage to exist); Putkamer, 563 N.W.2d at 687 (finding that Michigan's no-fault statute required the injury to be causally related to claimant's use of the parked motor vehicle); Shinabarger v. Citizens Mut. Ins. Co., 90 Mich.App. 307, 282 N.W.2d 301, 305 (1979) ("[Cjases construing the phrase ‘arising out of the use of a motor vehicle’ uniformly require that the injured person establish a causal connection between the use of the motor vehicle and the injury.”); Cont’l W. Ins. Co. v. Klug, 415 N.W.2d 876, 878 (Minn. 1987) (setting forth factors to consider in determining whether accident arises out of use or maintenance of automobile, including extent of causation between automobile and injury); Iordan, 486 S.W.2d at 667 (explaining that the "automobile must, in some manner, be involved in the accident”); Lebroke v. United States Fid. & Guar. Ins. Co., 146 N.H. 249, 769 A.2d 392, 394 (2001) (citing Peck with approval for the proposition that an auto accident requires, at the very least, the involvement of the automobile); Schweitzer v. Aetna Life & Cas. Co., 306 Pa.Super. 300, 452 A.2d 735 (1982) ("[T]here must be some connection, more than mere chance or happenstance, between the injuries sustained and the insured vehicle.”); Schulz v. State Farm Mut. Auto. Ins. Co., 930 S.W.2d 872, 875 (Tex.App.-Houston [1st Dist.] 1996, no writ) (explaining that mere fact that vehicle was involved is not sufficient; rather, claimant must show that injuries resulted from a motor vehicle accident); Tyrrell, 994 P.2d at 838 (holding that "the sensible and popular understanding of what a 'motor vehicle accident' entails necessarily involves the motor vehicle being operated as a motor vehicle ”); 8 Russ & Segalla, Couch on Insurance 3d § 119:5 (1997) ("[T]he automobile must, in some manner, be involved in the accident. ..."); 4 Long, The Law of Liability Insurance § 28.05(1), at 29 (1991) (“Under any reasonable interpretation of statutory or policy language there must be a nexus or causal connection between the motor vehicle and the injuries sustained in order for no-fault coverage to attach.”).
. See, e.g., Trinity Universal Ins. Co. v. Hall, 690 P.2d 227, 229 (Colo. 1984) (en banc); Blish v. Atlanta Cas. Co., 736 So.2d 1151, 1153 (Fla. 1999); State Farm Mut. Auto. Ins. Co. v. Canady, 143 Ga.App. 546, 239 S.E.2d 152, 153 (1977); Ky. Farm Bureau Mut. Ins. Co. v. Hall, 807 S.W.2d 954, 955 (Ky.Ct.App. 1991); Putkamer, 563 N.W.2d at 686-87; Haagenson v. Nat'l Farmers Union Prop. & Cos. Co., 277 N.W.2d 648, 651 (Minn. 1979); Ohio Cas. Group of Ins. Cos. v. Gray, 323 N.J.Super. 338, 732 A.2d 1145, 1146 (Ct.App.Div. 1999); Hill v. Metro. Suburban Bus Auth., 157 A.D.2d 93, 555 N.Y.S.2d 803, 806 (App.Div. 1990); State Farm Mut. Auto. Ins. Co. v. Estate of Gabel, 539 N.W.2d 290, 292 (N.D. 1995); Schweitzer, 452 A.2d at 736-37; 4 Long, The Law of Liability Insurance § 28.05(1), at 26 (1991) ("The typical policy requires that the accident involve the occupancy, operation, maintenance, or use of the vehicle in order to fall within the policy coverage.”). We note that the uniformity in language likely results from the widespread adoption of the language from the Uniform Motor Vehicle Accident Reparations Act. See Uniform Motor Vehicle Accident Reparations Act § 1, 14 U.L.A. 41 (1995); see also Estate of Gabel, 539 N.W.2d at 293 (quoting St. Paul Mercury Ins. Co. v. Andrews, 321 N.W.2d 483, 487 (N.D. 1982)) (" 'Unless one believes in a miraculous coincidence in choice of words or widespread plagiarism, it is difficult to escape the conclusion that North Dakota and many other jurisdictions have enacted parts of the [Uniform Act]....'”).
. See Walker v. M & G Convoy, Inc., No. CIV.A. 88C-DE-191, 1989 WL 158511, at *1 (Del.Super.Ct. Nov.2, 1989) (concluding that claimant who slipped and fell on ice while securing cars on his employer's car trailer was an occupier of the vehicle and therefore entitled to PIP coverage); Padron v. Long Island Ins. Co., 356 So.2d 1337, 1339 (Fla.Dist.Ct.App. 1978) (concluding that injuries
. See Allstate Ins. Co. v. Howe, 31 Conn.App. 132, 623 A.2d 1031, 1034 (1993) (finding that UIM coverage existed for injuries sustained when claimant was grasping door handle pri- or to being struck); State Farm Mut. Auto. Ins. Co. v. Vaughn, 253 Ga.App. 217, 558 S.E.2d 769, 771 (2002) (finding that a student was "using” a school bus, and thus was entitled to UM insurance, when she was hit by a vehicle while crossing the road to gain entry to the bus); Lumbermen's Mut. Cas. Co. v. Norris, 15 Ill.App.3d 95, 303 N.E.2d 505, 507 (1973) (UM coverage existed for passenger who got off car’s fender to avoid oncoming car but was struck nonetheless); Aucoin v. Lafayette Ins. Co., 771 So.2d 95, 100 (La.Ct.App. 2000) (UM insurance covered injuries sustained while leaning against car); Hunt v. Citizens Ins. Co., 183 Mich.App. 660, 455 N.W.2d 384, 386 (1990) (finding that PIP coverage existed for victim of hit-and-run accident since he was in the process of entering the vehicle when hit); Olsen v. Farm Bureau Ins. Co. of Neb., 259 Neb. 329, 609 N.W.2d 664, 671 (2000) (holding that liability insurance covered the injuries sustained when claimant exited car and was struck by a live wire since the claimant was still occupying the vehicle); Travelers Indem. Co. v. Commercial Union Ins. Cos., 368 Pa.Super. 159, 533 A.2d 765, 767-68 (1987) (holding UM policy provider was the proper source of loss benefits for injuries sustained when claimant’s car was struck while he was seated in his car with his left foot still on the ground); Whitmire v. Nationwide Mut. Ins. Co., 254 S.C. 184, 174 S.E.2d 391, 395 (1970) (UM coverage existed for injury sustained by insured while running away from parked car after noticing its imminent collision with an oncoming vehicle); Nat'l Life & Accident Ins. Co. v. Hunter, 519 S.W.2d 709, 710-11 (Tex.Civ.App.-Beaumont 1975, writ ref'd n.r.e.) (finding that testimony that decedent had not let go of the automobile from which he had emerged permitted the trial court to conclude that insured was a passenger entitled to coverage); Newman v. Erie Ins. Exch., 256 Va. 501, 507 S.E.2d 348, 352 (1998) (finding that a student was "using” a school bus, and thus was entitled to UM insurance, when she was hit by a vehicle while crossing the road to gain entry to the bus).
. See Chamblee v. State Farm Mut. Auto. Ins. Co., 601 So.2d 922, 924 (Ala. 1992) (liability coverage denied for injuries to child sustained when child darted into street from median while crossing the street after exiting parked vehicle, as this constituted new activity that was disassociated from the "use” of the vehicle); Testone v. Allstate Ins. Co., 165 Conn. 126, 328 A.2d 686, 690 (1973) (finding that tow truck worker was not entitled to UM coverage since he was two or three feet from vehicle when injured and was therefore not entering the vehicle); Adamkiewicz v. Milford Diner, Inc., No. 90C-JA-23, 1991 WL 35709, at *1 (Del.Super.Ct. Feb.13, 1991) (slip and
Dissenting Opinion
joined by Justice HECHT, Justice WAINWRIGHT, and Justice BRISTER, dissenting.
The average person would not think that tripping over the threshold of a pickup truck’s door while exiting is a “motor vehicle accident.” Because the Court does not give these words their commonly understood meaning, I respectfully dissent.
I
This case was submitted to the trial court on stipulated facts. Sturrock had been driving his truck. He stopped the vehicle, parked, and turned off the ignition. The parties’ agreed statement of facts says, “Sturrock then turned and opened the door, and as he was exiting the vehicle, his left foot somehow became entangled, and he almost slipped and fell and caught himself, and that is when he felt the burning in his neck and shoulder area. The exiting the vehicle [sic] caused him to do that.” In describing the incident further, the agreed statement of facts said, “[h]e hung his foot on the raised portion of the door facing on his truck,” “Sturrock somehow injured his neck, shoulder, and upper back as he was getting out of his pick-up,” and “Sturrock’s injury on April 10 was not caused by an impact between any portion of his body and any portion of his pickup.”
The personal injury protection (PIP) provisions of Sturrock’s policy say:
A. We will pay Personal Injury Protection benefits because [of] bodily injury:
1. resulting from a motor vehicle accident; and
2. sustained by a covered person.
* * *
C. “Covered person” as used in this Part means:
*135 1. You or any family member:
a. while occupying; or
b. when struck by;
a motor vehicle designed for use mainly on public roads or a trailer of any type.
2. Any other person while occupying your covered auto with your permission.
The trial court concluded that Sturrock’s injuries were covered. A divided court of appeals affirmed.
There is no dispute that Sturrock is a “covered person.” The parties so stipulated. There is no dispute that Sturrock was occupying a motor vehicle at the time of his injury. But coverage under the PIP provisions does not attach simply because an insured was injured “[wjhile occupying” a covered motor vehicle. “[Bjodily injury” must “result[ ] from a motor vehicle accident.”
This Court had occasion in Farmers Texas County Mutual Insurance Co. v. Griffin
The Peck decision, cited in Griffin, is instructive. Salazar was a passenger in Peck’s vehicle while Peck, the insured, was taking her dog from a groomer to a veterinarian. Salazar was sitting in the back seat with the dog when the dog bit him, inflicting severe lacerations to his face.
The ordinary, generally accepted meaning of “motor vehicle accident” does not call to mind tripping over the threshold of a vehicle while exiting, notwithstanding a decision from a court of appeals more than thirty years ago, which held that injury had occurred in a motor vehicle accident when an insured with phlebitis in his leg “was favoring it as he twisted in order to get out of the car and as he did so his right knee caught and the cartilage snapped.”
The Lindsey case construed another section of the Texas standard auto policy, the uninsured/underinsured motorist provision.
“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.”19
The Court’s decision in Lindsey primarily focused on the “ ‘arise out of the ownership, maintenance or use of the ... motor vehicle’ ” language.
In the instant ease, the policy provision at issue does not contain the broad “arise out of the ownership, maintenance or use of the ... motor vehicle” language. The policy instead says that coverage applies only if there is “bodily injury: resulting from a motor vehicle accident” while a covered person is “occupying” or “struck by” a motor vehicle. Sturrock’s injury occurred when he was alighting from his vehicle. But that does not answer the question of whether his injury was one “resulting from a motor vehicle accident,” as the PIP provisions of his policy require.
In Lindsey we only briefly discussed what constitutes an “auto accident.”
Nothing in Lindsey suggests that the mere fact that an accident took place in an automobile means that it was an “auto accident.” To the contrary, we cited Peck with approval for the proposition that when a vehicle is merely the situs of the injury, there is no “auto accident.”
The Court today cites five cases from other jurisdictions that find coverage when an insured is injured entering or exiting a vehicle or is injured near a vehicle.
The Court cannot convincingly distinguish the decisions that do deal with policies that require an auto or motor vehicle
Subsequently, the Washington Supreme Court had occasion to construe the term “motor vehicle accident” when used in a policy. The policy provided coverage for “ ‘bodily injury to each insured person caused by a motor vehicle accident.’ ”
An image that easily comes to mind is an insured tripping while making the oft-difficult step down from the high doorway of a pickup truck or sports utility vehicle. Another is tripping— over, say, the threshold or a seatbelt— while entering a vehicle. Making all such accidents “motor vehicle accidents” for insurance purposes is a logical extension of the Court of Appeals’ holding that “the use of a vehicle depends on an insured’s ability to safely enter and exit it.” However, this definition does not fit*140 with “a fair, reasonable, and sensible construction as would be given to the contract by the average person purchasing insurance.” Nor would this construction of the term “motor vehicle accident” comport with the plain, ordinary, and popular meaning of that term.52
The Washington Supreme Court correctly discerned that there are quite a number of insurance policies that use language much broader than “bodily injury resulting from a motor vehicle accident,” which is the language in the Texas personal injury protection provisions. Cases construing policies with broader language, including those relied upon by the Court in this case, are inapposite when faced with a policy that requires a “motor vehicle accident” or “auto accident.”
Even when the language is broader and does not require an auto or motor vehicle accident, courts are divided on what is and is not covered. Courts have found no coverage under policy provisions covering (or directed by statute to cover) injuries incurred when “occupying, entering into, alighting from or using an automobile,”
To bolster its conclusion that Sturrock’s injuries come within the PIP provision, the Court cites a number of decisions that hold there is coverage when a vehicle collides with someone entering or exiting a covered vehicle.
The Court cites two Texas cases to support its holding. One is Southern Surety Co. v. Davidson,
II
Sturrock contends that the policy’s provision requiring a “motor vehicle accident” as a prerequisite for coverage contravenes the statute that governs PIP provisions in Texas.
No automobile liability insurance policy, including insurance issued pursuant*143 to an assigned risk plan established under authority of Section 35 of the Texas Motor Vehicle Safety-Responsibility Act, covering liability arising out of the ownership, maintenance, or use of any motor vehicle shall be delivered or issued for delivery in this state unless personal injury protection coverage is provided therein or supplemental thereto.71
The statute’s definition of “personal injury protection” is detailed, but it does not specify whether merely “an accident” will trigger coverage or whether a “motor vehicle accident” is required.
(b)“Personal injury protection” consists of provisions of a motor vehicle liability policy which provide for payment to the named insured in the motor vehicle liability policy and members of the insured’s household, any authorized operator or passenger of the named insured’s motor vehicle including a guest occupant, up to an amount of $2,500 for each such person for payment of all reasonable expenses arising from the accident and incurred within three years from the date thereof for necessary medical, surgical, Xray and dental services, including prosthetic devices, and necessary ambulance, hospital, professional nursing and funeral services, and in the case of an income producer, payment of benefits for loss of income as the result of the accident; and where the person injured in the accident was not an income or wage producer at the time of the accident, payments of benefits must be made in reimbursement of necessary and reasonable expenses incurred for essential services ordinarily performed by the injured person for care and maintenance of the family or family household. The insurer providing loss of income benefits may require, as a condition of receiving such benefits, that the insured person furnish the insurer reasonable medical proof of his injury causing loss of income. The personal injury protection in this paragraph specified shall not exceed $2,500 for all benefits, in the aggregate, for each person.
(c) The benefits required by this Act shall be payable without regard to the fault or nonfault of the named insured or the recipient in causing or contributing to the accident, and without regard to any collateral source of medical, hospital, or wage continuation benefits. An insurer paying benefits pursuant to this Act shall have no right of subrogation and no claim against any other person or insurer to recover any such benefits by reason of the alleged fault of such other person in causing or contributing to the accident.
(d) All payments of benefits prescribed under this Act shall be made periodically as the claims therefor arise and within thirty (30) days after satisfactory proof thereof is received by the insurer subject to the following limitations:
(1) The coverage described in this Act may prescribe a period of not less than six months after the date of accident within which the original proof of loss with respect to a claim for benefits must be presented to the insurer.73
The reasoning in Le v. Farmers Texas County Mutual Insurance Co. is sound. It is certainly reasonable and permissible under article 5.06-3 for a policy providing personal injury protection to require the occurrence of a “motor vehicle accident” before coverage is applicable. The coverage afforded under article 5.06-3(c) is in addition to any other insurance coverage, including medical insurance.
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We are constrained by the policy’s language. Sturrock’s injuries did not constitute “bodily injury ... resulting from a motor vehicle accident.” I would reverse and render judgment for the insurer in this case.
. 955 S.W.2d 81 (Tex. 1997).
. Id. at 81.
. Id. at 82.
. Id.
. 900 S.W.2d 910, 913 (Tex.App.-Amarillo 1995, no writ).
. 955 S.W.2d at 83. We omitted the words "in some type of collision or near collision” from this quote, without indicating the omission. The statement in Peck was: "[Tjhe term 'auto accident’ refers to situations where one or more vehicles are involved in some type of collision or near collision with another vehicle, object, or person.” 900 S.W.2d at 913.
. Peck, 900 S.W.2d at 911.
.Id. at 912.
. Id. at 913.
. Id.
. Id.
. Berry v. Dairyland County Mut. Ins. Co. of Tex., 534 S.W.2d 428, 429 (Tex.Civ.App.-Fort Worth 1976, no writ).
. 997 S.W.2d 153 (Tex. 1999).
. Id. at 154.
. Id. at 155 (alteration in original).
. Id. at 156 n. 11, 157 n. 18.
. Id. at 157 n. 21.
. Id., at 157-61 & nn. 21, 25 & 26.
. Id. at 158.
. Id.
. Id. at 156.
. Id. at 155.
. Id. (quoting Farmers Tex. County Mut. Ins. Co. v. Griffin, 955 S.W.2d 81, 83 (Tex. 1997) (quoting State Farm Mut. Ins. Co. v. Peck, 900 S.W.2d 910, 913 (Tex.App.-Amarillo 1995, no writ) (words omitted from Peck by Griffin not indicated in the text of Griffin))).
. Id. at 156.
. See id.
. Id.
. Id.
. Id. at 159 (alteration in original) (quoting 8 Couch on Insurance 3d § 119:64, at 119-98 (1997)).
. Id.
. Id.
. Id. at 157 n. 21, 158 n. 22, 159 n. 25, 161 n. 26, 162 nn. 27-30.
. See 146 S.W.3d at 131 n.10.
. See Walker v. M & G Convoy, Inc., No. CIV. A. 88C-DE-191, 1989 WL 158511, at *1 (Del.Super.Ct. Nov.2, 1989) (finding coverage when statute provided that PIP coverage shall apply to each person "occupying a motor vehicle" and plaintiff slipped and fell on ice while walking around his employer’s car trailer, onto which he was loading new cars, the engine was running and plaintiff was preparing to travel with the loaded trailer); Padron v. Long Island Ins. Co., 356 So.2d 1337, 1338-39 (Fla.Dist.Ct.App. 1978) (finding coverage when PIP statute said " 'bodily injury ... arising out of the ownership, maintenance, or use of a motor vehicle' ” and insured's foot slipped as he was exiting the vehicle "causing his right leg to hit the bottom part of the car door and break his leg. The plaintiff did not slide out of the car, but injured himself on the car door threshold as he was alighting therefrom.”); Putkamer v. Transamerica Ins. Corp. of Am., 454 Mich. 626, 563 N.W.2d 683, 686 (1997) (finding coverage under statute requiring coverage for " 'accidental bodily injury arising out of the ownership, operation, maintenance or use of a motor vehicle as a motor vehicle' ” and the statute said " '[ajccidental bodily injury does not arise out of the ownership, operation, maintenance, or use of a parked vehicle as a motor vehicle unless ... [T]he injury was sustained by a person while occupying, entering into, or alighting from the vehicle ’ " when the insured fell on ice as she placed her foot on the floor board of her car (alteration and emphasis in original)); Haagenson v. Nat’l Farmers Union Prop. & Cas. Co., 277 N.W.2d 648, 650-51 (Minn. 1979) (finding coverage under statute that required coverage for " 'injury arising out of the maintenance or use of a motor vehicle ' ” and the policy said " ‘[m]aintenance or use of a motor vehicle’ ” includes use " ‘[ijncident to its maintenance or use as a vehicle, occupying, entering into, and alighting from it' " when passenger accompanied a friend to the scene of an accident and was electrocuted by a downed power line as he was opening the door of his vehicle (alterations added)); Hill v. Metro. Suburban Bus Auth., 157 A.D.2d 93, 555 N.Y.S.2d 803, 805 (N.Y.App.Div. 1990) (finding coverage under statute covering " 'use or operation’ ” of a bus when the bus door caught the plaintiff's arm and she
. 43 Wash.App. 475, 718 P.2d 812 (1986).
. Grelis, 718 P.2d at 813.
. Id.
. Id.
. Id.
. Id.
. Id. at 814.
. Tyrrell v. Farmers Ins. Co. of Wash., 140 Wash.2d 129, 994 P.2d 833, 835-36 (2000).
. Id. at 835.
. Id. at 838.
. Id. at 837.
.Id. (citations omitted); see also State Farm Mut. Auto. Ins. Co. v. Rains, 715 S.W.2d 232, 233 (Ky. 1986) (finding that there was no "motor vehicle accident” in two separate, consolidated cases when, in the first case, the insured was hit in the head by an assailant with a baseball bat while trying to enter his vehicle, and in the second case, when the insured was in a vehicle that overturned when the driver was shot and killed, and the insured was shot while crawling out of the vehicle); Jordan v. United Equitable Life Ins. Co., 486 S.W.2d 664, 666 (Mo.Ct.App. 1972) (finding no coverage under a policy that required "accidental bodily injury” caused "solely by reason of an automobile ... accident” when the insured taxicab driver was robbed and shot to death by his passenger); but see Ganiron v. Haw. Ins. Guar. Assoc., 69 Haw. 432, 744 P.2d 1210, 1212 (1987) (finding coverage under policy that required a "motor vehicle accident” for insured who was struck by a bullet from a gun fired from another vehicle on the freeway); Union Mut. Fire Ins. Co. v. Commercial Union Ins. Co., 521 A.2d 308, 310 (Me. 1987) (finding coverage under policy that required an "auto accident” when on hunting trip, insured’s shotgun accidentally discharged, injuring passenger, when insured reached for the gun, which was in the back seat); State Capital Ins. Co. v. Nationwide Mut. Ins. Co., 318 N.C. 534, 350 S.E.2d 66, 67 (N.C. 1986) (finding coverage under policy that required "bodily injury ... for which any covered person becomes legally responsible because of an auto accident" when passenger was injured when a rifle accidentally discharged as the insured reached into the vehicle to retrieve a gun; rifle was not stored in a gun rack, but in a storage area behind the driver’s seat).
. Kordell v. Allstate Ins. Co., 230 N.J.Super. 505, 554 A.2d 1, 2 (Ct.App.Div. 1989) (finding no coverage when PIP statute said "sustained bodily injury as a result of an accident while occupying, entering into, alighting from or using an automobile” and insured died of a heart attack while stopped at a red light).
. Ross v. Protective Indem. Co., 135 Conn. 150, 62 A.2d 340, 341 (1948) (finding no coverage under policy that required "bodily injury, caused by accident and arising out of the use of the automobile ... while in or upon, entering or alighting from the automobile” when passengers exited from vehicle that had pulled onto the shoulder, went to the rear of the vehicle to urinate, and were struck by another vehicle while conversing after urinating).
. Boykin v. State Farm Mut. Auto. Ins. Co., 195 Ga.App. 401, 393 S.E.2d 470, 471 (1990) (finding no coverage when statute said " 'accidental bodily injury' ” includes " 'bodily injury ... arising out of the operation, maintenance, or use of a motor vehicle [as a motor vehicle] which is accidental’ ” when insured slipped on wet oily pavement about two feet from her car as she was approaching the vehicle after stopping at a convenience store for fueling); Cole v. N.H. Ins. Co., 188 Ga.
. Marklund v. Farm Bureau Mut. Ins. Co., 400 N.W.2d 337, 338 n. 2, 341 (Minn. 1987) (finding no coverage under statute that said "injury arising out of the maintenance or use of a motor vehicle” when insured slipped on ice and fell on a self-service gasoline station's concrete apron after filling and capping his car’s gas tank; insured did not come into physical contact with the vehicle after completing the refueling operation, although he was walking toward the passenger seat with the intention of getting a check from his wife to pay for the gas).
. Classified Ins. Corp. v. Vodinelich, 368 N.W.2d 921, 923 (Minn. 1985) (finding no coverage under policy that required "arising out of the use” of a motor vehicle when children died of carbon monoxide poisoning when their mother committed suicide by running the insured vehicle in an enclosed garage while leaving the door to the house ajar).
. Padron v. Long Island Ins. Co., 356 So.2d 1337, 1338 (Fla.Dist.Ct.App. 1978) (finding coverage when PIP statute said " ‘bodily injury ... arising out of the ownership, maintenance, or use of a motor vehicle' ” and insured’s foot slipped as he was exiting the vehicle "causing his right leg to hit the bottom part of the car door and break his leg. The plaintiff did not slide out of the car, but injured himself on the car door threshold as he was alighting therefrom”).
. Blish v. Atlanta Cas. Co., 736 So.2d 1151, 1153, 1155 (Fla. 1999) (finding coverage under PIP policy provision that required injury " 'arising out of the ownership, maintenance, or use of a motor vehicle' ” when insured was attacked by several assailants after his tire blew out and he stopped to change it); Hernandez v. Protective Cas. Ins. Co., 473 So.2d 1241, 1242-43 (Fla. 1985) (finding coverage under PIP policy provision that required injury " 'arising out of the ownership, maintenance or use of a motor vehicle’ ” when insured suffered injuries in the course of his arrest for an alleged traffic violation; supreme court inferred insured was occupying the vehicle at the time); Barry v. Ill. Farmers Ins. Co., 386 N.W.2d 299, 300-01 (Minn.Ct.App. 1986) (finding coverage under policy that said " ‘maintenance or use of a motor vehicle’ ” means " 'maintenance or use of a motor vehicle as a vehicle, including, incident to its maintenance or use as a vehicle, occupying, entering into, and alighting from it’ ” when insured backed vehicle out of her garage, got out to close the garage door with vehicle idling and slipped and fell on the ice as she approached the car door to get back in); lor-gensen v. Auto-Owners Ins. Co., 360 N.W.2d 397, 399-401 (Minn.Ct.App. 1985) (finding coverage when statute said " 'all loss suffered through injury arising out of the maintenance or use of a motor vehicle’ ” and " 'maintenance or use of an automobile' ” means " 'maintenance or use of a motor vehicle as a vehicle, including, incident to its maintenance or use as a vehicle, occupying, entering into, and alighting from it. Maintenance or use ... does not include ... loading and unloading the vehicle unless the conduct occurs while occupying, entering into or alighting from it’ ”; plaintiff was burned when he caught fire after a can of gasoline stored inside the trunk of his father’s car exploded as he was opening the trunk to retrieve some jumper cables; plaintiff was not injured by the initial explosion; rather, he was injured when he reached in to remove the gas can, fearing that the car would blow up or cause the gas station (where the car was) to explode, and he tipped or caught the gasoline can on the trunk of the insured vehicle, causing gasoline to spill on himself; the parties stipulated that a defective trunk wire ignited the gas fumes); Spisak v. Nationwide Mut. Ins. Co., 329 Pa.Super. 483, 478 A.2d 891,
. Walker v. M & G Convoy, Inc., No. CIV. A. 88C-DE-191, 1989 WL 158511, at *1 (Del.Super.Ct. Nov.2, 1989) (finding coverage when statute provided that PIP coverage shall apply to each person “occupying a motor vehicle” and plaintiff slipped and fell on ice while walking around his employer’s car trailer, onto which he was loading new cars, the engine was running, and plaintiff was preparing to travel with the loaded trailer).
. Mid-Continent Cas. Co. v. Giuliano, 166 So.2d 443, 445 (Fla. 1964) (finding coverage under PIP policy provision that required "bodily injury ... caused by accident while ... alighting from” the insured motor vehicle when insured injured his back while exiting the insured motor vehicle).
. State Farm Mut. Auto. Ins. Co. v. Barth, 579 So.2d 154, 155 (Fla.Dist.Ct.App. 1991) (finding coverage under PIP policy provision that required " loss sustained ... as a result of bodily injury ... arising out of ... use of a motor vehicle’ ” when insured was attacked by an assailant while sitting in her car, struggled free, and fell out the driver’s door).
. 146 S.W.3d at 130-31 &n.ll.
. 280 S.W. 336 (Tex.Civ.App.-Fort Worth 1926, no writ).
. Id. at 336 (alteration added).
. 534 S.W.2d 428, 433 (Tex.Civ.App.-Fort Worth 1976, no writ).
. Farmers Tex. County Mut. Ins. Co. v. Griffin, 955 S.W.2d 81, 83 (Tex. 1997).
. Tex. Ins.Code art. 5.06-3.
. Act of April 11, 1973, 63d Leg., R.S., ch. 52, § 1, 1973 Tex. Gen. Laws 90, 90-93.
. Tex. Ins.Code art. 5.06-3(a).
. Id.
. Id. art. 5.06-3(b)-(h).
.Id. art. 5.06-3(b), (c), (d)(1) (emphasis added).
. 936 S.W.2d 317, 323-24 (Tex.App.-Houston [1st Dist.] 1996, writ denied).
. Id. at 324.
. Id.
. 534 S.W.2d 428, 431 (Tex.App.-Ft. Worth 1976, no writ).
. Tex. Ins. Code § 5.06-3(c).
.Id.
Reference
- Full Case Name
- TEXAS FARM BUREAU MUTUAL INSURANCE COMPANY, Petitioner, v. Jeff A. STURROCK, Respondent
- Cited By
- 51 cases
- Status
- Published