Why it matters

Bad facts sometimes leave a policyholder without coverage. But an insured man in Ohio managed to overcome some very bad facts when an appellate court reversed summary judgment for his insurer and held that he may be entitled to coverage – even though he pushed the man his wife cheated on him with into a urinal rendering him unconscious. The insurer refused to defend the man when the former lover filed suit on the basis that the incident was not a covered occurrence under the policy because it was not an accident. After all, the man admitted he shoved his former rival. The appellate court disagreed, holding that intentional acts can still give rise to accidental results, such as throwing a baseball (intentional act) and breaking a window (accident), or confronting your wife’s ex-lover and shoving him (intentional) and he hits his head on a urinal and is knocked unconscious (accident).

Detailed Discussion

John Musil and his wife Peggy have been married for 31 years. However, Peggy admitted to her husband in 2010 that she had an affair with Nick Schaefer. The couple underwent counseling and stayed together.

In 2011 the Musils attended a local concert. Returning from a trip to the concession stand, Peggy was crying and upset. She told her husband that she had run into Schaefer. After calming his wife, Musil went to the restroom. He testified that as he was waiting in line, he thought he saw Schaefer in front of him.

According to Musil’s testimony, he stepped out of line and confronted Schaefer when the man stepped up to use a urinal. Yelling at Schaefer to leave his wife alone, Musil pushed his right shoulder in an attempt to turn him so the men would be facing each other. Instead, Schaefer fell, hit his head, and was rendered unconscious.

Schaefer filed suit alleging he was injured by the fall. Musil’s insurer sought a declaratory judgment that it had no obligation to him under his homeowner’s policy. A trial court agreed and granted summary judgment for the insurer, holding that the incident was not a covered “occurrence” under the policy.

But the appellate court reversed.

The policy defined “occurrence” as “an accident…resulting in bodily injury or property damage,” but did not include a definition of “accident.” While the court recognized that Musil admitted he intentionally pushed Schaefer, “an intentional act does not necessarily preclude the finding of an accident, an unintended and unforeseen injury.”

For example, the court stated that a baseball intentionally thrown that accidentally breaks the neighbor’s window, the intentional lane change that forces another driver into the ditch, or the intentionally started trash fire that spreads to an adjacent lot – none of these would be covered under the insurer’s position.

Insurance contracts must be viewed as a whole, the court added, and if all injuries that resulted from an intentional act were automatically excluded under the definition of an occurrence, there would be no need for the intentional act exclusion.

To read the decision in Schaefer v. Musil, click here.