American Family Insurance Co. v. Walser

STRINGER, Justice

(dissenting).

I respectfully dissent. The insurance policy at issue here provides coverage if the insured becomes legally obligated to pay damages for “bodily injury or property damage * * * caused by an occurrence during the policy period.” The term “occurrence” is defined in the policy as “an accident, including continuous or repeated exposure to substantially the same general harmful conditions.” The policy also states that it “will not pay for damages due to bodily injury or property damage expected or intended from the standpoint of the insured.” Under the language of the insurance policy, it makes no difference whether the insured intended injury or not — the only concern is whether the act causing the injury was accidental or intentional.

It is undisputed that Jewison, a ninth grade student, was injured when he fell from where he was hanging from the rim of a basketball hoop to a gymnasium floor. It is also undisputed that Walser, a sophomore, and Shoemaker, a senior, deliberately and repeatedly tugged at Jewison’s ankles in an attempt to get him down from the basketball rim. Jewison testified that the boys backed up while pulling on his ankles so that he hung from the rim at an angle. Walser acknowledged they might have been pulling Jewison’s legs at an angle. Jewison fell when, after repeated attempts to dislodge Jewison from the basketball rim, Walser and Shoemaker both took hold of his ankles and pulled harder and at an angle from a direct line to the floor, causing him to lose his grip.

Beginning, as we must, with the language of the policy, Franklin v. Western Nat’l Mut. Ins. Co., 574 N.W.2d 405, 407 (Minn.1998), the American Family insurance agreement provides:

We will pay, up to our applicable limit, compensatory damages which any insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. The bodily injury or property damage must be caused by an occurrence during the policy period. The occurrence must take place in the coverage territory.

(emphasis removed). An occurrence, under the policy definition, is “an accident * * *.» ⅛6 p0iiCy provides coverage for bodily injury “caused by an accident.” “Accident,” as we defined it in Hauenstein, “is an unexpected, unforeseen, or unde-signed happening or consequence * * *.” 242 Minn. at 358-59, 65 N.W.2d at 126. Where the majority errs is in concluding that “an accident” is a “consequence” it is not, and that analysis ignores the plain policy language stating that “an accident” *616must be the cause of the bodily injury. Clearly, Jewison’s injury here was not caused by an accident for the simple reason that Walser and Shoemaker acknowledged that they intended to pull Jewison from the rim of the basketball hoop. His fall was not “an unexpected, unforeseen, or undesigned happening or consequence” it was fully intended. Thus, under the plain language of the insurance policy here, I would conclude there is no coverage.

Coverage is also barred by the intentional acts exclusion. Paragraph 11 of the American Family policy provides an exclusion for intentional injury: “We will not pay for damages due to bodily injury or property damage expected or intended from the standpoint of the insured.” (emphasis in original). Jewison characterized the incident as “just goofing around.” An inference of intent to cause bodily injury arises and the insured’s conduct falls within the intentional injury exception of an accident policy however where the insured’s actions are such that the insured knew or should have known “that harm was substantially certain to result” from that conduct. See, e.g., R.W. v. T. F., 528 N.W.2d 869, 872 (Minn.1995); State Farm Fire & Gas. Co. v. Wicka, 474 N.W.2d 324, 329 (Minn.1991).

The majority strains to redefine the common sense notion of accident to reach the conclusion that because the injury was not specifically intended, the event must have been an accident.1 But when Walser and Shoemaker repeatedly pulled on Jewi-son’s ankles, they accomplished precisely what they intended to cause him to lose his grip on the hoop and to fall. Where does their intentional conduct end just before Jewison crashed to the floor injuring himself? How does what Walser and Shoemaker did here differ from pushing Jewi-son to get him off a ledge injury is likely if not certain to occur. Jewison’s fall from the basketball rim was not an accident. It was the foreseeable and expected result of repeated tugs on his anides by his two older classmates pulling at an angle below him on the floor. Indeed, it is difficult to imagine a scenario in which injury is more likely to occur than where a young boy is hanging by his hands from a narrow metal rim several feet above a hard floor and his feet are pulled at an angle from under him by the two older boys, causing his fall. Only a suspension of the law of gravity could have interceded to prevent the ensuing injury.

The majority states that an insured’s conduct does not fall within the intentional injury exception unless the insured “acted with deliberate and calculated indifference to the risk of injury.” Evidence of deliberate and calculated indifference to the inherent risks of an action taken against another may be helpful in determining that an act was not accidental, but such a standard is an unnecessary departure from our previous holdings regarding intentional injury. See R.W. v. T.F., 528 N.W.2d at 873 (holding that “while not necessarily malicious,” insured’s decision to engage in unprotected sexual intercourse with claimant where the insured knew or should have known that he had herpes and that he could transmit the disease through such activity was intentional injury); Continental Western Ins. Co. v. Toal, 309 Minn. 169, 177-78, 244 N.W.2d 121, 126 (1976) (holding that although insureds did not specifically intend to injure anyone, they knew accomplices brought loaded guns and *617they followed through with the robbery with the knowledge that someone might well be injured or killed).

The policy at issue does not provide coverage for liability resulting from the conduct presented here. I would affirm the court of appeals.

. The majority argues this dissent hinges on the grammatical structure of the policy language and rejection of our definition of accident in Hauenstein. This is plainly incorrect, as no amount of grammatical maneuvering will alter the intentional and injurious character of the actions taken by Walser and Shoemaker.