September 26, 2014

Florida Homeowner’s Insurance Policy Must Cover Multiple Instances of Injury Because of Ambiguous Contract Language

dogWhen an accident or injury occurs at home, a homeowner’s insurance policy should provide personal liability coverage. It is not uncommon, however, for an insurance company to attempt to limit its responsibility under the policy. A Florida appeals court has addressed the issue of multiple occurrences of injury, and whether a homeowner’s policy will cover each occurrence.

In Maddox v. Florida Farm Bureau General, Etc. et. al., the Fifth District held in favor of an injury victim due to ambiguities in a homeowners’ insurance policy. In that case, the plaintiff was living with her boyfriend in a residence that was insured under a homeowner’s policy issued by the defendant insurer. The injuries at issue in the case were sustained as a result of multiple dog bites to the plaintiff as well as her son. The evidence showed that a dog belonging to the plaintiff’s boyfriend began attacking one of the plaintiff’s young sons. The plaintiff and her boyfriend attempted to stop the attack, but the dog then attacked the plaintiff. Both victims sustained facial injuries.

The homeowner’s insurance policy in question provided personal liability coverage limited to $100,000 for each “occurrence.” The term “occurrence,” as defined in the particular policy, meant an accident that resulted in bodily injury. However, the policy also stated that any bodily injury resulting from continuous exposure to the same harmful conditions would be considered to be the result of one “occurrence.”

When the plaintiff brought suit, the insurer claimed that it was not liable for any damages over and above the payments already made for the young son’s injuries. The insurance company contended that the plaintiff’s injuries were sustained during the same “occurrence” as the dog attack to her son. It argued, therefore, that the per occurrence limit of $100,000 had already been exhausted. On the contrary, the plaintiff argued that the injuries occurred as a result of two separate occurrences. The trial court agreed with the insurer, and it declared that only one payment of $100,000 was owed.

However, the appellate court held differently, concluding that the dog attacks constituted two occurrences. The Fifth District cited to a Florida Supreme Court decision in a gun violence case to support its ruling. In Koikos v. Travelers Ins. Co., the Florida Supreme Court adopted a method for determining the number of “occurrences” covered under a homeowners’ insurance policy. Unless a policy specifically states otherwise, a Florida court will look to the cause of an individual’s injuries in determining the number of occurrences. In Koikos, a restaurant was hosting a party when an intruder fired gunshots in the establishment. Two of the party-goers were struck by a single bullet, and three other guests were injured. In a similar argument, the insurance company in that case argued that the shooting was only one occurrence under the insurance policy. However, the Florida Supreme Court held that each individual shooting was distinct. Each act that causes injury or damage constitutes an occurrence, according to the high court.

Importantly, homeowners’ insurance policies can and do contain clear and specific provisions that limit the number of occurrences. However, if a policy is ambiguous, as in the Maddox and Koikos cases, it will be interpreted against the insurer. In the dog bite case, the policy was construed to mean that each dog attack constituted a separate occurrence.

If an insurance company has attempted to limit your recovery due to technicalities in the policy, you may have a claim for legal recourse. The Southwest Florida injury attorneys at Lusk, Drasites & Tolisano are skilled in dealing with insurance companies to get you the compensation for your medical costs and lost work. We encourage those living in Fort Myers, Naples, Cape Coral or surrounding areas to speak with one of our attorneys to discuss your injuries. You can contact us online or call toll-free at (800) 238-7442.

Posted in: Personal Injury, Dog Bites

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