Case Title: Estate of James B. Sustache v. American Family Mutual Ins. Co.

Citation: 2008 WI 87

Docket Number: 2006AP000939

State: wisconsin

Court: Wisconsin Supreme Court

Date: 2008-07-10T00:00:00Z

Document:
2008 WI 87 
 
SUPREME COURT OF WISCONSIN 
 
 
 
 
 
CASE NO.: 
2006AP939 
COMPLETE TITLE: 
 
 
Estate of James B. Sustache, by its Special 
Administrator, James Sustache, and Antoinette 
Sustache, 
          Plaintiffs, 
 
     v. 
 
American Family Mutual Insurance Company, 
          Defendant-Respondent, 
 
Carrie A. Roman, 
          Defendant, 
 
Larry Mathews and Jeffrey W. Mathews, 
          Defendants-Appellants-Petitioners. 
 
 
 
 
 
 
REVIEW OF A COURT OF APPEALS DECISION 
2007 WI App 144 
Reported at: 303 Wis. 2d 714, 735 N.W.2d 186 
(Ct. App. 2007-Published) 
 
 
OPINION FILED: 
July 10, 2008   
SUBMITTED ON BRIEFS: 
        
ORAL ARGUMENT: 
February 29, 2008   
 
 
SOURCE OF APPEAL: 
 
 
COURT: 
Circuit   
 
COUNTY: 
Kenosha   
 
JUDGE: 
Wilbur W. Warren III   
 
 
 
JUSTICES: 
 
 
CONCURRED: 
BRADLEY, J., concurs (opinion filed).   
 
DISSENTED: 
        
 
NOT PARTICIPATING:         
 
 
 
ATTORNEYS: 
 
For the defendants-appellants-petitioners there were briefs 
by John V. O’Connor and O’Connor, Dumez, Alia & McTernan, S.C., 
Kenosha, and oral argument by John V. O’Connor. 
 
For the defendant-respondent there was a brief by Terry J. 
Booth and Piper & Schmidt, Milwaukee, and oral argument by Terry 
J. Booth. 
 
 
 
2 
An amicus curiae brief was filed by James A. Friedman, 
Katherine Stadler, and Godfrey & Kahn, S.C., Madison, on behalf 
of the Wisconsin Insurance Alliance. 
 
 
 
 
2008 WI 87
NOTICE 
This opinion is subject to further 
editing and modification.  The final 
version will appear in the bound 
volume of the official reports.   
No.  2006AP939  
(L.C. No. 
2005CV1110) 
STATE OF WISCONSIN  
 
 
   : 
IN SUPREME COURT 
 
 
Estate of James B. Sustache, by its Special 
Administrator, James Sustache, and Antoinette 
Sustache, 
 
          Plaintiffs, 
 
     v. 
 
American Family Mutual Insurance Company, 
 
          Defendant-Respondent, 
 
Carrie A. Roman, 
 
          Defendant, 
 
Larry Mathews and Jeffrey W. Mathews, 
 
          Defendants-Appellants-Petitioners. 
FILED 
 
JUL 10, 2008 
 
David R. Schanker 
Clerk of Supreme Court 
 
 
 
 
 
REVIEW of a decision of the Court of Appeals.  Affirmed. 
 
¶1 
DAVID T. PROSSER, J.  This is a review of a published 
decision of the court of appeals,1 which affirmed an order of the 
Kenosha County Circuit Court, Wilbur W. Warren III, Judge.   
                                                 
1 Estate of Sustache v. Am. Family Mut. Ins. Co., 2007 WI 
App 144, 303 Wis. 2d 714, 735 N.W.2d 186. 
No. 2006AP939 
 
2 
 
¶2 
In this insurance coverage dispute, the circuit court 
entered summary judgment dismissing defendant American Family 
Mutual Insurance Company (American Family), which insured, under 
separate policies: (1) defendants Larry Mathews (Mathews) and 
Jeffrey W. Mathews (Jeffrey),2 and (2) defendant Carrie A. Roman 
(Roman).  American Family provided an initial defense to the 
Mathewses and Roman under a reservation of rights and moved to 
stay the proceeding on liability until the issue of coverage was 
resolved.  In this review, only the dismissal of American Family 
with respect to the defense of the Mathewses is before us. 
¶3 
The issue presented is whether an insurer has a duty 
to defend an insured, under the liability coverage provisions of 
a homeowner's insurance policy, when the plaintiffs' complaint 
asserts that the insured "without warning or provocation, 
punched decedent out, causing him to fall into a curb thereby 
causing serious injuries and ultimately death," leading to a 
count 
of 
"battery . . . by 
intentionally 
causing 
bodily 
harm . . . thereby causing decedent's death."  Relying on Berg 
v. Fall, 138 Wis. 2d 115, 405 N.W.2d 701 (Ct. App. 1987), the 
Mathewses contend that Jeffrey's affirmative defense of self-
defense requires the insurer to look beyond the four corners of 
the complaint to continue to provide a defense. 
¶4 
After 
carefully 
considering 
the 
facts 
and 
circumstances of this case, especially the allegations of the 
                                                 
2 Defendants Larry Mathews and Jeffrey W. Mathews will be 
referred to collectively as "the Mathewses." 
No. 2006AP939 
 
3 
 
complaint and the pertinent homeowner's policy, we conclude that 
the Mathewses' homeowner's policy does not provide coverage for 
the plaintiffs' claims.  Consequently, American Family has no 
duty to continue to defend the Mathewses.  Accordingly, we 
affirm the court of appeals. 
I. BACKGROUND 
¶5 
James 
B. 
Sustache (Sustache) died from injuries 
sustained after an altercation at an underage drinking party 
hosted by Roman and her minor son, Anthony Fuller.  During this 
altercation, Jeffrey punched Sustache in the face, causing him 
to fall to the curb and sustain severe injuries that ultimately 
led to his death.  The altercation stemmed from events earlier 
that evening when "a number of [party attendees] started calling 
[Jeffrey] on his cell phone," harassing and goading him to "come 
over to the party to engage in a fight with [Sustache]."  There 
is no dispute that Jeffrey intended to strike Sustache; there is 
also no dispute that Jeffrey did not intend his blow to be 
fatal.3 
¶6 
Sustache's 
estate 
and 
his 
parents, 
James 
and 
Antionette Sustache, sued Jeffrey, Mathews, Roman, and American 
Family, which had issued separate homeowner's insurance policies 
to Roman and Mathews.  The plaintiffs' first amended complaint 
alleged five causes of action, four of which relate to the 
                                                 
3 The record is silent regarding whether Jeffrey was 
criminally charged for the incident.  Counsel for the Mathewses 
indicated at oral argument that Jeffrey has not been criminally 
charged. 
No. 2006AP939 
 
4 
 
defendants participating in this appeal.4  Count 2 alleged that 
Jeffrey negligently failed to inquire into the true source of 
the phone calls before striking Sustache.  Count 3 alleged that 
"[Jeffrey] 
committed 
battery 
without 
provocation 
by 
intentionally causing bodily harm to [Sustache] without [his] 
consent thereby causing [his] death."  Count 4 sought to hold 
Mathews vicariously liable for Jeffrey's "willful, malicious and 
wanton" acts pursuant to Wis. Stat. § 895.035.5  Count 5 sought 
punitive damages for Jeffrey's "willful, wanton and malicious" 
acts.6 
                                                 
4 Count 1 of the plaintiffs' first amended complaint alleges 
that 
Roman 
was 
negligent 
per 
se 
for 
violating 
Wis. Stat. § 125.07 by failing to take action to prevent the 
illegal consumption of alcohol beverages by underage persons on 
premises owned or under her control.  The circuit court granted 
summary judgment to American Family on this count. 
5 All references to the Wisconsin Statutes are to the 2005-
06 version unless otherwise indicated. 
Wisconsin Stat. § 895.035(2)(a) provides in pertinent part: 
"The parent or parents with custody of a minor child, in any 
circumstances where he, she, or they may not be liable under the 
common law, are liable . . . for personal injury attributable to 
a willful, malicious, or wanton act of the child." 
6 To resolve this appeal, we need to consider only Count 3.  
Roman has not appealed, thereby eliminating the need to consider 
Count 1.  The plaintiffs conceded below that Count 2 fails to 
give rise to coverage.  We need not consider Count 4 because it 
involves the vicarious liability of Mathews, which hinges upon 
our determination of coverage under Count 3.  Furthermore, the 
American Family policy unambiguously excludes coverage for 
imputed liability.  Finally, Count 5 is also unambiguously 
excluded from coverage, and the Mathewses failed to rebut 
American Family's argument to that effect on summary judgment. 
No. 2006AP939 
 
5 
 
¶7 
Although the plaintiffs' opening complaint did not 
identify American Family as the Mathewses' insurer, American 
Family provided a defense under a reservation of rights.  The 
assigned attorney filed an answer to the plaintiffs' first 
amended complaint denying all allegations against the Mathewses 
and affirmatively defending, in part, on the ground that Jeffrey 
acted in self-defense. 
¶8 
The Mathewses' American Family homeowner's policy 
provides personal liability coverage for an "insured," which 
includes both Mathews and Jeffrey.  Specifically, the policy 
states: "We will pay, up to our limit, compensatory damages for 
which any insured is legally liable because of bodily injury or 
property damage caused by an occurrence covered by this policy." 
¶9 
The policy defines "occurrence" as "an accident, 
including exposure to conditions, which results during the 
policy period, in: a. bodily injury; or b. property damage."  
The term "accident" is not defined in the policy. 
¶10 The policy enumerates the following exclusions from 
coverage:  
8. 
Illegal Consumption of Alcohol.  We will not 
cover bodily injury or property damage arising out of 
the insured's knowingly permitting or failing to take 
action to prevent the illegal consumption of alcohol 
beverages by an underage person. 
9.   Imputed Liability.  We will not cover bodily 
injury or property damage arising out of any liability 
imputed to any insured which is otherwise excluded in 
this policy. 
10.  Intentional Injury.  We will not cover 
bodily injury or property damage caused intentionally 
No. 2006AP939 
 
6 
 
by or at the direction of any insured even if the 
actual bodily injury or property damage is different 
than that which was expected or intended from the 
standpoint of any insured. 
The policy also provides that personal liability coverage does 
not extend to punitive damages. 
¶11 The policy includes a defense provision that also 
references an "occurrence."  The defense provision states:   
Defense Provision.   
If a suit is brought against any insured for 
damages because of bodily injury or property damage 
caused by an occurrence to which this policy applies, 
we will provide a defense at our expense by counsel of 
our choice.  We will defend any suit or settle any 
claim for damages payable under this policy as we 
think proper.  (Emphasis added.) 
¶12 On December 27, 2005, American Family moved for 
summary judgment on the grounds that its policy did not cover 
the plaintiffs' claims and that it had no duty to continue to 
defend the Mathewses because: (1) the plaintiffs' damages were 
not caused by an "occurrence" covered under the policy; (2) the 
policy expressly excluded coverage for punitive damages; (3) the 
policy expressly excluded coverage for imputed liability——such 
as vicarious liability under Wis. Stat. § 895.035——"which is 
otherwise excluded in th[e] policy"; and (4) the policy 
expressly excluded coverage for intentional injury.  American 
Family asserted that the four-corners rule, which provides that 
an insurer's duty to defend is determined solely on the 
allegations in the complaint, not extrinsic facts, precluded any 
inquiry into Jeffrey's self-defense claim. 
No. 2006AP939 
 
7 
 
¶13 The Mathewses opposed American Family's motion by 
relying upon the court of appeals' opinion in Berg, which carved 
out an exception to the four-corners rule in a situation where 
the insured's claim of self-defense renders an intentional acts 
exclusion ambiguous.  Berg, 138 Wis. 2d at 120-21.  American 
Family responded that Berg does not apply because the policy 
language at issue here differs significantly from that in Berg.  
American Family also asserted that Berg contradicted the four-
corners rule of earlier supreme court decisions and that 
subsequent 
supreme 
court 
decisions 
had 
undermined 
Berg's 
continuing validity. 
¶14 While acknowledging the similarities between Berg and 
the case at bar, the circuit court concluded that the four-
corners rule "has been well settled law in the State of 
Wisconsin for many decades."  Based on the allegations in the 
plaintiffs' first amended complaint, the circuit court held that 
American Family had no duty to defend the Mathewses because 
coverage was excluded.  The court granted summary judgment to 
American Family and dismissed the insurer from the plaintiffs' 
suit.  The Mathewses appealed. 
¶15 The court of appeals affirmed in a published opinion.  
Estate of Sustache v. Am. Family Mut. Ins. Co., 2007 WI App 144, 
¶21, 303 Wis. 2d 714, 735 N.W.2d 186.  The court of appeals 
observed a tension between its opinion in Berg, which adopted an 
ambiguity exception to the four-corners rule, and this court's 
subsequent decisions in Doyle v. Engelke, 219 Wis. 2d 277, 580 
N.W.2d 245 (1998), and Smith v. Katz, 226 Wis. 2d 798, 595 
No. 2006AP939 
 
8 
 
N.W.2d 345 (1999).  Estate of Sustache, 303 Wis. 2d 714, ¶¶15-
16.  The court of appeals concluded that this court's opinions 
in Doyle and Smith tacitly overruled Berg and Grieb v. Citizens 
Casualty Co., 33 Wis. 2d 552, 148 N.W.2d 103 (1967), which the 
Berg court had cited.  Estate of Sustache, 303 Wis. 2d 714, ¶21.  
Following Doyle and Smith, the court of appeals concluded that 
Wisconsin law does not recognize exceptions to the four-corners 
rule and affirmed the circuit court.  Id., ¶21.     
¶16 The Mathewses petitioned this court for review, which 
we granted on September 13, 2007. 
II. ANALYSIS 
A. 
Standard of Review 
¶17 We review a grant of summary judgment de novo, relying 
on the same methodology as the circuit court.  Doyle, 219 Wis. 
2d at 283 (citation omitted).  Summary judgment is proper where 
the record demonstrates that no genuine issue as to any material 
fact exists and that the moving party is entitled to judgment as 
a matter of law.  Wis. Stat. § 802.08(2); Grams v. Boss, 97 Wis. 
2d 332, 337, 294 N.W.2d 473 (1980).   
¶18 This case requires us to interpret an insurance 
contract to determine the scope of an insurer's duty to defend 
its insureds.  This involves a question of law that we review de 
novo.  Everson v. Lorenz, 2005 WI 51, ¶10, 280 Wis. 2d 1, 695 
N.W.2d 298 (citation omitted); Doyle, 219 Wis. 2d at 284 
(citations omitted). 
No. 2006AP939 
 
9 
 
 
B. 
Discussion 
1. 
General Principles 
¶19 An insurance policy functions as a contract between 
the insured and the insurer.  Smith, 226 Wis. 2d at 806 
(citation omitted).  Thus, interpretation of an insurance policy 
is governed by the same rules of construction that apply to 
other contracts.  Donaldson v. Urban Land Interests, Inc., 211 
Wis. 2d 224, 230, 564 N.W.2d 728 (1997) (citation omitted).  Our 
role in interpreting insurance policy language is to effectuate 
the intent of the contracting parties.  Am. Family Mut. Ins. Co. 
v. Am. Girl, Inc., 2004 WI 2, ¶23, 268 Wis. 2d 16, 673 N.W.2d 65 
(citing Wis. Label Corp. v. Northbrook Prop. & Cas. Ins. Co., 
2000 WI 26, ¶23, 233 Wis. 2d 314, 607 N.W.2d 276).  Policy 
language is construed as it "would be understood by a reasonable 
person in the position of the insured."  Id. (citing Kremers-
Urban Co. v. Am. Employers Ins. Co., 119 Wis. 2d 722, 735, 351 
N.W.2d 156 (1984)).  We do not construe policy language to cover 
risks that the insurer did not contemplate or underwrite and for 
which it has not received a premium.  Id. (citing Wis. Label, 
233 Wis. 2d 314, ¶25)).  "An insurance policy is not interpreted 
in a vacuum or based on hypotheticals.  It is tested against the 
factual allegations at issue."  2 Arnold P. Anderson, Wisconsin 
Insurance Law § 7.26, at 25 (5th ed. 2004). 
¶20 An insurer's duty to defend its insured is determined 
by comparing the allegations of the complaint to the terms of 
the insurance policy.  School Dist. of Shorewood v. Wausau Ins. 
No. 2006AP939 
 
10 
 
Cos., 170 Wis. 2d 347, 364-65, 488 N.W.2d 82 (1992); Prof'l 
Office Bldgs., Inc. v. Royal Indem. Co., 145 Wis. 2d 573, 580, 
427 N.W.2d 427 (Ct. App. 1988).  The duty to defend is triggered 
by the allegations contained within the four corners of the 
complaint.  Newhouse v. Citizens Sec. Mut. Ins. Co., 176 Wis. 2d 
824, 835, 501 N.W.2d 1 (1993); Elliott v. Donahue, 169 Wis. 2d 
310, 320-21, 485 N.W.2d 403 (1992); Grieb, 33 Wis. 2d at 557-58.  
It is the nature of the alleged claim that is controlling, even 
though the suit may be groundless, false, or fraudulent.  Id. at 
558 (citations omitted).  The insurer's duty to defend is 
therefore broader than its duty to indemnify insofar as the 
former implicates arguable, as opposed to actual, coverage.  
Fireman's Fund Ins. Co. of Wis. v. Bradley Corp., 2003 WI 33, 
¶20, 261 Wis. 2d 4, 660 N.W.2d 666; Red Arrow Prods. Co., Inc. 
v. Employers Ins. of Wausau, 2000 WI App 36, ¶17, 233 Wis. 2d 
114, 607 N.W.2d 294. 
¶21 Courts liberally construe the allegations in the 
complaint and assume all reasonable inferences.  Fireman's Fund, 
261 Wis. 2d 4, ¶36; Doyle, 219 Wis. 2d at 284 (citing Atl. Mut. 
Ins. Co. v. Badger Med. Supply Co., 191 Wis. 2d 229, 241-42, 528 
N.W.2d 486 (Ct. App. 1995)).  This rule tends to help an 
insured's demand for coverage.  As usual, ambiguity in the 
coverage 
terms 
will 
be 
construed 
against 
the 
insurer.  
Vandenberg v. Cont'l Ins. Co., 2001 WI 85, ¶40, 244 Wis. 2d 802, 
628 N.W.2d 876.  This familiar rule of contract construction 
also helps the insured. 
No. 2006AP939 
 
11 
 
¶22 In determining whether there is a duty to defend, the 
court first considers whether the insuring agreement makes an 
initial grant of coverage——i.e., whether the insurer has a duty 
to indemnify its insured——for the claims asserted.  See Am. 
Girl, 268 Wis. 2d 16, ¶24.  If the court determines that the 
policy was not intended to cover the claims asserted, the 
inquiry ends.7  Id.  "[T]he insurer is under an obligation to 
defend only if it could be held bound to indemnify the insured, 
assuming that the injured person proved the allegations of the 
complaint, regardless of the actual outcome of the case."  
Grieb, 33 Wis. 2d at 558 (quoting 29A Am. Jur. Insurance § 1452, 
at 565 (1960)).   
¶23 Only after concluding that coverage exists does the 
court examine the policy's exclusions to determine whether they 
preclude coverage.  Am. Girl, 268 Wis. 2d 16, ¶24.  In other 
words, when a court determines that there is no coverage in the 
policy for the allegations in the complaint, it is not necessary 
to interpret the policy's exclusions.  See Smith, 226 Wis. 2d at 
806 ("Upon close examination, however, we are convinced that 
[the defendant] does not have coverage under his policies. 
                                                 
7 "Once the circuit court resolves the question of indemnity 
in the insurer's favor . . . coverage is no longer open to 
debate.  An insurer need not defend a suit in which it has no 
economic interest."  Baumann v. Elliott, 2005 WI App 186, ¶10, 
286 Wis. 2d 667, 704 N.W.2d 361 (citing School Dist. of 
Shorewood v. Wausau Ins. Cos., 170 Wis. 2d 347, 364, 488 
N.W.2d 82 (1992)). 
No. 2006AP939 
 
12 
 
Consequently, it is unnecessary . . . to interpret the exclusion 
clause in circumstances where coverage does not exist."). 
¶24 The Mathewses contend that their case requires this 
court to evaluate whether Wisconsin recognizes exceptions to the 
four-corners rule.  Specifically, they seek an exception to the 
four-corners rule where self-defense is claimed. 
¶25 When 
an 
insurer 
contests 
whether 
there 
is 
a 
contractual obligation to indemnify its insured, it has several 
options.8  One of the insurer's options is to provide a defense 
to the insured on the merits, under a reservation of rights, 
until the coverage issue is resolved.  Baumann v. Elliott, 2005 
WI App 186, ¶8, 286 Wis. 2d 667, 704 N.W.2d 361.  This is what 
American Family did.  It also moved the court to stay 
proceedings on liability issues until the issue of coverage was 
resolved, and it moved for summary judgment, seeking a dismissal 
of all causes of action against it, as well as a declaration 
that it had no duty to continue to defend any of its insureds in 
the pending action.   
¶26 Both the insurer and the insured have the right to 
have the court resolve the issue of coverage separate from any 
                                                 
8  In Baumann, the court of appeals indicated that insurers 
may seek to resolve coverage issues in several ways: (1) By 
seeking a declaratory judgment; (2) By entering into an 
agreement with the insured to defend while retaining the right 
to challenge coverage; (3) By affording a defense under a 
reservation of rights; and (4) By seeking a bifurcated trial in 
which the court decides the coverage issue in a separate action 
from the action on the merits of the complaint.  Baumann, 286 
Wis. 2d 667, ¶8. 
No. 2006AP939 
 
13 
 
trial on liability.  See 2 Arnold P. Anderson, Wisconsin 
Insurance Law §§ 7.51-52, at 38-40 (5th ed. 2004) (discussing 
alternatives for both the insurer and the insured when coverage 
is alleged or disputed). 
¶27 The four-corners rule is normally stated as a rule in 
which the insurer's duty to defend is determined "without resort 
to extrinsic facts or evidence."  Fireman's Fund, 261 Wis. 2d 4, 
¶19 (citing Atlantic Mut. Ins. Co., 191 Wis. 2d at 236).  In its 
amicus brief, the Wisconsin Insurance Alliance explains that 
"[w]hen a complaint alleges facts that, if proven, would 
constitute a covered claim, the insurer must appoint defense 
counsel for its insured without looking beyond the complaint's 
four corners."  This is the substance of the four-corners rule. 
¶28 Here, however, we are beyond the initial duty to 
defend stage of the proceedings.  American Family satisfied its 
duty to defend by providing the Mathewses with an attorney.  It 
then moved the court to stay the proceedings on liability so 
that it could contest the issue of coverage.  It moved for 
summary judgment and asked for a coverage hearing.  It presented 
the court with affidavits.  These affidavits included more 
evidence than the insurance policies and the complaint; they 
included transcripts of the depositions of Jeffrey and Anthony 
Fuller, Roman's son.  The Mathewses did not submit affidavits.  
The circuit court was not oblivious to this additional evidence 
when it concluded that the facts were "relatively clear and for 
the most part not in dispute." 
No. 2006AP939 
 
14 
 
¶29 Where the insurer has provided a defense to its 
insured, a party has provided extrinsic evidence to the court, 
and the court has focused in a coverage hearing on whether the 
insured's policy provides coverage for the plaintiff's claim, it 
cannot be said that the proceedings are governed by the four-
corners rule.  The insurer's duty to continue to defend is 
contingent upon the court's determination that the insured has 
coverage if the plaintiff proves his case.   
2. 
"Occurrence" 
¶30 We turn to comparing the coverage provided by the 
homeowner's policy to the allegations in the plaintiffs' first 
amended complaint, supplemented by affidavits.  With respect to 
personal 
liability 
coverage 
and 
defense 
of 
claims, 
the 
Mathewses' American Family homeowner's policy states: 
 
COVERAGE D – PERSONAL LIABILITY COVERAGE 
 
We will pay, up to our limit, compensatory damages for 
which any insured is legally liable because of bodily 
injury or property damage caused by an occurrence 
covered by this policy. 
 
Defense Provision. 
If a suit is brought against any insured for damages 
because of bodily injury or property damage caused by 
an occurrence to which this policy applies, we will 
provide a defense at our expense by counsel of our 
choice.  We will defend any suit or settle any claim 
for damages payable under this policy as we think 
proper.  (Emphasis added.) 
¶31 To determine whether the policy provides coverage for 
the plaintiffs' claims, the court must first consider whether 
the facts in the complaint allege an "occurrence" covered under 
No. 2006AP939 
 
15 
 
the policy.  See Everson, 280 Wis. 2d 1, ¶¶15-16; Am. Girl, 268 
Wis. 2d 16, ¶24.  Put more directly, is an alleged "battery 
without provocation . . . intentionally causing bodily harm to 
[the] plaintiff without plaintiff's consent" an "occurrence" 
covered by the policy? 
¶32 As 
stated 
above, 
the 
Mathewses' 
policy 
defines 
"occurrence" as "an accident, including exposure to conditions, 
which results during the policy period, in: a. bodily injury; or 
b. property damage."  The term "accident" is not defined in the 
policy. 
¶33 This court has construed the undefined term "accident" 
in an insurance policy on a number of occasions.  For example, 
in Doyle v. Engelke, we reviewed an insurer's duty to defend a 
claim alleging negligent supervision.  Doyle, 219 Wis. 2d at 
281.  The court was required to interpret the term "event," id. 
at 286-87, which was defined in a comprehensive general 
liability (CGL) policy as "an accident, including continuous or 
repeated exposure to substantially the same general harmful 
conditions."  Id. at 289.   
¶34 The Doyle court noted that "accident" was undefined in 
the policy and that words in insurance policies are given their 
"common, everyday meaning."  Id. (citing Schmidt v. Luchterhand, 
62 Wis. 2d 125, 133, 214 N.W.2d 393 (1974)).  The court 
consulted a dictionary to determine that an accident is "'[a]n 
unexpected, undesirable event' or 'an unforeseen incident' which 
is characterized by a 'lack of intention.'"  Id. (quoting The 
American Heritage Dictionary of the English Language 11 (3d ed. 
No. 2006AP939 
 
16 
 
1992)). 
 
It 
noted 
that 
the 
definitions 
"center 
on 
an 
unintentional occurrence leading to undesirable results," and 
concluded that a reasonable insured would expect a policy 
defining "event" as an "accident" to cover negligence, including 
negligent supervision.  Id. at 290. 
¶35 In American Girl this court reviewed a coverage 
dispute between a liability insurer and a general contractor 
over whether the general contractor's CGL policy provided 
coverage for "property damage" resulting from an alleged 
"occurrence."  Am. Girl, 268 Wis. 2d 16, ¶¶1-3.9   
¶36 The court construed "occurrence."  Id., ¶¶37-38.  
"Occurrence" was defined in the general contractor's policy as 
"an accident, including continuous or repeated exposure to 
substantially the same general harmful conditions."  Id., ¶37.  
"Accident" was not defined.  Id.  The American Girl court turned 
to several dictionary definitions for guidance:   
The dictionary definition of "accident" is: "an event 
or condition occurring by chance or arising from 
unknown or remote causes."  Webster's Third New 
International Dictionary of the English Language 11 
(2002).  Black's Law Dictionary defines "accident" as 
follows: "The word 'accident,' in accident policies, 
means an event which takes place without one's 
foresight 
or 
expectation. 
 
A 
result, 
though 
unexpected, is not an accident; the means or cause 
                                                 
9 In American Girl, a subcontractor's negligence led to the 
general contractor's faulty site preparation for a construction 
project, excessive settlement of soil on the site, and the 
building's foundation eventually sinking.  Am. Family Mut. Ins. 
Co. v. Am. Girl, Inc., 2004 WI 2, ¶3, 268 Wis. 2d 16, 673 N.W.2d 
65.   
No. 2006AP939 
 
17 
 
must be accidental."  Black's Law Dictionary 15 (7th 
ed. 1999). 
Am. Girl, 268 Wis. 2d 16, ¶37.   
¶37 The court concluded that the circumstances of the 
plaintiff's claim fell within the definition of "occurrence" 
because the property damage that occurred was "clearly not 
intentional," nor was it "anticipated by the parties."  Id., 
¶38.  The damage resulted due to "continuous, substantial, and 
harmful settlement of the soil underneath the building," which 
was caused by the subcontractor's inadequate site preparation 
advice to the general contractor.  Id.  Neither the cause of the 
damage nor the damage itself was "intended, anticipated, or 
expected"; therefore, it was found to be an "accident" and a 
covered "occurrence" under the policy.  Id.   
 
¶38 In Everson v. Lorenz this court reviewed whether 
strict 
responsibility 
misrepresentation 
and/or 
negligent 
misrepresentation in a real estate transaction constituted an 
"occurrence" for purposes of a CGL insurance policy, triggering 
the insurer's duty to defend.  Everson, 280 Wis. 2d 1, ¶2.   
¶39 In 
Everson, 
defendant 
Lorenz 
owned 
land 
in 
a 
subdivision, 
and 
plaintiff 
Everson 
bought 
a 
lot 
in 
the 
subdivision for the purpose of constructing a single-family 
home.  Id., ¶¶4-5.  After the transaction, Everson determined 
that a portion of the lot was located in a 100-year flood plain.  
Id., ¶5.  This was contrary to representations made by Lorenz in 
No. 2006AP939 
 
18 
 
a real estate condition report given to Everson.10  Id.  As a 
result, Everson was unable to build, and he sued Lorenz for 
negligent misrepresentation and breach of contract.  Id.   
¶40 Lorenz had a CGL liability policy that covered 
"property damage" caused by an "occurrence."  Id., ¶12.  
"Occurrence" was defined in the policy as "an accident, 
including continuous or repeated exposure to substantially the 
same general harmful conditions."  Id.  "Accident" was not 
defined.  Id.   
¶41 The Everson court evaluated whether Lorenz's alleged 
misrepresentation constituted an "accident" for purposes of 
coverage.  Id., ¶16.  The court noted that both American Girl 
and Doyle relied upon dictionary definitions for assistance and 
then referenced Black's Law Dictionary, which defines "accident" 
as 
"[a]n 
unintended 
and 
unforeseen 
injurious 
occurrence; 
something that does not occur in the usual course of events or 
that could not be reasonably anticipated."  Id., ¶15 (quoting 
Black's Law Dictionary 15 (7th ed. 1999)).  The court also cited 
the 
definition 
of 
"accident" 
established 
by 
Doyle: 
"'an 
unexpected, undesirable event' or 'an unforeseen incident' which 
is characterized by a 'lack of intention.'"  Id. (quoting Doyle, 
219 Wis. 2d at 289).   
                                                 
10 Lorenz appeared to make a negligent typographical error 
in the real estate condition report, typing lot "21" instead of 
lot "31" before giving the report to Everson.  Everson then 
bought lot 31, which had flood plain problems.  Everson v. 
Lorenz, 2005 WI 51, ¶¶5, 16 n.3, 280 Wis. 2d 1, 695 N.W.2d 298. 
No. 2006AP939 
 
19 
 
¶42 The 
Everson 
court 
concluded 
that 
Lorenz's 
misrepresentation could not be considered an "accident" for 
purposes of liability coverage.  Id., ¶18. The court noted that 
Lorenz's misrepresentation could be defined as an "act of making 
a false or misleading statement about something."  Id., ¶19 
(quoting Black's Law Dictionary 1016 (7th ed. 1999)).  Lorenz's 
false statement required a "degree of volition inconsistent with 
the term accident."  Id. (citing Sheets v. Brethren Mut. Ins. 
Co., 
679 
A.2d 
540, 
552-53 
(Md. 
1996) 
(Karwacki, 
J., 
dissenting)).   
¶43 The volitional nature of Lorenz's act was key.  The 
court determined that "where there is a volitional act involved 
in such a misrepresentation, that act removes it from coverage 
as an 'occurrence' under the liability insurance policy."  Id., 
¶20. 
 
The 
Everson 
court 
determined 
that 
Lorenz's 
misrepresentation, although possibly premised upon a mistake of 
fact or an error of judgment, was nonetheless a volitional act, 
not an "accident," and not a covered "occurrence" under the CGL 
policy.  Id., ¶22. 
¶44 Finally, 
we 
revisited 
the 
issue 
of 
whether 
misrepresentations 
constitute 
an 
"accident" 
in 
Stuart 
v. 
Weisflog's Showroom Gallery, Inc., 2008 WI ___, ___ Wis. 2d ___, 
___ N.W.2d ___.  The question in Stuart was whether Weisflog's 
Showroom Gallery, Inc.'s (WSGI) CGL insurance policy with 
American 
Family 
covered 
damages 
resulting 
from 
misrepresentations.  Id., ¶4.  The policy covered property 
damage caused by an "occurrence," defined as "an accident, 
No. 2006AP939 
 
20 
 
including continuous or repeated exposure to substantially the 
same general harmful conditions."  Id., ¶22.  "Accident" was not 
defined.  See id., ¶24. 
¶45 Stuart involved allegations of misrepresentations by 
WSGI personnel, made in violation of the Home Improvement Trade 
Practices Act,11 to induce the homeowners to enter into contracts 
for home remodeling and design.  Id., ¶¶7, 10.  WSGI personnel 
allegedly misrepresented the quality of WSGI products and 
claimed that WSGI personnel understood local building codes and 
regulations and that WSGI personnel were capable of providing 
architectural service and design work.  Id., ¶9.  A jury found 
that WSGI made false, deceptive, or misleading representations 
in order to induce the homeowners to enter into a remodeling 
architecture contract, that the homeowners relied on those 
representations, and that damages resulted.  Id., ¶10.   
¶46 In concluding that the misrepresentations to the 
homeowners were not accidental, and therefore not covered as an 
"occurrence" under WSGI's CGL policy, this court consulted 
dictionary definitions and past decisions in Doyle, Everson, and 
American Girl and concluded that an "accident" "is an event or 
condition occurring by chance or one that arises from unknown 
causes, and is unforeseen and unintended."  Id., ¶24; see id., 
¶¶24 n.13, 29-34, 40.  The court approvingly cited American 
Girl's definition of an "accident": "'an event which takes place 
without one's foresight or expectation.  A result, though 
                                                 
11 Wis. Admin. Code § ATCP 110 (Sept., 2001). 
No. 2006AP939 
 
21 
 
unexpected, is not an accident;' rather, it is the causal event 
that must be accidental for the event to be an accidental 
occurrence."  Id., ¶40 (quoting Am. Girl, 268 Wis. 2d 16, ¶37).  
WSGI's misrepresentations were made "volitionally with the 
particular intent to induce" the homeowners to enter into a 
contract and were therefore the non-accidental cause of their 
damages and not covered.  Id., ¶45. 
¶47 Keeping these analyses of "accident" in mind, we turn 
to the Mathewses' case. 
¶48 The plaintiffs' first amended complaint alleged that 
during the underage drinking party at Roman's house "a number of 
the attending teenagers started calling [Jeffrey] on his cell 
phone" to harass him and bait him to come to the party "to 
engage in a fight with [Sustache]."  The complaint further 
alleged that "[s]hortly thereafter, defendant [Jeffrey] showed 
up at the party, asked for [Sustache] and without warning or 
provocation, punched [Sustache] out, causing him to fall into a 
curb thereby causing serious injuries and ultimately death." 
¶49 Count 2 alleged that Jeffrey "was negligent in not 
asking [Sustache] whether or not he was the person that had been 
calling him on his cell phone and baiting him into a fight."  If 
Jeffrey had asked Sustache whether he was the person calling, 
Jeffrey allegedly would have learned that Sustache had not 
called him.  Count 2 alleged that Jeffrey's failure to take the 
"reasonable step" of ascertaining whether Sustache called him 
"was a proximate cause of the damages sustained by plaintiffs 
and resulted in [Sustache's] death."  Although claims of 
No. 2006AP939 
 
22 
 
negligence normally qualify for coverage, this negligence claim 
dropped out of consideration in circuit court when the Mathewses 
conceded that it was insufficient. 
¶50 Count 3 of the complaint alleged that "[Jeffrey] 
committed battery without provocation by intentionally causing 
bodily harm to [Sustache] without [his] consent thereby causing 
[Sustache's] death."  (Emphasis added.)  This count prompted 
Jeffrey's claim of self-defense. 
¶51 We conclude that the allegations in the plaintiffs' 
first amended complaint, supplemented by Jeffrey's deposition,12 
                                                 
12 Jeffrey testified regarding the incident at a January 10, 
2006, deposition.  He indicated that prior to hitting Sustache, 
the two individuals were encircled by a group of people yelling 
and chanting for a fight.  Jeffrey removed his shirt, despite 
the fact it was the middle of winter, to avoid having the shirt 
get in the way during a fight.  Sustache, who appeared 
intoxicated, had his fists clenched at his sides, stepped 
forward, and pushed Jeffrey in the chest with both hands.  
Someone in the circle yelled "cops," Jeffrey turned to look, and 
a person standing behind Sustache blurted out "hurry up and hit 
him, he's not looking."  Jeffrey testified: 
Q 
So did you——after you were pushed, did you stop 
your motion back and pause, or was it a fluid 
motion when you came back? 
A 
Fluid motion. 
Q 
Did you——ultimately you struck Mr. Sustache, 
correct? 
A 
Yes. 
Q 
At what point do you——did you strike him with a 
fist? 
A 
Yes. 
. . . .  
No. 2006AP939 
 
23 
 
cannot reasonably be construed to constitute a covered claim 
under the Mathewses' homeowner's policy.  The American Family 
policy provides indemnity coverage and a duty to defend for an 
"occurrence," defined as an "an accident, including exposure to 
conditions, which results during the policy period, in: a. 
bodily injury; or b. property damage."  Once again, the term 
"accident" is not defined. 
¶52 Considering the discussion of "accident" in Doyle, we 
cannot conclude that an allegation that Jeffrey "intentionally 
caus[ed] 
bodily 
harm 
to 
[Sustache]" 
could 
reasonably 
be 
"characterized by a 'lack of intention.'"  Doyle, 219 Wis. 2d at 
289 (quoting The American Heritage Dictionary of the English 
Language 11 (3d ed. 1992)).  The Doyle court noted that an 
"accident" might be viewed as "an unintentional occurrence 
leading to undesirable results."  Id. at 290.  Jeffrey's alleged 
                                                                                                                                                             
Q 
Where did you first strike Mr. Sustache? 
A 
In his left jaw. 
Q 
To your knowledge, was he facing you squarely 
when you struck him? 
A 
Yes. 
. . . .  
Q 
What happened after you struck Mr. Sustache in 
the left cheek? 
A 
He fell to the ground. 
Q 
Was it your intent to strike him in the left 
cheek? 
A 
Yes.  (Emphasis added.) 
No. 2006AP939 
 
24 
 
decision to intentionally "punch out" Sustache may have produced 
unexpected results, but this intentional act did not constitute 
an "accident."  One cannot "accidentally" intentionally cause 
bodily harm. 
¶53 The American Girl court's discussion of "accident" 
also buttresses our conclusion.  The court referred to Black's 
Law 
Dictionary 
for 
the 
notion 
that 
"[a] 
result, 
though 
unexpected, is not an accident; the means or cause must be 
accidental."  Am. Girl, 268 Wis. 2d 16, ¶37 (quoting Black's Law 
Dictionary 15 (7th ed. 1999)).  Here, the plaintiffs' first 
amended complaint stated "[Jeffrey] committed battery without 
provocation by intentionally causing bodily harm to [Sustache]" 
and that that was the "proximate cause of [Sustache's] damages 
and death."  The complaint also stated that Jeffrey "punched 
[Sustache] out."  By the complaint's terms, the punch that 
caused Sustache's injuries and death was not accidental; Jeffrey 
intended the punch.  Furthermore, the American Girl court 
observed that the cause of damages to the building in that case 
(settling of the foundation due to improper site preparation) 
was accidental because it was not "intended, anticipated, or 
expected."  Id., ¶38.  Here the plaintiffs' allegations that 
Jeffrey intentionally caused bodily harm to Sustache by punching 
him 
constitute 
a 
volitional 
assault 
that 
was 
intended, 
anticipated, and expected.13  Jeffrey's punch was not "an event 
                                                 
13 One treatise observes: 
In 
order 
to 
constitute 
an 
"accident" 
or 
"occurrence" under a policy of liability of insurance, 
No. 2006AP939 
 
25 
 
or condition occurring by chance or arising from unknown or 
remote 
causes." 
 
Id., 
¶37 
(quoting 
Webster's 
Third 
New 
International Dictionary of the English Language 11 (2002)). 
¶54 Like the allegation of a pre-sale misrepresentation of 
fact in Everson, the allegations of intentional battery here 
evince 
a 
degree 
of 
volition 
inconsistent 
with 
the 
term 
"accident."  See Everson, 280 Wis. 2d 1, ¶19.  Even if we were 
to assume, as alleged in Count 2, that Jeffrey was negligent in 
failing to ascertain whether it was Sustache who called him to 
propose a fight, Jeffrey's subsequent and separate volitional 
act 
of 
punching 
Sustache 
is 
inconsistent 
with 
the 
term 
"accident."  See id. (citation omitted).  As the Everson court 
recognized, an "accident" is "an unintended and unforeseen 
injurious occurrence."  Id., ¶15 (quoting Black's Law Dictionary 
15 (7th ed. 1999)).  According to the complaint, in response to 
                                                                                                                                                             
an 
event 
must 
be 
unforeseen, 
unexpected, 
or 
unanticipated.  The nature of an assault is such that 
the event itself is typically intentional in nature.  
On their face, therefore, assaults would appear to 
inherently fall outside of the coverage provided in a 
liability policy. . . .  
If the insured is also the assailant, the result 
is that there is no coverage for the assault because 
the act was intentionally committed by the insured. 
9 Lee R. Russ & Thomas F. Segalla, Couch on Insurance § 127:21, 
at 127-54——127-55 (3d ed. 2000). 
However, even if privileged, "an injury deliberately caused 
by an act of self-defense is still not an injury that was caused 
by an accident."  2 Allan D. Windt, Insurance Claims and 
Disputes § 11.3, at 11-38——11-39 (5th ed. 2007). 
No. 2006AP939 
 
26 
 
taunting telephone calls encouraging him to fight Sustache, 
Jeffrey voluntarily traveled to Sustache's location at Roman's 
house to confront him and intentionally punched Sustache in the 
face, ultimately causing severe injury and death.  These 
allegations assert a pattern of volitional action, regardless of 
whether Jeffrey was mistaken about Sustache's role in the 
taunts. 
¶55 Finally, 
there 
is 
nothing 
in 
Stuart 
that 
is 
inconsistent with this analysis. 
¶56 We conclude that no reasonable person would regard the 
alleged intentional battery perpetrated by Jeffrey against 
Sustache as an "unexpected . . . event," or an "unforeseen 
incident . . . characterized by a lack of intention,"14 or "an 
event . . . occurring by chance or arising from unknown or 
remote causes."15  Striking the words "without provocation" from 
the complaint would not alter the essence of the complaint: that 
Jeffrey 
intentionally 
caused 
bodily 
harm 
to 
Sustache.  
Accordingly, we hold that the Mathewses' policy does not cover 
the plaintiffs' claims because Jeffrey's actions were not 
accidental and, thus, did not give rise to an "occurrence." 
                                                 
14 Doyle v. Engelke, 219 Wis. 2d 277, 289, 580 N.W.2d 245 
(1998) 
(citation 
omitted); 
Everson, 
280 
Wis. 2d 1, 
¶15 
(citations omitted).   
15 Am. Girl, 268 Wis. 2d 16, ¶37 (citation omitted); Stuart 
v. Weisflog's Showroom Gallery, Inc., 2008 WI ___, ¶24, ___ 
Wis. 2d ___, ___ N.W.2d ___ (citation omitted). 
No. 2006AP939 
 
27 
 
 
3. 
Intentional Injury Exclusion  
¶57 In determining whether there is a duty to defend, the 
court first considers whether the insuring agreement makes an 
initial grant of coverage.  Am. Girl, 268 Wis. 2d 16, ¶24.  
Where it is clear that the policy was not intended to cover the 
claims asserted, the inquiry ends.  Id.  Only after concluding 
that coverage exists does the court examine the policy's 
exclusions to determine whether they preclude coverage.  Id. 
 
¶58 Since we concluded above that the plaintiffs' suit 
does not give rise to coverage for Jeffrey's actions, we need 
not consider the policy's intentional injury exclusion. 
¶59 The language of the Mathewses' policy resolves the 
question of the duty to continue to defend once the question of 
coverage has been decided.  The defense provision of the policy 
states that defense counsel will be provided by American Family 
"[i]f a suit is brought against any insured for damages because 
of bodily injury or property damage caused by an occurrence to 
which this policy applies."  (Emphasis added.) 
¶60 Since the plaintiffs' suit was not brought against the 
Mathewses for damages "caused by an occurrence to which th[e] 
policy applies," American Family has no duty to continue to 
defend.    
III. CONCLUSION 
¶61 After 
carefully 
considering 
the 
facts 
and 
circumstances of this case, especially the allegations of the 
complaint and the pertinent homeowner's policy, we conclude that 
No. 2006AP939 
 
28 
 
the Mathewses' homeowner's policy does not provide coverage for 
the plaintiffs' claims.  Consequently, American Family has no 
duty to continue to defend the Mathewses.  Accordingly, we 
affirm the court of appeals. 
By the Court.—The decision of the court of appeals is 
affirmed. 
No.  2006AP939.awb 
 
1 
 
¶62 ANN WALSH BRADLEY, J.   (concurring).  I agree with 
the majority that this is not a case in which the four corners 
rule is applicable. The majority aptly explains why this case 
does not present the issue of whether there are exceptions to 
the four corners rule.  
¶63 I also agree with the majority that the conduct here 
does not constitute an accident or occurrence within the meaning 
of the Matthews' insurance policy. I write separately because of 
the majority's mixed analysis of "accident," and my belief that 
we should interpret "accident" as would the reasonable insured.  
¶64 The majority fails to provide a clear statement of why 
Jeffrey's action does not constitute an accident, and hence an 
occurrence, within the meaning of the Matthews' insurance 
policy. Instead, it offers mixed rationales that lead to 
confusion rather than clarity. Ultimately, the majority proffers 
an understanding of "accident" that does not comport with the 
understanding of the reasonable insured.  
¶65 The focus of this case is the conduct alleged in count 
3 of the complaint, and supplemented by deposition testimony. 
See majority op., ¶¶50-51. Count 3 alleges that Jeffrey 
"committed battery without provocation by intentionally causing 
bodily harm . . . ." Specifically, Jeffrey punched Sustache in 
the face. 
¶66 In determining that this case does not involve an 
accident, the majority offers shifting rationales. The first 
rationale it offers is that Jeffrey intentionally caused bodily 
harm to Sustache. Id., ¶52. In other words, the intent to harm, 
No.  2006AP939.awb 
 
2 
 
rather than intent to perform the action that caused the harm, 
is the focus. 
¶67 The 
majority's second rationale is that Jeffrey 
"intended the punch" that caused Sustache's injury and death. 
Id., ¶53. Stating that an accident requires that the cause of 
damages be unintended, the majority reasons that damages due to 
an intended punch cannot be an accident. The action which caused 
the damage is the focus of the second rationale.  
¶68 The 
majority's third rationale is that "Jeffrey 
voluntarily traveled to Sustache's location . . . to confront 
him and intentionally punched Sustache . . . ." Majority op., 
¶54. According to the majority, this constitutes "a pattern of 
volitional action." Id. (emphasis added). The majority states 
that the actions here "evince a degree of volition inconsistent 
with the term 'accident.'" Id. (emphasis in original). A 
"pattern of volitional action" is the focus of the third 
rationale. 
¶69 My view is that we should stick with this court's 
longstanding 
doctrine 
in 
interpreting 
insurance 
policies. 
Language 
in 
an 
insurance 
policy 
should 
be 
construed 
as 
understood by a reasonable person in the position of the 
insured. Frost v. Whitbeck, 2002 WI 129, ¶20, 257 Wis. 2d 80, 
654 N.W.2d 225. As I have stated elsewhere, in determining 
whether there is an accident, the focus should be on the injury 
or damages, not on whether the action that caused the damages 
was intended. Stuart v. Weisflog, 2008 WI __, ¶4 & n.1, __ 
Wis. 2d __, __ N.W.2d __ (Bradley, J., concurring) (Stuart II). 
No.  2006AP939.awb 
 
3 
 
Such a view comports with the understanding of the reasonable 
insured. 
¶70 Thus, the majority's first rationale, the fact that 
Jeffrey intended harm to Sustache when he threw the punch, is 
sufficient to determine that there is no accident here. The 
analysis should end right there.  
¶71 Accordingly, because of the majority's mixed analysis 
of "accident," and for the reasons set forth more fully in my 
concurrence in Stuart II, I respectfully concur. 
 
 
 
 
No.  2006AP939.awb 
 
 
 
1