Opinion ID: 876931
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Heading: the policy coverage

Text: We note that in no provision of Northwestern's policy, does the word assault appear, nor intentionally inflicted, nor committed by or at the direction of the insured. Accordingly, cases construing policies with those types of provisions do not reflect what the state of the law is or should be under the coverage extended in Northwestern's policy. The policy in this case extends personal liability coverage to the insureds for damages caused by an occurrence. The policy defines an occurrence as an accident resulting in bodily injury or property damage, excluding only bodily injury or property damage, which is either expected or intended from the standpoint of the insured. In Grand River Lime Company v. Ohio Casualty Company (1972), 32 Ohio App.2d 178, 289 N.E.2d 360, it was held that the term occurrence is a broader term than accident where occurrence is defined in a policy as meaning an incident in which property damage is neither expected nor intended from the viewpoint of the insured. There is no reason why the same meaning should not be applied where personal injury damages are involved instead of property damages. The word occurrence instead of the word accident in the insuring clause means that the word occurrence is in fact broader than the word accident and is so intended by the insurer. In such case, the intent of the policy is to insure the acts or omissions of the insured, including his intentional acts, excluding only those in which the resulting injury is either expected or intended from the insured's standpoint. It is clear therefore, that the insured here would be debarred from coverage in those cases where his deliberate acts or assaults resulted in injuries which would be expected or intended by him to result from his deliberate acts. But what about coverage where the results of his acts (even though deliberate) are unexpected or not intended by the insured? The answer under which a policy provision is that (1) the event is an occurrence; (2) since it results in bodily injury it is an accident under the definition of the policy, and (3) since it is unintended or unexpected, it is within the coverage of the policy. Such a construction of the insurance policy is not strained or forced, but rather is an interpretation of the plain, ordinary and popular meaning of the words used by the insurer in defining the coverage extended. It should be interpreted in that sense. Conlon v. Northern Life Insurance Company (1939), 108 Mont. 473, 92 P.2d 284. Exclusions and words of limitations must be strictly construed against the insurer. Kansas City Fire and Marine Insurance Company v. Clark (D.C.Mont. 1963), 217 F. Supp. 231. We do not consider this provision to be ambiguous; the possibility of unintended bodily injury brings that result within the policy coverage, even though Phalen's actions may have been intentional. In interpreting the policy thusly, we have given consideration to the cases cited by Northwestern in support of its position that no coverage exists here. Most of the cases cited by Northwestern relate to a policy provision which excluded acts or injuries caused intentionally by or at the direction of the insured. On that basis, and on the factual basis on which those cases were decided, they can be distinguished from the case at bar. Some of those cases include the following: In Transamerica Insurance Company v. Cannon-Lowden Company (D.C.Mont. 1975), 400 F. Supp. 817, the jury found by special verdict that the insured had committed suicide when she drove her automobile at a speed in excess of 60 miles per hour out of her lane of traffic and directly into the path of a tractor-trailer unit driven by another. The court felt that the risk of damages from the insured's acts were so certain that it could be said as a matter of law that the damage was intentional and expected. The exclusion in the policy related to bodily injury and property damage caused intentionally by or at the direction of the insured. In Home Insurance Company v. Neilsen (Ind. 1975), 332 N.E.2d 240, again the exclusionary clause excluded bodily injury caused intentionally by or at the direction of the insured. In that case, the insured claimed he did not intend to inflict the injuries of which plaintiff complained, and that his actions were performed in self-defense. The decision of the court that coverage did not apply, turned on the court's construction of the word intentionally as used in the policy. 332 N.E.2d 242. In Caspersen v. Webber (1973), 298 Minn. 93, 213 N.W.2d 327, the policy excluded bodily injury ... caused intentionally by or at the direction of the insured. The insured pushed a hatcheck girl, who struck her back against a metal message rack attached to the wall. The insured stated he had no intention to harm her. The jury found that the insured had assaulted the hatcheck girl, and that he was negligent, and awarded general and punitive damages. The trial court refused judgment against the insurance company, saying the injuries were the direct result of the assault so that no coverage applied. The appellate court reversed, saying that the insurer is liable when the act is intended but the resulting injury is not. 213 N.W.2d at 230. More to the point are cases which have construed policies which contained language excluding coverage for bodily injuries either expected or intended from the standpoint of the insured. In determining the effect of this exclusionary clause, we note that it is a relatively recent provision used by insurers in this type of coverage. 79 A.L.R.3d 1125. On its face, the clause requires a two-fold test to determine coverage: (1) was the injury intended, or (2) was the injury to be expected by the insured? In Farmers Automobile Insurance Association v. Medina (Ill. 1975), 29 Ill. App.3d 224, 329 N.E.2d 430, it appears a minor boy intentionally flipped matches upon a gasoline spot directly below a parked automobile. The gasoline ignited and burned the automobile. In considering the clause identical to the one bar, the Illinois court said: In examining the various court decisions both in this state and from other jurisdictions, we find that the courts have considered this exclusionary clause, and a most comparable one, which reads as follows: `To injury ... caused intentionally by or at the direction of the insured.' It is to be noted that the exclusionary clause in the case before us contains the expression or word `expected'. The term `expected' has been judicially construed to mean a high degree of certainty. (Citing cases.) In several cases which have considered exclusionary clauses containing the term `expected' in addition to the term `intended' the courts have failed to find that the addition of the term `expected' affected the outcome of the case. (Citing cases.) It is possible to envision situations in which the inclusion of the term `expected' in an insurance exclusionary clause could alter the outcome of a suit which required interpretation of the clause, however, in view of the result we reach herein, we find that further discussion of the distinctions between the terms `intended' and `expected' is unnecessary. 329 N.E.2d at 432. (Emphasis added.) The Illinois court, in Medina, relying on the New Jersey case of Lyons v. Hartford Insurance Group (1973), 125 N.J. Super. 239, 310 A.2d 485, decided that the general rule is that coverage exists under an exclusion clause identical or similar to this one for the unintended results of an intentional act but not for damages assessed because of an injury which was intended to be inflicted. 329 N.E.2d at 433. No clear rule has yet emerged from those cases which have specifically considered and turned on this particular exclusionary clause. In State Farm Fire and Casualty Company v. Muth (Neb. 1973), 190 Neb. 272, 207 N.W.2d 364, in an action for declaratory judgment between the insurer, insured and judgment creditor of the insured, it appeared that the insured, a minor, had fired a b.b. gun from an automobile toward the judgment creditor and the pellet struck the judgment creditor in the eye, causing loss of sight. The trial judge in the declaratory judgment action found that when the minor caused the gun to discharge in the direction of the judgment creditor, the minor did not intend or expect to do bodily injury to him; therefore, it found the minor was negligent and the exclusion did not apply. In interpreting the exclusionary language, the Nebraska court said that bodily injury is excluded if the insured acted with a specific intent to cause harm to a third party. 207 N.W.2d 366. Other cases involving the same exclusionary clause include Armstrong v. Security Insurance Group (1973), 292 Ala. 27, 288 So.2d 134, where the husband and wife were the named insureds as the operators of a sandwich shop, and it was held that the clause excluded coverage for the husband who shot a patron but did not exclude coverage for the wife who was standing nearby. In Terito v. McAndrew (La. App. 1971), 246 So.2d 235, it was held that the owner of a hotel bar, who knocked the patron from a barstool to shut his mouth and who had fallen on the patron after he fell off a barstool so that the patron's knee was injured, did not have coverage under this clause. In Commercial Union Insurance Company v. City of Montpelier (1976), 134 Vt. 184, 353 A.2d 344, it was held that the insurer owed the City a defense where police officers were charged with assaults upon the plaintiff, again with the same clause. After examination of the cases, and the exclusion itself, we would interpret the clause to mean that it precludes coverage for bodily injuries or damages, though not specifically intended by the insured, if the resulting harm was within the expectation or intention of the insured from his standpoint. That statement more precisely fits the language of the coverage provided by the insurer. Out of that interpretation a question of fact exists in this case as to whether coverage should apply in view of the alleged accompanying and concurrently negligent acts of Harry Johnson which may have exacerbated the injuries Vo received.