A punch is not a car accident. A New York appeals court let Hereford Insurance deny an uninsured motorist claim over an ashtray attack.
The case began on June 6, 2021, when a taxi driver, insured by Hereford Insurance Company, was hit by another vehicle. Both drivers pulled over. The other driver got out, walked to the cab, and, in the court's words, "allegedly struck" the taxi driver "in the face with an ashtray" while he sat inside. The other driver's vehicle was uninsured.
The insured turned to the uninsured motorist part of his Hereford policy - the coverage that kicks in when the at-fault driver has none. Hereford refused. The insurer concluded that the injuries "did not arise out of the use or operation of a motor vehicle," that the vehicle "was not the proximate cause" of them, and that they "were solely the result of an assault by the adverse driver."
The driver pushed to arbitrate. Hereford went to court to block him, seeking a permanent stay. A judge in Westchester County agreed, and the driver appealed.
The Appellate Division, Second Department, affirmed, and its reasoning is what claims professionals should note.
The court accepted that, from the driver's view, the attack was "unexpected, unusual and unforeseen" - the usual test for an accident. But uninsured motorist coverage applies only when injuries arise "out of such uninsured motor vehicle's ownership, maintenance or use." That means the vehicle itself has to produce the injury, not just be there when it happened.
The vehicle, the court said, "must not merely contribute to the condition which produces the injury, but must, itself, produce the injury." Here, the injuries came from the alleged assault. The uninsured vehicle "merely contributed to the condition which produced the injuries." Not enough to trigger coverage.
Hereford, the court found, "established that a proximate causal relationship between the uninsured vehicle and the incident was lacking," and the driver "failed to rebut that showing." Another of his arguments failed because he raised it too late - "improperly raised for the first time on appeal."
The line for insurers is clear. A car being present when an injury happens is not the same as the car causing it. When the cause is an alleged assault, uninsured motorist coverage does not stretch to cover it.
