Exclusion Bars Coverage for Underinsured Motorist Injury Claim

The Superior Court of Pennsylvania had to construe the household exclusion in an auto insurance policy to determine if an injured plaintiff was entitled to underinsured motorist coverage. This case is Allstate Fire and Casualty Insurance Company v. Hymes, 2011 WL 4036094 (Pa.Super.).

 

Hymes was operating a motorcycle when he collided with Meyer. Meyer was subsequently determined to be at fault for the accident, but his liability insurance proved to be insufficient to fully compensate Hymes for his injuries. Hymes sought underinsured motorist coverage under his parents' policy with Allstate. The insurer denied coverage based on the household exclusion and sought a declaratory judgment that it had no duty to indemnify Hymes. The trial court found for the insurer and this appeal followed.

 

The central issue for the appeals court was whether the auto policy excluding coverage for damages suffered by Hymes applies. The exclusion denied underinsured (UIM) coverage to “anyone while in, or getting into or out of, or when struck by a motor vehicle owned or leased by you or a resident relative that is not insured for UIM coverage under this policy”. The facts of the accident showed that Hymes was injured after being thrown from his motorcycle and into the windshield and onto the ground some twenty feet away from the point of impact. So, Hymes claimed that technically he was not “on” the motorcycle when the injuries occurred; therefore, the exclusion was not applicable.

 

The court was not convinced by this argument. The court said that it could not conclude that there is any plausible argument that the injuries complained of here are not the direct result of Hymes' operation of his motorcycle while “on” it. The ruling of the trial court was affirmed.

 

Editor's Note: This was an attempt at a clever use of the exclusionary language by the insured. The claim was that Hymes was not injured while “on” the motorcycle, but only after he was thrown off the vehicle, and so, the exclusion did not apply as it was worded. The court found that even though the injuries may have actually occurred off the motorcycle, they are still the direct result stemming from the use of the cycle.