The Northern District of West Virginia ruled in favor of an insurer claiming it did not have to pay the policy limits under a business auto policy to a man injured while using an insured vehicle. The case is Carroll v. Westfield Nat'l Ins. Co., 2023 U.S. Dist. LEXIS 173222 (N.D.W.V. 2023).
Tyler Carroll and one of his co-workers were returning to their home base in a work van one night when a pickup truck going the opposite direction barrel-rolled across the median and almost hit their van. Carroll stopped the van and went to help the other driver, who was unconscious. A few minutes later, another vehicle approached the scene at a high speed and collided with the wrecked truck and Carroll, who was launched into the median. Carroll's injuries included fractures to his skull, both arms, and both legs. Carroll's left leg was so badly broken it had to be amputated above his knee.
The van Carroll had been driving was insured by his employer, West Virginia Heating and Plumbing, through a business auto policy from Westfield. The truck driver had an auto policy with State Farm and was deemed underinsured. The driver of the vehicle causing the secondary accident was uninsured. The truck driver's insurer paid its $25,000 policy limit. The Westfield policy had a $1 million per accident liability limit, $300,000 each for UM and UIM coverage per accident, and commercial excess liability limits for $2 million; there was no additional coverage for either UM or UIM benefits. Westfield paid Carroll the $300,000 limit for both UM and UIM coverage.
Carroll, whose injuries exceeded $5 million, claimed Westfield owed him the full policy limits. He also asserted Westfield had neither offered an option to purchase additional benefits for the commercial policy nor received a knowing and informed waiver of those benefits. Westfield counterargued that Carroll's employer had knowingly waived the additional coverage and, at any rate, Carroll had not been using or occupying the insured vehicle at the time of injury and was therefore not entitled to the benefits.
The question before the court boiled down to whether or not Carroll was an "insured" under the policy. In the context of his employer's commercial auto policy with Westfield, Carroll would only be considered an "insured" under the policy if he was using or occupying a covered auto at the time of the accident.
The judges looked to a four-part test developed by the Supreme Court of Appeals of West Virginia for guidance in determining whether Carroll was using or occupying the insured vehicle at the time of injury. This test looked at whether an individual was in reasonably close proximity to the insured vehicle at the time of the accident; was oriented to the vehicle, as opposed to a highway or sidewalk; had relinquished control of the vehicle; or had engaged in a transaction reasonably related to the use of the vehicle at the time of the accident. In developing the test, the Supreme Court of Appeals of West Virginia had explicitly stated that the factors were all of equal weight, and no one part was more determinative than another.
In applying the four-part test, the judges of the Northern District of West Virginia came to the conclusion that Carroll was neither using nor occupying the insured vehicle when he was injured. He had purposefully parked the truck on the opposite side of the highway from the wrecked truck and activated the hazard lights. Carroll was not in the insured vehicle or even in close proximity to it at the time of the accident, as evidenced by his testimony that one of the last things he remembered before the accident was trying to open the driver's side door of the wrecked pickup. Therefore, Carroll was not an "insured" within the meaning of his employer's business auto policy and was not entitled to coverage. The court ruled in favor of Westfield.
Editor's Note: In this case, Carroll's lack of physical proximity to his employer's insured auto at the time of injury played a significant role in the court's decision. What it means to "occupy" a vehicle is a tricky, oft-litigated insurance question. In general, a person "occupies" a vehicle if the person is in, upon, or getting in, out, on, or off of the vehicle. Courts in Michigan, Montana, and Ohio have also used an insured's or other claimant's physical proximity to the insured auto as a key, though not sole, factor in determining whether an insured or claimant was occupying the auto covered by the policy at issue.
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