Breland v. Schilling

• Citation: 550 So.2d 609
• Decision Date: 23 October 1989
• Docket Number: No. 89-C-1061,89-C-1061
• Parties: William Karon BRELAND and Deborah Adams Breland v. Ronnie L. "Bug" SCHILLING. 550 So.2d 609, 58 U.S.L.W. 2282
• Court: Supreme Court of Louisiana

Page 609

550 So.2d 609

William Karon BRELAND and Deborah Adams Breland v. Ronnie L. "Bug" SCHILLING.

No. 89-C-1061.

550 So.2d 609, 58 U.S.L.W. 2282

Supreme Court of Louisiana.

Oct. 23, 1989.

John N. Gallaspy, Gallaspy & Paduda, Bogalusa, for applicant.

Mark Reggie Simmons and Clayton S. Knight, Franklinton, for respondents.

CALOGERO, Justice.

This case involves the interpretation of an intended injury exclusion clause in a liability insurance policy, a matter which has given rise to innumerable cases both in this state and nationwide. ¹

The case poses two pertinent questions. First, where an insured punches another and fractures his jaw, what is the legal effect of a liability insurance contract provision barring coverage for "bodily injury ... which is either expected or intended from the standpoint of the insured." Second, is a jury determination that the defendant insured did not intend the bodily injury to the plaintiff reasonably supported by the facts of this case under the appropriate legal construction of the policy language.

The altercation which gave rise to this lawsuit arose during an Old Timers League softball game in Franklinton, La. on August 14, 1986. The defendant, Ronald "Bug" Schilling, was caught in a run down between second and third base. He raced toward third and slid head first. He was tagged out by the third baseman, William Karon Breland, who found need to step aside while making the tag lest he be run down by the aggressive base runner. After the play, as the defendant Schilling lay prone near third base, Breland either dropped, tossed, or threw the softball in the direction of the defendant. The ball struck Schilling on the chin. Words were instantly exchanged (plaintiff said he expressed regrets; defendant said no apology was made or that, if made, he didn't hear it), and defendant punched plaintiff Breland in the jaw.

Apparently because plaintiff's jaw was open at the time, he suffered unusually severe fractures. His jaw was broken on both sides of his face and had to be wired shut for twelve weeks. During this time, plaintiff was unable to eat solid foods and lost thirty pounds. He suffered from depression. He retains scars from this injury on both sides of his face.

In answer to interrogatories posed by the trial judge, the jury decided that the defendant Schilling did not intend the bodily injury to plaintiff, but that the defendant was negligent or at fault. The jury determined that plaintiff Breland was also negligent, and assigned defendant 75% fault, plaintiff 25%. Plaintiff's award of $45,000, and his wife's loss of consortium award of $5,000, were reduced by plaintiff's percentage of fault, to $33,750 and $3,750, respectively.

At issue here is an exclusion clause in the homeowner's liability insurance policy covering defendant. The clause provides:

EXCLUSIONS

This policy does not apply:

1. Under Coverage E-Personal Liability and Coverage F-Medical Payments to Others:

* * * * * *

f. to bodily injury or property damage which is either expected or intended from the standpoint of the Insured.

The purpose of the intentional injury exclusion is to restrict liability insurance coverage by denying coverage to an insured in circumstances where the insured acts deliberately and intends or expects bodily injury to another. The exclusion is "designed to prevent an insured from acting wrongfully with the security of knowing that his insurance company will 'pay the piper' for the damages." Transamerica Ins. Group v. Meere, 143 Ariz. 351, 694 P.2d 181, 186 (1984). Accord, United Servs. Auto. Ass'n v. Elitzky, 517 A.2d 982 (Pa.Super.Ct.1986).

The purpose of liability insurance, on the other hand, is to afford the insured protection from damage claims. Policies should be construed to effect, not deny, coverage. Borden, Inc. v. Howard Trucking Co., Inc., 454 So.2d 1081, 1090 (La.1984); LeJeune v. Allstate Ins. Co., 365 So.2d 471, 479 (1978). And an exclusion from coverage should be narrowly construed. Snell v. Stein, 261 La. 358, 259 So.2d 876 (1972).

The effect of the language used in this exclusion clause is not always clear. In fact, when construed in light of the myriad fact situations to which it has been applied, it is often ambiguous. See Annot., supra, 31 A.L.R. 4th 957, 978 n. 1. This Court noted in Pique v. Saia, 450 So.2d 654, 655 (1984) that the clause is indeed ambiguous.

Ambiguity in an insurance contract must be resolved according to the general rules governing contract interpretation. Albritton v. Fireman's Fund Ins. Co., 224 La. 522, 70 So.2d 111 (1964). Unless ambiguous, words used in an insurance contract will be given their commonly prevailing meaning. La.Civ.Code art. 2047. Ambiguous policy provisions are to be construed against the confector, the insurer. La.Civ.Code art. 2056; Salomon v. Equitable Life Assurance Soc'y of U.S., 202 La. 1001, 13 So.2d 329 (1943). Ambiguity will also be resolved by ascertaining how a reasonable insurance policy purchaser would construe the clause at the time the insurance contract was entered. ² See La.Civ.Code art. 2045.

This clause does not by its precise terms exclude coverage for bodily injury caused by the insured's intentional act. Rather, it excludes coverage for bodily injury "expected or intended from the standpoint of the Insured." The phrase "bodily injury ... which is expected or intended," emphasizes that an excluded injury is one which the insured intended, not one which the insured caused, however intentional the injury-producing act. The next phrase, "from the standpoint of the Insured," emphasizes again that it is the insured's subjective intention and expectation which delimit the scope of the exclusion. The subjective intention and expectation of the insured determine which injuries fall within and which fall beyond the scope of coverage under this policy.

This inquiry into the subjective intention or expectation of the insured contrasts sharply with the traditional tort inquiry into an actor's intent. The Restatement (Second) of Torts describes intended consequences as those which the actor knows are "substantially certain" to result from an act, whether the actor consciously desires those consequences or not. Restatement (Second) of Torts Sec. 8A (1965); see also W. Prosser, Law of Torts Sec. 8 (4th ed. 1971). While the inquiry regarding intentional torts asks which consequences an objective reasonable person might expect or intend as the result of a deliberate act, we are concerned, under the language of this insurance contract, with the injury subjectively intended or expected by the insured. ³

The field of criminal law, like Civil Law tort principles, adheres to an objective standard for identifying an actor's intent. That standard looks to the natural and probable consequences of an act for determining whether the actor intended the actual result. La.R.S. 14:10. ⁴

Furthermore, the inquiry into whether injuries are "intended or expected" by an insured under the terms of an insurance contract differs from the inquiry into whether an act is "intentional" under the worker's compensation statute's intentional acts exception to a co-employee's tort immunity. See La.R.S. 23:1032. Although the worker's compensation statute ordinarily limits to compensation the recovery available to an employee who suffers an on-the-job injury, the statute makes an exception for injuries produced by an employer's or co-employee's "intentional act." The statute provides, in pertinent part:

Nothing in this Chapter shall affect the liability of the employer, or any officer, director, stockholder, partner or employee of such employer or principal to a fine or penalty under any other statute or the liability, civil or criminal, resulting from an intentional act. (Emphasis added).

La.R.S. 23:1032.

In Bazley v. Tortorich, 397 So.2d 475, 480-81 (La.1981), this Court addressed the meaning of this statute's "intentional act" language, opining that the statute's "intentional act" exception mirrored the traditional distinction between intentional torts and negligence in common law. Id. at 480. The Court emphasized that in both the criminal and tort fields, "intent" refers to the consequences of the act, rather than to the act itself. Citing to Prosser and the Restatement (Second) of Torts, the Court held The meaning of intent in this context is that the defendant either desired to bring about the physical results of his act or believed they were substantially certain to follow from what he did.... If the actor knows that the consequences are certain, or substantially certain, to result from his act, and still goes ahead, he is treated by the law as if he had in fact desired to produce the result.

Bazley, 397 So.2d at 482. Bazley thus instructs that the tort-based intent standard should determine whether an act is intentional under R.S. 23:1032.

This tort-based standard exposes the actor to liability for injuries he did not in fact specifically envision or desire to produce. Thus, in Caudle v. Betts, 512 So.2d 389, 392 (La.1987), when a company officer administered an electric shock to a worker, intending to play a good-natured practical joke, yet nonetheless producing serious injury to the victim, we held the actor liable for all consequences flowing from his act. "The defendant's liability (under R.S. 23:1032) for the resulting harm extends ... to consequences which the defendant did not intend, and could not reasonably have foreseen...." Caudle, 512 So.2d at 392. By contrast, the contract of insurance between this defendant and his insurer excludes coverage only for those injuries which the defendant subjectively desired to inflict.

A decision by the Montana Supreme Court, Millers Mutual Ins. Co. v. Strainer, 204 Mont. 162, 663 P.2d 338 (1983), speaks directly to the distinction between the "intentional act" exception to a co-worker's tort immunity and the exclusion for "intended" bodily injury found in liability...