AUTO PIP POLICY INTERPRETED TO EXCLUDE COVERAGE IN ROOFING DELIVERY INJURY CASE
Texas Court of Appeals: Plaintiff Alan Kiely sued Defendant Texas Farm Bureau Casualty Insurance Company to recover personal injury protection (PIP) benefits for injuries he sustained when a lumber company employee was unloading metal roofing sheets at his home. Arguing that Kiely’s injuries did not result from a motor vehicle accident and that he was not a “covered person” under the insurance policy, Farm Bureau filed a motion for summary judgment. The trial court granted that motion.
The events leading to Kiely’s injuries began when his residence sustained windstorm damage. He ordered metal roofing sheets from Cragg’s Do It Best Lumbar to repair the roof. Cragg’s delivered the metal sheets in a flatbed delivery truck driven by its employee Brian Reeves. As Reeves was unloading the metal sheets, he misaligned the truck with pallets on which they were to be laid. As Reeves began moving the first bundle of metal sheets by hand, it slid off the truck bed and pinned Reeves between the ground and the metal sheets.
Reeves screamed for Kiely’s help. Kiely had a difficult time helping because of a leg injury requiring his use of a cane. But he wedged his cane under the metal sheets to get some leverage. When that was unsuccessful, Kiely bent over, grabbed a corner of the bundle, and tried to lift it. As he did so, Kiely heard a “pop” in his back and felt sharp pain. Kiely eventually freed Reeves by then using a plank to lift the sheet off of him. As a result of the actions, he fractured two vertebrae in his back and had multiple surgeries.
Kiely argued that his injuries stemmed from a motor vehicle accident, and that he was a “covered person” as defined by the insurance policy. For Kiely to be entitled to PIP benefits under his policy, he was required to show that he was injured in a motor vehicle accident, either while occupying the vehicle or when he was struck by a vehicle. Kiely contended that his injuries were caused from the use of a motor vehicle.
On appeal, the Texas Court of Appeals found that the phrase “auto accident” in an insurance policy was not ambiguous: “While a collision or near collision is not required, the vehicle must be more than the mere situs of the accident or injury-producing event.” This meant that a motor vehicle accident occurred when: (1) one or more vehicles are involved with another vehicle, an object, or a person; (2) the vehicle is being used as a motor vehicle; and (3) a causal connection exists between the vehicle’s use and the injury-producing event.
In this case, other than the truck being used to transport metal sheets, it was not directly involved in the circumstances leading to Kiely’s injuries. Kiely was not
exiting or entering the vehicle, and he was not injured while removing the metal sheets from the bed of the truck. Instead, the injury-producing event occurred as a direct cause of Kiely’s intentional act of lifting the metal sheets up. Thus, the Court found that he was not injured in a motor vehicle accident. The Court also
determined that Kiely was not a “covered person” under the policy because he was not using the truck, nor otherwise exiting, entering, or occupying it, at the time of his injuries. The trial court’s ruling was thus affirmed.
Kiely v. Texas Farm Bureau Casualty Insurance Company, 2019 WL 3269326 (Texas Court of Appeals, Texarkana, decided July 22, 2019, not yet released for publication in the permanent law reports).