The concept of fortuity is fundamental to insurance law. That is because insurance protects against the risk of contingent or unknown events or losses – not certainties of loss. Cal. Ins. Code § 22. Thus, in the context of third-party liability insurance, most policies condition coverage on an “occurrence,” meaning an “accident,” that causes bodily injury, property damage or personal injury.[1]
While most liability policies do not further define “accident,” California courts have given it a commonsense interpretation to mean “an unexpected, unforeseen, or undesigned happening or consequence from either a known or an unknown cause.” Delgado v. Interinsurance Exch. of Auto. Club of S. Cal., 47 Cal.4th 302, 308 (2009). And over the last few decades, California courts have further considered and refined the conduct that does (or more clearly does not) constitute an accident, leading to the following well-established guideposts:
- Not Intentional or Deliberate Conduct: As a threshold matter, “[a]n intentional act is not an ‘accident’ within the plain meaning of the word.” Albert v. Mid-Century Ins. Co., 236 Cal.App.4th 1281, 1290-91 (2015). An accident “is never present when the insured performs a deliberate act unless some additional, unexpected, independent, and unforeseen happening occurs that produces the damage.” Delgado, supra, 47 Cal.4th at 315.
- From the Standpoint of the Insured: “Accident” is viewed from the insured’s perspective and “refers to the injury-producing acts of the insured, not those of the injured party.” Delgado, supra, 47 Cal.4th at 315 (emphasis added).
- Antecedent Acts Immaterial: “Accident” refers to the “events in the causal chain after the acts of the insured, not to events preceding the acts of the insured.” Delgado, supra, 47 Cal.4th at 315 (original emphasis).
- State of Mind Immaterial: “Accident” refers to the conduct of the insured for which liability is sought to be imposed. It does not refer to the insured’s state of mind. Quan v. Truck Ins. Exch., 67 Cal.App.4th 583, 599 (1998).
Thus:
- “Accident” does not require an intent to injure: “Where the insured intended all of the acts that resulted in the victim’s injury, the event may not be deemed an ‘accident’ merely because the insured did not intend to cause injury.” Ray v. Valley Forge Ins. Co., 77 Cal.App.4th 1039, 1045-46 (1999). As another court succinctly put it: “The insured’s subjective intent is irrelevant.” Fire Ins. Exch. v. Sup. Ct. (“Bourguignon”), 181 Cal.App.4th 388, 392 (2010).
- It does not matter that the insured’s intentional conduct resulted in unintended consequences. See e.g. State Farm Gen. Ins. Co. v. Frake, 197 Cal.App.4th 568 (2011). “Accident” “cannot mean unintended damage . . . [W]here damage is the direct and immediate result of an intended . . . event, there is no accident.” Id. at 579, 583 (internal quotations and citations omitted).
- It does not matter what motivated the insured’s deliberate conduct. Even an insured’s mistake of law or fact does not transmute a purposeful act into an accident. See e.g. Ghukasian v. Aegis Security Ins. Co., 78 Cal.App.5th 270, 272-75 (2022) (rejecting argument that insured’s mistaken belief that she was removing trees on her property converted deliberate act into an accident); Bourguignon, supra, 181 Cal.App.4th at 396 (“the act of construction was intentional and not an accident even though [insured] acted under a mistaken belief that they had a right to [build on neighbor’s land]”); Delgado, supra, 47 Cal.4th at 315 (unreasonable belief in the need for self-defense not an “accident”).
Against this large body of California law, some insureds have turned to legal insanity standards in an effort to convert otherwise non-accidental conduct into an accident. That theory relies on the argument that an insured who suffers from mental illness or delusion may not have the capacity to understand the nature, quality or wrongfulness of their deliberate conduct, or may have otherwise acted under an irresistible impulse. See e.g. Allstate Cas. Ins. Co. v. Griffin, 2005 WL 2122053 *1 (N.D. Cal. 2005); Jacobs v. Fire Ins. Exch., 36 Cal.App.4th 1258 (1995). The argument continues: if the insured is unable to appreciate the nature of their deliberate conduct, or cannot stop it, then they cannot form the intent to act, which somehow renders their deliberate conduct accidental. Griffin, supra,2005 WL 2122053 at *3 (arguing that the insured’s “status as legally insane means that he was incapable of an intentional act”).
Surprisingly, few California courts have addressed the issue. And those that have done so seemingly conflate the impact that insanity may have on the application of California Insurance Code section 533 – an exclusion that does require an intent to harm – with the analysis of “accident” – which does not focus on the insured’s state of mind. See Griffin, supra,2005 WL 2122053 at *3. In doing so, those courts appear to have ignored that determining whether conduct constitutes an “accident” involves a coverage question, not an exclusion question. Ray, supra, 77 Cal.App.4th at 1048; Ross v. United Servs. Auto. Assn., 2005 WL 375581 *3 (Cal. Ct. App. 2005) (“coverage, not intent, is the threshold question”).
Recently, a federal district court considered the issue in First National Ins. Co. of America, et al. v. Redmond James O’Neal, et al., USDC, C.D. Cal., Case No. 2:22-cv-05201-GW-SKx (2023). There, two individuals alleged that Redmond O’Neal (“O’Neal”) violently attacked them in separate unprovoked incidents. Specifically, they accused O’Neal of slitting the throat and plunging a knife into the head of one of them, and hurling a homophobic slur and striking the other in the head with a bottle or other hard object.[2] Id., Dkt. 78, pp. 7-8 & Dkt. 79 (March 2, 2023).
Under homeowners and umbrella policies issued to his father, O’Neal tendered the subsequent civil litigation filed against him to his father’s insurers for defense and indemnity coverage. O’Neal, supra, Case No. 2:22-cv-05201-GW-SKx, Dkt. 78 at p. 2.
Thereafter, in coverage litigation with the insurers, O’Neal asserted that his mental status or capacity rendered him incapable of deliberate conduct and unable to control his actions. O’Neal, supra, Case No. 2:22-cv-05201-GW-SKx, Dkt. 61 at p. 41 & Dkt. 78 at p. 24. In granting the insurers’ motion for partial summary judgment that they owed no duty to defend or indemnify O’Neal, the district court rejected the argument. Id.,Dkt. 78 at p. 28 & Dkts. 79, 88. Relying on Delgado, the district court explained: “[T]he appropriate focus is on the ‘conduct of the insured’ and ‘the nature of the injury-causing event,’ not whether sufficient ‘intent’ or even capacity for intent underlay that conduct/event.” Id. at 24. While matters involving an appreciation of the wrongfulness or willfulness of conduct might impact application of exclusions requiring an intent to harm, they do not matter when examining the term “accident” in coverage provisions. Id. at 25.
O’Neal did not depart from the well-established principle that, for purposes of “accident,” the insured’s state of mind does not matter. And it recognized that those cases referring to an “intent to act” did not use that phrase to consider the insured’s mental capacity to form intent. Instead, “intent” for “accident” purposes refers to the conduct of the insured for which liability is sought to be imposed.
Liability insurance coverage should be reserved for true accidents – things like trip and falls, car accidents, and other acts that result in some additional, unexpected, independent, and unforeseen event that produces the damage. To draw a distinction for deliberate conduct caused by mental illness or incapacity would result in a strained interpretation of the term “accident,” which California courts do not sanction. Delgado, 47 Cal.4th at 313 (“[C]ourts will not indulge in a forced construction of the policy’s insuring clause to bring a claim within the policy’s coverage.”). To do so would be like finding no coverage for deliberate conduct by Dr. Jekyll, but finding the same conduct to be a covered “accident” if committed by Mr. Hyde.[3]
FOOTNOTES
[1] “Personal injury” is a term of art referring to offense-based liability coverage for, among other things, injury arising from defamation, false imprisonment, and invasion of privacy. Even then, some liability policies still apply an “accident” requirement to such coverage.
[2] These and other incidents alleged against O’Neal received significant media attention. See e.g. Redmond O'Neal, son of Farrah Fawcett, charged with attempted murder in crime spree - ABC News (go.com).
[3] A reference to Robert Louis Stevenson’s classic fictional work, Strange Case of Dr. Jekyll and Mr. Hyde, where Jekyll’s morally and/or legally insane alter ego, Hyde, commits murderous acts.