Allstate Prop. & Cas. v. Squire
Justia.com Opinion Summary: The insured was driving his pickup truck when he was injured after swerving to avoid a cardboard box lying in the middle of his lane. Allstate stipulated that an unidentified vehicle dropped the box, but rejected a claim for uninsured motorist benefits and sought a declaratory judgment. The insured responded with counterclaims for breach of contract and insurance bad faith under 42 Pa. Cons. Stat.8371. The district court entered judgment for Allstate, finding that the injuries did not "arise out of ownership, maintenance or use of an uninsured auto." The Third Circuit reversed, rejecting an argument that the harm was caused by a box, not a vehicle. Physical contact with an uninsured vehicle is not required for an accident to "arise out of" the use of an uninsured vehicle. Accepting for purposes of appeal that an unidentified vehicle that dropped the box was an uninsured vehicle, there is a sufficient causal connection. The court noted that the insurance law is to be liberally construed in order to afford the greatest possible coverage to injured claimants.
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PRECEDENTIAL
UNITED STATES COURT OF APPEALS
FOR THE THIRD CIRCUIT
______________
No. 11-1664
______________
ALLSTATE PROPERTY AND CASUALTY INSURANCE
COMPANY
v.
LARRY G. SQUIRES
Appellant
______________
On Appeal from the United States District Court
for the Western District of Pennsylvania
(D.C. Civ. No. 10-1458)
Honorable Joy Flowers Conti, District Judge
______________
Argued December 15, 2011
BEFORE: SLOVITER, VANASKIE, and GREENBERG,
Circuit Judges
(Filed: January 26, 2012)
______________
R. Sean OâConnell (argued)
James A. Godwin
Robb Leonard Mulvihill, LLP
500 Grant Street
23rd Floor, BNY Mellon Center
Pittsburgh, PA 15219
Attorneys for Appellee
Edward A. Shenderovich (argued)
Shenderovich, Shenderovich & Fishman
429 Fourth Avenue, Suite 1600
Pittsburgh, PA 15219
Attorneys for Appellant
______________
OPINION OF THE COURT
______________
GREENBERG, Circuit Judge.
I.
INTRODUCTION
After Larry Squires was injured in a motor vehicle
accident, his automobile insurer Allstate Property and Casualty
Insurance Company (âAllstateâ) filed an action in the District
Court seeking a declaratory judgment that it was not obligated to
pay uninsured motorist (âUMâ) benefits to Squires under his
policy. Subsequently, in response to Allstateâs motion, the
Court granted it a judgment on the pleadings on March 2, 2011,
2
as it held that Squiresâs injuries did not âarise out of ownership,
maintenance or use of an uninsured autoâ as his policy required
for Allstate to be liable to him for UM benefits. For the
following reasons, we will reverse.
II.
FACTS AND PROCEDURAL HISTORY
On October 20, 2008, Squires was driving his pickup
truck on State Highway 51 in Beaver County, Pennsylvania
when he was injured after swerving to avoid an approximately
two-foot square cardboard box lying in the middle of his lane.
The parties to this action are uncertain as to how the box came
to be left on the road but, for purposes of its motion in the
District Court, Allstate stipulated that an unidentified vehicle
dropped the box. 1 Following the accident, Allstate, after
rejecting Squiresâs claim for UM benefits, filed this action and
Squires responded with counterclaims for breach of contract and
insurance bad faith under 42 Pa. Cons. Stat. Ann. § 8371 (West
2007). 2 Allstate then moved for judgment on the pleadings and
1
Squires has contended that another vehicle must have dropped
the box because at the time of the accident he was traveling on a
limited access highway with no adjacent sidewalks or other
means of pedestrian access.
2
Neither party contends that the matter in dispute should be
resolved by way of the arbitration procedure for resolution of
UM claims set forth in Squiresâs policy. See app. at 48.
3
for dismissal of the counterclaims.
Squiresâs policy provides, in relevant part:
[W]e [Allstate] will pay damages to an insured
person [Squires] for bodily injury which an
insured person is legally entitled to recover from
the owner or operator of an uninsured auto.
Bodily injury must be caused by accident and
arise out of the ownership, maintenance, or use of
an uninsured auto.
App. at 44. The policyâs language tracks the Pennsylvania
Motor Vehicle Financial Responsibility Law (âMVFRLâ),
which requires that insurers offer UM benefits in motor vehicle
liability insurance policies. 3 The MVFRL provides for
3
75 Pa. Cons. Stat. Ann. § 1731(a) (West 2006) provides:
(a) Mandatory offering.âNo motor vehicle
liability insurance policy shall be delivered or
issued for delivery in this Commonwealth, with
respect to any motor vehicle registered or
principally garaged in this Commonwealth, unless
uninsured motorist and underinsured motorist
coverages are offered therein or supplemental
thereto in amounts as provided in [75 Pa. Cons.
Stat. Ann.] section 1734 (relating to request for
lower limits of coverage). Purchase of uninsured
motorist and underinsured motorist coverages is
optional.
4
âuninsured motorist coverageâ as follows:
Uninsured motorist coverage shall provide
protection for persons who suffer injury arising
out of the maintenance or use of a motor vehicle
and are legally entitled to recover damages
therefor from owners or operators of uninsured
motor vehicles.
75 Pa. Cons. Stat. Ann. § 1731(b) (West 2006). The MVFRL
defines âuninsured motor vehicleâ to include, inter alia:
An unidentified motor vehicle that causes an
accident resulting in injury provided the accident
is reported to the police or proper governmental
authority and the claimant notifies his insurer
within 30 days, or as soon as practicable
thereafter, that the claimant or his legal
representative has a legal action arising out of the
accident.
Id. § 1702.
Although Squiresâs insurance policy -- unlike the
MVFRL-- does not include unidentified motor vehicles in its
definition of âuninsured auto,â see app. at 45, Allstate did not
dispute -- and the District Court, quite reasonably in view of
section 1702, assumed -- that the unidentified vehicle was an
âuninsured motor vehicleâ for purposes of the Courtâs coverage
5
analysis. 4 Accordingly, the sole issue that the Court decided
was âwhether an accident caused by a box which fell from an
uninsured motor vehicle can be attributed, as a matter of law, to
the âownership, maintenance or useâ of an automobile.â App. at
5. The Court answered this question in the negative, concluding
that there is UM coverage for policies containing the âarising
out ofâ language only when a vehicle -- and not some other
object such as the box -- was âthe instrumentality causing . . .
the [a]ccident.â App. at 11. Accordingly, on March 2, 2011, the
Court granted Allstateâs motion for judgment on the pleadings,
denied its motion to dismiss the counterclaims as moot, and
dismissed Squiresâs counterclaims as moot. Squires timely
appealed.
4
Though the District Court did not directly address the question
of whether the policyâs language or the MVFRL controlled its
coverage analysis, in Pennsylvania â[i]nsurance contracts are
presumed to have been made with reference to substantive law,
including applicable statutes in force, and such laws enter into
and form a part of the contractual obligation as if actually
incorporated into the contract.â Clairton City Sch. Dist. v.
Mary, 541 A.2d 849, 851 (Pa. Commw. Ct. 1988) (citing First
Natâl Bank of Pa. v. Flanagan, 528 A.2d 134 (Pa. 1987)).
Accordingly, we refer to both Squiresâs policy and the MVFRL
in resolving this case.
6
III.
JURISDICTION AND STANDARD OF
REVIEW
The District Court had diversity of citizenship subject
matter jurisdiction under 28 U.S.C. § 1332. 5 We have
jurisdiction under 28 U.S.C. § 1291. We exercise plenary
review over the District Courtâs grant of Allstateâs motion for
judgment on the pleadings under Fed. R. Civ. P. 12(c). See
Ehrheart v. Verizon Wireless, 609 F.3d 590, 593 n.2 (3d Cir.
2010). A court will grant a motion for judgment on the
pleadings if the movant establishes that âthere are no issues of
material fact, and that he is entitled to judgment as a matter of
law.â Sikirica v. Nationwide Ins. Co., 416 F.3d 214, 220 (3d
Cir. 2005) (citing Socây Hill Civic Assân v. Harris, 632 F.2d
1045, 1054 (3d Cir. 1980)). In considering a motion for
judgment on the pleadings, a court must accept all of the
allegations in the pleadings of the party against whom the
motion is addressed as true and draw all reasonable inferences in
favor of the non-moving party. See Allah v. Al-Hafeez, 226
F.3d 247, 249 (3d Cir. 2000).
5
At oral argument, Squiresâs counsel tentatively represented
that the limit of Squiresâs UM coverage was $50,000, a
possibility that led us to question whether the District Court had
diversity jurisdiction as it appeared that the case might not
satisfy section 1332âs requirement that the amount in
controversy exceed $75,000. However, after oral argument
counsel for the parties advised us that Squiresâs insurance policy
had a UM coverage limit exceeding $75,000.
7
IV.
DISCUSSION
The parties agree that Pennsylvania law governs our
interpretation of Squiresâs policy and thus the extent to which it
provides coverage, and therefore we apply Pennsylvania law on
this appeal. Under Pennsylvania law,
the interpretation of a contract of insurance is a
matter of law for the courts to decide. In
interpreting an insurance contract, we must
ascertain the intent of the parties as manifested by
the language of the written agreement. When the
policy language is clear and unambiguous, we
will give effect to the language of the contract.
Paylor v. Hartford Ins. Co., 640 A.2d 1234, 1235
(Pa. 1994). However, where the policy language
is ambiguous, it âis to be construed in favor of the
insured and against the insurer, the drafter of the
agreement.â Dorohovich v. W. Am. Ins. Co., 589
A.2d 252, 256 (Pa. Super. Ct. 1991). In an
insurance policy, â[w]ords of common usage . . .
are to be construed in their natural, plain, and
ordinary sense . . . and we may inform our
understanding of these terms by considering their
dictionary definitions.â Madison Constr. Co. v.
Harleysville Mut. Ins. Co., 735 A.2d 100, 108
(Pa. 1999) (citations omitted).
As the District Court recognized, the sole question in this
case is whether under the policy and Pennsylvania law Squiresâs
8
accident should be regarded as having â[arisen] out of
ownership, maintenance, or use of an uninsured auto.â We note
that to the extent âthe stateâs highest court has not addressed the
precise question presented, we must predict how [that] court
would resolve the issue.â Wayne Moving & Storage of N.J., Inc.
v. Sch. Dist. of Phila., 625 F.3d 148, 154 (3d Cir. 2010)
(alterations and citations omitted). In doing so,
we must look to decisions of state intermediate
appellate courts, of federal courts interpreting that
stateâs law, and of other state supreme courts that
have addressed the issue, as well as to analogous
decisions, considered dicta, scholarly works, and
any other reliable data tending convincingly to
show how the highest court in the state would
decide the issue at hand.
Meyer v. CUNA Mut. Ins. Socây, 648 F.3d 154, 164 (3d Cir.
2011) (internal quotation marks and citations omitted).
âAlthough not dispositive, decisions of state intermediate
appellate courts should be accorded significant weight in the
absence of an indication that the highest state court would rule
otherwise.â Orson, Inc. v. Miramax Film Corp., 79 F.3d 1358,
1373 n.15 (3d Cir. 1996).
Although Pennsylvaniaâs
intermediate appellate courts have not addressed a factual
scenario similar to that presented here, their decisions provide
significant guidance for us in answering the question that we
address. 6
6
The cases we cite show that the question of whether an
accident arose out of the âownership, maintenance, or useâ of a
9
We start, however, with the Pennsylvania Supreme Court
case of Manufacturers Casualty Insurance Co. v. Goodville
Mutual Casualty Co., 170 A.2d 571 (Pa. 1961), in which that
court held that â[c]onstrued strictly against the insurer, âarising
out ofâ [in an insurance policy] means causally connected with,
not proximately caused by. âBut forâ causation, i.e. a cause and
result relationship, is enough to satisfy this provision of the
policy.â Id. at 573. This formulation of âarising out ofâ is now
well-settled in Pennsylvania, and has been applied in various
insurance law settings, both when interpreting insurance policies
and assessing issues arising by operation of statutes, even
though some of the cases applying the formulation do not cite
Goodville. See, e.g., Tuscarora Wayne Mut. Ins. Co. v.
Kadlubosky, 889 A.2d 557, 563 (Pa. Super. Ct. 2005) (assessing
a commercial general liability insurance policy); Roman Mosaic
& Tile v. Aetna Cas. and Sur. Co., 704 A.2d 665, 669 (Pa.
Super. Ct. 1997) (same); Smith v. United Servs. Auto. Assân,
572 A.2d 785, 787 (Pa. Super Ct. 1990) (applying the Goodville
formulation to an uninsured motorist policy provision); Erie Ins.
Exch. v. Eisenhuth, 451 A.2d 1024, 1025 (Pa. Super. Ct. 1982)
(no-fault automobile insurance policy). Accordingly, Squires at
this time only need have alleged adequately that the unidentified
vehicleâs use was a but-for cause of his injuries. 7
motor vehicle come from numerous different factual situations
and thus inevitably will be factually distinguishable.
7
We are not implying that in order to recover on his UM
coverage Squires will not be required ultimately to show that an
uninsured vehicle proximately caused the accident. But at this
10
In making our analysis we are aware that Pennsylvania
intermediate appellate courts quite broadly have indicated that if
injuries are caused by âan instrumentality or external force other
than the motor vehicle itself,â the vehicle will not be regarded as
having contributed to the cause of the injuries pursuant to the
âarising out ofâ language. See Lucas-Raso v. Am. Mfrs. Ins.
Co., 657 A.2d 1, 3 (Pa. Super. Ct. 1995). For example, in
Lucas-Raso the Superior Court of Pennsylvania held in a
workersâ compensation subrogation action that an employeeâs
injuries did not arise from the maintenance or use of a motor
vehicle when the employee slipped in a snow-covered pothole as
she was approaching her car. Accordingly, a provision of the
MVFRL, 75 Pa. Cons. Stat. Ann. § 1720 (West 2006), that bars
subrogation claims in cases âarising out of the maintenance or
use of a motor vehicleâ did not preclude the workersâ
compensation insurance carrier that had paid benefits to the
employee from subrogating to the recovery on the employeeâs
third-party claims for damages arising from the fall. Id. at 5.
The court acknowledged that while the employee was âvehicleoriented at the time of her fall, she has failed to establish the
necessary nexus between her injury and the use of the . . .
vehicle,â observing that the employee had âoffered no
connection to link her fall to the use of her vehicle other than
her claim that she was en route to enter it. The facts illustrate
that it was not the act of entering her vehicle which caused [the]
fall, and there was no other vehicle involved to break the chain
of entry.â Id.
stage of this case he only need satisfy the requirement to plead
facts that could support a conclusion that the unidentified
vehicle was a but-for cause of the accident.
11
The Superior Court employed reasoning similar to that of
Lucas-Raso in Smith v. United Services Automobile Assân, 572
A.2d 785, a case on which the District Court in this case heavily
relied. In Smith a boy was riding his bicycle on a road as a
tractor pulling a hay wagon passed by him. As the vehicles were
passing, a boy riding in the wagon threw hay in the bicycle
riderâs face, causing him to crash into a tree and suffer serious
injuries. Smith and his parents sued their automobile liability
insurer seeking uninsured motorist coverage, but the court held
that the injuries were not caused by a vehicle, but rather by the
âintentional act of a third party, [i.e.] the passenger, throwing
hay.â 8 Id. at 787. Accordingly, the court held that â[b]ecause
we are unable to discern any causal connection between the
vehicle and the injury, the injury cannot be said to arise from the
ownership, maintenance, or use of the vehicle,â and therefore
the plaintiffs were not entitled to uninsured motorist benefits
under their policy. Id.
Relying on Smith, the District Court rejected Squiresâs
claim for coverage as it concluded that âthe determinative fact is
that the instrumentality causing the Underlying Accident was a
box -- not a vehicle.â 9 App. at 11. We think, however, that
Smith is distinguishable from this case, and, when faced with a
set of facts similar to those here, the Pennsylvania Supreme
Court would hold that Squiresâs accident arose âout of the
8
During the time that the hay wagon was on the road it was
regarded as an uninsured vehicle.
9
The District Court also cited two not precedential opinions but
we do not discuss them as we afford them no weight.
12
ownership, maintenance, or use of an uninsured auto.â As
Squires points out, Smith concerned the intentional intervening
act of a third party: a person throwing hay from the back of a
vehicle. Hence, in line with Goodvilleâs emphasis on causation
in fact, the Smith court held that âit is clear that the injury was
not caused by the vehicle, but by the boy intentionally throwing
hay in Smithâs face.â Smith, 572 A.2d at 787. The court noted
that it had âinterpreted the phrase âmaintenance and use of a
motor vehicleâ to mean the âmaintenance or use of a motor
vehicle as a vehicle, including, incident to its maintenance or
use as a vehicle, occupying, entering into, or alighting from
it[.]â Id. (quoting Camacho v. Nationwide Ins. Co., 460 A.2d
353, 354 (Pa. Super. Ct. 1983)) (emphasis in original). In
Squiresâs case, in contrast to the incidental involvement of the
vehicle in the boyâs injury in Smith, we will infer that the
unidentified vehicle directly was involved in the accident as it
was transporting the box as cargo -- a common use for many
types of vehicles traveling on a roadway. See 75 Pa. Cons. Stat.
Ann. § 102 (West 2006) (Motor Vehicle Code definitions
section defining âvehicleâ as â[e]very device in, upon or by
which any person or property is or may be transported . . . .â)
(emphasis added). Thus, when the unidentified vehicle dropped
the cardboard box, it had more than an âincidental involvement .
. . in the situation that gave rise to [Squiresâs] injuries.â See
Alvarino v. Allstate Ins. Co., 537 A.2d 18, 21 (Pa. Super. Ct.
1988). 10 Rather, the accident was a direct consequence of the
10
Squiresâs case would have been indistinguishable from Smith
if in Smith the hay had been insufficiently secured while being
transported and consequently flew off the wagon and hit the
bicycle rider. In that situation the nexus between the âuseâ of
13
use of the vehicle for its intended purpose, for as is sometimes
said in another context, things âfall off the truck.â
We have examined the four cases on which Smith
principally relied but find them to be easily distinguishable from
this case as they all concerned intervening actions in situations
in which the injuries sustained were not attributable to common
uses of a vehicle. See Roach v. Port Auth. of Allegheny Cnty.,
550 A.2d 1346, 1350 (Pa. Super. Ct. 1988) (holding that a bus
passenger who was injured as a result of a fight between two
other passengers did not âestablish the requisite causal
connection between the âmaintenance and use of a motor
vehicleâ and the injuriesâ); Alvarino, 537 A.2d at 21 (holding
that a passenger who was bitten by a dog chained inside a van
did not suffer injuries arising out of the maintenance or use of a
motor vehicle, because the motor vehicle was merely âthe place
where injuries [were] sustainedâ); Camacho, 460 A.2d at 354
(holding that injuries sustained by driver sitting in car caused by
an explosive device that was thrown from another vehicle did
not arise out of the use of the other vehicle); Schweitzer v.
Aetna Life and Cas. Co., 452 A.2d 735, 738-39 (Pa. Super. Ct.
1982) (denying coverage for a claimant who was pulled from
her vehicle and assaulted, because neither she nor her assailant
was âacting in the role of motorist,â and âan assault by an armed
assailant upon the driver of a car [is not] the type of conduct that
is reasonably identifiable with the use of a carâ) (internal
quotation marks and citation omitted); see also Ohio Cas. Grp.
of Ins. Cos. v. Bakaric, 513 A.2d 462, 465 (Pa. Super. Ct. 1986)
the wagon and the accident would have been much stronger than
it actually was in Smith.
14
(refusing to interpret an incident where a husband shot his wife
in the face in the front seat of a car as one arising from the use
of a motor vehicle); Eisenhuth, 451 A.2d at 1025 (holding that
injuries suffered by a vehicle passenger as the result of a
gunshot did not satisfy Goodvilleâs causation-based standard for
âarising out ofâ); Day v. State Farm Mut. Ins. Co., 396 A.2d 3,
5 (Pa. Super. Ct. 1978) (holding that injuries sustained in a postcollision fistfight between two drivers did not arise out of the
ownership, maintenance, or use of a vehicle for purposes of
assessing uninsured motorist coverage).
In support of its position, Allstate points to our decision
in U.S. Underwriters Insurance Co. v. Liberty Mutual Insurance
Co., 80 F.3d 90 (3d Cir. 1996). In U.S. Underwriters, Robert
Hipl parked his car at a nursing home in preparation for a
business meeting. As he exited his vehicle, Hipl slipped on
grease that had come from the nursing homeâs kitchen and then
coated a section of the parking lot. Id. at 92. In the process, he
struck his back on the carâs door and was injured. Id. After
Hiplâs employerâs workersâ compensation carrier paid him
benefits, it asserted that it had acquired a subrogation lien on the
proceeds of a third-party action Hipl brought against the nursing
home and other defendants. Id. Following the settlement of the
third-party action, the third-party defendantsâ insurers sought to
invalidate the lien under the provision of the MVFRL involved
in Lucas-Raso that bars a workersâ compensation insurerâs right
of subrogation to recover benefits from an insuredâs tort
recovery if the injuries âarose from the maintenance or use of a
motor vehicle.â Id. We applied Goodvilleâs âbut-forâ
formulation of âarising out of,â but, noting that âevery incidental
factor that arguably contributes to an accident is not a âbut forâ
15
cause in the legal sense,â see Berry v. Sugar Notch Borough, 43
A. 240, 240 (Pa. 1899), we cited Smith and several similar
intermediate appellate court cases and concluded that a
Pennsylvania court would not hold that Hiplâs injuries âarose
out ofâ the use of his car based on the particular facts of the
case. Id. at 94-95.
U.S. Underwriters clearly is distinguishable from this
case. We first observe that while, as here, something physically
external to a vehicle caused the injuries in U.S. Underwriters as
the grease that directly caused Hipl to fall emanated from a
nearby building, the procedural posture of our case requires us
to consider that the cardboard box that caused the accident was
dropped on the road by an unidentified and thus uninsured
vehicle. Consequently, there is a stronger factual causal
connection here between the injuries sustained and the
âownership, maintenance, or useâ of an automobile than the
connection between the injuries and the vehicle in U.S.
Underwriters. In U.S. Underwriters we recognized how
attenuated the causal connection was between the injury and the
vehicle for in reaching our result we relied on the analogous
case of Lucas-Raso, which reasoned:
Presently, appellant, who intended to enter her
automobile, claims she stumbled after stepping
into a snow-covered pothole and was injured as a
result. She has failed to show how her vehicle
contributed to her fall. Clearly, if appellant had
encountered the same snow-covered pothole in a
different location in the parking lot, this case
would not be before us. Appellant has offered no
16
connection to link her fall to the use of her vehicle
other than her claim that she was en route to enter
it. The facts illustrate that it was not the act of
entering her vehicle which caused appellantâs fall,
and there was no other vehicle involved to break
the chain of entry.
Lucas-Raso, 657 A.2d at 5. Although Hipl, unlike the injured
party in Lucas-Raso, struck his vehicle rather than the ground
when he fell, a vehicle did not cause the fall. Thus, though the
vehicle involved in U.S. Underwriters was the situs of the
injury, its presence was not instrumental in the fall.
Significantly, in U.S. Underwriters we examined âPennsylvania
cases demontrat[ing] that the Commonwealthâs understanding of
âuse of a motor vehicleâ . . . will not encompass the causal nexus
at issue here,â 80 F.3d at 94, citing Smith, Roach, Alvarino,
Camacho, Schweitzer, and Eisenhuth, which as we have
mentioned were all cases where the presence of a vehicle was
merely incidental to the conditions that caused the injuries at
issue. See id. at 94-95.
As the Supreme Court of Pennsylvania set forth in
Goodville, the central inquiry in assessing whether an incident
âarose out of the maintenance, ownership, or useâ of a motor
vehicle concerns causation, which is informed by -- but does not
necessarily turn on -- the âinstrumentalityâ directly causing the
accident. Thus, the Pennsylvania intermediate appellate court
decisions that have indicated that if âan instrumentality or
external force other than the motor vehicle itselfâ caused the
accident the vehicle will not be regarded as having contributed
to its cause may not have precisely applied the Goodville
17
formulation. In fact, we think that while the identification of the
object that directly caused an accident surely is relevant in a
causation analysis, it is not dispositive and does not foreclose
the possibility that the accident arose out of the use of a motor
vehicle. In this regard, we point out that there may be two or
even more causes of an accident. Lehrer/McGovern v. Workersâ
Compensation Appeal Board, 720 A.2d 853 (Pa. Commw. Ct.
1998), is an example of a case in which there was a confluence
of an external object and a vehicle that caused an accident. In
that case a construction worker was injured when a metal refuse
container slid off of a nearby flatbed truck and traveled about
ten feet before hitting a large steel box that struck the worker.
Id. at 853-54. The worker filed a third-party action against the
truck owner, and after the parties settled that action, his
employer, who had paid its employee workersâ compensation
benefits, filed a subrogation action seeking to make a recovery
from the employeeâs proceeds from the third-party action. Id. at
854. However, as we already have noted in our discussions of
Lucas-Raso and U.S. Underwriters, a provision of the MVFRL
precludes an employer or insurance company that has paid
workersâ compensation benefits from subrogating to the
recovery from a third-party action âarising out of the
maintenance or use of a motor vehicle.â In affirming the
Workersâ Compensation Appeal Board, which rejected the
employerâs claim, the Commonwealth Court held that the
workerâs injuries arose from the maintenance or use of a motor
vehicle, and barred the employer from subrogating to the
recovery in the third-party action, despite the circumstance as
germane here that an object other than the vehicle itself struck
the worker. Id. at 856.
18
In a case similar to Lehrer/McGovern insofar as that case
involves an issue comparable to the issue here, the court in Fox
v. State Automobile Mutual Insurance Co., 461 A.2d 299 (Pa.
Super. Ct. 1983), faced a situation involving a plaintiff who was
injured after tripping over debris left when a car suddenly
crashed into her living room. In deciding that the plaintiff
qualified as a âvictimâ under an insurance policy issued
pursuant to the Pennsylvania No-fault Motor Vehicle Insurance
Act, the court determined that the causal connection between the
vehicle and the plaintiffâs injuries was strong enough to support
a conclusion that the accident âarose out ofâ the maintenance
and use of the vehicle. Id. at 302. Lehrer/McGovern and Fox,
cases that in our view describe cause-and-result relationships
which, if anything, were more attenuated than the causal
connection between the use of a vehicle and the accident here,
demonstrate that physical contact with an uninsured vehicle is
not required for an accident to âarise out ofâ the use of an
uninsured vehicle, and that, depending on the facts of the case,
some less direct causal relationship sometimes will suffice.
Accepting for purposes of this appeal that the unidentified
vehicle that dropped the box on the highway was an âuninsuredâ
vehicle, there is a sufficient causal connection for us to
determine that Squiresâs injuries âarose out ofâ the use of a
vehicle under his insurance policy.
We finally note that âthe MVFRL is to be liberally
construed in order to afford the greatest possible coverage to
injured claimantsâ and â[i]n close or doubtful insurance cases, a
court should resolve the meaning of insurance policy provisions
or legislative intent in favor of coverage for the insured.â
Houston v. SEPTA, 19 A.3d 6, 14 (Pa. Commw. Ct. 2011)
19
(citing 1 Pa. Cons. Stat. Ann. § 1928(c) (West 1998) (stating
with exceptions inapplicable here that statutes âshall be liberally
construed to effect their objects and promote justiceâ)); Motley
v. State Farm Mut. Auto. Ins. Co., 466 A.2d 609, 611 (Pa.
1983)). Thus, even though we recognize that this case is close,
we think that the Pennsylvania Supreme Court would reach the
result that we reach. 11
V.
CONCLUSION
For the foregoing reasons, we hold that in light of
Allstateâs concession for purposes of its motion for judgment on
the pleadings that the accident was caused by a box dropped
from an unidentified vehicle, Squiresâs accident âar[ose] out of
the maintenance, ownership, or useâ of an uninsured vehicle
11
We emphasize how narrow our opinion is. After all, we have
decided this case on the basis of an assumed set of facts and it is
entirely possible that in further proceedings whether in court or
in an arbitration case the facts may appear to be quite different.
Moreover, though we are reinstating Squiresâs counterclaims we
are not suggesting that in this close case we see any merit in
Squiresâs bad faith counterclaim. Rather, we express no opinion
on that issue as it is not before us for adjudication. We note,
however, that our experience in addressing Pennsylvania
insurance coverage disputes has demonstrated that insureds tend
to bring bad faith claims when insurers reject their claims even
though there are legitimate disputes over whether the claims are
covered.
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under his insurance policy. We therefore will reverse the
District Courtâs order of March 2, 2011, granting Allstateâs
motion for judgment on the pleadings and dismissing Squiresâs
counterclaims and will remand the case to the District Court for
further proceedings.
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