The heyday of playing games with the definition of “occurrence” has passed but it remains a perennial pastime for those trying to inflate the value of an insurance policy.
Two apprentice linemen were injured when the power pole they were working on collapsed. They agreed to settle for the apprentice-programs’ policy limits. The question became what those limits were, so the carrier filed this declaratory judgment case to decide that.
The limits in the declarations were $1,000,000 per occurrence, $2,000,000 aggregate. Cincinnati said there was one occurrence, relying on the policy’s definition of “occurrence,” which is nowadays fairly standard language: “an accident, including continuous or repeated exposure to substantially the same general harmful conditions.” The claimants cited Helme (1987) for the proposition that the number of occurrences depends on the number of negligent acts, of which they counted five. The trial court agreed with Cincinnati.
The Court of Appeals affirms. There was clearly one accident and therefore one occurrence. Helme is inapplicable because in that case (in which injury was caused by the independent negligence of two physicians) the policy defined “occurrence” as “any incident, act, or omission,” or series of related acts or omissions, causing an injury. The opinion isn’t quite clear on how the claimants attempted to square that circle. They argued that the two policies were “functionally the same”; the court politely but firmly disagrees. And they suggested that Cincinnati’s policy language was an attempt “to avoid Helme“; the court notes this without comment but apparently the claimants really were saying, or at least implying, that the interpretation of a policy should depend not on what it says, nor even on what the drafters intended it to mean, but on their alleged bad motives for having it mean that.