Insurance companies often deal with disputes over coverage. This often happens when the insured files a claim related to an incident not explicitly covered by the policy. In Wimberley, Texas, a man was recently denied coverage after being injured while moving construction materials off of another’s vehicle.
In Kiely v. Texas Farm Bureau Casualty Insurance, No. 06-19-00012-CV, a Texas appellate court affirmed a decision to deny personal injury protection benefits to an insured who was injured while attempting to unload metal roofing sheets from a delivery truck for a business he did not own or work for. The insured, Alan Kiely, was attempting to fix damages to his roof after a Wimberley hailstorm, ordering metal roofing sheets to his home.
The sheets arrived, bound in three bundles by length in a bed delivery truck driven by the Home Center employee, Brian David Reeves. Kiely had placed wooden pallets in front of his home in preparation for the arrival of the sheets. Kiely asked Reeves to position the truck so the lift “could be used to tilt the bed and unload the metal sheets onto the pallets,” as Reeves did not have a forklift. Reeves then allegedly misaligned the truck with the pallets, disregarding Kiely’s suggestion for unloading the sheets and began to move the first bundle by hand on his own. That first bundle slid off the truck bed and pinned Reeves between the ground and the sheets. Kiely, in an attempt to rescue Reeves, grabbed a corner of the bundle and attempted to lift it; and, as he did he heard a “pop” and felt a sharp pain in his lower back. Kiely fractured two vertebrae in his lower back, necessitating several surgeries.
Kiely sought personal injury protection (PIP) benefits from his insurer for his medical expenses and the insurer denied coverage. In the subsequent suit, Kiely’s insurer motion for summary judgment was granted based on his injuries not being the result of a motor vehicle accident and he was not listed as a “covered person” under the policy.
On appeal, the appellate court affirmed the trial court’s ruling. The appellate court found that, other than the truck being utilized to transport the metal sheets, the truck was not directly involved in the instance leading up to Kiely’s injuries. The court noted Kiely was not exiting or entering the vehicle when he was injured and he was not injured while removing the sheets from the bed of the truck. Instead, the appellate court held the “injury-producing event” occurred as a result of Kiely’s, “intentional act of lifting the metal sheets” off of Reeves. The court came to the conclusion Kiely neither occupied the vehicle when the incident occurred, nor was struck by the vehicle; and, therefore, he was not a “covered person” under the policy, nor entitled to PIP benefits.
Texas Insurance Defense Attorneys
In the competitive and rapidly evolving insurance industry, the need for effective defense counsel is paramount. An experienced insurance defense lawyer can help your company resolve disputes effectively and efficiently, protecting your financial interests in insurance disputes. If you have a coverage dispute at hand you believe needs the assistance of an experienced insurance defense attorney, contact MehaffyWeber today.