CAUSE
AND EFFECT: ONE OCCURRENCE / MULTIPLE OCCURRENCES UNDER THE “CAUSE THEORY”
By: Matthew M. Jackson, Esquire
Boyle, Gentile & Leonard, P.A.
A typical liability policy has an aggregate policy limit
for claims within a single policy period, and a lower limit for each
“Occurrence” within the policy period.
For example, a one-year liability policy might provide a $1,000,000
limit per “Occurrence” with a $2,000,000 aggregate limit for all “Occurrences”
within the one-year policy period no matter how many “Occurrences” there may
be. This structure creates a scenario
where plaintiffs’ counsel asserting covered losses in excess of the
“Occurrence” limit can access additional funds if it is successfully argued
that the claims asserted, constitute multiple “Occurrences” within the policy
period. In short, assuming coverage
otherwise exists, a claim deemed to be one “Occurrence” with $2,000,000 in covered
losses would be subject to the $1,000,000 “Occurrence” limit; while the same
fact pattern, if deemed to be two “Occurrences” with $1,000,000 in covered
losses each, would net the full $2,000,000 aggregate.
In a typical policy, “Occurrence” is
defined to mean: “an accident, including continuous or repeated exposure to
substantially the same general harmful conditions.”
A majority of jurisdictions use what
is termed the “Cause Theory” in determining what constitutes a single accident
with repeated or continuous exposure, and what constitutes multiple accidents; and
therefore multiple “Occurrences.”
Application of the cause theory has
most commonly been in conjunction with asbestos litigation, featuring multiple
plaintiffs with repeated exposure.
However, markedly different results stem from ostensible application of
the same theory depending on what each court determined as the “cause.” For example, one Court held:
“(Defendant) is being sued by thousands of claimants alleging exposure
to (asbestos product) on hundreds of job sites, on thousands of different
dates, and under a variety of conditions over a period of six years. Not
everyone exposed to asbestos is affected and not all claimants were exposed
under the same circumstances or to the same lot of asbestos. I hold that the “cause”
of the injuries in question is the exposure of each individual to asbestos.
That exposure thus constitutes an occurrence for the purposes of determining
the number of occurrences.” Pittsburgh Corning Corp. v. Travelers Indemnity Co., No.
84–3985, 1988 WL 5302 (E.D. PA 1988).
Taken
to the logical extreme, if exposure of each plaintiff is deemed the “cause,”
then multiple plaintiffs that might have sat in adjacent offices to be exposed
at the same time and in the same place to the same harmful conditions would
still constitute multiple occurrences.
However, it is clear that a spatial and temporal analysis is inherent in
the “cause theory:”
“the claims… do not result from exposure at one site to one person or
group. Indeed, this is not a case where there was a single product distributed
to a very limited number of customers. Here, the claimants’ alleged bodily
injuries stem from exposure to different lots of asbestos, multiple different
products (not all distributed at the same time), and in different industrial
settings. The bodily injuries were caused by varying types of exposure to a
variety of products in a multitude of different locations over many decades.” Westfield Insurance v. Continental
Insurance, 2015 WL 1549277 (N.D. Ohio 2015).
Florida
is among the majority and follows the cause theory. See Koikos v. Travelers Ins. Co., 849
So. 2d 263, 268 (Fla. 2003) citing American Indem. Co. v. McQuaig, 435 So.
2d 414 (Fla. 5th DCA 1983). Florida’s
litigation has resulted in multiple “Occurrences” even when the temporal and
spatial analysis might indicate that one “Occurrence” would apply.
In
the McQuaig case, the resident of a home fired three shots at two police
officers (McQuaig and Pope), injuring both. The insurance company argued that there was
only one occurrence because the injury was caused by one instrumentality of danger
(the shotgun), in one very specific location and in close duration. The insurance company cited a string of cases
for the proposition that the shots could be considered one occurrence. In finding that the shots constituted three
separate occurrences and in distinguishing the cases cited by the insurer, the
fifth district explained: “In each of these cases (cited by the insurer)… there
was a single force, that once set in motion caused multiple injuries. Analogous to this would be if a single shot
had injured both McQuaig and Pope. This
was not the case.” Id. In other words, if there had been only one
shot causing multiple injuries, then there would have been only one
“occurrence”- but there were multiple shots, and so multiple occurrences.
The
vague, amorphous definition of “Occurrence” in the typical liability policy
will undoubtedly continue to engender litigation for the foreseeable future, as
courts and counsel grapple with the individual facts of “exposure” cases.
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