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Insurance, the Flying Toilet, and the Leaky Body.

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Insurnace Claims picsInsurance companies get bum raps, and lots of people figure “If I file suit, they’ll come up with some money to just settle things.” But this doesn’t always happen, and an insurer isn’t going to roll over and play dead.  Sometimes, they’ll even have grounds to claim “Uh uh” and deny that the insured wasn’t covered for whatever happened.

And sometimes, the facts are bizarre, as in these two cases.

Martin Hays filed suit against his good friend, James Buckbee and the company which had Buckbee’s homeowner’s insurance. The question was, did the insurer have any duty to cover Buckbee against Hays’ claim?  (Don’t go “ho hum”; read on.)

In 2007, Hays and Buckbee were trying to hoist a portable toilet to the top of a deer stand on Buckbee’s property. (We don’t know why; the decision is silent on that point.)

Anyway, to pull the toilet up, the two friends tied a rope around the toilet, then ran the rope through a pulley on top of the deer stand, which was 20 feet off the ground.  Then they brought the rope down and tied it to a hook on the bumper of Buckbee’s pickup truck. They thought this ingenious idea would lead to the rope pulling the toilet up to Hays, who was standing in the deer stand.

But when Buckbee started driving his truck forward, something went wrong.  The deer stand collapsed, and it, the toilet, and Hays ended up on the ground.

Of course, Hays was injured.  He filed suit against his now-former friend, claiming Buckbee had negligently operated his truck and used excessive force pulling the rope through the pulley.

Buckbee’s insurance company didn’t think this was covered by Buckbee’s homeowner’s policy. The policy contained a clause that it did not cover injuries arising out of the use of a motor vehicle. (That’s normal for a homeowner’s policy.)

Hays argued that this would apply if this was a normal use of the truck, but what they were trying to do was different, it wasn’t a “normal use.”

“No way,” said the Georgia Court of Appeals.  The policy controlled. The insurance company was off the hook. (And the decision doesn’t let us know what happened afterward between Hays and Buckbee.)

But if you’re ever driving through Georgia and see a toilet hanging from a rope over a tree limb, you’ll know why.

Here’s another case where the insurance company was right. Equally bizarre. Maybe more so.

The ceiling in Judy Rodrigo’s condo started leaking this fluid.  And when the neighbors upstairs started complaining about an odor from the unit above Rodrigo’s, the maintenance crews went in.

Turns out, the upstairs neighbor who lived directly above Rodrigo had died of natural causes. But nobody missed her and her body lay there for two weeks.

And during those weeks, the body went through normal decaying.  This included gasses building up which exerted so much pressure that her abdomen burst. This released gasses and fluids which leaked through the floor of that condo – and through the ceiling of Rodrigo’s unit.

Rodrigo spent her own money to gut her unit and do the repairs. And when she was done, she sued the condo association who turned it over to their insurance company.  Her claim: they had a duty to reimburse her for what she spent restoring her unit.

The insurance company said that the cause of the damages was “not a covered risk,” and court agreed. The key was whether or not there was an explosion which would be covered. The court found that the plain meaning of the word “explosion” did not include “a decomposing body’s cells explosively expanding, causing leakage of bodily fluids.”

Okay, yuck. But two lessons here: insurance companies aren’t always  going to roll over and pay off claims just to get rid of lawsuits.  And in cases like these, they’re right.

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