Courts throughout the nation have held that personal injury protection coverage includes injuries that may not necessarily involve a collision between vehicles, but may arise out of the use of the vehicle, even though the connection between the use of the vehicle and the injury is remote. In the absence of a causal connection through an accident or a use of the vehicle, PIP coverage usually will not apply.
Imagine the scenario. You have parked the car and turned the engine off. You unlatch the seatbelt. You open the vehicle door with the intent to get out of the car, but in a moment, your arm is caught by the seat belt or your foot is caught in the door, and you find yourself impulsively twisting to get loose or stumbling to keep from falling out of the car. That is when the injury occurs to your back, your arm, your leg, or maybe your foot.
You contact your automobile insurance agent and yes, you have coverage for your own carelessness. Courts throughout the nation have interpreted personal injury protection (PIP) insurance coverage in the personal auto policy and no-fault statutes mandating such coverage to insure these types of injuries. The only requirement is a causal connection, though tenuous, between the vehicle and the injury suffered.
Most jurisdictions have statutes that mandate no-fault insurance coverage for accidents resulting from or arising out of the use of a vehicle. 1 For example, article 5.06-3 of the Texas Insurance Code requires that every automobile liability policy "covering liability arising out of the use of any motor vehicle" include PIP coverage. TEX. INS. CODE ANN. art. 5.06-3 (emphasis added).
The issue for most courts when addressing no-fault coverage is the causal connection between the injury and the use of the motor vehicle. While a collision or near collision is not necessarily required to trigger PIP coverage, the vehicle must be more than the mere situs of the accident or injury-producing event. The vehicle must somehow be involved in causing the injury. For example, the Texas Supreme Court found PIP coverage for an injury suffered when the insured entangled his left foot on the raised portion of his truck's door facing while exiting the truck. 2
In that regard, the general consensus among the courts is that no-fault coverage applies if a claimant sustains injuries from a slip-and-fall accident while entering into or alighting from the covered vehicle. 3 Similarly, if a collision with another vehicle occurs while the claimant is entering into or alighting from the covered vehicle, courts find coverage. 4
Courts, however, will not find no-fault coverage in the absence of a causal connection between the injury and the actual use of the vehicle. For example, in State Farm Mut. Ins. Co. v. Peck, 900 SW2d 910, 913 (Tex App—Amarillo 1995, no writ), the court upheld the denial of PIP coverage when the only connection between the injury and the vehicle was the fact that the insured was sitting in the vehicle when he was bitten by a dog. The fact that the vehicle was the situs of the injury, in the absence of any causal connection to the vehicle itself, was not sufficient to trigger PIP coverage.
In that regard, courts generally deny coverage for injuries sustained from slip-and-fall accidents and collisions that occur prior to the process of entering or after exiting the vehicle. The cardinal issue, once again, is whether a close nexus exists between the use of the vehicle and the injury. The nexus could be one of proximate time or location. 5
In summary, courts throughout the nation interpret PIP coverage to include injuries that may not necessarily involve a collision between vehicles, but may arise out of the use of the vehicle, even though the connection between the use of the vehicle and the injury is remote. In the absence of a causal connection through an accident or a use of the vehicle, PIP coverage usually will not apply.
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