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
Conclusion
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.
Dana Harbin is an attorney in the Dallas office of Cooper & Scully, P.C. where she specializes
in insurance coverage and bad faith involving all types of insurance policies,
both first and third party. Ms. Harbin earned her BA degree from the University
of Texas in Arlington and her JD degree from the University of Texas at Austin.
She can be reached at