UM Coverage and Unidentified Operator or Owner as Cause of Accident

 

June 23, 2014

The insured brought an action against the auto insurer to recover uninsured motorist (UM) benefits regarding injuries sustained in an auto accident. This case is West v. Ameriprise Insurance Company, 2014 WL 463020.

 

West was driving her car when the vehicle struck a large object that was lying in the road. As a result, she suffered personal injuries and the vehicle was damaged. The object was determined to be a large portion of a tree, squared because it had been cut. West submitted a claim for UM coverage to the insurer but the insurer denied coverage.

 

West argued that it was more likely than not that the object came into the roadway as the result of a phantom vehicle' operator's negligence. The insurer countered that there was no sufficient proof to demonstrate a genuine issue of fact that a phantom vehicle caused the accident, and moved for summary judgment. The trial court agreed with the insurer and said there was no evidence whatsoever as to how the object got on the road and any jury would only be speculating on this point. The insured appealed.

 

The Superior Court of New Jersey, Appellate Division, said that it disagreed with the trial court's conclusion that West's opposition to the insurer's summary judgment motion could not rationally establish the insured's entitlement to UM benefits. The court noted that New Jersey requires auto insurers to include UM coverage for injuries caused by an accident and arising out of the ownership, maintenance, operation, or use of such uninsured or hit and run motor vehicle. The auto policy issued by Ameriprise to West did provide this coverage and defined an uninsured motor vehicle as “a land motor vehicle that is a hit and run vehicle whose operator or owner cannot be identified and that hits or causes an accident resulting in bodily injury”.

 

The appeals court said that an insured who seeks UM benefits must satisfy a two-prong test: first, the injuries must have been caused by an accident; and two, the accident must have arisen from the ownership, maintenance, operation, or use of an uninsured vehicle. In this instance, the court found that West created a question of material fact as to the second prong's requirement that there be a substantial nexus between the accident and the ownership, operation, or use of an uninsured vehicle. The court decided that there were sufficient facts in the record to permit a rational jury to conclude that it is more likely than not that the tree part came to be in the roadway because it fell from a vehicle. The insured provided more than a mere scintilla of evidence on this point since she offered evidence that the wood was cut, that it was on an overpass with no overhead structures, that there were no nearby trees, and that there was no one else present at the time of the accident.

 

Since there was sufficient circumstantial evidence that the proof offered by West would allow a jury to infer that a cut tree part does not just appear on an empty overpass in the absence of negligence involving a vehicle, the appeals court reversed the trial court's ruling and remanded the case.

 

Editor's Note: This case is an example of the different approaches by different courts as to the point that, after a loss, the insured has to show that the insurance policy could apply to the loss. The trial court thought that the insured did not meet her burden of presenting positive proof for the UM claim that a genuine issue of fact that a phantom vehicle caused the accident, and ruled in favor of the insurer. The appeals court ruled that the insured did offer enough proof that the accident was caused by an unidentified driver, and ruled in favor of the insured. Same facts, different judicial interpretations.