S.S. v. State Farm Fire & Casualty Co.

808 S.W.2d 668, 1991 WL 63395
CourtCourt of Appeals of Texas
DecidedJune 12, 1991
Docket3-90-087-CV
StatusPublished
Cited by21 cases

This text of 808 S.W.2d 668 (S.S. v. State Farm Fire & Casualty Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
S.S. v. State Farm Fire & Casualty Co., 808 S.W.2d 668, 1991 WL 63395 (Tex. Ct. App. 1991).

Opinion

JONES, Justice.

State Farm Fire & Casualty Company (State Farm) sued G.W. and S.S. for a declaratory judgment that G.W. was not entitled to recover under his State Farm homeowner’s policy for certain claims made by S.S. against him. S.S., having been assigned a portion of G.W.’s rights under the policy, and G.W. counterclaimed for bad-faith claims settlement practices and for recovery under the policy. The trial court granted State Farm’s motion for summary judgment and rendered judgment: (1) declaring that as a matter of law G.W.’s policy provided no coverage for 5.5.’s claims; (2) ordering that G.W. and 5.5. take nothing by their counterclaims; and (3) denying S.S.’s motion for summary judgment for recovery under the policy. G.W. and S.S. appeal. We will reverse the judgment and remand the cause.

G.W. was insured by State Farm under a Texas standard homeowner’s policy. On November 29,1986, G.W. and S.S. had consensual sexual intercourse at G.W.’s home. They had not previously engaged in sexual relations. At the time, G.W. knew or suspected that he had genital herpes, but did not tell S.S. of his infection before exposing her. Shortly thereafter, S.S. contracted the disease and made demand on G.W. to compensate her for her damages. G.W. notified State Farm of S.S.’s claim and requested that it defend him. In response, State Farm had G.W. sign a “request for claim services and non-waiver of rights agreement,” which purportedly allowed it to investigate and defend G.W. against the claim without admitting liability.

Although State Farm had, on G.W.’s behalf, retained counsel to respond to S.S.’s claim, G.W. obtained personal counsel as well. State Farm later denied coverage, but offered to continue providing legal representation for G.W. as required by the policy. At G.W.’s direction, his personal counsel rejected State Farm’s offer and revoked the company’s authority to represent G.W.

Two days after G.W. terminated his representation by State Farm, S.S. filed suit against G.W., alleging that he had negligently harmed her by having sexual relations with her at a time when he knew or should have known that sexual contact with him could expose S.S. to a herpes virus infection. Neither G.W. nor S.S. notified State Farm of the existence of the lawsuit. G.W. and S.S. subsequently entered into an agreed judgment that awarded her one million dollars in damages. As a part of the agreement, G.W. assigned to S.S.all of his claims for coverage against any insurer for indemnity for his allegedly negligent transmission of the disease. He also assigned to S.S. one-third of any claims he had or might have against State Farm for its alleged bad-faith claims adjusting, deceptive trade practices, or Insurance Code violations. S.S. agreed not to execute on the judgment. State Farm remained unaware of the lawsuit until after the agreed judgment had been signed by the parties and approved by the court.

Once apprised of the agreed judgment, State Farm brought the present declaratory judgment action, seeking a declaration: (1) that the policy does not provide coverage for liability arising from S.S.’s claims, either (i) because of an express policy provision excluding from coverage “bodily injury ... caused intentionally by ... the Insured,” or (ii) because the public policy of the State of Texas prohibits insurance coverage for the negligent transmission of sexual diseases; and (2) that State Farm is not obligated to defend or indemnify G.W., because his “failure to cooperate and his collusive, fraudulent, and conspiratorial conduct” constitute breaches of the insurance contract, thereby excusing State Farm from performing any of its contractual obligations. G.W. and S.S. counterclaimed, *670 alleging that the pólicy covered the injury and that State Farm had adjusted the claim in bad faith.

State Farm moved for summary judgment on the same two basic grounds stated in its petition: (1) lack of coverage under the policy language; and (2) breaches of contract by G.W. in failing to notify State Farm of the lawsuit and entering into an agreed judgment without State Farm’s approval. S.S. also moved for summary judgment, asserting that coverage for her injury existed as a matter of law. The trial court rendered summary judgment for State Farm, declaring that the policy “provides no coverage for any of the claims asserted by [S.S.] against [G.W.].” In addition, the court ordered that G.W. and S.S. take nothing on their counterclaims and denied S.S.’s motion for summary judgment.

On appeal, State Farm argues that: (1) although the policy excludes coverage only for intentionally inflicted injuries, intent to harm should, in the present case, be inferred from G.W.’s knowledge of his infection, coupled with the intentional nature of his sexual contact with S.S.; (2) in conjunction with a recent amendment to the Texas standard homeowner’s policy expressly excluding coverage for sexually transmitted diseases, the Texas State Board of Insurance stated its opinion that the transmission of such diseases was never intended to be covered; and (8) a finding of coverage would violate public policy.

A summary judgment movant has the burden of showing that no genuine issue of material fact exists and that it is entitled to judgment as a matter of law. Tex.R.Civ.P. 166a(c). In determining whether the mov-ant has succeeded in showing that no such dispute exists, we assume the truth of evidence favorable to the non-movant, indulge every reasonable inference on behalf of the non-movant, and resolve any doubt in the non-movant’s favor. Nixon v. Mr. Property Management Co., 690 S.W.2d 546, 548-49 (Tex.1985). In construing an insurance policy, a court is obligated to adopt the construction urged by the insured “as long as that construction is not itself unreasonable, even if the construction urged by the insurer appears to be more reasonable or a more accurate reflection of the parties’ intent.” Glover v. National Ins. Underwriters, 545 S.W.2d 755, 761 (Tex.1977).

G.W.’s policy binds State Farm to pay, on G.W.’s behalf, “all sums which the Insured shall become legally obligated to pay as damages because of bodily injury or property damage.” However, the policy excludes from coverage “bodily injury or property damage caused intentionally by or at the direction of the Insured.” (Emphasis added.) This language is, in our opinion, clear and unambiguous as it relates to the present cause: the exclusion deals with an intentional “injury,” not simply an intentional “act.” Therefore, G.W.’s intent regarding the mere act of intercourse is not the point on which coverage turns. Rather, the critical issue is G.W.’s intent with regard to causing S.S.’s injury, i.e., her infection with herpes. Coverage for that injury is not excluded under the provision in question unless G.W. intended not merely to engage in intercourse, but actually to transmit the infection.

Because the plain language of the policy excludes coverage for S.S.’s herpes infection only if G.W. intended her to contract the virus, State Farm’s summary judgment burden was to show conclusively that G.W. possessed such an intent. This Court has held that “[s]ummary judgment is rarely proper when the cause involves an issue inherently for the fact-finder, such as intent.” Taylor v. Bonilla,

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Bluebook (online)
808 S.W.2d 668, 1991 WL 63395, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ss-v-state-farm-fire-casualty-co-texapp-1991.