Key Takeaway
NY court rules firefighter injured during rescue operation entitled to SUM coverage when accident arose from negligent vehicle use - duty to rescue analysis.
This article is part of our ongoing coverage coverage, with 149 published articles analyzing coverage issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
The question of when an injury “arises out of” the use of a motor vehicle has profound implications for insurance coverage under Supplemental Uninsured/Underinsured Motorist (SUM) policies. While most cases involve direct contact between vehicles or pedestrians, some situations present more complex causation questions. The Second Department’s decision in Matter of Encompass Indemnity Co. v Rich addresses a particularly compelling scenario: when first responders are injured while rescuing victims from vehicle accidents caused by another driver’s negligence.
New York courts have long recognized that SUM coverage exists to protect innocent victims from underinsured motorists. However, insurers frequently argue that coverage should be limited to those directly involved in the collision itself, excluding rescuers and other secondary victims. This restrictive interpretation would leave a critical gap in protection for public safety personnel who put themselves at risk responding to accidents. The Rich decision clarifies that New York law takes a broader view of causation when determining what injuries “arise out of” vehicle use.
Case Background
Matter of Encompass Indem. Co. v Rich, 2015 NY Slip Op 06432 (2d Dept. 2015)
Firefighter Kevin Rich responded to a motor vehicle accident scene where an individual named Goodman was trapped inside his vehicle following a collision. Goodman was seriously injured — bleeding, drifting in and out of consciousness, and in obvious distress. To extricate Goodman from the wreckage, Rich and his fellow firefighters had to use the “jaws of life” hydraulic rescue tools to cut away the vehicle’s roof. While Rich and three other firefighters were lifting the severed roof section off the vehicle, Rich sustained injuries to his right shoulder.
Rich sought SUM coverage under his own automobile insurance policy issued by Encompass Indemnity Company. Encompass denied coverage, arguing that Rich’s injuries did not arise from the use of a covered vehicle and that his injuries occurred during rescue operations rather than from the accident itself. The dispute proceeded to the courts to determine whether a first responder injured while rescuing an accident victim can recover SUM benefits.
Jason Tenenbaum’s Analysis:
“When firefighter Kevin Rich’s engine company responded to the scene of the accident, Goodman was trapped inside his vehicle, bleeding, drifting in and out of consciousness, and, when awake, moaning in pain. In order to extract Goodman from the vehicle, the firefighters used the “jaws of life” to cut the vehicle’s roof, and Rich and three other firefighters lifted the roof off of the vehicle. In the process thereof, Rich sustained injuries to his right shoulder.”
“SUM endorsements provide coverage only when the injuries are “caused by an accident arising out of such underinsured motor vehicle’s ownership, maintenance or use""
“Factors to be considered in determining whether an accident arose out of the use of a motor vehicle include whether the accident arose out of the inherent nature of the vehicle and whether the vehicle itself produces the injury rather than merely contributes to cause the condition which produces the injury”
“Here, Encompass failed to establish that Rich was not entitled to coverage under the SUM endorsement. The evidence in the record establishes that Goodman’s negligent use of his vehicle directly caused the accident that led to him being trapped and in obvious need of medical attention, which, in turn, led to Rich’s intervention and resulting injuries”
Legal Significance
This decision represents an important expansion of the “arising out of” standard for SUM coverage, applying a proximate cause analysis that extends beyond immediate physical contact with a vehicle. The Second Department rejected the insurer’s attempt to draw an arbitrary line excluding rescue-related injuries, recognizing that such injuries flow directly and foreseeably from the negligent use of a motor vehicle. This holding aligns with the fundamental purpose of SUM coverage: compensating innocent parties harmed by underinsured motorists.
The court’s analysis emphasizes the distinction between injuries that merely occur near a vehicle versus those that are causally connected to the vehicle’s use. Here, the causal chain was clear and unbroken: Goodman’s negligent driving caused the accident, which created the emergency situation, which necessitated the rescue operation, which resulted in Rich’s injury. Courts in similar circumstances must examine whether the vehicle’s use set in motion a foreseeable chain of events leading to the injury, not whether the injury occurred at the precise moment of impact.
This precedent has implications beyond first responder cases. It suggests that other secondary victims — such as Good Samaritans assisting at accident scenes or medical personnel treating accident victims — may also qualify for SUM coverage when their injuries arise from the original negligent vehicle operation. The decision reinforces New York’s public policy of broadly construing insurance coverage provisions to protect injured parties.
Practical Implications
For first responders and their families, this decision provides critical protection when firefighters, EMTs, and police officers are injured while performing rescue operations at accident scenes. It ensures that professional rescuers are not left financially vulnerable when they suffer injuries that directly result from another driver’s negligence. This coverage becomes particularly important when the at-fault driver lacks sufficient insurance to compensate for serious injuries sustained during rescue operations.
Insurance companies must carefully evaluate SUM denials in cases involving indirect injuries. A reflexive denial based on the absence of direct vehicle contact may not withstand judicial scrutiny when the causal connection between the vehicle’s negligent use and the ultimate injury is clear. Insurers should conduct thorough investigations into the full chain of causation before denying coverage in rescue scenarios.
For practitioners, this case provides a framework for analyzing “arising out of” questions in non-traditional SUM scenarios. The key inquiry focuses on whether the negligent vehicle use was a substantial factor in producing the injury, not whether the injury occurred in a conventional collision. Attorneys representing injured parties should carefully develop the factual record showing how the vehicle’s use created the specific conditions that led to their client’s injuries.
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Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
About This Topic
Insurance Coverage Issues in New York
Coverage disputes determine whether an insurance policy provides benefits for a particular claim. In the no-fault context, coverage questions involve policy inception, named insured status, vehicle registration requirements, priority of coverage among multiple insurers, and the applicability of exclusions. These articles examine how New York courts resolve coverage disputes, the burden of proof on coverage defenses, and the interplay between regulatory requirements and policy language.
149 published articles in Coverage
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Apr 27, 2011Common Questions
Frequently Asked Questions
What are common coverage defenses in no-fault insurance?
Common coverage defenses include policy voidance due to material misrepresentation on the insurance application, lapse in coverage, the vehicle not being covered under the policy, staged accident allegations, and the applicability of policy exclusions. Coverage issues are often treated as conditions precedent, meaning the insurer bears the burden of proving the defense. Unlike medical necessity denials, coverage defenses go to whether any benefits are owed at all.
What happens if there's no valid insurance policy at the time of the accident?
If there is no valid no-fault policy covering the vehicle, the injured person can file a claim with MVAIC (Motor Vehicle Accident Indemnification Corporation), which serves as a safety net for people injured in accidents involving uninsured vehicles. MVAIC provides the same basic economic loss benefits as a standard no-fault policy, but the application process has strict requirements and deadlines.
What is policy voidance in no-fault insurance?
Policy voidance occurs when an insurer declares that the insurance policy is void ab initio (from the beginning) due to material misrepresentation on the application — such as listing a false garaging address or failing to disclose drivers. Under Insurance Law §3105, the misrepresentation must be material to the risk assumed by the insurer. If the policy is voided, the insurer has no obligation to pay any claims, though the burden of proving the misrepresentation falls on the insurer.
How does priority of coverage work in New York no-fault?
Under 11 NYCRR §65-3.12, no-fault benefits are paid by the insurer of the vehicle the injured person occupied. For pedestrians and non-occupants, the claim is made against the insurer of the vehicle that struck them. If multiple vehicles are involved, regulations establish a hierarchy of coverage. If no coverage is available, the injured person can apply to MVAIC. These priority rules determine which insurer bears financial responsibility and are frequently litigated.
What is SUM coverage in New York?
Supplementary Uninsured/Underinsured Motorist (SUM) coverage, governed by 11 NYCRR §60-2, provides additional protection when the at-fault driver has no insurance or insufficient coverage. SUM allows you to recover damages beyond basic no-fault benefits, up to your policy's SUM limits, when the at-fault driver's liability coverage is inadequate. SUM arbitration is mandatory and governed by the policy terms, and claims must be made within the applicable statute of limitations.
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About the Author
Jason Tenenbaum, Esq.
Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.
Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
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