Key Takeaway
Court rules on uninsured motorist coverage dispute, finding no intentional acts exclusion applies and injuries resulted from accident despite criminal intent.
This article is part of our ongoing intentional loss coverage, with 14 published articles analyzing intentional loss 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.
Matter of Progressive Advanced Ins. Co. (Widdecombe), 2018 NY Slip Op 00061 (3d Dept. 2018)
(1)
“Initially, it is undisputed, as Supreme Court correctly determined, that Germain is an uninsured motorist as none of his automobile policies, including a prior policy with Hartford, was in effect on the date of this incident. Thus, any exclusion in Germain’s former policy with Hartford is irrelevant to this incident. Further, given Germain’s uninsured status, Widdecombe properly filed a claim for SUM coverage under his own policy with petitioner. To the extent that the court held that petitioner’s disclaimer of coverage was proper based upon an intentional acts exclusion in Widdecombe’s policy, this was clear error. Widdecombe’s policy, in effect on the date of this incident, does not contain an intentional acts exclusion for uninsured motorist coverage or anything similar to it (compare New York Cent. Mut. Fire Ins. Co. v Wood, 36 AD3d 1048, 1049 ). Thus, this did not provide a proper basis for permanently staying arbitration of Widdecombe’s claim for SUM benefits.”
(2)
“We now turn to the dispositive question on appeal, which is whether Widdecombe’s injuries were caused by an accident within the meaning of his policy with petitioner. Widdecombe’s policy included SUM coverage, for which he paid a premium, providing for payment of “all sums that the insured … shall be legally entitled to recover as damages from the owner or operator of an uninsured motor vehicle because of bodily injury … caused by an accident arising out of such uninsured motor vehicle’s ownership, maintenance or use” (emphasis added). ”
(3)
“Thus, whatever Germain’s intent and criminal liability, this incident was an accident from Widdecombe’s perspective. Contrary to petitioner’s contention, Widdecombe’s uncontroverted testimony established that the incident “happened so fast” and, after he attempted to grab the keys, Germain said that “he was going to cut leg off” and, as Widdecombe tried to get his leg out of the car, Germain “threw the car in drive” and “screeched” away, dragging Widdecombe. As in State Farm, this event “was clearly an accident from the insured’s point of view,” since having his leg trapped and being dragged was sudden and “unexpected, unusual and unforeseen” (State Farm Mut. Auto. Inc. Co. v Langan, 16 NY3d at 355-356; see Matter of Utica Mut. Ins. Co. v Burrous, 121 AD3d 910, 911 ; Matter of Progressive Northeastern Ins. Co. v Vanderpool, 85 AD3d 926, 927 ). Consequently, Supreme Court erred in granting the stay of arbitration and Widdecombe’s claim should proceed to arbitration.”
Oh Progressive – not very Progressive? My question – and I posed this to somebody – is whether the result would be different if this matter was guided under the intentional loss exclusion as opposed to whether there was coverage under the accident clause of the policy. I do not know the answer, but it has me thinking,
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- Verdict sustaining that the loss was intentional sustained
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.
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Feb 21, 2011Understanding Staged Accident Allegations in New York Insurance Claims
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Apr 19, 2014Common Questions
Frequently Asked Questions
What is the intentional loss exclusion in insurance?
The intentional loss exclusion allows insurers to deny claims when the loss was intentionally caused by the insured. In auto insurance, this typically applies to staged accidents or intentional vehicle damage. The insurer must prove the loss was deliberately caused, not merely negligent or reckless.
How do insurers prove intentional loss?
Insurers typically prove intentional loss through circumstantial evidence — surveillance footage, inconsistent statements, prior claim history, and expert analysis. In no-fault cases, the insurer may use EUO testimony, accident reconstruction, and SIU findings to establish that the accident was staged.
Can the intentional loss exclusion apply to innocent passengers?
Generally, the exclusion applies to the person who intentionally caused the loss, not innocent third parties. However, if the insurer voids the policy entirely based on fraud, innocent parties may lose coverage and must seek benefits from MVAIC (Motor Vehicle Accident Indemnification Corporation).
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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.
If you need legal help with a intentional loss matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.