INSURANCE: Insurer has duty to defend off-duty police officer against claims stemming from bar parking lot altercation in which Plaintiff alleges he was “brutally assaulted” as he was attempting to drive through the lot and the officer claims he acted in self-defense because of Plaintiff showing a firearm in his vehicle… underlying Complaint allegations read in conjunction with other facts known to insurer including self-defense claim asserted as affirmative defense in officer’s Answer… DeSoto.
Louis Delgado alleges that Billings police officer Matthew Frank, Steve Swanson, and Yellowstone Co. Dep. Brandon Smart spent more than a hour inside the Grandstand Bar drinking and then congregated in the parking lot, and as he was attempting to drive through the lot, Frank “did a flying knee into the driver’s side door,” damaging his vehicle. He alleges that the three aggressively approached the driver’s side door,” at which time he “advised and showed” them that he had a firearm in the vehicle in an attempt to de-escalate and get them away from the vehicle so he could continue to leave. He asserts that Frank, in his capacity as a law enforcement officer, “attempted to gain physical control over him in an attempt to apprehend him.” According to Delgado, Frank reached in through the window and “viciously” and “brutally assaulted” him and opened the door and attempted to drag him out “to continue the physical assault” and apprehend him. He alleges that he was able to maneuver his vehicle away from Frank and exited the lot. On 4/26/22 Delgado sued Frank in 13th Judicial Court naming him individually and in his official capacity and asserting negligence and negligence per se. (He also named Swanson, Smart, the Sheriff’s Dept., and the Billings PD; they are not relevant to the pending motions.)
Frank disputes Delgado’s version of events. He raised “self-defense” as an affirmative defense in his Amended Answer. He was insured under an Allstate homeowners policy and a personal umbrella policy. On 4/28/22 he notified Allstate of the suit. Allstate advised that the claims against him are not covered under the policies. It filed this declaratory action 7/7/22 and moves for summary judgment that it has no duty to defend & indemnify Frank. Frank moves for partial summary judgment on the duty to defend.
Allstate argues that there is no possibility that the homeowners policy will cover any of the claims asserted against Frank. It takes the threshold position that the duty to defend inquiry is limited to the facts alleged in the underlying complaint and because Delgado’s claims are based entirely on allegations of intentional conduct by Frank they do not constitute an “occurrence” under the homeowners policy’s general coverage provisions and are excluded by the intentional acts exclusion. To the extent that the underlying complaint alleges that he engaged in official misconduct and was acting in an official capacity, it argues that Delgado’s claims fall squarely within the business activities exclusion.
Frank disagrees that the Court’s inquiry is necessarily confined to the 4 corners of the underlying complaint. He contends that if the allegations in Delgado’s complaint are read in conjunction with other facts known to Allstate — including particularly that Frank has raised self-defense as an affirmative defense and the City has determined that he was not acting within the scope of his duties at the time — Delgado’s claims potentially fall within the homeowners policy’s general coverage and outside the intentional acts and business activities exclusions.
Whether the conduct alleged in the underlying complaint constitutes an “occurrence.”
The policy defines “occurrence” as “an accident, including continuous repeated exposure to substantially the same general harmful conditions during the policy period, resulting in bodily injury or property damage.” Under Montana law, an “accident” is an “unexpected happening that occurs without intention or design on the part of the insured.” Liss (Mont. 2000). Fisher Builders (Mont. 2016) established a test for whether conduct is an “accident” such that it constitutes an “occurrence”: “1) whether the act itself was intentional, and 2) if so, whether the consequence or resulting harm stemming from the act was intended or expected from the actor’s standpoint.”
The 2nd part of the test requires an objective inquiry to determine “what injuries could reasonably be expected to result from an intentional act.” Id. If the answer to either question is “no,” then the act is an “occurrence.”
Applying Fisher, Allstate contends that the conduct alleged in the complaint does not constitute an accident or occurrence. It maintains that although Delgado’s claims are titled “negligence” and “negligence per se,” the factual allegations plainly set forth only intentional conduct. As it correctly points out, what matters in determining the potential for coverage is the nature of the facts alleged, not how the claims are labeled or titled. This principle is well-established and Frank does not argue otherwise.
However, he does disagree with Allstate’s argument that the duty to defend inquiry is necessarily limited to the 4 corners of Delgado’s complaint. As a general rule, whether an insurer has a duty to defend is determined “by comparing the factual allegations in the underlying complaint to the coverage afforded under the policy.” Graber (Mont. 1990). Wessel (Mont. 2020) reaffirmed this principle: “Whether a duty [to defend] exists is determined by looking to the allegations within the complaint; ‘the complaint and the policy constitute the universe with regard to the insurers’ duty to defend.’ If there is no coverage under the terms of the policy based on the facts contained in the complaint, there is no duty to defend.” (quoting Weitzel (Mont. 2016)).
Citing Wessel, Allstate argues that it was not required to look beyond the allegations in Delgado’s complaint to determine whether it had a duty to defend Frank, and argues that the complaint allegations that Frank did a flying knee kick to Delgado’s car, used excessive force, brutally & viciously assaulted him, and acted with malice do not constitute an occurrence under the Fisher test because (1) the conduct was clearly intentional and (2) the consequences and resulting harm stemming from the conduct were reasonably expected from Frank’s standpoint.
Frank does not seem to dispute that on its face the Delgado complaint alleges intentional conduct that would not constitute a covered occurrence. But unlike Allstate, he takes the position that it is proper under the circumstances to consider extrinsic factual information in determining Allstate’s duty to defend. He invokes Revelation Industries (Mont. 2009) which held that even when the “complaint does not present a claim which on its face is covered by the policy,” an insurer may have a duty to defend if it is aware of factual information that would otherwise trigger such a duty. (italics in original). Revelation made clear that “an insurer cannot ignore knowledge of facts that may give rise to coverage under the policy simply because the complaint — which is, after all, drafted by a claimant over whose draftsmanship the insured has no control — does not allege those facts of which the insurer has knowledge.” While insurers are not required “to seek out such information,” they are not at liberty “to simply ignore factual information supplied to them by their insured but not alleged in the complaint or petition where those facts would trigger a duty to defend.” Id.
National Indemnity (Mont. 2021) reiterated that “an insurer’s duty to defend may arise from an insurer’s knowledge of ‘facts obtained from outside the complaint,‘ and thus, the duty is not exclusively dependent upon notice of facts from the insured.” (italics in original) (quoting Huckins (Mont. 2017) (citing Revelation).
Applying these principles, Frank argues that Allstate was not entitled to ignore his affirmative defense of self-defense when evaluating its duty to defend. The Court agrees. It is undisputed that he asserted self-defense in the amended answer he filed 8/24/22 — just 3 months after he was served with Delgado’s complaint and 6 weeks after Allstate filed this declaratory action. Allstate explained at oral argument that it is defending Frank subject to reservation and acknowledged that it was put on notice that he is claiming self-defense when defense counsel filed the amended answer 8/24/22. Because Allstate knew that Frank was asserting self-defense as an affirmative defense against Delgado’s claims, it was not at liberty to ignore that information when evaluating its duty to defend.
Allstate cites Abbey (D.Mont. 2006) for the proposition that an insurer is not required to consider later developed facts outside the original complaint when evaluating coverage. But the fact that it was put on notice of Frank’s affirmative defense at the pleading stage distinguishes Abbey in which the later-developed facts came from an affidavit filed in support of a summary judgment motion, 2 depositions, and a letter written nearly a year after the complaint was filed. Judge Molloy confined the coverage inquiry to the facts alleged in the complaint, reasoning that if an insurer was “required to consider facts introduced much later by the party seeking coverage that were not in the original complaint, an insurer could never deny a duty to defend.” Unlike the extrinsic evidence in Abbey, Frank’s affirmative defense was introduced at the pleading stage. Under Revelation, which post-dates Abbey, Allstate could not ignore that Frank was claiming self-defense — a fact that it has been aware of since the early stages.
Allstate additionally asserts that the Revelation rule applies only if the facts of which the insurer has knowledge are undisputed and that Frank disputes Delgado’s version of events. While whether Frank acted in self-defense is certainly disputed, the fact that he has asserted it is not in dispute. Allstate has been aware since he filed his amended answer in 8/22 that he is asserting self-defense. As explained below, it is the assertion of this affirmative defense that raises the possibility of coverage and triggers the duty to defend.
Allstate further contends that Frank’s reliance on Revelation is foreclosed by Wessel. The plaintiffs in Wessel were in an ongoing dispute with the insureds over use of a road traversing the insureds’ property. The plaintiffs alleged that the insureds threatened to harm them, installed obstacles, and discharged firearms at them. They sued for assault, trespass, civil conspiracy, and IIED and further alleged that the insureds acted intentionally, purposefully, and with malice. Wessel held that the conduct did not constitute an “occurrence” or “accident” under the homeowners policy because “the conduct alleged was both intentional and done purposefully by the Insured to cause injury and damages” to the plaintiffs. In finding no duty to defend, the Supreme Court reasoned that “although an insurer cannot ignore knowledge of facts that may give rise to coverage under the policy simply because the complaint does not allege these facts of which the insurer has knowledge, this exception does not apply due to the very nature of the claims.” Although the insureds “suggest that their denials to the allegations create factual disputes, the threshold question is whether the claim against the insured alleges facts that would trigger coverage” and the insureds could not “create coverage where it does not exist simply by denying the claims when the claims themselves do not trigger coverage.” Id.
Analogizing to Wessel, Allstate argues that because the conduct alleged in the complaint was intentional and purposeful, the duty to defend inquiry ends there and Frank cannot create the possibility of coverage by claiming he acted in self-defense. But unlike the insureds in Wessel who simply denied the factual allegations in the complaint, Frank asserted self-defense in his responsive pleading to Delgado’s complaint. While the mere denial of liability in the underlying action may not fall with the Revelation exception, the fact that Frank has asserted a colorable claim of self-defense distinguishes Wessel.
This distinction is material as evidenced by the primary case out of this District that Frank relies on to support his argument that the claims asserted in the underlying complaint are a covered occurrence. In Tunkle (D.Mont. 1998) the defendant was insured under a Safeco homeowners policy that defined “occurrence” as “an accident which results in bodily injury.” It also contained an intentional acts exclusion for bodily injury “which is expected or intended by any ‘insured’ or which is the foreseeable result of an act or omission intended by any ‘insured.’” The insured was prosecuted after shooting a home intruder but was acquitted based on self-defense. The intruder sued the insured for damages suffered in the shooting and Safeco sought a declaration that it did not have a duty to defend & indemnify its insured because the shooting was not an “occurrence” and the policy’s intentional act exclusion applied. Judge Molloy rejected both arguments, holding that “the duty to defend arises where an insured has a colorable claim of self-defense.” First, he found that the definition of “occurrence” was ambiguous because the policy did not define “accident.” Construing the ambiguity against Safeco, he concluded that the shooting “was an ‘accident’ as the term is reflected in the generally understood dictionary definitions” and thus was an “occurrence” under the policy. Second, he concluded that the intentional acts exclusion did not apply, reasoning that “self-defense is the very opposite of willful wrongdoing. By definition, the intent of a person acting in self-defense is to protect himself, not to cause harm to another” and thus “self-defense is volitional but not intentional within the policy exclusions.”
As in Tunkle, Frank has asserted a colorable claim of self-defense. Allstate has been on notice since 8/24/22 when he filed his amended answer to the complaint that he is claiming self-defense. That his affirmative defense is colorable is evident from the face of the complaint. Under Delgado’s version, he demonstrated to Frank during their encounter that he had a firearm in his vehicle, which is sufficient to raise a colorable claim of self-defense.
Also, contrary to the complaint allegations, Frank has provided an affidavit stating that he did not provoke Delgado to yell obscenities or to stop and point a gun at him. He explains that when Delgado pointed a gun he became fearful for his and his friends’ lives, at which point he attempted to disarm Delgado. This affidavit certainly bolsters Frank’s claim that he was acting in self-defense. But even without the affidavit, and considering only the complaint allegations, he has raised a colorable claim of self-defense.
Applying the reasoning in Tunkle, reading the complaint allegations in conjunction with Frank’s claim of self-defense, and using the Fisher test, the conduct alleged in the underlying action may qualify as an “accident” and thereby constitute an “occurrence” under the homeowners policy. Notwithstanding the way the claims are titled, the supporting factual allegations in the complaint describe intentional conduct by Frank. But when the factual allegations are considered in conjunction with Frank’s claim of self-defense it is not clear that the alleged conduct was intentional. As recognized in Tunkle, self-defense is the opposite of willful wrongdoing and while it is volitional conduct it is not intentional.
Although not necessary to do so, the Court also considers the 2nd part of the Fisher test which asks whether the consequences and harm stemming from the conduct were reasonably expected from the standpoint of the insured. Consistent with the reasoning in Tunkle, a number of other jurisdictions have concluded that an injury resulting from conduct by an insured acting in self-defense is not as a matter of law expected or intended from the standpoint of the insured. [Citing examples.] Applying similar reasoning, it is reasonable to conclude that if Frank was acting in self-defense as he claims, one in his position would not have reasonably intended or expected the consequences and harm resulting from his conduct. Thus if he succeeds in establishing in the State Court action that he acted in self-defense, the answer to both Fisher questions would be “no” and the conduct alleged in the complaint would constitute an occurrence under the homeowners policy.
Whether the Intentional Acts Exclusion applies.
Even if the conduct alleged in the complaint could potentially constitute an occurrence under the family liability coverage provisions, Allstate argues that coverage is barred under the intentional acts exclusion.
Montana courts apply the same Fisher test to determine whether coverage is precluded under an intentional acts exclusion like the one here. Lockard (D.Mont. 2018) (under Fisher, “the ‘Expected or Intended Injury’ exclusion is not triggered if there is a possibility that the conduct had unintended and unexpected consequence to the victim”). Although the intentional acts exclusion precludes coverage for harm intended by or which may reasonably be expected to result from the intentional acts of an insured, the Court has determined that if Frank prevails on his self-defense claim his conduct would not have been intentional and a reasonable person in his position would not have objectively intended or expected his conduct to cause the harm alleged in the complaint. Thus Allstate has not demonstrated that the underlying claims are unequivocally excluded under this exception to coverage.
Whether the Business Activities Exclusion applies.
Allstate asserts that to the extent that Frank was acting in his official capacity as a law enforcement officer, coverage is precluded under the business activities exclusion. Frank counters that this exclusion does not preclude coverage because the complaint alleges that he acted in both his individual and professional capacities.
As Allstate points out, the complaint contains allegations that Frank was acting in his capacity as a law enforcement officer during the altercation with Delgado. In addition, Delgado alleges negligence per se based on violations of MCA 45-7-402 (“A public servant commits the offense of official misconduct when in an official capacity the public servant commits any” of several listed acts.) To the extent that the complaint alleges negligence per se based on violations of this statute, the Court agrees with Allstate that the business activities exclusion precludes coverage. Likewise, to the extent that Delgado seeks to hold Frank liable in his official capacity for negligence and for negligence per se based on violations of statutes prohibiting unlawful restraint and criminal trespass, the business activities exclusion also precludes coverage. But, unlike in Chun (D.Haw. 2007), which Allstate cites, the factual allegations in support of Delgado’s common law negligence claim can easily be read as alleging conduct outside the course & scope of Frank’s employment as an officer. Thus to the extent that the complaint asserts an individual capacity negligence claim against Frank, Allstate has not demonstrated that the business activities exclusion applies. The Court need not address Frank’s argument that the Court should look beyond those allegations and consider a letter from the City stating that he was not in the course & scope of his employment at the time of the underlying events.
Whether there is potential coverage for punitive, exemplary, or statutory penalties.
Allstate contends that the homeowners policy does not provide coverage for certain remedies sought by Delgado including punitive or exemplary damages and statutory penalties. “Insurance coverage does not extend to punitive or exemplary damages unless expressly included by the contract of insurance.” MCA 33-15-317(1). Because the homeowners policy does not include insuring language covering punitive or exemplary damages, the statutory exclusion applies. Frank does not argue otherwise.
The complaint accuses Frank of negligence per se based on violations of Montana’s criminal trespass to property and unlawful restraint statutes. Both are offenses for which statutory penalties or fines may be imposed. Allstate thus argues — and Frank does not dispute — that any fines or penalties awarded for violations of these statutes are excluded from coverage.
Allstate has a duty to defend Frank under the homeowners policy.
Resolving all doubt about the meaning of the allegations in the complaint in favor of finding a duty to defend and reading those allegations in conjunction with Frank’s self-defense claim, the conduct alleged in the complaint constitutes an “occurrence” under the homeowners policy and Allstate has not unequivocally demonstrated that the intentional acts exclusion precludes coverage. Nor has it shown that the business activities exclusion precludes coverage to the extent that the complaint seeks to hold Frank liable in his individual capacity. Because there is a potential for coverage if Frank prevails on his affirmative defense of self-defense, Allstate has a duty to defend him. Pinski Bros. (Mont. 1972) (If an insurer has a duty to defend one claim, it must defend against all claims even if there is no possibility that those remaining claims would be covered.)
Umbrella policy.
The umbrella provides excess liability insurance for bodily injury and property damage and personal injury. It is undisputed that the homeowners policy served as the “Required Underlying Insurance Policy” for the umbrella. The claims alleged in the complaint are potentially covered by the homeowners policy. Thus for the same reasons that Allstate has a duty to defend Frank under the homeowners policy, it has a duty to defend him under the umbrella.
Conclusion.
Allstate has a duty to defend Frank under the policies. Its duty arose in 8/22 when it was notified that Frank had asserted self-defense as an affirmative defense in the underlying action. The duty to indemnify cannot be determined until the underlying action is resolved. Allstate’s motion for summary judgment is denied. Frank’s motion for partial summary judgment on the duty to defend is granted.
Allstate Vehicle & Property Ins. and Allstate Indemnity v. Frank, 44 MFR 299, 8/17/23.
Stephanie Oblander (Smith Oblander Meade & Mitcham), Great Falls, for Allstate; Fred Simpson & Lauren LaRance (Hall & Evans), Missoula, for Frank; Lyndon Scheveck (Scheveck & Salminen), Billings, for Delgado in the underlying State Court suit.