State Farm Fire & Casualty Company v. S.S. & G.W.
858 S.W.2d 374 (1993)
Premium Feature
Subscribe to Lexplug to listen to the Case Podcast.
Rule of Law:
For an intentional injury exclusion in an insurance policy to apply, the insured must have intended the specific injury, not just the act that caused it. Intent to injure is established only if the insured desires to cause the consequences of their act or believes the consequences are substantially certain to result from it.
Facts:
- G.W., who knew he had genital herpes, engaged in consensual sexual intercourse with S.S. at his home.
- G.W. had experienced an outbreak of herpes symptoms approximately three to four weeks prior to his encounter with S.S.
- G.W. did not inform S.S. of his condition before they had sexual intercourse.
- G.W. believed he could not transmit the disease unless he was experiencing active symptoms, which he claims he was not at the time of the encounter.
- After their encounter, S.S. contracted genital herpes.
- S.S. stated that she would not have consented to sexual intercourse had she known G.W. had herpes.
Procedural Posture:
- S.S. sued G.W. in a Texas district court (trial court), alleging G.W. negligently transmitted genital herpes to her.
- S.S. and G.W. settled, entering into an agreed judgment for $1 million, under which S.S. would not execute the judgment against G.W. in exchange for an assignment of G.W.'s rights against State Farm.
- State Farm filed a separate declaratory judgment action against G.W. and S.S. in trial court, seeking a declaration that it had no duty to pay the judgment.
- State Farm moved for summary judgment, arguing the claim was barred by the intentional injury exclusion and G.W.'s breach of the duty to cooperate.
- The trial court granted summary judgment for State Farm, holding that the policy provided no coverage for S.S.'s claims as a matter of law.
- G.W. and S.S., as appellants, appealed to the court of appeals, which reversed the summary judgment and remanded the case to the trial court, finding a genuine issue of material fact on G.W.'s intent to injure.
Premium Content
Subscribe to Lexplug to view the complete brief
You're viewing a preview with Rule of Law, Facts, and Procedural Posture
Issue:
Does an 'intentional injury' exclusion in a homeowner's insurance policy preclude coverage for the transmission of a sexually transmitted disease when the insured intentionally engaged in the sexual act but did not believe transmission of the disease was substantially certain to occur?
Opinions:
Majority - Hightower, J.
No. An 'intentional injury' exclusion does not preclude coverage as a matter of law because a fact issue exists as to whether the insured intended the specific injury. The court holds that an intentional act is distinct from an intentional injury. To trigger the exclusion, the insured must have intended the consequences of the act or believed they were substantially certain to follow, adopting the standard from the Restatement (Second) of Torts § 8A. The mere knowledge and appreciation of a risk amounts to negligence or recklessness, not intent. Because G.W.'s summary judgment evidence indicated he mistakenly believed he could not transmit herpes without active lesions, a fact issue exists as to whether he knew with substantial certainty that he would transmit the disease. Furthermore, the court refused to infer intent to injure as a matter of law, distinguishing this case involving consenting adults from cases of sexual misconduct with minors or forcible sex acts where intent is often inferred.
Concurring - Phillips, C.J.
This opinion concurs in the judgment only. While an appellate court may have the authority to affirm a summary judgment on grounds not recited in the trial court’s order, it should not be an inflexible rule. In this case, which involves a fact-intensive inquiry into the insured's conduct, it is more appropriate to remand the cause to the trial court for specific consideration of the remaining grounds asserted by State Farm rather than have the appellate court address them for the first time.
Concurring - Cornyn, J.
No. This opinion agrees with the majority that a fact issue exists regarding whether G.W. knew with substantial certainty that his actions would result in the transmission of herpes. It concurs with the majority's reasoning on the intentional injury exclusion. However, it disagrees with the majority's refusal to consider alternative grounds for affirming the summary judgment, aligning with Justice Hecht's dissent on that procedural point.
Dissenting - Gonzalez, J.
This opinion does not directly answer the substantive issue but argues that the court should have affirmed summary judgment for the insurer on an alternative legal ground. The dissent contends that the appellate court should have considered State Farm's argument that G.W. breached the policy's cooperation clause by entering into a collusive $1 million agreed judgment with S.S. without notifying State Farm of the lawsuit. The dissent argues that this breach prejudiced State Farm as a matter of law, and affirming the summary judgment on this ground would promote judicial economy by avoiding a remand and further appeals.
Dissenting - Hecht, J.
Yes. The intentional injury exclusion should preclude coverage as a matter of law. The relevant inquiry is not whether G.W. was substantially certain he would transmit herpes, but whether he was substantially certain that having sex with S.S. without disclosing his condition would injure her. The dissent argues that knowingly exposing another person to a serious disease without their consent is, in itself, an intentional injury. Because S.S. did not consent to the exposure, G.W.'s deliberate non-disclosure constituted intentional conduct causing a foreseeable injury, which should be excluded from coverage under the policy.
Analysis:
This decision significantly clarifies the application of 'intentional injury' exclusions under Texas insurance law, establishing a high bar for insurers. By firmly adopting the 'substantial certainty' test for intent, the court distinguishes intentional conduct from merely reckless or negligent conduct, thereby preserving coverage for insureds who commit an intentional act with an unintended result. This precedent makes it more difficult for insurers to win summary judgment on such exclusions, requiring them to produce evidence that the insured subjectively intended the specific harm or knew it was almost certain to happen. The ruling has broad implications beyond its specific facts, affecting how coverage disputes are litigated in various tort contexts where an intentional act leads to an unexpected injury.
Unlock the full brief for State Farm Fire & Casualty Company v. S.S. & G.W.