Deliberate punch in the testes is not an "accident" and thus not an insurable injury

A court has found that State Farm need not pay for the medical care required by Patrick Frake after his friend John King punched him in the testicles. The California Second Appellate Division found that Frake and King had made a long habit of getting drunk and punching each other in the balls, and that this habit meant that the injury wasn't an "accident," and thus wasn't covered by Frake's insurance.

During this 'consensual' ritual, one person would normally try to 'slap or hit [another person] in . . .the groin area,' and the recipient would then 'attempt to return [the slap or hit].' According to Frake, the practice was so common that his friends would 'greet each other with a one-arm hug,' while covering their 'groin area' with the other arm for 'protection in case [someone] decided to . . . instigate th[e] horseplay." Frake stated that [he] and his friends had, 'per usual,' been engaging in 'horseplay . . . [that] continued throughout the whole weekend."

Court Rules Punch to the Groin Was No "Accident"

• [Talia]

  Nothing better than a rollicking good tale of morons to brighten up a workday morning. :D

  And for once, the insurance company isn’t Doing Something Evil. How bizarrely unusual :P

  @Andy – no, read the comments here, they clarify. This is one instance where the insurance company SHOULD’NT pay – Frake is an idiot, and he basically assaulted his friend.

• [ZachMatthews]

  I’m an insurance coverage lawyer. The very first thing you’ll read in any general liability policy is the “insuring agreement.” It says, in almost every case, “this policy insures against any covered occurrence.” An “occurrence” is defined as an accident in the definitions page of the policy. As weird as it seems to non-insurance lawyers, this is the most basic tenet of an insurance coverage analysis: Was it an accident is the very first question we ask.

  There’s a good reason for this. An insurance policy is not going to insure against *intentional* conduct because it means you could go out and commit a crime or hurt someone and transfer the responsibility to someone else (i.e. your insurance company).

  The insurance policy here didn’t insure the injured guy but the dude doing the punching. There is no reason why State Farm should have to pay for someone to commit crimes and hurt people.

  Think it through; this makes good sense. If insurance companies were forced to pay in lawsuits like this it would encourage reckless, criminal conduct.

• [Anonymous]

  It would be great if either of these guys was from Kiek in de Kök.

• [Anonymous]

  As an insurance adjuster who handles general liability claims I would like to add to what has been stated above. Most liability policies not only specifically define an ‘occurrence,’ they also specifically exclude ‘intentional acts.’ It is also not good public policy to insure against criminal acts, which this would be. Assault.

  Also, if you and your friends were ‘horsing’ around, and you got hurt, would you sue his homeowner’s insuranve or renter’s insurance? That’s what happened here.

  Seems like the lawsuit is stupid, not the verdict.

• [RebNachum]

  A prayer: O Source of all random entertainments and rainy day distractions, I gratefully thank You for never making me this bored.

• [jnordb]

  …natural selection at work? (assuming permanent reproductive system malfunction.)

• [betatron]

  This seems to be some sort of spontaneous double recessive meme resident in young males. I’ve seen it arise before, on nuclear submarines and at particle accelerator control rooms (srsly). I believe RebNachum (#27) may have correctly isolated the activating potential: excessive boredom.

• [Deidzoeb]

  When it’s two jokers, I don’t see why the puncher shouldn’t pay medical costs, even if he had “consent” from the punched. Can you give consent for someone to commit crime like this?

  On the other hand, I wonder how it would apply to boxers, who seem to be in a similar situation: consenting to be potentially injured, presumably absolving each other of damages, and are they covered by insurance for that?

• [RingMod76]

  ahh, Darwinism at work…

• [Nylund]

  If I have this straight, Mr. King tried to hit Mr. Frake in the balls, but Mr. Frake blocked it. Mr. Frake retaliated by punching Mr. King in the balls causing injury. The injured Mr. King sued Mr. Frake and was awarded $400,000. Mr. Frake thought that he personally shouldn’t have to pay that money and instead his insurance company should pay on his behalf. The insurance company said, “No, we pay for accidents, and you hit the guy intentionally.”

  When I first read the article, I thought it was saying that the insurance was screwing over the guy who got hit, but that isn’t the case. The insurance company is refusing to help the ball-puncher.

  Do I have it right? If so, that is not so egregious. If you punch someone and cause them injury, there isn’t a really good reason why you shouldn’t be held personally responsible.

• [Nylund]

  I also think the headline of the post is misleading. The guy who got hit got awarded money. Its the guy who did the punching who wasn’t covered by his insurance…if I read the article correctly.

• [hfw01]

  @Nylund – yes you have it right. Frake punched King. King sued Frake. Frake wants his insurance company to foot the bill.

  Next time you get in an argument with your neighbor about his leaf blower, punch him in the nuts. Call your homeowner’s insurance company, and see if they will defend the lawsuit your neighbor files against you. As much as people dislike insurance companies, plaintiff’s and insured’s can be just as bad.

• [Anonymous]

  Looks like someone needs Balls Insurance

• [Anonymous]

  so if you’re a boxer and because you know you will be hit you’re insurance company doesn’t have to pay because you knew you were going to get hurt?

• [Anonymous]

  It takes balls to be so stupid; if they wanted to feel each other out, simply ask nicely.

• [DarthVain]

  I think the gist of it is that while he may have meant to punch him in the gonads, he didn’t me to injure them.

  Just like I might play some contact sport, and actually mean to hit you in some manner, but my intention wasn’t to actual injure you so in that context it was an accident.

  Bottom line is the guy liable for actions that lead to the injury. Many people do this sort of stupidity, but I think it is rather rare that anyone is actually permanently hurt by it.

  I think one would have to prove that the puncher took it too far and exceeded the parameters for “horsing around” and intentionally tried to injure the guy.

  The problem is “proving” intention is a very hard thing to do, one way or the other.

  IANAL

• [grimc]

  Not a medical care lawsuit, but a negligence lawsuit. The nutpunchee asked the nutpuncher to pay for medical costs; the nutpuncher wanted State Farm to pay for it through his renter’s policy (the lawsuit is State Farm v. Nutpuncher, not Nutpunchee v. State Farm).

  And I know I’m going to regret this, but I’m curious to know what “hematocele on the right scrotum . . . epididymal head cyst . . . chronic regional pain syndrome/reflex sympathetic dystrophe [and] nerve injury.” would be in layman’s terms.

  • [jellyfisher]

    In layman’s terms, I’m going with “ow, ow, ow, ow.”

• [jphilby]

  Too bad for Mr. Frake that he turned away the Ball-Punching Insurance Agent on the day he showed up at the door. Certainly Lloyd’s will be contacting him soon.

• [DarthVain]

  If I get in a Hockey fight, can I be charged with assault?

  • [cellocgw]

    @DarthVain: Go check the history log. There’s been more than one case of hockey violence (in the professional leagues) which led to criminal assault charges.
    Personally, I think this is a good thing: that in any (non pugilistic) sport, a fight or a hit which is judged to be intent to injure opens the perp to criminal charges.

• [Teller]

  Testimony comes from testicles – and his delivers the final blow.

• [pAULbOWEN]

  The insurers took a similarly po-faced and fun hating view of my social circle’s chucklesome little ‘stab one another in the face’ ritual.

  Also, just get a room guys, Jesus.

• [andygates]

  Well, that’s a lot of lawyers a bit richer and a lot of people a lot more stressed, instead of a sensible healthcare plan. You Americans are crazy. *taptaptap*

• [daev]

  Funny how I’m not really having a problem with the corporate stance on this… unless there’s a Rochambeau clause, of course…

• [SeattlePete]

  What’s the capitol of Thailand?

  • [Anonymous]

    > What’s the capitol of Thailand?

    Krung Thep. Why do you ask?

• [Utenzil]

  Does this refer to any intentionally inflicted injury, or just the observed consensual nature of their madcap nutsack bruising hi-jinks? Because that would mean the poor guy who got his junk tossed in the disposal it’s out of… Uh, even more out of luck.

• [Anonymous]

  Idiocracy: it’s happening.

• [Utenzil]

  …and what about “dutch rubs” and “indian burns” inflicted over the generations? Any recourse there? Because there’s this guy Dominick from seventh grade that I’m pretty sure I could assemble a class action against.

• [Paul_MD]

  Hopefully they’ll have done enough damage to remove themselves from the gene pool, if so I’d like to nominate them for a darwin award.

• [irksome]

  Trying very hard for sympathy and having no success.

  (They) for (two) (would) welcome our nut-punching overlords.

• [Anonymous]

  hematocele on the right scrotum . . . epididymal head cyst . . . chronic regional pain syndrome/reflex sympathetic dystrophe [and] nerve injury.

  I’ll walk you through it: the testes are enveloped by a layer called “tunica vaginalis” (yes it’s true). hematocele means there’s blood in this layer. the epididymus is the tissue that collect spermatozoa from the testes and has a role in finishing their maturation. The cyst in this region is a swelling, together with the hematocele, that can be caused by trauma (blunt force).
  Finally it seems that to finish it off, he had nerve injury. This means that he may heal of the hematocele and cyst, but will continue to have chronic (continuous pain).

  • [grimc]

    Argh. I knew I’d regret it.

• [Antinous / Moderator]

  Those guys are nuts.

• [Zinjanthropus]

  This lawsuit is bollocks.