Zalma on Insurance
Education • Business
Insurance Claims professional presents articles and videos on insurance, insurance Claims and insurance law for insurance Claims adjusters, insurance professionals and insurance lawyers who wish to improve their skills and knowledge. Presented by an internationally recognized expert and author.
Interested? Want to learn more about the community?
May 11, 2022
Homeowners Policy Provides no Cover for Killing Child by Leaving her in a Hot Car

Louisiana Court of Appeals Concludes that Leaving Child in Hot Car to Die is Excluded Use of Auto

Read the full article at https://lnkd.in/gZe69xug and at https://zalma.com/blog plus more than 4200 posts.

Family Security Insurance Company, appealed the trial court’s judgment denying its Motion for Summary Judgment and granting Katty Calderon, natural mother of decedent Avril Sanabria’s Motion for Partial Summary Judgment on the Issue of Insurance Coverage.

In Katty Calderon, Natural Mother Of The Decedent, Avril Sanabria v. Lezly Sanabria, Suly Sanabria, Jonathan Rivera, ABC Insurance Company, DEF Insurance Company, And GHI Insurance Company, No. 21-CA-579, Court of Appeals of Louisiana, Fifth Circuit (May 4, 2022) resolved the appeal.
FACTUAL BACKGROUND

This litigation arises out of the tragic death of two-year old Avril Sanabria (“Avril”), who remained secured in a car seat’s harness in the rear of a vehicle that was parked in the residential driveway of 494 Carolyn Drive in Destrehan, Louisiana for over six hours, when the external temperature was ninety-seven degrees Fahrenheit.

Suly Sanabria (“Suly”), the decedent’s paternal grandmother, picked up her daughter, Lezly Sanabria (“Lezly”), and her two-year-old granddaughter and Lezly’s niece, Avril Sanabria (“Avril”). Avril was seated in a car seat with the harness secured. Suly then drove Lezly and Avril to her residence. Suly parked her vehicle in the driveway and entered her home alone, leaving Lezly, Jonathon and Avril at the car. According to Suly, she was unable to fasten or unfasten Avril in her car seat because of disabling arthritis in her hands.

Neither Suly nor Lezly removed Avril from the vehicle. More than six hours later, Suly and Lezly realized that neither of them had Avril. Upon returning to her vehicle, Suly discovered Avril was still in the vehicle. As a result, Avril sustained injuries to her mind and body that led to her death.

Katty Calderon, sued Lezly Sanabria, Suly Sanabria, Jonathan Rivera, and three unknown insurance companies.

UPC filed a Motion for Summary Judgment on the issue of insurance coverage. Relying on a motor vehicle liability exclusion contained in the homeowners’ policy, UPC averred that Avril Sanabria’s death arose “out of the occupancy,” “use” and/or “unloading,” of a motor vehicle, as well as the “failure to supervise and/or negligent supervision,” of the child by Suly and Lezly involving a motor vehicle, which precluded coverage for any of Ms. Calderon’s damages.

The trial court determined that the homeowners’ policy issued by UPC provided indemnity coverage for Avril’s death and denied UPC’s Motion for Summary Judgment.
LAW AND DISCUSSION

UPC averred that the trial court erred in ruling that UPC’s homeowners’ policy affords coverage for Avril’s death when the language of the policy unambiguously excludes coverage for an incident arising out of the:

occupancy,

unloading, and

use of a vehicle.

Whether an insurance policy provides or precludes coverage is a dispute that can be properly resolved within the framework of a motion for summary judgment. An insurer has the burden of proving that a loss comes within a policy exclusion. Additionally, an exclusionary clause in an insurance policy must be strictly construed. However, an insurance policy, including its exclusions, should not be interpreted in an unreasonable or strained manner so as to enlarge or to restrict its provisions beyond what is reasonably contemplated by its terms or so as to achieve an absurd conclusion.

UPC’s Motor Vehicle Liability Exclusion

The appellate court found that the Motor Vehicle Liability exclusion under the homeowners’ policy is unambiguous and should be applied as written.

The Motor Vehicle Liability exclusion of the homeowners’ policy functions to broadly exclude coverage for bodily injury and property damage “arising out of the occupancy, use, unloading, and failure to supervise or negligent supervision.”
Arising Out Of Use

To conclude that an injury arose out of the use of the automobile, a court must find the vehicle essential to the theory of liability. In this regard, a court should apply a common sense approach to determine whether the duty breached by the insured flows from the automobile’s ‘use’ under the policy language.
Duty

As a custodian, Lezly had a general duty to supervise and protect Avril. The record establishes that Lezly frequently babysat Avril, typically three days per week. On the date of Avril’s tragic death, Lezy testified that Avril was in her care and was to stay overnight at her apartment.

In addition to her general duty, the court found that Lezly, as a custodian, also had a specific duty to protect Avril against the risks of harm that can arise out of the “use” of a motor vehicle by children who are left in or with access to the vehicle.

The specific duty relative to parents’ or custodians’ specific duty the “common sense” approach, was applicable to determining whether the operation or use of a motor vehicle is essential to the alleged breach of the specific duty. The complained-of-conduct was Avril remaining secured in her car seat in the rear of Suly’s vehicle, and thereafter, being left unattended in the vehicle, which was unventilated and trapped heat, for several hours, which led to Avril sustaining injuries that caused her death. Based on the record it is clear that Lezly breached both her general duty to supervise and her specific duty to protect Avril from the danger associated with abandoning a minor child in a vehicle under extreme heat conditions.

Suly breached her duty as a host driver by failing to protect her minor guest passenger, Avril, from being placed in a dangerous predicament – being abandoned in a hot vehicle.

Both Suly’s and Lezly’s negligence was a legal cause of the accident in question when Suly and Lezly failed to exercise the required degree of caution and care toward Avril under the specific circumstances of this case.
Use

Use of the vehicle in this case is an essential element to the theory of liability – Lezly’s and Suly’s failure to supervise or negligent supervision of Avril involved use of the motor vehicle.

Louisiana jurisprudence has given a broad interpretation to the words “arising out of the … use of the automobile.” The totality of the circumstances surrounding or leading up to an accident should be examined in determining if the accident arose out of the “use” of the automobile. Avril’s injuries occurred while the vehicle was used for a purpose inherent to vehicles, that is, to transport persons or things from one location to another.

While the vehicle was no longer being operated when Avril was left unattended, it is well established that one need not be actually operating or driving a vehicle in order to be using it. The vehicle was the catalyst for the heat-chamber-like conditions that arose which may not have occurred without the vehicle.

Avril’s injuries arose from the use of the vehicle since she was restrained in her car seat in the rear of Suly’s vehicle for the purpose of being transported. Suly’s and Lezly’s breach of their duties flows from the use of the vehicle when Avril was left unattended in the hot vehicle for several hours.
Arising Out of Occupancy

The plain meaning of “occupancy” refers to “the act, state, or condition of holding, possessing, or residing in or on something.” Black’s Law Dictionary, 10th Ed. 2014. Applying the ordinary, plain, and usual meaning of the term at issue, Avril was “occupying” or “in” the vehicle under the facts of this case, and that the Motor Vehicle Liability exclusion creates no ambiguity with respect to the coverage or lack of coverage contemplated by the homeowner’s policy.
Arising Out of Unloading

Applying the common sense approach to the instant matter, Lezly’s and Suly’s negligence in failing to unload Avril from the vehicle caused Avril to sustain fatal injuries after being left unattended in the rear of the vehicle for several hours. Accordingly, the Motor Vehicle Liability exclusion was triggered.
Arising Out of Failure to Supervise/Negligent Supervision

While the court was empathic towards the parties regarding the tragic incident that led to Avril’s death, it could not say that this homeowners’ policy and the exclusion at issue would lead to absurd consequences or that it is contrary to public policy.

Therefore, the judgment was reversed and UPC’s Motion for Summary Judgment was granted, and Ms. Calderon’s Motion for Partial Summary Judgment on the Issue of Coverage was denied.
ZALMA OPINION

The Louisiana Court of Appeal concluded, logically, and with both legal and common sense, that leaving an infant strapped into a hot vehicle sufficient to cause the child’s death was clearly a negligent use of an automobile. Since the claim against a homeowners policy specifically excluded injuries caused by, or arising from the use of an automobile, there was no possibility of coverage under the homeowners policy.

(c) 2022 Barry Zalma & ClaimSchool, Inc.

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business. He is available at http://www.zalma.com and [email protected].

Subscribe to Zalma on Insurance at locals.com https://zalmaoninsurance.local.com/subscribe.

Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome.

Write to Mr. Zalma at [email protected]; http://www.zalma.com; http://zalma.com/blog; daily articles are published at https://zalma.substack.com.

Go to the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; Follow Mr. Zalma on Twitter at https://twitter.com/bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/

Interested? Want to learn more about the community?
What else you may like…
Videos
Posts
September 18, 2026
Expert May Only Testify to What Experience Supports

Insurance Expert May Not Testify to Speculative and Contains Unsupported Conclusions.

Posted on September 18, 2026 by Barry Zalma

See the full video at and at https://rumble.com/v7fmifw-expert-may-only-testify-to-what-experience-supports.html

In Michele A. Over, and The Estate Of Paul R. Over v. State Farm Mutual Automobile Insurance Company, and State Farm Fire And Casualty Company, Civil Action No. 23-cv-02243-PAB-STV, United States District Court, D. Colorado (September 14, 2026) Michele and Paul Over sued State Farm Fire and State Farm Auto over hail-damage and stolen-vehicle claims.

The operative dispute concerned State Farm Auto’s motion to exclude or limit opinions from plaintiffs’ insurance-industry expert, Aaron Castillo. Castillo.

Law

The proponent of expert testimony must establish by a preponderance of the evidence that an expert is qualified and that the opinions are helpful, sufficiently grounded, and reliably derived and applied. Experience-based opinions must explain how the...

00:03:10
September 17, 2026
Convicted on 29 Tax-Refund-Fraud Counts

150 Months in Prison for Tax Fraud
Post 4846

Posted on September 17, 2026 by Barry Zalma

See the full video at https://lnkd.in/g8rh3JBX and https://lnkd.in/gmkdy-9C, In United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.

FACTS

In United States Of America v. Thomas Addaquay, United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS

Thomas Addaquay controlled United Consolidated Accounting and Business Services (UC), nominally a check-cashing business.

The government proved a three-stage tax-refund scheme that converted the resulting refund checks into usable funds through ...

00:05:23
September 14, 2026
Court Enforces Fifth Amendment & Refuses to Compel Answers

Major Fraud Perpetrator Asserts Fifth Amendment Privilege to Avoid Prosecution

Post 5489

Posted on September 14, 2026 by Barry Zalma

Fraudster Refuses to Answer Questions About His Alleged Fraud

See the full video at https://lnkd.in/gvicAMDr and at https://lnkd.in/gvicAMDr

In Great American Insurance Co. v. Gemstone Property Management, LLC, et al., No. 23-cv-9100 (LJL), United States District Court, S.D. New York (September 8, 2026) Great American Insurance Company alleged that it was defrauded through a scheme in which Subin Associates, LLP recruited individuals to stage construction-site injuries, arranged unnecessary medical treatment and litigation funding, and pursued fraudulent personal-injury claims.

Luis Manuel Garcia Salcedo, resulted in a $6 million settlement. Non-party Jose Hernandez allegedly worked as an assistant manager at Subin, operated Hernandez Associates, and owned litigation-funding companies that shared office space with Subin and provided services to its clients.

After Great American ...

00:05:14
21 hours ago
Denial Of Mental Health Diversion And Probation Condition Were Affirmed

Denial Of Mental Health Diversion And Probation Condition Were Affirmed

Posted on October 9, 2026 by Barry Zalma

Post 4860

In The People v. Nicholas Daniel Stiles, A173483, A173646, California Court of Appeals, First District, Second Division (September 29, 2026) Nicholas Daniel Stiles pleaded no contest to one count of insurance fraud arising from his purchase of automobile insurance after a June 2021 collision, and to grand theft arising from an April 2024 incident at a 7-Eleven.

In both cases, the trial court suspended imposition of sentence and placed him on two years’ probation. Before the pleas, Stiles sought mental health diversion in both matters and filed a written motion seeking substitute appointed counsel. The diversion applications were denied, and the court never held a hearing on the motion.

LAW

Penal Code section 1001.36 permits pretrial mental health diversion when a defendant is eligible and suitable and the proposed treatment will meet the defendant’s specialized needs; denial is reviewed for ...

post photo preview
October 05, 2026
Short And Plain Statement Containing Enough Factual Matter To State A Facially Plausible Claim

If Grounds For Dismissal Are Apparent From The Face Of The Complaint, A Court May Also Dismiss The Case on The Court’s Own Motion

Posted on October 5, 2026 by Barry Zalma

Pro Se Plaintiff Failed to Make a Short and Plain Statement

Post 4856

In Tak Lun Ng v. United Financial Casualty Company, No. 26-cv-03136-LJC, United States District Court, N.D. California (September 28, 2026) Tak Lun Ng, proceeding pro se, sued United Financial Casualty Company over a March 2, 2021 automobile accident and the insurer’s March 24, 2021 refusal to pay him.

He appeared to assert breach of contract, fraud, negligence, premises liability, product liability, and related theories. United removed the action from state court and moved to dismiss.

Ng missed that deadline but later filed several documents, including a motion for leave to amend, all of which the court reviewed.

LAW

Under Federal Rules of Civil Procedure, a complaint must provide a short and plain statement containing enough factual matter to state a facially plausible...

post photo preview
October 05, 2026
Short And Plain Statement Containing Enough Factual Matter To State A Facially Plausible Claim

If Grounds For Dismissal Are Apparent From The Face Of The Complaint, A Court May Also Dismiss The Case on The Court’s Own Motion

Posted on October 5, 2026 by Barry Zalma

Pro Se Plaintiff Failed to Make a Short and Plain Statement

Post 4856

In Tak Lun Ng v. United Financial Casualty Company, No. 26-cv-03136-LJC, United States District Court, N.D. California (September 28, 2026) Tak Lun Ng, proceeding pro se, sued United Financial Casualty Company over a March 2, 2021 automobile accident and the insurer’s March 24, 2021 refusal to pay him.

He appeared to assert breach of contract, fraud, negligence, premises liability, product liability, and related theories. United removed the action from state court and moved to dismiss.

Ng missed that deadline but later filed several documents, including a motion for leave to amend, all of which the court reviewed.

LAW

Under Federal Rules of Civil Procedure, a complaint must provide a short and plain statement containing enough factual matter to state a facially plausible...

post photo preview
See More
Available on mobile and TV devices
google store google store app store app store
google store google store app tv store app tv store amazon store amazon store roku store roku store
Powered by Locals