Is Injury in the Course of Self-Defense an Occurrence?
Post 5171
Read the full article at https://lnkd.in/gAJnVny9, see the full video at https://lnkd.in/gUTs-w6E and at https://lnkd.in/gQPspzmB, and at https://zalma.com/blog plus more than 5150 posts.
When There is no Accident the Intentional Acts Exclusion is Irrelevant
The case involves a tragic incident where Kimberly Mollicone was killed during a gunfight between her husband, Matthew Mollicone, and Daniele Giannone. The central issue is whether Giannone’s actions, taken in self-defense, are covered under his State Farm homeowner’s insurance policy.
In State Farm Fire And Casualty Company v. Daniele Giuseppe Giannone; Heidi C. Aull, personal representative for the estate of Kimberly Ann Mollicone, Nos. 24-1264, 24-1265, United States Court of Appeals, Sixth Circuit (August 5, 2025) resolved the dispute.
THE INSURANCE COVERAGE
Although rare in insurance contracts the policy in question provides coverage for the insured’s liability to third parties who are injured in an accident, State Farm’s policy includes a self-defense exception to the intentional-acts exclusion. Sixth Circuit discussed various legal precedents and interpretations of the policy language, focusing on whether actions taken in self-defense can be considered “occurrences” under the policy.
Appellate courts have generally held that intentional actions taken in self-defense are not accidental and therefore do not constitute occurrences under the policy.
The decision explored the interplay between the personal liability coverage provision, the intended-acts exclusion, and the self-defense exception. It highlights the importance of interpreting the insurance contract as a whole to honor the intent of the parties involved.
Ultimately, the court affirmed the district court’s decision that Giannone’s actions did not qualify as an “accident,” and therefore, State Farm had no duty to indemnify or defend him in the state-court litigation.
ANALYSIS
The key issue before the Sixth Circuit whether Ms. Mollicone’s shooting constituted an “occurrence.” The policy defined an occurrence as “an accident” that results in “bodily injury” or “property damage.” Ms. Mollicone’s estate and Giannone argued that while Giannone intended to fire the gun, he did not intend to injure or aim at Ms. Mollicone, and her injuries are therefore a covered accident.
Michigan law defines an accident, for purposes of interpreting insurance contracts, as an undesigned contingency, a casualty, a happening by chance, something out of the usual course of things, unusual, fortuitous, not anticipated, and not naturally to be expected. Generally, an accident may include an unforeseen consequence of an intentional act.
But unforeseen consequences are not accidental when the intended act created a direct risk of harm from which the consequences should reasonably have been expected by the insured.
Unless the policy language specifies otherwise, Michigan uses a subjective standard, meaning the appellate court must look to whether the insured should have reasonably expected the consequences of his act. To prevail, then, Ms. Mollicone’s estate and Giannone must show that Ms. Mollicone’s death was not a foreseeable result of aiming and shooting a gun at the vehicle she occupied.
The Sixth Circuit concluded that they cannot make the needed showing.
Giannone aimed his loaded gun at Mr. Mollicone and fired, expecting a bullet to leave the chamber. The act took place as intended, even if Giannone desired a different result.
Giannone subjectively intended to cause harm, just not the harm that ultimately came about. Accordingly, Giannone’s conduct was not accidental and not a covered occurrence.
Ms. Mollicone’s estate and Giannone next argued that the analysis changes if Giannone was plausibly acting in self-defense. Along these lines, Giannone claims that he saw a gun poke out of the passenger window and, out of concern for his and his family’s safety, fired back. At the stage of the appeal the factual record is not developed enough to determine whether Giannone acted in self-defense. But the Sixth Circuit did not need to reach the question of self-defense, because such a determination would not affect State Farm’s liability.
The Sixth Circuit noted that the Michigan Supreme Court has held that actions taken in self-defense are “intentional.” [Auto-Owners Ins. Co. v. Harrington, 565 N.W.2d 839, 842-43 (Mich. 1997).] In Harrington, an insured man intentionally shoo an intruder who he had reason to believe was armed and intended harm. The court held that the insured’s actions were not covered under his insurance policy, because actions taken in self-defense were different from “those that are purely accidental” and excluded as intentional acts. Harrington‘s reasoning implies that, under Michigan law, intentional actions taken in self-defense are not accidental. They likely thus do not constitute an “occurrence.”
Ms. Mollicone’s estate and Giannone are wrong to suggest it matters if Giannone was acting in self-defense. Even if Giannone were validly acting in self-defense such that the events fall into the exception to his intentional-acts exclusion, his actions were not accidental. So, the occurrence provision still precludes coverage.
In sum, Ms. Mollicone’s death was a direct result of Giannone’s foreseeable actions. Therefore, Ms. Mollicone’s estate and Giannone cannot show that Giannone’s actions fall under the policy’s definition of an “occurrence”without which coverage cannot exist making the intentional act exclusion surplusage.
Because Kimberly Mollicone’s death was the direct and foreseeable result of Giannone’s actions, there is no coverage under the policy.
ZALMA OPINION
Occurrence, as defined, is the key to every liability insurance contract. If there is no occurrence, no accident, there can never be coverage and there is no need to consider exclusions.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.
Subscribe to my substack at https://barryzalma.substack.com/subscribe
Go to X @bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://lnkd.in/gwEYk.
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...
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 ...
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 ...
Employee Report of Fraud Results in Damages Suit After Qui Tam Suit Settled
No Statutory Hearing Right Arose Because No Dental Commission Complaint License Suspension, Revocation, Or Sanction Occurred.
Post 4855
Posted on October 2, 2026 by Barry Zalma
In Abbas Mohammadi et al. v. William M. Tong et al., No. AC 47598, Court of Appeals of Connecticut (September 29, 2026) Abbas Mohammadi owned and operated Columbia Dental, P.C., which provided dental services through multiple Connecticut offices; Columbia Oral Maxillofacial Imaging, LLC served as the billing entity.
From April 2012 to February 27, 2013, Columbia Dental employed Brittany Ames Mahoney as a dental assistant. During her employment, Mahoney claimed to have discovered certain billing irregularities, including, but not limited to, false and fraudulent reimbursement claims submitted to the Department of Social Services for services rendered to Medicaid beneficiaries. Mahoney filed a complaint and an affidavit in the United States District Court for the District of...
Another Anniversary for Barry Zalma, Inc
Posted on October 1, 2026 by Barry Zalma
From October 1, 1979 – 2026
Post 4854
Read the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/09/ZIFL-10-01-2026.pdf Forty seven years ago today I left the world of the employed and became an entrepreneur by opening my own law firm. The law practice was incorporated shortly thereafter as Barry Zalma, Inc.
When I opened for business on October 1, 1979, I had no clients and no certainty that I would have any in the future. I had borrowed money from the bank to carry me through the first six months and was concerned about my ability to pay the loan with my third child about to be born.
Much to my surprise and pleasure, on October 1, 1979, at 8:10 a.m., the best claims handler in the London market, Alan Warboys, called from London and provided me with my first case as an independent lawyer to represent Certain Underwriters at Lloyd’s, London. He, and the Lloyd’s Underwriters he represented, showed faith in me as a lawyer and insurance expert. Alan is now, although ...
Defendants Successfully Moved for Summary Judgment
Post 4854
Posted on September 30, 2026 by Barry Zalma
In Jeffrey Wayne Phillips v. Creative Website Studios, et al., No. 5:23-CV-568-BO-BM, United States District Court, E.D. North Carolina, Western Division (September 28, 2026) the Court needed to rule on the order and memorandum and recommendation (“M&R”) of the Magistrate.
Jeffrey Wayne Phillips had contracted with Creative Website Studios and SR Telecommunications for website and hosting services. He alleged that defendants repeatedly billed him for hosting periods he had already paid for and later took down his website. Phillips claimed the outage prevented him from bidding on U.S. government security contracts and sought roughly $300 million in consequential damages.
LAW
Under North Carolina law, fraud requires a false material representation or concealment, intent and effect of deception, resulting damage, and reasonable reliance. Obtaining property by false pretenses similarly requires an ...