INSURANCE-RELATED COURT CASES
Digested from case reports published online
COURT DECISIONS
Controlled substance exclusion didn’t control loss
In July 2019, Christoffer, son of Denise and Owen Cox (Coxes), visited the home of his friend, Ryan Zinkweg. A serious injury occurred to Christoffer during his stay. The injury resulted in his becoming quadriplegic. Ryan’s parents were insured under a policy issued by Occidental Fire and Casualty Company of North Carolina (Occidental) at the time of the loss.
The Coxes sued because of their son’s injuries, which occurred when Christoffer fell out of a bed and struck his head against a nightstand. After a jury found in favor of the Coxes, Occidental then filed a motion asking to be relieved of any obligation to respond to the loss. The insurer argued that the cause of loss was excluded from coverage. A district court then ruled in favor of Occidental. The Coxes appealed.
Court records indicate that Christoffer and Ryan were enjoying time together after their graduation from high school. Both young men stated that most of their activity consisted of hanging out together and talking. However, a significant change took place after Ryan’s parents were asleep. Both Christoffer and Ryan took drugs, including lysergic acid diethylamide (LSD).
Initially, Christoffer took a single LSD tablet from his friend. He also took a THC gummy. Later, Ryan also took an LSD tablet. When Christoffer shared that he felt no effects from the tablet he took around an hour earlier, his friend gave him a second one, which he also consumed.
Hours passed and, per Christoffer’s statement, he began to feel effects from the drugs he took and he fell asleep. Later, while falling from the bed and hitting his head on a nightstand, Christoffer felt what he described as an electric shock before hitting the floor, where he could barely move.
Zinkweg stated that around 2:00 a.m. he noticed that Christoffer was lying face down on the floor and, with a raised voice, made it known that he needed help. Zinkweg, initially believed that Christoffer was merely experiencing a bad drug trip, but he also admitted that he was also in a heavy drug fog. Since he feared letting anyone know about the drugs, Zinkweg neither woke his parents nor called 911. Rather he called another friend who, rather than enter the house conventionally, snuck in by climbing up a rope to Zinkweg’s room. Court records show that the friend was in a sober condition.
The two friends lifted Christoffer from the floor and placed him face up upon the bed. During the move, Christoffer experienced a burning sensation around his neck and shoulders. Later, his friends moved Christoffer to an upright position and also shook his arms and head in attempts for him to regain mobility. At no time did either friend recognize any need to stabilize Christoffer’s neck. Early in the morning, the sober friend left the home. Several more hours passed as Zinkweg and Christoffer waited for the effect of the drugs to wear off, assuming that Christoffer would be able to move normally. Finally, Zinkweg notified his father of the problem. Christoffer’s father was called and, once he arrived, a 911 call was made.
A trial court jury found, after considering the events as well as testimony from medical experts, that the controlled substance exclusion did not apply. When Occidental appealed, a district court agreed with the insurer’s motion for a judgment as a matter of law (JMOL) that the trial jury did not have sufficient evidence to reach its conclusion.
The higher court placed its full attention on whether the district court properly granted the insurer’s JMOL motion. That court reviewed several cases cited by both parties, the expert witness testimony, the timeline of events, the state of the teens involved in handling the incident and the trial court jury’s rationale.
The court found that the cited court cases were not applicable to the dispute since they involved auto use exclusions that had causality issues that were distinct from a controlled substance exclusion. It also determined that, while the use of drugs could have had a plausible impact on the injury, there were other factors considered by the jury.
While the high court realized that the expert medical witness testimony was mixed, the information did allow the jury to consider any impact that drug use may have had in contributing to any injury—more specifically whether the jury had sufficient information to determine whether drug use was a direct cause of any injury.
Studying the timeline of events, there appeared to be significant information regarding elements that could be considered as contributors to Christoffer’s paralysis, particularly the delay in reaching for necessary medical response, the effect of the fall, and movement and mobility efforts taken by Zinkweg and his friend.
In the end, the high court found that the jury did hold enough information to come to its conclusion regarding the cause of Christoffer’s injury. As a result, the court reversed the district court decision, upholding the jury’s decision in favor of the Coxes.
Occidental Fire and Casualty Co. of North Carolina v. Christoffer Cox, Owen Cox, Denise Cox—United States Court of Appeals for the Fifth Circuit—No. 24-20388—December 9, 2025.
