In Integon National Insurance v. Helping Hands, a hospice patient was transported from the hospital to her residence for palliative care by a Helping Hands van. Upon arrival at the patient’s home, the patient was unloaded from the van, transferred to a wheelchair, and taken up the porch steps by the driver of the van. While the patient was being transported up the porch steps she sustained a gash on her leg. The patient passed away two days later.

Integon filed this action seeking a determination as to whether their automobile liability insurance policy with Helping Hands provides coverage for the alleged personal injuries and death of the patient.

North Carolina General Statute § 20-279.21 requires that an automobile liability insurance policy provide coverage for damages “arising out of the ownership, maintenance or use of” the covered vehicle. “Arising out of” has previously been defined in this context as affording protection for all damages caused by acts done in connection with or arising out of such use. There must be a causal connection between the use and the injury.

In this case, the insured van was intended for use to transport the patient from her hospital to her residence. Because the patient was unable to walk, the driver transported the patient into her residence, which the court found to be an activity necessarily associated with the use of the insured vehicle. The Court ultimately held a sufficient “causal connection” existed between the van used to transport the hospice patient and the injury that occurred out of that transport, requiring Integon’s policy to provide coverage.

N.C. Gen. Stat. § 20-279.21(b)(2) (2013).