PICKETT, Judge.
Shane Eads, an offshore diver, was providing temporary help to his wife's step-father in an unrelated business in a highway work zone when he was caught between a crashing vehicle and a stationary trailer. He sustained crushing injuries and the loss of his right leg. Mr. Eads appeals the granting of a motion for summary judgment in favor of Atlantic Casualty Insurance Company (Atlantic), arguing an ambiguity exists in the coverage extended to a "temporary worker" such as Mr. Eads which renders the policy inapplicable to him. We have reviewed Atlantic's policy in light of Mr. Eads' contentions and
We must decide whether the trial court erred in granting summary judgment to Atlantic and in denying Mr. Eads' cross-motion for summary judgment and motion for new trial.
Mr. Eads had been permanently employed as an offshore diving supervisor for six years when he agreed to provide his wife's step-father, Dewayne Spriggs, with temporary labor on a commercial job in the Town of Sunset, Louisiana. Mr. Spriggs owned a one-man sewer clean-out company, Dewayne K. Spriggs, LLC, d/b/a D/Von's Jetter Rooter Service.
On January 25, 2011, Mr. Eads was working with Spriggs on Duffy Avenue on a sewer clean-out for the Town of Sunset. Using Spriggs's truck, they had pulled an equipped jetting trailer over the manhole and fed a protective sleeve down into a pipe to protect the jetting hose. Mr. Eads tied the sleeve to the trailer. Mr. Spriggs fed the hose out, and Mr. Eads worked it into the sewer line. They were retracting the hose when a motorist suddenly crashed into the work zone, striking the Town of Sunset's parked truck and propelling it into Mr. Eads, pinning him between the Sunset truck and the jetting trailer.
Mr. Eads suffered numerous serious injuries, including a crushed pelvis, fractured lumbar vertebrae, severed urethra, and injuries so severe to his right leg that it had to be amputated. He sought workers' compensation benefits from Spriggs LLC's insurer, Louisiana Workers' Compensation Corporation (LWCC), but learned that Spriggs LLC did not have workers' compensation coverage in force because his policy had lapsed and was cancelled in December 2010.
Mr. Eads and his wife, on behalf of themselves and their two minor children (collectively referred to as "Eads" or "Mr. Eads"), brought suit against the defendants and their insurers. Pursuant to the original and supplemental petitions, the Eads filed suit against the motorist and his insurer; the Town of Sunset and its employee at the work site; trailer owner, Mallard Environmental, Inc., and its primary and excess insurers; Spriggs LLC, Spriggs individually; and three insurance carriers providing insurance to Spriggs and/or his LLC. Eads settled with the motorist and his insurer; the Town of Sunset and its employee; State Farm Mutual Automobile Insurance Company, the automobile insurer of Spriggs individually; and Spriggs LLC's excess liability insurer, Chartis Specialty Insurance Company. Eads also obtained a default judgment against Spriggs LLC for workers' compensation benefits which were not available. The judgment was not paid, and Eads sued Spriggs LLC in tort pursuant to La. R.S. 23:1032.1.
Spriggs LLC was the named insured on a commercial general liability (CGL) policy written by Atlantic. The trial court granted Atlantic's motion for summary judgment and denied Eads's cross-motion, finding that an endorsement to the policy replaced the definition of "employee" and that Mr. Eads was not covered under the policy. Eads's claims for general liability coverage from Atlantic were dismissed with prejudice. A subsequent judgment denied Eads's motion for a new trial on the
The trial court granted an exception of no cause or right of action to Dewayne Spriggs, individually. While Eads's motion for appeal indicated that the judgment granting the exception was being appealed, Eads did not assign error or mention the exception in any manner in his appellate brief to this court. Mr. Spriggs filed an appellee brief asserting that Eads's objection to the exception in his favor had been abandoned. We agree and do not address the exception and dismissal granted to Dewayne Spriggs, individually.
Whether the language of a contract is ambiguous is a question of law that subjects the judgment to a de novo standard of review on appeal. Cluse v. H & E Equipment Servs., Inc., 09-574 (La.App. 3 Cir. 3/31/10), 34 So.3d 959, writ denied, 10-994 (La.9/17/10), 45 So.3d 1043. "When an appellate court reviews a district court judgment on a motion for summary judgment, it applies the de novo standard of review, `using the same criteria that govern the trial court's consideration of whether summary judgment is appropriate.'" Gray v. Am. Nat'l Prop. & Cas. Co., 07-1670, p. 6 (La.2/26/08), 977 So.2d 839, 844 (quoting Supreme Servs. & Specialty Co., Inc. v. Sonny Greer, 06-1827, p. 4 (La.5/22/07), 958 So.2d 634, 638). The motion for summary judgment shall be granted if the pleadings, depositions, answers to interrogatories, admissions, and affidavits, if any, show that there is no genuine issue of material fact and that the mover is entitled to judgment as a matter of law. La.Code Civ.P. art. 966(B).
Mr. Eads initially sought workers' compensation benefits from Spriggs LLC but obtained a default judgment against the company that was not paid or appealed because the company's workers' compensation policy lapsed for nonpayment before he was injured. After the delays for an appeal had run and the sixty days for paying the judgment had expired, Mr. Eads amended his tort petition and added Spriggs LLC as a defendant, asserting negligence claims and a tort cause of action under La.R.S. 23:1032.1.
Because the issues presented on de novo review involve insurance coverage, we apply the rules on the interpretation of contracts.
Hebert v. Webre, 08-60, pp. 4-5 (La.5/21/08), 982 So.2d 770, 773-74 (citations omitted).
Succession of Fannaly v. Lafayette Ins. Co., 01-1355, p. 6 (La. 1/15/02), 805 So.2d 1134, 1139.
At the time of the accident, Spriggs LLC, d/b/a D/Von's Jetter Rooter Service was the named insured on a CGL policy with Atlantic, No. L034002841. The Atlantic policy provides in Section I — Coverage A — Bodily Injury and Property Damage Liability, that Atlantic "will pay those sums that the insured becomes legally obligated to pay as damages because of `bodily injury.'" When Eads named Atlantic as a defendant, Atlantic invoked Exclusion e of Combination Endorsement AGL-055 (the endorsement) that is attached to Spriggs LLC's policy to deny Eads coverage. Mr. Eads filed a cross-motion for summary judgment, seeking a judgment recognizing him as an insured under Atlantic's policy. The trial court granted Atlantic's motion for summary judgment and denied Eads's cross-motion. Eads asserts error on the part of the trial court based upon ambiguity that he contends is created by the endorsement.
"Exclusionary provisions in insurance contracts are strictly construed against the insurer, and any ambiguity is construed in favor of the insured. Garcia v. St. Bernard Parish Sch. Bd., 576 So.2d 975, 976 (La.1991)." Ledbetter v. Concord Gen. Corp., 95-809, p. 4 (La.1/6/96), 665 So.2d 1166, 1169. "[A]n ambiguity exists in an insurance policy when the pertinent provision can reasonably be construed in two different ways." McCarthy v. Berman, 95-1456, p. 8 (La.2/28/96), 668 So.2d 721, 726.
Whether a policy endorsement creates an ambiguity must be considered as follows:
Sims v. Guerrero, 39,091, pp. 4-5 (La.App. 2 Cir. 12/15/04), 889 So.2d 1184, 1186.
Atlantic's motion for summary judgment is based on Exclusion e contained in the endorsement which states, in pertinent part:
This definition of "employee" replaces the definition of "employee" contained in Section V of the policy "with respect to this endorsement only" while "[a]ll other terms and conditions remain unchanged."
Therefore, Mr. Eads is correct that Exclusion e of Atlantic's policy does not apply to a temporary worker, such as himself, because the definition of "employee" expressly removes him from the excluded group. He is not correct, however, that the definitions in Exclusion e of the policy and Exclusion e of the endorsement create an ambiguity.
Atlantic argues that because Mr. Eads was "hired" for the job in Sunset, the endorsement's definition of "employee" unambiguously applies to him. It cites Spell v. Mallett, Inc., 06-1477 (La.App. 3 Cir. 5/2/07), 957 So.2d 262, in support of its position. In Spell, this court found that the same endorsement in another Atlantic policy excluded coverage for the plaintiff who was injured while working short-term for the insured.
Eads contends, however, that because Atlantic's policy definitions of "temporary worker" and "leased worker" have been left untouched by the endorsement, and the definition of "leased worker" still states: "Leased worker" does not include a "temporary worker," an ambiguity is created by the endorsement's definition of "employee."
Exclusion e of the endorsement replaces the Employer's Liability of Coverage A. Bodily Injury and Property Damage Liability. Therefore, the policy's definition of "employee" is specifically replaced by the endorsement's definition of "employee," and "any person ... hired... for the purpose of providing services to or on behalf of any insured" is an employee excluded from coverage. Though the terms "leased worker" and "temporary worker" appear in the definition of "employee" and are each defined by the policy, those terms have no impact on the endorsement because they do not appear in the endorsement.
The fact that Atlantic's policy's definition of "employee" expressly excludes "temporary worker" is of no importance because the endorsement's definition of "employee" excludes "temporary worker." Louisiana Civil Code Article 2050 provides that "[e]ach provision in a contract must be interpreted in light of the other provisions so that each is given the meaning suggested by the contract as a whole." When the policy is read as a whole, i.e., the policy and the endorsement, Exclusion e of the endorsement excludes coverage for Mr. Eads because he is "any person ... hired ... for the purpose of providing services to or on behalf of any insured" and he seeks recovery for "bodily injury."
Barousse v. Western World Insurance Co., 07-1264 (La.App. 3 Cir. 3/5/08), 978 So.2d 1129, presented a similar situation. The plaintiff argued that the policy was ambiguous because the application signed by the insured stated, "I agree to promptly report all full and part time drivers," but neither the application nor the policy defined "promptly." The endorsement at issue in Barousse provided:
Id.
As in Barousse, any ambiguity arguably created by the policy's definitions of "employee," "temporary worker," and "leased worker" is resolved when Atlantic's policy is construed as a whole. Accordingly, we affirm the grant of summary judgment in favor of Atlantic and the denial of summary judgment in favor of Mr. Eads on his cross-motion for summary judgment, finding no issue of material fact regarding coverage for his injuries under the Atlantic policy.
Mr. Eads appeals the denial of the motion for new trial he filed regarding the trial court's grant of summary judgment in favor of Atlantic. He argues that a temporary worker, like himself, is not included in the employee exclusion of the endorsement, "not because the endorsement says this, but because the original definition of `employee' in the policy specifically excluded `temporary worker[]' and the amended definition just failed to include a temporary worker."
Louisiana Code of Civil Procedure Article 1972 lists the peremptory grounds for a motion for new trial, as relevant herein:
Further, La.Code Civ.P. art. 1973 addresses the discretionary grounds for a motion for new trial, stating that "[a] new trial may be granted in any case if there is good ground therefor, except as otherwise provided by law."
The grounds for new trial potentially applicable here are set forth in La.Code Civ.P. art. 1972(1) and Article 1973. As explained above, Mr. Eads is excluded from coverage under Atlantic's policy because he falls within the plain terms of the endorsement's definition of "employee." Accordingly, his motion for a new trial was properly denied.
The grant of summary judgment in favor of Atlantic and the denial of summary judgment in favor of Eads on general liability coverage are affirmed. The denial of Eads's motion for new trial is also affirmed. Costs of this appeal are assessed to Eads.
THIBODEAUX, Chief Judge, dissents and assigns written reasons.
THIBODEAUX, Chief Judge, dissenting.
Exclusion "e" provides that the insurance does not apply to "bodily injury" to an "employee." Policy section V — DEFINITIONS defines "employee" as:
AGL-055 states that the new definition replaces the original "with respect to this endorsement only" and that "[a]ll other terms and conditions remain unchanged." According to Atlantic, since Mr. Eads was "hired" for the job in Sunset, the new expansive definition of "employee" unambiguously applies to him. In support of its position, Atlantic cites and the majority relies upon Spell v. Mallett, Inc., 06-1477 (La.App. 3 Cir. 5/2/07), 957 So.2d 262, which found that the same endorsement in another Atlantic policy excluded coverage for the plaintiff who was injured while working short-term for the insured. When considering the policy as a whole, pursuant to Hebert v. Webre, 08-60 (La.5/21/08), 982 So.2d 770, I find Spell distinguishable from the present case.
In Spell, the description of the insured's business was carpentry and the
Further, the record in Spell indicated that the insured, Mallett, purchased Atlantic endorsements to cover the work of his contractors and their employees, not to provide an additional avenue of recovery for employees already covered by Mallet's workers' compensation policy. We do not have those facts in this record. In fact, Spell was receiving workers' compensation benefits under Mallett's other policy, and the workers' compensation carrier intervened to recover its payments from the Atlantic CGL policy.
While I acknowledge that endorsement exclusion "e" appears to be identical in both cases, the issues were entirely different in Spell, and the endorsement cannot be viewed in a vacuum. The endorsement clearly targets "contractors," more fully explained below. Before the endorsement in the present case, Spriggs's policy did not even contain a definition for "contractor." Whether that was true of the policy in Spell is unknown. The endorsement in Spell exists in conjunction with another endorsement relating to contractors and in a policy issued to a construction company that regularly hired building contractors. Spriggs's LLC was a one-man rotor-rooter operation. Spriggs testified that except for Eads, he had only had two other helpers in his eight-year-old operation.
Here, the trial court admitted that there was doubt surrounding the endorsement and that the policy writer could have removed this doubt by simply including temporary workers in the new definition. Atlantic even acknowledged a "lack of linguistic clarity" but distinguished it from "ambiguity." The trial court acknowledged that temporary worker was "still sitting out there" and that interpreting the new exclusion was a "close call" and a "hard decision." Doubts, close calls, hard decisions, and lack of linguistic clarity all point to ambiguity that should be interpreted against Atlantic, the insurer.
In this case, exclusion AGL-055 constitutes only one page in a ten-page endorsement. In the world of insurance contracts, the policy must be construed as a whole and one portion cannot be construed separately at the expense of disregarding another. See Hebert v. Webre, 982 So.2d 770.
More specifically, Atlantic's CGL form policy is a fourteen-page document. Its schedule of endorsements lists thirteen additional documents that are made part of the policy. Twelfth on the list is endorsement AGL-CO, which is itself a ten-page "Combination Endorsement" entitled, "Exclusions/Limitations — Combination Endorsement — Contractors." On page four (4) of Combination Endorsement AGL-CO is the single-page endorsement with the new exclusion "e", AGL-055, entitled, as discussed, "Exclusion of Injury to Employees, Contractors and Employees of Contractors." AGL-055 provides, as before, that the insurance does not apply to "bodily injury" to an "employee," but the new exclusion and the new definition of "employee" expressly address contractors to such an extent that it is clear that "contractors" are the target of the endorsement.
Accordingly, the endorsement is very comprehensive and all-inclusive; it is clearly meant to bring contractors of all descriptions into the realm of people whose bodily injuries are excluded from coverage. The extent of the detail signals a complete turnaround in the policy's treatment of contractors. Likewise, the new definition of "employee" expressly includes leased, loaned, hired, contracted, and volunteering persons in the realm of the newly-excluded. Yet nowhere does the new exclusion mention "temporary" workers, and at its end it states that "[a]ll other terms and conditions remain unchanged." One is left to ponder the rationale for this omission. It is quite possible that temporary people were omitted from the endorsement because in some jurisdictions they are not covered by workers' compensation laws. Such a reason applies specifically to Mr. Eads in this case. Given the all-inclusiveness and the extent of detail in the endorsement, its omission of "temporary" workers is glaring. This is particularly true when the unchanged provisions are examined.
The policy's Section V contains twenty-two (22) definitions. In addition to number 5, "employee," it contains three other pertinent definitions, numbers 10, 19, and 20. Considered together, they state:
While it is true that the old definition of "employee" expressly excludes "temporary worker," and the new definition of "employee" in AGL-055 does not, it is also true that AGL-055 does not include "temporary worker," or address the term in any way. In fact, the entire ten-page Combination Endorsement AGL-CO, of which AGL-055 is a part, does not address "temporary worker" on any of its ten pages. AGL-CO does, however, on page 10, address and delete Definition 20, "Volunteer worker," from Section V — DEFINITIONS.
Original definitions 10 ("Leased worker") and 19 ("Temporary worker") were left untouched by the endorsements. Endorsement AGL-055 did not change the definition of "leased worker" but specifically included "leased" persons in its new definition of "employee." The unchanged definition of "leased worker" still specifically excludes "temporary worker" the way the original definition of "employee" did. Now that leased worker is an employee, for purposes of AGL-055, and leased worker still excludes temporary worker, the result is the same, and it could be seen as redundant for the new definition of "employee" to also state that it excludes "temporary worker." Temporary worker has been excluded by the exclusion to coverage by reference, as it was never intended to be included in the employee exclusion to coverage. If it had been, AGL-055 would have expressly included it. This reasoning is consistent with the fact that the new definition of the excluded "employee" includes every kind of worker except a "temporary worker." Again, endorsement AGL-055 indicates at the bottom, that except for the changes expressed, all other terms and conditions remain unchanged.
Moreover, exclusion/endorsement CG 2166A also deletes "volunteer workers" from Section II — Who Is An Insured, while leaving "employees" as insureds, for their acts against others under limited circumstances. Because CG 2166A is a separate endorsement from AGL-055, though both are part of Combination Endorsement AGL-CO, the original definition of "employee" stands as to CG 2166A, since the new definition applies only to exclusion/endorsement AGL-055. The new definition of "employees" could not apply to CG 2166A because the new definition includes "volunteering" persons, which would conflict with CG 2166A's deletion of "volunteer workers" while it continued to maintain "employees" as insureds. This is additional evidence that the endorsements are consistent in including and excluding terminology and that AGL-055 would have said "temporary worker" if it meant "temporary worker."
Is it also reasonable to suggest that "temporary worker" was tacitly implied in AGL-055's reference to a "hired" person? After all, Mr. Eads was "hired," and he was "providing services to" the insured, D/Von's Jetter Rooter Service. I conclude that the pertinent provision can be reasonably construed in two different ways, thereby rendering it ambiguous under McCarthy v. Berman, 95-1456 (La.2/28/96), 668 So.2d 721.
Accordingly, in considering the policy and the ten-page Combination Endorsement as a whole, I find ambiguity in the coverage extended to "temporary workers" such as Mr. Eads. Thus, I interpret the policy against the writer, Atlantic, and I conclude that Mr. Eads is not excluded from general liability coverage under the Atlantic policy. Accordingly, I would reverse the granting of summary judgment in favor of Atlantic and render judgment in favor of Mr. Eads on his cross-motion for summary judgment, finding no issue of material fact regarding coverage for his injuries under the Atlantic policy.
For the foregoing reasons, I dissent.
AGL-0558/05