INSURANCE-RELATED COURT CASES

COURT DECISIONS

Digested from case reports published in Westlaw,
West Publishing Co., St. Paul, MN

Hey Crawdaddy: Brothers battle over boat

Wayne Guillot and Reece Guillot are brothers and also are former partners in their family's farming operation, known as Cleveland Guillot and Sons (Guillot Farms). Reece and his son, Benjamin, continue to work for Guillot Farms; Wayne left the employ of Guillot Farms before the incident at issue occurred.

Wayne and his wife, Sandra, filed suit against Reece, Benjamin, Guillot Farms, and their insurers, Louisiana Farm Bureau Mutual Insurance Company, Louisiana Farm Bureau Casualty Insurance Company, and Southern Farm Bureau Mutual Casualty Insurance Company (collectively Farm Bureau) for injuries that Wayne allegedly sustained arising out of an assault and battery that occurred on or about March 16, 2008.

The alleged incident took place after Wayne sought to recover a crawfish boat he owned and that apparently was abandoned in a crawfish field. Wayne loaded the boat onto a trailer and was driving home on a highway when Reece began to follow Wayne's vehicle and trailer. Wayne alleged that as he approached an intersection, Reece's son, Benjamin, acted in concert with his father to form a roadblock near the intersection, after which Benjamin "violently and intentionally rammed his vehicle into the driver's side of Wayne's vehicle," forcing Wayne off the roadway and partially into a ditch.

Wayne said he was able to maneuver his vehicle around the vehicle operated by Benjamin and continued to proceed toward his home. Reece and Benjamin pursued Wayne to his home "and thereafter exited their vehicles to assault, accost, and severely beat him, causing severe and debilitating injuries to him." Wayne asserted that, at the time of the incident, Reece and Benjamin were in the course and scope of their employment with Guillot Farms and that all three were insured by Farm Bureau. Farm Bureau denied liability coverage under seven policies that were in effect at the time of the incident. The policies were an automobile policy, a homeowners policy, and an umbrella policy issued to Reece; a homeowners policy issued to Benjamin; and an automobile policy, a farm liability policy, and an umbrella policy issued to Guillot Farms.

On January 14, 2010, Wayne and Sandra filed a motion for summary judgment on the issue of insurance coverage.

On March 5, 2010, Farm Bureau filed a cross-motion for summary judgment, seeking a ruling that its liability and umbrella policies did not provide coverage in this case.

The trial court denied Wayne and Sandra's motion for summary judgment and granted Farm Bureau's motion for summary judgment; and on May 16, 2011, the court dismissed the claims against Farm Bureau. Wayne and Sandra appealed.

On appeal, Wayne and Sandra raised one issue: "whether Farm Bureau was entitled to summary judgment as a matter of law . . . specifically [alleging] that there is no genuine issue of material fact regarding coverage, despite the evidence presented to the district court."

The Louisiana Appellate Court found that the policy language excluding the expected or unexpected results of an intentional act from coverage was a valid exclusion and had been upheld in numerous instances.

The judgment of the trial court was affirmed, and the costs of the appeal were assessed against the plaintiffs/appellants, Wayne and Sandra Guillot.     Guillot vs. Guillot-No. 12–109-Appeal-Court of Appeal of Louisiana, Third Circuit-June 6, 2012- 2012 WL 2016215 (La.).

Pedestrian's estate seeks UM benefits

In the early morning of March 18, 2006, Robert George was struck by a motor vehicle driven by an uninsured motorist. In the hours leading up to the accident, George and several of his friends had visited a bar in Glocester, Rhode Island. A friend had driven George to the bar, and at approximately 1:00 a.m. the same friend drove George and a group of their companions to George's residence on Putnam Pike in Glocester.

Upon exiting the friend's vehicle, George and one of his friends walked into the breakdown lane of Putnam Pike and engaged in a conversation with another group of people. While George was standing there, an automobile crossed over the solid double-yellow centerline, struck George and four other pedestrians, and then fled the scene. George died as a result of his injuries.

At the time of his death, George was the sole shareholder and employee of Allied Caulking, Inc., a Rhode Island corporation. In 2005, Michael DelSesto, who knew George on a professional basis, had lent George a van to use in his business. DelSesto allowed George to advertise his business on the side of the van, using magnetic signs, and George had the use of the van up to and including the day of his death. It was undisputed that George had not used or occupied the van in the hours leading up to the accident on March 18, 2006, and that he was not exiting, entering, or in proximity to the van at that time.

DelSesto's van was insured under a commercial automobile policy procured by the Cormack-Routhier Agency, Inc., and issued by Harleysville Worcester Insurance Company in November 2005. The declarations identified Allied Caulking as the named insured and only operator of the vehicle. The policy had a liability limit of $1 million and covered only hired and non-owned autos. It was undisputed that the policy provided no uninsured or underinsured motorist coverage.

On September 9, 2008, Pamela A. Riel and Glenn N. George, as co-administrators of Robert George's estate, and Riel on behalf of her and Robert George's minor daughter, filed suit against Harleysville and Cormack, seeking to recover uninsured motorist benefits under the Harleysville policy and alleging breach of contract and breach of the duty of good faith against Cormack. The Superior Court of Rhode Island granted summary judgment in favor of the defendants; the plaintiffs appealed.

On appeal, the plaintiffs argued that summary judgment was improperly granted because "[a] genuine issue of material fact [exists] as to whether [decedent was] a named insured under the [p]olicy," as he was "listed as an operator" in the policy and thus had a reasonable expectation of coverage.

The Supreme Court of Rhode Island disagreed. Although the Harleysville policy did not include UM coverage, the court noted that the "defendants assumed, for the purpose of their summary judgment motions, that such coverage was contained in the policy. We assume the same, without deciding whether such coverage was, indeed, provided to decedent."

In conjunction with the policy, the court reviewed the UM endorsement that Harleysville submitted in support of its summary judgment motion. The court found that the policy was unambiguous on its face because it defined "you" as the "[n]amed insured" and it plainly listed Allied as the named insured on the declarations page. For these reasons, the court said, the estate of Robert George was not entitled to coverage under the policy's plain terms.

With respect to the plaintiffs' claim that the trial court erred in granting summary judgment in favor of Cormack, the high court held that Cormack's motion was properly granted. Having determined that George was not entitled to UM coverage under the policy, the court said, the plaintiffs could not have suffered any damages as a result of Cormack's alleged failure to procure a policy containing UM coverage.

The judgment of the trial court was affirmed.

Riel vs. Harleysville Worcester Insurance Company-No. 2011-63-RI-Supreme Court of Rhode Island-June 22, 2012-2012 WL 2366299.

Ambiguity doesn't pay, so insurer does

Helen Poole owned a house in Fayette County, Pennsylvania, and was the named insured on a homeowners policy issued by Wall Rose Mutual Insurance Company. Helen's son, Abe Poole, and 18-year-old grandson, Daniel Poole, spent the night of April 1, 2005, at Helen's house, as Helen was in the hospital and the two men's new apartment did not yet have working utilities.

Helen Poole died the following day, April 2, 2005. Because Helen's will granted Abe a life estate in her house, Abe and Daniel moved their belongings from the new apartment to Helen's house and continued to stay there until September 2005.

On September 2, 2005, Daniel ignited the gas stove in the house to light a cigarette, and then left the house without turning off the stove. A fire ensued and spread to the adjacent property, which was owned by Scott and Glenda Miller.

The Millers sued Daniel for the damage caused by the fire. Wall Rose refused to defend Daniel and denied coverage for the Millers' property damage. The Millers eventually obtained a default judgment against Daniel.

On November 8, 2007, the Millers filed a declaratory judgment action against Daniel and Wall Rose, seeking a ruling that Wall Rose had a duty to indemnify Daniel for the judgment entered against him. After discovery, the Millers and Wall Rose filed cross-motions for summary judgment. The trial court granted Wall Rose's motion and denied the Millers' motion on October 14, 2011. The Millers appealed.

On appeal, the Millers raised two questions. First, did the liability coverage of the Wall Rose policy, affording protection to resident relatives of Helen Poole's household, cover a loss caused by the negligence of her grandson, Daniel Poole, while he was living at the insured property on the date of the fire? Second, did the uncontradicted facts warrant the conclusion that Daniel Poole was a resident of his grandmother's household as of the date of her death, particularly in view of the mandate that any ambiguity in the application of the policy language be construed against Wall Rose?

The Wall Rose policy stated: "Insured" means: a. "you" [the person named as the insured on the declarations page, which in this case was Helen Poole]; b. "your" relatives if residents of "your" household; c. persons under the age of 21 residing in "your" household and in "your" care or in the care of "your" resident relatives; and d. "your" legal representative, if "you" die while insured by this policy. This person is an "insured" only for liability arising out of the "insured premises." An "insured" at the time of "your" death remains an "insured" while residing on the "insured premises."

The Millers argued that, having lived in Helen Poole's house continuously from April 1, 2005, until the time of the fire, Daniel Poole was a "resident" of Helen Poole's "household" at the time of the fire, rendering him an "insured" under the terms of the policy.

The high court noted that there was no question that Daniel Poole was a relative of Helen Poole, and that he was under the age of 21 at the relevant time. Rather, the dispute was based on the meanings of the terms "residents," "residing," and "household," none of which was defined in the policy.

Construing the term "household" against Wall Rose as the drafter of the contract, the court held that Daniel Poole was an "insured" under the policy as a resident of Helen Poole's household. The court stated: "As drafter of the contract, Wall Rose had it within its power to define the terms 'resident' and 'household' in a way that would require the interpretation they now advance. It chose not to do so."

The judgment of the trial court was reversed and remanded.

Miller vs. Poole-No. J-S22037-12-PA-Pennsylvania Superior Court-June 4, 2012-2012 WL 1980647.

Lug nut lesson

Peter Caserta Jr., brought a truck to Wal-Mart Tire & Lube Express to have new tires mounted on the vehicle. After attempts to remove a lug nut on one of the wheels proved unsuccessful, the Wal-Mart technician agreed to take Caserta to the automotive service area to show him the problem.

The technician gave Caserta a pair of safety goggles and, at Caserta's request, agreed to allow Caserta to use the lug wrench to attempt to loosen the nut. As Caserta attempted to remove the lug nut, it snapped and injured him.

Caserta sued Wal-Mart and its insurer; they in turn moved for summary judgment, arguing in part that Wal-Mart was not responsible for Caserta's own negligence. The district court denied the motion, and the court of appeal denied the defendants' application for supervisory writs. The defendants applied to the Supreme Court of Louisiana for review.

In reviewing the defendants' application, the court stated: "If the facts of a particular case show that the complained-of condition should be obvious to all, the condition may not be unreasonably dangerous, and the defendant may owe no duty to the plaintiff."

The court pointed to Caserta's testimony, in which he said he was a machinist who regularly used a lug wrench and typically serviced his own truck. He admitted that he was using his body weight to put pressure on the lug in an attempt to turn it. Caserta also conceded that the wrench was not defective and did not break.

Based on these facts, the court said that any risk from attempting to move the frozen lug nut should have been obvious to Caserta and that he could have avoided the risk by using ordinary care.

The defendants' writ was granted. The judgment of the district court was reversed, and summary judgment was granted in favor of the defendants.

Peter Caserta Jr., vs. Wal-Mart Stores, Inc., and ABC Insurance Company-No. 12-CC-0853-Supreme Court of Louisiana-LA-June 22, 2012-2012 WL 2579892.