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High court addresses provision for 1st time

April 29, 2010


The Indiana Supreme Court affirmed the denial of summary judgment for an insurance company, finding the exclusion in the policy for injuries covered by workers’ compensation doesn’t apply.

The high court was asked for the first time to review a provision of the Worker’s Compensation Act. The provision states that anyone contracting for more than $1,000 of work may be liable to the same extent as the contractor for injuries under the Worker’s Compensation Act if the person hiring the contractor doesn’t verify that the contractor has workers’ compensation insurance liability.

Farmers Rick and Katrina Taylor hired Sherlock Contract Painting. One of Sherlock’s employees, Christopher Collis, was injured on the job. He discovered Sherlock didn’t have workers’ compensation benefits, which the Taylors didn’t verify before hiring Sherlock. Collis then sued the Taylors for benefits under Indiana Code Section 22-3-2-14(b).

The Taylors were insured with Everett Cash Mutual Insurance Co. and had a farm personal liability policy for “all risk” coverage. Everett Cash denied coverage for Collis’ accident. The Taylors then sued for breach of contract. The trial judge denied summary judgment for Everett Cash; a split Indiana Court of Appeals reversed.

The Taylors argued Collis’ claim is a premises liability claim, so their policy should cover it. Everett Cash argued Collis’ claim is for workers’ compensation benefits, which are excluded under the policy. It claimed the occurrence under the policy must be an accident, and that the claim arose because of the Taylors’ failure to verify workers’ compensation benefits.

In Everett Cash Mutual Insurance Co. v. Rick and Katrina Taylor, No. 02S03-0909-CV-395, the Supreme Court ruled the claim was a result of an accident, so it was an occurrence as defined by the policy. The justices also found the language in the policy that Everett Cash claims to exclude this coverage to be ambiguous. It’s possible to read the language to mean that if not for I.C. Section 22-3-2-14(b), Collis wouldn’t have asserted the Taylors were responsible for his injuries and so Everett Cash wouldn’t have to pay, wrote Justice Frank Sullivan.

It’s also possible to interpret the exclusion language as to apply to employers who are directly within the application of the Worker’s Compensation Act. Farm or agricultural employees are excluded under the act and the Taylors aren’t required to have workers’ compensation benefits because they own and work a farm.

One could conclude that the exemption only clarifies that the policy provides no coverage in the conventional worker’s compensation context when an employee seeks the benefits payable by an insured under the law.

“It would be beyond the ordinary understanding of the worker’s compensation system to extend the exclusion to the matter-of-first-impression scenario here – where a claim is filed against an insured by an injured worker in the employ of a third party who did not comply with its obligations under the Act,” wrote the justice. “Given that the Taylors could not have even purchased worker’s compensation insurance to protect themselves from claims by Sherlock’s employees, it is hard to imagine them thinking that an exclusion regarding worker’s compensation could preclude them from having protection from a lawsuit by someone injured in an accident on their property.”

The justices held for an insurance policy to exclude such a claim as the one in the instant case, the exclusion must be more explicit than the language used in the Everett Cash policy.
 

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