Phila. Indem. Ins. Co. v. Fla. Mem'l Univ.
Phila. Indem. Ins. Co. v. Fla. Mem'l Univ.
Opinion of the Court
Philadelphia Indemnity Insurance Company filed this action seeking a declaration that an insurance policy it issued to Florida Memorial University does not afford coverage for damages claimed, in state court, by FMU student Aaliyah Edmond. FMU, of course, disagrees, countering the policy does in fact support coverage. According to FMU, either the plain text of the policy requires coverage or, if multiple reasonable interpretations are possible, the Court should adopt FMU's interpretation over the Insurance Company's. FMU also argues that even if one aspect of Edmond's claim is not covered, because of an exclusion, another aspect is and therefore the Insurance Company's duty to defend extends to Edmond's entire claim. The Court finds FMU's position misses the mark and thus grants the Insurance Company's motion for summary judgment (ECF No. 49 ) and denies FMU's (ECF No. 48 ).
1. Background
The parties do not dispute the salient facts underlying this coverage dispute. Edmond, the plaintiff in the underlying state case against FMU, was a member of FMU's dance team. (Def.'s Stmt. of Undisputed Facts ("Def.'s Stmt.") ¶ 1, ECF No. 48, 2.) The complaint alleges the dance team was managed and organized by FMU. (Edmond's State Compl. ¶ 6, ECF No. 32-1, 2.) While under the supervision of an assistant dance-team coach, Edmond says that she, along with her team, attempted to execute a new stunt during a practice session on October 7, 2015, in preparation for an upcoming dance show. (Def.'s Stmt. ¶¶ 1-3.) In practicing the new stunt, Edmond's teammate failed to catch her and she hit her back and head on the bare tile floor of the practice room. (Id. at ¶ 5.) The coach, according to Edmond, directed her to sit down but did not otherwise instruct her to seek medical care even though she was experiencing concussive symptoms. (Id. at ¶ 6.) The next day, Edmond continued to experience concussive symptoms which she reported to FMU's trainer's office. (Id. at ¶ 7-8.) The trainer, however, determined she was fine. (Id. at ¶ 8.) Nonetheless, when Edmond followed up with a neurologist a few days later, she was diagnosed with a grade three concussion which was determined to be a result of the head trauma sustained during practice on October 7th. (Id. at ¶ 9.)
Edmond ultimately sued FMU, alleging the school had been negligent in a number of ways: (a) negligent supervision of the dance team; (b) failing to provide a proper practice room; (c) failing to provide safety mats; (d) introducing a dangerous stunt to an inexperienced dance team; (e) failing to assign spotters for dancers attempting the stunts; (f) failing to implement or follow a proper concussion protocol; (g) failing to provide medical care despite the presence of concussion-like symptoms; (h) failure of the coach to report Edmond's injury; and (i) failure of the trainer to provide proper medical care when Edmond presented with concussion-like symptoms the day after the incident. (Id. at 10.)
*1346At all relevant times, FMU was insured by a liability policy issued by the Insurance Company. This policy afforded coverage for FMU's liability for "bodily injury," subject to certain limitations and exclusions. One of those exclusions was added by an endorsement, "Form CG2101," which the Court will refer to as the "Sponsorship Exclusion." Under this endorsement, coverage was excluded for: " 'bodily injury' to any person while practicing for or participating in any sports or athletic contest or exhibition ... sponsor[ed]" by the school. (Policy, ECF No. 32-2, 81.)
Another endorsement, "Form CG2271," was also added to the policy. Under this endorsement, which the Court will refer to as the "No-Supervision Exclusion," coverage for " 'bodily injury' to any person while practicing for or participating in any sports or athletic contest or exhibition" was excluded "if there is no direct management, organization or supervision of such sports or athletic contest or exhibition by any insured." (Id. at 88.)
Finally, relevant to the instant dispute, the policy also contained an endorsement titled "General Liability Deluxe Endorsement: Schools." (Id. at 92-100.) This endorsement expanded the definition of "Insured" to include coverage for liability triggered by athletic trainers while acting within the scope of their duties for FMU.
Although the Insurance Company has assigned counsel to defend FMU in the underlying state action, while reserving its rights, it now seeks a declaration that coverage is not afforded under the policy and that the Insurance Company does not, therefore, have a duty to defend or indemnify.
2. Legal Standard
Summary judgment is proper if following discovery, the pleadings, depositions, answers to interrogatories, affidavits and admissions on file show there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law. Celotex Corp. v. Catrett ,
Once a party properly makes a summary judgment motion by demonstrating the absence of a genuine issue of material fact, whether or not accompanied by affidavits, the nonmoving party must go beyond the pleadings through the use of affidavits, documents, depositions, answers to interrogatories, admissions, or other materials, and designate specific facts showing that there is a genuine issue for trial. Celotex ,
*1347Morrison v. Amway Corp. ,
3. The Policy does not afford coverage to Edmond's claims.
A. Edmond's claims are excluded by the plain language of the policy.
"The construction of insurance contracts is governed by substantive state law"-here, Florida law. Provau v. State Farm Mut. Auto. Ins. Co. ,
In Florida, in determining an insurer's duty to defend, a court must look no further than "the allegations contained within the four corners of the complaint in the underlying action against the insured." Philadelphia Indem. Ins. Co. v. Yachtman's Inn Condo Ass'n, Inc. ,
On the other hand, "[w]here the complaint against the insured alleges any facts which actually, or even potentially, fall within the scope of coverage under the policy, the insurer is obligated to defend the entire suit." Yachtman's Inn ,
Here, the Sponsorship Exclusion unambiguously bars coverage for Edmond's underlying state claims. As a starting point, FMU itself agrees that this provision, at least when considered in isolation, "may prevent coverage as Ms. Edmond sustained bodily injury while in dance practice on the premises of FMU for an upcoming dance show." (Def.'s Mot. at 10.) FMU's argument, instead, is that the Sponsorship Exclusion is rendered unenforceable by what it describes as the wholly contradictory provision set forth in the No-Supervision Exclusion. (Def.'s Reply and Opposition, ECF No. 54, 9-11.) To the contrary, however, the Court finds no *1348conflict or inconsistency between these two provisions.
Instead, the Court concludes that these two endorsements serve different functions. The first, the Sponsorship Exclusion, bars coverage for injuries suffered by participants in school-sponsored events. (Policy, ECF No. 32-2, 81 (excluding coverage for " 'bodily injury' to any person while practicing for or participating in any sports or athletic contest or exhibition ... sponsor[ed]" by the school).) In contrast, the No-Supervision Exclusion excludes coverage for injuries that arise where there was no control by the school over an athletic event taking place on its grounds. (Id. at 88 (excluding coverage for " 'bodily injury' to any person while practicing for or participating in any sports or athletic contest or exhibition if there is no direct management, organization or supervision of such sports or athletic contest or exhibition by any insured").) In order for the Insurance Company to exclude coverage for injuries suffered by participants in official, school-sanctioned events as well as in unofficial or more casual games or contests, not sponsored or organized by the school (for example, a pick-up basketball game on school property or an event wholly organized and run by an outside vendor), both endorsements are necessary. Despite FMU's protestations, the Court finds these two provisions do not create any ambiguities in the policy as a whole. Just because coverage would not be barred under the No-Supervision Exclusion (because the assistant coach was clearly supervising Edmond's practice), it does not follow that coverage cannot be otherwise barred by virtue of the Sponsorship Exclusion.
Further, contrary to FMU's argument, nor does the Deluxe Endorsement-which FMU says expands coverage for an athletic trainer acting within the scope of his or her duties in response to a medical incident (Def.'s Mot. at 14)-support coverage in the face of the Sponsorship Exclusion. The Sponsorship Exclusion applies broadly, excluding coverage for injuries suffered during sponsored events; the Deluxe Endorsement merely expands the definition of an insured. This expanded definition, however, is inapplicable where coverage is barred by reason of the overarching exclusion. See Underwriters Safety & Claims, Inc. v. Travelers Prop. Cas. Co. of Am. ,
B. Edmond's claims for FMU's negligence following her fall are inseparable from her initial injuries.
FMU, in its response to the Insurance Company's motion for summary judgment, argues that, even if there is no coverage for the negligence alleged on the day of Edmond's fall, coverage lies for FMU's negligence in relation to its failure to address Edmond's concussion the next day. Those allegations relate to FMU's failure to follow a proper concussion protocol and failing to provide medical care the following day despite Edmond's concussion-like symptoms. According to FMU, the alleged post-incident negligence claims are (1) covered under the policy's Deluxe Endorsement and (2) are not barred from coverage by the Sponsorship Exclusion. The Court is not persuaded that FMU is right.
To begin with, FMU has not cited any legal authority to support its position. Next, the Court agrees with the Insurance Company that Edmond's claims relating to FMU's negligence in dealing with her concussion *1349the following day "are not separate and distinct claims." (Pl.'s Reply, ECF No. 56, 7.) Instead, the damages associated with these claims arise from the same bodily injuries Edmond sustained during the practice session with her coach and dance team the day before. See Nat'l Fire & Marine Ins. Co. v. Adoreable Promotions, Inc. ,
4. Conclusion
The parties here have filed cross motions for summary judgment. A party claiming coverage "generally bears the burden of proof to establish that coverage exists." St. Paul Fire & Marine Ins. Co. v. Sea Quest Int'l, Inc. ,
The Clerk shall close this case. Any other pending motions are denied as moot. The calendar call set for June 5, 2018 and the trial set for the trial period beginning June 11, 2018 are hereby canceled .
Done and ordered , at Miami, Florida, on April 6, 2018.
Reference
- Full Case Name
- PHILADELPHIA INDEMNITY INSURANCE COMPANY v. FLORIDA MEMORIAL UNIVERSITY and Aaliyah Edmond
- Cited By
- 3 cases
- Status
- Published