Sentry Select Ins. Co. v. Ruiz
Sentry Select Ins. Co. v. Ruiz
Opinion of the Court
This case presents disputes over insurance coverage. Plaintiff Sentry Select Insurance Company ("Sentry") filed this declaratory judgment action against Defendants Rudolph Automotive, LLC d/b/a Rudolph Mazda ("Rudolph Mazda"), Rudolph Chevrolet, LLC ("Rudolph Chevrolet") (collectively, the "Rudolph Entities"), Christian Ulises Ruiz ("Ruiz"), Marcelo Flores ("Flores"), and Lynn Crawford ("Crawford") (collectively, "Defendants"). Sentry seeks declarations that under a policy it issued to the Rudolph Entities, it has no duty to defend or indemnify Defendants in connection with a lawsuit entitled Andrea Juarez, individually and as Permanent Guardian of Irma Vanessa Villegas, an incapacitated person v. Christian Ulises Ruiz, et. al. , Cause No. 2015-DCV-0473, in the 384th Judicial District Court, El Paso County, Texas (hereinafter, the "Underlying Lawsuit"). The Underlying Lawsuit arose from an auto accident that occurred on the premises of Rudolph Mazda (a car dealership); Ruiz, an employee of Rudolph Mazda, hit Irma Vanessa Villegas ("Villegas"), a co-worker, with his vehicle. At the parties' request to try this case on written submission, the Court now enters its findings of fact and conclusions of law pursuant to Federal Rule of Civil Procedure 52(a)(1).
I. PROCEDURAL HISTORY
*878In August 2016, Sentry filed its Complaint (ECF No. 1) in this declaratory judgment action. Therein, it claims that it has no duty to defend or indemnify Defendants in the Underlying Lawsuit. Defendants filed an answer in November 2016. Moreover, Ruiz and the Rudolph Entities filed a counter-claim seeking declaratory judgment that Sentry has a duty to provide coverage, defend, and indemnify Defendants. Defs.' Original Answer at 11-12, ECF No. 12.
In July 2017, Sentry moved for summary judgment against Defendants. Pl.'s Mot. for Summ. J., ECF No. 25. On November 16, 2017, Sentry filed a motion for leave to supplement its motion for summary judgment, and on November 22, the parties filed a "Joint Motion to Try Case on Submission" (ECF No. 41), whereby they requested that the Court adjudicate their disputes based on stipulated facts and evidence. The Court denied Sentry's summary judgement and leave motions, but granted the parties' joint motion to try the case on submission. Order, ECF No. 43.
On January 10, 2018, Sentry filed its opening "Trial Brief" (ECF No. 44) (hereinafter "Plaintiff's Trial Brief"), and on January 11, Defendants filed their opening "Trial Brief" (ECF No. 45) (hereinafter "Defendants' Trial Brief"). The parties filed their responsive and reply briefs by February 1. Resp. to Pl.'s Tr. Br., ECF No. 46; Reply to Pl.'s Tr. Br., 48; Resp. to Defs.' Tr. Br., ECF No. 47; Reply to Defs.' Tr. Br., ECF No. 49.
II. FINDINGS OF FACTS
A. The Policy
Sentry issued Policy No. 24-48715-07, the insurance policy at issue ("Policy"), which was in effect on the date of the auto accident. Joint Stipulations at 3. Rudolph Mazda and Rudolph Chevrolet are named insureds. Policy Excerpt at 2, ECF No. 40-1;
The Policy provides coverage for, inter alia , commercial property coverage, commercial garage liability coverage, and commercial excess/umbrella liability coverage. Id. at 2, 14, 172, ECF No. 40-1; Finn Aff. at 2, ECF No. 26-1. Only the parts of the Policy regarding the garage liability coverage and excess/umbrella liability coverage are at issue in this lawsuit. Joint Stipulations at 3.
1. Commercial Garage Liability Coverage
Under the commercial garage liability coverage part of the Policy, Sentry assumed, subject to any applicable limitation and exclusion, the duty to "pay all sums an 'insured' legally must pay as damages ... because of 'bodily injury' ... to which this insurance applies, caused by an 'accident' and resulting from 'garage operations' involving the ownership, maintenance or use of" any auto. Policy Excerpt at 46, 50. "Garage operations" mean "the ownership, maintenance or use of locations for garage business" and "include all operations necessary or incidental to a garage business." Id. at 80.
Through a broadened coverage endorsement, Sentry further assumed, subject to any applicable limitation and exclusion, the duty to:
pay all sums the "insured" legally must pay as damages because of "bodily injury" ... arising out of the giving or serving of alcoholic beverages at func tions *879incidental to your garage business provided you are not engaged in the business of manufacturing, distributing, selling or serving of alcoholic beverages.
Id. at 127 (emphasis added). Heretofore, this broadened coverage will be referred to as the "Host Liquor Liability" coverage. Sentry assumed, subject to any applicable limitation and exclusion, the "duty to defend any 'insured' against a 'suit' asking for such damages. " Id. at 50 (emphasis added).
The garage liability coverage part of the Policy contains an exclusionary clause, under the heading "Employee Indemnification and Employers Liability," which provides in relevant part: "This insurance does not apply to ... 'Bodily injury' to[ ] [a]n 'employee' of the 'insured' arising out of and in the course of: (1) Employment by the 'insured'; or (2) Performing the duties related to the conduct of the "insured's business[.]" Id. at 53. Heretofore, this exclusion will be referred to as the "Employer's Liability" exclusion.
2. Commercial Excess/Umbrella Liability Coverage
As to the excess liability coverage, Sentry assumed, subject to any applicable limitation and exclusion, the duty to "pay on behalf of the insured the 'ultimate net loss' in excess of 'underlying insurance' because of[ ] ... "Bodily injury" ... to which this insurance applies." Id. at 177. "Ultimate net loss" is defined as "the total sum, after reduction for recoveries ..., that the insured becomes legally obligated to pay as damages by reason of settlement or judgments ...." Id. at 194. That part of the Policy provides: "When the limits of the 'underlying insurance' have been used up in the payment of judgments or settlements, [Sentry] will have the[ ] ... duty to defend the insured against any 'suit.' " Id. at 177. " 'Underlying insurance' means any policies of insurance listed in the Declarations under the schedule of 'underlying insurance.' " Id. at 198. The excess coverage does not apply to " 'Bodily injury' ... to which 'underlying insurance' does not apply for any reason other than the exhaustion of 'underlying insurance' limits of liability." Id. at 178.
As to the umbrella liability coverage, Sentry assumed, subject to any applicable limitation and exclusion, the duty to "pay on behalf of the insured the 'ultimate net loss' in excess of the Retained Limit stated in the Declarations because of 'bodily injury' ... to which this insurance applies," but only if the " '[underlying] insurance' does not apply," id. at 179; the Retained Limit as stated in the Declarations is "none," id. at 172. The umbrella liability coverage section of the Policy provides: "In the absence of 'underlying insurance', [Sentry] will have the[ ] ... duty to defend the insured against any 'suit.' " Id. at 180. That section contains an exclusion that is identical to the "Employer's Liability" exclusion in the garage liability coverage part of the Policy. Id.
B. The Underlying Lawsuit
On February 17, 2015, Villegas, through Andrea Juarez, brought the Underlying Lawsuit by filing her original petition, which named Ruiz as the sole defendant. State Ct. Pleadings at 1, ECF No. 40-4. Subsequently, Villegas filed multiple supplemental pleadings and joined Flores, Crawford, and the Rudolph Entities as defendants. Id. at 42.
According to these pleadings, at the relevant time, Flores and Crawford were managers of Rudolph Mazda. See id. at 44 (" ... Defendant RUDOLPH MAZDA managers (MARCELO FLORES and LYNN CRAWFORD ... ") ); see also id. 48 (describing Flores and Crawford as "managers and vice principals of ... Rudolph Mazda"). The pleadings refer to Villegas and Ruiz as the Rudolph Entities'
*880sales people, id. at 44 ("Defendants RUDOLPH had its [sic ] sales people including Defendant RUIZ and IRMA VANESSA VILLEGAS ...").
The allegations in the Underlying Lawsuit were in part as follows: To further their business, the Rudolph Entities had their sales people, including Ruiz and Villegas, begin work at 9:00 am, provided lunch on their premises to keep them on premises and sell its inventory, and had a policy that the sales people would stay as long as needed, sometimes until 10:00 pm. Id. at 44. On December 27, 2013, Flores sent Ruiz to a store during working hours to buy beer. Id. The beer was placed in the Rudolph Entities' refrigerator for consumption on their premises by sales people that night. Id. After Ruiz had consumed alcohol on Rudolph Mazda's premises with Flores and Crawford, he struck Villegas with his vehicle in the front sales/service area of Rudolph Mazda's premises at 1301 N. Lee Trevino Dr., El Paso, Texas; at the time, Villegas was a pedestrian crossing Rudolph Mazda's parking lot. Id. at 2, 44. As a result of this collision, she sustained injuries to her head, neck, and other parts of her body. Id. at 44.
In the Underlying Lawsuit, which is currently pending, see e.g. , Pl.'s Tr. Br. at 4, Villegas asserted several causes of action; among them were: negligence against Ruiz, negligence against Flores and Crawford, and vicarious liability against the Rudolph Entities. Id. at 45-48. She claimed that Ruiz owed a degree of reasonable care on operation of a motor vehicle to Villegas and that the collision and Villegas's damages were proximately caused by Ruiz's negligence. Id. at 45. She averred that Flores and Crawford, Rudolph Mazda's managers, were individually negligent for purchasing and providing alcohol for their employees on business premises, knowing full well that the employees would have to drive a motor vehicle on the business premises as well as on the public streets. Id. at 48. She claimed that the Rudolph Entities were vicariously liable for her damages and injuries, which were caused by the negligence of Ruiz, Flores, and Crawford. Id. at 47. She also claimed that a joint venture/joint enterprise existed between Rudolph Chevrolet and Rudolph Mazda, and therefore they were jointly and severally liable for the damages sustained by her. Id. at 45-46. She sought monetary relief over one million dollars and all other relief to which she is entitled. Id. at 3, 50.
In October 2014, Sentry sent a reservation of right letter to the Rudolph Entities, after receiving notice of claim. See Letter from Renee Schude of Sentry to Soraya Hanshew, counsel for the Rudolph Entities, ECF No. 40-2. Therein, it took the position that there would be no coverage under the Policy if Villegas was in the course and scope of her employment at the time of the accident. Id. at 4-5.
III. CONCLUSIONS OF LAW
A. Applicable law
The Court is exercising its diversity jurisdiction; so, it applies Texas law to this case. See Erie R.R. Co. v. Tompkins ,
1. Duty to Defend
Under Texas law, an insurer's duty to defend is determined by application of the so-called "eight-corners rule." Nat'l Union Fire Ins. Co. of Pittsburgh v. Merchs. Fast Motor Lines, Inc. ,
In applying the rule, "the insured bears the burden of showing that the claim against it is potentially within the policy's coverage," while "the insurer bears the burden of establishing that an exclusion in the policy constitutes an avoidance of or affirmative defense to coverage." Canutillo Indep. Sch. Dist. v. Nat'l Union Fire Ins. Co. ,
Moreover, the eight-corners rule "strictly circumscribes a court's analysis of the duty to defend": "a court may not read facts into the pleadings, look outside the pleadings, or speculate as to factual scenarios that might trigger coverage or create an ambiguity." Gilbane Bldg. Co. v. Admiral Ins. Co. ,
2. Duty to Indemnify
The duty to indemnify and the duty to defend are " 'distinct and separate duties." D.R. Horton-Texas, Ltd. v. Markel Intern. Ins. Co. ,
The only exception to this rule is "when the insurer has no duty to defend and the same reasons that negate the duty to defend likewise negate any possibility the insurer will ever have a duty to indemnify"
*882Farmers Tex. Cnty. Mut. Ins. Co. v. Griffin ,
3. Interpretation of Insurance Policies
Texas courts "construe insurance policies according to the same rules of construction that apply to contracts generally." Don's Bldg. Supply, Inc. v. OneBeacon Ins. Co. ,
"If policy language is worded so that it can be given a definite or certain legal meaning, it is not ambiguous," Schaefer ,
C. Discussion
As an initial matter, Sentry, in its opening brief, has argued at length why it has no duty to defend or indemnify Ruiz, Flores, or Crawford-because, as Sentry asserts, they are not insureds (for purposes of the garage liability coverage) or "Named Insured[s]" (for purposes of the excess/umbrella liability coverage). Pl.'s Tr. Br. at 10-14, 23, 25. Defendants have not responded to these arguments.
1. Summary of the Parties' Arguments
Defendants claim that, under the garage liability coverage, Sentry has a duty to defend and indemnify the Rudolph Entities based on the Host Liquor Liability coverage provision. Defs.' Tr. Br. at 4. It argues that the only exclusion that may arguably exclude coverage is the Employer's *883Liability exclusion, but the allegations in the Underlying Lawsuit show that the exclusion does not apply.
With respect to the excess liability coverage, Sentry points out an exclusion in the excess liability coverage section of the Policy, see Policy Excerpts at 177-78 ("This insurance does not apply to[ ] ... 'Bodily injury' ... to which 'underlying insurance' does not apply for any reason other than the exhaustion of 'underlying insurance' limits of liability."), and argues that because the garage liability coverage (i.e. , the underlying insurance) would not apply to the Rudolph Entities (due to the Employer's Liability exclusion), the excess liability coverage would also not apply, see Pl.'s Tr. Br. at 22-23. It claims, therefore, that under the excess liability coverage, Sentry has no duty to defend or indemnify them in the Underlying Lawsuit. See Compl. at 23-24.
With respect to the umbrella liability coverage, Sentry points out that an exclusion in that section of the Policy is identical to the Employer's Liability exclusion. Pl.'s Tr. Br. at 23. Consequently, it claims, for "the same reason set forth above," "no coverage would exist under the umbrella liability coverage" of the Policy. Pl.'s Tr. Br. at 23. Defendants dispute Sentry's claims as to the excess and umbrella liability coverage, on the basis of the same argument that the Employer's Liability exclusion does not apply. See Defs.' Tr. Br. at 18-19.
2. Whether Sentry Has a Duty to Defend the Rudolph Entities
As the parties' arguments reflect, the issues of whether the Host Liquor Liability coverage and the Employer's Liability exclusion apply are dispositive on the question of whether Sentry has a duty to defend the Rudolph Entities in the Underlying Lawsuit. The Court addresses them in turn.
(a) The Host Liquor Liability Coverage
The parties dispute only whether the December 27, 2013 beer consumption event at Rodolph Mazda's premises falls within the scope of the term "function" as used in the Host Liquor Liability coverage endorsement. Under it, coverage is broadened to include " 'bodily injury' ... arising out of the giving or serving of alcoholic beverages at functions incidental to your garage business provided you are not engaged in the business of manufacturing, distributing, selling or serving of alcoholic beverages." Policy Excerpts at 127, supra (emphasis added).
Specifically, relying on the dictionary definition of "function,"
*884for purposes of the Host Liquor Liability provision. Defs.' Tr. Br. at 17-18. Sentry responds that the Host Liquor Liability provision "only applies to company functions such as company Christmas parties, company picnics, etc." Pl.'s Tr. Br. at 21 (emphasis added). Characterizing the event as a gathering of "a few employees ... [who] stayed after work to socialize" at Rudolph Mazda's premises, Sentry contends that "no function took place." Id. at 22. In other words, "function," in Sentry's view, excludes a particular type of social gatherings, but not other.
The Policy does not define the term "function." The Court has not been cited, nor is it aware of, any Texas court decision interpreting or applying the term in the context of the Host Liquor Liability coverage. Two courts in other jurisdictions have construed it to include , "cocktail part[ies]," Heritage Ins. Co. of Am. v. Cilano ,
Sentry relies on Uptowner Inns and Hagan v. State Farm Insurance Company , CIV. A. No. 87-0452,
Sentry points to nothing in the Policy that evinces that the contracting parties intended the term "function" to exclude a particular type of social gathering, such as an after-work gathering of a few employees for beer consumption. See Nat'l Union Fire Ins. Co. of Pittsburgh, Pa. v. Hudson Energy Co. ,
Turning to the factual allegations in the Underlying Lawsuit, Villegas asserted the following. The Rudolph Entities, to further their business, provided lunch on their premises to their sales people so as to keep them on premises and sell their inventory. State Ct. Pleadings at 44. On December 27, 2013, Flores and Crawford (Rudolph Mazda's managers) provided beer for consumption that night by the Rudolph Entities' sales people on Rudolph Mazda's premises. Id. at 44, 45. This beer consumption was "authorized by" Flores and Crawford. Id. at 44. The beer was purchased by Flores and Crawford, and on that day, Flores sent Ruiz to a store during *885working hours to buy the beer. Id. The beer was kept in the Rudolph Entities' refrigerator; and Ruiz consumed the beer with Flores and Crawford on Rudolph Mazda's premises. Id.
Taking these allegations as true and reading them "liberally in favor of the insured," Willbros RPI, Inc. v. Cont'l Cas. Co. ,
(b) The Employer's Liability Exclusion
Sentry argues that even if the allegations in the Underlying Lawsuit fit within the term "function," no coverage would exist for the Rudolph Entities because of the Employer's Liability exclusion. See Pl.'s Tr. Br. at 22. That exclusion excludes from coverage " 'Bodily injury' to[ ] [a]n 'employee' of the 'insured' arising out of and in the course of [ ] ... Employment by the 'insured' ...." Policy Excerpts at 53 (emphasis added). The parties' dispute turns on whether Villegas's injury was in the course of her employment. Compare Resp. to Pl.'s Tr. Br. at 6, with Reply to Pl.s' Tr. Br. at 7-8.
Sentry relies on the "access doctrine," which "is used by courts in workers' compensation cases as a limited exception to the more general rule recognizing that compensation benefits do not extend to injuries incurred by employees going to and from work." OCI Beaumont LLC v. Barajas ,
Defendants respond that the "access doctrine" is inapplicable here. Resp. to Pl.'s Tr. Br. at 2-3. In support, it cites cases, where Texas courts have declined to apply the "access doctrine" in the vicarious-liability/common-law context.
On that issue, Nautilus Insurance Company v. Zamora ,
In view of Zamora , the Court declines to import the "access doctrine" here to interpret the Policy term "in the course of employment." See Parra v. Markel Int'l Ins. Co. , No. CV L-06-59,
The Court therefore turns to the task of construing the phrase "in the course of ... [E]mployment," which is not defined in the Policy. The dictionary meaning of "in the course of" is "during and as a part of the specified activity." New Oxford Am. Dictionary 398 (3rd ed. 2010). Turning to "the term's usage in ... prior court decisions," see Cooper Indus. ,
Second, Arrellano v. State Farm Fire and Casualty Company ,
These cases suggest, and the Court concludes, that the phrase "in the course of ... [e]mployment" as used in the Employer's Liability exclusion means "while the employee is performing work-related duties." See Sec. Indus. Ins. Co. v. Cigna Prop. & Cas. Co. , No. CIV. A. 96-2835,
Here, the parties agree that the accident and injury occurred after Villegas had ended her work on that day, as she was in the process of leaving the Rudolph Mazda's premises. See Pl.'s Tr. Br. 17-18 ("As Ms. Villegas was in the process of leaving the premises after working that day when she was struck by Mr. Ruiz's vehicle in the parking lot of the dealership ...." (emphasis added) ); Defs.' Tr. Br. at 13 ("the *887Accident occurred when Ruiz and Villegas were off duty , in the parking lot, as they were leaving Rudolph's premises." (emphasis added) ). The Court therefore finds that Villegas was not in the course of her employment when her injury occurred, and therefore, the Employer's Liability exclusion does not apply.
In sum, therefore, the Court finds that-under the garage liability coverage, excess liability coverage, and umbrella liability coverage of the Policy-Sentry has a duty to defend the Rudolph Entities in the Underlying Lawsuit.
3. Whether Sentry Has a Duty to Indemnify the Rudolph Entities
Relying on Griffin ,
IV. CONCLUSION
For the foregoing reasons, the Court hereby DECLARES that-under the parts of the policy numbered 24-48715-07 on the garage liability coverage, excess liability coverage, and umbrella liability coverage-Sentry has no duty to defend or indemnify Ruiz, Flores, and Crawford in the Underlying Lawsuit.
The Court further DECLARES that-under the parts of the policy numbered 24-48715-07 on the garage liability coverage, excess liability coverage, and umbrella liability coverage-Sentry has a duty to defend the Rudolph Entities in the Underlying Lawsuit.
Finally, the Court ORDERS that the District Clerk SHALL ADMINISTRATIVELY CLOSE the Case pending resolution of the Underlying Lawsuit. Any party may file a petition with the Court to re-open the Case upon final resolution of the lawsuit, or upon settlement.
So ORDERED and SIGNED this20th day of June 2018.
To the extent that any finding of fact is more aptly characterized as a conclusion of law, or any conclusion of law is more aptly characterized as a finding of fact, the Court adopts it as such.
The procedural history of this case has been chronicled to some extent in an earlier opinion issued by the Court. Mem. Op. & Order, Sentry Select Insurance Company v. Ruiz ,
Throughout this opinion, all citations to exhibits refer to the Electronic Case Filing (ECF) page numbers imprinted on the pages of the exhibits.
Although "[t]he Texas Supreme Court has never recognized any exception" to the rule, Gilbane Bldg. ,
Here, the parties submitted "Joint Stipulations of Facts" (ECF No. 40). However, to a large extent, their stipulations are unhelpful on the issue of duty to defend.
See Reply to Pl.'s Tr. Br. at ("Defendants do not address at all the evidence and authorities laid out by Sentry on pages 10-15 of its trial brief (Doc. No. 44) showing that no duty to defend or indemnify is owed to Ruiz, Crawford or Flores.").
Defs.' Tr. Br. at 17 ("The Merriam-Webster dictionary defines "function" as '4: an official or formal ceremony or social gathering' " (quoting Merriam-Webster Online Dictionary. 2018. https://www.merriamwebster.com/dictionary/function); see also Webster's Third New Int'l Dictionary of the English Language Unabridged 920-21 (3rd ed. 2002) (defining "function" as "an often formal public or social ceremony or gathering"); Am. Heritage Dictionary of the English Language 710 (5th ed. 2011) (defining "function" as "[a]n official ceremony or a formal social occasion"); Random House Webster's Unabridged Dictionary 775 (2nd ed. 2001) (defining "function" as "any ceremonious public or social gathering or occasion"); Am. Heritage Dictionary of the English Language 1223 (defining "official" as "[a]uthorized by a proper authority").
Under the "access doctrine," "employees injured while going to or from work, if on routes designated by their employers and at locations near where they work, may receive compensation benefits 'where such access route or area is so closely related to the employer's premises as to be fairly treated as a part of the premises.' " OCI Beaumont LLC ,
The Court declines to reach Sentry's alternate basis for finding that it has no duty to indemnify because there would be no duty owed by Rudolph Chevrolet to Villegas. Pl.'s Tr. Br. at 25.
Reference
- Full Case Name
- SENTRY SELECT INSURANCE COMPANY v. Christian Ulises RUIZ Rudolph Chevrolet, LLC Rudolph Automotive, LLC d/b/a Rudolph Mazda Marcelo Flores and Lynn Crawford, Christian Ulises Ruiz Rudolph Chevrolet, LLC Rudolph Automotive, LLC d/b/a Rudolph Mazda, Third-Party v. North American Capacity Insurance Company, Third-Party
- Status
- Published