Gemini Insurance Company v. Indemnity Insurance Company of North America
S.D. Tex.1/9/2023
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UNITED STATES DISTRICT COURT January 09, 2023 SOUTHERN DISTRICT OF TEXAS Nathan Ochsner, Clerk HOUSTON DIVISION GEMINI INSURANCE COMPANY, § § Plaintiff. § § V. § CIVIL ACTION NO. 4:20-cv-03889 § INDEMNITY INSURANCE § COMPANY OF NORTH AMERICA, § § Defendant. § OPINION AND ORDER Pending before me are two fully briefed, dueling motions for summary judgment. Plaintiff Gemini Insurance Company (âGeminiâ) has filed a Motion for Partial Summary Judgment (see Dkt. 34), to which Defendant Indemnity Insurance Company of North America (âIINAâ) has responded (see Dkt. 52), and Gemini has replied (see Dkt. 54). IINA has filed a Motion for Summary Judgment (see Dkt. 37), to which Gemini has responded (see Dkt. 49), and IINA has replied (see Dkt. 55). In support of these motions, the parties have filed a number of appendices and supplements. Having reviewed the briefing, the record, and the applicable law, Geminiâs Motion for Partial Summary Judgment (see Dkt. 34) is DENIED, and IINAâs Motion for Summary Judgment (see Dkt. 37) is GRANTED. BACKGROUND This case concerns the tragic death of Yesenia Espinoza (âEspinozaâ). Espinoza died in a December 2017 workplace accident at a hydrocarbon processing facility being built by ExxonMobil Oil Corporation (âExxonâ) in Beaumont, Texas. To build the facility, Exxon hired numerous contractors, including Bechtel Oil, Gas and Chemicals, Inc. (âBechtelâ). Bechtel, in turn, hired subcontractors, one of which was Echo Maintenance, LLC (âEchoâ). Espinoza was employed by Echo at the time of her death. Espinozaâs surviving family members filed suit against Bechtel and Echo in state court in Jefferson County, Texas (âthe Underlying Litigationâ). IINA defended Echo in the Underlying Litigation pursuant to a workersâ compensation and employerâs liability (âWC/ELâ) policy that IINA issued to Echo. IINA issued a similar WC/EL policy to Bechtel (âBechtelâs Policyâ), but IINA declined to defend Bechtel in the Underlying Litigation on the grounds that Bechtelâs Policy applied only to Bechtelâs employees and Espinoza was not a Bechtel employee. Instead, Gemini defended Bechtel in the Underlying Litigation as a potential additional insured pursuant to a commercial general liability policy that Gemini issued to Echo. Gemini ultimately settled the claims brought against Bechtel. In November 2020, Gemini brought this lawsuit against IINA, alleging that IINA breached its contractual obligations under Bechtelâs Policy. Gemini seeks to recover the attorneyâs fees and expenses it incurred in defending the Underlying Litigation, as well as the settlement payment made on behalf of Bechtel to resolve the Underlying Litigation. Gemini also seeks declaratory relief along the same lines. Gemini now seeks partial summary judgment establishing that IINA was required to defend and indemnify Bechtel in the Underlying Litigation pursuant to the terms of Bechtelâs Policy, and that Gemini is entitled to reimbursement. In turn, IINA seeks summary judgment that Bechtelâs Policy does not cover the claims asserted against Bechtel in the Underlying Litigation and that Gemini take nothing. SUMMARY JUDGMENT STANDARD Summary judgment is appropriate âif the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.â FED. R. CIV. P. 56(a). A genuine issue of material fact exists if a reasonable jury could enter a verdict for the non-moving party. See Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 252 (1986). Evidence is viewed âin the light most favorable to the non-moving party, and the movant has the burden of showing this court that summary judgment is appropriate.â QBE Ins. Corp. v. Brown & Mitchell, Inc., 591 F.3d 439, 442 (5th Cir. 2009) (citations omitted). ANALYSIS A. CHOICE OF LAW State law governs substantive matters in this diversity action. See Erie R.R. v. Tompkins, 304 U.S. 64, 78 (1938). Texas is the forum state, so I apply the choice of law rules of Texas. See Klaxon Co. v. Stentor Elec. Mfg. Co., 313 U.S. 487, 496 (1941). âExcept when a contract with a valid choice of law clause applies, Texas courts apply the substantive law of the state with the most significant relationship to the particular dispute at issue.â Scottsdale Ins. Co. v. Nat'l Emergency Servs., Inc., 175 S.W.3d 284, 291 (Tex. App.âHouston [ist Dist.] 2004, pet. denied) (citing Duncan v. Cessna Aircraft Co., 665 S.W.2d 414, 421 (Tex. 1984); RESTATEMENT (SECOND) OF CONFLICT OF LAWS (âRestatementâ) §§ 6, 188 (1971)). Bechtelâs Policy does not contain a choice of law clause and the parties have not addressed choice of law, yet they have briefed only Texas law. The Restatement provides that the validity of insurance contracts like the one at issue here is âdetermined by the local law of the state which the parties understood was to be the principal location of the insured risk during the term of the policy.â RESTATEMENT (SECOND) OF CONFLICT OF LAWS § 193 (1971). Bechtelâs Policy was issued to Bechtel at its Texas address to provide workersâ compensation insurance pursuant to Texas law for Bechtel workplaces in Texas. See Dkt. 38-8 at 6, 11. Accordingly, I find that Texas law governs this dispute. B. PRINCIPLES OF INSURANCE LAW âTo determine whether the insurer has an obligation to defend a lawsuit, Texas courts apply the âeight cornersâ rule.â Natl Cas. Co. v. W. World Ins. Co., 669 F.3d 608, 612 (5th Cir. 2012). Under the eight corners rule, âthe scope of an insurerâs duty to defend against a lawsuit is determined exclusively by the allegations in the pleadings and the language of the insurance policy.â Id. â[T]he duty to defend does not turn on the truth or falsity of the plaintiffs allegations.â GuideOne Elite Ins. Co. v. Fielder Rd. Baptist Church, 197 S.W.3d 305, 311 (Tex. 2006). â[I]n case of doubt as to whether or not the allegations of a complaint against the insured state a cause of action within the coverage of a liability policy sufficient to compel the insurer to defend the action, such doubt will be resolved in insuredâs favor.â Natl Union Fire Ins. Co. of Pittsburgh, Pa. v. Merchants Fast Motor Lines, Inc., 939 S.W.2d 139, 141 (Tex. 1997). The court must focus only on the pleadingâs factual allegations. See id. at 142. It is inappropriate to consider âthe legal theories asserted,â âlook outside the pleadings, or imagine factual scenarios which might trigger coverage.â Id. âTexas rules of contract interpretation control in this diversity case. Under Texas law, the same rules apply to the interpretation of insurance contracts as apply to the interpretation of other contracts.â Am. Natâl Gen. Ins. Co. v. Ryan, 274 F.3d 319, 323 (5th Cir. 2001) (citations omitted). âTerms are given their ordinary meaning unless the insurance policy shows that the words were meant in a technical or different sense.â Admiral Ins. Co. v. Ford, 607 F.3d 420, 423 (5th Cir. 2010) (cleaned up). I find the following guidance from the Fifth Circuit particularly salient: The rules in the Lone Star State for interpreting insurance policies have been around a long time. The paramount rule is that courts enforce unambiguous policies as written. We must honor plain language, reviewing policies as drafted, not revising them as desired. If an insurance contract, just like any other contract, uses unambiguous language, thatâs that. Our first task, then, is purely legal: deciding whether the Policy is ambiguous. And under Texas contract law, âambiguityâ means more than âlack of clarity.â A policy is not ambiguous merely because different partiesâor different judgesâoffer conflicting interpretations. If its wording can be given a definite meaning, then it is not ambiguous. A policy is only ambiguous if, giving effect to all provisions, its language is subject to two or more reasonable interpretations. Also, ambiguity must be evident from the policy itself; it cannot be fashioned via parol evidence. Finally, because we presume that contracting parties intended all that they enacted, we examine the entire contract in order to harmonize and give effect to all provisions so that none will be meaningless. Pan Am Equities, Inc. v. Lexington Ins. Co., 959 F.3d 671, 673â74 (5th Cir. 2020) (cleaned up). With these principles in mind, I turn to question of whether IINA had a duty to defend Bechtel in the Underlying Litigation. C. BREACH OF CONTRACT CLAIM 1. Duty to Defend I first address the breach of contract claim for failure to defend the Underlying Litigation. a. Allegations that the Injured Employee Was Employed âby Bechtelâ Are Required to Trigger the Duty to Defend Any duty IINA may have to defend Bechtel arises from Part Two of Bechtelâs Policy, which provides, in relevant part: PART TWO â EMPLOYERS LIABILITY INSURANCE A. How This Insurance Applies 3. Bodily injury by accident must occur during the This employers liability insurance applies to bodily policy period. injury by accident or bodily injury by disease. Bodily 4. Bodily injury by disease must be caused or injury includes resulting death. aggravated by the conditions of your 1. The bodily injury must arise out of and in the employment m employees last day of last course of the injured employee's employment exposure to & conenons causing or b aggravating such bodily injury by disease ye YOU, : must occur during the policy period. 2. The employment must be necessary or 5. If you are sued. th iainal it and an incidental to your work in a state or territory ⥠x 4 neta * viene sul a b âĄâĄ listed in Item 3.A. of the Information Page. related fegaâ actions for Camages for bodily injury by accident or by disease must be brought in the United States of America, its territories or possessions, or Canada. Dkt. 38-8 at 74. âYouâ refers to Bechtel.1 The state listed in Item 3.A. of the Information Page is Texas. See id. at 6. The policy period is January 1, 2017 to 12:01 a.m. on January 1, 2018. See id. Accordingly, Part Two provides employers liability insurance for bodily injury arising out of and in the course of an injured employeeâs employment by Bechtel during the year 2017, provided that the employment is necessary or incidental to Bechtelâs work in Texas. Bechtelâs Policy also provides Voluntary Compensation Insurance through an endorsement (the âVCEL Endorsementâ) that states, in relevant part: 1 Bechtelâs Policy states that âYou are insured if you are an employer named in Item 1 of the Information Page.â Dkt. 38-8 at 73. Item 1 of the Information Page lists the named insured as Bechtel. See id. at 6. VOLUNTARY COMPENSATION AND EMPLOYERS LIABILITY COVERAGE ENDORSEMENT This endorsement adds Voluntary Compensation Insurance to the policy. A. How This Insurance Applies This insurance applies to bodily injury by accident or bodily injury by disease. Bodily injury includes resulting death. 1. The bodily injury must be sustained by an employee included in the group of employees described in the Schedule. 2, The bodily injury must arise out of and in the course of employment necessary or incidental to work in a state listed in the Schedule. 3. The bodily injury must occur in the United States of America, its territories or possessions or Canada and may occur elsewhere if the employee is a United States or Canadian citizen temporarily away from those places. 4. Bodily injury by accident must occur during the policy period. F. Employers Liability Insurance Part Two (Employers Liabiity Insurance) applies to bodily injury covered by this endorsement as though the State of Employment shown in the Schedule were shown in Item 3.A. of the Information Page. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated, Schedule Employee EMPLOYEES OF A CONTRACTOR WITH WHOM THE NAMED INSURED HAS EXECUTED A WRITTEN CONTRACT TO PROVIDE WORKERS COMPENSATION INSURANCE IN CONNECTION WITH THE DESIGNATED PREMISES. Dkt. 38-8 at 13-14. Gemini argues that the VCEL Endorsement extends employers liability coverage to any injured âemployees of Bechtelâs contractors with whom Bechtel had a written contract to provide workers compensation insuranceâ (i.e., a âscheduled employeeâ). Dkt. 34 at 10. This argument hinges on Paragraph F of the VCEL Endorsement. Gemini contends that âParagraph F... expressly stat[es] that Part Two âappliesâ to bodily injury covered by the endorsementâ and that the âterm âappliesâ in Paragraph F is unambiguous.â Dkt. 54 at 3-4. ITNA counters that âthe VCEL Endorsementâs employerâs liability provision references and incorporates the terms and conditions of Part Two of the IINA Policy, and Part Two conditions coverage on injuries to employees in the course of employment by Bechtel.â Dkt. 52 at 11. Accordingly, IINA contends that âemployerâs liability coverage in any circumstance requires the axiomatic employment relationship, and a defense would require an allegation of that relationship.â Id. at 12. Thus, the real question is whether an employment relationship between a scheduled employee and Bechtel must be alleged to trigger Part Twoâs coverage. Without explicitly saying so, Geminiâs position seems to be that the VCEL Endorsement nullifies Part Twoâs requirement that the bodily injury âarise out of and in the course of the injured employeeâs employment by [Bechtel].â Dkt. 38-8 at 74. See Dkt. 34 at 12-14 (arguing that Espinozaâs injury is covered by the VCEL Endorsement without addressing whether Espinoza had an employment relationship with Bechtel); Dkt. 49 at 12 (âIINA owed Bechtel a duty to defend the Leatherwood Lawsuit, regardless of whether or not the pleadings specifically alleged that Bechtel was [Espinoza]âs direct employer or had the right to control her job duties.â); Dkt. 54 at 5 (âUnder IINAâs definition, [Espinoza] was Bechtelâs ââemployee.â...It is irrelevant whether or not she was directly employed by Bechtel.â). Accordingly, I understand Geminiâs position to be this: it is either unnecessary that Espinoza be employed âby [Bechtel],â Dkt. 38-8 at 74, or Espinozaâs employment relationship with Bechtel is automatically inferred because Espinoza is a scheduled employee.? It seems to be Geminiâs contention that the only thing that matters is that Espinoza is an âemployeeâ as defined by the VCEL Endorsement. I find this to be an unreasonable proposition. Texas law requires me to âexamine the entire contract in order to harmonize and give effect to all provisions so that none will be meaningless.â Pan Am Equities, 959 F.3d at 674. Further, under Texas law âan endorsement cannot be read apart from the main policy, and the added provisions will only supersede the previous policy terms to the extent they are truly in conflict.â Mesa Operating Co. v. Cal. Union Ins. Co., 986 S.W.2d 749, 754 (Tex. App.âDallas 1999, pet. denied). Accordingly, I cannot read out Part Twoâs requirement of an employment relationship if that requirement can be harmonized with the VCEL Endorsement. IINA contends âthat the VCEL Endorsement provides Bechtel with voluntary compensation options if it 2 | assume, without deciding, that the allegations in the Underlying Litigation show that Espinoza is a scheduled employee as that term is defined by the VCEL Endorsement. borrows employees from referenced contractors.â Dkt. 52 at 24 n.53; see also Dkt. 55 at 11 (âA scheduled [employee] could in some circumstances find himself or herself in the course and scope of work for Bechtel.â). Gemini tellingly does not address IINAâs borrowed employee argument in its reply. IINAâs interpretation makes sense to me. In the context of borrowed employees,3 there could be circumstances in which Bechtel directs and controls the work of another contractorâs employee such that Bechtel is the actual employer of that employee, despite not being the employeeâs direct employer. If the pleadings were to allege that Bechtel directed and controlled the injured employeeâs work, such that Bechtel was the employeeâs actual employer under the borrowed employee doctrine, then the conditions of coverage under both Part Two and the VCEL Endorsement would be satisfied. Accordingly, this a reasonable interpretation of Bechtelâs Policy. Because it is the only interpretation before me that harmonizes Part Two and the VCEL Endorsement and affords each provision meaning, it is the interpretation that prevails. Reviewing Bechtelâs Policy as a whole+ reassures me that IINAâs reading is correct. Throughout Bechtelâs Policy, where an endorsement is meant to alter policy language, it says so explicitly. For example, the Maritime Coverage Endorsement explicitly changes Part Two using language like âA. How This Insurance Applies is replaced by the followingâ; âC. Exclusions is changed by removing... .â; and âD. We Will Defend is changed by adding... .â Dkt. 38-8 at 8. The same is true for the Texas Amendatory Endorsement. See Dkt. 38-8 at 46. In contrast, the VCEL Endorsement merely âaddsâ to the policy without expressly altering any of Part Twoâs 3âAn employee ceases to be an employee of his general employer if he becomes the âborrowed employeeâ of another. One who would otherwise be in the general employment of one employer is a borrowed employee of another employer if such other employer or his agents have the right to direct and control the details of the particular work inquired about.â St. Joseph Hosp. v. Wolff, 94 S.W.3d 513, 537 (Tex. 2002) (quoting Comm. on Pattern Jury Charges, State Bar of Tex., TEX. PATTERN JURY CHARGESâ MALPRACTICE, PREMISES & PRODS. PJC 52.2 (1997)). 4 Gemini attached only 11 pages of the full 95-page policy in support of its Partial Motion for Summary Judgment. See Dkt. 35-1. Bechtelâs Policy is available in full as Exhibit H to âĄâĄâĄâĄâĄâĄ Motion for Summary Judgment. See Dkt. 38-8. requirements for triggering coverage. Id. at 13. Thus, I find as a matter of law that Bechtelâs Policy unambiguously requires an allegation that a scheduled employee was employed âby Bechtelâ to trigger IINAâs duty to defend.5 b. There Are No Allegations that Espinoza Was Employed âby Bechtelâ Having established that Espinozaâs employment by Bechtel must be alleged to trigger IINAâs duty to defend, I next look to see whether there are any allegations in the Underlying Litigation that would suggest such an employment relationship. The most Gemini points to are allegations âthat Bechtel exercised and retained control over the worksite and the pipefitting work being performed by Ms. Espinozaâ; âthat Ms. Espinoza was doing work for Bechtelâ; and âthat Bechtel was liable for breaching a number of specific duties which are commonly associated with an employment relationship.â Dkt. 34 at 10 (citing Dkt. 35-7 at 2-4 (Plaintiffs First Amended PetitionÂź); Dkt. 35-8 at 3â5 (Original Petition in Intervention7)). âThe duty to defend is determined by consulting the latest amended pleading.â Northfield Ins. Co. v. Loving Home Care, Inc., 363 F.3d 523, 528 (5th Cir. 2004). If the latest pleadings actually alleged âthat Bechtel exercised . . . control over the . . . pipefitting work being performed by Ms. Espinoza,â Dkt. 34 at 10, I might consider it a close call. However, a review of the pleadings in the Underlying Litigation reveals no such language. What the pleadings actually allege is that Bechtel âexercised and/or retained control over the worksite and the activities ongoing at the time of the fatal incident.â Dkt. 35-8 at 3; see also Dkt. 35-7 at 3 (alleging that Bechtel was âin control of the operations and construction of the SCANfining unitâ). These are merely allegations that Bechtel controlled Espinozaâs work environment, not allegations that Bechtel was functioning as Espinozaâs employer. Because there are no allegations that Bechtel directed the details of Espinozaâs work, I cannot find that an employment 5 Because I find Bechtelâs Policy to be unambiguous, I do not reach Geminiâs arguments regarding ambiguity or consider parol evidence. 6 Plaintiffs First Amended Petition was filed by Zachery Leatherwood, Espinozaâs husband, on behalf of himself and their two minor children. 7 The Petition in Intervention was filed by Espinozaâs parents. relationship was alleged. See BJB Constr., LLC v. Atl. Cas. Ins. Co., No. H-07-0157, 2008 WL 1836690, at *6 (S.D. Tex. Apr. 23, 2008) (âThe court is not allowed to read anything into the underlying pleading or imagine factual scenarios, even in its search for potential coverage. Although [allegations regarding control of the workplace environment] may be considered related to employment in some situations, they also could be relevant to liability based on the condition of the work premises. The former is simply too big of a leap in a vacuum of employment language, especially when the latter is just as likely.â), aff'd, 338 F. Appâx 382 (5th Cir. 2009). This is especially true given that the pleadings contain explicit allegations that Espinoza was employed by Echo. See Dkt. 35-7 at 3 (alleging that Espinoza was âan employee of Defendant ECHOâ); Dkt. 35-8 at 3 (âDeceased Plaintiff was employed by ECHO MAINTENANCEâ). Because I find that there is no allegation that Espinoza was employed by Bechtel, I must also find that IINA had no duty to defend Bechtel in the Underlying Litigation.Âź 2. Duty to Indemnify I next turn to Geminiâs duty to indemnify claim. âAn insurer must defend its insured if a plaintiffs factual allegations potentially support a covered claim, while the facts actually established in the underlying suit determine whether the insurer must indemnify its insured.â Zurich Am. Ins. Co. v. Nokia, Inc., 268 S.W.3d 487, 490 (Tex. 2008). Gemini advances two arguments in support of its indemnity claim. First, Gemini argues that Espinozaâs injury is covered by the VCEL Endorsement because Espinoza falls within the Scheduleâs definition of âEmployee.â See Dkt. 34 at 12-14. This argument assumes that it is unnecessary that Espinoza was not employed by 8 Because the absence of an allegation in the Underlying Litigation that Espinoza was employed by Bechtel is an independent and sufficient basis for finding that IINA did not have a duty to defend, I do not reach the partiesâ dispute about whether I can infer a written contract between Echo and Bechtel, a requirement to trigger coverage under the VCEL Endorsement. See Dkt. 34 at 11 (âThe pleadings do not expressly state that a written contract was in place between Echo and Bechtel, but this can be reasonably inferred.â); Dkt. 52 at 12â 13 (âGemini is incorrect in its suggestion that the eight corners rule requires that coverage should be inferred contrary to explicitly pleaded facts.â). 10 Bechtel. For the reasons discussed above in Section C, IINA has no duty under Part Two unless the scheduled employee was employed âby [Bechtel].â Dkt. 38-8 at 74. Gemini does not contend that Bechtel was Espinozaâs actual employer. Thus, Geminiâs first argument fails. Gemini next argues that Espinozaâs injury is covered by Part Two because Bechtel is Espinozaâs statutory employer under the Texas Workersâ Compensation Act (âTWCAâ). See Dkt. 34 at 14â17. There is no dispute that Bechtel was Espinozaâs statutory employer under the TWCA. Rather, IINA argues that the statutory employer relationship is a âlegal fictionâ that Texas statutory and case law has clearly limited âonly for purposes of the workersâ compensation laws of this state.â Maxim Crane Works, L.P. v. Zurich Am. Ins. Co., 642 S.W.3d 551, 559 (Tex. 2022) (quoting TEX. LAB. CODE § 406.123(e)). Gemini does not address Maxim in its reply brief and, wisely, appears to have abandoned this argument in its reply. See Dkt. 54 at 5 (âIt is also irrelevant, in this case, whether statutory employment renders someone an âemployeeâ under a standard workerâs compensation and employerâs liability insurance policy.â). Nevertheless, I note that IINA is correct. I cannot use Bechtelâs statutory employment relationship under the TWCA as a substitute for the actual employment relationship required by Part Two. Because Bechtel was not Espinozaâs actual employer, IINA has no duty to indemnify. 3. Subrogation Last but not least, I discuss the subrogation issue. I need not decide whether Gemini is contractually or equitably subrogated to Bechtelâs rights. Even if it were, Bechtel had no right to defense or indemnity from IINA. Accordingly, Bechtel, and thus Gemini, should take nothing from IINA. D. DECLARATORY JUDGMENT CLAIM Gemini also asserts a declaratory judgment claim that mirrors its breach of contract claim. Notably, the Federal Declaratory Judgment Act âdoes not create any substantive rights or causes of action.â Sid Richardson Carbon & Gasoline Co. v. Interenergy Res., Ltd., 99 F.3d 746, 752 n.3 (5th Cir. 1996). Accordingly, if Gemini cannot proceed on the breach of contract cause of action, the declaratory judgment cause of action also fails. See Williams v. Wells Fargo Bank, N.A., 560 F. Appâx 233, 243 (5th Cir. 2014) (finding that because âdeclaratory judgment is remedial in natureâ a determination that the underlying causes of action were properly dismissed âlikewise warrants affirmance of the courtâs dismissal of [a] request for declaratory judgmentâ). CONCLUSION Geminiâs Motion for Partial Summary Judgment (see Dkt. 34) is DENIED, and IINAâs Motion for Summary Judgment (see Dkt. 37) is GRANTED. I will issue a separate final judgment. SIGNED this 9th day of January 2023. ______________________________ ANDREW M. EDISON UNITED STATES MAGISTRATE JUDGE
Case Information
- Court
- S.D. Tex.
- Decision Date
- January 9, 2023
- Status
- Precedential