Bechen v. AMERICAN GUAR. AND LIABILITY INS. CO.

298 F. Supp. 2d 806
CourtDistrict Court, W.D. Wisconsin
DecidedMay 5, 2003
Docket02-C-562-C
StatusPublished

This text of 298 F. Supp. 2d 806 (Bechen v. AMERICAN GUAR. AND LIABILITY INS. CO.) is published on Counsel Stack Legal Research, covering District Court, W.D. Wisconsin primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bechen v. AMERICAN GUAR. AND LIABILITY INS. CO., 298 F. Supp. 2d 806 (W.D. Wis. 2003).

Opinion

298 F.Supp.2d 806 (2003)

James L. BECHEN, Plaintiff,
v.
AMERICAN GUARANTY AND LIABILITY INSURANCE COMPANY, Aetna Life Insurance Company, Aetna U.S. Healthcare, and Zurich American Insurance Company, Defendants.

No. 02-C-562-C.

United States District Court, W.D. Wisconsin.

May 5, 2003.

Jay A. Urban, Milwaukee, WI, for Plaintiff.

*807 Thomas R. Schrimpf, Hinshaw & Culbertson, Milwaukee, WI, for Defendants.

OPINION AND ORDER

CRABB, District Judge.

This is an insurance coverage dispute arising from injuries sustained by plaintiff James Bechen while on a bear hunting expedition in Idaho in June 2001. Plaintiff filed this lawsuit in state court to recover damages for injuries he sustained while he was a passenger on a motorcycle that crashed, killing the driver. One of the named defendants in that suit was Aetna Life Insurance Company, which removed this case from state court on the ground that plaintiff's claims against it for payment of his medical expenses fell within the scope of the exclusive civil enforcement provisions of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. § 1132(a)(1)(B). Also, defendant Aetna filed a cross claim against American Guaranty and Liability Insurance Company, which it thought had issued a policy of worker's compensation insurance to plaintiff's employer. (The parties learned subsequently that the policy was issued by Zurich American Insurance Company, which is part of the same group of insurance companies as American Guaranty.) In its cross claim, Aetna alleges that American Guaranty, a/k/a Zurich, has commenced an action in the Circuit Court for Milwaukee County seeking reimbursement from Aetna for amounts Zurich has paid out under its worker's compensation policy for plaintiff's medical expenses. Aetna seeks a declaration from this court that its plan does not provide coverage for plaintiff's injuries and therefore, Zurich is not entitled to reimbursement from Aetna for payment of plaintiff's medical expenses.

Pursuant to a stipulation by the parties, this court agreed to remand most of this case to state court, retaining only the issue of determining whether Aetna is responsible for the payment of plaintiff's medical expenses. Now Aetna has moved for summary judgment, contending that plaintiff was entertaining customers for his employer's benefit at the time of the accident, making his injuries compensable under Wisconsin's worker's compensation law and excluded from coverage under Aetna's policy. Zurich denies that plaintiff's injuries are covered by worker's compensation. It contends that plaintiff's activities during the trip, particularly on the date of the accident, amounted to a personal frolic unrelated to his employment.

I conclude that the undisputed facts establish that plaintiff was entertaining customers at the time of the accident. Therefore, Aetna is not responsible for payment of plaintiff's medical expenses, including those that Zurich may have paid.

One other matter remains. In March 2003, plaintiff filed a motion for injunctive relief, seeking an order directing either defendants Aetna and Zurich or both to pay his Montana hospital bill while this case is pending. That motion will be denied. Aetna has no liability to plaintiff; Zurich has no liability in the absence of a worker's compensation claim.

For the purposes of deciding Aetna's motion for summary judgment, I find from the parties' proposed findings of fact and the record that there is no genuine dispute with respect to the following facts.

FACTS

Plaintiff James L. Bechen is an adult resident of Wisconsin. At all times relevant to this action, plaintiff was employed as a branch manager by Glendale Plumbing Supply. Builders Plumbing and Heating Supply Company was Glendale Plumbing's parent company. Defendant Aetna Life Insurance Company underwrote a *808 health benefit plan sponsored by Builders Plumbing and Heating Supply pursuant to ERISA. Defendant Zurich American Life Insurance Company issued a policy of worker's compensation insurance to Builders Plumbing and Heating Supply Company.

As branch manager, plaintiff oversaw complete branch operations, from purchasing to payables. He was responsible for daily billings, dealing with manufacturers and their representatives, and handling discrepancies in billing. He was expected to entertain existing and potential clients as a means of developing business and he often did so.

Plaintiff has taken clients golfing, fishing, hunting and on tours of plants around the country. He organized his own trips and decided which of his customers he would invite to accompany him. When making that decision, plaintiff considered the volume of the customer's purchases from Glendale Plumbing, whether there was additional business that might be derived from a customer and Glendale Plumbing's interest in maintaining its relationship with that customer. In addition, he considered whether the customer might have a personal interest in the activity he had planned. After a trip, plaintiff's employer would reimburse him for his expenses. Plaintiff's employer did not require him to obtain permission from the home office before taking customers on a trip unless it involved large expenditures.

In June 2001, plaintiff organized a trip to Idaho for bear hunting and fishing. Plaintiff had taken the same trip with customers the year before and wanted to book with the same outfitter. The outfitter required at least four people per party. Plaintiff invited Don Breunig, Raymond Hughes, Jr., Breunig's son Terry and Terry's friend. Hughes was the owner of Hughes Plumbing and Breunig was the manager of Prairie Plumbing and Heating. Breunig and Hughes were good customers of Glendale Plumbing. Neither Terry Breuning nor Terry's friend was employed by Prairie Plumbing or was a customer of Glendale Plumbing.

Plaintiff and Hughes met through their respective businesses in 1988 and had developed a social relationship in addition to their business relationship. They both enjoyed golfing, hunting and fishing and often participated together in recreational and social activities away from the business setting. On these occasions, each would pay his own way. Plaintiff had also participated in a few social events with Breunig, although their relationship was more business than social.

The group traveled to Idaho in plaintiff's personal motor home. Plaintiff did not take any deduction for his motor home as a business expense or claim a deduction for "wear and tear" from the trip. Each individual was responsible for his own outfitting fees in the amount of approximately $1,400 per person, which covered accommodations, food, gear and transportation to and from the hunting areas. Plaintiff furnished food, drink and gas for the trip to Idaho and back, although the others contributed food and chipped in for gas. Plaintiff also paid for the cost of a one-night campground stay en route to Idaho. Plaintiff did not get prior approval from the home office for the trip and is not sure whether his employer knew about the trip in advance. Plaintiff intended to submit his receipts to his employer for reimbursement upon his return.

During the trip, plaintiff discussed a number of business topics that he thought would help Breunig's and Hughes's companies. These conversations were general business-related conversations typical of those he had with Breunig and Hughes on *809 a regular basis, both in and out of the office.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Continental Casualty Co. v. Industrial Commission
132 N.W.2d 584 (Wisconsin Supreme Court, 1965)
Village of Butler v. Industrial Commission
61 N.W.2d 490 (Wisconsin Supreme Court, 1953)
Ide v. Labor & Industry Review Commission
589 N.W.2d 363 (Wisconsin Supreme Court, 1999)
Weiss v. City of Milwaukee
559 N.W.2d 588 (Wisconsin Supreme Court, 1997)
Linderman v. Cownie Furs
13 N.W.2d 677 (Supreme Court of Iowa, 1944)
Ohlsen v. J. G. Dill Co.
23 N.W.2d 15 (Supreme Court of Minnesota, 1946)
Bechen v. American Guaranty & Liability Insurance
298 F. Supp. 2d 806 (W.D. Wisconsin, 2003)

Cite This Page — Counsel Stack

Bluebook (online)
298 F. Supp. 2d 806, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bechen-v-american-guar-and-liability-ins-co-wiwd-2003.