Continental Western Insurance Co. v. Knox County EMS, Inc.

2016 IL App (1st) 143083, 2016 WL 1258490
Appellate Court of Illinois·Decided March 31, 2016·No. 1-14-3083·Unpublished·Cited by 9 cases

Opinion

2016 IL App (1st) 143083

No. 1-14-3083

Filed March 31, 2016

FIFTH DIVISION

IN THE APPELLATE COURT

OF ILLINOIS

FIRST JUDICIAL DISTRICT

CONTINENTAL WESTERN INSURANCE COMPANY, INC., ) Appeal from the ) Circuit Court

Plaintiff-Appellee, ) of Cook County )

v. )

) No. 11 CH 31612

KNOX COUNTY EMS, INC., a Corporation, and CHAD ) STEPHENS, Guardian of the Person and Estate of Stacy ) Stephens, ) Honorable ) Moshe Jacobius,

Defendants-Appellants. ) Judge Presiding.

JUSTICE GORDON delivered the judgment of the court, with opinion.

Presiding Justice Reyes and Justice Lampkin concurred in the judgment and opinion.

OPINION

¶1 Defendant Knox County EMS, Inc. (Knox) appeals from the circuit court's orders granting summary judgment to plaintiff Continental Western Insurance Company, Inc. (Continental) on its declaratory judgment action against Knox and denying Knox's motion to reconsider. Continental had issued a workers' compensation policy to Knox. It sought a ruling that, under the policy, it had no duty to defend Knox against or pay benefits on an Illinois workers' compensation claim brought against Knox by a Knox employee. The circuit court

agreed with Continental that the policy did not cover Illinois workers' compensation claims. It held that Illinois law required Knox to purchase separate workers' compensation insurance coverage for its operations in Illinois and Knox, therefore, had not met the conditions for coverage in the policy's residual market limited other states insurance endorsement. The questions on appeal are whether the circuit court (1) should have dismissed the action as the Illinois Workers' Compensation Commission 1 (commission) had primary jurisdiction over the action and (2) erred in finding that section 4(a)(3) of the Illinois Workers' Compensation Act (Act) (820 ILCS 305/4(a)(3) (West 2012)) required Knox to purchase separate workers' compensation insurance coverage for its Illinois claim. We reverse and remand. 2

¶2 BACKGROUND

¶3 Knox is a provider of ambulance services. Its regular place of business is Indiana but its drivers also make trips into Illinois to pick up patients and take them to Indiana for treatment. Stacy Stephens lived in Indiana and was employed in Indiana by Knox as an emergency medical technician. On September 29, 2010, while in Illinois to pick up a patient for Knox, Stacy was seriously injured in a car accident. Chad Stephens, Stacy's husband and guardian, filed workers' compensation claims on her behalf against Knox in both Indiana and Illinois. Only the Illinois claim is relevant on appeal.

¶4 Knox tendered defense of the Illinois claim to Continental. Knox held a workers' compensation insurance and general liability policy issued by Continental for the period from

1

The parties refer to the Illinois Industrial Commission. Effective January 1, 2005, the name of the Industrial Commission was changed to the “Illinois Workers' Compensation Commission.” 820 ILCS 305/1(c) (West 2004). Accordingly, we will use that name.

2

This case was originally assigned to Justice Palmer and filed as a Rule 23 order. Ill. S.

Ct. R. 23 (eff. July 1, 2011). Subsequent to Justice Palmer's departure from the court, a motion to publish was granted. Justice Gordon has been replaced as the authoring judge. He has reviewed the case and concurs in the result. Presiding Justice Reyes and Justice Lampkin, also having reviewed the opinion, continue to concur.

February 2010 to February 2011. The policy provided in section 3.A of the "Information Page" that Continental would promptly pay the benefits required of Knox by the workers' compensation law of the state of Indiana.

¶5 In a "Residual Market Limited Other States Insurance Endorsement" (other states endorsement), the policy also provided for payment of workers' compensation benefits due under the laws of states other than Indiana, but only if certain conditions were met. The endorsement provided:

"We will pay promptly when due the benefits required of you [Knox] by the workers' compensation law of any state not listed in Item 3.A of the Information Page [i.e., any state other than Indiana] if all of the following conditions are met:

a. The employee claiming benefits was either hired under a contract of employment made in a state listed in Item 3.A of the Information Page or was, at the time of injury, primarily employed in a state listed in Item 3.A of the Information Page; and

b. The employee claiming benefits is not claiming benefits in a state where, at the time of injury, (i) you have other workers' compensation insurance coverage, or (ii) you were, by virtue of the nature of your operations in that state, required by that state's law to have obtained separate workers' compensation insurance coverage, or (iii) you are an authorized self-insurer or participant in a self-insured group plan; and c. The duration of the work being performed by the employee claiming benefits in the state for which that employee is claiming benefits is temporary."

The endorsement carried the warning that, if the insured began operations in any state not listed in section 3.A of the information page, i.e., in any state other than Indiana, it "should do whatever may be required under that state's law, as this endorsement does not satisfy the requirements of that state's workers' compensation law."

¶6 Continental defended Knox on the claim under a reservation of rights. It filed a declaratory judgment action against Knox and Stephens in the circuit court of Cook County, seeking a ruling that it had no duty to defend Knox on the Illinois claim or to pay on Knox's behalf any benefits due on the claim. Continental argued that, pursuant to section 3.A of the policy information page, the policy only applied to workers' compensation claims filed in Indiana or alternatively, coverage for claims filed in other states were covered only to the extent of coverage available under Indiana law.

¶7 Continental also argued that the "other states" endorsement did not provide coverage for the Illinois claim as Knox could not meet the condition set forth in subparagraph A.1.b of the endorsement. This condition provided that the employee could not be claiming benefits in a state where, at the time of injury, Knox was, by virtue of the nature of its operations in that state, "required by that state's law to have obtained separate workers' compensation insurance coverage." Continental asserted that Knox did not meet this condition as, pursuant to section 4(a)(3) of the Illinois Workers' Compensation Act, Knox was required to insure its entire liability in the State of Illinois, meaning that Illinois law required him to purchase separate workers' compensation insurance coverage for its liability in Illinois. 3

3

Section 4(a)(3) of the Act provides, in relevant part, that an employer must "[i]nsure his entire liability to pay such compensation in some insurance carrier authorized, licensed, or permitted to do such insurance business in this State. Every policy of an insurance carrier, insuring the payment of compensation under this Act shall cover all the employees and the entire compensation liability of the insured ***." 820 ILCS 305/4(a)(3) (West 2012).

¶8 Continental also argued that Knox failed to meet the condition in subparagraph A.1.b of the endorsement, which required that "[t]he duration of the work being performed by the employee claiming benefits in the state for which that employee is claiming benefits is temporary." It asserted that Stacy was injured while performing work for Knox in Illinois that was not "temporary" given that Knox regularly performed such work in Illinois.

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

Continental Western Insurance Co. v. Knox County EMS, Inc., 2016 IL App (1st) 143083, 2016 WL 1258490 (Ill. Ct. App. 2016).

2016 IL App (1st) 143083 (Continental Western Insurance Co. v. Knox County EMS, Inc.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

West Bend Mutual Insurance Co. v. TRRS Corp.
2019 IL App (2d) 180934 (Appellate Court of Illinois, 2020)
Illinois Insurance Guaranty Fund v. Priority Transportation, Inc.
2019 IL App (1st) 181454 (Appellate Court of Illinois, 2020)
West Bend Mutual Insurance Co. v. TRRS Corp.
2019 IL 124690 (Illinois Supreme Court, 2020)
LM Insurance Corp. v. B&R Insurance Partners, LLC
2016 IL App (1st) 151011 (Appellate Court of Illinois, 2016)