Gemini Ins Co v. Indemnity Ins Co

CourtCourt of Appeals for the Fifth Circuit
DecidedJanuary 12, 2024
Docket23-20026
StatusUnpublished

This text of Gemini Ins Co v. Indemnity Ins Co (Gemini Ins Co v. Indemnity Ins Co) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gemini Ins Co v. Indemnity Ins Co, (5th Cir. 2024).

Opinion

Case: 23-20026 Document: 00517031302 Page: 1 Date Filed: 01/12/2024

United States Court of Appeals for the Fifth Circuit United States Court of Appeals Fifth Circuit ____________ FILED January 12, 2024 No. 23-20026 ____________ Lyle W. Cayce Clerk Gemini Insurance Company,

Plaintiff—Appellant,

versus

Indemnity Insurance Company of North America,

Defendant—Appellee. ______________________________

Appeal from the United States District Court for the Southern District of Texas USDC No. 4:20-CV-3889 ______________________________

Before Richman, Chief Judge, and Haynes and Duncan, Circuit Judges. Per Curiam:* This is an insurance coverage dispute that arose out of the tragic death of an employee on a construction site. For the reasons set forth below, we REVERSE the district court’s grant of Indemnity Insurance Company of North America’s motion for summary judgment, and REMAND to the district court with instructions to: (1) grant Gemini Insurance Company’s

_____________________ * This opinion is not designated for publication. See 5th Cir. R. 47.5. Case: 23-20026 Document: 00517031302 Page: 2 Date Filed: 01/12/2024

No. 23-20026

motion for summary judgment on Indemnity’s duties to defend and indemnify under the Policy, and (2) consider the subrogation issues in the first instance.

I. Background A. Facts 1. Owner Controlled Insurance Program ExxonMobil Corporation (“Exxon Mobil”) retained Bechtel Oil, Gas, and Chemicals, Inc. (“Bechtel”) as a general contractor to build a new hydrocarbon processing facility in Beaumont, Texas (the “Project”). As part of its contract with Bechtel, Exxon Mobil implemented an Owner Controlled Insurance Program (“OCIP”), which provided workers’ compensation and employers’ liability coverage to Bechtel and all of its subcontractors. Bechtel, in turn, retained Echo Maintenance, L.L.C. (“Echo”) as a subcontractor to perform mechanical, structural, and piping work on the Project. Bechtel and Echo subsequently entered into a contract that incorporated the OCIP and required Echo to enroll in the program (the “Subcontract”). Both Bechtel and Echo were enrolled in the OCIP. 2. Indemnity’s Workers’ Compensation and Employers’ Liability Policies Issued Under The OCIP Under the OCIP, Indemnity Insurance Company of North America (“Indemnity”) issued a workers’ compensation and employers’ liability insurance policy to Bechtel (“OCIP Policy”). Separately, Gemini Insurance Company (“Gemini”) issued a general commercial liability policy to Echo under which Bechtel was an additional insured. Two portions of the OCIP Policy are at issue in this case: (1) Part Two – Employers’ Liability Insurance (“Part Two”); and (2) the Voluntary Compensation and Employers’ Liability Coverage Endorsement (“VCEL Endorsement”).

2 Case: 23-20026 Document: 00517031302 Page: 3 Date Filed: 01/12/2024

Part Two sets forth the type of covered claim that Indemnity agrees to defend and indemnify Bechtel for. Specifically, it provides that “employers liability insurance applies to bodily injury by accident,” which includes death, so long as “[t]he bodily injury . . . arise[s] out of and in the course of the injured employee’s employment by you” and the “employment [is] necessary or incidental to your work in a state . . . listed in Item 3.A of the Information Page.” “[Y]ou” is defined in this policy under the “General Section” to mean the “employer named in Item 1 of the Information Page,” which is Bechtel. Item 3.A of the Information Page lists Texas. The VCEL Endorsement contains three relevant provisions. The first provision explains that the endorsement “adds Voluntary Compensation Insurance to the policy,” and that this insurance applies to bodily injury by accident so long as it is “sustained by an employee included in the group of employees described in the Schedule” and “arise[s] out of and in the course of employment necessary or incidental to work in a state listed in the Schedule.” The second provision, as the name of the endorsement suggests, explains how Part Two-Employers’ Liability Insurance is impacted: F. Employers[’] Liability Insurance Part Two (Employers[’] Liabi[lity] 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. The last provision is the aforementioned “Schedule,” which defines “Employee” as “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.” It further defines “State of

3 Case: 23-20026 Document: 00517031302 Page: 4 Date Filed: 01/12/2024

Employment” in relevant part as “Texas but only at the site indicated in the designated premises endorsement.” 3. Underlying Incident and Lawsuit In December 2017, Ms. Espinoza was working as a pipefitter helper on the Project when she was struck by a piece of pipe and sustained fatal injuries. Zachery Leatherwood, individually and on behalf of Ms. Espinoza’s two minor children, filed wrongful death and survival claims against Bechtel and Echo in Texas state court alleging negligence and gross negligence. Ms. Espinoza’s parents later joined the lawsuit as intervenors (collectively “Underlying Litigation”). In response, Bechtel sought coverage as an additional insured on the commercial general liability policy issued by Gemini to Echo and received a defense from Gemini under a reservation of rights. Bechtel moved for summary judgment against the Intervenors on the ground that because Exxon Mobil’s OCIP provided blanket workers’ compensation insurance and coverage to Bechtel and Echo, Intervenors’ sole remedy in accordance with Texas Labor Code § 408.001 was workers’ compensation benefits. The state court granted Bechtel’s motion for summary judgment dismissing the Intervenors’ claims. In September 2020, Bechtel requested Indemnity assume Bechtel’s defense in the Underlying Litigation in accordance with the policy it had previously issued. Indemnity denied Bechtel’s request on the ground that its policy required an actual employment relationship between the injured employee and Bechtel and there were no allegations to that effect in the Underlying Litigation. The Leatherwood plaintiffs then settled their claims against Bechtel and Echo. Gemini funded the settlement on behalf of Bechtel while Indemnity partially funded the settlement on behalf of Echo.

4 Case: 23-20026 Document: 00517031302 Page: 5 Date Filed: 01/12/2024

B. Procedural History Gemini filed suit against Indemnity seeking a declaratory judgment that Indemnity had a duty to defend and indemnify Bechtel in the Underlying Litigation based on the policy it issued to Bechtel and also asserted breach of contract, subrogation, and reimbursement claims for the costs it expended defending Bechtel and settling the Underlying Litigation. The parties filed cross-motions for summary judgment. The main dispute was whether Ms. Espinoza qualified as an “employee” of Bechtel within the meaning of the OCIP Policy such that Indemnity had a duty to defend and indemnify Bechtel in the Underlying Litigation. Gemini raised two primary theories to support its argument that Ms. Espinoza was an “employee”: (1) VCEL Endorsement expanded the scope of Part Two so that employees of a Bechtel subcontractor constituted Bechtel “employees,” and, alternatively, (2) Bechtel was Ms. Espinoza’s “statutory employer” under § 408.001(a) thereby satisfying the actual employment relationship under Part Two.1 According to Gemini, because Ms. Espinoza was an “employee” of Bechtel, it was entitled to reimbursement through contractual or equitable subrogation.

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Bluebook (online)
Gemini Ins Co v. Indemnity Ins Co, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gemini-ins-co-v-indemnity-ins-co-ca5-2024.