Gunther v. Metropolitan Cas. Ins. Co.

109 A.2d 485, 33 N.J. Super. 101
CourtNew Jersey Superior Court Appellate Division
DecidedNovember 5, 1954
StatusPublished
Cited by11 cases

This text of 109 A.2d 485 (Gunther v. Metropolitan Cas. Ins. Co.) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gunther v. Metropolitan Cas. Ins. Co., 109 A.2d 485, 33 N.J. Super. 101 (N.J. Ct. App. 1954).

Opinion

33 N.J. Super. 101 (1954)
109 A.2d 485

MONROE GUNTHER AND MADELINE GUNTHER, PLAINTIFFS,
v.
METROPOLITAN CASUALTY INSURANCE COMPANY, A CORPORATION OF NEW YORK, DEFENDANT.

Superior Court of New Jersey, Law Division.

Decided November 5, 1954.

*102 Mr. Harold D. Feuerstein, attorney for plaintiffs.

Messrs. Lum, Fairlie & Foster (Mr. Charles S. Barrett, Jr., appearing), attorneys for defendant.

*103 GAULKIN, J.C.C. (temporarily assigned).

Plaintiffs contend that, upon the proper construction of the insurance policy sued upon, they are entitled to summary judgment.

The facts are not in dispute. Plaintiffs' part-time maid was injured while at work in plaintiffs' home. She filed a petition for workmen's compensation. Plaintiffs, contending that the policy which had been issued to them by defendant obligated defendant to indemnify them against such a claim, forwarded the petition to defendant. Defendant refused to defend plaintiffs on the ground that the policy does not cover workmen's compensation claims. The maid thereafter received an award from the Workmen's Compensation Division, and the plaintiffs in this action ask that the defendant pay the amount of the award.

The policy, headed "Comprehensive Personal Liability Policy," contains the following pertinent provisions.

The policy on its face shows that it was designed to cover residence locations. Item 5 of the declarations states that "No business pursuits are conducted at the premises." Item 7 asks for "the number of full time residence employees," to which the answer is "none." The coverage, for "A Liability" is "$10,000 each occurrence," while for "B Medical Payments" it is "$250 each person."

"Coverage A — Liability" is defined as the obligation

"To pay on behalf of the insured all sums which the insured shall become legally obligated to pay as damages because of bodily injury, sickness or disease, including death at any time resulting therefrom, sustained by any person, and as damages because of injury to or destruction of property, including the loss of use thereof."

"Coverage B — Medical Payments" is defined as the obligation

"To pay all reasonable expenses incurred within one year from the date of accident for necessary medical, surgical, ambulance, hospital, professional nursing and funeral services, to or for each person who sustains bodily injury, sickness or disease, caused by accident * * *."

sustained (among others) "by a residence employee while engaged in the employment of an insured. * * *"

*104 Under coverage A the company undertakes to

"defend any suit against the insured alleging such injury, sickness, disease or destruction and seeking damages on account thereof * * *."

Under the heading "Exclusions" the policy provides that it does not apply:

"(a) to any business pursuits of an insured * * *

(b) to (1) automobiles while away from the premises * * * (2) watercraft * * *, while away from the premises, or (3) aircraft, or the loading or unloading of any of the foregoing; but, with respect to injury sustained by a residence employee while engaged in the employment of the insured, parts (1) and (2) of this exclusion do not apply, and part (3) applies only while such employee is engaged in the operation or maintenance of aircraft; * * *

(d) to bodily injury to or sickness, disease or death of (1) any employee of the insured while engaged in the employment of the insured, if benefits therefor are either payable or required to be provided under any workmen's compensation law; or (2) any residence employee of the insured while engaged in the employment of the insured if the insured has in effect on the date of the occurrence a policy providing workmen's compensation benefits for such employee; * * *."

It is agreed that the plaintiffs did not have in effect on the date of the occurrence any policy other than the one sued upon.

The "Exclusions" further provide that the policy does not apply:

"(e) under coverage A, to liability assumed by the insured under any contract or agreement * * *"

(g) under coverage B, to bodily injury to or sickness, disease or death of (1) any person while engaged in his employment if benefits therefor are payable under any workmen's compensation law; * * * or (3) any person, other than a residence employee, if such person is regularly residing on the premises * * *."

Plaintiffs' argument may be summarized as follows. Although exclusion (d) (1), standing by itself, clearly excludes a workmen's compensation award to "any employee," the insertion of exclusion (d) (2), to cover "residence employees" specially must be held to mean that defendant meant to take *105 the special class "residence employees" out of the general class "any employee" mentioned in (d) (1), and therefore, although workmen's compensation claims by employees generally are not covered by the policy, workmen's compensation claims of residence employees are covered if the policyholder has no specific workmen's compensation insurance "in effect on the date of the occurrence."

Plaintiffs say that the reason for placing residence employees in a special category may have been R.S. 34:15-92 which provides as follows:

"Nothing in this article [Article 5, Compulsory Insurance, requiring every employer to make provision for the payment of workmen's compensation by carrying insurance or qualifying as a self-insurer] * * * shall apply to any employer of farm laborers or domestic servants * * *."

Plaintiffs suggest that, having this section in mind, the defendant company meant by (d) (2) to make special provision to indemnify, against his liability under the Workmen's Compensation Act, the "employer of * * * domestic servants," who did not procure specific workmen's compensation insurance.

Plaintiffs contend that, in any event, (d) (2) is separate, complete, and free from ambiguity, and plainly means that the policy does cover the workmen's compensation claim of plaintiffs' maid, since plaintiffs did not have in effect, on the date of the occurrence, a special workmen's compensation policy. Further, say plaintiffs, even if it be argued that (d) (2) does not clearly and unambiguously have the meaning which they urge, the least that can be said is that the policy is ambiguous, and therefore, applying well recognized rules of interpretation, the policy must be construed liberally in favor of the insured (Schneider v. New Amsterdam Casualty Co., 22 N.J. Super. 238 (App. Div. 1952), and cases therein cited), and against the company, which chose the language, since this is not a statutory standard policy (Herbert L. Farkas Co. v. New York Fire Insurance Co., 5 N.J. 604, at 610 (1950); Steiker v. Philadelphia National Insurance Co., *106 7 N.J. 159, at 166 (1951)). Therefore, say the plaintiffs, ambiguous or unambiguous, the contract should be interpreted as covering their maid's workmen's compensation claim.

Defendant's answering argument may be summarized as follows. The Comprehensive Personal Liability policy is designed to cover only the employer's so-called "common law" liability, as modified by Article 1 (actions at law) of the Workmen's Compensation Act, R.S. 34:15-1 et seq. All workmen's compensation awards, whether to residence or other employees, made under Article 2 (elective compensation) of the Workmen's Compensation Act, R.S.

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Bluebook (online)
109 A.2d 485, 33 N.J. Super. 101, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gunther-v-metropolitan-cas-ins-co-njsuperctappdiv-1954.