Home Insurance v. Liberty Mutual Fire Insurance

444 Mass. 599
CourtMassachusetts Supreme Judicial Court
DecidedJuly 7, 2005
StatusPublished
Cited by14 cases

This text of 444 Mass. 599 (Home Insurance v. Liberty Mutual Fire Insurance) is published on Counsel Stack Legal Research, covering Massachusetts Supreme Judicial Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Home Insurance v. Liberty Mutual Fire Insurance, 444 Mass. 599 (Mass. 2005).

Opinion

Spina, J.

This insurance coverage action arises from an injury to a leased employee. The insurance company of a lessee-special employer seeks indemnification and reimbursement of costs for defense from the insurance company of the lessor-general [600]*600employer under workers’ compensation and employers’ liability policies the lessor’s insurer issued to the lessor. A judge in the Superior Court granted summary judgment to the lessor’s insurer. We transferred the case here on our own motion, and now affirm on different grounds. For the reasons discussed below, we find that under the plain language of the policies the lessee-special employer was not insured. Therefore, no coverage liability existed and the lessee’s insurer is not entitled to either indemnification or costs of defense.

1. Background. Carmelo Mercado was an employee of Abel Leasing Company, Inc. (Abel), and as such was leased to Pure Tech International, Inc., for employment at its Massachusetts facility, Pure Tech SPP, Inc. (collectively, Pure Tech). Mercado sustained serious injuries related to his employment in August, 1995, while leased to Pure Tech. He filed a workers’ compensation claim against Abel and received compensation for his claims through Abel’s insurer, Liberty Mutual Fire Insurance Company (Liberty).

In April, 1996, Mercado filed a third-party civil action against Pure Tech, alleging negligence for failure to ensure that the machinery that injured him was functioning in a reasonable and safe manner and for failing to implement policies and procedures that would have prevented the accident. Pure Tech’s comprehensive general liability insurer, Home Insurance Company (Home Insurance), defended the action.

At some point prior to trial, Pure Tech had filed a motion for summary judgment asserting the exclusive remedy of workers’ compensation defense, but its expert determined that Pure Tech had no better than a thirty per cent chance of success on that motion. Pure Tech’s counsel stated the likelihood of success as “less than [fifty per cent] due to the uncertainty in the law of this Commonwealth on the issue and the damaging testimony.” He put the risk of a finding of liability if the matter went to a jury at ninety per cent. In light of this, a settlement was reached on or about October 25, 2000, for $850,000. Pure Tech incurred $129,770.29 in defending against the tort claim before settlement was reached. Some of the settlement recovery was used to satisfy a lien Liberty had for reimbursement of the workers’ compensation benefits it had paid on behalf of Abel.

[601]*601On September 29, 2000, over four years after the suit initially was filed, just over two months before the firm trial date of December 4, 2000, and less than one month before the final settlement was reached, Home Insurance sent Liberty a first demand letter “demand[ing] that Liberty Mutual acknowledge its obligations to Pure Tech, assume full responsibility for the defense and indemnification of Pure Tech . . . and control any negotiations to settle the case.”2 Liberty never responded. Pure Tech ultimately assigned to Home Insurance any claims it might have against Liberty for failure to defend and indemnify it. In October, 2001, Home Insurance and Pure Tech (collectively, Home) filed a complaint in Superior Court seeking a declaration as to the obligations and liabilities of Liberty, and also seeking damages arising from the failure to defend and claims alleging violations of the consumer protection act, G. L. c. 93A. With the facts largely undisputed, the parties filed cross motions for summary judgment.

In December, 2003, the motion judge issued summary judgment in favor of Liberty. He declined to determine whether the Liberty policy insured Pure Tech. Instead, he concluded that, even if it did, the policy imposed no duty on Liberty to defend and indemnify against a negligence claim such as this, filed by an injured employee who had not rejected the workers’ compensation system. The judge interpreted the employers’ liability coverage provided by the policy as “intended to provide coverage in the rare circumstance in which an employee [who] has affirmatively opted out [of the workers’ compensation system] brings a tort action for personal injuries.” HDH Corp. v. Atlantic Charter Ins. Co., 425 Mass. 433, 439 n.11 (1997). Home has appealed.

2. Standard of review. The interpretation of the language of the insurance policy naming those whom it insures is a question of law. See Herbert A. Sullivan, Inc. v. Utica Mut. Ins. Co., 439 Mass. 387, 394 (2003); Lumber Mut. Ins. Co. v. Zoltek Corp., [602]*602419 Mass. 704, 707 (1995). So too is the extent of the coverage provided by the employers’ liability provision. “In the absence of an ambiguity, we will ‘construe the words of the policy in their usual and ordinary sense.’ ” 116 Commonwealth Condominium Trust v. Aetna Cas. & Sur. Co., 433 Mass. 373, 376 (2001), quoting Citation Ins. Co. v. Gomez, 426 Mass. 379, 381 (1998). The mere fact that the parties disagree on the proper construction of policy language does not necessarily establish an ambiguity. Lumbermens Mut. Cas. Co. v. Offices Unlimited, Inc., 419 Mass. 462, 466 (1995).

3. Discussion, a. Claims for defense and indemnification. The work Mercado did for Pure Tech was done pursuant to an employee leasing agreement. Under the terms of the agreement, while Pure Tech directed his day-to-day activities, Abel retained the rights and obligations of the employer. Abel chose whether to continue Mercado’s employment, determined his rate of pay, provided his benefits, paid for his workers’ compensation insurance, and was responsible completely for payroll, payroll tax, insurance, and other administrative matters. Home does not contest that Abel was Mercado’s employer. Instead, it seeks to assert that Pure Tech also was his employer, functioning as a “special employer” under case law relating to employee leasing arrangements. See Ramsey’s Case, 5 Mass. App. Ct. 199, 202-204 (1977). Home refers to this as a “dual employers” situation. In addition, Home seeks to focus our attention on understandings and obligations between Pure Tech and Abel with regard to the employee leasing contract.

The action Mercado filed against Pure Tech was the type of negligence claim someone injured in the course of his employment may file against a third-party tortfeasor. Even if Pure Tech functioned as Mercado’s special employer, that status did not insulate it from such a claim. See Lang v. Edward J. Lamothe Co., 20 Mass. App. Ct. 231, 232 (1985) (special employer of leased employee not liable to pay workers’ compensation claim, and therefore not immune from action at law for damages). General Laws c. 152, § 15, the section of the workers’ compensation act that concerns third-party claims, does not prohibit such an action or provide Pure Tech with any defense, [603]*603and Pure Tech does not argue to the contrary. The only remaining question is whether Pure Tech was insured against Mercado’s independent tort claim under any Liberty policy.

Initially after the incident, faced with some uncertainty as to who was the true employer of Mercado, Liberty filed suit against Pure Tech to recover its workers’ compensation expenditure. As discovery progressed, Liberty chose to dismiss the complaint.

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Cite This Page — Counsel Stack

Bluebook (online)
444 Mass. 599, Counsel Stack Legal Research, https://law.counselstack.com/opinion/home-insurance-v-liberty-mutual-fire-insurance-mass-2005.