Milton Donald v. Liberty Mutual Insurance Company

18 F.3d 474, 1994 U.S. App. LEXIS 4403, 1994 WL 70538
CourtCourt of Appeals for the Seventh Circuit
DecidedMarch 9, 1994
Docket93-2595
StatusPublished
Cited by43 cases

This text of 18 F.3d 474 (Milton Donald v. Liberty Mutual Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Milton Donald v. Liberty Mutual Insurance Company, 18 F.3d 474, 1994 U.S. App. LEXIS 4403, 1994 WL 70538 (7th Cir. 1994).

Opinion

CUMMINGS, Circuit Judge.

On June 25, 1990, plaintiff Milton Donald (“Donald”) severely injured his right arm when he attempted to remove his clothes from laundry equipment that he had neglected to switch off. This suit followed. Plaintiff sued the University of Evansville, Indiana (the “University”), which owned the equipment, and Daryl Buente (“Buente”), an employee of the University who had given Donald permission to use the equipment, alleging negligence (R. 1 at 2-4, Complaint Count One). The parties settled that claim and it is not at issue here. In addition, however, plaintiff sued the University’s insurer, Liberty Mutual Insurance Company (“Liberty Mutual”), alleging breach of contract on account of Liberty Mutual’s refusal to pay him $5,000 in benefits (id. at 4-5, *477 Complaint Count Two), and alleging that Liberty Mutual breached a duty to deal with him in good faith (id. at 5-6, Complaint Count Three). Plaintiff, a citizen of Ohio, sought contract damages on Count Two and punitive damages on Count Three.

Due to the parties’ diverse citizenship, and because the amount in controversy at the time the suit was filed exceeded $50,000, the district court had jurisdiction over the dispute. 28 U.S.C. § 1332. The parties agree that Indiana law governs the action. Cf. Erie Railroad Co. v. Tompkins, 304 U.S. 64, 58 S.Ct. 817, 82 L.Ed. 1188 (1938). Having determined that Indiana law does not allow plaintiffs such as Donald to bring suit directly against insurance companies to recover on policies issued to third parties, the district court entered summary judgment in favor of Liberty Mutual on both remaining counts of Donald’s complaint. We reverse.

Background

At the time of his accident Donald, a recent graduate of the University, worked as an instructor at a basketball camp conducted on the University premises but not sponsored by the University. After camp ended on June 25 plaintiff asked Buente if he could use the Athletic Department’s laundry equipment because he could not afford to use a laundromat. Buente gave Donald permission and showed him how to work both the clothes washer and the water extractor. After washing his clothes in the washer Donald transferred them to the extractor and turned it on. The extractor did not have a timer or automatic shut-off; it had to be turned off manually by moving a switch to off and depressing a brake pedal. Donald tried to remove his clothes from the extractor without first turning the machine off. His hand became entangled in the clothing, resulting in serious injury and high medical expenses.

The University was insured by Liberty Mutual 1 for, inter alia, “bodily injury and property damage liability” (App. 15) (“Coverage A”), including liability such as that alleged in Count One of Donald’s Complaint. It was also insured for “medical payments” to certain persons injured on its premises (App. 17) (“Coverage C”). Donald’s appeal concerns Liberty Mutual’s refusal to pay him $5,000 in medical payment benefits under Coverage C of the insurance contract between the University and Liberty Mutual. Coverage C provides, in full (App. 17-18, 31):

COVERAGE C. MEDICAL PAYMENTS
1. Insuring Agreement.
a. We will pay medical expenses as described below for “bodily injury” caused by an accident:
(1) On premises you own or rent;
(2) On ways next to premises you own or rent; or
(3) Because of your operations; provided that:
(1) The accident takes place in the “coverage territory” and during the policy period;
(2) The expenses are incurred and reported to us within one year of the date of the accident; and
(3) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require.
b. We will make these payments regardless of fault. These payments will not exceed the applicable limits of insurance. We will pay reasonable expenses for:
(1) First aid at the time of an accident;
(2) Necessary medical, surgical, x-ray and dental services, including prosthetic devices; and
(3) Necessary ambulance, hospital, professional nursing and funeral services.
2. Exclusions.
We will not pay expenses for “bodily injury”:
a. To any insured.
*478 b. To a person hired to do work for or on behalf of any insured or a tenant of any insured.
e.To a person injured on that part of premises you own or rent that the person normally occupies.
d. To a person, whether or not an employee of any insured, if benefits for the “bodily injury” are payable or must be proved under a workers compensation or disability benefits law or a similar law.
e. To a person injured while taking part in athletics.
f. Included within the “products-completed operations hazard.”
g. Excluded under Coverage A.
h. Due to war, whether or not declared, or any act or condition incident to war. War includes civil war, insurrection, rebellion or revolution.

The “applicable limit of insurance” for Coverage C was $5,000 (App. 13). Excluded from medical payment benefits under Coverage C were “any insured” persons (Coverage C(2)(a)). Section II of the contract defined “who is an insured” in relevant part as the executive officers, directors, stockholders and employees of the entity designated in the insurance contract as the “named insured” (App. 13, 18, 28), in this case the University through the Board of Higher Education and Ministry of the United Methodist Church. It follows from the terminology employed by this contract that persons entitled to medical payment benefits under Coverage C are not “insureds” under the contract, which led to some unfortunate cross-talk and confusion among the parties to this suit. This opinion will refer to persons eligible for medical payment benefits under Coverage C as “covered” individuals to distinguish them from “insureds” who are, by definition, not covered under Coverage C.

After the accident Donald’s attorney and representatives of Liberty Mutual corresponded by mail and over the telephone. It was clear that Donald was exploring the possibility that the University and Buente might be Hable in tort for his injuries; if they were, then Liberty Mutual would be required under Coverage A to pay the amount of that HabiHty.

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Bluebook (online)
18 F.3d 474, 1994 U.S. App. LEXIS 4403, 1994 WL 70538, Counsel Stack Legal Research, https://law.counselstack.com/opinion/milton-donald-v-liberty-mutual-insurance-company-ca7-1994.