Mutual Ben. Ins. Co., Aplt v. Politsopoulos

115 A.3d 844
CourtSupreme Court of Pennsylvania
DecidedMay 26, 2015
Docket60 MAP 2014
StatusPublished

This text of 115 A.3d 844 (Mutual Ben. Ins. Co., Aplt v. Politsopoulos) is published on Counsel Stack Legal Research, covering Supreme Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mutual Ben. Ins. Co., Aplt v. Politsopoulos, 115 A.3d 844 (Pa. 2015).

Opinions

OPINION

Justice SAYLOR.

This appeal concerns the scope of an employer’s liability exclusion in an umbrella commercial liability insurance policy.

Leola Restaurant maintained an umbrella commercial liability insurance policy with Appellant, Mutual Benefit Insurance Company, which containéd an employer’s liability exclusion. This exclusion prescribed, inter alia, that the policy did not provide coverage pertaining to liability for injury to “[a]n ‘employee’ of the insured arising out of and in the course of ... [ejmployment by the insured[J” Complaint, Ex. C, Employer’s Liability Exclusion. In addition, the policy contained a clause captioned “Separation of Insureds,” which provided, subject to exceptions not relevant here, that “this insurance applies ... [separately to each insured against [846]*846whom claim is made or suit is brought.” Id. at Ex. C, § V ¶ 14(b) (emphasis in original).

Leola Restaurant conducted its business on a property leased from Appellees Chris-tos Politsopoulos and Dionysios Mihalo-poulos (the “Property Owners”). The lease required the Property Owners to be “named as ... additional insured parties” on the liability policy. Id. at Ex. E, ¶ 1(d). While the Property Owners were not specifically designated on the declarations page of the umbrella policy, the instrument was designed to extend coverage to unidentified persons doing business with Leola Restaurant for whom the latter had agreed in writing to provide insurance. See id. at Ex. C, § III ¶ 2(f).

In December 2007, during the policy period, Appellee Marina Denovitz, an employee of Leola Restaurant, fell from an outside set of stairs and suffered injuries. She commenced a negligence action against the Property Owners in the common pleas court, asserting that they were negligent in maintaining the stairs in an unsafe and dangerous condition.

The Property Owners sought defense and indemnification from Appellant, per the umbrella policy.1 Appellant acknowledged that the Property Owners were insureds under the umbrella policy but nevertheless disclaimed coverage, invoking the employer’s liability exclusion. Based on the policy's broad definition of “insured” to encompass named insureds to include Leola Restaurant, Complaint, Ex. C, § III ¶ 1, it was Appellant’s central position that Ms. Denovitz was an employee of “the insured,” for purposes of the exclusion (albeit she was not an employee of the Property Owners, ie., the insureds against whom a claim had been asserted). The Property Owners, on the other hand, took the position that the exclusion was unclear, and coverage should be deemed to be negated only upon injury to an employee of the specific insured seeking coverage. In particular, the Property Owners pointed to the separation-of-insureds clause providing that coverage extends separately to each insured against whom claims are asserted.

Appellant commenced a declaratory judgment action in an effort to vindicate its position that the exclusion pertained. Summary judgment was awarded in Appellant’s favor, with the common pleas court — per the Honorable Jeffrey D. Wright — explaining that it was bound by precedent with which it did not agree, in particular, Pennsylvania Manufacturers’ Association Insurance Co. v. Aetna Casualty & Surety Insurance Co., 426 Pa. 453, 233 A.2d 548 (1967) [hereinafter, “PMA ”].

The common pleas court explained that PMA’s holding reflected that the term “the insured,” as it appears in an employer’s exclusion appearing in a liability policy,2 encompasses the named insured, regardless of whether coverage was sought by a different insured. Thus, the court reasoned, the exclusion prevented coverage from extending to redress harm to Ms. Denovitz, since she was an employee of the named insured (Leola Restaurant), and her injuries were occasioned in the course of such employment, even though suit was brought against additional insureds, ie., the Property Owners.

The common pleas court also observed that the PMA Court rejected the argument that a severability-of-interests [847]*847clause — which provided that “the term ‘the insured’ is used severally and not collectively,” representing an analogue to the separation-of-insureds provision presently in issue — applied in a way that would undermine a broad application of the employer’s liability exclusion relative to claims asserted by employees of a named insured. See id., 233 A.2d at 551.

In the common pleas court’s view, however, absent the PMA overlay, the policy language used in both PMA and in the present case should be deemed ambiguous. The court continued to summarize several decisions of the Superior Court which, it believed, were consistent with such view and reflected a more apt treatment of insurance law. See, e.g., Maravich v. Aetna Life & Cas. Co., 350 Pa.Super. 392, 408-11, 504 A.2d 896, 905-06 (1986) (holding that a fire insurance policy exclusion eliminating coverage for losses deriving from “neglect of the insured ... to save and preserve property” applied only to defeat coverage relative to a neglectful insured and not any or all insureds (emphasis added)); McAllister v. Millville Mut. Ins. Co., 433 Pa.Super. 330, 338-41, 640 A.2d 1283, 1287-89 (1994) (distinguishing Maravich on the basis that the exclusionary terms in the policy at issue in McAllister applied by their terms more broadly to neglect by “an insured” or “any insured”).

Had it been free to discount PMA, the common pleas court explained, it would have implemented the following legal analysis centered upon the use of a definite article in conjunction with the term “insured” in the umbrella policy’s employer’s liability exclusion:

The use of the phrase “the” insured rather than “any” insured or “an” insured, particularly in a policy which contains a severability of interests clause, demonstrates that the interests of the different insureds were intended to be several rather than joint. In other words, the policy, as written by Mutual Benefit, provides for coverage to [the Property Owners] separate and independent from that to [Leola Restaurant]. Since Denovitz was not an employee of “the” insured Owners, the Employers’ Liability Exclusion should not be applied to preclude coverage to [the Property Owners] under the Umbrella Policy. At the very least, the use of “the” insured rather than “the named insured” or. “any insured” makes the term ambiguous, and thus necessarily interpreted against [Appellant]; as the insurer.

Mut. Benefit Ins. Co. v. Politopoulos, No. CI-10-02578, slip op. at 9 (C.P. Lancaster Feb. 2, 2012) (emphasis in original).

Notwithstanding this analysis and its point of view that PMA was “flawed and outdated,” id. at 10, the common pleas court considered itself bound by the decision. Accordingly, as noted, summary judgment was awarded in Appellant’s favor.

On appeal, the Superior Court reversed in a published decision. See Mut. Benefit Ins. Co. v. Politopoulos, 75 A.3d 528 (Pa.Super.2013). In the opinion, initially, PMA

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Bluebook (online)
115 A.3d 844, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mutual-ben-ins-co-aplt-v-politsopoulos-pa-2015.