National Casualty Co. v. Western World Insurance

669 F.3d 608, 2012 WL 339568
CourtCourt of Appeals for the Fifth Circuit
DecidedFebruary 3, 2012
Docket10-41012
StatusPublished
Cited by53 cases

This text of 669 F.3d 608 (National Casualty Co. v. Western World Insurance) 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
National Casualty Co. v. Western World Insurance, 669 F.3d 608, 2012 WL 339568 (5th Cir. 2012).

Opinion

*611 CARL E. STEWART, Circuit Judge:

Two insurers dispute whether their respective insurance policies require them to defend the insured against allegations regarding an accidental death. Both insurers sought a declaratory judgment from the district court that their policies did not cover the underlying lawsuit. After the district court ruled that each insurer must provide primary coverage for the accident, both insurers appealed. We AFFIRM the district court’s judgment.

I.

Alma Batie, daughter of Darline Rigsby, sued Preferred Ambulance, Inc. (“Preferred Ambulance”) in Texas state court on behalf of herself and as representative of Rigsby’s estate (“the underlying lawsuit”). In her complaint, Batie alleged that Rigsby was injured while emergency medical technicians 1 (“EMTs”) loaded her into an ambulance, and died from these injuries several days later. Batie further averred that Preferred Ambulance’s negligence caused Rigsby’s death. Specifically, she alleged that Preferred Ambulance and its employees “failed to use ordinary care by various acts and omissions,” including

(a.) failing to properly secure Darl[i]ne Rigsby to the gurney to transport her from the dialysis facility to the ambulance; (b.) in moving Darline Rigsby from one place to another when it was unsafe to do so; (c.) in failing to provide sufficient, competent personnel to safely transport Darline Rigsby from the dialysis center to and into the ambulance, (d.) In failing to properly train its employees. (e.) In failing to use appropriate equipment and devices to assist in safely moving Darl[i]ne Rigsby from the dialysis treatment facility into the ambulance or van.

At the time of the accident, National Casualty Company (“National Casualty”) and Western World Insurance Company (‘Western World”) each had issued insurance policies to Preferred Ambulance. In relevant part, the Business Auto Coverage insuring agreement issued by National Casualty (the “National Casualty policy”) provided coverage for

all sums an insured must pay as damages because of “bodily injury” ... to which this insurance applies, caused by an “accident” and resulting from the ownership, maintenance or use of a covered “auto.”

The National Casualty policy also contained an exclusion for bodily injuries “resulting from the providing or the failure to provide any medical or other professional services.” The policy limit was $1,000,000 per incident.

Western World’s Commercial General Liability policy (the “Western World policy”) provided coverage for the following:

those sums the insured becomes legally obligated to pay as damages because of any “bodily injury,” “property damage” or “personal injury” to which this coverage part applies caused by a “professional incident.”

The Western World policy excluded coverage for “bodily injury ... arising out of the ... use ... of any ... ‘auto’----” It further provided that its policy is excess over “any of the other insurance, whether primary, excess, contingent or on any other basis ... if the loss arises out of the maintenance or use of aircraft, ‘autos’ or watercraft to the extent not subject to Exclusion g, of Section 1 — Coverage A— *612 Bodily Injury and Property Damage Liability.” The policy explained that “[w]hen this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any ‘suit’ if any other insurer has a duty to defend the insured against that ‘suit.’ ” The policy limit was $1,000,000 per incident.

National Casualty sought a judgment from the United States District Court for the Southern District of Texas declaring that (1) the National Casualty policy did not cover the underlying lawsuit; (2) the Western World policy did cover the underlying lawsuit; (3) National Casualty had no duty to indemnify Preferred Ambulance in the underlying lawsuit; and (4) National Casualty is entitled to reimbursement from Western World for defense costs already expended. Both parties moved for summary judgment. The district court ruled that both the National Casualty policy and the Western World policy provided primary coverage for the underlying lawsuit. The district court further held that indemnification was not justiciable at the time of its ruling and therefore declined to rule on this issue. This appeal followed.

II.

Both parties challenge aspects of the district court’s ruling. National Casualty argues that while the district court correctly held that the Western World insurance policy provided primary coverage, it erred in the following ways: by holding that the National Casualty policy provided primary coverage; by ruling that the issue of indemnification was not justiciable; and by failing to decide whether Western World must reimburse a share of the costs National Casualty has already paid to defend the underlying lawsuit. Western World, conversely, argues that the district court correctly held that the National Casualty policy provided primary coverage of the underlying lawsuit, but erred in holding that the Western World policy provided primary coverage of the underlying lawsuit and by failing to consider the effect of the “other insurance” provision in Western World’s policy. We address each of these contentions in turn.

A.

We review the district court’s grant of summary judgment de novo. Admiral Ins. Co. v. Ford, 607 F.3d 420, 422 (5th Cir.2010). The interpretation of an insurance contract is also reviewed de novo. Id.

B.

We begin by considering whether National Casualty’s policy applies to the underlying lawsuit. To make this determination, we must consider whether the allegations in the underlying lawsuit are sufficient to establish that the accident resulted from a “use” of the ambulance as that term is interpreted under Texas law, and whether any exclusions in the National Casualty policy apply to the underlying lawsuit.

1.

To determine whether the insurer has an obligation to defend a lawsuit, Texas courts apply the “eight corners” rule. According to the eight corners rule, the scope of an insurer’s duty to defend against a lawsuit is determined exclusively by the allegations in the pleadings and the language of the insurance policy. Nat’l Union Fire Ins. Co. v. Merchants Fast Motor Lines, 939 S.W.2d 139, 141 (Tex.1997). The scope of the duty to defend is interpreted broadly: “Where the complaint does not state facts sufficient to clearly bring the case within or without the coverage, the general rule is that the insurer is obligated to defend if there is, *613 potentially, a case under the complaint within the coverage of the policy." Id. (quoting Heyden Newport Chem. Corp. v. S. Gen. Ins. Co., 387 S.W.2d 22, 26 (Tex.1965)). “Terms in insurance policies that are subject to more than one reasonable construction are interpreted in favor of coverage.” Gilbert Tex. Constr., L.P. v.

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Cite This Page — Counsel Stack

Bluebook (online)
669 F.3d 608, 2012 WL 339568, Counsel Stack Legal Research, https://law.counselstack.com/opinion/national-casualty-co-v-western-world-insurance-ca5-2012.