Security National Insurance Company v. Le

Superior Court of Maine·Decided October 20, 2022·No. CUMcv-21-465·Unpublished

Opinion

STATE OF MAINE SUPERIOR COURT CUMBERLAND, ss. CIVIL ACTION Docket No. CV-2021-465

SECURITY NATIONAL )

INSURANCE COMP ANY, )

)

Plaintiff, )

)

V. ) ORDER ON CROSS MOTIONS FOR ) SUMMARY JUDGMENT SHAUN LE and CHRISTOPHER )

COURT, )

)

Defendants. )

This matter is before the Court on Plaintiff Security National Insurance Company's ("Security") Motion for Summary Judgment and Defendant Christopher Court's Cross Motion for Summary Judgment. Defendant Shaun Le, who was defaulted on September 26, 2022, has not opposed either motion. For the following reasons, the Court grants Security's Motion for Summary Judgment. Summary judgment is entered in favor of Security on its Complaint for Declaratory Judgment. Mr. Court's Cross Motion for Summary Judgment is denied. I. Background This declaratory judgment action arises out of a separate case filed in this court, captioned Court v. Five Star Roofing Experts, Inc., CV-2021-338 ("the Underlying Action"). 1 The Underlying Complaint contains the following allegations. Mr. Le operates a roofing business in Maine individually and as Five Star Roofing Experts, Inc. ("Five Star"). (Pl.'s Supp'g S.M.F. 'I[ 1; Underlying Comp!. 'I[ 5.) Five Star and/ or Mr. Le was a subcontractor hired by On Center Construction to install roofing at a new residential development

1The Court will refer to Christopher Court's First Amended Complaint in the Underlying Action as "the Underlying Complaint."

under construction at Dogwood Lane, Yarmouth, Maine. (Pl.'s Supp'g S.M.F. 'II 2; Underlying Compl. 'II 7.) Mr. Court was an independent contractor hired by Five Star and/ or Mr. Le to work on the roofing project at the new residential construction development at Dogwood Lane. (Pl.'s Supp'g S.M.F. 'II 3; Underlying Compl. 'II 9.)

On or about February 4, 2019, Mr. Court was present at the new construction development at Dogwood Lane for work. (Pl.'s Supp'g S.M.F. 'II 4; Underlying Compl. 'II 10.) When Mr. Court returned to the job site after lunch, Mr. Court's supervisor, Jessie Lavalle, and Nate Adams, a laborer, had erected new staging approximately fourteen to sixteen feet off the ground in an L-shape on the back of a garage. (Pl.'s Supp'g S.M.F. 'II 5; Underlying Compl. '['I[ 11, 14.) Mr. Lavalle was already on the staging. (Pl.'s Supp'g S.M.F. 'II 5; Underlying Comp!. 'II 14.) Mr. Court climbed up onto the staging and stepped on one of the planks, which flipped toward Mr. Court and caused him to fall. (Pl.' s Supp'g S.M.F. 'II 6; Underlying Comp!. '['I[ 15-16.) As a result of the fall, Mr. Court sustained injuries. (Pl.'s Supp'g S.M.F. 'I[ 7; Underlying Compl. 'II 17.) Mr. Court filed suit against Five Star, and later added Mr. Le as a defendant to the Underlying Action.

At the time of the accident, Mr. Le had a Commercial General Liability Policy ("the Policy") issued by Security. (Pl.'s Supp'g S.M.F. 'l[ 8; Def. Court's Add'! S.M.F. 'lI 17.) Mr. Le was the only named insured on the Policy. (Pl.'s Supp'g S.M.F. 'II 9.)

The Commercial General Liability Coverage Form of the Policy includes the following provision within a section entitled "Coverage A - Bodily Injury and Property

Damage Liability":

We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "bodily injury" or "property damage" to which this insurance does not apply. We may, at our discretion, investigate any "occurrence" and settle any claim or "suit" that may result ....

(Pl.'s Supp'g S.M.F. 'l[ 10; Pl.'s Ex. A at SNIC000030.)

There is one relevant exclusion set forth in an endorsement that modifies Coverage A of the Commercial General Liability Coverage Part ("the Designated Ongoing Operations Exclusion"). 2 (Pl.'s Supp'g S.M.F. 'l[ 13.) The Designated Ongoing Operations Exclusion provides:

This insurance does not apply to "bodily injury" or "property damage"

arising out of the ongoing operations described in the Schedule of this endorsement, regardless of whether such operations are conducted by you or on your behalf or whether the operations are conducted for yourself or for others.

(Pl.'s Supp'g S.M.F. 'l[ 13; Pl.'s Ex. A at SNIC000067.) The schedule defines "designated ongoing operations" as follows:

New construction of a dwelling and work within, or on, the premises of a dwelling prior to the certificate of occupancy of the owner, regardless of whether the dwelling is a custom home or the dwelling is built as part of a tract or a multi-dwelling development ....

(Pl.'s Supp'g S.M.F. 'lI 14; Pl.'s Ex. A at SNIC000067.)

The Policy also includes medical payments coverage for certain bodily injuries caused by an accident. (Pl.'s Supp'g S.M.F. 'l[ 15; Pl.'s Ex. A at SNIC000037.) The Policy excludes medical payments coverage "for expenses for 'bodily injury' ... excluded under Coverage A." (Pl.'s Supp'g S.M.F. 'l[ 16; Pl.'s Ex. A at SNIC000037.)

On July 17, 2019, Security' sent Mr. Le a letter stating:

AmTrust North America is the claims administrator for [Security], your liability insurer and we received a claim against you in connection with the

2 Security also cites to and briefly discusses an exclusion that applies to bodily injury included in the "products-completed operations hazard," but fails to cite to a portion of the record defining "products­ completed operations hazard" or explain why the allegations within the Underlying Complaint fall within this exclusion. The Court, therefore, omits further discussion of this exclusion. 3 As both Mr. Court and Security note, the letters discussed were sent by AmTrust North America, the claim

administrator for Security. The Court will refer to Am Trust North America acting on behalf of Security as "Security."

above-captioned matter. Please be advised that we reviewed this matter and determined that coverage may not be available for this matter for the reasons set forth below. Accordingly, Security hereby reserves the right to disclaim coverage of this matter to you.

(Def. Court's Add'! S.M.F. 'l[ 18; Def. Court's Ex. B; Pl.'s Add'! S.M.F. 'l['l[ 30, 31.) This letter continued to describe the claim and explain Security's bases for its determination that there may not be coverage for the claim. (Pl.'s Add'! S.M.F. 'l[ 32; Def. Court's Ex. B.) After describing the possible applicable exclusions under the Policy, the letter states: "For the foregoing reasons, Security is reserving its right to disclaim coverage of this matter to you." (Pl.'s Add'! S.M.F. 'l[ 33; Def. Court's Ex. B.) The letter also states that it "does not constitute a waiver of any policy provisions or defenses available to Security." (Pl.' s Add'! S.M.F. 'l[ 34; Def. Court's Ex. B.)

On October 8, 2019, Security sent Mr. Le a letter stating, among other things, that it was "reiterating its reservation of its right to disclaim coverage of this matter to you." (Def. Court's Add'! S.M.F. 'l[ 19; Def. Court's Ex. C; Pl.'s Add'! S.M.F. 'l['l[ 35, 38.) The letter also described the claim and each potential reason for denial of coverage. (Pl.' s Add'! S.M.F. 'l[ 37; Def. Court's Ex. C.)

On October 15, 2020, Security sent Mr. Le another letter in which it restated its reservation of its right to disclaim coverage. (Def. Court's Add'! S.M.F. 'l[ 20; Def. Court's Ex. D; Pl.'s Add'! S.M.F. 'l[ 39.) It read, in part:

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Security National Insurance Company v. Le, (Me. Super. Ct. 2022).

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