Western National Mutual Insurance Co. v. Decker

2010 S.D. 93, 2010 SD 93, 791 N.W.2d 799, 2010 S.D. LEXIS 168, 2010 WL 4997387
CourtSouth Dakota Supreme Court
DecidedDecember 8, 2010
Docket25507
StatusPublished
Cited by9 cases

This text of 2010 S.D. 93 (Western National Mutual Insurance Co. v. Decker) is published on Counsel Stack Legal Research, covering South Dakota Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Western National Mutual Insurance Co. v. Decker, 2010 S.D. 93, 2010 SD 93, 791 N.W.2d 799, 2010 S.D. LEXIS 168, 2010 WL 4997387 (S.D. 2010).

Opinion

KONENKAMP, Justice.

[¶ 1.] A parent whose child was injured while in the care of a babysitter brought *801 suit to recover damages. In a declaratory-judgment action, the insurance company successfully argued that its policy did not cover injuries sustained in a daycare-type business. We conclude that the circuit court correctly ruled that the policy was unambiguous and the business exclusion applied.

Background

[¶ 2.] On January 11, 2001, Joe Decker left his eight-month-old child, L.E.D., with Sarah Decker. Sarah placed L.E.D. in his car seat thinking he would go to sleep. Moments later she heard him make an odd noise. She took him out of the car seat; he had stopped breathing; he was choking on a small object. Sarah called for help, but ultimately the child suffered permanent brain damage.

[¶ 3.] At the time, Sarah was living with Benjamin Waldner, her brother. Benjamin owned the home. It was insured by Western National Mutual Insurance Company. Benjamin allowed Sarah to live there rent free. She cleaned and cared for the home while Benjamin, a trucker, was gone. Sarah’s fiancé, Mark Decker, lived there also, along with others who rented rooms from Benjamin. Mark Decker is Joe Decker’s cousin. Benjamin, Sarah, Mark, and Joe all came from the same Hutterite colony.

[¶ 4.] Sarah cared for several children in Benjamin’s home. She did not have a name for her babysitting service or a written agreement with the parents about when and how she would be paid. In the year 2000, she provided care for nine children from six families. Sarah kept no records and filed no income tax returns. She recalled that she charged some parents $1.50 per hour. The hours Sarah cared for the children varied, but she provided care five days a week, generally from nine to five.

[¶ 5.] In March 2000, Joe Decker and his wife Valerie began using Sarah to care for their older child, B.D. L.E.D. was born on May 23, 2000. Sarah started caring for him, according to Valerie, in August 2000. Sarah testified that when Joe dropped off and picked up the children, she did not charge him, in honor of the relationship between her fiancé, Mark, and his cousin, Joe. When Valerie picked the boys up, however, Valerie would pay her and Sarah accepted the payments. Valerie did not document these payments, but claimed $1,684 in child care credits on their 2000 federal income tax return for amounts paid to Sarah. It is undisputed that on the day of L.E.D.’s injury, Joe dropped off L.E.D. and Sarah did not charge him for her services.

[¶ 6.] A lawsuit on behalf of L.E.D. was brought against Sarah Decker and Benjamin Waldner for negligence. Western National sought a declaratory judgment that it had no duty to defend the action against Sarah or Benjamin or indemnify them because the policy unambiguously excluded coverage for L.E.D.’s injury. Both sides moved for summary judgment.

[¶ 7.] Western National argued that when the accident occurred, Sarah was operating a business, and the injury was sustained as a result of her business activities, which were not covered under the express terms of the policy. Valerie, on the other hand, asserted that Western National’s policy is ambiguous on the facts of the case, and the ambiguity should be construed against Western National and in favor of coverage.

[¶ 8.] The policy defines “Business” as “a trade, a profession, or an occupation including farming, all whether full or part time.... ‘Business’ includes services regularly provided by an ‘insured’ for the care of others and for which an ‘insured’ is compensated. A mutual exchange of like *802 services is not considered compensation.” The policy farther states that “ ‘[business’ does not include: ... b. activities that are related to ‘business,’ but are usually not viewed as ‘business’ in nature.” Under the section entitled “EXCLUSIONS THAT APPLY TO LIABILITY COVERAGES,” the policy provides, “ ‘We’ do not pay for ‘bodily injury’ or ‘property damage’ resulting from one or more of the following excluded ‘occurrences,’ ... g. ‘bodily injury’ or ‘property damage’ resulting from activities related to the ‘business’ of an ‘insured,’ except as provided by Incidental Business Coverage.” No incidental business coverage existed in this case.

[¶ 9.] Finding the policy language unambiguous, the circuit court ruled that Sarah regularly provided care for others for which she was compensated. In the court’s view, it was immaterial that Sarah did not charge Joe and Valerie Decker each time she cared for their children: she cared for children on a daily basis and was “compensated” as part of her business pursuit. The court ruled inapplicable the exception to the exclusion, which provided that “business” does not include “activities that are related to ‘business,’ but are usually not viewed as ‘business’ in nature.” In the court’s view, L.E.D. was injured as a result of the care provided through Sarah’s operation of her business. Because Sarah was operating a business as defined under the policy, and the policy does not cover bodily injury caused by the operation of a business, the court granted summary judgment for Western National.

Analysis and Decision

[¶ 10.] On appeal, Valerie argues that Western National’s insurance policy is ambiguous because the policy defines business to include certain activities while it excludes “activities related to ‘business’ but are not usually viewed as ‘business’ in nature[.]” Insurance contract interpretation is a question of law reviewed de novo. Auto-Owners Ins. Co. v. Hansen Hous., Inc., 2000 S.D. 13, ¶ 10, 604 N.W.2d 504, 509 (citations omitted). According to Valerie, without any parameters or guidelines on what activities Western National considers related to business but not usually viewed as business in nature, the policy provisions are “open to multiple interpretations” and are, therefore, ambiguous. *

[¶ 11.] “Ambiguity in an insurance policy is determined with reference to the policy as a whole and the plain meaning and effect of its words.” Nat’l Sun Indust., Inc. v. SD Farm Bureau Ins. Co., 1999 S.D. 63, ¶ 18, 596 N.W.2d 45, 48 (citation omitted). In construing the provisions of an insurance contract, we do not seek strained interpretations. Id. Moreover, “[t]he terms of an unambiguous insurance policy cannot be enlarged or diminished by judicial construction.” Am. Family Mut. Ins. v. Elliot, 523 N.W.2d 100, 102 (S.D.1994) (citation omitted).

[¶ 12.] There are three policy provisions we must examine here. First, the policy defines business to include “services regularly provided by an ‘insured’ for the care of others and for which an ‘insured’ is compensated.” There is no dispute Sarah is an insured. Therefore, if Sarah regular *803 ly provided care to others and was compensated for such care, her activities satisfy the policy definition of a business. The fact that the policy does not define “regularly” or “compensated” does not make the policy ambiguous. “Ambiguity in an insurance policy is determined with reference to the policy as a whole and the plain meaning and effect of its words.” Natl Sun Indust., Inc.,

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Cite This Page — Counsel Stack

Bluebook (online)
2010 S.D. 93, 2010 SD 93, 791 N.W.2d 799, 2010 S.D. LEXIS 168, 2010 WL 4997387, Counsel Stack Legal Research, https://law.counselstack.com/opinion/western-national-mutual-insurance-co-v-decker-sd-2010.