Injured Employee Seeks
Coverage Under Employer's Policy
|
Commercial Auto |
Who is An Insured |
|
Uninsured Motorists Coverage (UM) |
Not in the Scope of Work |
Renee Reese (Reese) and her son, Austin (the Reese family),
were injured in a car accident in June 1996 after an unidentified driver cut
off Reese. She was driving to Sarcom, Inc., her workplace. The Reeses settled
with their own uninsured motorist insurance and later sought coverage under
Sarcom's business auto, umbrella, and commercial general liability policies
from Fidelity & Guaranty Insurance Company (F&G). When F&G denied
their claim, they filed a lawsuit for declaratory judgment. Both sides then
filed motions for summary judgment.
The trial court found in favor of F&G. The Reeses
appealed.
The
F&G business auto policy issued to Sarcom identified the named insureds as
"Sarcom, Inc., J.R. Wilcox & Associates DBA: Inacomp Computer Rentals,
Sarcom Properties, Inc., J.J.S. Wilcox, Ltd." Three additional insureds,
who were businesses identified as lessors, were added via endorsements for
liability coverage. The policy identified "Sarcom, Inc." as the named
insured, and the section "Who Is An Insured" question was answered in
part as "You" and included "If you are an individual, any family
member." Applying current Ohio law, the Reese family qualify as
"You" according to the policy's definition.
On
appeal, Fidelity contended that the definition of "You" was altered
when James R. Wilcox was added as an additional insured in the F&G
commercial umbrella policy. F&G argued that explicitly including an
individual removed the ambiguity that previously allowed the court to interpret
the contract as including the Reese family under the definition of
"You."
The
Ohio Eighth District Court of Appeals in Cuyahoga County disagreed, emphasizing
that James Wilcox was not listed as an additional insured on the auto policy.
The use of "You" in the uninsured motorist section was ambiguous,
making it appropriate to include the Reese family within that definition.
The
main issue was whether the Reese family was covered by the policy, which
depended on if Reese was an employee acting within the scope of her employment
with Sarcom at the time of the accident. Both parties agreed Reese was en route
to work when the accident happened. According to Ohio law, an employee is not
considered to be acting within the scope of employment when driving to a fixed
workplace unless there is a "special benefit" to the employer beyond
providing the employee's services at the needed location. There was no evidence
that Reese provided such a "special benefit" to Sarcom. Since she was
injured while commuting to work, she was not covered under the policy and was
not entitled to coverage.
Sarcom
also maintained a commercial general liability policy with Fidelity. This
policy excluded coverage for bodily injuries caused by autos, but the exclusion
did not apply to "Parking an 'auto' on, or on the ways next to, premises
you own or rent, as long as the auto is not owned, rented, or loaned to them.”
The Reese family contended that this parking provision effectively expanded the
policy to include motor vehicle liability coverage.
The
court disagreed, stating that one provision does not convert what is otherwise
a non-motor vehicle insurance policy into a motor vehicle insurance policy. In
addition, even if the policy were changed, Reese would not be eligible for
coverage since she failed to demonstrate that she was acting within the scope
of employment. This reasoning also applied to the commercial umbrella policy.
The
court concluded that the trial court correctly granted summary judgment to
F&G and upheld that decision.
Reese v. Fidelity & Guaranty Insurance Underwriter-No.
83606-Court of Appeals of Ohio, Eighth District, Cuyahoga County-October 7,
2004-821 North Eastern Reporter 2d 1052