Case ID: so2d_715/html/0503-01.html
Source: Caselaw Access Project
Author: {"author": "\n      hMcKAY, Judge. 1 iPLOTKIN, Judge,", "license": "Public Domain", "url": "https://static.case.law/"}
Date Created: 2024-08-24T03:29:51.129683

Ambrose PETERSON v. Robert A. SCHIMEK, M.D. and Lafayette Insurance Company.
    No. 97-CA-2801.
    Court of Appeal of Louisiana, Fourth Circuit.
    June 2, 1998.
    Geoffrey H. Longenecker, Longenecker & Associates, Ltd., - Covington, for Defendant/Appellant.
    Darleen M. Jacobs, Al Sarrat, Law Offices of Darleen M. Jacobs, New Orleans, for Plaintiff/Appellee.
    William J. Wegmann, Jr., Orr Adams, Jr., Law Offices of William J. Wegmann, L.L.C., Metairie, for Defendant/Appellee.
    Before KLEES, PLOTKIN and McKAY, JJ.
   hMcKAY, Judge.

Defendant, Lafayette Insurance Company, appeals the granting of a motion for summary judgment which found that a commercial insurance policy issued by it provided coverage for the claim on the alleged personal injury which gave rise to this case. In their answers to this appeal, both the other defendant Robert A. Shimek and the plaintiff Ambrose Peterson urge that the Trial Court did not err in the granting of the motion for summary judgment. We affirm.

Robert A. Shimek is an ophthalmologist with offices in New Orleans and Metairie. Dr. Shimek is also the owner of a piece of rental property located at 2533 River Road in Metairie. Ambrose Peterson was the lessee of this property. Mr. Peterson was allegedly injured on September 9, 1994 when he grabbed on to a handrail which broke and caused him to fall. Mr. Peterson subsequently filed a petition for damages due to his alleged injury. Lafayette Insurance Company is the insurer of Dr. Shimek. On the date of the accident which gave rise to this case, Lafayette had in effect two polices of insurance in favor of Dr. Shimek which would possibly cover his liability in this case. One of these provided coverage of $1,000,-000.00; the other provided coverage of only $100,000.00. On September 20, 1996, the Trial Court heard cross motions for summary judgment filed on behalf of Lafayette Insurance Company and Ambrose Peterson concerning whether or not the above mentioned insurance policies provided coverage for Mr. Peterson’s alleged injury. The Trial Court granted Peterson’s motion, denied Lafayette’s, and found that both |2poIicies provided coverage for the alleged personal injury.

The issues on appeal in this case are whether the Trial Court erred in granting Peterson’s motion for summary judgment finding that coverage existed under Lafayette’s commercial policy and whether the judge erred in refusing to reform the policy in question to conform with the intent' of the parties. The answer to both of these questions is no.

To answer these questions we must first ask whether a policy of insurance should be treated as other contracts. The Louisiana Supreme Court in Schroeder v. Board of Supervisors of L.S.U., 591 So.2d 342 (La. 1991), stated: “It is well settled in our law that general rules of interpretation apply to insurance policies in the same way that they apply to other contracts.” Massachussetts Mutual Life Insurance v. Nails, 549 So.2d 826 (La.1989); Savoie v. Fireman’s Fund Insurance Company, 347 So.2d 188 (La.1977). Therefore, our examination of the policy must be governed by the rules that apply to contracts generally. Louisiana Civil Code Article 2046 provides that “when the words of a Contract are clear and explicit and lead to no absurd consequences, no further interpretation may be made in search of the parties’ intent.” Further, Civil Code art. 2047 provides ■ that when determining the meaning of the words of a contract, they “must be given their generally prevailing meaning.”

In this case, the policy of insurance issued by Lafayette to Dr. Shimek governs the relationship between the parties and its wording must be studied to determine what obligations are owed by the parties. Lafayette correctly argues that the only properties listed on the declarations page of the policy are Dr. Shimek’s medical office buildings. However we must look at the entire policy and not just the declarations page in order to determine the actual agreement 1 ^between the parties.

First of all it should be noted that the policy was in effect on the date of the alleged injury. The policy provided that it would pay all sums that the insured became legally obligated to pay as damages because of bodily injury to which this insurance applies. It goes on to say that damages because of bodily injury include “damages claimed by any person at any time resulting from the bodily injury.” The coverage territory is defined as “anywhere in the United States of America.”

Section II of this policy provides that an individual is an insured, “but only with respect to the conduct of a business of which you are the sole owner.” Lafayette argues that this applies only to Dr. Shimek’s medical practice. However, the policy is not that restrictive; it states that an individual policy holder is insured with respect to the conduct of “a business” of which he is the sole owner,

Lafayette also questions whether Dr. Shimek’s rental property is a business. According to La. R.S. 12:1301 A. (2), the definition of business is “any trade, occupation, profession, or other commercial activity, including but not limited to professions licensed by a state or other governmental agency whether or not engaged in for profit.” From this definition Dr. Shimek’s rental property qualifies as a business. Normally when determining the meaning of the words of a contract, they are to be given their generally prevailing meaning. La. C.C. art. 2047. Even if it is ambiguous whether or not Dr. Shimek’s rental property constitutes a business, any ambiguity in the policy must be resolved against its writer and in favor of coverage. Smith v. Matthews, 611 So.2d 1377 (La.1993). It should also be noted that in case of doubt in a standard form contract that provision must be interpreted against the party who furnished |4its text. La. C.C. art. 2056. Thus, we must find that Dr. Shi-mek’s rental property is a business.

When the entire contract is read it is clear coverage existed on the date of the alleged accident. Damages due to bodily injury are covered under this policy. The coverage territory is the United States of America and an insured is covered for the conduct of a business of which he is the sole owner. Therefore, Dr. Shimek is covered under the commercial policy because Mr. Peterson’s claim was for bodily injuries he allegedly sustained on a date the policy was in effect, at a business of which Dr. Shimek was the sole owner, and which was located in the United States of America.

Although Lafayette contends that it was the intent of the parties for the coverage to extend only to Dr. Shimek’s medical practice, the language of the policy is much broader. It covers not only Dr. Shimek’s medical practice but also any business of which he or he and his spouse were the sole owner/owner. Since the language of the policy is clear, we will look no further than the policy itself.

For the foregoing reasons, the granting of the motion for summary judgment by the district court is affirmed.

AFFIRMED.

PLOTKIN, J., dissents with written reasons.

1 iPLOTKIN, Judge,

dissenting.

I respectfully dissent in the majority opinion affirming the trial court judgment denying the motion for summary judgment in favor of defendant Lafayette Insurance Co. and granting the motion for summary judgment in favor of plaintiff Ambrose Peterson. The declarations page of the Commercial General Liability Policy issued by Lafayette Insurance, policy number 88-112 700, is clear; the policy is intended to cover only those injuries which occur on the premises where defendant Robert A. Schimek’s medical practice is located.

The policy in question lists the named insured as “SCHIMEK ROBERT A DR”; the policy period is identified as June 14, 1994 through June 14, 1995. Under the heading “DESCRIBED PREMISES AND COVERAGES,” the policy lists the following addresses:

4224 HOUMA BLVD STE 110
METAIRIE LA 70003
JOISTED MASONRY
OFFICE
3217 CANAL ST
,NEW ORLEANS LA 70119
FRAME .
OFFICE

As the majority points out, the “Insuring Agreement” section under the heading “COVERAGE A: BODILY INJURY AND PROPERTY DAMAGE LIABILITY,” the policy provides, in pertinent part, as follows:

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. ... This insurance applies only to “bodily injury” and |2“property damage” which occurs during the policy period. The “bodily injury” or “property damage” must be caused by an “occurrence.” The “occurrence” must take place in the “coverage territory.”

The term “Coverage Area,” is defined, in pertinent part, under “SECTION V — DEFINITIONS” as “The United States of America (including its territories and possessions), Puerto Rico and Canada.” Under “SECTION II — WHO IS AN INSURED,” the policy states, in pertinent part, as follows:

1. If you are designed in the Declarations as:
a. An individual, you and your spouse are insured, but only with respect to the conduct of a business of which you are a sole owner.

The majority incorrectly interprets the above provisions of the insurance policy to provide coverage for injuries incurred in any accident which occurs on premises where the named insured conducts a business of which he is the sole owner within the continental United States. In so doing, the majority finds that the Commercial General Liability Policy in question provides coverage for injuries incurred by the plaintiff at an address completely separate from the addresses listed on the Declarations Page under “DESCRIBED PREMISES AND COVERAGES.”

The court in Consolidated American Insurance Co. v. Landry, 525 So.2d 567 (La.App. 3 Cir.1988) faced almost the exact same issue raised by the instant appeal — i.e., whether an insurance policy insuring the defendant’s apartment business covered injuries occurring as a result of the defendant’s other business, a lumber yard. In finding that the policy did not find coverage for the plaintiffs injuries, the court quoted the trial court’s judgment with approval, in pertinent part, as follows:

The insurance policy, when read as a whole, clearly indicates that coverage applies only to the apartment business. This can be ascertained from the “four corners” of the policy, without need to look to the intent of the parties to the contract. Although [the defendant owner] may have incurred some liability through the operation of [the lumber business], this is a '^separate and distinct business pursuit, even theough [sic] he operates both as a sole proprietor.

The reasoning of the Landry case is sound and should be followed in the instant ease. The only thing distinguishing Landry from this case is the fact that the named insured listed on the policy in Landry was “LANDRY, LERSEY DBA LANDRY’S APARTMENTS,” while the named insured in the instant case is simply “SCHIMEK ROBERT A DR,” without any designation concerning the exact business interest insured. However, the same declarations page listing the “named insured” lists the “DESCRIBED PREMISES AND COVERAGES” as 4224 Houma Blvd, Ste. 110, Metairie, LA 70003 and 3217 Canal St., New Orleans, LA 70119. The accident in question in the instant case occurred at Dr. Schimek’s rental property located at 2533 River Road, Jefferson, LA 70121. Accidents at that location are not covered by the Commercial General Liability Policy at issue.

This conclusion is supported by the fact that Lafayette Insurance issued a second policy to Dr. Schimek, policy number 73-710 543, a “Dwelling Policy.” The Declarations Page of that policy identifies “SCHIMEK ROBERT A DR” as the named insured; the policy period is designated as April 19, 1994 through April 19,1995. The following address is listed under the heading “COVERAGE AND DESCRIBED LOCATION(S)”:

2533 RIVER ROAD (FRONT) ME-TAIRIE LA 70003, PERMANENT, NON-OWNER, 2 FAMILIES, 2 STORIES, FRAME.

The injuries sustained by the plaintiff in the instant case are clearly covered by the second policy, the Dwelling Policy, policy number 73-710 543.

Furthermore, the uneontroverted testimony of the insurance agent who wrote the policy was that the Commercial General Liability policy applied only to Dr. Schimek’s “business as an eye doctor.” Moreover, the agent testified | concerning the dwelling policies on Dr. Schimek’s various investment rental properties. The insurance agent gave detailed testimony concerning Dr. Sehimek’s requests for insurance coverage on the premises housing his medical practice, as opposed to the insurance coverage for his investment rental properties.

Accordingly, the trial court judgments denying Lafayette General’s motion for summary judgment concerning the Commercial General Liability Policy, policy number 88-112 70, and granting the motion for summary judgment in favor of Mr. Peterson concerning the same policy is manifestly erroneous. I dissent from the majority’s decision affirming those judgments.