Opinion ID: 150548
Heading Depth: 3
Heading Rank: 2

Heading: The Amerisure Exclusions

Text: The workers'-compensation exclusion does not preclude coverage for Texas Crewboats or Sylvester.
Clanton and Satterfield sued Texas Crewboats for negligence under the Jones Act. This exclusion precludes coverage for [a]ny obligation for which the insured or the insured's insurer may be held liable under any workers compensation ... or any similar law. The issue, therefore, is whether the Jones Act is similar to workers' compensation. It is not. The Texas Supreme Court has not addressed this precise question, and we have located only one published decision that is directly on point, Sanders v. Home Indemnity Insurance Co., 594 So.2d 1345, 1352-53 (La.Ct.App.3d Cir.1994). [4] In Sanders, 594 So.2d at 1352, the court considered the effect of a similar exclusion, stating that [t]his insurance does not cover... [a]ny obligation imposed by a worker's compensation ... law ... or any similar law. The court held that the Jones Act is not similar to workers' compensation because the former is based on the employer's negligence while the latter is not. See Sanders, 594 So.2d at 1352-53; see also Abogado v. Int'l Marine Carriers, 890 F.Supp. 626, 630 (S.D.Tex.1995) (explaining that workers'-compensation claims, which are imposed without regard to fault, are not similar to and independent of claims based on ... Jones Act negligence (citation omitted)). We find this reasoning persuasive. Furthermore, the operative phrase here, any similar law, is ambiguous with respect to the Jones Act claims. In light of this ambiguity, the court must interpret the term so that it does not exclude coverage. See Mid-Continent Cas. Co. v. Swift Energy Co., 206 F.3d 487, 491 (5th Cir. 2000) (citation omitted).
This exclusion does not apply to Sylvester. Clanton and Satterfield charged Sylvester with negligent and reckless driving. Because Sylvester was not Clanton or Satterfield's employer, such claims, if proven, would not create obligation[s] for which [Sylvester] or [his] insurer may be held liable under any workers compensation, disability benefits or unemployment compensation law or any similar law.
This exclusion precludes coverage for Texas Crewboats, but not for Sylvester.
The parties agree that the accident involved bodily injury to ... employee[s] of [Texas Crewboats] arising out of and in the course of employment by [Texas Crewboats].... Navigators, however, contends that the exclusion is inapplicable under the subsection of the exclusion that states, [t]his exclusion does not apply to bodily injury to domestic employees not entitled to workers compensation benefits.... According to Navigators, the term domestic employees does not refer to butlers and chambermaids, but rather to employees who work in the United States as opposed to those who work abroad. This interpretation is unreasonable, and therefore, does not defeat the otherwise applicable exclusion. Cf. Barnett v. Aetna Life Ins. Co., 723 S.W.2d 663, 666 (Tex. 1987) (citations omitted). Navigators admits that it was only able to locate one decision to support its interpretation, Carroll v. Castillo, No. 13-99-006-CV, 2000 WL 34592617, at  (Tex. App.Corpus Christi April 6, 2000, no pet. h.) (finding that the term domestic employee is ambiguous because it can refer to someone who works in the United States, and therefore, the term is incapable of precise determination for summary judgment purposes). Carroll was not designated for publication, which means that, under Texas Rule of Appellate Procedure 47.7, it has no precedential value. Furthermore, this court does not consider unpublished opinions when making an Erie guess. See Primrose Operating Co. v. Nat'l Am. Ins. Co., 382 F.3d 546, 565 (5th Cir.2004). The Texas Supreme Court has not resolved this question. Nor does it appear that any Texas court has resolved this issue in a published opinion. Thus, we consult decisions from other jurisdictions and the majority rule in making this Erie guess. See SMI Owen Steel Co. v. Marsh USA, Inc., 520 F.3d 432, 437 (5th Cir.2008) (citation omitted). Several courts have found that the term domestic employees, as used in an insurance exclusion, refers to household workers and not to those working in the United States. See, e.g., United Fire & Cas. Co. v. Gravette, 182 F.3d 649, 655 (8th Cir.1999) (holding that domestic refers to a person who performs services in a private household); Dakota, Minn., & E. R.R. Corp. v. Heritage Mut. Ins. Co., 639 N.W.2d 513, 517 (S.D.2002) (holding that domestic servant means a person whose labor is directed to the construction, maintenance or repair of the master's private properties or care of the master's family (internal quotation marks and citation omitted)); U.S. Fid. & Guar. Co. v. Rosso, 521 A.2d 301, 304 (Me.1987) (holding that the phrase domestic employee, as found in an insurance exclusion, refers to one that works in a house or on household chores). We agree with the interpretation of these courts. This domestic-employee exception to the exclusion is inapplicable for another reasonit only applies to those domestic employees who are not entitled to workers'-compensation benefits. Clanton and Satterfield were entitled to such benefits because Texas Crewboats was a workers'-compensation subscriber. In sum, the employer-indemnification exception barred coverage for Texas Crewboats.
This exception does not apply to Sylvester because he was not Clanton or Satterfield's employer: This insurance does not apply to ... bodily injury to ... [a]n employee of the insured .... Sylvester is the insured. Clanton and Satterfield suffered bodily injuries. In order for this exclusion to apply, they must be employees of Sylvester. Neither party has claimed this, nor is there any basis in the record for this conclusion.
The fellow-employee exclusion does not preclude coverage for Texas Crewboats, but it may preclude coverage for Sylvester if he was an employee of Texas Crewboats.
This exclusion does not apply to Texas Crewboats because it is Clanton and Satterfield's employer, not their fellow employee. The exclusion only applies to [b]odily injury to any fellow employee of the insured ....
Amerisure and Navigators contest whether Sylvester was an employee of Texas Crewboats when the incident occurred. If he was, the exclusion applies, but if he was not, the exclusion does not apply. There is a genuine issue of material fact on this point. Navigators submitted the Declaration of James Travis, the Operations Manager of Texas Crewboats, explaining that Sylvester was not an employee, but rather, an independent contractor. Amerisure disputes this, pointing to deposition testimony from Clanton indicating that Sylvester was an employee. This court must consider the declaration and the deposition testimony when determining an insurer's duty to indemnify. See D.R. Horton-Texas, Ltd. v. Markel Int'l Ins. Co., 300 S.W.3d 740, 741, 744 (Tex.2009). In light of this conflicting testimony, neither party is entitled to summary judgment on Amerisure's duty to indemnify.