Opinion ID: 1506689
Heading Depth: 2
Heading Rank: 2

Heading: Exclusion e

Text: [¶ 12] The Academy argues that because the language of the exclusion e mirrors the immunity provisions of the workers' compensation law, it should be construed in a similar fashion. Thus, it excludes only claims already covered by workers' compensation. The Academy contends the court erred by applying the exclusion here because various injuries alleged by Martin either did not arise out of her employment, or did not arise in the course of her employment. Commercial Union contends that nothing in exclusion e limits its application to claims covered by workers' compensation and that the presence of exclusion d regarding such claims supports rejection of the Academy's overly narrow interpretation. Commercial Union further contends that exclusion e applies in this case because all claims in the underlying complaint are based on wrongful acts occurring during the course of Martin's employment with MSAHD and there are no factual allegations unconnected with such employment. Although we agree that the Academy's interpretation of the exclusion is more narrow than warranted by the policy language, we disagree that exclusion e precludes coverage in this case. [¶ 13] Both parties rely on Bond Builders, Inc. v. Commercial Union Ins. Co., 670 A.2d 1388 (Me.1996), to support their interpretations of the exclusion at issue. In Bond Builders the underlying complaint consisted of an action brought by a former employee of the defendant, Bond Builders, Inc., against the company, its president, and another employee. The complaint contained allegations of, among other things, assault and battery, employment discrimination, and infliction of severe emotional distress. Id. at 1389. After concluding Bond Builders' workers' compensation insurer had no duty to defend, we concluded that the comprehensive general liability and umbrella insurers had such a duty despite the fact each policy contained an employee exclusion provision similar to the exclusion at issue here. We stated: [The insurers] fail to recognize that the complaint does not allege that [the plaintiff's] injuries arose out of and in the course of his employment. In fact the contrary is alleged. Id. at 1391. Similarly, in the instant case Martin does not allege in her complaint that all of her injuries arose out of and in the course of her employment, but rather claims merely that all the incidents occurred during the period of time that she was employed by MSAHD. Martin's notice pleading does not necessarily imply that all of the alleged actions leading to her injuries occurred at the work place, nor does it necessarily imply that her injuries arose while working. For example, based on the allegations in her complaint, at trial Martin may prove that inappropriate sexual advances occurred at her home, or at other locations or under circumstances that trigger coverage. Because Martin's complaint reveals at least the potential that the facts proved at trial may come within the policy coverage, the duty to defend exists. Vigna, 686 A.2d at 599. See also Gibson, 673 A.2d at 1352 (Given the possible existence of any legal or factual basis for payment under a policy, an insurer's duty to defend should be decided summarily in favor of the insured.).