In Melvin West v. Southern County Mut. Ins. Co., No. 05-13-00012-CV (Tex.App. Dallas April 10, 2014), the Dallas Court of Appeals affirmed a summary judgment favoring Southern County Mutual Insurance Company (“Southern County”) on an exclusion in a business automobile insurance policy (“auto policy.”)  West was employed by Super Surface, Inc. (“Super”) to drive concrete trucks.  He was injured when the truck rolled over.   Super was a workers compensation insurance nonsubscriber.  Super filed an insurance claim for West’s injuries under their auto policy with Southern County.  Super and West then settled, and Super assigned its insurance claim to West.  West sued Southern County.  Southern County filed a motion for summary judgment on the basis that the following exclusion applied to West’s bodily injuries:

Bodily Injury to:

A.  An employee of the insured arising out of and in the course of employment by the insured …

But this exclusion does not apply to bodily injury to domestic employees not entitled to workers’ compensation benefits or to liability assumed by the insured under an insured contract.

West opposed the summary judgment on the grounds that “domestic employee” in the exception to the exclusion was ambiguous “because it could refer either to employees who work in a household or to employees who are citizens of the United States.”  As a result, West argued it should be construed in favor of coverage; that is, “all employees who are within the United States are excepted from the bodily-injury exclusion.” 

Southern County argued “the full phrase ’domestic employees not entitled to workers’ compensation benefits’ is unambiguous and refers to a class of employees who both work in a household and are not covered by workers’ compensation.”  Southern County argued that West’s injuries were not covered because he fell under the bodily-injury exclusion, and that the domestic-employee exception did not apply to West because he is not a household employee who is not entitled to workers’ compensation insurance.  The trial court granted the summary judgment.

The Dallas Court of Appeals affirmed the summary judgment and followed the Fort Worth Court of Appeals in concluding “the ‘domestic employee’ exception unambiguously referenced employees who work in the home.” The full phrase in the exception “refers to a specific class of employees referenced on the Texas Workers’ Compensation Act (TWCA) and the Texas Motor Vehicle Safety Responsibility Act (TMVSRA).”  “We conclude this is the only reasonable meaning.”  Thus, “considering the contract as a whole and the regulatory framework, we conclude ‘domestic employee not entitled to workers’ compensation insurance’ unambiguously refers to employees who work in a home.  We overrule West’s sole issue.”  Summary judgment in favor of the insurer was affirmed.

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