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Car accident exclusion applies in injured worker case


A federal judge on Friday tossed out a suit involving two insurers battling over who is liable for an accident involving an injured worker who suffered grave, secondary injuries while being transported for medical care by a third party.

Workers compensation insurer Employers Insurance Group contracted with One Call Medical Inc. to provide services to its clients, including arranging transportation for injured workers. In 2016, One Call arranged for an injured worker covered under Employers to be transported to his medical appointment in a taxi, neither owned nor operated by One Call. On the return trip the van was involved in a five-vehicle collision. The worker was rendered a quadriplegic as a result, according to documents in One Call Medical Inc., et al. v. National Fire & Marine Insurance Co., filed in U.S. District Court in Sacramento, California.

Employers later demanded indemnification from One Call, whose parent company, Coral Acquisition Inc., had previously purchased a managed care errors and omissions liability insurance policy for itself and its subsidiaries from defendant National Fire & Marine Insurance Co. One Call therefore claimed National Fire & Marine Insurance was liable to defend and indemnify it for the Employers claim stemming from the exacerbation of the worker’s injuries, according to documents.

National Fire & Marine Insurance, in turn, moved for summary judgment on the basis that automobile accidents are excluded from coverage, as it claims was clearly stated in the policy, according to documents.

A federal judge ruled in National Fire & Marine’s favor, presenting California case law that provides guidance on automobile accident exclusions, writing that in this case the policy “clearly states it excludes from coverage liability that is ‘based upon, arising out of . . . or in any way involving the actual or alleged ownership, operation, use, maintenance, loading or unloading of any motor vehicle.’”

One of the attorneys for National Fire & Marine Insurance applauded the decision. “We’re happy with the decision because we think it’s consistent with the policy terms and with the law of California,” said Mark Bonino, San Carlos, California-based partner with Hayes Scott Bonino Ellingson Guslani Simonson & Clause LLP.

Attorneys with One Call declined to comment. National Fire & Marine and One Call did not immediately respond to requests for comment.



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