Tippie v. OneBeacon America Insurance Company

Filing 79

MEMORANDUM AND ORDER granting 41 defendant's Motion for Summary Judgment; and denying 48 plaintiff's Motion for Summary Judgment. Signed by District Judge J. Thomas Marten on 2/2/2012. (mss)

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF KANSAS

CLYDE J. TIPPIE,
Plaintiff,

vs.

Case No. 11-2066-JTM

ONEBEACON AMERICA INSURANCE COMPANY,
Defendant.

MEMORANDUM AND ORDER
Clyde Tippie and OneBeacon American Insurance Company dispute whether benefits are due
under an occupational accident insurance policy. OneBeacon moves for summary judgment on all
claims (Dkt. No. 41). Mr. Tippie, a commercial truck driver, moves for summary judgment on
whether he was “under dispatch” by the policy’s terms, and for attorney fees under Kansas Statute
§ 40-256 for failure to pay benefits without just cause (Dkt. No. 48). Because the unambiguous
language of the policy provides that no benefits are payable on any loss filed under a workers
compensation law until such a filing is approved or denied, and Mr. Tippie has a pending workers
compensation claim, OneBeacon’s motion is granted, and Mr. Tippie’s motion is denied.

I. Summary Judgment Legal Standard
“A party may move for summary judgment, identifying each claim or defense—or the part
of each claim or defense—on which summary judgment is sought.” FED. R. CIV. P. 56(a). “The court
shall grant summary judgment if the movant shows that there is no genuine dispute as to any material

fact.” Id. Summary judgment is proper when the pleadings, depositions, answers to interrogatories,
and admissions on file, together with affidavits, if any, show there is no genuine issue as to any
material fact, and that the moving party is entitled to judgment as a matter of law. FED. R. CIV. P.
56. In considering a motion for summary judgment, the court must examine all evidence in a light
most favorable to the opposing party. McKenzie v. Mercy Hosp., 854 F.2d 365, 367 (10th Cir. 1988).
The party moving for summary judgment must demonstrate its entitlement to summary judgment
beyond a reasonable doubt. Ellis v. El Paso Nat. Gas Co., 754 F.2d 884, 885 (10th Cir. 1985). The
moving party need not disprove [nonmovant’s] claim; it need only establish that the factual
allegations have no legal significance. Dayton Hudson Corp. v. Macerich Real Estate Co., 812 F.2d
1319, 1323 (10th Cir. 1987) (alterations added).
In resisting a motion for summary judgment, the opposing party may not rely upon mere
allegations or denials contained in its pleadings or briefs. Anderson v. Liberty Lobby, Inc., 477 U.S.
242, 256 (1986). Rather, the nonmoving party must come forward with specific facts showing the
presence of a genuine issue of material fact for trial and significant probative evidence supporting
the allegation. Id. Summary judgment may be granted if the nonmoving party’s evidence is merely
colorable or is not significantly probative. Id. at 250-51. Once the moving party has carried its
burden under Rule 56(c), the party opposing summary judgment must do more than simply show
there is some metaphysical doubt as to the material facts. Matsushita Elec. Indus. Co., Ltd. v. Zenith
Radio Corp., 475 U.S. 574, 586 (1986). “In the language of the Rule, the nonmoving party must
come forward with ‘specific facts showing that there is a genuine issue for trial.’” Id. at 587 (quoting
FED. R. CIV. P. 56(e)) (emphasis in Matsushita).
Finally, the court reminds the parties that summary judgment is not a “disfavored procedural
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shortcut.” Celotex Corp. v. Catrett, 477 U.S. 317, 327 (1986). It is an important procedural vehicle
“designed to secure the just, speedy and inexpensive determination of every action.” Id. One of the
principal purposes of the summary judgment rule is to isolate and dispose of factually unsupported
claims or defenses, and the rule should be interpreted in a way that allows it to accomplish this
purpose. Id.

II. Uncontroverted Facts
Mr. Tippie, the owner-operator of a truck, entered into an independent contractor agreement
with Greatwide Dedicated Transport. OneBeacon issued an occupational accident insurance policy
(Policy) to Greatwide for a one-year period beginning February 20, 2009, and Mr. Tippie obtained
coverage through the Policy. Mr. Tippie alleges he sustained injuries in late May or early June 2009,
while working on his truck under his agreement with Greatwide, and he submitted a claim to
OneBeacon for benefits under the Policy—the accident insurance policy covering independent
contractors. The claim was denied. On July 9, 2010, Mr. Tippie filed a workers compensation claim
with the Kansas Division of Workers Compensation (KDWC), on the theory that at the time of injury
he was actually an employee of Greatwide, rather than an independent contractor. OneBeacon, which
covers Greatwide employees under a different insurance program, has denied the worker’s
compensation claim. The claim filed before the KDWC is still pending. Mr. Tippie filed this suit on
January 18, 2011, in Kansas state court, and it was later removed to this court.

III. The Policy Language and Outstanding KDWC Claim
OneBeacon makes two arguments in support of its motion for summary judgment. First, that
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under the Policy, OneBeacon is not required to pay benefits for any loss until the workers
compensation claim filed with the KDWC has been resolved. Second, that Mr. Tippie was not
“under dispatch” at the time of his injury, and so the injury falls outside the Policy’s coverage. Mr.
Tippie urges resolution of the “under dispatch” question. Because this court finds OneBeacon’s
argument based on the Policy language persuasive, there is no need to reach the question of whether
Mr. Tippie was under dispatch.
The interpretation of an insurance contract is a question of law. Karlin v. Paul Revere Life
Ins. Co., 742 F. Supp.2d 1253, 1262 (D. Kan. 2010). Unambiguous language must be construed in
its plain, ordinary, popular sense, and according to the sense and meaning of the terms used. Id. “An
insurance policy is ambiguous when it contains language of doubtful or conflicting meaning based
on a reasonable construction of the policy’s language.” Id. But the language is not ambiguous simply
because the parties disagree about its interpretation. Id. Further, the court must not consider what the
insurer intends the language to mean. Id. Rather the court must view that language as to what a
reasonably prudent insured would understand the language to mean. Id. This court must consider the
terms of the insurance contract as a whole. Id.
OneBeacon cites the following Policy language for its contention that no benefits are due
until the KDWC workers compensation claim is resolved:
No benefits will be payable under this Policy for any loss which the Insured Person
claims or files under any Workers’ Compensation, employers’ liability, occupational
disease or similar law or any other insurance until such claim or filing is approved
or denied. Upon approval or denial, We will determine Our liability under the terms
and conditions of the Policy.
Dkt. No. 42, Ex. B., pg. 27. Like OneBeacon, Mr. Tippie believes the language is unambiguous. He
argues, however, that because OneBeacon denied the claim for workers compensation pending
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before the KDWC, there has been a denial of the claim which obligates OneBeacon to determine its
liability. The court agrees with the parties that the Policy language is unambiguous as it pertains to
the present dispute.
Omitting mid-sentence words superfluous to the issue, and adjusting the tense, the Policy
provision reads:
No benefits will be payable for any loss claimed or filed under any Workers’
Compensation law or insurance until such claim or filing is approved or denied.
Upon approval or denial, We will determine Our liability.
Mr. Tippie’s argument—that OneBeacon’s denial of the workers compensation claim pending before
the KDWC operates as a denial that triggers a determination of liability—is unpersuasive. Mr. Tippie
does not dispute that he has filed a loss under workers compensation law with the KDWC. Under
the Policy terms, no benefits are payable on any loss filed under a workers compensation law until
such a filing is approved or denied. And the KDWC is the organization that approves or denies
claims filed under Kansas Workers’ Compensation law—not OneBeacon. Mr. Tippie conflates his
filing under workers compensation law with his claim for the same loss under workers compensation
insurance, and in doing so formulates an unreasonable interpretation of the Policy’s language. For
these reasons, summary judgment for OneBeacon is appropriate.

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IT IS ACCORDINGLY ORDERED this 2nd day of February, 2012, that OneBeacon’s Motion
for Summary Judgment (Dkt. No. 41) is granted.
IT IS FURTHER ORDERED that Mr. Tippie’s Motion for Summary Judgment and for
attorney fees (Dkt. No. 48) is denied.

s/ J. Thomas Marten
J. THOMAS MARTEN, JUDGE

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