274 So. 3d 575
La. Ct. App.2019Background
- Prejean was injured on Oct. 11, 2012 while trimming a residential tree for Garden of Eden LLC (GOE) / owner Corey McMillan; he alleged he worked as an independent contractor or an under‑the‑table employee.
- Prejean sued GOE, McMillan, and Western World Insurance (Western World), GOE’s commercial general liability insurer.
- Western World moved for summary judgment, arguing the policy excluded coverage for any injured "hired person" (employees, independent contractors, temporary workers, contractors/subcontractors and their workers).
- The trial court granted summary judgment, finding the policy exclusions precluded coverage; Prejean’s motion for new trial was denied and he appealed.
- On de novo review, the appellate court construed the policy language as clear and unambiguous and concluded each possible hired‑person classification of Prejean would be excluded by the policy.
- The appellate court affirmed the summary judgment and assessed appeal costs to Prejean.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Western World’s policy covers Prejean’s injury | Prejean: Coverage exists under Coverage A (bodily injury) and/or Coverage C (medical payments); "hired person" exclusion in Coverage C should not bar Coverage A | Western World: Policy expressly excludes "hired person(s)" and separately excludes employees, independent contractors, temporary workers, contractors/subcontractors and their workers from coverage | Held: Policy unambiguously excludes Prejean under one or more hired‑person exclusions; no coverage |
| Whether the term "Hired Person" is a separate category entitling coverage | Prejean: "Hired Person" is a distinct category; because Coverage A doesn’t use the titled "Hired Person" exclusion, Coverage A should apply | Western World: "Hired Person" is a general reference to any person hired to do work for insured; other exclusions specifically exclude the relevant categories for Coverage A | Held: Court rejects Prejean’s strained reading; "Hired Person" is not a separate avenue to coverage |
| Whether Prejean’s status as an employee of GOE or McMillan precludes coverage | Prejean: disputed factual status (employee v. contractor) — argues coverage should be analyzed in his favor | Western World: Employer’s Liability exclusion bars coverage for bodily injury to an employee arising out of employment or duties related to insured’s business; GOE’s member McMillan qualifies as an insured | Held: If Prejean is an employee of GOE or McMillan, Employer’s Liability exclusion bars Coverage A |
| Whether independent‑contractor, temporary‑worker, or contractor/subcontractor exclusions apply | Prejean: factual dispute over classification should favor coverage on summary judgment | Western World: Policy contains specific endorsements excluding independent contractors, temporary workers, and contractors/subcontractors and their workers | Held: Any factual finding that Prejean fits one of these categories eliminates coverage under the policy |
Key Cases Cited
- Guste v. Lirette, 251 So.3d 1126 (La. App. 1st Cir.) (appellate de novo review of summary judgment)
- Green v. Johnson, 241 So.3d 1188 (La. App. 1st Cir.) (insurance contract interpretation rules)
- Hinchcliffe v. Siaotong, 253 So.3d 1304 (La.) (construction of exclusions against insurer when ambiguous)
- Donahue v. Donahue, 206 So.3d 858 (La.) (successor judge may sign prior judge’s judgment)
- Byrd v. Pulmonary Care Specialists, Inc., 209 So.3d 192 (La. App. 1st Cir.) (appeal treated as from merits where intent is clear)