Navarro-Martha v. American Home Assurance Co., No. 01-02-01157-CV (TX 9/9/2004)
| Decision Date | 09 September 2004 |
| Docket Number | No. 01-02-01157-CV.,01-02-01157-CV. |
| Court | Texas Supreme Court |
| Parties | DEBRA NAVARRO-MARTHA, Appellant v. AMERICAN HOME ASSURANCE CO., Appellee. |
On Appeal from the 165th District Court, Harris County, Texas, Trial Court Cause No. 2001-20443.
Panel consists of Justices TAFT, HANKS, and HIGLEY.
Appellant, Debra Navarro-Martha ("Debra"), appeals a take-nothing judgment rendered upon cross-motions for summary judgment. We determine whether certain endorsements within the business automobile policy of Debra's husband's employer made Debra, when not riding in a covered automobile and when on an excursion unrelated to her husband's work, an insured for purposes of that policy's uninsured and underinsured motorist ("UM/UIM") endorsement. We affirm.
On the date of the accident on which this suit is based, Debra was married to Vince Martha ("Vince"). Vince was an operations manager for NES Companies d/b/a Genpower Pump and Equipment. The company by whom Vince was employed was one in which National Equipment Services, Inc. ("NES") had an ownership interest. NES had a Texas standard business automobile policy ("the policy") with American Home Assurance Company ("American"). The policy listed as named insureds NES and certain of its affiliated business entities, including Vince's employer, but no individuals. The policy's declarations page listed "any auto" in the column for "covered auto[s]" for liability coverage, and it listed the UM/UIM endorsement number in the column for "covered auto[s]" for UM/UIM coverage. The policy also contained an endorsement for UM/UIM coverage and separate "Employees As Insureds" ("EAI") and "Drive Other Car—Broadened Coverage for Named Individuals" ("DOC") endorsements for liability coverage. Vince possessed a company vehicle that was a covered automobile under the policy.
On January 5, 2001, Debra was riding as a passenger in a car owned and driven by Jeff Fulkerson. The car was involved in a one-car accident in which Debra was injured. Fulkerson's car was not a covered automobile for any coverage afforded by the policy. Fulkerson's car was instead covered by a different carrier and had a $25,000 policy limit for liability coverage. Neither Fulkerson nor Debra was an employee of or was furthering the business of any named insured under the policy on the night of the accident. Vince was not involved in the accident and was not driving, occupying, or otherwise using Fulkerson's car at the time.
According to Debra's petition, the accident caused her to incur far more than $25,000 in medical expenses. Fulkerson testified by affidavit that he accepted full responsibility for the accident and Debra's resulting injuries. Debra made a claim for UM/UIM coverage under the policy,1 but American denied coverage. Debra sued Fulkerson for negligence and sued American for UM/UIM coverage under the policy and for various violations of the Insurance Code. Debra settled with Fulkerson in exchange for the full policy liability limits of $25,000.
American moved for summary judgment on the ground that Debra's claims failed because she was not an insured entitled to UM/UIM coverage under the policy. Debra moved for partial summary judgment on the ground that she was entitled to UM/UIM coverage. Without specifying grounds, the trial court granted American's motion, denied Debra's motion, rendered a take-nothing judgment on Debra's claims against American, and dismissed with prejudice Debra's claim against Fulkerson.
Traditional summary judgment under rule 166a(c) is proper only when a movant establishes that there is no genuine issue of material fact and that he is entitled to judgment as a matter of law. Randall's Food Mkts., Inc. v. Johnson, 891 S.W.2d 640, 644 (Tex. 1995). A defendant is entitled to a traditional summary judgment if the evidence disproves as a matter of law at least one element of each of the plaintiff's causes of action or if the evidence conclusively establishes all elements of an affirmative defense. Id. When a plaintiff moves for traditional summary judgment on its own claims for affirmative relief, the plaintiff has the burden of proving conclusively each element of its causes of action. MMP, Ltd. v. Jones, 710 S.W.2d 59, 60 (Tex. 1986). The plaintiff carries this burden if it produces evidence that would suffice to support an instructed verdict at trial on its claims for affirmative relief. Ortega-Carter v. Am. Int'l Adjustment Co., 834 S.W.2d 439, 441 (Tex. App.-Dallas 1992, writ denied). We indulge every reasonable inference in favor of the non-movant, resolve any doubts in its favor, and take as true all evidence favorable to it. Randall's Food Mkts., 891 S.W.2d at 644; Flameout Design & Fabrication, Inc. v. Pennzoil Caspian Corp., 994 S.W.2d 830, 834 (Tex. App.-Houston [1st Dist.] 1999, no pet.).
When both sides move for summary judgment and the trial court grants one motion and denies the other, we can consider both motions, their evidence, and their issues and may render the judgment that the trial court should have rendered. Holy Cross Church of God in Christ v. Wolf, 44 S.W.3d 562, 566 (Tex. 2001); CU Lloyd's of Tex. v. Feldman, 977 S.W.2d 568, 569 (Tex. 1998). When an order granting summary judgment does not specify the grounds upon which the trial court ruled, we must affirm to the extent that any of the summary judgment grounds is meritorious. Star-Telegram, Inc. v. Doe, 915 S.W.2d 471, 473 (Tex. 1995).
We construe an insurance contract we do as any other contract. Balandran v. Safeco Ins. Co. of Am., 972 S.W.2d 738, 740-41 (Tex. 1998). Our primary goal is to effectuate the written expression of the parties' intent. Id. at 741. We read the contract as a whole, striving to give every part meaning and effect. Id. The Supreme Court has recently explained that, " Progressive County Mut. Ins. Co. v. Sink, 107 S.W.3d 547, 551-52 (Tex. 2003) (quoting United States Ins. Co. of Waco v. Boyer, 269 S.W.2d 340, 341 (Tex. 1954)).
A contract is unambiguous when, after applying construction rules, we conclude that it can be given a definite legal meaning. Nat'l Union Fire Ins. Co. of Pittsburgh, PA v. CBI Indus., Inc., 907 S.W.2d 517, 520 (Tex. 1995). When the contract is unambiguous, we give effect to its plain language. Perrotta v. Farmers Ins. Exch., 47 S.W.3d 569, 574 (Tex. App.-Houston [1st Dist.] 2001, no pet.). Ambiguity is a question of law. CBI Indus., Inc., 907 S.W.2d at 520. A contract is ambiguous when, after applying construction rules, we conclude that it could have two or more reasonable interpretations. Balandran, 972 S.W.2d at 741. We may consider parol evidence of the parties' interpretation only if the contract is ambiguous. CBI Indus., Inc., 907 S.W.2d at 520. If the contract is ambiguous, we must adopt the construction most favorable to the insured. Nat'l Union Fire Ins. Co. of Pittsburgh, PA v. Hudson Energy Co., 811 S.W.2d 552, 555 (Tex. 1991).
In an insurance dispute, the claimant has the initial burden to establish that his claim comes within the scope of coverage provided by the policy. Comsys Info. Tech. Servs., Inc. v. Twin City Fire Ins. Co., 130 S.W.3d 181, 188 (Tex. App.-Houston [14th Dist.] 2003, pet. granted); Evergreen Nat'l Indem. Co. v. Tan It All, Inc., 111 S.W.3d 669, 675 (Tex. App.-Austin 2003, no pet.). In contrast, the insurer has the burden to prove that a claim comes within a policy exclusion or limitation of coverage. Tex. Ins. Code Ann. art. 21.58(b) (Vernon Supp. 2004-2005); Tan It All, 111 S.W.3d at 675. Whether Debra was an insured under the UM/UIM endorsement is a question of the existence of coverage, rather than of an exclusion, limitation, or exception to coverage; accordingly, Debra had the burden of proof.2 See Comsys Info. Tech. Servs., 130 S.W.3d at 188; Tan It All, 111 S.W.3d at 675.
The policy contains the standard Texas UM/UIM endorsement, which provided in pertinent part as follows:
A. COVERAGE
We will pay damages which an insured is legally entitled to recover from the owner or operator of an uninsured motor vehicle because of bodily injury sustained by an insured . . . .
. . .
C. WHO IS AN INSURED
. . .
F. ADDITIONAL DEFINITIONS
The following are added to the DEFINITIONS Section and have special meaning for UNINSURED/UNDERINSURED MOTORISTS INSURANCE:
1. "Family member" means a person related to you by blood, marriage or adoption who is a resident of your household, including a ward or a foster child.
2. "Designated person" means an individual named in the schedule. By such designation, that person has the same coverage as you. . . .
a. owned or leased by you or
b. while temporarily used as a substitute for an owned covered auto that has been withdrawn from normal use because of its breakdown, repair,...
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