Brianna Robinson v. Monroe Guaranty Insurance Company

IMPORTANT NOTICE
NOT TO BE PUBLISHED OPINION
THIS OPINION IS DESIGNATED “NOT TO BE PUBLISHED.”
PURSUANT TO THE RULES OF CIVIL PROCEDURE
PROMULGATED BY THE SUPREME COURT, CR 76.28(4)(C),
THIS OPINION IS NOT TO BE PUBLISHED AND SHALL NOT BE
CITED OR USED AS BINDING PRECEDENT IN ANY OTHER
CASE IN ANY COURT OF THIS STATE; HOWEVER,
UNPUBLISHED KENTUCKY APPELLATE DECISIONS,
RENDERED AFTER JANUARY 1, 2003, MAY BE CITED FOR
CONSIDERATION BY THE COURT IF THERE IS NO PUBLISHED
OPINION THAT WOULD ADEQUATELY ADDRESS THE ISSUE
BEFORE THE COURT. OPINIONS CITED FOR CONSIDERATION
BY THE COURT SHALL BE SET OUT AS AN UNPUBLISHED
DECISION IN THE FILED DOCUMENT AND A COPY OF THE
ENTIRE DECISION SHALL BE TENDERED ALONG WITH THE
DOCUMENT TO THE COURT AND ALL PARTIES TO THE
ACTION.
RENDERED: AUGUST 18, 2022
NOT TO BE PUBLISHED
Supreme Court of Kentucky
2019-SC-0451-DG & 2020-SC-0153-DG
BRIANNA ROBINSON APPELLANT/CROSS-APPELLEE
ON REVIEW FROM COURT OF APPEALS
V. NOS. 2016-CA-1667 & 2016-CA-1668
CALLOWAY CIRCUIT COURT NO. 13-CI-00519
JOHN ABBINGTON THOMAS; JOHN
ABBINGTON THOMAS D/B/A ROOM
TO GROW PRESCHOOL; AND ROOM
TO GROW PRESCHOOL, LLC APPELLEES/CROSS-APPELLANTS
MONROE GUARANTY INSURANCE APPELLEE/CROSS-APPELLEE
COMPANY
MEMORANDUM OPINION OF THE COURT
AFFIRMING IN PART, REVERSING IN PART, AND REMANDING
In this consolidated insurance coverage case, the Court of Appeals
affirmed an order of the Calloway Circuit Court granting declaratory and
summary judgment to Monroe Guaranty Insurance Company by interpreting
an exclusion to a Commercial General Liability (CGL) insurance policy as
precluding coverage. Brianna Robinson allegedly sustained injuries from an
assault while attending a preschool insured under the CGL policy. Brianna, as
well as John Abbington Thomas, John Abbington Thomas d/b/a Room to Grow
Preschool, and Room to Grow Preschool, LLC, moved this Court for
discretionary review, which we granted, to determine whether the trial court
properly found no insurance coverage existed under the policy issued by
Monroe Guaranty. Having reviewed the record, the law, and the arguments of
the parties, we affirm in part, reverse in part, and remand for further
proceedings.
Over two decades ago, two-year-old Brianna was enrolled in Room to
Grow Preschool owned and operated by John Thomas in Murray, Kentucky.
Monroe Guaranty had issued a CGL insurance policy to “Room to Grow
Preschool John A. Thomas DBA.”
Within a few days, it became clear Brianna did not want to attend the
preschool. At bedtime on May 31, 2000, she told her mother, Lisa Robinson,
another child at Room to Grow, Madison, had touched her vaginal area
inappropriately. Unsure how to respond, Lisa put the child to bed. The
following day, Brianna’s father, Dr. Thomas Robinson, picked her up from
Room to Grow. Shortly thereafter, she told her father “it hurts to go potty.”
After Dr. Robinson found her vaginal area to be “red and raw,” he and his wife
agreed Brianna should be seen by their family physician, Dr. Richard Crouch.
Dr. Crouch opined a serious fall caused the injury or the irritation had
been caused by someone’s intentional act. Dr. Crouch recommended Brianna
be taken to a gynecologist immediately. The next day, Dr. Dawn Deeter
examined Brianna under anesthesia. She determined Brianna’s hymen was
stretched and discovered labial and vulvar lacerations indicative of attempted
penetration with a blunt object. Dr. Deeter and Brianna’s parents reported the
incident to police and the Cabinet for Health and Family Services (CHFS).
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During the ensuing investigation, officers spoke with Dr. Deeter regarding her
findings. After recounting her observations of Brianna’s injuries, Dr. Deeter
indicated she had consulted with another physician who opined Brianna’s
injuries were not caused by a child. Both physicians believed the injuries
resulted from some sort of penetration.
Officers then spoke with the Robinsons. Lisa indicated Brianna had
made various statements suggesting several possible perpetrators. On
separate occasions, Brianna stated she had been touched or rubbed by five-
year-old Madison, Thomas’s thirteen-year-old son, and Thomas, himself. When
questioned about who was present when the abuse occurred, Brianna looked
at her father and said “somebody gonna get you.”
Interviews were conducted with four daycare employees, Thomas, and
his wife. All stated the abuse did not occur at Room to Grow and none recalled
any injuries or complaints of pain from Brianna. Further, because of the open
setup of the daycare, each indicated it would have been impossible for anyone
to be alone with a child without being observed.
Dr. Robinson and Thomas subsequently underwent polygraph and urine
testing, and each provided DNA samples. Thomas was deemed to have been
truthful during the polygraph. Dr. Robinson’s polygraph results were deemed
to be inconclusive. Semen was discovered on several pairs of Brianna’s
underwear, including a pair she had not worn to Room to Grow. DNA testing
excluded Thomas as the contributor, but the sample included a mixture of
DNA from Brianna and Dr. Robinson.
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Dr. Robinson was ultimately indicted for sexual abuse. He was acquitted
following a jury trial. No other criminal charges have been brought against any
other alleged perpetrator. Thomas never informed Monroe Guaranty of the
alleged assault or the ensuing police investigation.
Thirteen years after the assault, Lisa sued Thomas and Room to Grow for
negligence, negligent infliction of emotional distress, and negligent failure to
rescue. Upon reaching the age of majority, Brianna was substituted as plaintiff
in place of her mother. The complaint alleged various acts of negligence,
including:
a. permitting an employee or other person to be alone with a child on
the premises of Room to Grow Pre-school during school hours
during which time the employee was able to penetrate the vagina
of [Brianna];
b. failing to properly and adequately supervise and discipline
its employees to prevent the injuries that occurred to
[Brianna];
c. failing to implement, enforce and/or follow adequate
protective and supervisory measures, policies and
procedures for the protection of students at Room to Grow
Pre-school, including [Brianna];
d. failing to adopt enforce and/or follow policies and
procedures to protect minors against harmful influence and
contact by its teachers and/or employees and/or other
persons;
e. failing to provide [Brianna] with any assistance in coping
with the injuries sustained;
f. failing to warn or otherwise make reasonably safe the
property which Defendants possessed and/or controlled,
leading to the harm to [Brianna];
g. negligently managing and/or operating Room to Grow Pre-
school;
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h. negligently hiring, training, and/or supervising employees of
Room to Grow Pre-school; and
i. failing to report suspected or known child abuse.
Monroe Guaranty intervened, seeking a declaration of its rights regarding
its obligation to defend and indemnify Thomas and the preschool. The CGL
policy issued by Monroe Guaranty included a Day Care Professional Liability
coverage endorsement which contained several exclusions. In seeking
summary judgment, Monroe Guaranty first argued no liability could attach to
the Room to Grow Preschool, LLC, because it had not been formed and was not
in existence at the time of the incident, and, as a result, it should be dismissed
as a party. Further, Monroe Guaranty contended sexual abuse did not qualify
as an “Occurrence” as defined by the policy, all of the daycare endorsement
exclusions applied, and the insureds failed to timely report Brianna’s claims.
Citing K.M.R. v. Foremost Ins. Group, 171 S.W.3d 751 (Ky. App. 2005),
the trial court concluded no coverage existed for Brianna’s alleged injuries
because they arose out of violations of multiple sections of KRS1 Chapter 510.
The trial court found the CGL and daycare endorsement contained an
exclusion of coverage for any “bodily injury” arising out of the violation of any
statute, government rule, or regulation. Thus, the trial court held Monroe
Guaranty owed no duty under the policy to provide insurance coverage, a
defense, or indemnification to the defendants for Brianna’s claims. There being
1 Kentucky Revised Statutes.
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no genuine issue of material fact as to coverage, the trial court granted
summary judgment in favor of Monroe Guaranty. Brianna, Thomas, and Room
to Grow appealed.
A divided Court of Appeals panel affirmed concluding:
It is unthinkable penetration of the vagina of a two-year-old child,
resulting in four lacerations, is not violative of our statutes,
regardless of the identity of the perpetrator and regardless whether
a conviction could be obtained. The language of the exclusion does
not specify that the statutory violation must result in a conviction.
Thus, the majority held the endorsement’s “violation of any statute” exclusion
precluded coverage for Brianna’s injuries. Further, the majority rejected
Brianna’s assertions the policy language and exclusions rendered coverage
illusory and violated the doctrine of reasonable expectations. Finally, the
majority was unpersuaded by Brianna’s assertion her claims “arose out of”
common law negligence rather than from the violation of any statute, reasoning
insurance coverage and the duty to defend come solely from the express
language of the insurance contract, not from allegations raised in a complaint.
Discerning no genuine issue of material fact and concluding Monroe Guaranty
owed no duty to provide insurance coverage as a matter of law, the Court of
Appeals affirmed. These consolidated appeals followed.
Initially, we note Room to Grow Preschool, LLC, was not formed until
2007, some seven years after Brianna allegedly sustained her injuries. As it
was not a legal entity in existence when the cause of action arose, no liability
could attach, and it obviously could not be deemed to be covered by an
insurance policy issued years before its formation. Thus, Monroe Guaranty
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plainly had no obligations to defend against or provide coverage for any claims
raised relative to Room to Grow Preschool, LLC, and was therefore entitled to
judgment as a matter of law. Insofar as the trial court’s declaratory and
summary judgment dismissed Brianna’s claims against Monroe Guaranty
related to actions of Room to Grow Preschool, LLC, it is affirmed. We turn now
to issues surrounding the remaining parties.
Before this Court, Brianna2 argues the Court of Appeals erred in
affirming the trial court’s entry of declaratory and summary judgment in favor
of Monroe Guaranty. She raises many of the same issues she has brought
previously, but primarily asserts the “violation of any statute” exclusion is
inapplicable, and the policy language contains no other applicable bars to
coverage. She contends the trial court and Court of Appeals read the daycare
endorsement’s exclusion too broadly to exclude coverage when any person
violates any statute. Monroe Guaranty defends the decisions of the lower
courts and insists the endorsement’s exclusions apply to deny coverage for
Brianna’s claims.
Our review reveals the trial court and the Court of Appeals have
overlooked a critical step in the calculus of determining coverage under the
CGL, and in so doing, summary judgment was improvidently granted and
affirmed on appeal. At the outset of our analysis, however, we underscore
2 Thomas and Room to Grow were granted leave to adopt Brianna’s brief
relative to their cross-motion for discretionary review. No further action has been
taken by either since that time.
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insurance coverage is a separate issue from liability. Our decision today,
therefore, should not be read as expressing an opinion relative to the merits of
Brianna’s underlying negligence claims.
At the time of Brianna’s assault, Thomas, doing business as Room to
Grow Preschool, was insured under a Monroe Guaranty CGL insurance policy,
with an additional endorsement relating specifically to operation of a “Day Care
Center.” In pertinent part, the CGL provided Monroe Guaranty would
indemnify Thomas for “those sums that the insured becomes legally obligated
to pay as damages because of ‘bodily injury’ or ‘property damage’ to which this
insurance applies.” The insurance applied only if such “‘bodily injury’ or
‘property damage’ is caused by an ‘occurrence’ that takes place in the coverage
territory[.]” Further, the CGL provided insurance would not apply to “‘bodily
injury’ or ‘property damage’ expected or intended from the standpoint of the
Insured.” The policy follows the widely used definition of “Occurrence” as
meaning “an accident, including continuous or repeated exposure to
substantially the same general harmful conditions.” The policy did not define
the term “accident.”
The endorsement for “Home Child Day Care/Day Care Professional
Liability” coverage provided additional coverage specific to the operation of a
preschool. The endorsement excluded coverage for any “bodily injury,”
“property damage,” or other “injury” arising out of “violation of any statute, or
government rule or regulation;” “individual liability for personal acts or
omissions of a nature other than day care;” or “[d]ishonest, fraudulent,
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criminal or malicious acts or omissions of the insured, and partner, or
employee.” The endorsement also altered the definition of “occurrence” relative
to day care operations, amending the term “to include any act or omission
arising out of the rendering of or failure to render professional service as a day
care.”
Interpretation of insurance contracts is subject to de novo review by this
Court. Cincinnati Ins. Co. v. Motorists Mut. Ins. Co., 306 S.W.3d 69, 73 (Ky.
2010).
As a general rule, interpretation of an insurance contract is a
matter of law for the court. While ambiguous terms are to be
construed against the drafter and in favor of the insured, we must
also give the policy a reasonable interpretation, and there is no
requirement that every doubt be resolved against the insurer.
Finally, the terms should be interpreted in light of the usage and
understanding of the average person.
Stone v. Kentucky Farm Bureau Mut. Ins. Co., 34 S.W.3d 809, 810-11 (Ky. App.
2000) (citations omitted). When “a summary judgment has been granted in a
declaratory judgment action and no bench trial held, the standard of review for
summary judgments is utilized.” Ladd v. Ladd, 323 S.W.3d 772, 776 (Ky. App.
2010) (citation omitted). “The standard of review on appeal of summary
judgment is whether the trial court correctly found there are no genuine issues
of material fact and the moving party is entitled to judgment as a matter of
law.” Carter v. Smith, 366 S.W.3d 414, 419 (Ky. 2012) (citations omitted). “If a
question of material fact exists when viewing the evidence through a lens most
favorable to . . . the party opposing summary judgment, summary judgment is
inappropriate.” Allstate Ins. Co. v. Smith, 487 S.W.3d 857, 860 (Ky. 2016).
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Summary judgment is only proper when “it would be impossible for the
respondent to produce evidence at the trial warranting a judgment in his
favor.” Steelvest, Inc. v. Scansteel Serv. Ctr., Inc., 807 S.W.2d 476, 480 (Ky.
1991) (citation omitted). The word “impossible” in Steelvest was “used in a
practical sense, not in an absolute sense.” Perkins v. Hausladen, 828 S.W.2d
652, 654 (Ky. 1992).
In the case at bar, the trial court based the entirety of its coverage
decision on the language of the exclusions contained in the daycare
endorsement. Likewise, the Court of Appeals focused its attention on the same
language. However, no determination appears in the record regarding whether
Brianna’s claimed injuries resulted from an “occurrence” which would trigger
an initial grant of coverage. Thus, because the trial court skipped a
fundamental threshold step in deciding the matters before it, we must conclude
the grant of declaratory and summary judgment was premature and improper.
Unless terms are defined in the written insurance policy, the language
thereof is given its plain meaning. Kentucky Ass’n of Cntys. All Lines Fund
Trust v. McClendon, 157 S.W.3d 626, 630 (Ky. 2005). As previously stated, the
policy defined “Occurrence” as “an accident, including continuous or repeated
exposure to substantially the same general harmful conditions” but did not
define “accident.” The term “accident” has not acquired a technical meaning
within the law and is therefore defined by its ordinary meaning. Cincinnati,
306 S.W.3d at 74. “Inherent in the plain meaning of ‘accident’ is the doctrine
of fortuity.” Id.
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[I]n determining whether an event constitutes an accident so as to
afford the insured CGL policy coverage, courts must analyze this
issue according to the doctrine of fortuity: 1) whether the insured
intended the event to occur; and 2) whether the event was a
“‘chance event’ beyond the control of the insured.” If the insured
did not intend the event or result to occur, and the event or result
that occurred was a chance event beyond the control of the
insured, then CGL coverage covering accidents will apply to the
benefit of the insured.
Martin/Elias Properties, LLC v. Acuity, 544 S.W.3d 639, 643 (Ky. 2018) (quoting
Cincinnati, 306 S.W.3d at 76). Where either intent or control is present, the
event is not an accident, and therefore not an occurrence under the CGL
language.
The question presented is whether injuries sustained as the result of a
sexual assault inflicted upon a child of tender years while that child is under
the care and supervision of a licensed daycare qualifies as an “occurrence”
within the meaning of the CGL policy. The answer to that question necessarily
depends on the facts of the case and factual determinations are to be made by
trial courts as those tribunals are ideally situated to make such decisions.
Unfortunately, the trial court did not do so, and the record is insufficiently
developed to permit an appellate court to adequately discern the appropriate
answer. Instead of first determining whether Brianna’s claims could, under
any circumstances, qualify as triggering events for the CGL policy, the trial
court moved directly to analyzing the exclusions contained in the daycare
endorsement. Such reverse analysis was in error.
CGL coverage analysis is a three-step process: (1) was the event
covered under the policy as an “occurrence?” If so, (2) are there
any explicit policy exclusions for the damage that occurred? If not,
(3) are there any exclusions to those policy exclusions, such as
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PCOH coverage?
....
In simplistic terms, the process is such: if the insuring clause
does not extend coverage, one need look no further. If coverage
exists, exclusions must then be considered. If an exclusion
excludes coverage, an exception to the exclusion may re-grant
coverage. However, the entire process must begin with an initial
grant of coverage via the insuring clause; otherwise, no further
consideration is necessary. Therefore, in the present case, we do
not address any arguments regarding exclusions or exceptions to
exclusions because here there is no initial coverage due to the lack of
. . . an “occurrence.”
American Mining Ins. Co. v. Peters Farms, LLC, 557 S.W.3d 293, 298 (Ky. 2018)
(quoting Cincinnati 306 S.W.3d at 78 n.35).
The exclusionary provisions of the CGL and any endorsements thereto
only become relevant after the court has first determined if the claim is
potentially covered under the insuring provisions of the policy. Here the trial
court has put the proverbial cart before the horse by determining Brianna’s
claims are subject to the particular exclusionary language of the endorsement
without ever discerning whether coverage should exist in the first instance.
“[E]xclusion clauses do not grant coverage; rather, they subtract from it.”
Kemper Nat. Ins. Companies v. Heaven Hill Distilleries, Inc., 82 S.W.3d 869, 872
(Ky. 2002). “[A] court need not consider the applicability of an exclusion if
there is no initial grant of coverage under the policy.” Id. Because the trial
court’s grant of declaratory and summary judgment was based on a flawed and
incomplete factual and legal analysis, it was infirm. Thus, we are constrained
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to reverse the Court of Appeals and remand to the trial court for further
proceedings.
Because we are reversing on other grounds, we need not decide the
remainder of the issues raised which do not impact the result of these appeals.
However, we believe it is important to briefly address certain matters which are
likely to reoccur on remand. We are troubled by the expansive reading
embraced by the trial court of the “violation of any statute” exclusion and the
apparent broadening of that interpretation by the Court of Appeals to include
the violation by any person—not limited to the insured’s or their employees—of
any of the Commonwealth’s thousands of statutes—regardless of the subject
matter covered thereby. As noted by Judge Acree in his dissent, the exclusions
in the endorsement would appear to apply only to the expanded coverage for
damages “arising out of the rendering or failure to render professional services
in connection with the operation of the Insured’s business as a daycare.”
Neither court below adequately analyzed or explained why the statutory
violation exclusion should be read to cover anyone other than the insured or
apply to statutes outside the realm of operating a daycare. On remand, should
the trial court determine there was an “occurrence” triggering coverage and
again be tasked with interpreting the exclusionary provisions of the base policy
and the endorsement, it must rely solely on facts which are in evidence and
draw all reasonable inferences in favor of the party opposing any summary
judgment motion. The trial court is encouraged to make adequate findings
which clearly denote the reasoning for its ruling on coverage. The trial court
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should also carefully analyze and explicitly explain its ruling on the
applicability of exclusionary language based on its factual findings. Including
such findings will ensure the record is fully developed to enable effective and
adequate appellate review, if necessary and requested.
For the foregoing reasons, the decision of the Court of Appeals is affirmed
in part, reversed in part, the matter is remanded to the Calloway Circuit Court
for further proceedings consistent with this Opinion.
All sitting. Conley, Keller, Nickell, VanMeter, JJ., concur. Minton, C.J.,
Hughes and Lambert, JJ., concur in result only.
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COUNSEL FOR APPELLANT/CROSS-APPELLEE, BRIANNA ROBINSON:
Kevin C. Burke
Jamie K. Neal
Burke Neal PLLC
John B. Bruce
Kevin M. Monsour
Bruce Law Group, LLC
Nathan Williams
Bahe, Cook, Cantley & Nefzger PLLC
COUNSEL FOR APPELLEE/CROSS-APPELLEE, MONROE GUARANTY INS.
CO.:
David K. Barnes
Matthew R. Londergan
Schiller Barnes Maloney PLLC
COUNSEL FOR APPELLEES/CROSS-APPELLANTS, ROOM TO GROW
PRESCHOOL, LLC, & JOHN ABBINGTON THOMAS:
Richard L. Walter
Boehl Stopher & Graves
COUNSEL FOR AMICUS CURIAE, INSURANCE INSTITUTE OF KENTUCKY:
Ronald L. Green
James M. Inman
Green Chestnut & Hughes, PLLC
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