EPLI Coverage is Governed by Definition
Posted
7:10 PM
by Michael Fox
Although it's probably only a matter of time, there are still not many EPLI coverage questions that have been decided. In fact, I can only remember one prior case that I have commented on, see Check Your EPLI Policy - When Coverage For Discrimination Doesn't Mean The Most Common Type of Discrimination Claim.
And I would not have caught the latest one, Valley Imaging Partnership Medical Group LP v. RLI Ins. Co. (9th Cir. 3/5/08) [pdf] an unpublished decision, if it hadn't been for the ever vigilant work of the folks at Alaska Employment Law.
There's not a clear explanation of the underlying situation in the appellate decision. However, from the district court summary judgment opinion ($ Pacer) it appears that VIP was a doctor's practice which performed imaging services for a hospital. The underlying suit for which the EPLI carrier was contesting coverage was a sexual harassment suit against VIP brought by Hernandez.
Hernandez was a registration clerk at a VIP office which was on the campus of the hospital. Pursuant to a Service Agreement between VIP and the hospital, she was actually paid by the hospital, but reported to VIP personnel and VIP reimbursed the hospital for her wages plus 26% (apparently to cover benefits).
VIP bought the EPLI policy, which defined employee as "any person who receives wages or a salary from the Entity (defined as VIP) for work that is directed and controlled by the Entity..."
Unfortunately VIP, which I am sure intended and thought it had EPLI insurance, learned the important lesson that the definitions in a policy are critical. Here the above definition, didn't fit the actual situation since the registration clerk "received [her] wages or salary" from the hospital, not VIP, the Entity.
As the 9th Circuit wrote:
That VIP reimbursed [the hospital] does not change that fact that [the hospital] was the entity paying Hernandez’s salary and that, therefore, Hernandez was not a VIP employee as defined by the insurance contract.
Bottom line, no coverage. But the lesson is clear -- make sure you have read the policy carefully to ensure that it covers your particular situation.
Labels: EPLI
Wednesday, December 28, 2005
EPLI Insurance for Sexual Harassment Challenged on Public Policy Grounds
Posted
4:02 PM
by Michael Fox
What is now viewed as no longer a novelty in America - an insurance policy that protects a company from lawsuits based on employment practices - has been challenged by a member of the Israeli Parliament. According to the Jerusalem Post story, Gal-on Petitions JCJ on harassment:
Meretz Chair MK Zehava Gal-On petitioned the High Court of Justice on Sunday to prevent the AIG insurance company from selling an insurance policy that includes coverage for high-ranking corporate employees accused of sexual harassment.
According to the Knesset Member and Chair of the Meretz political party:
legitimizing such a policy reduces the danger associated with committing sexual harassment, neutralizes [the law's] preventative force, and neutralizes the law in terms of preventing sexual harassment.
The Christmas day filing was probably not the sort of gift AIG was hoping for, although given the year the company has had it may not seem like that big a deal.
Although I would be surprised if the motion was successful, for possible purchasers of such policies, if they are not going to be valid, much better to find out before paying the premiums than after the fact - as happened to the policyholder in a 5th Circuit decision earlier this year. See Check Your EPLI Policy - When Coverage For Discrimination Doesn't Mean The Most Common Type of Discrimination Claim.
Labels: EPLI