Jeffrey A. Holmstrand, Esquire
Jeffrey M. Wakefield, Esquire
McDermott & Bonenberger, PLLS
Erica M. Baumgras, Esquire
Wheeling, West Virginia
Flaherty, Sensabaugh &
Attorney for Animal Urgent Care
Bonasso, PLLC
Charleston, West Virginia
Attorneys for American States
Insurance Company
Ancil G. Ramey, Esquire
Karen E. Kahle, Esquire
Steptoe & Johnson
Charleston, West Virginia
Attorneys for Dr. Yurko
JUSTICE SCOTT delivered the Opinion of the Court.
JUSTICE MCGRAW dissents and reserves the right to file a dissenting Opinion.
2. In an insurance liability policy, a claim based on sexual harassment does not come within
the definition of occurrence, which is defined as an accident, including continuous or repeated exposure
to substantially the same general harmful conditions.
3. There is neither a duty to defend an insured in an action for, nor a duty to pay for,
damages allegedly caused by the sexual misconduct of an insured, when the liability insurance policy
contains a so-called 'intentional injury' exclusion. In such a case the intent of an insured to cause some
injury will be inferred as a matter of law. Syllabus, Horace Mann Ins. Co. v. Leeber, 180 W.Va. 375,
376 S.E.2d 581 (1988).
4. The inclusion of negligence-type allegations in a complaint that is at its essence a sexual
harassment claim will not prevent the operation of an intentional acts exclusion contained in an insurance
liability policy which is defined as excluding bodily injury expected or intended from the standpoint of
the insured.
5. An employee exclusion, which exempts coverage under a liability policy for bodily
injury arising in the course of employment, includes claims for sexual harassment by a co-employee since
those claims arise out of and in the course of employment.
Scott, Justice:
Appellant Animal Urgent Care (Animal Care) appeals from the May 21, 1999, order of
the Circuit Court of Ohio granting summary judgment to Appellee American States Insurance Company
(American States) on the issue of whether American States was required to indemnify or defend Animal
Care in connection with an underlying sexual harassment claim.See footnote 1
1
The lower court relied on two policy
exclusions exempting coverage for bodily injuries intended from the insured's standpoint (intentional
acts exclusion) and for those bodily injuries sustained by an employee that arose out of and in the
course of employment (employee exclusion). Having examined the policy language in conjunction with
the pleadings filed below, we find no error with regard to the circuit court's ruling and accordingly, affirm.
Through a declaratory judgment proceeding, American States sought a determination of
whether it was required under a general commercial liability policy to provide coverage and/or a defense
in connection with the lawsuit filed by Ms. Smith.See footnote 4
4
After examining the policy provisions against the
allegations of the complaint, the lower court determined that both the intentional acts and employee
exclusionary clauses exempted coverage. Citing this Court's decision in Horace Mann Insurance Co. v.
Leeber, 180 W.Va. 375, 376 S.E.2d 581 (1988), the lower court concluded that the intentional acts
exclusion precluded coverage for the sexual harassment based complaint. The circuit court ruled
additionally that the allegations of the complaint fell squarely within the parameters of the employee
exclusion. Animal Care seeks a ruling from this Court that neither exclusion applies and therefore American
States has an obligation to indemnify, or alternatively, that Animal Care has a minimal obligation to defend
until such time as the facts of the case are further developed to properly permit a determination as to the
applicability of the policy exclusionary language.See footnote 5
5
Our examination of whether the lower court correctly ruled below is necessarily linked to
the language of the applicable policy exclusions, as well as pertinent definitions. The commercial general
liability policy provides that:
We will pay those sums that the insured becomes legally obligated to pay
as damages because of bodily injury, property damage, personal
injury, or advertising injury to which this insurance applies. (emphasis
supplied)
The policy indicates that [t]his insurance applies: (1) To 'bodily injury' and 'property damage' only if: (a)
The 'bodily injury' or 'property damage' is caused by an ' occurrence' that takes place in the 'coverage
territory'; . . . . (emphasis supplied) The exclusions section of the policy provides that [t]his insurance
does not apply to:
a. 'Bodily injury' or 'property damage' expected or intended from the
standpoint of the insured. . . .
. . . .
e. 'Bodily injury' to: (1) An employee of the insured arising out of
and in the course of employment by the insured; . . . .
(emphasis supplied)
Both bodily injury and occurrence are specifically defined as follows:
Bodily Injury means bodily injury, sickness or disease sustained by
a person, including death resulting from any of these at any time.
Occurrence means an accident, including continuous or repeated
exposure to substantially the same general harmful conditions.
and mental anguish could come within a separate definition of bodily injurySee footnote 8
8
under the theory that if the
definition was intended to cover only external, physical injuries, then 'bodily injury' easily could have been
defined in a more restrictive fashion . . . . Id. at 744.
American States distinguishes Crabtree first, based upon its differing policy definition of
bodily injury; second, as an aberrational result in light of the clear weight of authority; and third, as an
inapposite decision which failed to address whether solely emotional damages constitute bodily injury in
the context of a sexual harassment claim.See footnote 9
9
Of these three valid distinctions, we focus on the dearth of
authority supporting Animal Care's position. Both commentators and tribunals alike identify the majority
view to espouse that absent physical manifestations or physical contact, purely emotional distress
allegations are insufficient to qualify as bodily injury. Kathleen S. Edwards and Molly Nelson Ferrante,
Insurance Coverage for Employment-Related Claims, 46 Prac. Law. 35, 36 (July 2000); see O'Dell v.
St. Paul Fire & Marine Ins. Co., 478 S.E.2d 418, 420 (Ga. Ct. App. 1996) (holding that alleged emotional
distress arising from sexual harassment was not bodily injury where such distress did not result from
physical harm or injury); Greenman v. Michigan Mut. Ins. Co., 433 N.W.2d 346, 348-49 (Mich. Ct. App.
1988) (finding no coverage for alleged mental distress injuries arising out of sexual harassment and
discrimination claim on grounds that injuries lacked any physical manifestation); Garvis v. Employers
Mut. Cas. Co., 497 N.W.2d 254, 257 (Minn. 1993) (ruling that only emotional distress with appreciable
physical injury could qualify as bodily injury); Citizens Ins. Co. v. Leiendecker, 962 S.W.2d 446, 450-54
(Mo. Ct. App. 1998) (adopting majority position that bodily injury encompasses only physical harm and
excludes mental suffering or emotional distress and citing numerous state and federal decisions following
majority position as well as limited authority espousing minority position); David v. Nationwide Mut. Ins.
Co., 665 N.E.2d 1171, 1173 (Ohio Ct. App. 1995) (relying upon national judicial trend and ruling that
emotional distress did not come within policy definition of bodily injury defining same as bodily injury,
sickness, or disease); Trinity Universal Ins. Co. v. Cowan, 945 S.W.2d 819, 823 (Tex. 1997) (holding
that bodily injury unambiguously requires injury to physical structure of human body and stating that
commonly understood meaning of 'bodily,' . . . implies a physical, and not purely mental, emotional, or
spiritual harm); see also Vienna Family Med. Assocs., Inc. v. Allstate Ins. Co., 78 F.3d 580, 1996 WL
93830, at * 5 (4th Cir. March 5, 1996) (noting that significant weight of authority holds that bodily injury
does not encompass nonphysical injuries such as emotional distress).
In discussing the rationale for excluding purely emotional injuries from the category of bodily
injury, the court in Leiendecker explained that in insurance law 'bodily injury' is considered to be a
narrower concept than 'personal injury' which covers mental or emotional injury. 962 S.W.2d at 453.
Further elucidating the distinction between personal and bodily injury, the court commented:
It is well settled in insurance law that bodily injury and personal injury
are not synonyms and that these phrases have two distinct definitions. The
term personal injury is broader and includes not only physical injury but
also any affront or insult to the reputation or sensibilities of a person.
Bodily injury, by comparison, is a narrow term and encompasses only
physical injuries to the body and the consequences thereof.
Id. (citation omitted) (quoting Allstate Ins. Co. v. Diamont, 518 N.E.2d 1154, 1156 (Mass. 1988)).
Finding the reasoning underlying the majority position to be persuasive,See footnote 10
10
we determine that in an insurance
liability policy, purely mental or emotional harm that arises from a claim of sexual harassment and lacks
physical manifestationSee footnote 11
11
does not fall within a definition of bodily injury which is limited to bodily injury,
sickness, or disease.See footnote 12
12
Animal Care does not dispute the accepted view that sexual harassment does not come
within the meaning of an occurrence under an accident-based definition, but instead argues that coverage
is required because of the negligence-type allegations involving Animal Care. For the same reasons
discussed in section B.1. of this opinion, infra, the inclusion of a negligence-oriented theory of recovery
against Animal Care does not alter the essence of the claim for purposes of determining the availability of
insurance coverage. Sexual harassment, and its inherently non-accidental nature, remain the crux of the
case regardless of whether negligence is alleged against Animal Care. See GATX Leasing Corp. v.
National Union Fire Ins. Co., 64 F.3d 1112, 1118 (7th Cir. 1995) (holding that insured's negligence in
failing to prevent employee's intentional act does not constitute an occurrence, reasoning that 'volitional
act does not become an accident simply because the insured's negligence prompted the act') (quoting Red
Ball Leasing, Inc. v. Hartford Accident & Indem. Co., 915 F.2d 306, 311 (7th Cir. 1990)). We conclude
that in an insurance liability policy, a claim based on sexual harassment does not come within the definition
of occurrence, which is defined as an accident, including continuous or repeated exposure to
substantially the same general harmful conditions.
We are unpersuaded by Animal Care's contention that Leeber is not controlling because
it was not a sexual harassment case. Clearly, our holding that intent will be implied as a matter of law in
instances of sexual misconduct extends logically to allegations of sexual harassment.See footnote 15
15
The United States
District Court for the Southern District of West Virginia recently considered and rejected the argument that
Leeber would only apply where an actual sexual assault has occurred. In American States Insurance Co.
v. Fishes Hot Dog Huntington, Inc., No. 3:98-0165 (S.D. W.Va. Jan. 22, 1999), the district court stated
that Leeber rejects such line-drawing. Id. at 3. As support for this conclusion, the court reasoned that
Leeber's holding explicitly applies to allegations of 'sexual misconduct,' not just sexual assault. Id. In
addition, the district court relied upon the fact that this Court was careful in Leeber not to limit its holding
to those cases involving 'violence,' or penetration or a lengthy period of time during which the sexual
contacts have occurred. Id. at 3-4 (quoting Leeber, 180 W.Va. at 379-80, 376 S.E.2d at 585-86).
Both the district court in Fishes Hot Dog and the lower court correctly applied Leeber to sexual harassment
cases to conclude that coverage is precluded for such claims where the liability policy contains an
intentional acts exclusion.
As a final means of attempting to avoid the preclusive effects of the intentional acts
exclusion, Animal Care contends that the complaint filed by Ms. Smith contains additional allegations that
are couched in negligence. Specifically, Animal Care maintains that averments stating that it knew or
should have known of Dr. Yurko's conduct,See footnote 16
16
but failed to implement proper and appropriate corrective
action in response thereto imply a cause of action in negligence.See footnote 17
17
An analogous argument was rejected
by this Court in Leeber where the insured focused on the inclusion of allegations concerning the negligent
seduction of the assaulted student involved in an attempt to secure coverage. Borrowing from a Maryland
decision, we stated that the allegations of 'negligence' in the complaint are 'a transparent attempt to trigger
insurance coverage by characterizing allegations of [intentional] tortious conduct under the guise of
'negligent' activity. 180 W.Va. at 381, 376 S.E.2d at 587 (quoting Harpy v. Nationwide Mut. Fire Ins.
Co., 545 A.2d 718, 725 (Md. Ct. App. 1988)). In Fishes Hot Dog, the district court cited this same
language from Leeber in rejecting the insured's attempt to avoid the intentional acts exclusion based on
inclusion of the term negligent in the complaint. Slip op. at 4.
Other courts have similarly determined that inclusion of negligence-type allegations in
complaints that are essentially sexual harassment claims will not defeat the application of an intentional
acts exclusion. See Bilstein Corp. v. Federal Ins. Co., 168 F.3d 497, 1999 WL 96438, at *1 (9th Cir.
1999) (finding no duty to defend sexual harassment case that included claims of negligence and defamation
under intentional act exclusion since non-harassment claims were 'inseparable' from intentional
harassment conduct); Medallion Indus., Inc. v. Atlantic Mut. Ins. Co., 152 F.3d 927, 1998 WL 403338,
at *2 (9th Cir. 1998) (upholding district court's determination of no coverage in sexual harassment case
including count of negligent supervision, reasoning that mere labeling does not create negligence especially
where Oregon law requires proof of employer's knowledge of employee's wrongful act); Green Chimneys
Sch. for Little Folk v. National Union Fire Ins. Co., 664 N.Y.S.2d 320, 321 (N.Y. App. Div. 1997)
(affirming denial of coverage for sexual harassment claim because claim did not constitute occurrence
under policy definition and ruling that inclusion in the underlying complaint of causes of action sounding in
negligent hiring and supervision does not alter the fact that 'the operative act[s] giving rise to any recovery
[are] the [intentional sexual] assault[s]'); Board of Educ. v. Continental Ins. Co., 604 N.Y.S.2d 399, 400
(N.Y. App. Div. 1993) (finding no coverage for teacher's claim against school district for failing to prohibit
sexual harassment by principal, creating offensive work environment, and wrongful termination and
observing that inclusion of knew or should have known language did not change the gravamen of the
complaint from one alleging intentional acts . . . to one involving negligent conduct). Accordingly, we
determine that the inclusion of negligence-type allegations in a complaint that is at its essence a sexual
harassment claim will not prevent the operation of an intentional acts exclusion contained in an insurance
liability policy which is defined as excluding bodily injury expected or intended from the standpoint of
the insured.
A second exclusionary provision relied upon by the trial court was the provision that denied
coverage to employees for bodily injury arising out of and in the course of employment by the insured.
Numerous tribunals have ruled that an employee exclusion precludes coverage for sexual harassment
claims which allege injuries sustained in the course of the victim's employment. See Gates, Hudson &
Assocs., Inc. v. Federal Ins. Co., 141 F.3d 500 (4th Cir. 1997) (ruling that sexual harassment claim was
an injury that fell within employee exclusion language of commercial excess umbrella policy); Cornhill Ins.
PLC v. Valsamis, Inc., 106 F.3d 80 (5th Cir.) (holding that broadly-worded employee exclusion precluded
coverage for employee's sexual harassment claims against her supervisors), cert. denied, 522 U.S. 1008
(1997); Security Indus. Ins. Co. v. CIGNA Property & Cas. Co., No. Civ. A 96-2835, 1997 WL
403415, at *3 (E.D. La. July 16, 1997) (finding coverage barred under employee exclusion for sexual
harassment claims as well as negligent failure to take action against harassers, reasoning that alleged injuries
incurred at place of employment during the work day and were caused by co-employee or supervisor);
Old Republic, 786 F.Supp. at 632, (holding that employee exclusion precluded coverage for sexual
harassment and negligence claims which were inextricably intertwined with underlying sexual harassment
and discrimination claims). Even where part of the alleged misconduct occurs away from the work
premises, courts have nonetheless found that the employee exclusion is applicable. See Meadowbrook,
Inc. v. Tower Ins. Co., 559 N.W.2d 411, 420 (Minn. 1997) (concluding that three instances of off-
premises conduct were directly related to creation of hostile work environment and that sexual harassment
claims necessarily fell within exclusion for claims arising out of and during scope of employment because
such harassment results in injury to working relationships); but see Maine State Academy of Hair Design,
Inc. v. Commercial Union Ins. Co., 699 A.2d 1153, 1157 (Me. 1997) (finding duty to defend where
complaint averred only that harassment incidents occurred during period of her employment, but not that
all of plaintiff's injuries arose out of and in course of her employment and suggesting that non-workplace
sexual advances would trigger coverage).
Animal Care cites only one decision for its contention that this Court should rule that sexual
harassment cases do not arise out of and in the course of employment.See footnote 18
18
In SCI Liquidating Corp. v.
Hartford Insurance Co., 526 S.E.2d 555 (Ga. 2000), the Georgia Supreme Court, in answering a question
certified to it by the Eleventh Circuit, decided to apply workers' compensation precedent concerning the
terms arising out of and in the course of employment and determined that sexual harassment cases do not
arise out of employment, reasoning that sexual harassment results from 'the willful act of a third person for
personal reasons' rather than a work-related condition. Id. at 557 (quoting Murphy v. ARA Servs., Inc.,
298 S.E.2d 528, 530 (Ga. Ct. App. 1982)). We find the logic employed by the dissenting justice in
Hartford Insurance to be more convincing:
The use of workers' compensation law to guide the interpretation of a
contract not involving workers' compensation is inappropriate. Workers'
compensation is a state-imposed and regulated system that provides
limited benefits to employees who suffer injuries on the job without regard
to the traditional principles of tort law. Public policy concerns have led the
legislature to mandate that courts interpret the workers' compensation act
liberally in order to bring both employers and employees within its
coverage, but these concerns have no place in interpreting private
contracts. Additionally, the umbrella policy contains a specific exclusion
for claims covered by workers' compensation, and it is therefore illogical
and redundant to incorporate workers' compensation law into exclusion
16 [employee exclusion].
Id. at 557-58 (Fletcher, J., dissenting) (footnote omitted); see also SCI Liquidating Corp. v. Hartford Fire
Ins. Co., 181 F.3d 1210, 1218-19 (11th Cir. 1999) (discussing reasons for treating phrase arising out
of and in the course of employment differently for workers' compensation and liability insurance purposes
and recognizing that other jurisdictions have excluded coverage of sexual harassment claims under an
employee exclusion, reasoning that such claims necessarily 'arise[] out of and in the course of
employment').
Finding no sound basis for applying worker's compensation principles to insurance law,
we decline to adopt the approach advocated by Animal Care. We also reject Animal Care's contention
that the trial court could not rule on the applicability of the employee exclusion given the absence of
allegations in the complaint alleging that all of the conduct at issue occurred within the scope and course
of Ms. Smith's employment.See footnote 19
19
We conclude that an employee exclusion, which exempts coverage under
a liability policy for bodily injury arising in the course of employment, includes claims for sexual
harassment by a co-employee since those claims arise out of and in the course of employment.
Based on the foregoing, we affirm the decision of the Circuit Court of Ohio County.
Affirmed.
Most courts deny liability insurance coverage for alleged sexual
misconduct by applying an objective test to an intentional injury exclusion
because the sexual misconduct is so inherently injurious, or 'substantially
certain' to result in some injury that public policy precludes a claim of
unintended consequences, that is, a claim that no harm was intended to
result from the act.
Smith v. Sears, Roebuck & Co., 191 W.Va. 563, 565, 447 S.E.2d 255, 257 (1994) (quoting Leeber, 180
W.Va. at 379, 376 S.E.2d at 584-85); cf. Maine State Academy of Hair Design, Inc. v. Commercial
Union Ins. Co., 699 A.2d 1153, 1157-58 (Me. 1997) (applying subjective method of interpreting
intended acts exclusion to hold that only if insured specifically intended injury that flowed from acts of
harassment would exclusion apply and commenting that bodily injury is not necessarily expected or
intended by the perpetrator of unwanted sexual advances and wrongful discharge).
Refuting Animal Care's contention that the knew or should have known averments imply liability under negligence principles, American Insurance states that if Ms. Smith could prove that Animal Care failed to act upon complaints of misconduct and then actually discharged her following such complaint, Animal Care could be found to have committed the intentional tort of inflicting emotional distress. See Ford v. Revlon, Inc., 734 P.2d 580, 584-85 (Ariz. 1987) (holding that corporation's failure to take appropriate action in response to employee's complaint of sexual harassment constituted tort of intentional infliction of emotional distress). Moreover, American Insurance points to the fact that the complaint is replete with allegations that Animal Care committed intentional acts. Specifically, Ms. Smith avers that defendants, Animal Urgent Care . . . engaged in acts designed to harass, degrade, and embarrass her; she was discriminated or retaliated against by Animal Care; and that the actions of the defendants were extreme and outrageous and intended to inflict . . . emotional distress. In American States Insurance Co. v. Natchez Steam Laundry, 131 F.3d 551 (5th Cir. 1998), an analogous case recently decided by the Fifth Circuit, the court determined that the intentional acts exclusion applied to both the alleged harasser and the defendant business because the business was charged with intentional conduct: failure to investigate, failure to take action against alleged harasser, and failure to provide an avenue for redress. Id. at 554.