The PA Supreme Court
recently ruled on the meaning of the word “the” in an important personal injury case involving a restaurant worker, the employer, and the third-party landlord.
The Letter of the Law
Most people have heard the phrase “the letter of the law.” The meaning behind the phrase is that legal language — the fine print, if you will — is exceptionally precise.
Lawyers are trained to create and interpret legal documents that accomplish various objectives for their clients. It is not uncommon, however, for clients to occasionally believe that they don’t really need legal counsel for any number of situations that come up. This can often be a mistake, because the letter of the law can become quite complex.
Take, for example, a recent Pennsylvania Supreme Court case that actually wound up questioning the meaning of the word “the”.
It’s an interesting perspective on the necessary precision of legal documents and serves to highlight the need for legal counsel whenever contracts are involved.
If you don’t think this applies to you, think again — any employment contracts, business contracts, or insurance contracts that you are party to contain this type of language.
When the Workplace Is Unsafe
This particular case began in a Pennsylvania Common Pleas Court as a work-related personal injury claim when a restaurant employee fell on a set of stairs outside of the restaurant. The employee, who suffered injuries from her fall, decided to file a lawsuit based on the assertion that the stairs were unsafe.
Because she was covered by the Pennsylvania Workers’ Compensation Act
, she could not sue her employer. As with many other states, Pennsylvania prevents an employee who is automatically covered by the Workers’ Compensation Act from filing a personal injury claim. The reasoning behind this law is that an injured employee is already eligible to receive benefits.
There are some loopholes, such as when an employee is deliberately or intentionally subjected to a situation that results in an injury. Hazing or harassment resulting in a personal injury is an example of such an exclusion. But in this case, there was no evidence of deliberate or intentional conduct — the employee simply injured herself on the stairs.
Who Is at Fault in this Personal Injury Case?
The Workers’ Compensation Act only applies to the employer, however. Employees are permitted to seek compensation from other parties that might have borne some degree of responsibility for the injuries that they suffered. In this case, since the restaurant was leased, the employee decided to sue the landlord for negligence that resulted in personal injury.
Here is where it starts to get complicated.
As a part of most standard commercial leases, the lessee — in this case the restaurant — is required to carry a Commercial General Liability (CGL) policy. Most knowledgeable landlords additionally require their tenant to add them (the landlord) to the policy as “additional insureds.” This protects the landlord if someone should be injured and file a claim that involves their tenant.
In this case, when the employee filed a claim against her employer’s landlords, the landlords turned around and filed a claim for coverage from the insurance company, since they were in fact named as additional insureds. The landlords, believing that they were covered under their tenant’s policy, simply filed a claim for coverage with the insurance company instead of going to court. The insurance company then denied the landlord’s claim, using an employer exclusion provision in the CGL policy.
In the particular policy in question, the language stated that the policy did not cover injuries suffered by “an employee of the insured” that resulted from an employment-related accident. The claim was denied because the insurance company interpreted the phrase “the insured” was plural and included both the restaurant that initiated the policy and the landlord who was listed as an additional insured party.
Lawyers for the landlord saw it differently. They argued that the term “the insured” was singular and only applied to the restaurant — the policy holder, and the claimant’s employer. Therefore, the landlord’s claim could not be rejected and had to be paid.
So the question became this: is the term “the” as it applies to an entity or entities covered under this particular insurance policy singular or plural. In this case, what, exactly, does the word “the” refer to, at least according to the letter of the law?
As a side note, this isn’t the first time this question has been raised. Liability exclusion clauses have long been used to deny coverage to an additionally insured party when an employee of the insured files a personal injury claim. In this case, however, the landlords challenged the insurance company’s rejection of their claim, and the case wound up before the Pennsylvania Supreme Court.
The PA Supreme Court Ruling
The ruling the PA Supreme Court handed down makes it abundantly clear that the precision of words is essential to crafting a legal document that does everything it’s supposed to do. This fact alone should be sufficient reason to hire a lawyer for any situation that requires precise legal language.
The PA Supreme Court ruled that if the insurance company wanted to deny claims made by any party other than the policy holder, they should have said exactly that. In the view of the court, the words “the insured” is singular and only refers to the entity that took out the insurance policy. In this case, that is the employer who in fact could not be sued due to the workers compensation issue.
Anyone else listed as an additional insured party, however, was in fact covered and legitimate claims filed against such a party would need to be paid. If the insurance company intended to deny claims against additional insured parties as a result of the workers compensation provision, the language should have stated “any insured” instead of “the insured.”
As a result of this ruling, the employee’s claim against the landlord was ultimately paid by the insurance company. It also provides a very clear example why you need a skilled and experienced personal injury lawyer to file a claim on your behalf, whether you’re hurt at work, or anyplace else.
Put Our Personal Injury Experience to Work for You
This case shows why a knowledgeable and trusted personal injury attorney can mean the difference between the successful recovery of monetary damages or a rejected claim. Call the experienced personal injury lawyers at Donaghue & Labrum today for a free consultation about your case.