The 8th U.S. Circuit Court of appeals has affirmed the ruling of a district court that a high school wrestler, who became injured while “horsing around” in the hotel room the night before his team’s competition, is not covered by an insurance policy issued to the Missouri High School Activities Association (MHSAA), which was hosting the event.
During the 2008-2009 academic year, Kalee DeAtley was a student at Odessa High School (Odessa) and a member of the Odessa wrestling team. In February 2009, the Missouri State Wrestling Tournament, an annual statewide high school wrestling tournament held by the MHSAA, took place in Columbia, Missouri. Although he did not qualify to compete at the state tournament, DeAtley was allowed to accompany the wrestling team to the tournament. The night before the tournament, after traveling on the bus with the wrestling team to Columbia, DeAtley suffered a ruptured spleen and internal bleeding while “horsing around” with other non-qualifying students in his hotel room.
DeAtley sought benefits under an insurance policy that Mutual of Omaha had issued to the MHSAA. The policy covered MHSAA’s participating member high schools, including Odessa, and provided that “benefits will be paid on an excess basis . . . for Covered loss which is Incurred by the Insured Person . . . .”
The Policy defined an Insured Person as:
a student attending the participating school including only those activities performed as part of the sports team or cheer unit and under the direct supervision of the participating school and directly associated with a covered event or any other activities as specified in the plan of insurance and participating as:
a player on an athletic team in a covered event sanctioned and recognized by the participating school;
a student coach, student manager, or student trainer of such a team formally identified as such by the participating school;
a student cheerleader officially recognized as such by the participating school (includes dance team members and mascots); or
a student as shown in the eligibility section in the plan of insurance.
The policy defines “eligibility” as “all student athletes, student managers, student trainers, student cheerleaders and students participating in interscholastic competition.” The policy defines a “covered event” as “students participating in interscholastic competition, governed by the regulations of the state high school athletic/activities authority, including school-supervised practice, tryouts, game related activities and covered travel as defined under the policy.”
After he was denied a claim for benefits, DeAtley sued Mutual, claiming the company breached its contract to provide him with coverage and seeking damages under Mo. Rev. Stat. § 375.420 for Mutual’s refusal to pay. The parties filed cross motions for summary judgment on the issue of coverage.
DeAtley argued that the phrase “participating in interscholastic competition” as set forth in the “eligibility” and “covered event” provisions should be interpreted “in its broadest sense including participation in any manner, whether [as a] competitor or otherwise.” The district court granted Mutual’s motion for summary judgment, holding that the policy was unambiguous and that DeAtley did not meet the policy’s definition of an “insured person” because he was not participating in interscholastic competition. The district court denied DeAtley’s motion for summary judgment and entered judgment in favor of Mutual.
The plaintiff appealed, renewing his original argument as well as adding a new one that “the ‘insured person’ provision can be read to split the definition of an insured person into the following two categories:
“1) students attending the participating school including only those activities performed as part of either a sports team or cheer unit and under the direct supervision of the participating school and directly associated with a covered event; or 2) students attending the participating school including any other activities as specified in the plan of insurance and participating as: a player on an athletic team; a student coach; student manager; student trainer; student cheerleader; or student as shown in the eligibility section of the plan of insurance.”
While noting that the plaintiff could not raise a new argument on appeal, the court considered the argument anyway and concluded that DeAtley “fails to satisfy the first category’s definition of an insured person because at the time that he was injured he was ‘horsing around’ at the hotel, not performing an activity ‘directly associated with a covered event.’
“Nor does DeAtley qualify for coverage under the second category of his proposed construction,” since it “overlooks the fact that … he is required to demonstrate not only that he qualifies as a student under the eligibility section, but also that he was ‘participating as’ such a student.”
The court went on to add that “DeAtley’s only role at the tournament was as a spectator, and thus he was not participating in the wrestling tournament as a student athlete. Because DeAtley was not an insured person under the policy, the district court did not err in granting Mutual’s motion for summary judgment.”
Kalee Dutchman DeAtley v. Mutual of Omaha Insurance Company; 8th Cir.; No. 12- 1068, 2012 U.S. App. LEXIS 23283; 12/13/12
Attorneys of Record: (for plaintiff) Michael Andrew Childs, Eryn Michelle Peddicord, Michael David Townsend, PEDDICORD & TOWNSEND, Kansas City, MO. (for defendant) Elizabeth C. Carver, Attorney, BRYAN & CAVE, Saint Louis, MO; Robert Hoffman, John Polhemus, BRYAN & CAVE, Kansas City, MO.
