“May Be Held Liable Under Any Workers’ Compensation Law” Excludes Coverage for Work-Related Employee Injuries Regardless of Actual Workers’ Compensation Recovery

1. Introduction

Jimale v. State, Comm’r of Ins. (Nev. Dec. 30, 2025) arose from a catastrophic trucking accident in South Carolina. Appellant Mohamed Jimale was tandem driving in a tractor-trailer owned by Cargo Transportation Services, LLC. While Jimale slept, co-driver Antoine Dramou drove off the road into a tree; Dramou died and Jimale sustained significant injuries.

Jimale obtained a $1,896,000 negligence judgment against Dramou’s estate, then sought recovery under Cargo’s auto policy issued by Spirit Commercial Auto Risk Retention Group, Inc., a Nevada insurer later placed into receivership. The statutory receiver denied Jimale’s claim based on a workers’ compensation exclusion in the auto policy.

The core issues were: (1) how to interpret a standard exclusion for obligations an insured “may be held liable” for under “any” workers’ compensation law; and (2) whether the receiver’s factual determination—Jimale was an employee and a workers’ compensation claim was filed—could be disturbed on appeal, particularly given gaps in the appellate record.

2. Summary of the Opinion

The Supreme Court of Nevada affirmed the district court’s order upholding the receiver’s denial. The court held that the exclusion’s plain language bars coverage for injuries that could potentially give rise to workers’ compensation liability, i.e., injuries to employees arising in the course and scope of employment—regardless of whether workers’ compensation benefits were actually recovered and regardless of whether the auto insurer also provided workers’ compensation coverage.

On the factual disputes (employee vs. independent contractor; whether a workers’ compensation claim was denied), the court relied on the rule that an appellant must supply a complete appellate record. Because Jimale’s arguments depended on materials not in the record, the court presumed the missing evidence supported the receiver’s findings and concluded substantial evidence supported the determination that the exclusion applied.

3. Analysis

A. Precedents Cited

1) Standards of review for administrative/agency determinations

• Wright v. State, Dep’t of Motor Vehicles, 121 Nev. 122, 110 P.3d 1066 (2005): The court reiterated that its review mirrors the district court’s review of an administrative decision—asking whether the decision was arbitrary or capricious (abuse of discretion) and, for factual determinations, whether they are supported by substantial evidence. In this case, that framing mattered because the receiver’s decision involved both fact finding (employment status; existence of a workers’ comp claim) and law (policy interpretation).
• State Farm Mut. Auto. Ins. Co. v. Comm’r of Ins., 114 Nev. 535, 958 P.2d 733 (1998): The court invoked this decision for the proposition that agencies receive less deference on appeal for legal determinations than for fact findings. That principle allowed the court to independently interpret the insurance policy while still deferring (under substantial evidence review) to supported factual findings.

2) Nevada insurance-policy interpretation principles

• Powell v. Liberty Mut. Fire Ins., 127 Nev. 156, 252 P.3d 668 (2011): The court relied on Powell for multiple interpretive rules: policy interpretation is a question of law; unambiguous terms receive their plain meaning; ambiguity depends on whether the policy creates reasonable expectations of coverage; and exclusions are construed narrowly against the insurer. In Jimale, these rules were the benchmark against which the exclusion’s “may”/“any” wording was evaluated.
• Aubin v. State Farm Mut. Auto. Ins. Co., 118 Nev. 299, 43 P.3d 1018 (2002): The court reiterated that policy language is construed from a layperson’s perspective and that limitations must clearly communicate their scope. The Jimale court used this framework to conclude the exclusion clearly signals that work-related employee injuries are outside the auto policy’s coverage grant.

3) Persuasive federal authority interpreting identical or similar exclusions

• Gear Auto., LLC v. Acceptance Indem. Ins., No. 11-CV-00421-W-FJG, 2012 WL 1833892 (W.D. Mo., May 18, 2012) (Order): Cited to support the reading that an identical exclusion applies even if the employer failed to purchase workers’ compensation insurance. This case helped the Nevada court reject Jimale’s attempt to tie the exclusion to actual workers’ compensation coverage (or recovery) under Spirit.
• Nat'l Liab. & Fire Ins. v. Sidelines Tree Serv., LLC, No. 2:22-CV-01283-CBB, 2024 WL 5186484 (W.D. Pa. Dec. 20, 2024) (Memorandum Opinion): Cited for the proposition that the exclusion does not require that the employer actually be held liable in workers’ compensation; it is enough that the worker was an employee acting in the course of employment. This authority directly matched the Nevada court’s focus on potential liability (“may be held liable”).
• Progressive Mountain Ins. v. Chen, No. 1:22-CV-1913-JPB, 2024 WL 476962 (N.D. Ga. Feb. 7, 2024) (Order): Cited as further support that similarly worded exclusions bar coverage for injuries arising out of and within the scope of employment.

4) Appellate record completeness and presumptions

• Cuzze v. Univ. & Cmty. Coll. Sys. of Nev., 123 Nev. 598, 172 P.3d 131 (2007): The court used Cuzze to enforce a decisive procedural principle: an appellant bears the burden of providing a complete record. When the record is incomplete, the court presumes missing materials support the decision below. Here, that presumption effectively foreclosed Jimale’s factual challenges because his assertions depended on evidence not contained in the appellate record.

B. Legal Reasoning

The opinion’s legal analysis turned on the exclusion’s text: “Any obligation for which the ‘insured’ or the ‘insured’s’ insurer may be held liable under any workers’ compensation… law.” The court’s reasoning proceeded in three key moves:

1. Plain-meaning focus on “may” and “any.” The court treated “may” as signaling potential liability rather than liability already adjudicated or benefits already paid, and treated “any” as expanding the exclusion beyond a particular policy or carrier. That combination, in the court’s view, defeats an interpretation requiring an “actual determination” of workers’ compensation liability under Spirit.
2. Exclusion keyed to employment circumstances, not payment source. The court held that the relevant question is whether the injury is of a type that could give rise to workers’ compensation liability (employee + course and scope of employment), not whether Spirit was the workers’ compensation insurer or whether a workers’ compensation claim succeeded. In other words, the exclusion is status-and-context based (work-related employee injury), not outcome based (workers’ comp recovery).
3. Even narrow construction does not create reasonable expectations of coverage. Although Nevada construes exclusions narrowly against insurers, the court found no ambiguity and no reasonable expectation that an auto liability policy would cover an employee’s work-related bodily injury when the policy expressly removes obligations potentially covered by workers’ compensation law.

On the factual side, the receiver (and district court) found Jimale was an employee and a workers’ compensation claim was filed, which—under the court’s legal rule— triggers the exclusion. Jimale’s appellate arguments (independent contractor status; denial of the workers’ comp claim) failed because he did not support them with record evidence; applying Cuzze v. Univ. & Cmty. Coll. Sys. of Nev., the court presumed missing evidence supported the receiver’s findings.

C. Impact

This opinion’s practical effect is to clarify Nevada law on a widely used workers’ compensation exclusion in commercial auto policies:

• Coverage litigation: Claimants cannot avoid the exclusion by showing that no workers’ compensation benefits were paid, that a workers’ compensation claim was denied, or that the auto insurer was not the workers’ compensation carrier. The dispute will pivot to whether the injured person qualifies as an employee and whether the injury arose in the course and scope of employment (and thus could trigger workers’ compensation liability).
• Insurance receiverships: In delinquency/receivership claim determinations, the ruling supports receivers applying exclusions based on potential legal obligation rather than proof of actual payment under another policy—potentially reducing the receiver’s exposure to large tort judgments recharacterized as “auto liability” claims.
• Appellate practice: The decision underscores that factual reframing on appeal (e.g., “independent contractor”) is ineffective without record citations; missing-record presumptions can be outcome determinative.

4. Complex Concepts Simplified

• Workers’ compensation exclusion: A clause that removes coverage for workplace injuries that the employer could be responsible for under workers’ compensation law. The key point in this case: the exclusion can apply even if no workers’ compensation benefits were ultimately paid.
• “May be held liable”: Legal drafting that points to possible responsibility, not a final judgment or confirmed payment obligation. Here, it means the exclusion can apply if the injury is the type that could trigger workers’ compensation liability.
• “Any” workers’ compensation law: Broad language that is not limited to one insurer, one policy, or one jurisdiction’s program. The court read this to mean the exclusion is not confined to obligations under Spirit’s policies.
• Course and scope of employment: A workers’ compensation concept: injuries sustained while performing job duties (or activities sufficiently tied to work) are generally work-related. The court treated this as the touchstone for whether the exclusion applies.
• Substantial evidence vs. legal interpretation: Facts found by an agency/receiver are upheld if supported by enough evidence that a reasonable person could agree; policy interpretation is reviewed as a legal question.
• Burden to provide the appellate record: The appellant must include the documents and transcripts needed to evaluate claims of error; otherwise, the appellate court assumes the missing material supports the decision.

5. Conclusion

Jimale v. State, Comm’r of Ins. establishes (or, at minimum, squarely adopts for Nevada) a clear rule for a standard workers’ compensation exclusion: where an auto liability policy excludes obligations the insured “may be held liable” for under “any” workers’ compensation law, the exclusion applies to workplace injuries to employees arising in the course and scope of employment—even without proof of actual workers’ compensation recovery and regardless of whether the auto insurer provided workers’ compensation coverage.

The opinion also reinforces a consequential procedural point: appellants challenging receiver or administrative fact findings must furnish a complete appellate record, or the court will presume missing evidence supports the determination and affirm if the remaining record supports substantial evidence review.