Coverage Pointers
Volume IV, No. 15
Friday, February 14, 2003
A Biweekly Electronic Newsletter
Hurwitz & Fine, P.C.
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As a public service, Hurwitz & Fine, is pleased to present its biweekly newsletter, providing summaries of and access to the latest insurance law decisions from the New York State appellate courts. The primary purpose of this newsletter is to provide timely educational information and commentary for our clients and subscribers.
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New Page 1
02/13/03:
PECKER IRON WORKS OF NEW YORK, INC. v TRAVELERS INS. CO.
New York Court of Appeals
In Construction Case,
Promise to Provide “Additional Insured” Protection to General Contract is
Implied Promise to Provide Primary Coverage
General contractor (Pecker)
required subcontractor (Upfront) to name Pecker as an additional insured on
Upfront’s liability policy. Upfront did so through its policy with Travelers,
but the “additional insured” provisions in the policy stated its policy would be
excess unless the named insured (Upfront) agreed to provide “primary coverage”
to the additional insured. The contract between Pecker and Upfront did not
specifically require that primary coverage be provided. New York’s high court
determined that contractual promise to provide coverage and additional insured
status implied a promise to provide primary coverage. The court held that
“additional insured” is a recognized term in insurance contracts -- the
“well-understood meaning” of the term is “an ‘entity enjoying the same
protection as the named insured.’” When Pecker engaged Upfront and in writing
provided that Upfront would name Pecker as an additional insured, Pecker
signified, and Upfront agreed, that Upfront’s carrier – “not Pecker’s” -- would
provide Pecker with primary coverage on the risk. Pursuant to the policy
provision at issue, Travelers agreed to provide primary insurance to any party
with whom Upfront had contracted in writing for insurance to apply on a primary
basis. When Upfront agreed to it, the policy provision was satisfied.
EDITORIAL NOTE: At a
minimum, this case stands for the proposition that implicit in all construction
contracts requiring coverage for contractors as “additional insureds” is the
requirement that such coverage be afforded on a primary basis, unless the
contract specifically provides otherwise, notwithstanding contrary provisions in
the additional insured endorsement. But does the decision also purport to
determine the primacy of coverage between Travelers and Upfront’s carrier, and
signal an intent by the court to place the coverage issued by Travelers below
the other? After all, the first sentence of the decision states that “[t]his
case involves the relative obligations of two liability insurance carriers
covering the same risk,” and later states that“ . . . Pecker signified, and
Upfront agreed, that Upfront’s carrier – not Pecker’s -- would provide
Pecker with primary coverage on the risk.”
We were curious, so we contacted
respondent’s counsel and learned that the parties agreed Travelers would be
co-primary (rather than sole primary) if the court held Travelers in as a
primary carrier. Since the issue was never briefed or argued by the parties, we
believe the court never decided the issue.
02/08/03:
CARCONE v D'ANGELO INSURANCE AGENCY
New York State Supreme Court, Appellate Division, Fourth Department
Action Against Insurance
Agent Time Barred; Statute Permitting Direct Action by Injured Party After
Judgment Inapplicable to Suits Against Agents
Court refuses to permit statute,
which allows direct action against carrier who refuses to pay judgment, to
revive time-barred claim against insurance agent.
02/07/03:
BOSHNAKOV v EDEN CENTRAL SCHOOL DISTRICT
New York State Supreme Court, Appellate Division, Fourth Department
Language in Contractual
Indemnification Clause Requiring Indemnity “From and Against All Claims and
Suits” is Broad Enough to Encompass Attorneys Fees and Disbursements
Plaintiffs commenced this Labor
Law action seeking damages for injuries sustained by Boshnakov while employed by
Color Technics. Supreme Court previously granted that part of
defendant/third-party plaintiffs’ motions for summary judgment for common-law
indemnification and the claim of defendant/third-party plaintiff Higgins for
contractual indemnification from Color Technics, and the court granted their
subsequent motion to recover attorney’s fees and disbursements from Color
Technics. Public Service Mutual, Color Technics’ insurer for common-law
indemnification only, appealed from the order directing it to pay 100% of the
attorney’s fees and disbursements recoverable by defendants/third-party
plaintiffs, plus interest. The court agreed with Public Service Mutual that ITT
Hartford Group, Inc., the insurer of Color Technics with respect to claims for
contractual indemnification, was required to pay an equal portion of those
attorney’s fees and disbursements. The court held that a prior judgment
establishing that Public Service Mutual was obligated to defend and indemnify
Color Technics did not address whether Hartford must share in the obligation, as
that issue was not before the court. The court also concluded that the language
in the contractual indemnification clause pursuant to which Color Technics
agreed to indemnify and hold Higgins harmless “from and against all claims or
suits” was broad enough to encompass the attorney’s fees and disbursements,
particularly in view of the fact that Color Technics was also obligated by the
contract to defend Higgins.
02/06/03:
CARMEAN v ROYAL INDEM. CO.
New York State Supreme Court, Appellate Division, Third Department
Lend Me You Ear -- Because
If I Take It -- There'll No Coverage When You Sue Me
Plaintiff was sitting in the
front passenger seat of Ozolins’s parked vehicle with his feet hanging out the
window and his back to Ozolins while the two individuals engaged in a
discussion. Ozolins removed a knife from his pocket, reached across the front of
the vehicle from his position in the driver’s seat and cut off plaintiff’s left
ear. The plaintiff then sued Ozolins, alleging negligent and reckless conduct.
The carrier denied coverage based on the intentional act exclusion. In this
action by the injured claimant to compel Royal to indemnify its insured,
plaintiff relied on the fact that Ozolins pleaded guilty to a crime premised
upon reckless, rather than intentional, conduct. The court held that merely
because an assailant receives a favorable plea to a crime with a criminal intent
element of recklessness does not necessarily foreclose finding that the
underlying conduct falls within an insurance policy’s intentional acts
exclusion. Although Ozolins’s recitation of the crime at his allocution was
aptly characterized by Supreme Court as “disjointed” and “rambling,” it
nevertheless revealed that he removed the knife from his pocket, opened it,
swung it and struck plaintiff. In a sworn statement to police shortly after the
incident, plaintiff stated that Ozolins grabbed his left ear before cutting it.
Plaintiff later changed his position after commencing this action by claiming
that he no longer recalled Ozolins grabbing his ear prior to the assault.
Notwithstanding the change in plaintiff's version of events, the evidence in the
record reveals that Ozolins removed the knife from his pocket, opened it,
reached across the front of the car, swung the knife at plaintiff and cut off
his ear. Under these circumstances, the court concluded that the injuries that
plaintiff sustained could not be fairly characterized as unexpected, unusual or
unforeseen. Ozolins’s conduct and the resulting injury to plaintiff were
intentional within the meaning of the intentional acts exclusion in Royal’s
policy.
02/03/02:
DEETJEN v NATIONWIDE MUT. FIRE INS. CO.
New York State Supreme Court, Appellate Division, Second Department
Insurer Has Obligation to
Defend Insured Charged With Discharging Weapon and Killing Plaintiff’s Decedent
The plaintiff’s decedent,
Deetjen, sustained gunshot wounds from a weapon that discharged while in the
defendant Allison’s possession. She died as a result of those injuries six days
later. Allison was charged with murder in the second degree, manslaughter in the
second degree, criminally negligent homicide, assault in the first degree,
assault in the second degree, and criminal possession of a weapon in the fourth
degree. After a non-jury trial, he was acquitted of all counts except criminal
possession of a weapon in the fourth degree. The plaintiff commenced the
underlying action against Allison to recover damages for wrongful death. After
Allison’s insurer disclaimed coverage, the plaintiff commenced this action
seeking a declaration that the appellant is obligated to defend and indemnify
Allison in the underlying action. The appellant moved for summary judgment
declaring that it was not required to defend or indemnify Allison because the
shooting was not an “occurrence” as defined by Allison’s homeowner’s policy, and
the policy excluded coverage for injuries that could have been reasonably
expected from the insured’s conduct or intended by the insured. Court held that
an insurer’s duty to defend is triggered whenever the allegations in a
complaint, liberally construed, suggest a reasonable possibility of coverage, or
when the insurer has actual knowledge of facts establishing such a reasonable
possibility. An insurer may be relieved of its duty to defend only if it can
establish, as a matter of law, that there is no possible factual or legal basis
on which it might eventually be obligated to indemnify its insured, or by
proving that the allegations fall within a policy exclusion. If any of the
allegations arguably arise from a covered event, the insurer must defend the
entire action. The appellant failed to demonstrate as a matter of law that the
shooting was not an occurrence covered by the policy or that Allison’s conduct
fell wholly within a policy exclusion
ACROSS BORDERS
Visit the
HOT CASES
section of the Federation of Defense and Corporate Counsel website for cases
covering a broad range of legal issues from other jurisdictions.
02/13/03:
CARROL v ALLSTATE INS. CO.
Connecticut Supreme Court
$500,000 Compensatory Damage Award Against Fire Insurer
Upheld -- Jury Properly Concluded Insurer Negligently Inflicted Emotional
Distress on Policyholder in its Investigation and Denial of Property Claim
Court held that the evidence was
not sufficient for a jury reasonably to conclude that defendant’s conduct in its
fire investigation was extreme and outrageous. The plaintiff produced evidence
that defendant did not conduct a thorough or reasoned investigation and may have
decided too quickly that the fire had been set deliberately. As distressing as
this insurance investigation may have been to plaintiff, however, it simply was
not so atrocious as to trigger liability for intentional infliction of emotional
distress. The plaintiff did prove the elements required for negligent infliction
of emotional distress, and there was sufficient evidence that plaintiff’s
distress was reasonable in light of the defendant’s conduct. The defendant
conducted an arson investigation to establish whether the plaintiff had engaged
in conduct that was criminal. Moreover, there was evidence from which the jury
could have inferred that the defendant’s investigation was not only shoddy, but
that it possibly was influenced by racial stereotypes.
02/12/03:
BRAYMAN CONSTR. CORP. v HOME INS. CO.,
Third Circuit (applying Pennsylvania law)
Bad Faith Insurance Claim
and Retrospective Premium Dispute Arbitrable
An arbitration provision in a
retrospective premium agreement made a dispute arising from a workers’
compensation claim arbitrable. A Pennsylvania bad-faith insurance claim was also
arbitrable.
02/07/03:
OZBAY v PROGRESSIVE INS.
Ohio Court of Appeals
Clause Providing Policy Is
Void for False Statements in Application Is Sufficient to Transform Insured’s
Statements Into Warranties
Plaintiff is the owner/operator
of several commercial hauling vehicles. Defendant insurer issued an automobile
policy for plaintiff’s dump truck. In completing the application, plaintiff
indicated that he was the only driver and that the truck would be used for
hauling jobs within a 50 mile radius of Perrysburg, Ohio. Less than a month
following the issuance of the policy, plaintiff moved the truck to New Jersey
due to a lack of hauling jobs available in Ohio. Subsequently, the truck was
destroyed in an accident and defendant insurer rescinded the policy based upon a
misrepresentation of fact on the application, as plaintiff had moved the truck
to New Jersey. In addition, at the time of the accident, plaintiff’s employee
was driving the truck, despite plaintiff being listed as the only driver. The
court stated that an insurer must clearly and unambiguously indicate in the
policy that a misstatement by the insured shall render the policy void. If the
policy is not clear, then a misstatement only renders the policy voidable, if it
the misstatement is material to the risk and fraudulently made. In this case,
just above the signature line, the policy included a statement indicating the
insured agreed that the policy would be null and void if a statement in the
application was false or misleading. The court held that the said clause was
sufficient for the policy to unambiguously provide that the statements in the
application were warranties and, if false, could render the policy void ab
initio. The court reversed summary judgment as a genuine issue of fact
remained as to whether the insured’s statements were false at the time of the
application.
Prepared by Bruce Celebrezze and Steve Bermudez of
Celebrezze & Wesley in Los Angeles
02/06/03:
HECHTMAN v NATIONS TITLE INS. OF NEW YORK
Florida Supreme Court
Insurers Not Liable for
Attorney’s Misappropriation of Funds While Acting as a Title Insurance Agent
Florida Statutes § 627.792 makes
title insurers liable for the misappropriation by their licensed title agents if
the funds are held in trust. Plaintiffs brought suit alleging that defendant
insurers were liable for the misappropriation of funds committed by a licensed
Florida attorney who was serving as a title insurance agent on behalf of
plaintiffs. Attorneys licensed to practice law in Florida who serve as title
insurance agents are exempt from the title insurance licensing requirements,
pursuant to Florida Statutes § 626.8417. Rather, an attorney may act as a title
insurance agent pursuant to his license to practice law. Plaintiffs argued that
the legislature intended a title insurer be liable for its agent’s
misappropriation, regardless of whether the agent acts under the authority of
his license as a title insurance agent or as an attorney. The court determined
that the legislature’s intent was to create an avenue of relief for victims of
non-attorney title insurance agents, since the Florida Bar provides relief for
those injured by lawyers. Therefore, the court held that an insurer is not
liable for the misappropriation of funds by an attorney acting as a title
insurance agent pursuant to his license to practice law.
Prepared by Bruce Celebrezze and Steve Bermudez of
Celebrezze & Wesley in Los Angeles
02/06/03:
INSURA PROPERTY AND CAS. INS. CO. v ASHE
Tennessee Court of Appeals
CGL Policy Does Not Cover
Defamation or Slander of a Personal Nature As Such Actions Do Not Arise Out of
Business Operations
Insured sought defense and
indemnity from plaintiff insurer relative to a defamation, libel and slander
complaint filed against them by the Ashes. Plaintiff filed a complaint for
declaratory judgment seeking a declaration that the general commercial liability
policy issued to the insured provided no coverage for the claims. The court
noted that CGL policies are designed to protect the insured from losses arising
out of business operations. The policy provided for “personal injury or
advertising injury,” which may include claims of defamation. However, the policy
requires that these injuries be caused by an offense arising out of the
insured’s business. The court rejected the insured’s argument that the
statements arose from the renting of property to the Ashes and thus arose from
the insured’s business as a property owner. Since the defamations and slanders
were of a personal nature, the court concluded that the alleged actions could
not have arisen out of the business of owning property.
Prepared by Bruce Celebrezze and Steve Bermudez of
Celebrezze & Wesley in Los Angeles
Hurwitz & Fine, P.C. is a
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Newsletter
Editor
Kevin T. Merriman
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Insurance Coverage
Team
Dan D. Kohane,
Team Leader
ddk@hurwitzfine.com
Michael F. Perley
Kevin T. Merriman
Phyllis A. Hafner
Audrey A. Barr
Fire, First Party
& Subrogation Team
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Gauthier, Team Leader
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Donna L. Burden
Andrea Schillaci
Jody E. Briandi
©
COPYRIGHT 2002 Hurwitz & Fine, P.C., ALL RIGHTS RESERVED.
PECKER IRON WORKS OF NEW YORK, INC. v
TRAVELER’S INS. CO.
ROSENBLATT, J.:
This case involves the relative obligations of two
liability insurance carriers covering the same risk. The outcome turns on
whether the insurance policy in question extends primary or merely excess
coverage to "additional insureds." We conclude that the policy provides primary
coverage, and therefore affirm the order of the Appellate Division.
At the time of the injury giving rise to the present
dispute, Pecker Iron Works engaged Upfront Enterprises to provide labor,
materials and equipment for a construction project under the supervision of a
general contractor. As a subcontractor, Upfront agreed "to furnish [Pecker] with
certificates of insurance for Liability and Workers Compensation and name Pecker
* * * as an additional insured." Upfront's insurance contract with the Travelers
Indemnity Company of Connecticut* -- the policy at issue -- provided Upfront
with primary coverage, and also covered such "additional insureds" as Upfront
would designate in a written contract. Another provision of the policy provided
that for those "additional insureds," coverage would only be excess, unless
Upfront "ha[d] agreed in a written contract for this insurance to apply on a
primary or contributory
basis."
An Upfront worker was injured at the site and brought suit
against the owner of the property and the general contractor see Jansen v C.
Raimondo & Son Constr. Co., 293 AD2d 574 [2002]). They in turn commenced a
third-party action against Pecker. Pecker then brought this declaratory judgment
action, seeking a judicial determination that Travelers was obligated to provide
primary coverage for any liability resulting from the accident. Pecker based its
claim on its contract with Upfront and on Upfront's policy with Travelers.
Supreme Court granted Travelers' motion to
dismiss,concluding that, by its terms, the Travelers policy provided only excess
coverage in the absence of a written, express designation of primary coverage
and that the Upfront-Pecker contract contained no such written designation. The
Appellate Division reversed, holding that there was no indication in the Pecker-
Upfront agreement that as an "additional insured" Pecker would receive only
excess, as opposed to primary, coverage. The Court thus determined that coverage
for "additional insureds" was primary coverage unless unambiguously stated
otherwise. We agree, and affirm.
Pecker's claim against Travelers arises from its status as
an "additional insured" under the policy, so we begin with that document. It is
undisputed that Travelers provided Upfront with primary coverage and that
Upfront agreed to make Pecker an additional insured. "Additional insured" is a
recognized term in insurance contracts, with an understanding crucial to our
conclusion in this case. As cases have recognized, the "wellunderstood meaning"
of the term is "an 'entity enjoying the same protection as the named insured'"
(Del Bello v General Accid. Ins. Co., 185 AD2d 691, 692 [1992], quoting Rubin,
Dictionary of Insurance Terms [Barron's 1987]; see also Jefferson Ins. Co. v
Travelers Indemnity Co., 92 NY2d 363, 372 [1998]; Wong v New York Times Co., 297
AD2d 544, 546 [2002]). When Pecker engaged Upfront as a subcontractor and in
writing provided that Upfront would name Pecker as an additional insured, Pecker
signified, and Upfront agreed, that Upfront's carrier -- not Pecker's -- would
provide Pecker with primary coverage on the risk. Pursuant to the policy
provision at issue, Travelers agreed to provide primary insurance to any party
with whom Upfront had contracted in writing for insurance to apply on a primary
basis. When Upfront agreed to it, the policy provision was satisfied.
Accordingly, the order of the Appellate Division should be
affirmed, with costs.
* * * * * * * * * * * * * * * * *
Order affirmed, with costs. Opinion by Judge Rosenblatt.
Chief
Judge Kaye and Judges Smith, Ciparick, Wesley, Graffeo and
Read concur.
Decided February 13, 2003
Appeal from an order of Supreme Court,
Herkimer County (Kirk, J.), entered October 23, 2001, which granted the motion
of defendant D'Angelo Insurance Agency for summary judgment dismissing the
complaint against it.
It is hereby ORDERED that the order so appealed from be and
the same hereby is unanimously affirmed without costs.
Memorandum: Contrary to the contention of plaintiffs,
Supreme Court properly granted the motion of defendant D'Angelo Insurance Agency
(D'Angelo) to dismiss the complaint against it under, inter alia, CPLR 3211 (a)
(5). The action as against D'Angelo sounds in
negligence and accrued, at the latest, in 1995, but it was
not commenced until 2001. Thus, the complaint against D'Angelo is timebarred (see
214 [4]). Contrary to the further contention of plaintiffs, the complaint
against D'Angelo was also properly dismissed
pursuant to CPLR 3211 (a) (7) to the extent that it
purports to assert a cause of action under Insurance Law § 3420 against him.
Section 3420 permits "a cause of action on behalf of the injured party against
the insurer" (Clarendon Place Corp. v Landmark Ins. Co., 182 AD2d 6, 9,
appeal dismissed 80 NY2d 918; see § 3420 [b] [1]). That statute is
in derogation of the common law and is therefore subject to
strict construction (see Clarendon Place Corp., 182 AD2d at 9). Courts
"'have consistently refused to grant any other or further privileges than the
statute specifically provides'" (id., quoting Morton v
Maryland Cas. Co., 1 AD2d 116, 126, affd 4
NY2d 488). The statute does not provide for a direct cause of action by an
injured party against an insurance broker, agent or agency, and thus plaintiffs
have failed to state a cause of action against D'Angelo under that statute.
The court properly denied plaintiffs' cross motion seeking
leave to amend the complaint. Plaintiffs failed to establish that any of the
proposed additional causes of action against D'Angelo had merit (see Farrell
v K.J.D.E. Corp., 244 AD2d 905, 905). Finally, we reject plaintiffs'
contention that the court converted the motion to dismiss to one for summary
judgment. The decision and the order establish that the complaint against
D'Angelo was dismissed pursuant to CPLR 3211.
Appeal from an order of Supreme Court, Erie County (Fahey,
J.), entered January 22, 2002, which directed Public Service Mutual Insurance
Company to pay 100% of the attorney's fees and disbursements recoverable by
defendants-third-party plaintiffs against third-party defendant, plus interest.
It is hereby ORDERED that the order so appealed from be and
the same hereby is unanimously modified on the law by directing Public Service
Mutual Insurance Company and ITT Hartford Group, Inc. to pay equally the
attorney's fees and disbursements recoverable by defendants-third-party
plaintiffs against third-party defendant, plus
interest, and as modified the order is affirmed without
costs.
Memorandum: Plaintiffs commenced this Labor Law action
seeking damages for injuries sustained by plaintiff Vancho Boshnakov while
employed by third-party defendant, Color Technics Painting Corp. (Color
Technics). Supreme Court previously granted that part of the motion of
defendants-third-party plaintiffs for summary judgment on their third-party
claims for common-law indemnification and the claim of defendant-third-party
plaintiff Higgins-Kieffer, Inc. (Higgins) for contractual indemnification from
Color Technics, and the court granted their subsequent motion to recover
attorney's fees and disbursements
from Color Technics. Public Service Mutual Insurance
Company (PSM), the insurer of Color Technics with respect to claims for
common-law indemnification only, now appeals from an order directing it to pay
100% of the attorney's fees and disbursements recoverable by
defendants-third-party plaintiffs against Color Technics, plus
interest. We agree with PSM that ITT Hartford Group, Inc.
(Hartford), the insurer of Color Technics with respect to claims for contractual
indemnification, must pay an equal portion of those attorney's fees and
disbursements (see Hawthorne v South Bronx Community Corp., 78 NY2d 433,
435; National Union Fire Ins. Co. of Pittsburgh, Pa. v State Ins. Fund,
222 AD2d 369, 372). The court erred in determining that a prior judgment
(denominated order) granted in August 1998, which was affirmed by this Court (Public
Serv. Mut. Ins. Co. v ITT Hartford Group, 267 AD2d 986, lv denied 94
NY2d 763), conclusively establishes that PSM is solely responsible for the
attorney's fees and
disbursements at issue here. That prior judgment, inter
alia, declared that PSM is obligated to defend and indemnify Color Technics, but
the issue whether Hartford must share in PSM's obligation to pay attorney's fees
and disbursements was not before the court. We agree with PSM that the language
in the contractual indemnification clause
pursuant to which Color Technics agrees to indemnify and
hold Higgins harmless "from and against all claims or suits" is broad enough to
encompass the attorney's fees and disbursements (see Blair v County of Albany,
127 AD2d 950), particularly in view of the fact that Color Technics is also
obligated by the contract to defend Higgins. We
therefore modify the order by directing PSM and Hartford to
pay equally the attorney's fees and disbursements recoverable by
defendants-third-party plaintiffs against Color Technics, plus interest.
Lahtinen, J.
Appeal from an order and judgment of the Supreme Court
(Nolan Jr., J.), entered December 10, 2001 in Saratoga County, which, inter
alia, granted defendant Royal Indemnity Company's motion for summary judgment
dismissing the complaint against it.
Plaintiff seeks to compel defendant Royal Indemnity Company
to indemnify its insured, defendant Peter A. Ozolins, for a default judgment
that plaintiff obtained against Ozolins as a result of Ozolins cutting off
plaintiff's left ear with a knife. On July 5, 1997, plaintiff was sitting in the
front passenger [*2]seat of Ozolins' parked
vehicle with his feet hanging out the window and his back to Ozolins while the
two individuals engaged in a discussion
[FN1]. Ozolins removed a knife from his pocket, reached across
the front of the vehicle from his position in the driver's seat and cut off
plaintiff's left ear. Ozolins was arrested upon a charge of first degree assault
and, in September 1997, entered a plea of guilty to second degree assault.
Thereafter, plaintiff commenced a personal injury action against Ozolins.
Ozolins resided with his parents, who had a homeowners' insurance policy with
Royal. Royal disclaimed coverage upon the ground that Ozolins' action fell
within a policy exclusion for "bodily injury * * * which is expected or intended
by the insured." Ozolins defaulted in the civil action and plaintiff entered a
default judgment against Ozolins for $330,361.63 in February 1999.
In May 1999, plaintiff commenced the instant action
seeking, inter alia, a declaration that Royal was obligated to indemnify Ozolins
for the default judgment. Following disclosure, Royal and plaintiff moved for
summary judgment. Supreme Court granted Royal's motion and denied plaintiff's
motion. Plaintiff appeals.
Plaintiff contends that there is evidence indicating that
Ozolins did not intend to injure him and, therefore, Supreme Court erred in
granting summary judgment under the insurance policy's intentional acts
exclusion
[FN2]. Not every intentional act falls within the parameters of
an insurance policy's intentional acts exclusion since "insurable 'accidental
results' may flow from 'intentional causes'" (Slayko v Security Mut. Ins. Co.,
98 NY2d 289, 293; see McGroarty v Great Am. Ins. Co., 36 NY2d 358,
364). "[I]n deciding whether a loss is the result of an accident, it must be
determined, from the point of view of the insured, whether the loss was
unexpected, unusual and unforeseen" (Agoado Realty Corp. v United Intl. Ins.
Co., 95 NY2d 141, 145 [*3][emphasis
omitted]).
Plaintiff places considerable reliance upon the fact that
Ozolins pleaded guilty to a crime premised upon reckless, rather than
intentional, conduct (see Penal Law § 120.05 [4]). However, the fact that
an assailant receives a favorable plea to a crime with a criminal intent element
of recklessness does not necessarily foreclose finding that the underlying
conduct falls within an insurance policy's intentional acts exclusion (see
Pennsylvania Millers Mut. Ins. Co. v Rigo, 256 AD2d 769, 770-771).
Although Ozolins' recitation of the crime at his allocution was aptly
characterized by Supreme Court as "disjointed" and "rambling," it nevertheless
revealed that he removed the knife from his pocket, opened it, swung it and
struck plaintiff. In a sworn statement to police shortly after the incident,
plaintiff stated that Ozolins grabbed his left ear before cutting it. Plaintiff
later changed his position after commencing this action by claiming that he no
longer recalled Ozolins grabbing his ear prior to the assault. Notwithstanding
the change in plaintiff's version of events, the evidence in the record reveals
that Ozolins removed the knife from his pocket, opened it, reached across the
front of the car, swung the knife at plaintiff and cut off his ear. Under such
circumstances, the injuries that plaintiff sustained cannot be fairly
characterized as unexpected, unusual or unforeseen. We agree with Supreme Court
that Ozolins' conduct and the resulting injury to plaintiff were intentional
within the meaning of the intentional acts exclusion in Royal's policy (see
id. at 770-771; Doyle v Allstate Ins. Co., 255 AD2d 795, 796-797;
Utica Fire Ins. Co. of Oneida County, N.Y. v Shelton, 226 AD2d 705, 706;
see also Dinneny v Allstate Ins. Co., 295 AD2d 797, 799).
Crew III, J.P., Spain, Carpinello and Kane, JJ., concur.
ORDERED that the order and judgment is affirmed, with
costs.
Footnotes
Footnote 1:Although there is considerable evidence in the record
indicating that plaintiff and Ozolins were, in fact, arguing, we accept for
purposes of this appeal from the grant of a summary judgment motion plaintiff's
current contention that they were not arguing.
Footnote 2:We note that, although plaintiff argues that Royal has a
duty to both defend and indemnify, the issue at this juncture — following entry
of a judgment against Ozolins — pertains to indemnification.
DEETJEN v
NATIONWIDE MUT. FIRE INS. CO.
In an action, inter alia, for a judgment declaring that the
defendant Nationwide Mutual Fire Insurance Company is obligated to defend and
indemnify the defendant Mark Allison in an underlying action entitled Deetjen v
Allison, pending in the Supreme Court, Kings County, under Index No. 38189/98,
the defendant Nationwide Mutual Fire Insurance Company appeals from an order and
judgment (one paper) of the Supreme Court, Kings County (Harkavy, J.), dated
September 18, 2001, which denied its motion for summary judgment declaring that
it is not obligated to defend and indemnify the defendant Mark Allison in the
underlying action, and, in effect, upon searching the record, granted the
plaintiff summary judgment and declared that it was obligated to defend and
indemnify the defendant Mark Allison in the underlying action.
ORDERED that the order and judgment is modified, by
deleting the provisions thereof granting the plaintiff summary judgment, and
declaring that the defendant Nationwide Mutual Fire Insurance Company is
obligated to defend and indemnify the defendant Mark Allison in an underlying
action entitled Deetjen v Allison, pending in the Supreme Court, Kings County,
under Index No. 38189/98, and substituing therefor a provision granting the
plaintiff partial summary judgment and declaring that the defendant Nationwide
Mutual Fire Insurance Company is obligated to defend the defendant Mark Allison
in the underlying action; as so modified, the order and judgment is affirmed,
without costs or disbursements.
The plaintiff's decedent, Natacha Deetjen, sustained
gunshot wounds from a weapon which discharged while in the defendant Mark
Allison's possession. Six days later, she died as a result of those injuries.
Allison was charged with murder in the second degree, manslaughter in the second
degree, criminally negligent homicide, assault in the first degree, assault in
the second degree, and criminal possession of a weapon in the fourth degree.
After a nonjury trial, he was acquitted of all counts except criminal possession
of a weapon in the fourth degree.
The plaintiff, the administrator of Natacha Deetjen's
estate, commenced the underlying action against Allison, inter alia, to recover
damages for wrongful death. After Allison's insurer, Nationwide Mutual Fire
Insurance Company (hereinafter the appellant), disclaimed coverage, the
plaintiff commenced this action seeking a declaration that the appellant is
obligated to defend and indemnify Allison in the underlying action. The
appellant moved for summary judgment declaring that it was not required to
defend or indemnify Allison in the underlying action, contending that there was
no coverage because the shooting was not an occurrence as defined by Allison's
homeowner's policy, and the policy excluded coverage for injuries that could
have been reasonably expected from the insured's conduct or intended by the
insured.
An insurer's duty to defend is triggered whenever the
allegations in a complaint, liberally construed, suggest a reasonable
possibility of coverage, or when the insurer has actual knowledge of facts
establishing such a reasonable possibility (see Frontier Insulation Contrs. v
Merchants Mut. Ins. Co., 91 NY2d 169, 175; Continental Cas. Co. v Rapid-Am.
Corp., 80 NY2d 640, 648). An insurer may be [*3]relieved
of its duty to defend only if it can establish, as a matter of law, that there
is no possible factual or legal basis on which it might eventually be obligated
to indemnify its insured, or by proving that the allegations fall within a
policy exclusion (see Frontier Insulation Contrs. v Merchants Mut. Ins. Co.,
supra at 175; Allstate Ins. Co. v Zuk, 78 NY2d 41, 45). If any of the
allegations arguably arise from a covered event, the insurer must defend the
entire action (see Frontier Insulation Contrs. v Merchants Mut. Ins. Co., supra
at 175).
Here, the appellant failed to demonstrate as a matter of
law that the shooting was not an occurrence covered by the policy or that
Allison's conduct fell wholly within a policy exclusion (see Frontier Insulation
Contrs. v Merchants Mut. Ins. Co., supra). Consequently, the Supreme Court
correctly concluded that the appellant is obligated to defend Allison in the
underlying action (see Allstate Ins. Co. v Zuk, supra). However, a determination
as to whether the appellant is obligated to indemnify Allison should await the
outcome of the underlying action (see Frontier Insulation Contrs. v Merchants
Mut. Ins. Co., supra at 178).
ALTMAN, J.P., SMITH, H. MILLER and MASTRO, JJ., concur.
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