Coverage Pointers
Volume V, No. 12
Friday, January 16, 2004
A Biweekly Electronic Newsletter
Hurwitz & Fine, P.C.
1300 Liberty Building
Buffalo, NY 14202
Phone: 716-849-8900
Fax: 716-855-0874
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© 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.
If you know of others who may wish to subscribe to this free publication, or if you wish to discontinue your
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at ddk@hurwitzfine.com
or call 716-849-8900. You will find back issues of Coverage Pointers here.
New Page 1
FDCC LITIGATION MANAGEMENT
COLLEGE
We are pleased to advise you of
two superb educational programs available for claims professionals: The 10th
Annual FDCC Litigation Management College and the Graduate Program of the FDCC
Litigation Management College, and urge you to consider attendance. You can
find additional information and brochures for these two programs, as well as
online registration, at the FDCC website:
www.thefederation.org.
The 10th Annual FDCC Litigation Management
College is being held at the J. L. Kellogg
Graduate School of Management, Northwestern University in Evanston, Illinois,
May 24 - 28, 2004. It is a program designed exclusively for the Claim
Professional to enhance litigation management and negotiation skills. The
Litigation Management College is sponsored by the Federation of Defense &
Corporate Counsel as a service to claim professionals from the insurance
industry and self-insureds organizations. The target group for the College is
claim professionals with three to twelve years claims and/or litigation
management experience. The college consists of an intensive five-day series of
workshops and participatory, interactive educational experiences. It provides a
unique opportunity for claim professionals to meet, study, and discuss issues of
common interest with the focus on the increasingly important area of litigation
management. The curriculum is designed to provide a practical approach to
litigation management. Everyone who attends should leave with new and enhanced
skills to improve the work of litigation management.
The Graduate Program of the FDCC Litigation
Management College
is being held at the J. L. Kellogg Graduate School of
Management, Northwestern University in Evanston, Illinois, May 24 - 26, 2004.
In response to the demand in the insurance industry for advanced skills
training in litigation management, nine years ago the Federation of Defense &
Corporate Counsel began an annual five-day intensive course devoted to the
advanced study of litigation management. In response to the overwhelming success
of the Litigation Management College and also requests from Alumni, the FDCC is
pleased to offer its Graduate Program to the Alumni of the Litigation Management
College, as well as to any students certified by their employers to have company
experience equivalent to the rigors of the College to satisfy the admission
prerequisite. The purpose of the Graduate Program is to build on the solid
foundation provided by the Litigation Management College to refine the student’s
understanding of advanced coverage issues, strategic litigation tactics, and
alternatives for resolution of disputes on favorable terms, while gaining
further understanding of the process to allow application of these skills to any
litigation challenge that may arise on the job in a cost-effective.
Dan Kohane has served on the
faculty of the Litigation Management College for the past five years, and is now
involved in the planning of the Graduate Program. If you have any questions
about either of these programs, please call him at 716-849-8942.
12/29/03
GENERAL ELECTRIC CAPITAL CORP. v VOLCHYOK
New York State Supreme Court,
Appellate Division, Second Department
Additional Insured Named in
Declarations Page of Policy Entitled to Notice Prior to Policy Cancellation
A vehicle leased by defendant from the plaintiff was stolen
and never recovered. In accordance with the terms of the lease, defendant had
obtained a policy naming the plaintiff vehicle owner as an additional insured
and as loss payee. The insurer denied plaintiff’s claim, asserting that it
cancelled the insurance policy for nonpayment of premiums before the loss by
mailing a proper notice of cancellation to defendant. Plaintiff asserted a cause
of action against Progressive to recover damages for breach of the policy
because it failed to provide plaintiff with prior notice of cancellation as
required by the terms of the policy. Specifically, the cancellation clause
provided that a notice of cancellation was required to be mailed at least 15
days before the effective date of cancellation to the named insured shown on the
declarations page. Plaintiff claimed it was entitled to such notice, as it was
named as an additional insured on the declarations page. The court agreed,
finding as a matter of law that it was the intent of the drafter of the
cancellation clause that notice of an impending cancellation be given to those
named insureds on the declarations page of the policy. Moreover, the insurer
knew that plaintiff was the owner of the vehicle, as plaintiff was named as an
insured on the policy. Therefore, the insurer was obligated to notify plaintiff
regarding the cancellation of the policy.
12/18/03
DURHAM v NEW YORK EAST TRAVEL, INC.
New York State Supreme Court,
Appellate Division, Third Department
Expert’s Designation of Numeric
Percentage of Loss of Range of Motion Substantiates Claim of “Serious Injury”
Where Herniated Disc Established by Objective Medical Evidence
Plaintiff commenced this action to recover for personal
injuries she sustained when her motor vehicle was rear-ended by another.
Defendants moved for summary judgment, contending that plaintiff did not sustain
a serious injury under Insurance Law §5102 (d). Supreme Court found that the
affidavit of plaintiff’s treating physician was insufficient to raise a question
of fact as to whether she had suffered a serious injury because his objective
finding of a herniated cervical disc was unsupported by further objective
medical evidence of observed limitations. The lower court granted defendants
summary judgment dismissing the complaint. On appeal, plaintiff contended she
met her burden by proffering evidence that plaintiff sustained a serious injury
under the permanent consequential limitation of use and significant limitation
of use categories. Specifically, an orthopedist who had been treating plaintiff
averred that an MRI taken one month after the accident revealed a “moderate to
large” disc herniation in her cervical spine that was not present on a CT scan
performed two months before the accident, and opined that the accident caused
the herniated disc. In an examination two years after the accident, he conducted
unspecified range of motion tests and determined that plaintiff had only 50% of
the normal range of motion in her neck. The orthopedist concluded that this loss
of range of motion was permanent because it existed two years after the accident
and, thus, plaintiff had suffered a permanent consequential and significant
limitation of use of her neck and cervical spine. Court held that proof of a
herniated or bulging disc, by itself, is insufficient to establish a serious
injury. However, once a herniated disc has been established by objective medical
evidence, such as an MRI, CT scan or X ray, “an expert’s designation of a
numeric percentage of a plaintiff’s loss of range of motion can be used to
substantiate a claim of serious injury.” The court explained that while it has
repeatedly held that a finding of reduced range of motion alone is insufficient
to support a finding of serious injury because such a determination is based on
subjective complaints of pain, the cases which so held were devoid of any
independent objective medical evidence of a serious injury. Accordingly, the
court held that plaintiff’s physician was not required to identify further
objective medical evidence of the herniated disc, and the 50% reduction in range
of motion. There was independent objective medical evidence of an injury,
namely, a postaccident MRI showing a herniated cervical disc. While the
orthopedist’s affirmation parroted the statutory language and included several
conclusory assertions regarding the seriousness of disc herniations, he did
opine that the accident caused the disc herniation in plaintiff’s cervical spine
and that the resulting 50% loss of range of motion was permanent. This medical
evidence, when coupled with the MRI showing the herniated disc, raised a
question of fact sufficient to survive defendants’ motions for summary judgment.
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.
01/15/04
MOTORISTS MUT. INS. CO. v HAMMOND
Sixth Circuit (applying
Kentucky law)
Used Car Dealer, as
Constructive Titleholder, Was Owner and Defendant’s Daughter Therefore an
Insured under Garage Policy
Albin Used Cars, Inc. was the
constructive titleholder, and thus an owner, of the car that defendant’s
daughter was occupying at the time of the accident. The daughter was therefore
an insured pursuant to Albin’s “garage coverage” policy with plaintiff, and was
entitled to underinsured motorist benefits thereunder.
01/14/04
CAROLINA CAS. INS. CO. v BURBACH
Eighth Circuit (applying
Minnesota law)
No Need to Examine Intent if
“Other Insurance” Clauses are Clear
The district court erred in
looking to policy insuring intent to resolve the question of primary coverage
where there was no conflict between the “other insurance” clauses in the
policies at issue.
01/14/04
VISION FINANCIAL GROUP, INC. v MIDWEST FAMILY MUT. INS. COMPANY
Seventh Circuit
Loss Payee subject to Same
Exclusions as Insured
Vision Financial Group, Inc.
sued Midwest Family Mutual Insurance Company to recover for stolen computer
equipment under an insurance policy that designated Vision Financial as loss
payee. In May 2001, Vision Financial leased computer equipment and furniture to
Mufti Hospitality Group. A few days after delivery of the equipment, Mufti's
president, Muhammad Arshad, stole the equipment and the furniture. Vision
Financial, as loss payee, filed a claim with Midwest to recoup the value of the
stolen property, which Midwest denied. The Court found that the equipment was
covered property under the policy, but the “dishonesty” and “false pretense”
policy exclusions are applicable. The loss payable provision dictates that the
policy's exclusions be applied to the loss payee and the insured equally. A
contrary decision would afford the loss payee greater protection under the
policy than the insured.
Robert Cooper and Charlie
Shah, Christian & Small
01/12/04
CASCO INDEMNITY CO. v GONSALVES
Rhode Island Supreme Court
Junk Motor Vehicle Carcass Not
Motor Vehicle for Purposes of Uninsured Motorist Claim
At the time Gonsalves contracted
with Casco he could not, nor would any “ordinary reader,” understand the
uninsured motorist provision of his policy to cover damages or injuries incurred
from an automobile that has been sold for parts and scrap metal, is missing
several important parts, and is found stationed on top of two other similar
automobile hulks. Gonsalves argues that the Horizon was a motor vehicle because
it could have been restored. Taking the facts in the light most favorable to
Gonsalves, the Horizon could have become a motor vehicle again at some point. It
is clear, however, that at the time of the accident the Horizon was used for
spare parts, not for transportation “mainly on public roads.” The Horizon could
not have been operated legally on a public highway and Gonsalves was reaching
toward the Horizon because he wanted to “use” the car as a cadaver for a part he
needed for another vehicle. Accordingly, the motion justice did not err in
finding that the Horizon was not a motor vehicle, but, rather, “junk.”
01/12/04
THE UPPER DECK CO., LLC v FED. INS. CO.
Ninth Circuit (applying
California law)
No Duty to Defend RICO Claims
Insurance policies covering
claims for bodily injury did not obligate defendant to defend plaintiff against
RICO claims. Neither the RICO complaint nor the extrinsic evidence available at
the time of tender could be construed as giving rise to a claim to bodily injury
as defined in the policies.
01/12/04
GRAY CARY WARE & FREIDENRICH v VIGILANT INS. COMPANY
California Court of Appeal
“Cumis Counsel” Not Required
for Arbitration over Fees
Civil Code section 2860 (all
undesignated statutory references are to this code) requires that an insurer
provide independent counsel to its insured in certain conflict situations and
subdivision (c) of this section requires the arbitration of “any dispute
concerning attorney[] fees . . . .” In this appeal court addresses the question
of whether this section encompasses disputes between an insurer and its insured
over the insurer’s responsibility for defense expenses incurred by the insured's
independent counsel. Section 2860 does not require the arbitration of disputes
regarding defense costs and the court affirmed the trial court’s denial of a
petition to compel arbitration under section 2860.
01/09/04
AMERICAN FAMILY MUT. INS. CO. v AMERICAN GIRL, INC.
Wisconsin Supreme Court
Exclusion for Contractual
Liability does not Preclude Coverage for all Breach of Contract Liability
A soil engineering subcontractor
gave faulty advice to a general contractor in connection with construction of a
warehouse. As a result, there was excessive settlement of the soil after the
building was completed, causing the foundation to sink and crack, as well as
significant damage to the rest of the structure. Ultimately the building had to
be torn down. The general contractor notified its insurance carrier of the loss,
and a dispute over coverage ensued. While the trial court found coverage, the
court of appeals concluded the “contractual liability” exclusion excluded
coverage. The Wisconsin Supreme Court held that the sinking, buckling, and
cracking of a warehouse was clearly physical injury to tangible property as
defined by the contractor’s CGL policy. Furthermore, it was accidental and
unintentional, so it was covered as an occurrence. Finally, the contractual
liability exclusion on which the appeals court relied to preclude coverage did
not exclude coverage for breaches of contract, but rather for instances where
the insured assumed the liability of another by contract, such as an
indemnification or hold harmless agreement. As a result, there was coverage for
the damage under the CGL policy.
Bruce D. Celebrezze and Erin
Adrian, Sedgwick, Detert, Moran & Arnold LLP
01/07/04
AMERICAN TRAVELERS LIFE INS. CO. v AIG LIFE INS. CO.
Eighth Circuit
Insurer who Purchases Insurance
Contracts from Another Insurer is Required to Defend Selling Insurer on Breach
of Contract Claim by Insured as well as Additional Claims Arising Out of
Contractual Relationship
An insured purchased a long-term
nursing home healthcare insurance policy with a provision that it only covered
care in the event the nursing home stay was preceded by a hospital stay of at
least three consecutive days. Shortly thereafter, North Dakota passed a law
prohibiting such a requirement. The insurer, AIG, sold its book of long-term
nursing home healthcare business to Conseco. When the insured was admitted to a
nursing home, Conseco denied coverage based on the fact that she had not had the
required hospital stay prior to her admittance. The insured sued AIG and Conseco
for bad faith and fraud. AIG filed a cross-claim against Conseco, arguing that
under the purchase agreement, Conseco had a duty to defend them in the insured’s
action. Conseco argued that, under the purchase agreement, they were only
required to defend and indemnify AIG in simple breach of contract suits. The
court held that, even though it was not stated as such, this was a simple breach
of contract suit because the insured alleged that both AIG and Conseco had
failed to pay benefits under the agreement. Furthermore, Conseco was also
required to defend and indemnify against claims in addition to breach of
contract because they arose out of the contractual relationship between the
insured and AIG, which Conseco assumed.
Bruce D. Celebrezze and Erin
Adrian, Sedgwick, Detert, Moran & Arnold LLP)
01/07/04
ANDERSON GAS & PROPANE, INC. v WESTPORT INS. CORP.
Arkansas Court of Appeals
Pollution Exclusion is
Ambiguous as to Whether or Not it Includes Gasoline Leak
Owners of a lodge discovered a
gasoline leak in an underground pipe, which leaked gasoline that migrated to the
wells of adjoining landowners. The landowners sued the lodge and Anderson Gas
for bodily injury and property damage. Anderson made a claim on its CGL policy
with Westport, but the insurer denied based on the pollution exclusion. The
trial court granted summary judgment in favor of the insurer, Westport. On
appeal, Anderson argued that, under the policy’s definition of pollution, gas
was not included because it was meant to cover industrial pollutants. Westport
argued that the pollution exclusion was intended to cover just such a situation.
The court held that the definition was ambiguous, and as a result, summary
judgment was inappropriate.
Bruce D. Celebrezze and Erin
Adrian, Sedgwick, Detert, Moran & Arnold LLP
01/07/04
TERRY v METROPOLITAN LIFE INS. CO. v LAGROIS, ET AL.
Sixth Circuit
The devil is in the details
when it comes to dispersing life insurance benefits
Life insurance benefits are not
to be paid to an apparent intended beneficiary when the decedent signed the
designation of beneficiary form with only her first name, did not date the form
and did not check a box indicating she had signed the form in the presence of
two witnesses.
J. Richard Caldwell, Jr. and
Michael Forte, Rumberger, Kirk & Caldwell
12/24/03
EDWARDS & SONS v CINCINNATI INS. COMPANY
Fourth Circuit
A Two Year "Statute of
Limitation" in Insurance Policy is an Affirmative Defense and Therefore Waived
if Not Raised in Answer
Cincinnati Insurance Company had
a provision in its insurance policy under Commercial Property Conditions that
"(n)o one can bring a legal action against us under this coverage part unless
... (t)he action is brought within 2 years after the date on which the direct
physical loss or damage occurred." Cincinnati failed to raise in its "grounds
for defense" that the action had not been commenced within the two (2) year time
period. The Court held that the defense urged by Cincinnati of such a breach of
a provision was an affirmative defense under Fed. R. Civ. P. 8(c). The Court
held that Cincinnati had waived the defense as a result of its failure to raise
it as an affirmative defense and its conduct in responding to the claimant's
allegations (in particular, failing to raise the limitation in its denial
letter). The Court also found that a product was "damaged" for purposes of
triggering policy coverage.
Robert Cooper and Charlie
Shah, Christian & Small
12/22/03
ADMIRAL INS. CO. v CRESENT HILLS APARTMENTS
Eleventh Circuit
Insurance Company’s Attempt to
Send Cancellation Notice by Taping Envelope to Mailbox with Note Asking Letter
Carrier to send by Certified Mail Surprisingly Violated Georgia Statute
Admiral Insurance Company issued
a commercial property insurance policy covering the Cresent Hills Apartments.
Admiral decided to cancel the policy after it was reported the apartments were
in deplorable condition. An Admiral underwriting assistant prepared an undated
cancellation notice for Cresent stating the policy would be canceled effective
November 8, 2000. According to an Admiral employee, she taped the envelope
containing the notice of cancellation to the outside of the mailbox in the lobby
of their office building on October 5, 2000. Attached to the envelope was a note
asking the letter carrier to date and sign or postmark the certified mail
receipt with the date it was picked up for delivery. The receipt was returned to
Admiral, undated and without a postmark. A Cresent employee signed the receipt,
returned the receipt to Admiral and placed the envelope on the desk of the
president of the corporation that owns Cresent Apartments. The president did not
open the envelope until December 29, 2000. In the interim, a fire destroyed five
apartment units on December 27. The Court found that the cancellation was
ineffective because it was not in compliance with O.C.G.A. § 33-24-44(b). There
was no evidence the notice of cancellation had been mailed at least 30 days
before the date of the purported cancellation.
Robert Cooper and Charlie
Shah, Christian & Small
12/22/03
INDIANA INS. CO. v AUTO-OWNERS INS. CO.
Michigan Court of Appeals
School Bus Insurer has Duty to
Indemnify Insured School Bus Operator for Injuries Incurred by 2 Children
Kidnapped upon Exiting Bus
Three men contacted the bus
operators and convinced them to drop three young girls off at a different bus
stop, came onto the bus and physically kidnapped the girls. The girls sued the
school district and the case was settled. The school district claimed that the
settlement was covered by the no-fault provision of district’s school bus
liability policy. Under the policy the insurer promised to defend and indemnify
the school district in regard to claims for bodily injury arising out of the
ownership, maintenance or use, including the loading and unloading, of its
school buses. The court found that the dispositive issue in this appeal is
whether a no- fault insurer or a general liability carrier is responsible for
insuring injuries resulting from a criminal act that happens to involve a school
bus. The court held that a school bus is “used” to ensure the safe delivery of
children and, thus, the school bus driver’s failure to deliver the children to
the appropriate stop and her allowing the kidnappers to physically remove the
protesting girls from the bus arose out of the use of the bus and was covered by
the policy.
Bruce D. Celebrezze and Hank
Brier, Sedgwick, Detert, Moran & Arnold
12/22/03
CANAL INDEMNITY CO. v GREENE ET AL.
Georgia Court of Appeals
Where Insurer Didn’t Make
Effort to get Insured’s Cooperation, Genuine Issue of Fact Raised Whether Lack
of Cooperation Negated Insurer’s Duty to Defend
Where insured cooperated with
the victim’s adjuster and attorneys and was not even contacted directly by his
own insurance company, there was a material issue of fact that supported the
denial of the insurer’s motion for summary judgment on the claim that it had not
duty to defend because the insured breached his duty to cooperate.
Bruce D. Celebrezze and Hank
Brier, Sedgwick, Detert, Moran & Arnold
12/22/03
DAIRY SOURCE, INC. v BIERY CHEESE CO.
Wisconsin Court of Appeals
No Duty to Defend under
Exclusion for Intentional Conduct even if Underlying Claims Could Be Proven
Without Establishing Intentional Conduct
Insurer had no duty to defend
under policy covering personal and advertising injury because allegations in
complaint were “Caused by or at the direction of the insured with the knowledge
that the act would violate the rights of another and would inflict "personal and
advertising injury". The fact that liability for the claims asserted in this
complaint might be established without proving conduct that would come within
the knowing injury exclusion does not alter the fact that the conduct
establishing liability alleged in this complaint indisputably comes within the
exclusion. We can see that if this complaint could arguably be read to suggest
that Biery Cheese did not do the acts alleged with knowledge that they would
violate Dairy's Source's rights and inflict a personal and advertising injury,
then Biery Cheese might have liability for conduct that would not come within
the exclusion. But we conclude this complaint cannot be read in that manner,
even when read most favorably to Biery Cheese. Based on the allegations in this
complaint, there is not a possibility of liability for conduct that does not
come within the exclusion.
Bruce D. Celebrezze and Hank
Brier, Sedgwick, Detert, Moran & Arnold
And
In defense
The Court of
Appeals Speaks Out on Labor Law §240: An Analysis of
Blake v Neighborhood Housing Services of New York City, Inc.
By Michael F. Perley
INTRODUCTION:
On December 23, 2003, the Court of
Appeals issued a lengthy decision, during which it addressed the evolving
jurisprudence pertaining to Labor Law § 240 (1). Although the Court could have
determined the case on a narrow issue of whether or not the sole defendant,
Neighborhood Housing Services of New York City, Inc. (NHS), a financing entity,
was an “agent of the owner” under Labor Law § 240 (the Court held, in § D of its
opinion, that NHS was such an agent and therefore the case against it should
have been dismissed) it chose to elaborate on the nature of § 240 liability,
perhaps in an effort to clear the air and to establish some working guidelines
among the judicial departments.
FACTUAL BACKGROUND:
Plaintiff, Rupert Blake, operated
his own contracting company and was the sole employee of that company on the job
site at the time of the accident. He was hired to perform renovation work on a
two-family home in the Bronx, a project financed through Neighborhood Housing
Services of New York City, Inc. (NHS), a not-for-profit lender.
At the jobsite the plaintiff had
set up an extension ladder, which he owned and used frequently. According to
plaintiff’s testimony, the ladder was steady, had rubber shoes and was in proper
working condition. The plaintiff used the ladder for purposes of scraping rust
from a portion of the building when the extension ladder suddenly retracted,
causing the plaintiff to fall and injure his ankle.
The plaintiff sued the homeowner
and NHS alleging a violation of Labor Law § 240. The homeowner obtained summary
judgment on the basis of the exemption contained in Labor Law § 240 for owners
of a single or two-family home that do not direct or control the work. NHS
moved for summary judgment on the grounds that it was not an agent within the
meaning of the Labor Law and challenged plaintiff’s § 240 claim as conclusory,
citing any lack of evidence of deficiency in the ladder or the worksite.
The case then proceeded to trial
where, again, plaintiff conceded that he could not identify a defect in the
ladder and that it was stable and there was no reason to have it steadied during
use. He also revealed that he was not sure if he had locked the extension clips
in place before ascending the rungs of the ladder to begin his work. At the
close of the case, the jury was presented with two interrogatories. The first
question was directed to whether NHS “had the authority to direct, supervise and
control Mr. Blake’s work,” to which the jury responded “yes.” The second
question to the jury, “Was the ladder used by the plaintiff, Rupert Blake, so
constructed and operated as to give proper protection to the plaintiff?” was
also answered “yes” by the jury, leading to the conclusion that the accident
happened solely as a result of plaintiff’s negligence in the way he used the
ladder.
EVOLUTION OF “ABSOLUTE LIABILITY”:
The Court devotes approximately
one-third of its opinion to the concept of strict or absolute liability, noting
that employers had an “absolute duty” to furnish safe scaffolding and would be
liable when they failed to do so and injury resulted. The phrase “absolute
liability” arose in 1958 in Connors v Boorstein, (4 N.Y.2d 172) and has
since worked its way into the parlance surrounding § 240 cases. Blake provided
the Court an opportunity to elaborate on the intended meaning of the phrase
“absolute liability” in the Labor Law § 240 context and, thereby, distinguish it
from the use of the phrase in other area. The Court noted:
It is imperative, therefore, to recognize that the phrase “strict (or absolute)
liability” in the Labor Law § 240 (1) context is different from the use of the
term elsewhere.
The term means, “liability without fault [cit.], as where a person is
automatically liable for causing an injury even though the activity violates no
law and is carried out with the utmost care…we also refer to strict liability
when discussing products liability arising out of a defective design or failure
to warn [cit.]. In this, manufacturers of defective products may be held
“strictly liable” for injury caused by those products regardless of privity,
foreseeability or reasonable care.
The Court then noted that, due to
the varying meanings of strict liability within the context of litigation:
The terms may have given rise to a mistaken belief that a fall from a scaffold
or ladder, in and of itself, results in an award of damages to the injured
party. That is not the law, and we have never held or suggested otherwise.
Having already noted that a
defendant should not be treated as an insurer of the plaintiff’s safety after
having provided a safe work place, the Court provided its interpretation of
strict or absolute liability within the § 240 context... Noting that not all
accidents that involved scaffolding or such work surfaces give rise to § 240
liability, the Court explained that “strict or absolute liability is necessarily
contingent on a violation of § 240 (1).” According to its decision in Melber
v 6333 Main Street, Inc., (91 N.Y.2d 759), the Court restated its definition
that “the statute establishes absolute liability for a breach which proximately
causes an injury.” Referring to its decision in Zimmer v Schemung County
Performing Arts, Inc. (65 N.Y.2d 513), the Court noted that “the failure to
provide any safety devices is such a violation” and, finally, referring to its
decision in Duda v (32 N.Y.2d ) the Court noted that the plaintiff “was
obligated to show that the violation [of § 240 (1)] was a contributing cause of
his fall.”
Once liability is established under
§ 240, the comparative fault of the plaintiff is not a defense. However, the
Court took pains to distinguish comparative fault from sole proximate cause
which it discussed extensively.
SOLE PROXIMATE CAUSE:
The Court took the opportunity to
reaffirm its decision in Weininger v Hagedorn & Co. (91 N.Y.2d 958) which
held that it was impermissible for the Supreme Court to direct a verdict in
favor of the plaintiff where a jury could conclude that “the plaintiff’s actions
were the sole proximate cause of his injuries, and consequently that liability
under…did not attach,” noting that:
It is conceptually impossible for a statutory violation (which serves as a
proximate cause for a plaintiff’s injury) to occupy the same ground as a
plaintiff’s sole proximate cause for the injury. Thus, if a statutory violation
is a proximate cause of an injury, the plaintiff cannot be solely to blame for
it. Conversely, if the plaintiff is solely to blame for the injury, it
necessarily means that there has been no statutory violation.
In footnote 10 of the opinion, the
Court cited, with apparent approval, a series of Appellate Division cases
addressing this issue. Most of these cases were decided after Weininger
and include Meade v Rock-McGraw, Inc. (307 A.D.2d 156), a First
Department case holding that the question of plaintiff’s misuse of the ladder
created a question of fact precluding a motion for summary judgment on liability
by the plaintiff; a Second Department case, Heffernan v Bais Corp. (294
A.D.2d 401), affirming the denial of summary judgment where an expert
affidavit “raised a question of fact as to whether the failure of the scaffold
to support the plaintiffs resulted solely from their own conduct;” Gomez v
State of New York, (272 A.D.2d 440) (Second Department), affirming a
determination by the Court of Claims dismissing plaintiff’s claim on the basis
of an experts testimony that “misuse of the ladder was responsible for the
incident” when an aluminum extension ladder suddenly began telescoping downward
stopping when the claimant’s arm became caught in the rungs; Bahrman v
Holtsville Fire District (270 A.D.2d 438) (Second Department), affirming the
denial of summary judgment when the Supreme Court determined that a question of
fact existed with regard to whether or not plaintiff’s own action was the sole
proximate cause.
Noting that § 240 is to be
construed as liberally as may be for the accomplishment of the purpose for which
it was framed, the Court noted that it was not the Legislature’s purpose to make
owners and contractors “insurers of the workers’ safety”; thus, every § 240 case
must be “supported by the evidence, from which the jury could find that
defendants had failed to satisfy [their] § 240 (1) responsibilities.”
PROCEDURAL GUIDELINES ON MOTIONS FOR SUMMARY JUDGMENT:
Footnote 8 sets forth the Court’s
guidelines for summary judgment motions involving ladders or scaffolds under §
240. Initially the Court pointed out that:
in cases involving ladders or scaffolds that collapse or malfunction for no
apparent reason, we have…continued to aid plaintiffs with a presumption that the
ladder or scaffolding device was not good enough to afford proper protection.
Having said that, the Court noted
that once the plaintiff makes the prima facie showing the burden shifts to the
defendant, who may defeat the plaintiff’s motion for summary judgment:
only if there is a plausible view of the evidence – enough to raise a fact
question – that there was no statutory violation and that plaintiff’s own acts
or omissions were the sole cause of the accident.
The Court further noted that the
plaintiff will be entitled to summary judgment if “defendants assertions in
response fail to raise a fact question as to these issues...,” and conversely,
that defendant will be entitled to summary judgment, “if the record establishes
conclusively that no Labor Law § 240 (1) violation was shown to have been a
proximate cause of the accident and that the accident was therefore caused
solely by plaintiff’s conduct.”
Based upon the Court’s apparent
approval of several Appellate Division cases, it appears that defendants can use
expert testimony, in whole or in part, to establish a question of fact, or in
some cases, entitlement to summary judgment dismissing the Labor Law § 240 (1)
claim.
Certainly, the presumption in favor
of the plaintiffs is a strong one. Overcoming this presumption will require
strong evidence, either based upon plaintiff’s own testimony, the testimony of
eyewitnesses or of experts with respect to plaintiff being the sole proximate
cause of his own injury.
UNANSWERED QUESTIONS:
Although the Court of Appeals
analysis of liability under Labor Law § 240 is extensive, several unanswered
questions remain.
First, this case involves a
worksite where the plaintiff was solely in control. In fact, the plaintiff,
Blake, appears to be a contractor who is the owner of his own company and may
have incorporated his business where he was the sole employee (although this is
not explicitly set forth in the record). Thus, the Court of Appeals does not
address the question where there was active supervision or the possibility of
supervision at a jobsite by foremen or other supervisory personnel with regard
to plaintiff’s activities and whether the existence of such supervision could
contribute to a finding of a § 240 violation by eliminating the plaintiff as the
“sole proximate cause” of his injury.
Second, the Court did not address
potential liability for failure to provide safety devices, in place of ladders,
as a potential §240 violation in situations where ladders are, arguably, not
appropriate. It appears conceded in Blake that the extension ladder
was the appropriate device for the plaintiff to use. In part, this may
result from the plaintiff’s status as an alter ego of his own company. In cases
where there is additional supervision, selection of a different device
potentially lies with the supervisory personnel giving rise to another avenue of
§ 240 liability.
Finally, the Court of Appeals,
explicitly limits this case to ladders and, possibly scaffolds. Other hoists or
devices are excluded from the analysis of footnote 8, and by implication, from
the analysis within the case.
While the Blake decision is
generally favorable for defendants, as the Court seeks to limit the application
of § 240 only to those cases where plaintiff has established a statutory
violation, the limitations within the opinion may allow lower court’s to
distinguish Blake as controlling authority.
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GENERAL ELECTRIC CAPITAL CORP. v VOLCHYOK
In an action to recover damages for breach of contract, the
defendant Progressive Direct, Inc., a/k/a Progressive, appeals, as limited by
its brief, from so much of an order of the Supreme Court, Kings County (G.
Aronin, J.), dated November 6, 2002, as granted the plaintiff's motion for
summary judgment on the complaint insofar as asserted against it and denied its
cross motion to compel discovery.
ORDERED that the order is affirmed insofar as appealed
from, with costs.
On or about August 31, 2000, an automobile leased by the
defendant Gennady Volchyok from the plaintiff, General Electric Capital
Corporation, was stolen and never recovered. In accordance with the terms of the
lease, Volchyok had obtained a policy of insurance from the defendant
Progressive Direct, Inc., a/k/a Progressive (hereinafter Progressive), naming
the plaintiff vehicle owner as an additional insured and as a loss payee.
Progressive denied the plaintiff's claim, asserting that it
cancelled the insurance policy for nonpayment of premiums before the loss by
mailing a proper notice of cancellation to Volchyok. The plaintiff asserted a
cause of action against Progressive to recover damages for breach of the
insurance policy because it failed to provide the plaintiff with prior notice of
the cancellation as required by the terms of the subject policy. Specifically,
the cancellation clause provided that a notice of cancellation was required to
be mailed at least 15 days before the effective date of cancellation to the
named insured shown on the declarations page. The plaintiff claims it was
entitled to such notice, as it was named as an additional insured on the
declarations page of the policy. The Supreme Court awarded the plaintiff summary
judgment on that cause of action. We affirm.
"It is axiomatic that a contract is to be interpreted so as to give effect to
the intention of the parties as expressed in the unequivocal language employed"
(Breed v Insurance Co. of North Amer., 46 NY2d 351, 355). Whether or not
a writing is ambiguous is a question of law to be resolved by the courts (see
W.W.W. Assocs. v Giacontieri, 77 NY2d 157, 162). A determination of the
intent of the parties to a contract can be made as a matter of law without a
trial where that intent is discernible from the four corners of an
unambiguously-worded agreement (see Hartford Acc. & Ind. Co. v Wesolowski,
33 NY2d 169).
The Supreme Court correctly determined as a matter of law that it was the intent
of the drafter of the cancellation clause that notice of an impending
cancellation be given to those named insureds on the declarations page of the
policy. Accordingly, summary judgment was properly awarded to the plaintiff.
Moreover, Progressive knew that the plaintiff was the owner of the vehicle, as
the plaintiff was named as an insured on the policy. Therefore, Progressive was
obligated to notify the plaintiff regarding the cancellation of the policy on
that basis as well (see e.g. Matter of American Cas. Ins. Co. v Walcott,
300 AD2d 478; Government Employees Ins. Co. v Employers Commercial Union Ins.
Co., 62 AD2d 123).
The appellant's remaining contention is without merit.
DURHAM v NEW YORK EAST TRAVEL, INC.
Appeal from an order of the Supreme Court (Demarest, J.),
entered February 3, 2001 in St. Lawrence County, which granted defendants'
motions for summary judgment dismissing the complaint.
Plaintiff Linda Durham (hereinafter plaintiff) and her
husband, derivatively, commenced this action to recover for personal injuries
she sustained when her motor vehicle was rear-ended by defendant Gedney J.
Gorgrant, who, in turn, had been rear-ended by a van owned by defendant New York
East Travel, Inc. and operated by defendant Tai An Kim. Gorgrant moved, and the
remaining defendants cross-moved, for summary judgment, contending, among other
things, that plaintiff did not sustain a serious injury under Insurance Law _
5102 (d). As is relevant here, Supreme Court found that the affidavit of
plaintiff's treating physician was insufficient to raise a question of fact as
to whether she had suffered a serious injury because his objective finding of a
herniated cervical disc was unsupported by further objective medical evidence of
observed limitations. The court granted defendants summary judgment dismissing
the complaint, and plaintiffs appeal.
Plaintiffs concede on this appeal that defendants made
prima facie showings of entitlement to summary judgment as a matter of law, so
we are concerned only with whether plaintiffs met their shifted burden to raise
a triable issue of fact (see Weller v Munson, 309 AD2d 1098, ___,
766 NYS2d 252, 254 [2003]; Serrano v Canton, 299 AD2d 703, 703 [2002]).
As limited by their brief, plaintiffs contend that they met this burden by
proffering evidence that plaintiff sustained a serious injury under the
permanent consequential limitation of use and significant limitation of use
categories.[1] Specifically, Steven Fish, an orthopedist who has been treating
plaintiff since the accident, averred that an MRI taken one month after the
accident revealed a “moderate to large” disc herniation in her cervical spine
that was not present on a CT scan performed two months before the accident, and
he opined that the accident caused the herniated disc. In an examination two
years after the accident, Fish conducted unspecified range of motion tests and
determined that plaintiff had only 50% of the normal range of motion in her
neck. Fish concluded that this loss of range of motion was permanent because it
existed two years after the accident and, thus, plaintiff had suffered a
permanent consequential and significant limitation of use of her neck and
cervical spine.
It is well settled that proof of a herniated or bulging
disc, by itself, is insufficient to establish a serious injury (see
Toure v Avis Rent A Car Sys., 98 NY2d 345, 353 n 4 [2002]; Tornatore v
Haggerty, 307 AD2d 522, 523 [2003]). However, once a herniated disc has been
established by objective medical evidence, such as an MRI, CT scan or X ray, “an
expert's designation of a numeric percentage of a plaintiff's loss of range of
motion can be used to substantiate a claim of serious injury” (Toure v Avis
Rent A Car Sys., supra at 350). While we have repeatedly held that a
finding of reduced range of motion alone is insufficient to support a
finding of serious injury because such a determination is based on subjective
complaints of pain, the cases which so held were devoid of any independent
objective medical evidence of a serious injury (see e.g. McCreesh v
Hoehm, 307 AD2d 638 [2003] [X ray and MRI normal]; Temple v Doherty,
301 AD2d 979 [2003] [no abnormalities on postaccident X ray and MRI];
Blanchard v Wilcox, 283 AD2d 821 [2001] [X ray, CAT scan and MRI normal];
Gillick v Knightes, 279 AD2d 752 [2001][X rays, MRI and other tests showed
no injuries]; Wiley v Bednar, 261 AD2d 679 [1999] [subjective complaints
not corroborated by X ray, MRI or other tests]). Accordingly, we reject
defendants' contention that plaintiff's physician was required to identify
further objective medical evidence not only of the herniated disc, but also of
the 50% reduction in range of motion.
Here, there is independent objective medical evidence of an
injury, namely, a postaccident MRI showing a herniated cervical disc. While
Fish's affirmation parrots the statutory language in places and includes several
conclusory assertions regarding the seriousness of disc herniations, he
nonetheless does opine, based upon plaintiff's treatment history and his
clinical examination, that the accident caused the disc herniation in
plaintiff's cervical spine and that the resulting 50% loss of range of motion is
permanent. In our view, this medical evidence, when coupled with the MRI showing
the herniated disc, raises a question of fact sufficient to survive defendants'
motions for summary judgment.
Cardona, P.J., Crew III, Rose and Lahtinen, JJ., concur.
ORDERED that the order is reversed, on the law, with costs,
and motions denied.
[1] Because plaintiffs have not briefed their claims under
the 90/180-day and permanent loss of use categories under Insurance Law _ 5102
(d), these claims are deemed abandoned (see Mrozinski v St. John,
304 AD2d 950, 951 [2003]; Santos v Marcellino, 297 AD2d 440, 441 [2002]).
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