Florida Court Reassess Insured's Right to Reject Insurer's Defense

Taking the brave step of deciding an insurance case on its own without certifying questions to the Florida Supreme Court, the Eleventh Circuit has ruled in Mid-Continent Cas. Co. v. American Pride Building Co., No. 09-11238 (11th Cir. March 29, 2010) that a Florida district court erred in granting summary judgment to a liability insurer in a copyright infringement case where the insurer was defending under a reservation of rights but ignores the view of defense counsel in assessing whether to settle. Without reaching the issue of whether American Pride had breached the duty to cooperate, the Eleventh Circuit found disputed issues of fact with respect to whether Mid-Continent had changed the terms pursuant to which its defense was being provided when it added a later condition that it be entitled to recoup its defense costs if coverage was held not to apply. If such facts were found to exist, the Eleventh Circuit ruled that Mid-Continent would have been entitled to withdraw its assent to the defense being provided and would therefore have been free to enter into a settlement of its own volition without breaching the duty to cooperate.

 

American Pride, a Florida home builder, was sued by a competitor for copyright infringement and unfair competition for distributing flyers copying the plaintiff’s designs for local homes.  Its liability insurer, Mid-Continent, initially denied coverage but six months later agreed to appoint defense counsel pursuant to a reservation for rights.  Mid-Continent’s reservation of rights letter did not advise American Pride that it had the right to reject the proffered defense and insist on defense counsel of its own.  Nor did the letter advise American Pride that Mid-Continent might later seek to recoup its costs of defense.

Prior to trial, defense counsel advised Mid-Continent that liability was certain and the damages could exceed $10 million.  Nevertheless, counsel opined that the case could probably settle within policy limits and recommended an offer of $550,000.  In response, Mid-Continent declined to offer more than $75,000. 

Following the collapse of mediation talks, the insured engaged independent counsel who insisted that Mid-Continent either withdraw the reservation of rights or permit the insured to take over its own defense.  In response, Mid-Continent took the position that under Florida law once an insured accepts a defense it cannot thereafter reject it and would, in fact, lose its right to coverage if it proceeded on its own. 

Despite these strains in their relationship, Mid-Continent and American Pride continued to cooperate towards a settlement.  Mid-Continent raised its offer to $100,000 at which point the plaintiff’s demand was reduced to $250,000.  Defense counsel warned Mid-Continent at that point that if it did not accept the reduced demand, American Pride would “fire” him and settle on its own.  Mid-Continent ignored this warning and stated that its coverage concerns precluded it from offering more than $100,000.  As a result, American Pride filed a coverage suit against Mid-Continent and advised Mid-Continent that it was “respectfully rejecting any continued defense under a reservation of rights.”  A week later, the insured entered into a $1.7 million stipulated judgment and assigned its coverage rights against Mid-Continent to the plaintiff.

In the ensuing coverage litigation, the District Court granted summary judgment to Mid-Continent, holding that American Pride’s settlement in a case where it was already being defended by its insured violated the duty to cooperate.  These findings were reversed on appeal to the Eleventh Circuit. 

As a preliminary matter, the Eleventh Circuit ruled that a policyholder was not obliged to accept a defense under a reservation of rights.  Citing the Florida District Court of Appeals decision in Taylor v. Safeco Ins. Co., 361 So.2d 743 (Fla. 1st DCA 1978), the court opined that, “If the insurer offers to defend under a reservation of rights, the insured has the right to reject the defense and hire its own attorneys and control the defense.”  In this case, the court questioned whether Mid-Continent had acted in good faith in the manner in which it conducted the insured’s defense.  Nevertheless, as the insured had accepted a defense under a reservation of rights, the court found that American Pride was required to cooperate with Mid-Continent so long as it was being defended.

Without reaching the issue of whether American Pride had breached the duty to cooperate, the Eleventh Circuit found disputed issues of fact with respect to whether Mid-Continent had changed the terms pursuant to which its defense was being provided when it added a later condition that it be entitled to recoup its defense costs if coverage was held not to apply.  If such facts were found to exist, the Eleventh Circuit ruled that Mid-Continent would have been entitled to withdraw its assent to the defense being provided and would therefore have been free to enter into a settlement of its own volition without breaching the duty to cooperate.  The court ruled that American Pride would only have violated the policy’s cooperation clause if it had secretly negotiated a settlement prior to rejecting Mid-Continent’s defense.  In this case, the court found that the district court had erroneously granted summary judgment to Mid-Continent based upon its conclusion that the settlement had been negotiated in secrecy, citing contrary facts to the effect that Mid-Continent’s appointed defense counsel had been aware of these ongoing discussions and had reported that information to the insurer. 

 

"Cumis" Counsel Continues to Create Challenges for Court Consideration

“Cumis” – California’s rule on the right to independent counsel (codified at Civil Code Section 2860) – continues to raise issues requiring courts to more clearly define, among other aspects:

  • under what circumstances does the right to independent counsel arise?
  • when is there is an actual “conflict” for defense counsel retained by the insurer?
  • can the right to independent counsel arise due to the insurer’s failure to defend immediately (rather than any conflict in that defense)?
  • what reporting is required from independent counsel?
  • when should an insurer retain defense counsel in addition to paying for the insured’s independent counsel?
  • what issues can be arbitrated under Section 2860 along with the dispute over “usual” rates?

In Intergulf Dev. v. Superior Ct., __ Cal.App.4th __ (2010), California’s appellate court for the Fourth Appellate District (San Diego County) held the parties had to first litigate issues of breach of contract and bad faith prior to arbitrating the issue of independent counsel’s rates. The insurer agreed to defend an Additional Insured under its policies in a lawsuit arising out of defects on a construction project. However, the insurer did not respond to the question of whether it would agree that the additional insured had a right to independent counsel. The insurer was sued for breach of contract and bad faith. In the course of that lawsuit, the insurer made payments toward defense costs but claimed independent counsel’s rates far in excess of the usual rates the insurer paid to defend similar actions. Five weeks before trial of the breach of contract/ bad faith case, the insurer filed a petition to compel arbitration. The trial court granted the petition, but the appellate court issued a writ of mandate vacating that order. The appellate court ruled that arbitration over the fees charged by independent counsel was premature. First, there had to be a determination of whether the insurer breached its contract in not defending “immediately” and “entirely.”  As that court explained, breach of those duties may “place the section 2860, subdivision (c) procedures out of [the insurer’s] reach.”

Second Circuit Uphold Insurer's Right To Appoint Counsel

In the ongoing struggle between policyholders and liability insurers concerning the scope of the independent counsel doctrine, an emerging battlefield has focused on whether disputes between the parties that are unrelated to insurance coverage issues allow policyholders to dispossess liability insurers of their right to control the insured’s defense and appoint defense counsel of the insured’s own choosing Notwithstanding the consequences of this issue, there has been little or no case law addressing this issue up to this point. Now, the Second Circuit has issued a significant new Katrina opinion that emphatically states an insured cannot reject a proposed defense firm merely because the insured believes that they are too small to handle a "bet the company" case.   The opinion also restates New York's interpretation of Cumis that a right to independent counsel should only arise where an insurer has reserved rights on a coverage issues that is of a sort that might influence appointed defense counsel to try the case in such a manner that could result in an uninsured verdict.

The consolidated insurance coverage cases decided in New York Marine & General Ins. Co. v. Lafarge North America, Inc., No. 08-5504 (2nd Cir. March 15, 2010) had their origins in a barge (Barge ING 4727) that broke loose from its moorings on the Mississippi River on August 29, 2005 during Hurricane Katrina and came to rest against a house on the land side of the levee protecting the Lower Ninth Ward of New Orleans. On September 9, 2005, an article in the Wall Street Journal suggested that the barge itself might have been responsible for the disastrous breach of the levee that flooded the Lower Ninth Ward in the days that followed Katrina. As a result, Barge ING 4727 figured prominently in the ensuing flood of Katrina litigation in Louisiana.

At the time of this loss, Barge ING 4727 was owned by Ingram Barge Company and was under contract to transport materials for Lafarge, one of the largest suppliers of construction materials in the United States and Canada. Upon reading the Wall Street Journal article blaming Barge ING 4727 for the levee breach, Lafarge immediately engaged the Goodwin Procter law firm to coordinate and plan its defense against anticipated class action and mass tort litigation. Lafarge also retained the Holland & Knight law firm to investigate maritime issues presented by the loss. The following day, at Goodwin Procter’s recommendation, Lafarge hired the New Orleans law firm of Chaffe McCall, which had a sizeable maritime practice, to advise it on local concerns.

The day after receiving the Wall Street Journal report (September 9), LaFarge also notified its primary insurer (NYMAGIC) that litigation was likely. At the time, LaFarge only disclosed that it had engaged Holland & Knight to investigate maritime issues. No mention was made of the role of Goodwin Procter or Chaffe MCall.

On September 13, NYMAGIC acknowledged receipt of the notice and advised LaFarge that it had excellent law firms in New Orleans ready to defend any resulting suits. It was not until September 20 that LaFarge advised NYMAGIC that it had already engaged both national and local counsel. Two days later, NYMAGIC told LaFarge that it:

would not consent to any of the six law firms proposed by NYMAGIC and ... that they intended to continue to employ Goodwin Procter, Chaffe ... and [H&K]." In an e-mail dated September 28, 2005, NYMAGIC advised Lafarge that "[we] can agree to the costs of the experts and surveyors but [we] cannot agree to pay for the three sets of attorneys on the case, none approved by us." In a separate e-mail dated the same day, NYMAGIC also informed Lafarge that "[w]e have decided to appoint Sutterfield & Webb as defense counsel in Louisiana."

Lafarge ignored NYMAGIC’s offered list of counsel and continued to insist that NYMAGIC agree to pay for the defense provided by Goodwin Procter, Chaffe and Holland & Knight. As a result, NYMAGIC appointed the New Orleans law firm of Sutterfield & Webb to act as defense counsel, which thereafter associated with these other law firms in the In Re: Katrina Canal Breaches Consolidated Litigation.

Although the Holland & Knight law firm was discharged after completing its initial investigation of maritime issues, its bills, combined with the substantial legal fees charged by Goodwin Procter and local counsel ultimately totalled over $10 million, far more than the $5 million primary limit provided by the NYMAGIC policy.

The issued presented to the Second Circuit was whether NYMAGIC and various excess insurers of LaFarge were required to reimburse its insured for fees incurred by law firms that were not of the insurers’ choosing. Alternatively, the court was asked to consider whether the daunting exposure presented by these Katrina claims, which far exceeded the $50 million in total available limits, was in and of itself a "conflict" that would permit the insured to ignore the provisions of the policies and appoint its own counsel.

The NYMAGIC policy contained non-standard provisions that were claimed to be in conflict here. The so-called "Naming Clause" stated that the insurer, in consultation with Lafarge, "shall have the option of naming any mutually acceptable attorneys to defend Lafarge." However, the policy also contained a so-called "Protection Clause" which required the policyholder to take all reasonable steps to protect NYMAGIC’s interests in the event that a claim was likely to arise under the policy.

The Second Circuit ruled that under the extraordinary circumstances presented by Katrina, as borne out by the successive waves of Katrina litigation since 2005, it was appropriate for Lafarge to immediately engage skilled national counsel (Goodwin Proctor) as well as a law firm with specialized maritime experience (Holland & Knight) and local counsel (Chaffe) in fulfillment of its obligations under the protection clause. The court ruled that the immediate assistance of these firms was vital to promptly identifying and preserving evidence and positioning Lafarge with respect to its strategy for the ensuing litigation. Indeed, the court took the view that the Holland & Knight fees were separately covered under the policy as involving a cost of investigation since Holland & Knight’s role was not so much as defense counsel as providing a specific opinion to Lafarge on maritime issues.

Lafarge is correct that in light of the exceptional circumstances of Hurricane Katrina, it was reasonable to act quickly to retain Goodwin Procter, H&K, and Chaffe to preserve evidence, investigate the cause of the breached levee, and minimize exposure to the damages that would be at stake in the foreseeable and inevitable lawsuits. Considering the level of complexity of the case in both procedural and substantive respects, as well as the possibility of being cast in damages that could exceed the value of Lafarge several times over, we agree with the District Court that "it was reasonable for Lafarge to retain at once a large firm such as Goodwin, with complex case and mass tort experience, to take immediate control of Lafarge's defense against the anticipated litigation flood (which in fact materialized). It was also reasonable for Lafarge to retain an admiralty firm such as H&K, with experience in the `rapid response' investigation and evaluation of major marine casualties."

On the other hand, the court ruled that nothing in the Protection Clause suggested an intention to trump the significance of the naming clause, even in cases of extreme liability, as here. The court observed that, "While Goodwin Procter, H&K and Chaffe were reasonably retained to minimize potential liability arising from the extraordinary circumstances here, the protection clause does not qualify NYMAGIC’s option to name mutually acceptable counsel pursuant to the naming clause. . . ." As a result, the court found that, "Once NYMAGIC clearly expressed its intention to fulfill its obligations and offered Lafarge a choice of six qualified law firms, it was incumbent upon Lafarge to act in good faith to consider agreeing to retain a firm from NYMAGIC’s list." The Court therefore refused to require NYMAGIC to reimburse Lafarge for those fees that were incurred by Goodwin Procter and Chaffe after NYMAGIC had provided a list of proposed defense counsel to Lafarge.

The Second Circuit rejected Lafarge’s argument that the Sutterfield & Webb law firm, which had only five attorneys, had inadequate resources to provide a proper defense to it. The Second Circuit pointed out that the initial list of law firms proposed by NYMAGIC included law firms of between 40 and 160 attorneys specializing in maritime law and experienced in class actions and that it was only after Lafarge refused to consider any of these larger firms that NYMAGIC retained Sutterfield to associate in the defense. In any event, the court rejected any unqualified suggestion that a small law firm is less competent than a larger firm pointing out that the Rules of Professional Responsibility would prohibit a law firm from undertaking a representation that it was unqualified to accept.

The court also rejected Lafarge’s suggestion that the sheer size of the anticipated Katrina claims created a conflict of interest that allowed it an independent right to select counsel of its own choosing without regard to the wording of the policies. The Second Circuit pointed out that, under New York law, "Independent counsel is only necessary in cases where the defense attorney’s duty to the insured would require that he defeat liability on any ground and his duty to the insurer would require that he defeat liability only upon grounds which would render the insurer liable." Public Service Mut. Ins. Co. v. Goldfarb, 53 N.Y.2d 392, 401 (1981). In contrast to the issues in Goldfarb, the Second Circuit pointed out that both NYMAGIC and Lafarge shared a common interest in defeating Lafarge’s liability in the barge litigation. The court declined to find that the mere fact that Lafarge’s potential exposure far exceeded the limits of liability was itself a basis for finding a conflict. Indeed, the Second Circuit pointed out that the New York Court of Appeals had implicitly rejected a similar characterization of a "conflict" in Goldfarb when it observed:

Where multiple claims present no conflict – for example where the insurance contract provides liability coverage only for personal injuries and the claim against the insured seeks recovery for property damage as well as for personal injuries – no threat of divided loyalty is present and there is no need for the retention of separate counsel. This is so because in such a situation the question of insurance coverage is not intertwined with the question of the insured’s liability.

Id.

The court noted that tension might nonetheless exist in settlement negotiations but found that "such a potential or actual conflict is not apparent in this case."

Accordingly, the Second Circuit ruled that Lafarge was only entitled to be reimbursed for fees incurred by the Goodwin Procter and Chaffe law firms from the time of their retention in early September through September 28, 2005, when it became clear that Lafarge was not acting in good faith in considering the list of six qualified law firms proposed by NYMAGIC on September 22 and when NYMAGIC advised Lafarge that it would not agree to pay for three sets of attorneys, none of which had been selected or approved by it.

The Second Circuit adopted a similar conclusion with respect to certain excess carriers whose policies rested over the $5 million NYMAGIC primary policy. Lafarge had argued that these "bumbershoot" policies must accept coverage for losses that were not insured under the primary policy. Despite the fact that the excess policies did not contain any "Naming Clauses" similar to those contained in the NYMAGIC policy and only contained an "assistance clause" permitting the excess carriers to associate in the insured’s defense at their option, the Second Circuit summarily concluded that the excess carriers nonetheless had no duty to pay for the Goodwin Procter or Chaffe fees as their obligation was only to reimburse "reasonable legal expenses." In this case, the court found that the excess carriers were entitled to rely on the insured’s compliance with requirements in the primary policy with respect to the effect of the naming clause and that, "The excess insurers therefore reasonably expected Lafarge’s defense counsel to be selected pursuant to the plain terms of the primary policy." As a result, "While it may have been reasonable for Lafarge to retain its own attorneys to protect any remote potential conflict of interest between the insurers and Lafarge, the continued retention of Goodwin Procter and Chaffe goes well beyond the necessity of filling that modest role." As a result, the court concluded that the fees charged by the Goodwin Procter and Chaffe law firms after September 28, 2005 were not "reasonable" and therefore fell outside the scope of the coverage obligations of the excess carriers.

Despite its convoluted fact pattern and the non-standard wordings at issue in this case, Lafarge sets forth a significant precedent in an emerging area of independent counsel litigation. As the field of mass torts has continued to grow over the last 20 years, carriers have increasingly faced demands by policyholders that they agree to appoint National Coordinating Counsel to assist in the defense of mass tort and class action claims around the country. Some policyholders have also, with the urging of large national policyholder counsel, disputed the qualifications of smaller insurance defense law firms to provide an adequate defense to asbestos, silica and other mass torts.

Lafarge

 

makes clear that whether a conflict of interest exists so as to give rise to a right to independent counsel, which is itself subject to differing interpretations in different states, is a function of a conflict of interest arising out of coverage concerns that carriers have raised that might influence the manner in which counsel defend the insured. Lafarge makes clear that such conflicts and the right to independent counsel do not arise merely due to the risk that exposures may exceed available limits. The court’s analysis with respect to the obligations of excess carriers and the limitation of their duty to pay only "reasonable" fees may also provide a significant tool to umbrella and other excess carriers whose policies may be called upon to pay defense costs as large lawsuits burn through primary limits that are "wasted" by attorney’s fees in such cases.
at 401.

2000, 2001, 2002 - Additional California Highlights

2000, 2001, 2002 – Of the final decisions issued by the California courts during those years which had a significant impact on insurers over the course of this decade, in addition to what Mike Aylward notes, I would add the following:

2000

  • No comparative bad faith. Kransco Int. v. American Empire Surplus Lines Ins. Co. (2000) 23 Cal.4th 390. There are still affirmative defenses, affirmative relief, and defenses insurers can pursue, and the insured’s conduct is relevant.
  • Construction defects that do not cause damage to property fall within the economic loss rule. Aas v. Superior Court (2000) 24 Cal.4th 627. Not an insurance case, but the ruling is in line with insurance coverage requirements that there be physical injury to tangible property.
  • An insurer’s reconsideration of whether there is coverage for a claim vitiates claims of bad faith. Shade Foods, Inc. v. Innovative Product Sales & Marketing (2000) 78 Cal.App.4th 847.
  • Other insurance may satisfy self-insured or deductible requirements. Vons Cos., Inc. v. United States Fire Ins. Co. (2000) 78 Cal.App.4th 52. This depends, of course, on the policy language. But where the insurance policy does not require the insured to pay the SIR, other insurance applicable to the claim may be used by the insured to satisfy that requirement.
  • Self-insurance is not insurance. Montgomery Ward & Co. v. Imperial Cas. & Indem. Co. (2000) 81 Cal.App.4th 356. It looks like insurance and acts like insurance and has insurance in its name, but it is not insurance.

 

2001

  • Where there is a genuine issue in dispute – factual or legal – there cannot be bad faith liability imposed on an insurer for advancing its side of the dispute. Chateau Chamberay v. Associated Int. Ins. Co. (2001) 90 Cal.App.4th 335.
  • Cumis counsel is not required where insurer agreed to defend all claims even though it denied coverage for some, distinct claims and refused to prosecute insured’s cross-claim. James 3 Corp. v. Truck Ins. Exchg. (2001) 91 Cal.App.4th 1093.
  • Additional insured is entitled to same considerations as named insured, insured can select insurer to pursue, and award of attorney fees against the insured are covered by the policy’s “supplementary payments provision” even if the claim upon which they are based is not covered by the policy. Pressley Homes, Inc. v. American States Ins. Co. (2001) 90 Cal.App.4th 571. On the third point, there has been further clarification that attorneys fees awarded on claims that cannot be covered by insurance (i.e., the insured’s willful conduct) are not covered. Combs v. State Farm Fire & Cas. Co. (2006) 143 Cal.App.4th 1338. Further in State Farm General Ins. Co. v. Mintarsih (2009) 175 Cal.App.4th 274, the court held that there was no coverage for attorney fees awarded against the insured if based on a claim not potentially covered by the policy (there, a wage and hour claim).
  • The insured must prove the amount of damage attributable to the covered portion of the loss in order to prove breach of contract. Golden Eagle Refinery Co. v. Assoc. Int. Ins. Co. (2001) 85 Cal.App.4th 1300. This decision was recently overruled in State of Calif. v. Allstate Ins. Co. (2009) 45 Cal.4th 1008, in which the court held the burden is on the insurer.

2002

  • Insurance policy can be proven by secondary evidence, including oral testimony and standard forms, and other evidence. Dart Industries, Inc. v. Commercial Union Ins. Co. (2002) 28 Cal.4th 1059.
  • Insured cannot settle around its insurer where the insurer is defending the insured. Hamilton v. Maryland Cas. Co. (2002) 27 Cal.4th 718.
  • An affirmative defense that seeks damages in the form of a set-off is a claim for damages. Constructive Protective Services, Inc. v. TIG Specialty Ins. (2002) 29 Cal.4th 189.
  • No duty to provide independent counsel even where counsel retained by insurer was staff counsel of insurer. Gafcon, Inc. v. Posnor & Assocs. (2002) 98 Cal.App.4th 1388.