Bear Stearns' Double Whammy

All in all, it hasn't been a good month for the folks at Bear Stearns.  First, a run on the bank results in a takeover by JP Morgan at $2 a share and the prospect of endless shareholder litigation.  Then, the New York Court of Appeals holds that it blew any chance at $50 million in excess E&O coverage for a 2002 settlement of conflict of interest claims.

 

The dispute in Vigilant Ins. Co. v. The Bear Stearns Co., No. 25 (N.Y. March 13, 2008) arose out of a joint investigation by the SEC and various states attorney-general (hello, Eliot) of claimed conflicts of interest between in-house research and investment banking at ten major financial service firms on Wall Street.  Following meetings with regulators, Bear Stearns signed a settlement in principle on December 20, 2002 wherein it committed to pay $50 million in retrospective relief, together with $25 million to fund independent research and $5 million for investor education.  The document stated that it was subject to final approval by the SEC and state regulators.  In April 2003, the parties entered into a final consent agreement memorializing these terms.  This agreement was filed with a U.S. District Court in Manhattan which approved it in October 2003.  Under the terms of the final agreement, Bear Stearns paid a $25 million penalty to the SEC; disgorged $25 million in past profits and agreed to fund $25 milion for research and $5 million for investor education.  Bears Stearns agreed as part of the settlement not to seek insurance coverage for the $25 million penalty.

Three days after signing the consent agreement, Bear Stearns had belatedly given notice of the settlement to its excess professional liability insurers:  Vigilant, Gulf and Federal.  Vigilant had written a $10 million layer excess of a $10 million self-insured layer.  Federal and Gulf (now Travelers) underwrote a $40 million following form excess layer over that.

These carriers disclaimed coverage due to the insured's failure to give notice to them before settling.  Additionally, the insurers noted that their policies contained an exclusion for claims arising out of investment banking.  Finally, issues were raised with respect to whether the disgorgement penalty or sums paid for investment research or education were a covered loss.

In the ensuing coverage litigation, a state trial declined to grant summary judgment to the carriers, finding issues of fact with respect to whether the settlement in principle constituted a breach or whether the investment banking exclusion applied.  The Supreme Court also ruled that the insurers could not look beyond the terms of the settlement to determine whether the $25 million payment was for disgorged ill-gotten gains.  The court also rejected the insurers' "loss" argument.

In 2006, the Appellate Division agreed that issues of fact precluded summary resolution of the insured's claimed breach of the policies' consent to settle condition but granted summary judgment against the carriers on their alternative defenses to coverage.  The Appellate Division subsequently agreed to certifiy its ruling to the New York Court of Appeals.

In its analysis, the Court of Appeals focused on the consent to settle clause, which stated that Bear Stearns would not enter into any settlement or confess liability for an amount over a $5 million threshold without first obtaining its insurers' consent, said consent not to be unreasonably withheld.  The court concluded that Bear Stearns clearly breached this condition to coverage when it signed the consent agreement in April 2003 agreeing to pay $80 million to state and federal authorities.  Unlike the lower courts, the Court of Appeals declined to assign any significance to the fact that the consent agreement did not become final until it was approved by a U.S. District Court the following October.  The court noted that even though court approval was required, Bear Stearns was not free to walk away from its committments in the interim, nor was the consent agreement drafted so as to be subject to final approval by the insurers.  In light of its sophistication as a business entity, the court concluded that Bear Stearns could not on the one hand enter into insurance contracts stating that its insurers would not be liable for settlements entered into without their consent and then execute a consent agreement calling for the payment of millions of dollars without informing the insurers of the terms of the settlement.

The Court of Appeals therefore directed that judgment enter for the insurers on the basis of the insured's breach of the consent to settle clause.  As a result, the court did not reach the issue of whether portions of the settlement payment that called for payments into an investor educational fund or for disgorgement of profits would otherwise be a covered loss.

In light of the swirl of political and legal events now going on in New York state concerning conditions to coverage, this opinion is perhaps as surprising for what is not contained in it as for what is stated.  Nowhere in the opinion is there any discussion of whether this was a "material" breach or one that prejudiced the insurers.  Nowhere is there any argument that, given the District Court's holding that the settlement was reasonable, the insurers might have obtained a windfall due to the insured's negligence since they might well have given their assent to the settlement otherwise.  Nor is there any questioning of whether the the insured knew that it had coverage for such claims or whether its E&O carriers, who are all large sophisticated insurers who may well have read press reports at the time of the December 2002 settlement in principle, had actual knowledge of this agreement.  Indeed, none of the arguments that insureds have typically made in late notice cases appears in this opinion, nor does the court make any reference to notice issues beyond the specific condition at issue.

One may well surmise that the court's attitude was hardened by the inexcusable negligence of Bear Stearns in waiting months after signing the settlement in principle to notify its insurers.   The court's willingness to take the case and the absence of any dissents may also reflect the sense that much if not all of the settlement was also not covered by these policies.  Finally, the court may well be sending a signal to the legislature with respect to the fact that it continues to believe that New York businesses should stand by the terms of their written agreements.

Insured's Late Notice Vitiates Coverage

In York Specialty Food, Inc. v. Tower Ins. Co. of New York (NY App., 1st Dept., Jan. 31, 2008), a New York appellate court has held that an insured, who became aware of the claimant’s accident within three days, but did not notify its insurer of the accident until eight months later, breached the notice requirements of its liability policy. The court rejected the insured’s excuse for delay premised upon an alleged good-faith belief in non-liability because the insured never investigated the possibility of its liability for the accident. The court found that an investigation by the insured that included interviews of employees who witnessed the accident would have revealed that the claimant, after falling in front of the insured's premises, had been taken from the scene in an ambulance. Since no investigation was conducted, the insured could not claim a good-faith belief in non-liability. As continues to be the law in New York, the insured was not required to demonstrate prejudice to invoke the late notice defense.

Waiver Creates Coverage for Uninsurable Losses

An insurer that undertakes the defense of its insured for a sufficiently lengthy period of time without reserving its rights to deny coverage waives coverage defenses. So held the 7th Circuit in Nutmeg Ins. Co. v. East Lake Management & Development Corp. (7th Cir. (Ill.) Jan. 22, 2008) (unreported). In this case, the insurer hired counsel to defend its insured, but did not issue a reservation of rights until two years later. The insurer continued to defend for another two years before issuing a coverage denial. The court concluded that, whether the delay was two or four years, it was too long under Illinois law. The court rejected arguments that the insured was required to demonstrate prejudice by the delay; while prejudice would be required to establish a claim of estoppel, the delay in this case constituted a waiver for which no showing of prejudice was required. The court also rejected arguments that the loss was uninsurable as a matter of state law, and that neither waiver nor estoppel could create coverage for uninsurable losses. Finding no Illinois cases, the court cited precedent in California and New Jersey for the proposition that the defense of uninsurability may be waived or forfeited, and predicted that Illinois courts would agree. Compare this holding with the rule in New York that an insurer cannot through waiver create coverage that a policy was not written to provide (see Schiff Assoc. v. Flack, 51 NY2d 692 (1980); Zappone v. Home Ins. Co., 55 NY2d 131 (1982); Central General Hosp. v. Chubb Group of Ins. Cos., 90 NY2d 195 (1997)). While coverage may be created by estoppel (which requires prejudice), waiver applies only to defenses based on policy exclusions and breach of policy conditions.

New Late Notice Legislation Proposed In New York

Only two months after Governor Spitzer vetoed efforts to permit "direct actions" in New York and impose a requirement of prejudice in late notice cases, a new bill has been introduced in the State Senate and Assembly that would change New York law in much the same way that SB 06306 proposed to.  The new proposal, which is co-sponsored by 38 senators and 120 Assemblymen, would:

  • Permit injured parties to bring declaratory judgment actions directly against the insurer of the party responsible for their injuries.
  • Give insurers that deny coverage for bodily injury claims on the basis of late notice a 60 day grace period in which to file a DJ naming the third party claimant (in which event the claimant may not bring its own DJ). 
  •  Stipulate that untimely notice will not invalidate coverage (except as to claims made policies) without proof of prejudice.  Prejudice is defined as the impairment of a "significant interest," including the ability to investigate, settle or defend a claim.
  • Require insurers to prove prejudice if the delay was two years or less but assign the burden of disproving prejudice to policyholders if the delay was longer than two years.  Prejudice shall exist as a matter of law if, prior to notice, the insured's liability is fixed by a judgment, arbitration or settlement.        
  • Add a new section to 3420(d) requiring insurers to confirm the existence and limits of liability insurance coverage to injured parties within 60 days of a written request.

To the extent that there are olive branches in this legislative thicket, they appear to be contained in the 60 day "safe harbor" provision; the shifting burden of proof provision and the determination of prejudice as a matter of law.

The "safe harbor" provision at least allows the insurer to choose where it wishes the coverage litigation to occur (but is there a trap here?--under Mighty Midgets, insurers are only liable for an insured's DJ fees if the the insurer commenced the DJ). 

The shifting burden rule reflects the compromise approach that some states have adopted by legislaton (Wisconsin) or common law and reflects the general view that prejudice is not only more likely to increase with the passage of time but that, as a practical matter, the longer the delay, the more difficult it is for the insurer to recreate what might have been to show how it would have investigated or responded to the claim had it been timely. 

The prejudice as a matter of law provision is welcome but does little more than is already accepted at common law.  It does at least moot the argument that has been accepted in some states that even a settlement is not prejudice per se unless the insurer can show that it would have gotten a better deal if it had control of the defense.

When Governor Spitzer vetoed SB06036 last August, he stated in his veto message that he felt that the bill had been brought forward precipitously and without adequate consideration for its implications.  While there has since been some consultation with the insurance industry, it' far from clear that this latest proposal truly takes into account the role that notice provisions play in a liability policy, the crucial inter-relationship between timely notice and an insurer's ability to exercie its right to defend or the consequences of such a significant restructuring of the common law mere years after it was affirmed by the Court of Appeal in Argo.  Nor does the legislation address the patent unfairness that a mere 60 day delay can estop an insurer from disputing coverage under 3420(d), whereas an insured can now wait up to two years with relative impunity.  Nevertheless, given the number of co-sponsors, it's clear that the insurance industry will face an uphill battle in any effort to block or substantially modify this new