Court Opinion

ID: 9646860
Source: CourtListenerOpinion
Date Created: 2023-08-23 13:14:01.682327+00
Date Added: 2024-06-11T14:59:14.251814
License: Public Domain

Melvin Mayfield, Judge, dissenting. I cannot agree to affirm the summary judgment granted by the trial court in this case. The judgment was granted upon matters of record which include the pleadings, depositions, answers to interrogatories and admissions, and affidavits. These matters include a number of exhibits which are also in the record. Summary judgment is an extreme remedy and any proof submitted must be viewed most favorably to the party resisting the motion, and any doubts and inferences must be resolved against the moving party. Leigh Winham, Inc. v. Reynolds Ins. Agency, 279 Ark. 317, 651 S.W.2d 74 (1983). In Baggett v. Bradley County Farmers Coop., 302 Ark. 401, 789 S.W.2d 733 (1990), the court said that “the object of a summary judgment is not to try the issue but to determine if there are issues to be tried,” and “if there is any doubt whatever, it should be denied.” The court quoting from a previous case, also said: Summary judgment is not proper where evidence, although in no material dispute as to actuality, reveals aspects from which inconsistent hypotheses might reasonably be drawn and reasonable men might differ. 302 Ark. at 403. There is no dispute about the essential facts in this case. The appellant is an insurance agency in Arkansas. A customer of that agency, Carlton Dorey, applied to appellant for insurance on a piece of logging equipment referred to as a “loader.” Appellant obtained an oral quotation and binder for the coverage from an insurance agency in Texas. Appellant forwarded a check to the Texas agency, Bloomburg Insurance Agency, and some six months later the loader was destroyed by fire. The loss was promptly reported to Bloomburg and it retained an adjuster and purported to be acting to investigate and settle the claim, but it was ultimately learned that Bloomburg had negligently failed to obtain insurance on the loader and there was, in fact, no coverage for Dorey’s loss. The majority opinion holds that the errors and omissions policy issued by the appellee to Bloomburg did not cover Bloom-burg’s negligence because the policy is a “claims-made” policy, and no coverage exists unless the claim is made within the period of time provided in the policy. The majority agrees with the appellee that this is a condition of coverage and that this policy is different from an “occurrence” policy which provides coverage for loss within the policy period. The policy issued by appellee provides that “upon any insured becoming aware of any negligent act, error or omission which would reasonably be expected to give rise to a claim against any insured, written notice with all available particulars shall be given by or for the insured to the [appellee] or its authorized agent.” The policy also provides that this notice must be given during the policy period. The period of the policy issued by the appellee in this case was April 7,1986, to April 7,1987. Although Dorey’s loss occurred during the period of Bloomburg’s errors and omissions policy and it is undisputed that the loss was reported to Bloomburg during the period of that policy, the appellee contends it is not liable because Bloomburg’s failure to secure the insurance coverage for Dorey was not reported to appellee during the period of the policy it issued to Bloomburg. My view is that the appellee’s motion for summary judgment should not have been granted because (1) there is a genuine issue of fact as to whether Bloomburg’s error or omission was reported to appellee within the policy period, and (2) under the evidence in this case, public policy considerations should prevent appellee from avoiding liability on its policy unless it was unfairly prejudiced by failing to receive notice, within a reasonable period of time, of the negligent acts, errors, or omissions of its insured. The majority opinion recognizes that the record contains a report to appellee from its employee, Walter Trzcinski, which states that in March of 1987 a letter was forwarded to him by a claimant named D.E. Thompson who said that Bloomburg was supposed to obtain a policy for Thompson but that Bloomburg cashed the premium check and never placed the insurance. The report also said that attempts to reach Bloomburg had failed because its telephones had been disconnected or were not in service. Mr. Trzcinski’s report concluded: “I can only deduce that there is a possibility that this insured had either some sort of financial problems or simply took premium dollars from clients and/or other agents and never placed the coverage.” This report was dated April 8, 1987. It refers to information forwarded to Trzcinski on March 20, 1987. Appellee’s policy period ran from April 7,1986, to April 7,1987. Thus, it is clear that this employee of appellee received notice within the policy period of a “negligent act, error or omission” on the part of Bloomburg “which would reasonably be expected to give rise to a claim against” appellee’s insured Bloomburg. And there is surely, at least, a genuine issue of fact as to whether Trzcinski was appellee’s “authorized agent” to receive this information. The majority opinion, however, cites the case of Safeco Title Ins. Co. v. Gannon, 774 P.2d 30 (Wash. App. 1989), as authority for holding that Trzcinski’s “mere suspicion that something was awry” was not sufficient notice to appellee of the existence of “appellant’s claim.” Now the appellant is Campbell & Company, the Arkansas insurance agency who attempted to place insurance coverage for Dorey with the Bloomburg agency in Texas. When Dorey sued Campbell and Bloomburg, the suit was settled by Campbell who cross-complained against Bloomburg and obtained a judgment against it for the amount of the settlement with Dorey. The appellant, Campbell, then brought this present suit against the appellee under Campbell’s right to be subrogated to Bloomburg’s rights against appellee. The appellee’s errors and omissions policy which was issued to Bloomburg required notice to appellee of Bloomburg’s claim. However, the insuring agreement of appellee’s policy states that it will pay all sums the insured (Bloomburg) becomes legally obligated to pay for “any claim or claims first made against the Insured during the policy period, arising out of any negligent act, error or omission ... in the conduct of Insured’s business.” And the policy also provides that “a claim is first made” if the insured “shall during the policy period” give written notice of “any negligent act, error or omission which could reasonably be expected to give rise to a claim under the policy.” Therefore, I strongly disagree with the majority opinion’s statement that “mere suspicion that something was awry” was not sufficient to constitute notice of a claim as required by the policy issued to Bloomburg by the appellee. In my opinion, the information received by appellee’s employee, Trzcinski, was more than enough to cause a “mere suspicion” that something was wrong at Bloomburg’s. It was exactly the information the appellee’s policy called for — “any negligent act, error or omission which could reasonably be expected to give rise to a claim under the policy.” The majority opinion also states that “it is the function of the court to construe insurance policies in litigation, ascertain their meaning, and give effect thereto.” But what is overlooked is the following rule: It is also established law in our state that provisions contained in a policy of insurance must be construed most strongly against the insurance company which prepared it, and if a reasonable construction may be given to the contract which would justify recovery, it is the duty of the court to do so. Home Indemnity Co. v. City of Marianna, 297 Ark. 268, 272, 761 S.W.2d 171 (1988). See also the case of American Home Assurance Co. v. Ingeneri and Foss, 479 A.2d 897 (Me. 1984), where the insurance company had issued a claims-made policy to Ingeneri. The court said: It is undisputed that Ingeneri did not himself give written notice as required by the policy; however, Foss’s new counsel did give written notice of the suit to the agent of the insurer by letter dated July 17, 1980. . . .By virtue of the July 17 letter from Foss’s new counsel, plaintiff had ample opportunity to investigate the claim and to protect its interests prior to the entry of the default judgment. The evidence does not support the Superior Court’s finding that plaintiff was prejudiced by Ingeneri’s failure to give notice. In the absence of prejudice to the insurer, we hold that notice by a third party constituted sufficient compliance with the provisions of the policy. See generally Couch on Insurance, supra, at § 49:101. Id. at 902. Under the circumstances of the present case, I think the issue regarding the sufficiency of the notice of the claim should not have been decided by summary judgment. I also think that public policy considerations, under the circumstances of this case, should prevent the appellee from avoiding liability on its policy unless it is established that the appellee was unfairly prejudiced by failing to receive notice, within a reasonable period of time, of the negligent acts, errors, or omissions of its insured. I am aware that is not as yet the majority view in this country. Perhaps typical of the majority view is Esmailzadeh v. Johnson and Speakman, 869 F.2d 422 (8th Cir.1989), where the court affirmed a Minnesota District Court decision holding that an insurance company was not liable on a claims-made professional-liability policy because the insured law firm did not report the claim against it to the insurance company within the policy period. Finding no convincing reason to disturb the district court’s holding that the policy provisions did not violate Minnesota public policy, the appellate court said: As a result, plaintiffs, initially injured by their law firm’s professional neglect, are again injured by the same firm’s negligent failure to give notice to its insurance company. This is a grievous wrong, but it is not one which the insurance company agreed to protect against. Under this kind of policy, the company clearly disclaims the risk of failure on the part of its insured to give it timely notice. 869 F.2d at 425. The obvious harshness of such a result has caused some courts to soften the application of the claims-made policy. This is not different from what has been occurring for many years in other areas of insurance law. A law review article written by Professor Clarence Morris, Waiver and Estoppel in Insurance Policy Litigation, 105 U. Pa. L. Rev. 925 (1957), states: Indexes to the great nineteenth century insurance texts do not list waiver and estoppel. But times had changed. The 1951 third edition of Vance on Insurance enfolds an excellent and important seventy-six page “Waiver & Estoppel” chapter — about a fourteenth of the book’s bulk. What has fostered this growth in the last hundred years? My thesis is that waiver and estoppel are two of several guises that cloak the courts’ part in changing insurance from a service safely bought only by sophisticated businessmen to a commodity bought with confidence by untrained consumers. Judges, at the urging of policyholders’ advocates, have used waiver and estoppel to convert insurance from a custom-made document designed in part by knowing buyers to a brand-name staple sold over the counter by mine-run salesmen to the trusting public. A recent treatise on insurance law has observed that the courts have considered thousands of cases in which insureds have sought to assert rights that have conflicted with the terms specified in an insurance policy, and in hundreds of appellate decisions judges have held that the rights of the insureds were at variance with the policy terms. Pointing out that from 1945 to the mid 1960’s the appellate courts increasingly sustained variance claims, the treatise states that by 1970 it was possible to discern that several justifications provide a common foundation for a significant portion of what otherwise appeared to be unrelated judicial decisions in favor of claimants. It is then stated: The determinations were implicitly, and occasionally explicitly, predicated on one or more of the following three principles: An insurer will be denied unconscionable advantages in an insurance transaction. An insurance contract embodies an implied covenant of good faith and fair dealing. The reasonable expectations of applicants, insureds, and in some instances third party beneficiaries, should be protected. R. Feeton & A. Widiss, Insurance Law 614-15 (1988). This treatise also notes that the judicial decisions of recent decades have sustained a large number of variance claims on the ground that provisions of the insurance policy, if literally enforced, would conflict with public policy. Id. at 646-47. The case of Sparks v. St. Paul Ins. Co., 495 P.2d 406 (N.J. 1985), is cited as an example of such a holding. This case involved a claims-made legal-malpractice policy which was found to violate the state’s public policy because it afforded such minimal protection it did not conform to the objectively reasonable expectations of the insured and the public. The court stated: Although we held today in Zuckerman v. National Union Fire Ins. Co., supra, 100 N.J. 304, 495 A.2d 395 (1985), that a “claims-made” policy that fulfills the reasonable expectations of the insured with respect to the scope of coverage is valid and enforceable, the policy at issue here is substantially different from the standard “claims-made” policy. 495 A.2d at 414. The Arkansas Supreme Court in Arkansas Blue Cross & Blue Shield v. Long, 303 Ark. 116, 792 S.W.2d 602 (1990), affirmed a trial court’s decision that a policy exclusion was against public policy. The exclusion stated that “No benefits are provided for inpatient services where you terminate such inpatient admission against medical advice.” The court held this provision would divest an insured of benefits already accrued. The insurer said its purpose was to encourage patients to follow the advice of their physicians and remain hospitalized until fully recovered, but the court said that while the purpose might be worthy, when weighed against the consequences for the insured, the policy provision did not “square with public policy.” Even more recently, in Ferrell v. Columbia Mutual Casualty Ins. Co., 306 Ark. 533, 816 S.W.2d 593 (1991), the court stated: Many courts have interpreted “no fault” insurance legislation, see Ark. Code Ann. § 23-89-202 (1987), and compulsory motor vehicle acts, see Ark. §§ 27-22-101 — 104 (Supp. 1991), as expressing a public policy that one who suffers a loss as the result of an automobile accident shall have a source and means of recovery. 306 Ark. at 537-38. However, in that case the court pointed out that only the insurer and the insured were involved, and the loss involved only the insured’s property, so “there is no public policy reason to hold that the insurance company’s common law right to rescission has been abrogated.” Id. at 538. In the present case the appellee’s policy was issued to “Bloomburg Insurance Agency, Inc.,” and the appellee points out that Texas statutory law requires that a corporation licensed as an insurance agent must have the ability to pay up to $25,000 for which it might become legally obligated to pay on account of any claim made against it for any “negligent act, error or omission” of the corporation in the conduct of its business as an insurance agent. One of the statutory ways to prove such ability to pay is “an errors and omissions policy.” See Tex. Ins. Code §21.14 (Vernon 1990 Cum. Supp.). Thus, there is a public policy consideration involved in this case. It is obvious that Bloomburg was not inclined to give appellee notice of Bloomburg’s failure to secure coverage for Dorey’s loader. Therefore, unless Trzcinski’s report to the appellee is sufficient to meet the notice provisions of appellee’s claims-made policy, the reasonable expectations of the statutory beneficiary (Dorey) will not be protected. Based upon the Blue Cross and Columbia Mutual cases, supra, I would hold that, under the circumstances in this case, public policy considerations will prevent the appellee from avoiding liability unless it can establish that it was unfairly prejudiced by failing to receive notice, within a reasonable period of time, of Bloomburg’s negligent acts, errors, or omissions which could have reasonably been expected to give rise to the Bloomburg claim under which recovery is sought in this case. For reasons discussed above, I would reverse and remand. Cooper, J., joins in this dissent.