ADI Worldlink, L.L.C. v. RSUI Indemnity Company , 932 F.3d 369 ( 2019 )


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  •      Case: 17-41050    Document: 00515061895       Page: 1   Date Filed: 08/02/2019
    IN THE UNITED STATES COURT OF APPEALS
    FOR THE FIFTH CIRCUIT
    United States Court of Appeals
    Fifth Circuit
    FILED
    No. 17-41050                      August 2, 2019
    Lyle W. Cayce
    ADI WORLDLINK, L.L.C.,                                                       Clerk
    Plaintiff - Appellant
    v.
    RSUI INDEMNITY COMPANY,
    Defendant - Appellee
    Appeal from the United States District Court
    for the Eastern District of Texas
    Before DENNIS, OWEN, and SOUTHWICK, Circuit Judges.
    LESLIE H. SOUTHWICK, Circuit Judge:
    The defendant insurance company denied the plaintiff policyholder’s
    claims under a directors and officers liability policy. The district court held
    that the insured had learned of a related claim when the previous year’s policy
    was in effect; under clear policy provisions, the first policy was therefore the
    one to cover all of the claims. The court then concluded that all claims were
    properly denied because, even though the insured gave timely notice of the
    later claims, it had failed to give timely notice of the initial one.
    We AFFIRM.
    Case: 17-41050     Document: 00515061895      Page: 2   Date Filed: 08/02/2019
    No. 17-41050
    FACTUAL AND PROCEDURAL BACKGROUND
    Beginning in late 2012, the plaintiff ADI Worldlink, L.L.C. annually
    purchased directors and officers liability insurance policies from the defendant
    RSUI Indemnity Company.         The 2014 policy had a coverage period from
    December 31, 2013 to December 31, 2014, while the 2015 policy covered the
    subsequent year, ending December 31, 2015.           The 2015 policy was later
    extended through January 14, 2016.
    Significant provisions in the 2014 and 2015 policies include RSUI’s
    obligation to pay “all Loss [Worldlink] is legally obligated to pay” in relation to
    “a Claim for a Wrongful Act . . . first made against [Worldlink] during the Policy
    Period” and timely noticed by Worldlink to RSUI under the terms of the
    policies.
    The 2015 policy also contained a provision that deemed all claims related
    in a specific manner to have been made at the time of the earliest such claim.
    We label it the 2015 interrelatedness provision, and it stated:
    All Claims based on, arising out of, directly or indirectly resulting
    from, in consequence of, or in any way involving the same or
    related facts, circumstances, situations, transactions or events, or
    the same or related series of facts, circumstances, situations,
    transactions or events, shall be deemed to be a single Claim for all
    purposes under this policy, . . . and shall be deemed first made
    when the earliest of such Claims is first made, regardless of
    whether such date is before or during the Policy Period.
    The purpose of this provision appears obvious. An initial claim is made;
    the insured gives notice of the claim; if in later policy years new claims are
    made that are related in the relevant ways to the first one, their handling
    continues consistently under that first policy. The relevant claims in this case
    concern Wordlink’s employment practices, primarily an alleged failure to pay
    overtime wages to nonexempt employees.           The insurance dispute arises
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    because of Worldlink’s failure to give notice to RSUI of the first employee’s
    claim, which it received in August 2014. In April 2015, other employees filed
    similar claims against Worldlink. Finally, in September 2015, Worldlink first
    notified RSUI of the claims.
    Relying on the 2015 interrelatedness provision, RSUI deemed all the
    employment claims to be a single claim that were controlled by the 2014 policy.
    The 2014 policy states that “it shall be a condition precedent to the Insurer’s
    obligation to pay, that the Insured give written notice of such Claim to the
    Insurer as soon as practicable” after Worldlink learns of the claim.
    Comparable language is in the 2015 policy. A final deadline for notice was no
    later than the expiration of the 2014 policy. Worldlink does not argue it
    complied with that obligation as to the 2014 claim. Because of the absence of
    notice of the first claim and the deeming of all later claims to be related to that
    initial claim, RSUI denied coverage on all.
    Worldlink sought a declaratory judgment to compel RSUI to cover all the
    claims. It also sought damages for breach of contract and violations of the
    Texas Unfair Insurance Practices Act, the Texas Deceptive Trade Practices
    Act, and the Texas Prompt Payment of Insurance Claims Statute. The parties
    filed cross motions for summary judgment.           The district court granted
    summary judgment for RSUI. It concluded that timely notice of the 2014 claim
    was not given. Further, it found the 2015 claims related back to the 2014 claim
    and were governed by the 2014 policy, thus making it proper for RSUI to deny
    coverage of all the claims. Because RSUI had no obligation to cover any claims,
    the district court held it also had no liability under the Texas statutes. This
    same analysis would reasonably apply to Worldlink’s breach of contract claim,
    which the district court dismissed without a separate analysis.
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    DISCUSSION
    On an appeal from the grant of a summary judgment, we generally are
    concerned at least in part with whether the district court properly determined
    that there were no genuine disputes of material fact. See FED. R. CIV. P. 56(a).
    Today’s appeal concerns only legal issues, though, namely, the interpretation
    of insurance policy provisions. Regardless of the questions posed, we review
    the district court’s ruling on a summary judgment de novo. RSUI Indem. Co.
    v. Am. States Ins. Co., 
    768 F.3d 374
    , 377 (5th Cir. 2014).
    Worldlink’s principal challenge is to the district court’s reliance on the
    interrelatedness provision in the 2015 policy, joined with the provision in the
    2014 policy obligating the insured to give timely notice, to deny the claims that
    arose in 2015 and for which it gave notice. A central component of our review
    is the effect of a 2013 Texas Court of Appeals decision about a similar policy.
    The only state statutory claim Worldlink pursues on appeal concerns the Texas
    Prompt Payment Statute.
    I. Interrelatedness of the 2014 and 2015 Claims
    There was some dispute in district court as to whether Texas law applies
    in this diversity suit. The district court determined that it did, and the issue
    is not renewed on appeal. We thus accept that Texas law controls.
    Most relevant to our analysis would be applicable authority from the
    Texas Supreme Court. CHS, Inc. v. Plaquemines Holdings, L.L.C., 
    735 F.3d 231
    , 235 (5th Cir. 2013). We have no such decisions. In their absence, we
    “defer to intermediate state appellate court decisions, ‘unless convinced by
    other persuasive data that the highest court of the state would decide
    otherwise.’” Memorial Hermann         Healthcare    Sys.,    Inc.   v.   Eurocopter
    Deutschland, GMBH, 
    524 F.3d 676
    , 678 (5th Cir. 2008) (quoting Herrmann
    Holdings Ltd. v. Lucent Tech., Inc., 
    302 F.3d 552
    , 558 (5th Cir. 2002)).
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    No. 17-41050
    One Texas intermediate court opinion has been the center of attention
    in this case: Gastar Exploration Ltd. v. U.S. Specialty Insurance Co., 
    412 S.W.3d 577
    (Tex. App.—Houston [14th Dist.] 2013, pet. denied). The parties
    have not proposed nor have we found any reason to form a conviction that the
    Texas Supreme Court would reject that court’s application of state law to policy
    provisions similar to those at issue here. The district court distinguished
    Gastar but did not suggest the opinion was inconsistent with what the Texas
    Supreme Court would hold on the issues the Gastar court decided. Thus, we
    consider that decision to be controlling on this appeal. We examine it closely.
    A. Texas Court of Appeals’ Gastar Opinion
    The background for the Texas Court of Appeals’ opinion was that Gastar
    Exploration obtained directors and officers liability policies from U.S. Specialty
    Insurance Company as its primary insurer and Axis Insurance Company as its
    excess carrier. 
    Gastar, 412 S.W.3d at 579
    . The policies each covered the period
    of November 1, 2008 to November 1, 2009. 
    Id. Because the
    provisions of the
    two policies were identical, the court evaluated only the U.S. Specialty policy.
    
    Id. at 579
    n.1.    That policy contained an interrelatedness provision that
    aggregated claims
    alleging, arising out of, based upon or attributable to the same
    facts, circumstances, situations, transactions or events or to a
    series of related facts, circumstances, situations, transactions or
    events will be considered to be a single Claim and will be
    considered to have been made at the time the earliest such Claim
    was made.
    
    Id. at 580
    (emphases omitted).
    Thus, if a claim arising during the policy period was related under this
    quoted provision to claims arising before the policy period, U.S. Specialty
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    would consider the former claims to predate the policy’s existence and would
    not cover them under that policy.
    Gastar was named as a defendant in ten lawsuits, all pertaining to the
    same alleged fraudulent investment scheme. 
    Id. at 580
    –81. Seven of the
    lawsuits arose during the 2008-2009 policy period; three predated it. 
    Id. at 581.
    U.S. Specialty denied coverage of the seven claims brought during the
    policy period, asserting they fell into the policy’s interrelatedness provision and
    effectively predated the policy. 
    Id. Gastar argued
    that a different provision in the policy permitted
    coverage. That provision, labeled an “endorsement,” provided that the insurer
    would not be liable to pay on a claim “arising out of, based upon or attributable
    to any pending or prior litigation as of 5/31/2000, or alleging or derived from
    the same or essentially the same facts . . . [as the] pending [or] prior litigation.”
    
    Id. at 584–85.
          The Gastar court concluded that the endorsement, when read with the
    interrelatedness provision, created ambiguity.           That was because the
    endorsement excluded new claims only if the prior related claims arose before
    May 31, 2000, while the interrelatedness provision excluded coverage of
    related claims made prior to November 1, 2008, the beginning date of the
    policy. 
    Id. at 584.
    The court stated: “When provisions of an insurance policy
    appear to conflict, a court should first attempt to harmonize [them while] . . .
    giv[ing] effect to the entire agreement.” 
    Id. at 583.
    If that is impossible, and
    “more than one reasonable interpretation [of the policy exists, Texas courts]
    will hold the contract is ambiguous and adopt the interpretation that most
    favors coverage for the insured.” 
    Id. In the
    specific context of clauses excluding
    coverage, Texas courts adopt the insured’s reasonable interpretation even if
    the insurer’s position “appears to be more reasonable or a more accurate
    reflection of the parties’ intent.” 
    Id. 6 Case:
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    No. 17-41050
    In understanding an authoritative state-court precedent such as Gastar,
    it may help to acquire context by examining the arguments made by the
    parties. Worldlink and RSUI eased that task by submitting to the district
    court the Gastar appellate briefs. Gastar’s brief had a vigorous argument that
    the first three suits were not related to the seven later claims, while the insurer
    argued the contrary. The dispute over this central point was barely noted in
    the Gastar opinion. The court simply said it “need not resolve this issue”
    because the interrelatedness provision “does not control.” 
    Id. at 581.
    Placing
    this factual issue aside, the Gastar court held that the interrelatedness
    provision “render[ed the endorsement] meaningless because any ‘Claims’ that
    would be excluded from coverage by [the endorsement] would already be
    excluded by operation of” the interrelatedness provision. 
    Id. at 584.
    The other
    side of the coin was that the interrelatedness provision purported to exclude
    claims arising before the policy while the endorsement restored them to
    coverage if they fell into “the covered window for Claims related to litigation
    filed after May 31, 2000, but before the effective date of the policy.” 
    Id. The interrelatedness
    provision and the endorsement “conflict[ed] or at best, when
    read together, create[d] an ambiguity.”        
    Id. Citing interpretation
    rules
    favorable to insureds, the court held the endorsement controlled and
    “restore[d] coverage [of claims] . . . that would have been excluded by” the
    interrelatedness provision. 
    Id. at 585.
          We now consider the district court’s application of Gastar in our case.
    B. Gastar’s applicability to the Worldlink-RSUI Policies
    The district court assumed that the 2015 claims were factually related
    to the 2014 claim.     That finding then led to the holding that the 2015
    interrelatedness provision deemed them all to fall under the 2014 policy. The
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    assumption of relatedness is unchallenged on appeal. We thus make the same
    assumption for purposes of the following analysis.
    As we have discussed, the Gastar opinion refused to apply that policy’s
    interrelatedness provision because of what was labeled an endorsement. We
    have not yet quoted a similar provision in the Worldlink-RSUI policies. There
    is one, and this is it:
    Exclusion – Prior and/or Pending Litigation Backdated
    The Insurer shall not be liable to make any payment for Loss in
    connection with any Claim made against any Insured . . . alleging,
    arising out of, based upon or attributable to, in whole or in part,
    any litigation involving any Insured that was commenced or
    initiated prior to, or pending as of December 31, 2012, or arising
    out of or based upon, in whole or in part, any facts or circumstances
    underlying or alleged in any such prior or pending litigation.
    The general role of such provisions is described in a treatise:
    When an insurer first issues a D&O policy to a corporation,
    an exclusion is frequently included which eliminates coverage for
    claims arising from pending or prior litigation or from any facts or
    circumstances involved in such litigation. The insurers’ intent is
    to avoid exposure for the “burning building” (i.e., claims which the
    insured knew about or should expect when they purchased the
    policy). This exclusion will reference a date (frequently the
    inception date of the first D&O policy issued by the insurer to the
    insureds) which is used to determine whether the litigation is
    “pending or prior.”
    4 NEW APPLEMAN ON INSURANCE LAW LIBRARY EDITION § 26.07[3][e] (2018).
    This statement of purpose indicates the earliest date “frequently” is the
    commencement date of the first policy. The Gastar Endorsement, though,
    excluded claims predating May 31, 2000, a date the briefing from that case
    seems to indicate was before coverage by any policy. The similar provision in
    the RSUI policy here extended coverage on related claims to no earlier than
    December 31, 2012, which was the commencement date of Worldlink’s first
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    policy with RSUI. In Gastar, then, claims that predated any insurance policies
    by three years were still provided some protection. In the present case, the
    reach of the similar exclusion is only to the commencement date of the first
    policy. We do not wish to make too much of the distinction, as indeed there
    may be other facts unavailable to us explaining the 2000 date in Gastar. We
    can say that the Gastar provision was broader to the extent the insurer did not
    foreclose, at least in that provision, earlier claims for which no notice would
    have been given because the claimant had not yet been insured. This gives
    additional complexity to assessing a failure of notice in Gastar.
    Despite the difference we just discussed, there are certainly similarities
    between the provisions regarding prior and pending litigation here and in
    Gastar. The provisions were not distinguished by the district court. The
    district court simply found no significance to the language because it accepted
    the insurer’s argument that RSUI denied coverage to Worldlink for a reason
    that was not discussed in Gastar. The 2015 RSUI policy stated that sufficiently
    related claims “shall be deemed to be a single Claim for all purposes under this
    policy.” The court found that the claims from 2014 and from 2015 were single
    claims. Thus, it was essential that this “single Claim” get properly initiated.
    The plaintiff’s failure to make a timely report of the 2014 claim was held to
    preclude coverage for all the claims.
    In addition, the district court explicitly held that Gastar was not directly
    on point. We agree to the extent that the Texas Court of Appeals did not
    discuss any obligations for the insured that may have arisen in prior policies.
    The focus by the Gastar court was on two groups of lawsuits: those filed against
    the insured during the 2008-2009 policy period and others that the court
    labeled the “pre-policy suits.” 
    Gastar, 412 S.W.3d at 581
    . The court’s opinion
    does not mention that there were any policies covering the earlier period.
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    As we already mentioned, though, the Gastar briefing reveals there were
    earlier policies. The insured had policies with both of its insurers for several
    years before the ones at issue in the litigation. Gastar first purchased a policy
    from its primary insurer, U.S. Specialty, in November 2006, and renewed or
    replaced it up to the policy period of November 2008 – November 2009 that
    was relevant to the case. The excess carrier, Axis, first issued a policy to
    Gastar in 2003 and renewals or replacement policies continued until the
    November 2008 – November 2009 policy year at issue in the lawsuit. The
    Gastar court also addressed an interrelationship provision, but it did not go
    back to the prior policies that existed but were unmentioned in its opinion to
    tease out any obligations that may have arisen at that time that could affect
    later related claims.
    This additional information from the Gastar briefs undermines the
    district court’s distinction that all the current claims in our case fell within the
    period of some policy “and not wholly outside of any policy period” as in Gastar.
    Still, we do not find the possible factual error to be significant. While learning
    of these prior policies from the Gastar briefing, we also learned the parties had
    not made an issue of a failure to give timely notice to the insurer of claims
    under earlier policies. We see it as beyond our proper role in interpreting this
    state court opinion to try to factor in unraised and unaddressed insurance-
    policy provisions.
    Had the parties focused the Gastar court on notice provisions in earlier
    policies, we see it as an unanswerable question of whether the court would
    have still reached the same result. We take the Texas precedent as it was
    written, not as it might have been. What caused that court to rule in favor of
    coverage was an inconsistency between the provision on interrelated claims
    with the provision that barred related claims only in narrower circumstances.
    
    Id. at 584.
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    We do not have that situation here. Instead, a policy provision construes
    the relevant 2015 claims as being subject to the 2014 policy. That earlier policy
    would have provided coverage except that the insured failed to comply in 2014
    with a notice provision. We conclude the district court was correct to rely on
    this difference. We must go beyond Gastar to consider the effect of Worldlink’s
    failure to comply with the 2014 policy’s requirement of giving notice before the
    end of that policy. As did the district court, we conclude that the absence of
    notice, joined with the fact that the 2015 policy deemed all the later claims to
    fall under the 2014 policy, prevented coverage of the claims.
    Our refusal to augment the Gastar holding to make it apply even when
    no notice of earlier related claims was given under earlier policies is driven by
    our limited role. We are here to interpret a contract between two parties. The
    straightforward effect of the terms appears clear. Nonetheless, if there were
    controlling law that reasonably would reach these terms and demand a
    different interpretation, we would adjust our view. We do not have that. The
    Gastar court relied on an inconsistency in two provisions. That inconsistency
    is not in play here. Instead, we have the operation of several provisions that
    must be read in sequence.      The final step in the sequence, a step never
    discussed in Gastar, convinces us there is no coverage because notice of the
    claim under the controlling policy for these related claims was not timely given.
    Consequently, the 2015 claims arising from lawsuits that were related
    to the others brought in 2014 were governed by the earlier policy. The absence
    of timely notice means the claims were properly denied.
    II.   The Texas Prompt Payment Claim
    The Texas Prompt Payment Statute requires insurers to respond to
    claims’ processing within defined time periods on penalty of damages and
    attorneys’ fees. See TEX. INS. CODE ANN. §§ 542.051–061. In the district court,
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    Worldlink argued for Texas Prompt Payment relief on the 2015 claims.
    Because the district court held “there is no coverage for the 2015 Claims under
    the 2015 Policy,” it necessarily denied relief under this statute.
    For the same reason, we conclude there is no relief available to Worldlink
    under this statute.
    AFFIRMED.
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    JAMES L. DENNIS, Circuit Judge, dissenting:
    As the majority acknowledges, Texas law governs our decision in this
    diversity case. In Gastar Exploration Ltd. v. U.S. Specialty Insurance Co., 
    412 S.W.3d 577
    (Tex. App. 2013), a Texas Court of Appeals addressed a claim by a
    plaintiff, the insured, that it was covered under an insurance company’s
    claims-made-and-reported insurance policy that was worded similarly to the
    policy at issue here. In that case, the Texas court ruled in favor of coverage for
    the insured, finding an inconsistency in that policy between a provision on
    interrelated claims that excluded a claim from coverage under the policy at
    issue and a Prior and Pending Litigation Endorsement that “barred related
    claims only in narrower circumstances.” Maj. at 11. The majority concludes
    that the case before us is different from Gastar because it finds that “that
    inconsistency is not in play” in the policy at issue here. Maj. at 11. Because I
    disagree and believe Gastar is materially indistinguishable and thus mandates
    reversal, I respectfully dissent.
    Here, as in Gastar, the parties entered into claims-made-and-reported
    insurance   policies.     The policies    at issue     in both     cases included
    “interrelatedness provisions,” which stated that all related claims would be
    aggregated together and deemed to have been made at the time of the earliest
    such claim. If that earliest claim was made under a prior policy period covered
    by a different contract, then the later related claim would also be covered under
    that prior contract instead of the present policy. 
    Gastar, 412 S.W.3d at 580
    ;
    Maj. at 2. In both Gastar and the case before us, the policies also included
    Prior and Pending Litigation Endorsements that excluded claims from
    coverage if they arose from litigation initiated prior to a certain date. In both
    cases, the cut-off date provided in those endorsements was several years before
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    that contract’s policy period began. 1           Gastar held that the two contract
    provisions in that case conflicted because “any ‘Claims’ that would be excluded
    from coverage by [the] Endorsement would already be excluded by operation of
    [the interrelatedness provision].” 
    Gastar, 412 S.W.3d at 584
    . The majority
    declares that “we do not have that situation here,” finding that the
    interrelatedness provision did not exclude the 2015 claim from coverage—it
    merely rendered it subject to a predecessor policy.                  Because the 2015
    interrelatedness provision did not prevent the claim from being covered under
    that different, earlier policy, the majority reasons, this is not a case like Gastar
    where the interrelatedness condition bars coverage of a claim while the
    Endorsement would permit coverage.
    Respectfully, I believe the majority errs by relying on whether the 2015
    interrelatedness provision was what ultimately prevented Wordlink from
    receiving any insurance coverage for its 2015 claim. Gastar itself demonstrates
    that the majority’s analysis relies on a red herring. In determining that the
    substantially similar interrelatedness provision at issue in Gastar was an
    exclusion, the Texas court did not, as the majority appears to do here, ask
    whether that provision precluded insurance coverage altogether for the claim.
    Instead, the critical question was whether the provision narrowed what that
    particular contract would otherwise cover under the terms of its Insuring
    Agreement. Gastar held that the interrelatedness provision—labeled in that
    contract as “Condition C”—was “effectively an exclusion because it narrows the
    1 Though the date in Worldlink’s 2015 policy—December 31, 2012—was, as the
    majority identifies, the commencement date of its first policy with RSUI, this was still two
    years before the policy period governed by the 2015 contract. Maj. at 2, 9.
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    coverage originally created by the Insuring Agreement.” 
    2 412 S.W.3d at 583
    (emphasis added). It then elaborated:
    When read in conjunction with the Insuring Agreement,
    Condition C excludes from coverage a Claim that is initially made
    during the Policy Period if it is determined to be related to the facts
    or circumstances underlying another Claim that was made prior
    to the Policy Period. In other words, but for the operation of
    Condition C deeming the later Claim to have been made prior to
    the Policy Period, the insurers would be liable for covering the later
    Claim under the Insuring Agreement (assuming the other policy
    requirements were met) because that Claim was first made during
    the Policy Period.
    
    Gastar, 412 S.W.3d at 584
    (citation omitted).
    As the majority acknowledges, Gastar “did not go back to prior policies
    that existed but were unmentioned in its opinion to tease out” whether the
    later related claims could still get coverage under those former policies. This
    is because foundational contract law principles dictate that contract
    interpretation is based, first and foremost, on the language in that contract
    itself, without consideration of the effect of a separate, former contract. See
    Sefzik v. Mady Dev., L.P., 
    231 S.W.3d 456
    , 460 (Tex. App. 2007) (“When
    interpreting a contract, the entire instrument, taken by its four corners, must
    be read and considered to determine the true intention of the parties.”); Forbau
    v. Aetna Life Ins. Co., 876 S.W.2 d 132, 133 (Tex. 1994) (explaining that general
    contract interpretation rules apply to the interpretation of insurance contracts
    2  The Insuring Agreement, the interrelatedness provision, and the Endorsement are
    all separate provisions of the insurance policies at issue.
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    under Texas law).     The court in Gastar adhered to this methodology—it
    evaluated the terms of the single contract in dispute, determined that there
    was ambiguity within the provisions of that single contract, and resolved that
    ambiguity in favor of the insured, as required under Texas law. See 
    Gastar, 412 S.W.3d at 583
    –85.
    Following Gastar’s reasoning, then, we should read the 2015
    interrelatedness provision at issue in this case in conjunction with the 2015
    Insuring Agreement, determine what coverage was originally created by that
    Insuring Agreement, and ask whether the interrelatedness provision narrows
    that coverage. See 
    Gastar, 412 S.W.3d at 583
    (“Each insurance policy must be
    interpreted according to its own specific provision and coverages. . . . [W]e limit
    our examination to the language of the policy.” (citations omitted)). The 2015
    Insuring Agreement reads:
    “if a Claim for a Wrongful Act is first made against any
    Insured Person during the Policy Period and reported in
    accordance with [the notice requirements], the Insurer will pay on
    behalf of such Insured Person all Loss such Insured Person is
    legally obligated to pay.”
    (emphasis added).      “Policy period” is then defined as “the period
    beginning at the inception date and ending at the expiration date stated in
    Item 2. of the Declarations Page,” which in turn designates the Policy Period
    as “from 12/31/2014 to 12/31/2015 12:01 AM Standard Time at the Insureds
    address.” See 
    Gastar, 412 S.W.3d at 583
    (“[W]hen an insurance policy defines
    its terms, those definitions control.” (citing Evanston Ins. Co v. Legacy of Life,
    Inc., 
    370 S.W.3d 377
    , 380 (Tex. 2012)). The 2015 Insuring Agreement, then,
    covers claims made and timely reported during the defined Policy Period, from
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    No. 17-41050
    December 2014 through December 2015. The 2015 claim falls under this
    definition.
    However, because of the effect of the interrelatedness provision, the 2015
    policy does not cover the 2015 claim. Instead, the claim is only eligible for
    coverage under the terms of the predecessor 2014 policy. Maj. at 3 (“Relying
    on the 2015 interrelatedness provision, RSUI deemed all the employment
    claims to be a single claim that were controlled by the 2014 policy.”). “In other
    words, but for the operation of [the interrelatedness provision] deeming the
    later Claim to have been made prior to the Policy Period”—defined in the
    contract as “12/31/2014 to 12/31/2015”—“the insurers would be liable for
    covering the [] [c]laim under the Insuring Agreement.” See 
    Gastar, 412 S.W.3d at 584
    . Because the interrelatedness provision means that the 2015 policy no
    longer covers a claim made during the designated Policy Period as it otherwise
    would under the Insuring Agreement, the “coverage originally created by [the
    2015] Insuring Agreement” has been narrowed. As in Gastar, it is irrelevant
    whether the claim is or is not covered under an earlier policy—the only
    pertinent question is whether the interrelatedness provision excludes the
    claim from coverage under the 2015 policy.           Under Gastar, the 2015
    interrelatedness provision is an exclusion.
    Once we establish that the interrelatedness provision here is just as
    much an exclusion as the corresponding condition in Gastar, it becomes clear
    that these cases are materially indistinguishable.            While the 2015
    interrelatedness provision excludes claims from coverage under the 2015 policy
    if they relate to claims brought before December 2014, the Endorsement only
    excludes claims if they are related to claims from before December 2012.
    Accordingly, as in Gastar, the interrelatedness provision “renders [the]
    Endorsement [] meaningless because any ‘Claims’ that would be excluded from
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    No. 17-41050
    coverage by [the] Endorsement would already be excluded by operation of [the
    interrelatedness provision].” 
    Gastar, 412 S.W.3d at 584
    . As in Gastar, the
    provisions “conflict or at best, when read together, create an ambiguity.” 
    Id. And “[w]hen
    provisions in an insurance contract conflict, a court must adopt
    the interpretation that most favors coverage for the insured.” 
    Id. (citations omitted).
          For these reasons, I respectfully dissent.
    18
    

Document Info

Docket Number: 17-41050

Citation Numbers: 932 F.3d 369

Judges: Dennis, Owen, Southwick

Filed Date: 8/2/2019

Precedential Status: Precedential

Modified Date: 10/19/2024