Century Surety Company v. Jim Hipner, LLC and Huey Brock , 2016 Wyo. LEXIS 89 ( 2016 )


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  •                 IN THE SUPREME COURT, STATE OF WYOMING
    
    2016 WY 81
                                                                APRIL TERM, A.D. 2016
    August 17, 2016
    CENTURY SURETY COMPANY,
    Appellant
    (Plaintiff),
    v.                                                   S-15-0294
    JIM HIPNER, LLC; and HUEY BROCK,
    Appellees
    (Defendants).
    W.R.A.P. 11 Certification
    from the United States Court of Appeals for the Eighth Circuit
    The Honorable Lavenski R. Smith, Judge
    Representing Appellant:
    Christopher C. Voigt and Nicholas T. Haderlie of Crowley Fleck PLLP, Sheridan,
    Wyoming; Jeffrey C. Gerish of Plunkett Cooney, Bloomfield Hills, Michigan;
    Bradford S. Moyer of Plunkett Cooney, Kalamazoo, Michigan. Argument by Mr.
    Gerish.
    Representing Appellees:
    Duane A. Lillehaug of Maring Williams Law Office, P.C., Fargo, North Dakota,
    representing Jim Hipner, LLC; Colleen M. Pratt and Michael D. Ainbinder of
    Ainbinder & Pratt, Long Beach, California, representing Huey Brock; Philip
    White Jr. of Karpan and White P.C., Cheyenne, Wyoming, representing Jim
    Hipner, LLC and Huey Brock. Argument by Mr. Ainbinder.
    Before BURKE, C.J., and HILL, DAVIS, FOX, and KAUTZ, JJ.
    NOTICE: This opinion is subject to formal revision before publication in Pacific Reporter Third.
    Readers are requested to notify the Clerk of the Supreme Court, Supreme Court Building,
    Cheyenne, Wyoming 82002, of any typographical or other formal errors so that correction may be
    made before final publication in the permanent volume.
    FOX, Justice.
    [¶1] The United States Court of Appeals for the Eighth Circuit certified a question to
    this Court concerning the enforceability of an insurance policy notice provision.
    Specifically, the Eighth Circuit asked:
    [W]hether, under Wyoming law, an insurer must be
    prejudiced before being entitled to deny coverage when the
    insured has failed to give notice “as soon as practicable.”
    Many states have expressly adopted a notice-prejudice rule
    under which an insurer will only be able to disclaim coverage
    if it demonstrates it was actually prejudiced by late notice.
    See 46A C.J.S. Insurance § 1769. To date, Wyoming has not.
    We answer in the affirmative.
    FACTS
    [¶2] Although the parties provided a record containing various documents, we find it
    unnecessary to refer to that record. Where a question of law is certified to this Court
    pursuant to W.R.A.P. 11, we rely upon the factual determinations of the certifying court.
    Wexpro Co. v. Brimhall, 
    7 P.3d 42
    , 43 (Wyo. 2000); Allhusen v. State By and Through
    Wyo. Mental Health Professions Licensing Bd., 
    898 P.2d 878
    , 881 (Wyo. 1995). The
    following facts were provided in the Eighth Circuit’s Order for Certification of Questions
    of State Law:
    In 2010, [Jim Hipner, LLC (“Hipner”)], a trucking
    company, obtained a $2 million umbrella policy (“Century
    Policy”) from Century [Surety Company (“Century”)] in
    order to secure a contract with a customer. In paragraph 3,
    the Century Policy contains the following notice provision:
    b. If you notify any “underlying insurer” of an
    “occurrence” or an offense involving “bodily injury”
    or “personal and advertising injury”, you must see to it
    that we are also notified in writing as soon as
    practicable.
    Later, in the same paragraph, the Century Policy contains an
    exclusion provision that states:
    Failure to notify us, as required per paragraphs 3.a. and
    3.b. above, of an “occurrence” or offense as soon as
    1
    practicable will result in exclusion of coverage
    whether we are prejudiced or not.
    On March 31, 2011, one of Hipner’s drivers created a
    road obstruction that produced an injury-generating, multi-
    vehicle collision (“the accident”) in North Dakota. According
    to the North Dakota Motor Vehicle Crash Report, a passenger
    in a car that was rear-ended by another vehicle suffered
    injuries deemed minor at the time. The Motor Vehicle Crash
    Report indicates that the other persons involved in the
    accident had “non-incapacitating” injuries at the time of the
    accident. Jim Hipner (“Jim”), a co-owner of Hipner, learned
    of the accident the same day that it occurred.
    Jim testified that, upon his arrival to the scene of the
    accident, the state patrol officer told him “there were no
    serious injuries.” Jim also testified that the officer told him
    that one of the passengers had “some numbness or tingling,”
    but that “it was nothing to worry about” and that this
    “happens quite often in these cases.” According to the
    medical records, one person, Huey Brock, arrived at Trinity
    Hospital on March 31 unable to move his arms or legs.
    On the day of the accident, Jim called and reported the
    accident to representatives at Willis of Wyoming and Great
    West Casualty Company (“Great West”), the underlying
    primary insurance companies for Hipner. But, no one at
    Hipner notified Century. In his deposition, Jim stated that he
    thought notifying Willis of Wyoming satisfied his obligations
    to notify all of the insurance companies. On March 31, Great
    West set up a claim and began investigating the accident.
    Brock’s injuries rendered him quadriplegic. Jim
    testified that he did not know that Brock sustained significant
    injuries from the accident until May 2011. On September 20,
    2011, Century was notified of the accident indirectly when
    Willis of Wyoming sent Century the policy renewal for
    Hipner. The next day, Century created an umbrella claim
    relating to the accident. On December 31, 2011, Great West
    sent its claim file, including the investigation materials, to
    Century. Century did not perform its own investigation of the
    accident because “[t]he duty to investigate the accident fell
    upon Great West Casualty. Century Surety relied upon Great
    2
    West Casualty to perform a competent investigation.”
    Nevertheless, Century later found fault with Great West’s
    investigation, claiming it was not thorough enough. In
    November 2012, Century received Brock’s settlement
    demand but declined to participate in the settlement “based
    upon lack of coverage for Jim Hipner LLC under the Century
    Policy coupled with serious questions regarding liability and
    damages.”
    Century then filed the instant action in federal court
    seeking a declaratory judgment that Century does not have an
    obligation to defend or indemnify Hipner in connection with
    any claims arising out of or relating to the accident. Both
    Hipner and Brock filed motions for summary judgment, or in
    the alternative a motion for partial summary judgment,
    requesting Century’s claims for declaratory relief be denied.
    Century, in response, filed a cross-motion for summary
    judgment seeking a declaration that it has no obligation to
    defend or indemnify Hipner in connection with the accident.
    Specifically, Century argued that it is not liable under
    Wyoming law because Hipner failed to provide written notice
    “as soon as practicable” as required by the Century Policy.
    The district court determined that although the Century
    Policy clearly and unambiguously requires written notice of a
    claim, the “as soon as practicable” requirement is ambiguous.
    Citing to Pacheco v. Continental Cas. Co., 
    476 P.2d 166
                 (Wyo. 1970), the district court concluded that Wyoming
    courts have found similar language ambiguous. After a
    “balancing of the beneficiary’s right to have the policy
    liberally construed in his favor with the legitimate interest of
    the insurer in being protected from stale claims,” 
    Pacheco, 476 P.2d at 169
    , the district court found that Century received
    timely notice under the Century Policy as a matter of
    Wyoming law.
    [¶3] Century appealed to the United States Court of Appeals for the Eighth Circuit. On
    December 28, 2015, the Eighth Circuit filed the Order for Certification of Questions of
    State Law, stating the question quoted above, see supra ¶ 1. On January 20, 2016, this
    Court issued a Notice of Agreement to Answer Certified Question.
    3
    STANDARD OF REVIEW
    [¶4]                Pursuant to W.R.A.P. 11.01, we may answer a
    question of law that may be determinative of a cause pending
    in the certifying court for which there appears to be no
    controlling precedent from this Court. Preston v. Marathon
    Oil Co., 
    2012 WY 66
    , ¶ 4, 
    277 P.3d 81
    , 83 (Wyo. 2012).
    Certified questions are queries of law that are reviewed de
    novo. Id.; State v. Mares, 
    2014 WY 126
    , ¶ 10, 
    335 P.3d 487
    ,
    493 (Wyo. 2014).
    State v. Black Hills Power, Inc., 
    2015 WY 99
    , ¶ 4, 
    354 P.3d 83
    , 85 (Wyo. 2015).
    DISCUSSION
    [¶5] In North Fork Land & Cattle, LLLP v. First American Title Insurance Company,
    
    2015 WY 150
    , ¶ 14, 
    362 P.2d 341
    , 346 (Wyo. 2015), we explained that Wyoming courts
    interpret insurance policies like other contracts; however, we give insurance policy
    language “the plain meaning a reasonable insured would understand it to mean,” and
    where terms are ambiguous, they are strictly construed against the insurer. We take this
    approach because insurance policies are contracts of adhesion where “the insured has
    little or no bargaining power to vary the terms . . . .” 
    Id. (quoting Doctors’
    Co. v. Ins.
    Corp. of America, 
    864 P.2d 1018
    , 1024 (Wyo. 1993) (internal citations omitted)).
    [¶6] Century argues that the policy language at issue is unambiguous and even a strict
    construction of that language in favor of Hipner requires its enforcement. Century also
    claims that because the notice provision language is not unconscionable, it must be
    enforced. Finally, Century avers that Wyoming law requires the rejection of the notice-
    prejudice rule (which requires an insurance company to be prejudiced before it can deny
    coverage based upon the violation of a notice provision in an insurance policy),
    especially in this case where the notice provision contains language requiring notice
    whether Century was prejudiced or not. In response, Hipner asserts that, regardless of the
    policy language, prejudice should be required when an insurer denies coverage based
    upon a failure to provide timely notice of a claim or occurrence and urges this Court to
    adopt the notice-prejudice rule because it is consistent with Wyoming precedent and is
    warranted by a variety of public policy considerations.
    The Traditional Rule and the Notice-Prejudice Rule
    [¶7] Traditionally, courts held that in order to avoid liability or its duty to defend, an
    insurance carrier only needed to establish that an insured’s notice of an occurrence or
    claim was untimely; prejudice to the insurer was irrelevant to the inquiry. Charles C.
    Marvel, Annotation, Modern Status of Rules Requiring Liability Insurer to Show
    4
    Prejudice to Escape Liability Because of Insured’s Failure or Delay in Giving Notice of
    Accident or Claim, or in Forwarding Suit Papers, 
    32 A.L.R. 4th 141
    , § 2 (updated 2106).
    According to this view, “timely notice is not merely a technical requirement, but, rather, a
    valid prerequisite to coverage, and any prejudice resulting from a delay in giving notice
    becomes immaterial.” 13 Steven Plitt et al., Couch on Insurance § 193:32 (3d ed.
    updated 2016). This approach “is grounded upon a strict contractual interpretation of
    insurance policies under which delayed notice was viewed as constituting a breach of
    contract, making the issue of insurer prejudice immaterial.” Clementi v. Nationwide Mut.
    Fire Ins. Co., 
    16 P.3d 223
    , 227 (Colo. 2001) (citing Alcazar v. Hayes, 
    982 S.W.2d 845
    ,
    849 (Tenn. 1998); Aetna Cas. & Sur. Co. v. Murphy, 
    538 A.2d 219
    , 220 (Conn. 1988)
    (overruled in part on other grounds by Arrowood Indem. Co. v. King, 
    39 A.3d 712
    , 725
    (Conn. 2012)); Ouellette v. Maine Bonding & Cas. Co., 
    495 A.2d 1232
    , 1234 (Me. 1985);
    Brakeman v. Potomac Ins. Co., 
    371 A.2d 193
    , 195 (Pa. 1977)). A handful of
    jurisdictions still follow the traditional rule. 13 Plitt, supra, § 193:32 (citing cases);
    1 Barry. R. Ostrager and Thomas R. Newman, Handbook on Insurance Coverage
    Disputes § 4.05[a] (17th ed. 2015).
    [¶8] Many courts and commentators have acknowledged the public policy rationales
    justifying the inclusion of notice provisions in insurance policies. For example, the
    Tennessee Supreme Court noted:
    The purpose of a policy provision requiring the insured to
    give the company prompt notice of an accident or claim is to
    give the insurer an opportunity to make a timely and adequate
    investigation of all the circumstances. An adequate
    investigation often cannot be made where notice is long
    delayed, because of the possible removal or lapse of memory
    on the part of witnesses, the loss of opportunity for
    examination of the physical surroundings and making
    photographs thereof for use at the trial, and the possible
    operation of fraud, collusion, or cupidity. Such a requirement
    tends to protect the insurer against fraudulent claims, and also
    against invalid claims made in good faith. If the insurer is
    given the opportunity for a timely investigation, reasonable
    compromises and settlements may be made, thereby avoiding
    prolonged and unnecessary litigation.
    Alcazar v. Hayes, 
    982 S.W.2d 845
    , 849 (Tenn. 1998) (quoting 1 Eric Mills Holmes
    & Mark S. Rhodes, Appleman on Insurance § 4.30 (2d ed. 1996) and citing 13A George
    J. Couch, et al., Couch on Insurance § 49:50 (2d rev. ed. 1982); Richard L. Suter,
    Insurer Prejudice: An Analysis of an Expanding Doctrine in Insurance Coverage Law,
    
    46 Me. L
    . Rev. 221, 223-24 (1994); F. Warren Jacoby, Comment, The Materiality of
    Prejudice to the Insurer as a Result of the Insured’s Failure to Give Timely Notice, 74
    5
    Dick. L. Rev. 260, 262-63 (1970); Comment, 68 Harv. L. Rev. 1436, 1436-38 (1955));
    see also Pacheco v. Continental Cas. Co., 
    476 P.2d 166
    , 169 (Wyo. 1970). Further, the
    public can be harmed by untimely claims due to “increased premiums and inadequate
    insurance administration.” 
    Alcazar, 982 S.W.2d at 849
    . Prompt notice also enables
    insurers to preserve adequate reserve funds. Utica Mut. Ins. Co. v. Fireman’s Fund Ins.
    Companies, 
    748 F.2d 118
    , 121 (2d Cir. 1984) (“Prompt notice permits the insurer to . . .
    adjust its books in order to maintain a proper reserve fund in light of the insured’s
    claim.”).
    [¶9] Recognizing that this public policy is not harmed by requiring insurers to be
    prejudiced before denying coverage for late notice, many courts have adopted the notice-
    prejudice rule which requires proof of prejudice for an insurer to avoid liability in the
    event that a policyholder provides them with untimely notice of an occurrence. 13 Plitt,
    supra, § 193:49; 1 Jeffrey E. Thomas and Francis J. Mootz, III, New Appleman on
    Insurance Law § 4.04[4][d][ii] (2015); 
    Clementi, 16 P.3d at 229
    (“Since the purpose of a
    policy’s notice requirement is to allow an insurer to adequately investigate and defend a
    claim, courts that have adopted the notice-prejudice rule have permitted an insurer to
    deny benefits only where its ability to investigate or defend the insured’s claim was
    compromised by the insured’s failure to provide timely notice.”) A “vast majority” of
    jurisdictions now follow the modern trend and have adopted the notice-prejudice rule.
    
    Alcazar, 982 S.W.2d at 850
    ; Atlantic Cas. Ins. Co. v. Greytak, 
    350 P.3d 63
    , 66 (Mont.
    2015); Prince George’s Cty. v. Local Gov’t Ins. Trust, 
    879 A.2d 81
    , 94 n.9 (Md. 2005)
    (listing thirty-eight states and two territories that have adopted the rule as a matter of
    common law); Ferrando v. Auto-Owners Mut. Ins. Co., 
    781 N.E.2d 927
    , 934 (Ohio 2002)
    (“Very few courts today follow the traditional approach in notice cases.”). These courts
    have countenanced three policy justifications for departing from the traditional approach:
    1) “the adhesive nature of insurance contracts”; 2) “the public policy objective of
    compensating tort victims”; and 3) “the inequity of the insurer receiving a windfall due to
    a technicality.” 
    Ferrando, 781 N.E.2d at 935
    ; see also Friedland v. Travelers Indem.
    Co., 
    105 P.3d 639
    , 646 (Colo. 2005).
    [¶10] In Brakeman v. Potomac Insurance Company, 
    371 A.2d 193
    (Pa. 1977), the
    Pennsylvania Supreme Court explained its departure from the traditional rule, remarking
    that the traditional approach fails to recognize the true nature of insurance contracts. The
    court stated:
    The rationale underlying the strict contractual approach
    reflected in our past decisions is that courts should not
    presume to interfere with the freedom of private contracts and
    redraft insurance policy provisions where the intent of the
    parties is expressed by clear and unambiguous language. We
    are of the opinion, however, that this argument, based on the
    view that insurance policies are private contracts in the
    6
    traditional sense, is no longer persuasive. Such a position
    fails to recognize the true nat[u]re of the relationship between
    insurance companies and their insureds. An insurance
    contract is not a negotiated agreement; rather its conditions
    are by and large dictated by the insurance company to the
    insured. The only aspect of the contract over which the
    insured can ‘bargain’ is the monetary amount of coverage.
    And, as we have recognized, notice of accident provisions,
    such as that with which we are concerned instantly, are
    uniformly found in liability insurance policies. Meierdierck
    v. Miller, 147 A.2d [406,] 408 [(Pa. 1959)]. Indeed, a review
    of the cases indicates that often the policies express the
    condition in identical language. In Cooper v. Government
    Employees Insurance Co., 
    51 N.J. 86
    , 
    237 A.2d 870
    (1968),
    the Supreme Court of New Jersey stated:
    ‘. . . (W)e have recognized that the terms of an
    insurance policy are not talked out or bargained for as
    in the case of contracts generally, that the insured is
    chargeable with its terms because of a business utility
    rather than because he read or understood them, and
    hence an insurance contract should be read to accord
    with the reasonable expectation of the purchaser so far
    as its language will 
    permit.’ 51 N.J. at 93
    , 237 A.2d at 873. Thus, an insured is not able to
    choose among a variety of insurance policies materially
    different with respect to notice requirements, and a proper
    analysis requires this reality be taken into account.
    
    Id. at 196
    (emphasis added); see also Susan Randall, Freedom of Contract in Insurance,
    14 Conn. Ins. L.J. 107, 107-08 (2007) (“There is no ‘bargain’ to be protected [in an
    insurance policy]; instead, there is an agreement on terms over which the consumer has
    no control and the insurance company has incomplete control.”).
    [¶11] We have repeatedly recognized the unequal bargaining power between an
    insurance company and an insured, and in a number of cases, we have held that insurance
    policies are contracts of adhesion. See, e.g., Evans v. Farmers Ins. Exch., 
    2001 WY 110
    ,
    ¶ 9, 
    34 P.3d 284
    , 286 (Wyo. 2001) (“Because insurance policies represent contracts of
    adhesion where the insured has little or no bargaining power to vary the terms, if the
    language is ambiguous, the policy is strictly construed against the insurer.” (citation
    omitted)); Harper v. Fidelity & Guar. Life Ins. Co., 
    2010 WY 89
    , ¶ 37, 
    234 P.3d 1211
    ,
    1222 (Wyo. 2010) (acknowledging “the usual disparity of bargaining power between an
    7
    insurer and the fact that insurance contracts are generally contracts of adhesion”); Shaffer
    v. Winhealth Partners, 
    2011 WY 131
    , ¶ 24, 
    261 P.3d 708
    , 714 (Wyo. 2011) (Golden, J.,
    dissenting) (“[R]egardless of the source of one’s health insurance, there is severely
    limited opportunity for negotiation as to the standard terms of the health insurance
    contract.” (citation omitted)); see also North Fork Land & Cattle, 
    2015 WY 150
    , ¶ 
    14, 362 P.3d at 346
    ; T.M. ex rel. Cox v. Executive Risk Indem. Inc., 
    2002 WY 179
    , ¶ 8, 
    59 P.3d 721
    , 725 (Wyo. 2002); Gainsco Ins. Co. v. Amoco Prod. Co., 
    2002 WY 122
    , ¶ 7, 
    53 P.3d 1051
    , 1056 (Wyo. 2002); Doctors’ 
    Co., 864 P.2d at 1024
    ; St. Paul Fire & Marine
    Ins. Co. v. Albany Cty. Sch. Dist. No. 1, 
    763 P.2d 1255
    , 1258 (Wyo. 1988).
    [¶12] A second basis for adopting the notice-prejudice rule is the public interest in
    enforcing insurance contracts to further compensate accident victims, including innocent
    third parties. As one court explained, “adoption of the modern rule . . . promotes the
    social function of insurance coverage: providing compensation for injuries sustained
    by innocent members of the public.” Great American Ins. Co. v. C.G. Tate Constr. Co.,
    
    279 S.E.2d 769
    , 774 (N.C. 1981). “Insurance contracts are not purely private
    matters between insurance companies and their insureds; rather there is a public
    interest in automobile liability insurance contracts and that is the protection of innocent
    victims . . . .” 
    Alcazar, 982 S.W.2d at 851
    (quoting 
    Brakeman, 371 A.2d at 198
    n.8); see
    also Suter, 
    46 Me. L
    . Rev. at 235; David P. Leonard, The New Wigmore: A Treatise on
    Evidence: Selected Rules of Limited Admissibility § 6.4.3 (2016) (“Victim compensation
    is a well-recognized goal of the law, and broader insurance would help to assure that the
    compensation of accident victims does not depend on the fortuity of the wrongdoer’s
    financial status.”).
    [¶13] Wyoming’s legislature recognized this public interest when it enacted the Motor
    Vehicle Safety Responsibility Act, Wyo. Stat. Ann. §§ 31-9-101 through 31-9-415. That
    statute requires motor vehicle owners and operators to provide proof (via insurance, a
    bond, or depositing money with the director of the department of transportation) that they
    are financially able to meet a minimum level of damages to third parties that might result
    from accidents arising out of the use of their motor vehicle. Wyo. Stat. Ann. §§ 31-9-
    102(a)(xi) and 31-9-402 (LexisNexis 2015). In upholding the constitutionality of that act,
    we acknowledged the need to protect innocent parties and that insurance serves such a
    purpose. We explained that “[a]ny appropriate means adopted by the states to insure
    competence and care on the part of its licensees and to protect others using the highway is
    consonant with due process. Some states require insurance or its equivalent as a
    condition of the issue of a license.” Thornley v. Wyoming Highway Dep’t, Motor Vehicle
    Div., 
    478 P.2d 600
    , 602 (Wyo. 1971) (citation omitted).
    [¶14] A final justification given for adopting the notice-prejudice rule is that when
    prejudice to the insurer is required before it can deny coverage based upon late notice,
    “no undeserved windfalls will be reaped by the insurer.” Suter, 
    46 Me. L
    . Rev. at 235.
    For example, the court in Brakeman reasoned that “[a]llowing an insurance company,
    8
    which has collected full premiums for coverage, to refuse compensation to an accident
    victim or insured on the ground of late notice, where it is not shown timely notice would
    have put the company in a more favorable position, is unduly severe and inequitable.”
    
    Brakeman, 371 A.2d at 198
    ; see also Foundation Reserve Ins. Co. v. Esquibel, 
    607 P.2d 1150
    , 1152 (N.M. 1980) (“If we were to hold otherwise, a ‘windfall for the insurer at the
    expense of the public’ would result.”) (citation omitted)). The Restatement (Second) of
    Contracts allows a court to excuse a party’s failure to perform a condition in the contract
    if an inequitable forfeiture would occur and the condition is not a material part of the
    contract. Restatement (Second) of Contracts § 229 (updated 2016).
    The insurer prejudice rule is essentially an application of this
    principle. By excusing non-performance of procedural
    requirements in cases where an insurer has not been
    prejudiced, the court is essentially excusing the non-
    occurrence of an immaterial condition. If the insured’s
    failure to perform the condition did not result in prejudice to
    the insurer, the rule assumes that the condition was not a
    material part of the insurance contract.
    Suter, 
    46 Me. L
    . Rev. at 235-36 (citing Restatement (Second) of Contracts § 229 (1979)).
    In Wyoming, we have expressed our disfavor of undeserved windfalls to insurance
    companies. See Aaron v. State Farm Mut. Auto. Ins. Co., 
    2001 WY 112
    , ¶ 12, 
    34 P.3d 929
    , 932-33 (Wyo. 2001) (citations omitted) (“We will presume the payment of
    additional premiums was not intended to result in a ‘windfall to the insurer’ . . . .”).
    [¶15] Based upon these policy rationales, a majority of courts have overturned precedent
    following the traditional approach in favor of the notice-prejudice rule. See, e.g.,
    
    Clementi, 16 P.3d at 227
    ; 
    Alcazar, 982 S.W.2d at 853-54
    ; Cooperative Fire Ins. Ass’n of
    Vermont v. White Caps, Inc., 
    694 A.2d 34
    , 36-38 (Vt. 1997); Great American Ins. 
    Co., 279 S.E.2d at 774
    ; see also 
    Ouellette, 495 A.2d at 1235
    . We agree with these courts and
    hold that the better-reasoned approach is to require prejudice to the insurer before
    coverage may be denied based upon a violation of a notice provision contained in the
    policy. As the Alcazar court concluded:
    Though we are hesitant to carve out an exception to the axiom
    proscribing judicial alteration of the terms of an unambiguous
    contract, we have determined, due to compelling public
    policy justifications, that it is . . . appropriate to depart from a
    rigid application [of contract interpretation]. We join the vast
    majority of jurisdictions which take into consideration the
    degree to which the insurer has been prejudiced by the delay
    in notice.
    
    Alcazar, 982 S.W.2d at 853
    .
    9
    [¶16] We note that while we have never had the occasion to adopt the notice-prejudice
    rule before now, our precedent is consistent with such an approach. In Pacheco v.
    Continental Cas. Co., the insurer received notice of an accident three years after it
    occurred. We concluded that the untimely notice violated the policy requirement that the
    insured give notice “within 20 days after the alleged accident . . . or as soon thereafter as
    was ‘reasonably possible.’” 
    Id., 476 P.2d
    at 168. In reaching this conclusion, we
    considered the prejudice to the insurance company caused by this late notice:
    If a timely claim for accident benefits had been made,
    evidence pertaining to the happening of the accident and to
    the nature and extent of injuries, together with evidence of
    resulting complications, if any, could probably have been
    obtained at that time which cannot be obtained some three
    years later.
    
    Id. at 168.
    We remarked that “a beneficiary’s demand must be made within a reasonable
    time for the insurer to investigate the claim, i.e., before its staleness poses a substantial
    obstacle to ascertaining the facts surrounding the occurrence.” 
    Id. at 169.
    [¶17] In Brown v. Life Insurance Company of North America, 
    8 P.3d 333
    (Wyo. 2000),
    we considered prejudice to the insurer in our determination of whether timely notice had
    been provided. In the course of our discussion, we found the lack of prejudice to the
    insurer significant. We stated that “based on the record before us, [the insurer] does not
    have a viable defense based on prejudice because of an inability to investigate the claim.”
    
    Id. at 337.
    [¶18] Consistent with this precedent and the public policy rationales discussed in the
    preceding paragraphs, we find that a two-step approach to an insurer’s claim of late
    notice is appropriate. This approach requires a preliminary determination that an
    insured’s notice was untimely, in violation of the notice requirement contained in the
    insurance policy. The question of the timeliness of the insured’s delay in providing
    notice will depend upon a number of factors, including, but not limited to, the language
    of the notice requirement in the policy, the timing of the notice, the insured’s knowledge
    of the underlying facts and ability to provide notice, the sophistication of the parties, the
    type of insurance at issue, and the reasonableness of any delay. See, e.g., Northbrook
    Prop. & Cas. Ins. Co. v. Applied Sys., Inc., 
    729 N.E.2d 915
    , 922 (Ill. App. Ct. 2000).
    Once it is determined that notice was untimely, a court should then turn to the question of
    whether the insurer was prejudiced by that delay. If the insurer was prejudiced, then the
    insurer will be relieved of its obligation to provide coverage.
    10
    The Century Policy
    [¶19] The Eighth Circuit’s Order for Certification of Questions of State Law also
    requests this Court to answer the question of whether, under Wyoming law, an insurance
    clause is enforceable where it excludes coverage unless the insured notifies the insurer
    “as soon as practicable . . . whether [the insurer] [is] prejudiced or not.” Century argues
    that this language is enforceable, regardless of whether we adopt the notice-prejudice
    rule. Hipner contends that once the notice-prejudice rule is adopted, this language is void
    as against public policy.
    [¶20] “Contracts against public policy are considered illegal and void. Consequently,
    the parties to an insurance contract are free to agree to coverage terms as they desire so
    long as the policy terms do not violate public policy.” 7 Steven Plitt et al., Couch on
    Insurance § 101:11 (3d ed. updated June 2016). Public policy may affect coverage
    through statutes and regulations, as we recognized in Allstate Insurance Company v.
    Wyoming Insurance Department, 
    672 P.2d 810
    , 820-21 (Wyo. 1983), where we
    explained that a policy provision is void as against public policy if it is contrary to
    statute. See also 7 Plitt, supra, § 101:12. Public policy may also affect coverage via the
    “jurisdiction’s application of public policy to the construction of the insurance contract.”
    7 Plitt, supra, § 101:12. The types of public policy concerns that may require or exclude
    coverage are “arguably unlimited” but include the prevention of “illusory coverage when
    the insured purchases ineffective insurance protection” and the compensation of injuries
    to innocent third parties. 7 Plitt, supra, §§ 101:18, 101:20.
    [¶21] Only two courts have considered policy language intending to override the notice-
    prejudice rule. In Steadfast Insurance Company v. Casden Properties, Inc., 
    837 N.Y.S.2d 116
    , 117 (N.Y. App. Div. 1st Dep’t 2007), the court applied California law and
    held that because California had adopted the notice-prejudice rule, an endorsement that
    waived the prejudice requirement for untimely notice was void as against public policy.
    Similarly, in Service Management Systems, Inc. v. Steadfast Insurance Company, 216
    Fed. Appx. 662 (9th Cir. 2007), the court considered whether a clause stating that the
    insurer “shall not be required to establish prejudice resulting from noncompliance” with
    the notice provision would render the notice-prejudice rule inapplicable in that case. 
    Id. at 664.
    The court held such language was “insufficient to defeat California’s strong
    public policy behind the notice-prejudice rule.” 
    Id. [¶22] Likewise,
    in this instance, the notice-prejudice rule is supported by sound public
    policy, as discussed above, see supra ¶¶ 9-15. Century cannot circumvent that rule by
    simply adding language to its policy stating that insufficient notice “will result in
    exclusion of coverage whether [Century is] prejudiced or not.” We therefore hold that
    this language is void as against public policy.
    11
    CONCLUSION
    [¶23] We hereby adopt the notice-prejudice rule. Before being entitled to deny coverage
    based upon untimely notice of an occurrence that triggers coverage, an insurer must be
    prejudiced, regardless of the express language of the policy.
    12
    

Document Info

Docket Number: S-15-0294

Citation Numbers: 2016 WY 81, 377 P.3d 784, 2016 Wyo. LEXIS 89, 2016 WL 4399921

Filed Date: 8/17/2016

Precedential Status: Precedential

Modified Date: 11/13/2024

Authorities (24)

Prince George's County v. Local Government Insurance Trust , 388 Md. 162 ( 2005 )

Arrowood Indem. Co. v. King , 304 Conn. 179 ( 2012 )

Gainsco Insurance Co. v. Amoco Production Co. , 2002 Wyo. LEXIS 132 ( 2002 )

Preston v. Marathon Oil Co. , 2012 Wyo. LEXIS 70 ( 2012 )

Shaffer v. WinHealth Partners , 2011 Wyo. LEXIS 138 ( 2011 )

Harper v. Fidelity & Guaranty Life Insurance Co. , 2010 Wyo. LEXIS 92 ( 2010 )

State , 2014 WY 126 ( 2014 )

Northbrook Property & Casualty Insurance v. Applied Systems,... , 313 Ill. App. 3d 457 ( 2000 )

utica-mutual-insurance-company-cross-v-firemans-fund-insurance , 748 F.2d 118 ( 1984 )

Cooperative Fire Insurance v. White Caps, Inc. , 166 Vt. 355 ( 1997 )

Brown v. Life Insurance Co. of North America , 2000 Wyo. LEXIS 152 ( 2000 )

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Cooper v. Government Employees Insurance , 51 N.J. 86 ( 1968 )

Brakeman v. Potomac Insurance Co. , 472 Pa. 66 ( 1977 )

Pacheco v. Continental Casualty Company , 1970 Wyo. LEXIS 203 ( 1970 )

Clementi v. Nationwide Mutual Fire Insurance Co. , 2001 Colo. J. C.A.R. 512 ( 2001 )

Allhusen v. State Ex Rel. Wyoming Mental Health Professions ... , 1995 Wyo. LEXIS 106 ( 1995 )

Thornley v. Wyoming Highway Department, Motor Vehicle ... , 1971 Wyo. LEXIS 189 ( 1971 )

Doctors' Co. v. Insurance Corp. of America , 864 P.2d 1018 ( 1993 )

North Fork Land & Cattle, Lllp v. First American Title ... , 2015 Wyo. LEXIS 167 ( 2015 )

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