DocketNumber: No. PC 98-2187
Judges: SAVAGE, J.
Filed Date: 12/1/2005
Status: Non-Precedential
Modified Date: 4/18/2021
The Roweys claim that in February 1995, "they first learned that material information had been previously withheld from them" by CFS. (Id. ¶ 19.) They claim that CFS negligently (a) "failed to provide accurate and complete information regarding [Lisa Rowey's] general background and history," particularly with respect to her medical, psychological, and family history; (b) "misrepresented and/or omitted material information" of the same ilk; (c) "failed to supply [the Roweys with] medical records regarding [Lisa Rowey's] past diagnosis, treatment, and care;" and (d) "failed to properly inform [the Roweys] of [Lisa Rowey's] probable need for future treatment." (Id. ¶ 16.)
The Roweys allege that as a result of CFS's negligence, they were deprived of the ability to make informed decisions as to "(a) whether they should or should not adopt the child; (b) whether they were capable of properly raising and caring for the child; and (c) how to properly address the child's needs regarding future care, treatment and general upbringing." (Id. ¶ 15.) The Roweys contend that "as a direct and proximate result" of CFS' negligence, the Roweys, their adopted daughter, Lisa Rowey, and her sister, Meghan Rowey, all have suffered great mental anguish, emotional distress, property damage, and bodily injury; that they have been forced to expend large sums of money for medical and psychiatric treatment; that they have lost opportunities for Lisa Rowey's proper medical and psychiatric treatment; that Lisa Rowey was not properly diagnosed or treated for her psychological and developmental problems; and that they lost opportunities for her proper diagnosis, treatment, and care. (Id. ¶ 20.)
The Rowey plaintiffs1 filed suit on January 12, 1998, alleging (1) negligent misrepresentation, (2) intentional misrepresentation, (3) negligent infliction of emotional distress, (4) intentional infliction of emotional distress, (5) negligence, (6) breach of fiduciary duty, and (7) breach of contract. (See id.) Subsequently, Travelers filed the present action seeking, inter alia, a declaration that National Union has a duty to contribute to Travelers' defense of CFS in Rowey.
In the past, both Travelers and National Union have provided coverage to CFS. Travelers issued five policies to CFS, providing coverage from January 1, 1982 until January 31, 1986 when CFS cancelled its policy. National Union provided coverage for two different periods. It issued a policy to CFS covering the period between January 1, 1985 and January 1, 1986. Subsequently, National Union issued six more policies to CFS that covered the period from January 29, 1986 to January 29, 1992.
Travelers filed its motion for partial summary judgment with supporting memorandum, affidavit, and exhibits, arguing simply that under the Rowey plaintiffs' complaint, National Union owes CFS a duty to defend because the complaint meets the appropriate standard — the "pleadings test" — by alleging that, as a result of CFS's negligence, "bodily injury" and "property damage" were incurred "within the policy periods." (Travelers' Mem. in Supp. of Summ. J. 6.) National Union filed an objection in which it analogizes the present cause of action to a cause of action for "wrongful birth," arguing that the "occurrence and ``injury'" resulting from a "wrongful adoption" caused by negligent misrepresentation occur at or before the point of adoption and, thus, fall outside National Union's coverage. (National Union's Objection to Travelers' Mot. for Part. Summ. J. 13.) Travelers filed a response in which it contends that National Union's focus on the timing of the "occurrence and ``injury'" goes impermissibly beyond the allegations of the complaint. Travelers further argues that the timing of the "injury" is relevant only to the issue of the duty to indemnify and not to the duty to defend. Finally, Travelers asserts that National Union's analogizing the instant cause of action to a cause of action for wrongful birth is inapt and that in the present case, the injury occurs at the point of discovery.
Both Travelers and National Union have provided supplemental memoranda. In its supplemental memorandum, Travelers principally reiterates its argument that the allegations in the complaint satisfy the requirements of the "pleadings test," adding that the language of the policies requires only that the "injury" be sustained during the policy period. By contrast, National Union argues that the cause of the Rowey's injuries — CFS's negligent misrepresentation — is not an occurrence, and that even if it were, the "occurrence" and resulting injury fall outside National Union's coverage period.
A. The Coverage Provisions
Each of the seven policies issued by National Union to CFS features one of four substantially similar coverage provisions.2 The National Union insurance policy covering the period from January 1, 1985 to January 1, 1986, Policy No. S 996-24-75, provides that National Union will cover all:
damages because of A. bodily injury or B. property damage to which this insurance applies, caused by an occurrence and arising out of the ownership, maintenance or use of the insured premises and all operations necessary or incidental thereto, and the company shall have the right and duty to defend any suit against the insured seeking damages on account of such bodily injury or property damage, even if any of the allegations of the suit are groundless, false or fraudulent. (Travelers' ex. F.) The insurance applies only to "bodily injury" and "property damage" as they are defined in the policy. "Bodily injury" is defined therein as "bodily injury, sickness or disease sustained by any person which occurs during the policy period, including death at any time resulting therefrom." (Id.) The policy defines "property damage" as "(1) physical injury to or destruction of tangible property which occurs during the policy period, including the loss of use thereof at any time resulting therefrom, or (2) loss of use of tangible property which has not been physically injured or destroyed provided such loss of use is caused by an occurrence during the policy period." (Id.)
The two policies that cover the period between January 29, 1986 and January 29, 1988 — both labeled as Policy No. MP 905 04 33 — do not require that the damages arise "out of the ownership, maintenance, or use of the insured premises and all operations necessary or incidental thereto," but are otherwise identical to the original policy. (Travelers' ex. G, H.) The three policies that cover the period between January 29, 1988 and January 29, 1991 — Policy Nos. MLP 5224796, MLP 5239224, and MLP 525477 — are worded the same as each other as follows:
We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" to which this insurance applies. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under SUPPLEMENTARY PAYMENTS — COVERAGES A AND B. This insurance applies only to "bodily injury" and "property damage" which occurs during the policy period. The "bodily injury" or "property damage" must be caused by an "occurrence."3
(Travelers' ex. I, J.) The final policy, Policy No. MLP 203 4119, provides that National Union will cover "``bodily injury' or ``property damage' to which this insurance applies," and that the insurance "applies to ``bodily injury' and ``property damage' only if: (1) The ``bodily injury' or ``property damage' is caused by an ``occurrence' that takes place in the ``coverage territory;' and (2) The ``bodily injury' or ``property damage' occurs during the policy period." (Travelers' ex. K.)
B. The First National Union Policy (Policy No. S 996-24-75)
In their complaint, the Rowey plaintiffs allege that as a "direct and proximate" result of CFS's negligent misrepresentation to the Roweys, the Rowey plaintiffs "have suffered great mental anguish, emotional distress, property damage, and bodily injury." With respect to the policy covering the period between January 1, 1985 and January 1, 1986, National Union argues that it owes CFS no duty to defend because the alleged "bodily injury" and "property damage" are not alleged to and do not arise "out of the ownership, maintenance, or use of the insured premises and all operations necessary or incidental thereto" as required by the plain language of the policy. This Court agrees with National Union.
As noted, an insurance company is obligated to defend its insured if the facts asserted in the complaint are sufficient to bring the case "potentially within the risk coverage of the policy." Peerless,
The question of how to interpret this phrase in the policy — namely, the language, "arising out of the ownership, maintenance or use of the insured premises and all operations necessary or incidental thereto" — has never been addressed by Rhode Island's courts. In fact, only the Maryland Court of Special Appeals appears to have decided the issue. See Chesapeake PhysiciansProf'l Ass'n v. Home Ins. Co.,
The policy in Chesapeake was a business owners policy that included provisions excluding certain types of damages and claims from its broad comprehensive general liability coverage. Id. at 823. Importantly, the pertinent language of the general coverage provision was identical to that of the policy in question here. The insurer argued that by the language of the general coverage provision, the policy was a limited premises liability policy; the insured argued, however, that business operations conducted from the premises were covered under the language of the endorsement. Id. Ultimately, the court ruled in favor of the insurer, concluding as follows:
[I]n the language of the liability limitation endorsement . . . "operations necessary or incidental thereto" modifies not "premises" but "ownership, maintenance, or use of the premises." Thus, the coverage afforded by the policy extends to claims arising from the "ownership, maintenance or use" of the property, and "operations necessary or incidental" to the "ownership, maintenance or use" of the property.
Id. at 826.
The Maryland court based its conclusion on the linguistic structure of the policy and "other portions of the insurance policy." Id. at 827. First, the court noted that the description of the property and operations covered by the policy was limited to the single word, "Office," and not a "more precise definition of the types of operations covered." Id. Second, the court stressed the fact that premiums were calculated based on the square footage of the properties and premises covered, not on the basis of certain types of risks. Id. Finally, the court observed that, in accordance with industry custom, policies are not individually tailored to each particular customer. Id. Rather, policies start with the most expansive coverage and are whittled down using exclusionary language that is tailored to the particular customer. Id. The court opined that this final factor was "perhaps most important." Id. Applying these three factors to the facts of the instant case, this Court concludes that Policy No. S 996-24-75 provides premises liability insurance coverage, not general liability insurance coverage.
With respect to the first factor, the policy in question actually provides a somewhat more detailed description of the property and operations covered by the policy than did the policy in Chesapeake. The description includes the term "social services" in addition to two more generic, premises-oriented terms — "Dwelling" and "Office." (Travelers' ex. F.) This marginal improvement as to the first factor, however, is outweighed by the second and third factors. As in Chesapeake, the premiums are computed on the basis of square footage rather than risk. (Travelers' ex. F.) Most importantly, as inChesapeake, the disputed limitation is included in the general coverage provision, which means that "there was never a time when the analyzed language was not part of the policy." Id. In addition, this Court notes that even the policy's title — "Owners', Landlords' and Tenants' Liability Insurance: Coverage for Designated Premises and Related Operations in Progress Including Structural Alterations, New Construction and Demolition" — suggests that the policy is limited to insurance of the premises and does not contemplate professional negligence.
Based on the foregoing, this Court concludes that Policy No. S 996-24-75 provides premises liability insurance coverage as opposed to general liability insurance coverage. Indeed, Travelers has failed to convince this Court otherwise. As the Rowey plaintiffs' complaint asserts no cause of action for premises liability, within the meaning of the policy as defined by this Court, National Union does not owe CFS a duty to defend under that policy. It necessarily follows, therefore, that Traveler's motion for partial summary judgment is denied to the extent it seeks a contrary declaration under that policy.
Of the seven insurance policies in question, however, only this policy contains the premises limitation. This Court must undertake additional analysis, therefore, to determine whether the possibility of coverage exists under the remaining policies. Such analysis must begin with defining the word "occurrence" as it is used in the policies at issue.
C. The Remaining National Union Insurance Policies 1. Defining an "Occurrence"
Each of the seven insurance policies issued by National Union to CFS features one of two definitions for "occurrence." The first three policies provide that "``occurrence' means an accident, including continuous or repeated exposure to conditions, which results in bodily injury or property damage neither expected nor intended from the standpoint of theinsured." (Travelers' ex. F, G, H.) The remaining four policies are more simply worded, defining "occurrence" as "an accident, including continuous or repeated exposure to substantially the same general harmful conditions." (Travelers' ex. I, J, K.) These same four policies further provide that the insurance does not apply to "bodily injury" or "property damage" that is "expected or intended from the standpoint of the insured." (Id.) Though worded slightly differently, the language of all of the policies is alike inasmuch as an "occurrence" must be an "accident" causing damages neither expected nor intended from the standpoint of the insured.
By itself, the word "accident" is problematic. An "accident" is "[a]n unintended and unforeseen injurious occurrence; something that does not occur in the usual course of events or that could not be reasonably anticipated." Black's Law Dictionary 15 (8th ed. 2004). This definition is not helpful to this Court's analysis because it includes the word "occurrence," making the definition circular with respect to the insurance policies in question. Moreover, according to that dictionary definition, an "accident" is presumptively unintentional, yet the Rhode Island Supreme Court has held, to the contrary, that an "accident" may be an intentional act, provided that the result was unexpected from the point of view of the insured. Liberty Mut. Ins. Co. v.Tavarez,
As listed above, the Rowey plaintiffs assert seven causes of action in their eleven count complaint. Of those seven, intentional misrepresentation and intentional infliction of emotional distress, by definition, allege intentional acts and cannot be the basis of a duty to defend. The remaining five causes of action — negligent misrepresentation, negligent infliction of emotional distress, negligence, breach of fiduciary duty, and breach of contract — are based on the theory that CFS acted negligently in making certain representations to the Roweys. Accordingly, this Court need not address each cause of action separately. Rather, this Court need only determine whether the baseline claim of negligent misrepresentation is an "accident," including "continuous or repeated exposure to conditions," causing damages "neither expected nor intended from the standpoint of the insured:" in other words, whether negligent misrepresentation is an "occurrence."
2. Negligent Misrepresentation is an "Occurrence"
Whether negligent misrepresentation may be considered an "accident" is a question of first impression in Rhode Island. Guided by Rhode Island and extraterritorial case law, this Court answers the question in the affirmative.
In Craven, as noted above, the Rhode Island Supreme Court held that regardless of whether the facts in a complaint are described in terms of negligence, when the insurance policy defines an "occurrence" as an "accident," an insurer owes its insured no duty to defend if the complaint alleges intentional acts.
Relying on the Rhode Island Supreme Court's ruling in Sanzi v.Shetty,
Not all courts, however, are in agreement on this issue. InSafeco Ins. Co. of Am. v. Andrews,
As in California, intent to induce reliance is an element of negligent misrepresentation in Rhode Island. See Mallette v.Children's Friend Serv.,
Only Brethren's third argument — that misrepresentations are not an "occurrence" — is before this Court, and, lacking Rhode Island precedent that is squarely on point, this Court finds the Court of Appeals' treatment of that argument persuasive. InSheets, the court opined that, rather than follow those cases characterizing negligent misrepresentation as a form of fraud, it "prefer[red] to follow those cases that treat negligent misrepresentation like other forms of negligence, which are covered as accidents if the insured did not expect or foresee the resulting damage." Id. at 551. Thus, the court ruled in favor of the insured, concluding that whether negligent misrepresentation constitutes an "accident" depends, ultimately, on whether the resulting damage is "an event that takes place without one's foresight or expectation." Sheets,
This Court agrees with the court's rationale inSheets;4 negligent misrepresentation is a tort closer to negligence than to fraud, especially within the context of this case. The primary act that makes the actor's conduct actionable is the misrepresentation, not the intent to induce reliance. Negligent misrepresentation, therefore, is notably unlike fraud because the actor does not intend to make a false statement upon which he or she intends another to rely. It follows that the actor does not expect injury to result.
This Court is satisfied that, by stating a cause of action against CFS for negligent misrepresentation, plaintiffs do not suggest that CFS made intentional false statements to the Roweys or that CFS either expected or intended that damage of any sort would result from those representations. As a result, this Court concludes that such claim of negligent misrepresentation falls within the definition of "accident" and is an "occurrence" as defined by the National Union insurance policies.
3. The Timing Issue
Typically, coverage under occurrence-based liability insurance policies, such as those issued by National Union to CFS, depends on whether the "occurrence" falls within the policy period. Seegenerally Textron, Inc. v. Liberty Mut. Ins. Co.,
Travelers argues, however, that the timing of the "occurrence," for the purpose of determining whether National Union owes CFS a duty to defend, is irrelevant. Travelers asserts that the policies here require only that the "bodily injury" or "property damage" caused by an "occurrence," not the "occurrence" itself, occur during the period of coverage. As the Rowey plaintiffs alleged in their complaint that they sustained "property damage" and "bodily injury" as a proximate result of CFS's negligent misrepresentation, and as it is possible that they sustained such claimed injury during the periods in which National Union's policies covered CFS, Travelers maintains that National Union owes CFS a duty to defend.
In support of its argument, Travelers relies on an opinion from the Supreme Court of New York: National Casualty Ins. Co. v.City of Mount Vernon,
the language of the occurrence clause herein ascribes no temporal relevance to the causative event preceding the covered injury, but rather premises coverage exclusively upon the sustaining of specified injuries during the policy period. . . . [A]s one commentator has stated in discussing a similar provision, "[the] policy will not depend upon the causative event of occurrence but will be based upon injuries or damages which result from such an event and which happened during the policy period. It will not be material whether the causative event happened during or before the policy period." Willard J. Obrist, The New Comprehensive General Liability Insurance Policy: A Coverage Analysis 6 (1966).6 See also Appalachian Ins. Co. v. Liberty Mut. Ins. Co.,
676 F.2d 56 , 61-62 (3d Cir. 1982); Bartholomew v. Appalachian Ins. Co. of N. Am.,502 F. Supp 246 ,252 (D.R.I. 1980); Am. Motorists Ins. Co. v. Squibb Sons,406 N.Y.S.2d 658 (N.Y. Spec. Term 1978); Deodato v. Hartford Ins. Co.,363 A.2d 361 (N.J.Super. 1976); Acorn Ponds Inc. v. Hartford Ins. Co.,105 A.D.2d 723 (N.Y.App. Div. 1984); Richard C. Tinney, Event as Occurring Within Period of Coverage of "Occurrence" and "Discovery" or "Claims Made" Liability Policies, 37 A.L.R. 4th 382 (1985). We note, moreover, that there is nothing in the policy which requires, as a prerequisite to ascertaining whether there is coverage, that the injury resulting from a causative event be reduced to a single or fixed occurrence in time. Nor does the policy distinguish, in terms of coverage, between compensable injuries which are continuous in nature and those whose occurrence is discrete and noncontinuous or require that a personal injury take place in its entirety during the policy period. These omissions are particularly significant in that the policy specifically recognizes that an injury can be caused by "continuous or repeated exposure to conditions." Cf. Keene Corp. v. Ins. Co. of N. Am.,667 F.2d 1034 , 1049 (D.C. Cir. 1981). Accordingly, the operative event triggering exposure, and thus resulting in coverage under the policy, is the sustaining of a specified injury during the policy period.
Id. at 270. Travelers asks this Court to apply the analysis of the court in National Casualty in the instant case to reach the conclusion that National Union owes CFS a duty to defend.
With respect to the interpretation of the language of the insurance policies at issue, this Court finds National Union persuasive. Moreover, this Court has neither found nor have the parties made it aware of any authority — domestic or otherwise — requiring this Court to assume that the parties intended that the "occurrence" must take place within the policy period even though the plain language of the policy suggests otherwise. See,e.g., Ins. Co. of N. Am. v. Kayser-Roth Corp., No. PC 92-5248, 1999 R.I. Super. LEXIS 66 (R.I.Super.Ct. July 29, 1999). This Court, therefore, reads the National Union insurance policies according to their plain language.
The insurance policies issued by National Union to CFS are all substantially similar in this regard to the policy in NationalCasualty. All seven policies — including Policy No. S 996-24-75 — provide coverage for "bodily injury," sustained during the policy period, that was originally caused by an "occurrence." The policies specify only that the "bodily injury" — not necessarily the "occurrence" — must occur during the policy period.
With respect to "property damage," every policy through January 29, 1988 — again, including Policy No. S 996-24-75 — draws a distinction, for the purpose of coverage, between "physical injury to or destruction of property . . . including the loss of use thereof at any time resulting therefrom" and "loss of use of tangible property which has not been physically injured or destroyed." (Travelers' ex. F, G, H.) According to the language of the policies, the former is covered as long as it — the physical injury or destruction — occurs during the policy period. (Id.) The latter is covered, however, only if "such loss of use is caused by an occurrence during the policy period." (Id. (emphasis added).) Under the policies providing coverage through January 29, 1988, therefore, loss of use of tangible property, absent physical injury or destruction of the property, is covered only if the causing "occurrence" occurred during the policy period. The policies covering from January 29, 1988 to January 29, 1992 make no such distinction; the "property damage" need only occur "during the policy period." (Travelers' ex. I, J, K.) Thus, the date of the "occurrence" matters only to the extent that the Rowey plaintiffs suffered "loss of use of tangible property which has not been physically injured or destroyed" prior to January 29, 1988. Since the Rowey plaintiffs claimed both "property damage" and "bodily injury," however, the duty to defend will attach as long as either the claim of "property damage" or "bodily injury" is sufficient to bring the case "potentially with the risk coverage of the policy."
Accordingly, this Court agrees with Travelers' reading of National Union's insurance policies and finds that, for the purpose of determining whether National Union owes a duty to defend, the date of the "occurrence" is immaterial because, even though the timing of the "occurrence" matters with regard to "property damage" under certain circumstances, the policies do not place any temporal restrictions on "bodily injury" other than that they be sustained during the policy period. This Court finds, therefore, that whether National Union owes CFS a duty to defend depends on whether the Rowey plaintiffs' alleged "bodily injury" could have been sustained during the period of time covered by the National Union policies.
National Union contends, however, that regardless of whether the Rowey plaintiffs sustained "bodily injury" or "property damage" during the period of National Union's coverage, these alleged injuries are resulting damages, not the actual injury suffered when parents adopt relying on the negligent misrepresentations of an adoption agency. Analogizing the present cause of action to a cause of action for wrongful birth, National Union contends that the actual injury is "that the parents were denied the opportunity to make a meaningful decision about whether to adopt a child and as a result have taken on an economic (and emotional) obligation to rear a child" whom they might not have adopted had they been fully informed. (National Union's Objection to Travelers' Mot. for Partial Summ. J. 10.) Accordingly, National Union maintains that the Rowey plaintiffs' "injury" could not have been sustained later than the date of adoption, when the Roweys relied on CFS's negligent misrepresentation. National Union asserts, therefore, that it has no obligation to defend CFS. This Court disagrees.
National Union's argument finds its origin in case law regarding the timing of the "occurrence." See Bartholomew,
This Court finds that the Rowey plaintiffs' complaint alleges that as a result of CFS's negligent misrepresentation — an "occurrence" — they suffered "bodily injury" which, as plead, may have been sustained during the coverage periods of the six remaining policies by which National Union insured CFS. Ergo, this Court is satisfied that the Rowey plaintiffs' complaint meets the requirements of the "pleadings test," thereby subjecting National Union to a duty to defend.
Counsel shall confer and submit to this Court forthwith for entry an agreed upon form of order and judgment that is consistent with this Decision.
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