Madelaine Chocolate Novelties, Inc. v. Great Northern Insurance Company
1:15-cv-05830
E.D.N.YJul 19, 2019Background
- Madelaine Chocolate sustained extensive building, inventory, and business-income losses from Superstorm Sandy (Oct. 29, 2012) and submitted a proof of loss > $53M; Great Northern paid ≈ $4M and denied the remainder under the Policy's Flood Exclusion.
- The Policy is an "all-risks" commercial property policy with coverage for direct physical loss by a "peril not otherwise excluded" and business-income coverage "caused by or resulting from" covered peril loss.
- The Policy includes a Flood Exclusion containing an anti-concurrent-causation (ACC) clause excluding loss caused by flood "regardless of any other cause ... that contributes concurrently to ... the loss."
- A Windstorm Endorsement (simultaneously executed) defines "windstorm" to include wind-driven rain and contains its own ACC clause, plus higher windstorm deductible and longer waiting period for business income losses.
- On prior appeal the Second Circuit held the Windstorm Endorsement adds an ACC clause to the definition of a covered peril for the entire Policy and remanded to assess whether that creates a conflict/ambiguity with the Flood Exclusion.
- On remand the district court found the Policy ambiguous as to whether wind-caused losses are covered when a flood concurrently contributes, and held extrinsic evidence raises triable issues of fact; denied both parties’ summary-judgment motions.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does the Windstorm Definition (with ACC clause) apply to the Policy’s coverage grants (i.e., to "peril"/"covered peril")? | Windstorm is a "covered peril," so its definition (including ACC) is incorporated into coverage grants. | Windstorm definition applies only where the term "windstorm" appears; it does not alter general coverage grants. | Court: Windstorm Definition applies to the Policy generally, including where "peril/covered peril" is used. |
| Does applying the Windstorm ACC clause create a conflict or ambiguity with the Flood Exclusion’s ACC clause? | Windstorm ACC supersedes or renders Flood Exclusion inapplicable; any ambiguity must be resolved for insured. | The Flood Exclusion unambiguously bars coverage; no ambiguity exists. | Court: Application creates a genuine ambiguity—"dueling" ACC clauses and other policy language can be reasonably read two ways. |
| If ambiguous, can the court resolve the ambiguity as a matter of law (contra proferentem)? | The endorsement controls; ambiguity should be resolved for the insured as a matter of law. | Even if ambiguous, extrinsic evidence establishes the parties’ intent favoring insurer. | Court: Ambiguity cannot be resolved as a matter of law; extrinsic evidence creates triable factual disputes. |
| Did the Windstorm Endorsement "supersede" the Flood Exclusion because it was an endorsement? | Yes—endorsement language controls conflicting printed terms. | No—the endorsement was not separately negotiated and was incorporated simultaneously; it does not automatically supersede. | Court: Endorsement did not supersede the exclusion as a matter of law because it was not shown to be separately negotiated. |
Key Cases Cited
- Tolan v. Cotton, 572 U.S. 650 (discussing summary-judgment standard and drawing inferences for nonmovant)
- Andy Warhol Foundation for Visual Arts, Inc. v. Federal Ins. Co., 189 F.3d 208 (2d Cir. 1999) (ambiguous policy language permits resort to extrinsic evidence)
- Wards Co., Inc. v. Stamford Riveway Assocs., 761 F.2d 117 (2d Cir. 1985) (ambiguity requires that provisions be "susceptible of at least two fairly reasonable meanings")
- U.S. Fidelity & Guaranty Co. v. Fendi Adele S.R.L., 823 F.3d 146 (2d Cir. 2016) (court must give fair meaning to all policy language and avoid rendering clauses meaningless)
- Beazley Ins. Co., Inc. v. ACE American Ins. Co., 880 F.3d 64 (2d Cir. 2018) (exclusions must be clear and unmistakable; construed narrowly)
