Mary Pat Rooks, a registered nurse, purchased professional liability insurance from American Casualty Co. of Reading, Pennsylvania (ACC) with a policy limit of $1 million per occurrence. She also qualified as an insured under a policy issued by Health Care Indemnity, Inc. (HCI) to her employer with a limit of $10 million per occurrence. In May 2004 she was named as a defendant in a wrongful-death action filed in Oklahoma state court, and she sought сoverage under both policies. This litigation concerns the apportionment of liability between the two insurers.
That apportionment depends on the nature of the two policies. The pertinent definitions were provided by the Oklahoma Supreme Court in
Equity Mutual Insurance Co. v. Spring Valley Wholesale Nursery,
Primary coverage is provided when, under the terms of the policy, the insurer is liable without regard to any other insurance coverage available. Excess coverage or secondary coverage is provided when, under the terms of the policy, the insurer is liable for a loss only after any primary coverage — other insurance — has been exhausted.... An escape clause, also known as a no liability clause, disclaims any and all liability if other insurance is available.
(footnotes omitted). The district court held that both policies provided excess coverage to Ms. Rooks for professional liability, and that the ACC policy did not have an escape clause. Applying the doctrine of equitable contribution, the court ruled that each insurer should pay its pro-rata share of both the underlying loss and the defense costs. We affirm, agreeing with the court’s characterization of the policies and the application of equitable contribution.
The ACC policy’s “Coverage Agreement” is what would be expected for primary coverage. It states:
We will pay all amounts up to the limit of liability which you become legally obligated to pay as a result of injury or damage. In addition to the limit of liability, we will also pay claim expenses. The injury or damage must be caused by a medical incident arising out of the supplying of, or failure to supply, professional services by you, or by anyone for whose professional acts or omissions you are legally responsible.
R. Vol. 1 at 32. The relevant “Limit of Liability” provision also reads as it would in a primаry policy:
Each Claim
The limit of liability stated on the certificate of insurance for each claim is the limit of our liability for all injury or damage arising out of, or in connection with, the same or related medical incident.
Id. at 37. So does the “Defense and Settlement” clause:
We have the right and will defend any claim. We will:
A. do this even if any of the charges of the claim are groundless, false or fraudulent; and
B. investigate and settle any claim, as we feel appropriate.
Our payment of the limit of liability ends our duty to defend or settle. We have no duty to defend any claims not covered by this policy.
Id. at 34. The “Other Insurance” clause, however, which precedes the above policy provisions, limits coverage when other insurance applies:
Any loss resulting from any claim insured under any other insurance policy or risk transfer instrument, including but not limited to, self-insured retentions, deductibles, or other alternative arrangements, which applies to this loss, shall bе paid first by those instruments, policies or other arrangements. This insurance will not serve as primary insurance where there is other applicable insurance. It is the intent of this policy to apply only to loss which is more than the total limit of all deductibles, limits of liability, self-insured amounts or other valid and collectible insurance or risk transfer arrangements, whether primary, contributory, excess, contingent, or otherwise. This insurance will not contribute with any other applicable insurance. In no event will we pay more than our limit of liability.
These provisions do not apply to other insurance policies or risk transfer arrangements written as specific excess insurance over the limits of liability of this policy.
Id. at 27.
The HCI policy’s “Insuring Agreements,” like ACC’s “Coverage Agreement,” suggests primary coverage:
[HCI] will pay on behalf of the insured all sums which the insured shall become legally obligated to pay as damages because of ... Injury ... to which the Policy applies, caused by an occurrence [that is, an act or omission arising out of the provision of health care services] during the policy period.
R. Vol. 2 at 242; see id. at 252-53 (defining occurrence). The provision also states that HCI “shall have the right and duty to defend any suit against the insured seeking such damages even if any of the allegations of the suit are groundless, false, or fraudulent.” Id. at 242. Unlike ACC’s limit-of-liability provision, however, the HCI “Limits of Liability” section includes language limiting coverage when there is other insurance:
[I]n any state or country where there exists a state fund or where other primary insurance has been purchased for purpose of providing compensation for patient injury and for which application has been made and for which coverаge is included in this policy, the limits of liability shall apply excess over any other valid and collectible insurance.
Id. at 248. The policy’s “Other Insurance” clause repeats the point:
If other insurance not afforded by the Company is available to any insured covering an occurrence also covered hereunder, the insurance afforded hereunder shall be excess of and not contribute with such other insurаnce. Amounts collectible under a self-insured trust plan or any other self-insured program are other insurance for the purposes of this policy. This Article VI, Paragraph 7, does not apply to excess insurance written specifically to be in excess of this policy. Nothing contained herein shall be construed to make this policy subject to terms, conditions, and limitations of any other insurance.
Id. at 255.
ACC and HCI disagreed аbout their respective obligations under their policies. ACC filed a declaratory-judgment action in
On cross-motions for summary judgment, the district court concluded that both policies provided excess coverage, that the other-insurance clauses in the policies were irreconcilable, and that the indemnity payments and defense costs must therefore “ ‘be shared on a pro rata basis according to the ratio each respective policy limit bears to the cumulative limit of all concurrent policies’ ” — that is, HCI is liable for 10/11 of defense costs and indemnity payments and ACC is liable for the remaining 1/11.
Id.
at 309-310 (quoting
Equity Mutual,
I. DISCUSSION
We review de novo the district court’s grant of summary judgment, applying the same legal standard that the district court was required to use.
See Carpenter v. Boeing Co.,
A. Proration of Liability
If two policies cover the same risk for the same insured, but neither provides primary coverage, “an excess clause controls over ... an escape clause ... and ... conflicting ‘other insurance’ clauses cancel each other,”
Equity Mutual,
The district court interpreted both the HCI and ACC policies as providing only excess coverage. There is no dispute on appeal that this is a proper description of the HCI policy. But HCI challenges that description of the ACC policy. It contends that ACC’s policy was a primary policy. It argues that unlike its policy, the only language in ACC’s policy that limits coverage when another policy applies is language “buried” in its other-insurance clause. Aplt. Br. at 11. Alternatively, it argues that the limiting language in the ACC policy is an escape clause. Following Oklahoma law regarding construction of insurance policies, we disagree.
“An insurance policy is to be treated as a contract and will be enforced according to its terms.”
Equity Mutual,
Applying these propositions to the ACC policy, we agree with the district court. The policy’s other-insurance clause states that any loss “shall be paid first” by other policies that apply to the loss, that it “will not serve as primary insurance where there is other applicable insurance,” and
We alsо are not persuaded by HCI’s contention that ACC’s other-insurance clause is an escape clause — that is, that it “disclaims any and all liability if other insurance is available.”
Equity Mutual,
In sum, both policies provide excess coverage. Accordingly, the other-insurance clauses must be “disregarded, with the loss shared by the insurers on a pro rata basis.”
Equity Mutual,
B. Proration of Defense Costs
The district court found that both ACC and HCI had contributed to Ms. Rooks’s defense costs and attorney fees— ACC had spent $134,578.43 and HCI $353,001.71. Recognizing that ACC had paid more than 3/11 of the total, the court entered a judgment for ACC in the amount of $90,252.96, so that the net payments by the parties would be in the same ratio as their liability limits.
HCI asserts that the district court erred in awarding the $90,252.96 judgment. It
Controlling precedent of this court, however, compels us to disagree. In
St. Paul Mercury Insurance Co. v. Underwriters at Lloyds of London, England,
HCI relies on two Tenth Circuit cases for thе proposition that defense costs cannot be apportioned. But in neither case did the two insurance policies cover the same insured at the same level for the same risk. In
United States Fidelity & Guaranty Co. v. Tri-State Insurance Co.,
Likewise, in
West American Insurance Co. v. Allstate Insurance Co.,
HCI also relies on authority from Oklahoma state courts. We are, of course, bound by declarations of state law in decisions of the state’s highest court.
See TMJ Implants, Inc. v. Aetna, Inc.,
The most recent opinion cited by HCI,
United Services Automobile Ass’n v. State Farm Fire & Casualty Co.,
However, in that case, the Supreme Court did not make a determination that the doctrine of equitable contribution is the law in Oklahoma. The law in Oklаhoma is set forth in Fidelity & Casualty Co. of New York v. Ohio Casualty Insurance Company, [482 P.2d 924 (Okla.1971)], wherein the Supreme Court held the duty of an insurance company to defend lawsuits against the insured is personal to each insurer, and that insurer is not entitled to divide the duty nor require contribution from another insurer, absent a specific contractual right.
USAA,
For two reasons we do not follow
USAA.
First, a decision by a state intermediate appellate court is not binding on us with respect to matters of state law,
see Occusafe, Inc. v. EG&G Rocky Flats, Inc.,
Second, with respect to the issue before us,
USAA
is unpersuasive.
Fidelity & Casualty,
Equitable contribution is the right to recover, not from a party primarily liable for the loss, but from a co-obligor or co-insurer who shares common liability with the party seeking contribution. The doctrine applies only when co-insurers have covered the same insured and the same particular risk at the same level of coverage. The right of contribution is not derivative of the rights of the insured, but belongs to each insurer independently to seek reimbursement from a co-insurer those sums which were paid in excess of an insurer’s proportionate share of the common obligation.
Id. At the least, we do not read the Oklahoma Supreme Court’s decision as undermining this court’s otherwise controlling precedent in St. Paul.
Both ACC and HCI insured Ms. Rooks for the same risk at the same level of coverage. Accordingly, we conclude that the district court properly applied the doctrine of equitable contribution to apportion defense costs.
II. CONCLUSION
We AFFIRM the district court’s judgment.
