CLARENDON NATIONAL INSURANCE COMPANY, Plaintiff, Appellant, v. PHILADELPHIA INDEMNITY INSURANCE COMPANY, Defendant, Appellee.
No. 19-1212
United States Court of Appeals For the First Circuit
April 1, 2020
Torruella, Lynch, and Kayatta, Circuit Judges.
APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MASSACHUSETTS [Hon. Leo T. Sorokin, U.S. District Judge]
David W. Zizik, with whom Sulloway & Hollis PLLC was on brief, for appellee.
TORRUELLA, Circuit Judge.
In this diversity case, Clarendon National Insurance Company (“Clarendon“) appeals the district court‘s entry of summary judgment against its claim that Philadelphia Indemnity Insurance Company (“Philadelphia“) breached its contract with Lundgren Management Group, Inc. (“Lundgren“) when Philadelphia declined to tender a defense to Lundgren, whom Philadelphia had insured from 2007 to 2008. Lundgren had assigned these claims to Clarendon. The district court determined that because the property damage allegations were excluded by the prior policy period exclusion, the complaint did not give rise to a duty to defend. Furthermore, Clarendon challenges the summary dismissal of its additional claims for contribution and alleged violations of Massachusetts General Laws, chapters 93A and 176D, which the district court concluded should also be dismissed because they were premised on the incorrect notion that Philadelphia had breached its duty to defend. After careful consideration, we affirm.
I. Background
A. Factual Background
Clarendon, a New York corporation, provided indemnity insurance to Lundgren, a building management corporation, from June 24, 2004, to June 24, 2005. Subsequently, Philadelphia, a Pennsylvania corporation, provided insurance for Lundgren from
b. This insurance applies to “bodily injury” and “property damage” only if:
. . . .
(3) Prior to the policy period, no insured listed . . . and no “employee” authorized by you to give or receive notice of an “occurrence” or claim, knew that the “bodily injury” or “property damage” had occurred, in whole or in part. If such a listed insured or authorized “employee” knew, prior to the policy period, that the “bodily injury” or “property damage” occurred, then any continuation, change or resumption of such “bodily injury” or “property damage” during or after the policy period will be deemed to have been known prior to the policy period.
On February 12, 2009, Denise Doherty (“Doherty“), a resident in a Lundgren-managed building, filed a complaint in the Superior Court for Suffolk County, Massachusetts, against the Admirals Flagship Condominium Trust (“Admirals“), certain named trustees of Admirals, Lundgren, and Construction by Design, LTD (“CBD“). In the complaint, Doherty asserted negligence claims against Lundgren stemming from alleged water infiltration into her condominium. On April 29, 2009, Doherty filed an amended complaint that proffered new factual information and asserted additional claims of misrepresentation, nuisance, trespass, and breach of contract under Massachusetts law (“the Underlying Complaint“).
On March 10, 2006, Gordon Mycology Laboratory, Inc., hired by Lundgren to conduct mold testing, “issued a report disclosing the presence of hazardous mold in unsafe levels in [Doherty‘s] unit caused by water intrusions and chronic dampness.” Doherty complained that although Lundgren had assured her that the mold problem would be resolved, the cleanup was “ineffectual.” According to Doherty, “Lundgren . . . promised [her] that [CBD] would stop the leaks into the unit but it [did] not [do] so.” On
Doherty alleged that she suffered damages as a result of the defendants’ actions, including adverse health effects, loss of personal belongings, loss of her home, loss of value to her condominium unit, and loss of income.
On June 30, 2009, shortly after the Underlying Complaint was filed, Lundgren tendered the defense of the Underlying Complaint to Philadelphia. In a letter dated July 24, 2009, Philadelphia denied coverage. It stated that “there are no allegations in the complaint that occurred within our policy period.” In addition, it stated that the “damages sought in this matter pertain to exposure to mold,” yet, “the policy specifically excludes ‘property damage’ . . . and any damages that result from ‘fungi’ as defined in the policy”1 (hereinafter the “mold exclusion“). Clarendon, on the other hand, financed the defense of Lundgren with a Reservation of Rights to exclude mold and fungus damage.
B. Procedural Background
On November 29, 2017, Clarendon filed suit against Philadelphia in the Superior Court for Suffolk County, Massachusetts, based upon Philadelphia‘s denial of coverage to Lundgren. Clarendon brought three claims: “Contribution” (Count I), “Breach of Contract” (Count II), and “93A/176D Violations” (Count III). In essence, Clarendon‘s complaint stated that Philadelphia breached its contract with Lundgren when it “improperly denied coverage for defense and indemnity,” failed to contribute “its pro rata share for either coverage,” and “failed to investigate the matter.” On December 21, 2017, Philadelphia removed the case to the United States District Court for the
The parties agreed to discovery in phases. Discovery Phase I was for the purpose of collecting information related to Philadelphia‘s duty to defend Lundgren, and later phases were scheduled for remaining issues in the case. On May 21, 2018, Philadelphia served its Rule 26(a)(1) initial disclosures on Clarendon. Clarendon did not provide its initial disclosures and did not conduct any discovery. Philadelphia then filed a motion for summary judgment on July 2, 2018, which Clarendon opposed. On January 8, 2019, the district court granted summary judgment for Philadelphia on all claims. Clarendon Nat‘l Ins. Co. v. Phila. Indem. Ins. Co., No. 17-12541, 2019 WL 134614, at *4 (D. Mass. Jan. 8, 2019). Regarding the breach of contract claim -- which was premised on the allegations that Philadelphia breached its contract with Lundgren when it “improperly denied coverage for defense and indemnity” -- the court noted that Philadelphia‘s policy only covered damages caused by “bodily injury” or “property damage” that occurred during the policy period, and that did not result from the “continuation, change or resumption” of “bodily injury” or “property damage” “deemed to have been known prior to the policy period.” Id. at *3 (citation omitted). The court further noted that the Underlying Complaint alleged damages that began in 2004, “well before the beginning of Philadelphia‘s policy
The court also rejected Clarendon‘s contention that the Underlying Complaint could be read to suggest that the original leaks arising prior to the policy period were adequately repaired and “new leaks” had arisen during the period of Philadelphia‘s policy, reasoning that the Underlying Complaint clearly states that “the leaks and resulting problems were continuous throughout the relevant period,” and “Philadelphia‘s policy also excludes coverage for damage that resumes during the policy period if the damage began and was known before the period.” Id. Furthermore, the court noted that the Underlying Complaint “does not allege that Lundgren‘s repair efforts were ever successful at abating the leaks entirely, [or] even temporarily, such that leaks occurring during the policy period could have been considered new leaks.” Id. The court concluded that, because the Underlying Complaint did not contain allegations “‘reasonably susceptible of an interpretation that they state’ a claim covered by Philadelphia‘s policy,” Philadelphia did not have a duty to defend or indemnify its insured and, thus, Clarendon‘s breach of contract claim failed. Id. at *4 (quoting Cont‘l Cas. Co. v. Gilbane Bldg. Co., 461 N.E.2d 209, 212 (Mass. 1984)).
On January 17, 2019, Clarendon moved for reconsideration, which the district court denied on January 24, 2019. Clarendon Nat‘l Ins. Co. v. Phila. Indem. Ins. Co., No. 17-12541, 2019 WL 319993, at *2 (D. Mass. Jan. 24, 2019). Thereafter, on February 25, 2019, Clarendon filed a timely notice of appeal.2
II. Discussion
We review a district court‘s grant of summary judgment de novo, construing the record in the light most favorable to the nonmovant and resolving all reasonable inferences in that party‘s favor. Ocasio-Hernandez v. Fortuno-Burset, 777 F.3d 1, 4 (1st Cir.
A. Duty to Defend
On appeal, Clarendon argues that the district court erred in its interpretation of Massachusetts law and its dismissal of Clarendon‘s breach of contract claim, which Clarendon contends was premised on the alleged breach of Philadelphia‘s duty to defend Lundgren. Specifically, citing Metropolitan Property and Casualty Insurance Company v. Morrison, 951 N.E.2d 662 (Mass. 2011) (“Metropolitan“), Clarendon posits that under Massachusetts law,
In support of the contention that the Underlying Complaint is reasonably susceptible to an interpretation entailing coverage, Clarendon argues that the Underlying Complaint specifies the date for only one leak: a “leak near a roofline,” which occurred “in 2004.” It emphasizes that there is no “specific information as to the time and the location of other leaks,” and that the Underlying Complaint fails to provide information about “when each leak occurred, what measures were taken to repair them, and whether any of the repairs were effective.” Thus, in Clarendon‘s view, the Underlying Complaint‘s assertion of “several leaks” suggests that there were multiple issues over time. Accordingly, this assertion is reasonably susceptible to an interpretation in which “a new leak occurr[ed] during
In addition, Clarendon posits that Philadelphia, as an insurer, had an independent duty to investigate the “claim or loss” regardless of the language in the Underlying Complaint. To comply with that duty, Clarendon asserts that Philadelphia should have “take[n] steps to obtain a copy of the [original] complaint” and should have “sp[oken] to its insured.” According to Clarendon, Philadelphia‘s failure to investigate, to file an interpleader action, and to draw inferences in favor of the insured, together warrant a “remand[] in its entirety” because each of those failures amounts to a breach of the duty to defend.
Finally, Clarendon argues that Philadelphia should be estopped from denying coverage by relying on the “known loss” justification -- the policy provision establishing that damages occurring during the policy period are not covered if they result from the “continuation, change or resumption,” of damages known prior to the policy period -- because, according to Clarendon, Philadelphia did not rely on those grounds to deny coverage in 2009 when it initially considered Lundgren‘s claim. Clarendon
The parties agree that Massachusetts law governs. Under Massachusetts law, an insurer‘s duty to defend “is determined based on the facts alleged in the complaint, and on facts known or readily knowable by the insurer that may aid in its interpretation of the allegations in the complaint.” Metropolitan, 936 N.E.2d at 667; Bos. Symphony Orchestra, Inc. v. Commercial Union Ins. Co., 545 N.E.2d 1156, 1160 (Mass. 1989). To establish an insurer‘s duty to defend and investigate allegations against an insured, a plaintiff must demonstrate that the “allegations in [the underlying complaint] are reasonably susceptible of an interpretation that states or roughly sketches a claim covered by the policy terms.” Metropolitan, 951 N.E.2d at 667 (quoting Billings, 936 N.E.2d at 414). The underlying complaint need not “unequivocally make out a claim within the coverage,” but rather, “need only show, through general allegations, a possibility that the liability claim falls within the insurance coverage,”
However, where the allegations within the underlying complaint “lie expressly outside the policy coverage and its purpose,” an insurer is relieved of its duty to defend and investigate. Metropolitan, 951 N.E.2d at 668 (quoting Herbert A. Sullivan, Inc. v. Utica Mut. Ins. Co., 788 N.E.2d 522, 531 (Mass. 2003)). Additionally, “[e]ven where the allegations in the complaint state or roughly sketch a claim covered by” an insured‘s policy, no duty to defend and investigate arises if “there is ‘undisputed, readily knowable, and publicly available information’ in court records that demonstrates that the insurer has no duty to
A close read of the Underlying Complaint and the record shows that the district court did not err by granting summary judgment for Philadelphia on the duty to defend issue. Examined according to Massachusetts law, the allegations in the Underlying Complaint are not “reasonably susceptible of an interpretation that states or roughly sketches a claim covered” by Philadelphia‘s policy. Metropolitan, 951 N.E.2d at 667 (quoting Billings, 936 N.E.2d at 414). The parties do not dispute that Philadelphia‘s policy expressly excludes coverage for property damage known prior to Philadelphia‘s period of coverage. To establish that the Underlying Complaint “roughly sketches” a potentially covered event, Clarendon points to small differences in grammatical structure between paragraphs and ambiguities arising from missing information about the time and place of various leaks. Neither of these assertions give rise to a rough sketch of a covered claim.
Notes
Any person who engages in the conduct of any trade or commerce and who suffers any loss of money or property, real or personal, as a result of the use or employment by another person who engages in any trade or commerce of an unfair method of competition or an unfair or deceptive act or practice declared unlawful by section two or by any rule or regulation issued under paragraph (c) of section two may, as hereinafter provided, bring an action in the superior court . . . whether by way of original complaint, counterclaim, cross-claim or third-party action for damages and such equitable relief, including an injunction, as the court deems to be necessary and proper.
