The parties advance several assignments and cross-assignments of error. The dispositive issue, however, is whether the trial court erred when it admitted evidence with respect to the intent of the parties and permitted the jury to determine whether the parties intended that the defense costs incurred in the Ostrander case would be included as part of the self-insured retention of $250,000.00 under the Northbrook policy. Both parties argue, and we agree, that the construction and application of the Northbrook policy was an issue of law for the court, rather than one of fact for the jury. Thus, it was error to submit the issue of intent to the jury. Moreover, we agree with Cone that the Northbrook policy requires that Allstate reimburse Cone for legal expenses incurred in defense of the Ostrander litigation and, therefore, Cone’s motion for a directed verdict should have been granted. Because the jury answered the issue in Cone’s favor, however, Cone was not prejudiced by the error and we will not disturb the trial court’s judgment.
Under North Carolina law “the construction and application of the policy provisions to the undisputed facts is a question of law for the court.”
Walsh v. National Indemnity Co.,
There is no question that the Northbrook policy provided coverage for the Ostrander claim. The only question is whether the policy provided coverage for Cone’s defense costs. To determine that question, we must examine the Limitations of Liability provision and Ultimate Net Loss definition contained in the policy. The relevant portions of these provisions are as follows:
Limit OF Liability. The Company [Allstate] shall only be liable for the Ultimate Net Loss in excess of either [¶] A. The limits of the underlying Insurances as set out in the attached Schedule of Underlying Polices in respect of each Occurrence covered by said underlying insurances ....
Ultimate Net Loss. “Ultimate Net Loss” shall mean the total sum which the Insured, or the Insured’s underlying insurance as scheduled, or both, become obligated to pay by reason of Personal Injuries ... either through adjudication or compromise, and shall also include expenses consisting of: hospital, medical and funeralcharges; all sums paid as salaries, wages, compensation, fees, charges and law costs, premiums on attachment or appeal bonds, interest, expenses for docotors [sic], lawyers, nurses, and investigators and other persons; litigation, settlement, adjustment and investigation of claims and suits which are paid as a consequence of any Occurrence covered hereunder.
In our view, the foregoing policy provisions are clear and unambiguous. The term Ultimate Net Loss specifically includes all sums paid for legal expenses. In
Vesta Ins. Co. v. Amoco Production
Co.,
The Limit of Liability section determines what Allstate will be liable for under the Northbrook policy. This section provides that Allstate is liable only for the Ultimate Net Loss in excess of the limits of the policies set out in the “Schedule of Underlying Policies.” The underlying schedule lists Cone’s SIR of $250,000.00 and the Am Re policy for $250,000.00. In essence, this provision provides a floor, or level, at which Allstate’s excess coverage begins. The floor is determined according to the schedule of underlying policies. Accordingly, Allstate is liable for the Ultimate Net Loss which exceeds Cone’s SIR and Am Re’s policy. Once Cone tendered the limits of its SIR and Am Re tendered the limits of its coverage toward the settlement, Allstate became liable for the Ultimate Net Loss in excess of the amounts tendered. In other words, Allstate is liable for the Ultimate Net Loss above the $250,000.00 tendered for settlement by Cone and the $250,000.00 tendered for settlement by Am Re. Since we have already determined that Ultimate Net Loss includes all defense related costs, Allstate is clearly liable for the Ostrander defense costs under the Northbrook policy.
Allstate, however, posits three arguments to escape liability for the Ostrander defense costs. We conclude that none of these arguments are reasonable interpretations of the Northbrook policy. Under the interpretations urged by Allstate, Cone would pay in excess of $750,000.00, over three times the limit of its SIR, on the Ostrander claim. Given the fact that the definition of Ultimate Net Loss, as contained in the policy, explicitly includes defense costs, Allstate’s position is unreasonable. Moreover, its interpretations of the Northbrook policy are not supported by North Carolina case law.
First, Allstate asserts that, because of its status as an excess carrier, it is under no obligation to pay Cone’s defense costs from the Ostrander claim. Allstate maintains that the law of primary and excess insurance carriers requires the primary carrier to pre sent the defense and pay for all costs associated with such defense without reimbursement from the excess carrier. This argument fails because Allstate’s relationship with Cone is not one of excess carrier to primary carrier.
The question of whether a self-insured retention is the equivalent of primary insurance, as argued by Allstate, is addressed in
Wake County Hosp. System v. National Cas. Co.,
Additional support for this position exists. “[Insurance has been defined as a contract through which one party indemnifies another against loss due to certain specified contingencies, but the term ‘self-insurance’ has no
Second, Allstate maintains that its policy did not attach until the time of settlement, when the limits of Cone’s SIR and Am Re’s coverage were exhausted, and, therefore, it could not be liable for defense costs incurred by Cone up to that point. We disagree. Under the provisions of Allstate’s policy, it is liable for the Ultimate Net Loss in excess of the underlying Am Re policy and Cone’s SIR. The Allstate policy contains no time limitation within which expenses covered under the definition of Ultimate Net Loss must be incurred. Moreover, the Allstate policy allows Cone one year within which to make written demand on Allstate for reimbursement of those expenditures covered under Ultimate Net Loss.
The various terms of an insurance policy are to be harmoniously construed, and if possible, every word and every provision is to be given effect. All clauses of the policy are to be construed, if possible, so as to bring them into harmony.
Trust Co.,
Allstate mistakenly relies on the case of
Harnischfeger Corp. v. Harbor Ins. Co.,
There is a fundamental difference in the present case. Here, the Northbrook policy did attach, because Allstate became liable on the Ostrander claim. This is the fundamental difference. If the Northbrook policy had not attached, Allstate would not be liable for any costs associated with the Ostrander claim. However, because the policy did attach, Allstate is liable for the Ultimate Net Loss in excess of the underlying insurances. This case would parallel Harnischfeger only if the Ostrander claim had not exceeded the limits of the Am Re policy. Since that is not the case, Harnischfeger does not support Allstate’s position.
Finally, Allstate claims that the Assistance & Cooperation Clause shows an intent for defense costs to be excluded from coverage. The Assistance and Cooperation clause states in part:
The Company shall not be called upon to assume charge of the settlement or defense of any claim made or suit brought or proceeding instituted against the Insured, but the Company shall have the right and shall be given the opportunity to associate with the Insured or the Insured’s underlyinginsurers, or both, in the defense and control of any claim, suit or proceeding relative to an Occurrence where the claim or suit involves, or appears reasonably likely to involve the Company.
This policy provision concerns whether Allstate will become involved in the actual defense of the claim itself. Allstate’s argument that this provision has been interpreted to exclude the excess carrier from the obligation to defend is correct, but irrelevant. Cone did not ask Allstate to provide a defense of the
Ostrander
suit. However, Allstate’s further contention that the Assistance & Cooperation Clause also relieves Allstate from the obligation to reimburse Cone for defense costs is incorrect. In
Institute of London Underwriters v. First Horizon,
Thus, we hold as a matter of law that the defense costs incurred by Cone in the Ostrander case are included in the calculation of the self-insured retention and that, as such, Allstate must indemnify Cone for these defense costs which total $501,374.34. All other assignments of error, with the exception of the assignment concerning the setoff, are moot since those assignments concern the issue of intent and the submission of that issue to the jury. Because the policy is unambiguous, the intent of the parties is irrelevant.
The last issue on appeal is whether the trial court erred in ruling that Allstate was entitled to a credit against the judgment for the $27,500.00 which Cone received from Am Re and by entering judgment for Cone less $27,500.00. Cone contends that the $27,500.00 which it received pursuant to settlement with Am Re should not be credited to reduce the judgment' it received from Allstate since it and Am Re are not joint tortfeasors.
In
Duke University v. St. Paul Mercury Ins. Co.,
[Defendant in an action for breach of contract is entitled to show any matters which go to reduce the amount of loss actually suffered by plaintiff, provided such matters have a proximate relation to the contract .... Payment of compensation ... to plaintiff by a third party on the same cause of action, or partial satisfaction from a third person against whom a claim for damages is made with respect to the same subject matter may be shown in reduction of damages for breach of contract.
Id.
at 681,
Cone argues that Allstate offered no proof at trial that the Am Re payments were in settlement for Cone’s action for declaratory judgment for defense costs. However, Cone’s attorneys admitted to the trial judge on the record that the $27,500.00 settlement with Am Re was for attorney’s fees. Thus, the trial court correctly reduced the judgment against defendant to prevent Cone from obtaining a double recovery.
In summary, we hold that the trial court erred when it submitted the issue of intent of the parties to the insurance contract to the jury because the contract was unambiguous and should have been interpreted as a matter of law to require Allstate to provide coverage for the legal expenses incurred by Cone in defense of the
Ostrander
suit. However, the error was rendered harmless by the jury’s verdict and the entry of judgment
Affirmed.
