205 F.3d 253 | 5th Cir. | 2000
In this diversity case, Defendant-Appellant Azrock Industries Inc. (“Azrock”) appeals from the district court’s grant of summary judgment to Plaintiff-Appellee Guaranty National Insurance Co. (“Guaranty National”). We must decide what event triggers an insurer’s duty to defend its insured against asbestos-related personal injury claims under a Commercial General Liability (“CGL”) policy, here, one
I.
Facts and Proceeding
From the 1930s to the early 1980s, Azrock manufactured floor tiles containing asbestos fibers. Between January 1989 and March 1998, Azrock was sued in at least thirty-three separate actions for personal injuries allegedly caused by exposure to asbestos; and was sued in one case by a governmental entity for property damage from asbestos installation. Faced with the costs of litigation and the potential for substantial liability, Azrock turned to its liability insurance providers for defense and indemnity.
Azrock had no general liability insurance from 1930 to 1958. From 1958 to 1983, Azrock’s primary CGL insurance provider was Employers Casualty Company (“Employers”). Employers became insolvent and was placed in receivership by the state of Texas in 1994. From 1983 to 1985, Azrock’s primary CGL insurance provider was Western Employers Insurance Company (“Western”). Western also became insolvent and was placed in receivership in 1991. From 1986 to 1991, Azrock’s CGL policies were issued by Kemper and Reb-anee; but those policies contained asbestos exclusion provisions on the basis of which both insurers denied coverage for the underlying asbestos-related claims.
For the period of July 1, 1985 through June 30, 1986, Azrock’s primary CGL coverage was provided by National American Insurance Company of New York (“NAIC”). For that same twelve-months period, Azrock was covered by an umbrella (excess) liability policy issued by Guaranty National, covering personal injury, property daiftage, and advertising liability. NAIC, as the primary carrier, undertook the defense of Azrock until 1996, when that insurer notified Guaranty National that its policy limit had been exhausted, Subsequently, Azrock formally demanded that Guaranty National, as the umbrella carrier, take over the defense of the lawsuit and indemnify it on any ultimate liabilities.
In response to Azrock’s formal demand, Guaranty National assumed the defense of the underlying claims, but, early in 1997, filed this declaratory judgment action in federal district court, seeking to establish that it had no duty to defend Azrock in the underlying lawsuits. Later that year, Guaranty National filed a motion for partial summary judgment grounded on the assertion that it had no duty to defend Azrock. The following March, the district court granted Guaranty National’s motion, declaring that as a matter of law it had no duty to defend Azrock in the underlying asbestos claims. In so ruling, the district court applied a “manifestation theory” of triggerage for continuous bodily injury claims. It noted that none of the plaintiffs in the underlying suits had alleged that their illnesses became identifiable during the term of the Guaranty National policy; accordingly, there was no “occurrence” during the coverage period within the meaning of the policy. Therefore, reasoned the district court, Guaranty National had no duty to defend the suits and thus no duty to indemnify Azrock in the underlying claims. Azrock appealed.
II.
Analysis
A. Standards of Review
This appeal arises from the grant of summary judgment to Guaranty National. The district court applied Texas law to hold that coverage under the Guaranty National policy was not triggered by any of the underlying lawsuits; thus, as a matter of law, Guaranty National had no duty to defend (and consequently no duty to indemnify) Azrock in those lawsuits. We review the district court’s grant of sum
B. Jurisdiction and Choice of Law
Guaranty National filed this federal court declaratory judgment suit in the Southern District of Texas on the basis of diversity of citizenship: Guaranty National is a Colorado corporation with its principle place of business in Englewood, California; Azrock is a Delaware corporation with its principle place of business in Houston, Texas. Federal district courts sitting in diversity apply the law and the choice’ of law rules of the forum state.
C. Constmcbion of Insurance Policies
In reaching the conclusion that, as a matter of law, Guaranty National had no duty to defend and, accordingly, no duty to indemnify Azrock in various underlying claims for damages resulting from asbestos exposure, the district court examined only the insurance policy and the underlying complaints, applying the so-called “eight-corners” rule. Under this maxim, an insurer’s duty to defend is determined by reference to the allegations in the pleadings and the language of the insurance policy only.
The duty to defend is broader than the duty to indemnify.
Generally, insurance policies are subject to the same rules of interpretation as other contracts.
The district court in this case determined that the insurance contract was not ambiguous and purported to interpret the policy language according to its plain meaning. We conclude, however, that the policy provisions, in particular the terms “occurrence” and “bodily injury,” are susceptible of more than one reasonable interpretation in the progressive disease context, and are therefore ambiguous as a matter of law. Consequently, Texas law requires that we resolve those ambiguities in favor of Azrock. A cumulative, progressive disease does not fit any of the disease or accident situations that the CGL policy typically covers.
The Guaranty National policy issued to Azrock provides that the insurance company will “pay on behalf of the insured all sums which the insured shall be legally obligated to pay as ultimate net loss because of (A) Personal Injury, (B) Property Damage, or (C) Advertising Liability caused by an occurrence during the policy period ...” (emphasis added). The policy defines “occurrence” as
an accident, or a happening or event, or a continuous or repeated exposure to conditions which unexpectedly or unintentionally results in personal injury, property damage or advertising liability. All such exposure to substantially the same general conditions existing at or emanating from one premises location shall be deemed one occurrence.
In defining “personal injury,” the policy lists numerous types of injurious events, such as false arrest, wrongful entry, libel, slander, and the like, including “bodily injury.” In contrast, the policy specifically defines “property damage” as
(a) 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 (b) 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.
We agree with the district court’s construction of the policy to the extent the court determined that “occurrence during the policy period” requires that the actual “injury,” not merely the negligent act or omission that causes the injury, must happen during the policy period. Where we part ways with that court is in defining the relevant “injury.” The district court defined “injury” as the date an asbestos-related condition or disease manifests or becomes identifiable. In granting summary judgment, the court looked to the date of diagnosis alleged in the underlying complaints and equated “manifestation” with that date. As the court found no complaints that contained allegations of a date of diagnosis within the one-year policy period, it held that the duty to defend was not triggered in any of the suits. By contrast, we define “injury” as the subclinical tissue damage that occurs on inhalation of asbestos fibers, contingent, however, on Azrock’s introduction of medical evidence establishing that fact. In remanding this case, we instruct the district court to examine each underlying complaint for allegations of exposure during the policy period, approximated by alleged dates of employment involving work with Azrock’s products, to determine whether the duty to defend is triggered.
As noted above, these precise policy provisions, or essentially identical versions in earlier uniform CGL policies, have been interpreted by numerous courts in the latent disease context, and four main theories of triggerage of coverage have evolved. Unfortunately, construction of the exact terms, under different sets of facts, against the backdrop of the contra proferentem doctrine, has resulted in irreconcilable holdings.
1. Manifestation Theory:
Here, the district court held that, according to Texas law, coverage in instances of progressive diseases is triggered when the condition “manifests.” According to this theory, the term “occurrence” in the CGL policy means the time when the condition, such as asbestosis or lung cancer, becomes clinically evident, identifiable, or diagnosable. The date of “manifestation” is usually equated with the date of diagnosis by a physician or the date a claimant experiences symptoms that impair his sense of well-being.
2. Exposure Theory:
Interpreting such policy language under Louisiana law, we have previously held that coverage under a CGL policy is triggered at the time the claimant is initially exposed to the injury-causing agent.
3.Continuous or “Triple” Trigger Theory:
In this appeal, Azrock asks us to hold that coverage is triggered continuously, from the initial exposure to asbestos to the manifestation of a disease. Some courts refer to this theory as the “triple trigger” theory because the policy is triggered by (1) inhalation exposure, (2) “exposure in residence,” and (3) manifestation.
4. Injury-in-Fact Theory:
The final theory of coverage triggering in continuous exposure cases is the “injury-in-fact” theory, according to which
insurance obligations under the CGL policy arise when real injury occurs during the policy period. Real injury need not have been compensable or diagnosable during the policy period if its existence during that period can be proved in retrospect.... [T]he central issue is when injury actually occurred. Injury need not be manifest, but it must exist in fact.24
The challenge in adopting the injury-in-fact approach is that, in each case of an individual suing a manufacturer, a “mini-trial” must be held to determine “at what point the build-up of asbestos in the plaintiffs lungs resulted in the body’s defenses being overwhelmed. At that point, asbestosis could truly be said to ‘occur.’ ”
As Texas courts have not squarely addressed the issue of the trigger of coverage in progressive disease cases, we must make an Erie guess on this aspect of Texas law.
The district court, in adopting the manifestation theory, relied by analogy on Fifth Circuit and Texas cases involving coverage for non-bodily injury. The court declined to distinguish the 'property damage context from the personal injury context on the rationale that the policy language itself made no such distinction. Citing three cases involving non-bodily injury from continuous exposure,
In the second case, American Home Assurance Co. v. Unitramp Ltd.,
The third case relied on by the district court was a Texas Court of Appeals decision, Dorchester Development Corp. v. Safeco Insurance Co.,
Guaranty National, in its brief, relies on an unpublished Texas Court of Appeals decision, Aetna Casualty and Surety Co. v. Naran,
We agree that such a distinction is relevant. Federal district courts applying Texas law in the progressive disease context have distinguished between property damage cases, in which “manifestation” of injury triggers coverage, and bodily injury cases, in which coverage is triggered by exposure or injury-in-fact.
Only one federal circuit court has adopted the manifestation trigger for progressive disease cases. The First Circuit, in Eagle-Picher Industries, Inc. v. Liberty Mutual Insurance Co.,
In granting summary judgment, the district court in the instant case relied on the dates of diagnosis of asbestos, carcinoma, or other conditions alleged by the claimants, as a proxy for the date their harm became “manifest” or “identifiable,” and concluded that none of the complaints contained an allegation of a diagnosis during the one-year policy period. Therefore, reasoned the court, under the eight-corners rule, none of the claims was covered. We cannot agree with the district court that the meaning of “injury” in the CGL policy is best understood as the date of diagnosis. To do so would require us to rely on a fiction that suggests a person is “injured” on the date he decides, for whatever reason, to go to the doctor about a condition. “No doctor would say that asbestosis occurred when it was discovered.”
As to the one underlying complaint alleging property damage,
Having rejected the manifestation trigger, we next must decide which other theory of triggerage should be applied to the remaining personal injury claims and what additional record facts may be required before the duty to defend is triggered. In applying the eight-corners rule, the district court dismissed the case on the strength of the pleadings and the policy only, holding that none of the underlying complaints alleged a covered claim. The record on appeal contains no medical evidence or expert testimony regarding the disease process that results from asbestos exposure. Irrespective of which trigger of coverage theory we adopt, the posture of the
Azrock urges us to adopt the so-called continuous or “triple” trigger, asserting that it is a reasonable interpretation of the policy language and that under the contra proferentem doctrine we should defer to the interpretation they propose. The obvious advantage of the triple-trigger theory to an insured is that it maximizes coverage and requires little or no individual proof of injury. Under this theory, the duty to defend is triggered if the plaintiff has alleged that he was exposed, was diagnosed or developed identifiable symptoms, or has yet to develop an identifiable condition as a result of exposure at an earlier time. Under this theory, Guaranty National would be required to defend Azrock in each of the underlying claims.
We acknowledge that Texas law requires us to construe ambiguous policy terms in favor of the insured, but we are not required blindly to adopt the interpretation profferred by the insured, especially if we perceive such an interpretation to be an unreasonable construction of the policy terms or to be unsupported in law. To adopt the continuous trigger approach, we would have to interpret the term “bodily injury” in the policy as encompassing three distinct events: (1) inhalation exposure, (2) exposure in residence, and (3) manifestation or diagnosis. Azrock would be required to introduce medical evidence that exposure begins an injurious process that persists until manifestation.
We decline to adopt the continuous trigger theory as the best Erie guess of what the highest Texas court would do if squarely faced with this issue. No Texas court has ever adopted or implicitly endorsed the continuous trigger theory. The three federal district court opinions construing Texas law and applying the continuous trigger theory to which Azrock directs us are of limited precedential value to our decision. In Mustang Tractor & Equipment Co. v. Liberty Mutual Insurance Co.,
Azrock has not presented adequate support for its proffered theory to convince us that if a Texas court were faced squarely with the issue of the trigger of coverage in
In arguing that we should reject the manifestation theory applied by the district court, however, Azrock correctly observes that we have twice adopted the “exposure” theory of triggerage when making an Erie guess on Louisiana law. Porter v. American Optical Corp.,
We reaffirmed Porter and the application of the exposure theory under Louisiana law in Ducre v. Executive Officers of Halter Marine, Inc., a silicosis case.
The third of our cases that implicitly raised the trigger of coverage issue for progressive disease cases was governed by Texas law.
We are not persuaded by any cases from Texas courts or from federal cases construing Texas law that there is any defensible reason to apply a different trigger of coverage theory for cases governed by Texas law than we have previously adopted in construing Louisiana law. The Forty-Eight Insulations court itself noted that the choice of law issue mattered only to the extent that both New Jersey and
We further note that on the facts of this case, application of the exposure theory will likely trigger the duty to defend, based on the eight-corners rule, in a number of the underlying claims. Thus, our holding comports with the requirement under Texas law to construe ambiguities in favor of coverage. By contrast, the district court’s application of the manifestation theory relieved Guaranty National of the duty to defend in every one of the underlying claims.
This case comes to us, however, in a similar procedural posture, following the grant of summary judgment, as did Ducre.
In addition, we remand with instructions for the district court to examine closely the underlying pleadings to determine which complaints allege exposure to Azrock’s asbestos products between July 1, 1985 and June 30, 1986. Our cursory review of the pleadings included in the record on appeal suggests that some of the complaints clearly allege relevant employment in asbestos tile installation or related work during the policy period; those complaints would trigger the duty to defend. Others clearly allege employment (ergo exposure) that ended prior to the policy period; Guaranty National would have no duty to defend those complaints. And still others do not allege a period of exposure or relevant employment at all. Again, Texas law instructs us that in applying the eight-corners rule, a court must resolve doubts in favor of the insured but may not read facts into the pleadings, may not look outside the pleadings, and may not merely imagine fact patterns that might trigger coverage. Therefore, for complaints lacking an allegation of exposure, the district court on remand should not impose a duty to defend on Guaranty National.
As we are put to “the always-dangerous undertaking”
In sum, our best Erie guess as to what Texas would choose as the event that triggers the insurer’s duty to defend in asbestos personal injury cases under a uniform CGL policy is the exposure theory. Designating that as the appropriate trigger, we remand this case to the district court for (1) the parties to develop medical evidence that some bodily injury, such as subclinical lung tissue damage, occurs at the time of inhalation of the particular type of encapsulated asbestos fibers that were contained in the Azrock floor tiles; (2) the court to examine (a) the pleadings in the underlying property damage case to determine whether, under the eight-corners rule of Texas law, it alleges a manifestation during the policy period; and (b) the pleadings in each personal injury suit to determine which ones, if any, allege exposure during that period; and (3) further proceedings consistent with this opinion, including briefing and determination on apportionment of coverage, if any,
One final point: The district court not only held that, as a matter of law, Guaranty National owed Azrock no duty to defend it on any of the underlying claims, but also held that, as a matter of law, there could be no duty to indemnify. As we presume that Guaranty National might well be found to have a duty to defend Azrock in at least some of the underlying lawsuits, it thus might be found to have a duty to indemnify as well. Although the duty to defend is based on the allegations in the complaints, the duty to indemnify must be determined on the actual facts as established at trial. Accordingly, we also reverse the district court’s ruling that Guaranty National has no duty to indemnify in any of the underlying suits, and we remand that issue as well for further determination consistent with this opinion.
III.
Conclusion
We reverse the district court’s application of the manifestation trigger of coverage (except as to the single property damage case) and reverse its holding that, as a matter of law, based on the allegations in the underlying pleadings, Guaranty National had no duty to defend Azrock in any of those suits. We also reverse the district court’s holding that, as a matter of law, Guaranty National had no duty to indemnify Azrock in any of those cases. We therefore remand this case to the district court for further development of the record and other legal determinations and proceedings consistent with this opinion.
REVERSED and REMANDED with instructions.
. New York Life Ins. Co. v. Travelers Ins. Co., 92 F.3d 336, 338 (5th Cir.1996).
. Salve Regina College v. Russell, 499 U.S. 225, 239, 111 S.Ct. 1217, 113 L.Ed.2d 190 (1991).
. Klaxon v. Stentor Elec. Mfg. Co., 313 U.S. 487, 61 S.Ct. 1020, 85 L.Ed. 1477 (1941).
. See N.K. Parrish, Inc. v. Southwest Beef Indus. Corp., 638 F.2d 1366, 1370 n. 3 (5th Cir.1981).
. American Physicians Ins. Exch. v. Garcia, 876 S.W.2d 842, 848 (Tex.1994); St. Paul Ins. Co. v. Texas Dept. of Transp., 999 S.W.2d 881, 884 (Tex.App.1999).
. National Union Fire Ins. Co. v. Merchants Fast Motor Lines, Inc., 939 S.W.2d 139, 141 (Tex. 1997).
. St. Paul Ins. Co., 999 S.W.2d at 885 (citing National Union, 939 S.W.2d at 142).
. St. Paul Ins. Co. v. Texas Dep’t. of Transp., 999 S.W.2d 881, 884 (Tex.App.1999).
. Trinity Universal Ins. Co. v. Cowan, 945 S.W.2d 819, 821-22 (Tex.1997).
. Barnett v. Aetna Life Ins. Co., 723 S.W.2d 663, 665 (Tex.1987).
. Puckett v. U.S. Fire Ins. Co., 678 S.W.2d 936, 938 (Tex.1984).
. Barnett, 723 S.W.2d at 667; see also Canutillo Indep. Sch. Dist. v. National Union Fire Ins. Co., 99 F.3d 695, 701 (5th Cir.1996) (interpreting Texas law); National Union Fire Ins. Co. v. Hudson Energy Co., 811 S.W.2d 552, 555 (Tex.1991); Glover v. National Ins. Underwriters, 545 S.W.2d 755, 761 (Tex.1977).
. Insurance Co. of N. Amer. v. Forty-Eight Insulations, Inc., 633 F.2d 1212, 1222 (6th Cir.1980).
. "The reason for this seemingly anomalous result is that each court considered the case of a different asbestos company which had purchased liability insurance at a different stage in its asbestos product-line development. Each of the courts, however, subjected the policies to an interpretation designed to 'promote coverage' and to fulfill the 'dominant purpose of [providing indemnification].’ ” Lac D'Amiante Du Quebec, Ltee. v. American Home Assurance Co., 613 F.Supp. 1549, 1557 (D.N.J.1985).
. See Eagle-Picher Indus., Inc. v. Liberty Mutual Ins. Co., 682 F.2d 12, 19-20 (1st Cir.1982).
. Porter v. American Optical Corp., 641 F.2d 1128, 1142 (5th Cir.1981) (agreeing with the "reasoning and result” of, and declining to "prolong [an] already lengthy opinion by paraphrasing and rephrasing the Sixth Circuit opinion” in, Forty-Eight Insulations); see also Ducre v. Executive Officers of Halter Marine, Inc., 752 F.2d 976, 993 (5th Cir.1985) (holding that Porter represents the best Erie guess of Louisiana law and applying exposure theory in silicosis context).
. Ducre, 752 F.2d at 994 (noting importance of medical evidence in Porter and Forty-Eight Insulations and remanding to allow parties to develop such evidence); Porter, 641 F.2d at 1132-33.
. Ducre, 752 F.2d at 994.
. Keene Corp. v. Ins. Co. of N. Amer., 667 F.2d 1034, 1047 (D.C.Cir.1981).
. Id. at 1046.
. Zurich Ins. Co. v. Raymark Indus., Inc., 118 Ill.2d 23, 112 Ill.Dec. 684, 514 N.E.2d 150 (1987), aff'ing 145 Ill.App.3d 175, 98 Ill.Dec. 512, 494 N.E.2d 634 (1986).
. Id. 514 N.E.2d at 161.
. Id. 514 N.E.2d at 160.
. Ahex Corp. v. Maryland Cas. Co., 790 F.2d 119, 124-25 (D.C.Cir.1986) (relying on American Home Prods. Corp. v. Liberty Mutual Ins. Co., 748 F.2d 760 (2d Cir.1984)).
. Forty-Eight Insulations, 633 F.2d at 1217.
. See Aetna Cas. and Sur. Co. v. Naran, 1999 WL 59782, at *4 (Tex.App. Feb.10, 1999) (noting that “the Texas Supreme Court has never directly addressed the coverage trigger issue”); Clemtex, Inc. v. Southeastern Fidelity Ins. Co., 807 F.2d 1271, 1274-75 (5th Cir.1987) (noting that Texas courts have not ruled on exposure theory but adopting district court's holding as parties did not challenge it on appeal); Garcia, 876 S.W.2d at 853 n. 20 (noting that "Texas has limited precedent” on issue of triggers of coverage but declining to select among the theories as resolution of that question was not necessary to the holding).
. American Home Assurance Co. v. Unitramp Ltd., 146 F.3d 311 (5th Cir.1998); Snug Harbor Ltd. v. Zurich Ins., 968 F.2d 538 (5th Cir.1992); Dorchester Dev. Corp. v. Safeco Ins. Co., 737 S.W.2d 380 (Tex.App.1987).
. 968 F.2d 538 (5th Cir.1992).
. 146 F.3d 311 (5th Cir.1998).
. 737 S.W.2d 380 (Tex.App.1987).
. 1999 WL 59782 (Tex.App. Feb. 10, 1999).
. Id. at *4.
. See Mustang Tractor and Equip. Co. v. Liberty Mut. Ins. Co., 1993 WL 566032 (S.D.Tex. Oct.8, 1993) (rejecting manifestation trigger for bodily injury but declining to select between exposure or continuous trigger theories); see also National Standard Ins. Co. v. Continental Ins. Co., CA3-81-1015-D (N.D.Tex. Oct. 4, 1984) (applying exposure theory).
. Forty-Eight Insulations, 633 F.2d at 1219.
. 682 F.2d 12 (1st Cir.1982).
. Id. at 19.
. Id. at 23.
. Forty-Eight Insulations, 633 F.2d at 1219.
. State v. United States Gypsum Co., No. 98-L-61 (Cook Co. Cir. Ct., filed Feb. 17, 1998).
. See Borel v. Fibreboard Paper Prods. Corp., 493 F.2d 1076, 1083 (5th Cir.1973); see also Forty-Eight Insulations, 633 F.2d at 1214 (noting that "there is universal agreement that excessive inhalation of asbestos can and does result in disease").
. 1993 WL 566032 (S.D.Tex. Oct.3, 1993).
. 682 F.Supp. 1403 (E.D.Tex.1988), rev’d sub nom. W.R. Grace & Co. v. Continental Cas. Co., 896 F.2d 865 (5th Cir.1990).
. 1984 WL 23448 (N.D.Tex., April 9, 1984).
. Id. at *2.
. Salve Regina College, 499 U.S. at 237, 111 S.Ct. 1217 ("When de novo review is compelled, no amount of deference is acceptable.”).
. 641 F.2d 1128 (5th Cir.1981).
. Id. at 1133.
. Id. at 1145.
. 752 F.2d 976 (5th Cir.1985).
. Id. at 992 (citing American Home Prod. Corp. v. Liberty Mutual Ins. Co., 565 F.Supp. 1485, 1497 (S.D.N.Y.1983), aff'd as modified, 748 F.2d 760 (2d Cir.1984)).
. 807 F.2d 1271 (5th Cir.1987).
. Id. at 1274-75.
. Id. at 994.
. Stephens v. State Farm Mutual Auto. Ins. Co., 508 F.2d 1363, 1366 (5th Cir.1975).
. Texas Prop. and Cas. Ins. Guar. Assoc. v. Southwest Aggregates, Inc., 982 S.W.2d 600, 604-05 (Tex.App.1998) (holding that, under eight-corners rule, Texas law does not require pro rata allocation of costs of defense).