¶ 1. Heather Nugent appeals from a summary judgment in favor of American Family Mutual Insurance Company. Nugent was injured in a car accident caused by Charles Slaght and she sued Slaght and American Family. The circuit court granted
¶ 2. We hold that the circuit court erred in granting summary judgment in favor of American Family. We agree with the circuit court's conclusion that American Family did not waive its cancellation defense. However, it appears the circuit court erroneously assumed that the elements of equitable estoppel were not present. Accordingly, we reverse and remand with directions.
I. Background
¶ 3. Prior to July 16, 1996, Charles Slaght had a valid auto insurance policy with American Family Mutual Insurance Company. The last premium payment Slaght made was received by American Family on June 16, 1996, and was sufficient to pay for coverage until July 16, 1996.
¶ 4. • Slaght's auto insurance policy contained a provision specifying that the policy "may" be cancelled for nonpayment by mailing a notice of cancellation not less than ten days prior to the effective date of the cancellation. On June 27,1996, American Family sent a notice to Slaght informing him that his policy "will be cancelled" on July 16, 1996, if his premium payment was not received by American Family by that date. We will assume for purposes of this decision that Slaght received the notice, but did not submit payment. 1
¶ 6. The American Family claims representatives assigned to handle the accident were not aware of the cancellation entry, apparently because the only check for cancellation they made was prior to the recording of the cancellation. A company employee testified that this failure was due to a flaw in American Family's internal procedures.
¶ 7. Nugent did not immediately file suit, but instead sought to obtain a settlement from Slaght and American Family. During a three-year period, from the time of the collision on July 19, 1996, and until it responded to Nugent's complaint on August 11, 1999, American Family acted as though Slaght had a valid policy in effect at the time of the collision. Among other things, American Family's claims representatives negotiated with Nugent, made payments to Nugent for property damage loss, made a settlement offer to Nu-gent, and reached a settlement with a passenger in Nugent's vehicle. American Family agrees that during this time period its claims representatives acted as though American Family was Slaght's insurer and that Nugent had no reason to suspect that Slaght's policy might not have been in effect at the time of the collision.
¶ 9. The parties were unable to fully settle, and on June 22, 1999, Nugent filed suit. American Family responded to the lawsuit by taking steps to verify Slaght's coverage and discovered the basis for asserting cancellation.
¶ 10. American Family moved for summary judgment on the ground that Slaght's policy had been cancelled prior to the accident. Nugent moved for summary judgment in her favor on grounds of waiver and equitable estoppel. The circuit court granted summary judgment in favor of American Family, concluding that the company did not waive its cancellation defense because it did not relinquish a right "which it knew that it had." The circuit court also rejected Nugent's equitable estoppel argument, but the basis for that decision is unclear.
II. Standard of Review
¶ 11. This court reviews summary judgment decisions
de novo,
applying the same standards as the trial court.
Smith v. Dodgeville Mut. Ins. Co.,
III. Discussion
A. Waiver
¶ 12. Waiver is often defined as the "voluntary and intentional relinquishment of a known right."
E.g., Bank of Sun Prairie v.
Opstein,
¶ 13. Although the waiving party need not intend a waiver, he or she must act intentionally and with knowledge of the material facts.
State v. Mudgett,
¶ 14. Based on the foregoing principles, Nugent argues that American Family waived its right to raise its cancellation defense because it acted inconsistently with asserting this defense for nearly three years while possessing constructive knowledge of all material facts. Nugent contends that American Family claims representatives had only to review the records of their own company to discover the facts supporting the cancellation defense, but failed to do so because they did not exercise ordinary care and diligence.
¶ 15. American Family responds that its claims representatives acted under a "mistake of fact." American Family quotes the following phrases from 56 Am. Jur
Waiver
§ 14, at 114-15 (1947), which have been repeated several times in Wisconsin cases: "[i]gnorance of a material fact negatives waiver" and "[w]aiver cannot be established by a consent given under a mistake of fact."
See, e.g., Ryder v. State Farm Mut. Auto. Ins. Co.,
¶ 16. The pertinent facts of
Ryder are
these. An insured party made material misrepresentations to
¶ 17. In the context of the injured pedestrian's lawsuit, State Farm argued that it was not liable because the insured's policy had been rescinded. The pedestrian argued that State Farm waived its right to assert its policy defense by electing to renew the insured's policy.
Id.
at 325-26. One of the reasons the
Ryder
court gave for rejecting waiver applies here. The court found that even if State Farm's adjuster had information giving knowledge of the right to rescind the policy, its underwriting supervisor did not have the same information.
Id.
at 327. The
Ryder
court did not discuss constructive knowledge or the ease with which such information might have been shared within the State Farm organization. Instead, the court simply said: "the knowledge of one agent or employee is not imputed to another in these circumstances for the
¶ 18. In keeping with Ryder, we hold that when the claims representatives acted without knowledge held by other employees of American Family, such action did not constitute a waiver of the cancellation defense. While we might reach a different conclusion if writing on a clean slate, we think the Ryder decision contains the general directive that waiver does not occur when one employee mistakenly takes action inconsistent with a policy defense because he or she does not have knowledge held by a different employee of the same company. 3
¶ 19. Equitable estoppel may be applied when the inaction or action of a party induces reliance by another to that other person's detriment.
Gonzalez v. Teskey,
1. Applicability of the doctrine of equitable estoppel to the type of cancellation defense asserted by American Family
¶ 20. American Family broadly asserts that equitable estoppel can never be used to resurrect an insurance policy that has been properly cancelled, regardless of actions subsequently taken by its employees. The company does not back up this assertion, but instead points to two cases that stand for a much more limited proposition. Both of these cases,
Ingalls v. Commercial Insurance Co.,
¶ 22. Shannon involved an insurance policy that excluded a relative of the insured from bodily injury coverage. While it was undisputed that policy language excluded the relative from this coverage, the relative argued that the insurance company waived its right to rely on the exclusion clause by acting inconsistently with such reliance for approximately eight months. Id. at 439, 450. The question in Shannon was not whether waiver or equitable estoppel could be applied when an insurance company acts inconsistently with its right to assert a cancellation or forfeiture defense. Instead, the question was whether waiver or equitable estoppel could be used to expand the scope of coverage under a policy. The Shannon court explained that these doctrines may not be used to create coverage that does not exist in the insurance policy. Id. at 453-54.
¶ 23. The fact that
Shannon
addressed the scope of coverage, and not forfeiture or cancellation situations, is apparent from language the court extensively
[W]hile estoppel may be used to prevent an insurer from insisting upon conditions which result in forfeiture, estoppel has not been used in this state or in the majority of states as a means whereby the scope of coverage of an insurance policy can be expanded to include coverage which was not provided for or was excluded in the contract....
The rule that estoppel may apply to a forfeiture of benefits contracted for but cannot be successfully invoked to create a liability for benefits or coverage not contracted for was first laid down in this state in McCoy v. Northwestern Mut. Relief Asso. (1896),92 Wis. 577 ,66 N.W. 697 ....
Estoppel rules have consistently been held by this court not to apply to extend coverage... This court [has] refused to apply waiver or estoppel to enlarge coverage .... This court [has] held neither waiver nor estoppel could be used to enlarge the coverage of the policy....
What terms, conditions and provisions in a policy may be considered as forfeiture clauses and what language is considered essentially coverage is not always free from doubt. We think neither the type of insurance policy nor the form of language in the policy necessarily controls the question. The coverage provisions of the policy must, of course, be distinguished from its liability provisions. As a general rule, conditions and terms, either of an inclusionary or exclusionary nature in the policy, go to the scope of the coverage or delineate the risks assumed, as distinguished from conditions and terms which furnish a ground for the forfeiture of coverage or defeasance of liability.... 'While waiver and estoppel have been held applicable tonearly every area in which an insurer may deny liability, the courts of most jurisdictions agree that these concepts are not available to broaden the coverage of a policy so as to protect the insured against risks not included therein or expressly excluded therefrom. The theory underlying this rule seems to be that the company should not be required by waiver and estoppel to pay a loss for which it charged no premium, and the principle has been announced in scores of cases involving almost every conceivable type of policy or coverage provision thereof.'
What we have said applies both to waiver and equitable estoppel or estoppel in pais in the traditional sense in which those concepts are understood ....
Shannon,
¶ 24. American Family points to that part of the above-quoted language which states: "The theory underlying this rule seems to be that the company should not be required by waiver and estoppel to pay a loss for which it charged no premium. . . ." However, in context, it is apparent that neither
Shannon
nor
Ahnapee
sets forth the general rule that an insurance company cannot be forced to provide coverage whenever it did not receive premium payment for the time period in question. Moreover, such a rule would be directly at odds with
Peterson v. Truck Insurance Exchange,
¶ 25. The insurance policy at issue in
Peterson
contained an "automatic lapse" clause providing that if the insured failed to make a timely monthly premium payment, the policy would automatically lapse and be void at the end " 'of the monthly period for which the
The insurance company cites Madgett v. Monroe County Mut. Tornado Ins. Co. (1970),46 Wis. 2d 708 ,176 N.W.2d 314 , to the effect that an insurance policy cannot be created by estoppel if an insurance policy does not exist; that is true. However, Madgett is distinguishable from the instant case because there no contract of insurance ever existed between the plaintiff and the insurance company. It is our opinion that only a hearing can determine conclusively whether or not the insurance company in this case waived its right to have the policy lapse for nonpayment of premiums.
Id. at 550-51.
¶ 26. Thus, cases holding that waiver and equitable estoppel cannot be used to create coverage have no application here.
¶ 27. Finally, American Family argues that equitable estoppel should not be applied because the cancellation situation in this case is factually different from prior cases applying waiver and equitable estoppel to "automatic lapse" and "forfeiture" clause defenses. However, the company does not explain why the factual
¶ 28. Accordingly, we reject each of American Family's arguments offered in support of the proposition that equitable estoppel can never be used to bar defenses asserting policy cancellation prior to the event giving rise to potential liability.
2. Application of equitable estoppel analysis to the facts in this case
¶ 29. We now address the application of the doctrine of equitable estoppel to the facts in this case. Equitable estoppel has four elements: "(1) action or non-action, (2) on the part of one against whom estop-pel is asserted, (3) which induces reasonable reliance thereon by the other, either in action or non-action, and (4) which is to his or her detriment."
Milas v. Labor Ass'n of Wisconsin, Inc.,
An appeal to equity requires a weighing of the factors or equities that affect the judgment — a function which requires the exercise of judicial discretion. "The basis of all equitable rules is the principle of discretionary application." Yuba Consolidated Gold Fields v. Kilkeary,206 F.2d 884 , 889 (1953) (footnote omitted).
A trial court has the power to apply an equitable remedy as necessary to meet the needs of the particular case. Prince v. Bryant,87 Wis. 2d 662 , 674,275 N.W.2d 676 , 681 (1979).
[Elquity "has .. . never placed any limits to the remedies which it can grant, either with respect to their substance, their form, or their extent; but has always preserved the elements of flexibility and expansiveness, so that new ones may be invented, or old ones modified, in order to meet the requirements of every case." 1 Pomeroy, Equity Jurisprudence, § 111. Equity has "power to enlarge the scope of the ordinary forms of relief, and even to contrive new ones adapted to new circumstances." Ibid. § 116. If the customary forms of relief do not fit the case, or a form of relief more equitable to the parties than those ordinarily applied can be devised, no reason is perceived why it may not be granted.
Meyer v. Reif,
¶ 31. The only element of equitable estoppel that American Family seriously disputes is detriment. "Detriment" in this context is equated with "prejudice" and means " 'injury or damage.'"
Milas,
¶ 32. The circuit court held without explanation: "I do not think that the conduct of the insurance company rises to the level to support either waiver or estoppel." It appears the circuit court believed that the elements of estoppel are not present in this case. However, the undisputed facts show that Nugent suffered detriment. She engaged in three years of negotiations and correspondence with American Family. She was interviewed by American Family representatives and responded to inquiries. Nugent signed releases for confidential medical and employment records. She retained counsel and incurred the expense of filing suit. This detriment is not merely technical or formal.
¶ 34. American Family also suggests that Nugent is better off than she would have been had American Family not made its mistake. American Family points out that it paid Nugent $9600 for property damage. American Family asserts that the money it paid to Nugent's passenger would have come out of Nugent's uninsured motorist coverage payments. We conclude that these arguments do not address the existence of the element of detriment, but are better directed at whether the circuit court should exercise its discretion to actually apply estoppel to bar the cancellation defense. Moreover, we cannot tell from the record or briefs before us whether these are actual benefits to Nugent. It may be that if Nugent is forced to pursue uninsured motorist coverage, American Family will seek to recover payments made, or that the company providing
¶ 35. Accordingly, we hold that the elements of equitable estoppel have been established in this case. We remand on the separate question of whether the doctrine should actually be applied to bar American Family's cancellation defense because it does not appear that the circuit court exercised its discretion in this respect and we may not exercise discretion for the circuit court.
¶ 36. We acknowledge that our supreme court has, on at least one occasion, seemingly exercised discretion in deciding whether to apply equitable estop-pel after it determined as a matter of law that all of the elements of estoppel were present.
E.g., Milas,
By the Court. — Judgment reversed and cause remanded with directions.
Notes
The record shows that American Family sent Slaght the cancellation notice by first class mail. There is no suggestion in the record that Slaght did not receive this notice. An affidavit signed by an American Family employee states that no payments were received from Slaght after the June 16 payment.
American Family informs us, and Nugent does not disagree, that Nugent has until July 19, 2002, to file a claim under her uninsured motorist policy.
Ryder
appears to be a departure from the general approach used when imputing knowledge to corporations.
See Suburban Motors of Grafton, Inc. v. Forester,
American Family says that
Webster v. Phoenix Insurance Co.,
