PINCKNEY COMMUNITY SCHOOLS v CONTINENTAL CASUALTY COMPANY
Docket No. 163986
Court of Appeals of Michigan
September 22, 1995
213 Mich App 521 | 540 NW2d 741
Docket No. 163986. Submitted January 18, 1995, at Lansing. Decided September 22, 1995, at 9:10 A.M. Leave to appeal sought.
Pinckney Community Schools brought an action in the Livingston Circuit Court against Continental Casualty Company and other liability insurers for reimbursement of amounts expended by the plaintiff to satisfy an award made by the Department of Civil Rights to one of the plaintiff‘s teachers as the result of a complaint claiming discrimination on the basis of gender that had been filed with the department on December 18, 1981. In March 1982, the plaintiff notified Continental that the complaint had been filed. The claims-made liability policy issued by Continental to the plaintiff for the period of April 1, 1979, to April 1, 1982, provided for payment of a loss “if during the policy period any claim or claims” were made against the plaintiff and if the plaintiff gave Continental written notice within one year of receiving notice of a claim that arose during the term of the policy. On receiving the March 1982 notice from the plaintiff, Continental acknowledged receipt of the notice and subsequently indicated that it had assigned a claim number. The complaint languished before the Department of Civil Rights until 1988, when the department investigated the claim, leading the department to issue a formal complaint against the plaintiff that resulted in a finding of gender-based discrimination and entry of a monetary award for the teacher. When Continental declined coverage, the plaintiff satisfied the award and commenced the action to seek insurance benefits. The court, Stanley J. Latreille, J., granted summary disposition for Continental on the basis that the charge filed with the Department of Civil Rights was not a claim within the meaning of the insurance policy but rather was only a notice of an impending investigation. The plaintiff appealed.
The Court of Appeals held:
1. The language of Continental‘s policy placed no special
2. Because of the sweeping powers granted to the Department of Civil Rights with respect to enforcement of the rights guaranteed under the Civil Rights Act,
3. The gravamen of the complaint filed by the teacher with the Department of Civil Rights was a charge of gender-based discrimination prohibited under the Civil Rights Act. Accordingly, the obligation placed on the plaintiff by the award that resulted from that complaint did not fall within the contractual-obligation exclusion of the insurance policy.
4. Because the actions of Continental on being notified of the civil rights complaint could have led the plaintiff to believe that it had perfected a timely claim under the policy and thereby induced the plaintiff not to take additional actions to protect its claim under the policy, Continental is estopped from now claiming that the plaintiff did not make a timely claim.
5. Because genuine issues of fact remain and Continental is not entitled to a judgment as a matter of law, the trial court erred in granting summary disposition for Continental.
Reversed and remanded.
CAVANAGH, P.J., dissenting, stated that a claim for the purpose of a claims-made insurance policy must include a present demand of a right of payment of an amount due and cannot be the mere awareness of a possible claim. A complaint filed with the Department of Civil Rights serves only as a notice of an investigation that might lead to a possible claim and, thus, does not constitute a claim within the meaning of the policy at issue. Under the circumstances, the trial court properly granted summary disposition on the basis that a timely claim had not been made within the meaning of the policy.
REFERENCES
Am Jur 2d, Insurance § 277.
See ALR Index under Insurance and Insurance Companies.
WORDS AND PHRASES — “CLAIM” — INSURANCE — CIVIL RIGHTS ACT.
A complaint filed with the Department of Civil Rights seeking relief pursuant to the Civil Rights Act is a claim within the meaning of a claims-made insurance policy where there is no specific language in the insurance policy giving the term “claim” a restrictive meaning that would specifically preclude such a complaint from constituting a claim under the insurance policy (
Thrun, Maatsch & Nordberg, P.C. (by Martha J. Marcero and Timothy R. Winship), for the plaintiff.
Meagher & Geer (by Christian A. Preus) and Kerr, Russell & Weber (by Roy H. Christiansen), for the defendant.
Before: CAVANAGH, P.J., and HOLBROOK, JR., and MARKEY, JJ.
MARKEY, J. Plaintiff appeals as of right from an order granting summary disposition for defendant Continental Casualty Company (hereinafter defendant) pursuant to MCR 2.116(C)(10). We reverse and remand for further proceedings.
On March 16, 1979, plaintiff renewed its insurance policy with defendant. The policy, in effect from April 1, 1979, to April 1, 1982, provided coverage for claims against plaintiff for “Wrongful Acts,” defined as “any actual or alleged errors or act or omission or neglect or breach of duty by the Assureds in the discharge of their duties.”
In 1978, plaintiff hired Douglas Rutherford as a physical education instructor. In August 1981, Rutherford was laid off from his full-time job because of financial problems in the school district. Rutherford was assigned a part-time position teaching physical education at a district middle school. However, at the same time, plaintiff hired a full-time female instructor to teach a physical
On December 18, 1981, Rutherford filed a charge of discrimination with the Department of Civil Rights (DCR), alleging that he was discriminated against on the basis of his sex in violation of the Civil Rights Act,
The DCR notified plaintiff of Rutherford‘s charge. In March 1982, plaintiff in turn notified defendant, which acknowledged receipt of the information in a letter and informed plaintiff that it had assigned a claim number to the case. Defendant also stated that if Rutherford were to file a lawsuit, defendant would review the complaint and make a coverage determination at that time.
Between 1981 and 1988, Rutherford‘s claim languished at the DCR. The delay was due in part to the illness of the investigator and to budget cuts at the DCR; in addition, the file may have been misplaced for a time. Eventually, the DCR investigated Rutherford‘s claim. On May 10, 1989, the DCR issued a formal complaint against plaintiff. In an opinion and order dated October 29, 1989, the DCR concluded that plaintiff had discriminated against Rutherford on the basis of his sex and awarded Rutherford monetary damages for lost wages for the 1981-82, 1982-83, 1983-84, and 1985-86 school years.
Plaintiff informed defendant of the award to Rutherford, but in a letter dated July 16, 1990, defendant declined coverage. On June 17, 1991, plaintiff satisfied the judgment by paying $67,737.46 to Rutherford.
On February 5, 1992, plaintiff filed a complaint against defendant and three other insurance companies. Plaintiff sought indemnification for the liability payment to Rutherford and for attorney
Because plaintiff timely notified defendant in writing of Rutherford‘s DCR complaint (and the concurrent complaint filed with the Equal Employment Opportunity Commission [EEOC]) filed against plaintiff and because the DCR complaint constituted a “claim” under defendant‘s “claims-made” insurance policy, we believe that the trial court erred in granting defendant‘s motion for summary disposition brought pursuant to MCR 2.116(C)(10).
On appeal, an order granting or denying summary disposition is reviewed de novo. A motion for summary disposition may be granted pursuant to MCR 2.116(C)(10) when, except with regard to the amount of damages, there is no genuine issue of material fact and the moving party is entitled to judgment as a matter of law. Giving the benefit of reasonable doubt to the nonmoving party, the trial court must determine whether a record might be developed that would leave open an issue upon which reasonable minds might differ. Michigan Mutual Ins Co v Dowell, 204 Mich App 81, 85-86; 514 NW2d 185 (1994).
Defendant‘s policy provided coverage only for claims made “during the policy period.” Thus, the policy is a “claims-made” policy. In general, a “claims-made” policy provides coverage no matter
I. The Insurer designated in the declarations in consideration of the payment of the premium and subject to all of the terms, conditions and limitations of this policy agrees as follows:
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(c) With the School District that if during the policy period any claim or claims are made against it as a result of any Wrongful Act occurring during the policy period, the insurer will pay on behalf of, in accordance with the terms of this policy, all loss which the School District shall become legally obligated to pay.
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III. Definitions:
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(c) Wrongful Act shall mean any actual or alleged errors or misstatement or misleading statement or act or omission or neglect or breach of duty by the Assureds in the discharge of their duties, individually or collectively, or any matter claimed against them solely by reason of their being or having been Assureds during this policy period.
(d) Loss shall mean any amount which the Assured or School District are [sic] legally obligated to pay, including, but not limited to, any amounts which the School District may be required or permitted to pay as indemnity to an Assured, for a claim or claims made against an Assured for a Wrongful Act and shall include but not be limited to damages, judgments, settlements and costs, cost of investigation and defense of legal actions
claims or proceedings and appeals therefrom, costs of attachment or similar bonds . . . .1 * * *
VII. Notice of Claim:
(a) If the School District or any Assureds shall receive written or oral notice from any party that it is the intention of such party to hold the Assureds responsible for a Wrongful Act which occurred during the policy period, they shall give written notice within one year to the Insurer of the receipt of such written or oral notice, then any claim made within the space of two years following the termination of this policy against the Assureds arising out of such Wrongful Act shall, for the purpose of this policy, be treated as a claim made during the policy year in which the Wrongful Act occurred.
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(c) The School District, or the Assureds shall, as a condition precedent to their rights under this policy, give the Insurer notice in writing of any claim made and shall give the Insurer such information and cooperation as it may reasonably require. [Emphasis added.]
Courts must enforce the terms of an insurance contract as written. Courts may not read into an insurance policy an ambiguity that does not exist. When the terms of a policy are plain and unambiguous, their plain meaning should be given effect. Upjohn Co v New Hampshire Ins Co, 438 Mich 197, 206-207; 476 NW2d 392 (1991).
This appeal presents an issue of first impression for this Court: Whether a sex discrimination complaint filed with the DCR or the EEOC constitutes a “claim” within the meaning of an insurance policy
In resolving whether Rutherford‘s 1981 complaint to the DCR alleging discrimination constituted a claim for a “wrongful act” within the meaning of defendant‘s policy, we must first ask whether “claim” is ambiguous in the context of the insurance policy. Id. at 567. Second, if “claim” is ambiguous and capable of a broad definition, we must determine whether it reasonably may be understood to encompass Rutherford‘s DCR complaint against plaintiff. Id.
Black‘s Law Dictionary (6th ed), p 247, defines the term “claim” as follows:
To demand as one‘s own or as one‘s right; to assert; to urge; to insist. A cause of action. Means by or through which claimant obtains possession or enjoyment of privilege or thing. Demand for money or property as of right, e.g., insurance claim. [Emphasis added.]
The Random House Webster‘s College Dictionary, p 249, defines “claim” as follows:
Michigan courts have also defined the word “claim” as “‘a demand of a right or alleged right; a calling on another for something due or asserted to be due,‘” Central Wholesale Co v Chesapeake & OR Co, 366 Mich 138, 149; 114 NW2d 221 (1962), quoting Allen v Bd of State Auditors, 122 Mich 324, 328; 81 NW 113 (1899), and “more than a notice of loss; it must include a demand for payment of damages,” Dawlen Corp v New York Central R Co, 328 Mich 360, 362; 43 NW2d 887 (1950). Nonetheless, in Continental Casualty Co v Enco Associates, Inc, 66 Mich App 46, 50-51; 238 NW2d 198 (1975), this Court refused to “split hairs” over whether a telephone call constituted a “demand for payment” or assertion of a right. Instead, this Court held that when the construction company‘s architect told the insured that structural faults had been discovered in a parking ramp the insured had designed and that the insured would be held responsible, “a ‘claim’ was made in the ordinary sense of the word.” Id. Any subsequent correspondence reiterating the construction company‘s intention did not alter the status of the earlier claim for purposes of Continental‘s claims-made policy. Id. at 48-51.
These definitions of the word “claim” are unambiguous, they are consistent with the policy language, and they certainly encompass complaints filed with the DCR and the EEOC. In the case at bar,
The recent case of Michigan Millers Mutual Ins Co, supra, addressed an analogous issue and, therefore, is instructive. In Michigan Millers, our Supreme Court determined that a letter from the Environmental Protection Agency notifying the defendant of its potential liability for alleged environmental contamination constituted a “suit” that gave rise to the insurers’ duties to defend under the terms of the applicable insurance contracts. Id. at 566. Like the trial court in the instant case, our Supreme Court in Michigan Millers first went through the exercise of deciding whether the term “suit” was ambiguous, i.e., “whether the term may refer to some legal action other than a court proceeding initiated by a complaint.” Id. at 567. Then, after concluding that indeed it was ambiguous, our Supreme Court went on to decide whether “suit” reasonably could be understood to encompass the receipt of a letter from the United States Environmental Protection Agency informing the defendant of its potential liability for a contaminated site. Id.
In its determination that the letter received by
Similarly, a person alleging that an employer is guilty of sex discrimination as prohibited by the Civil Rights Act,
In light of the practical import of filing a DCR complaint and the potential ramifications of such a complaint, we believe that the trial court “split hairs” and incorrectly concluded that Rutherford‘s DCR complaint against plaintiff did not constitute a “claim” because it did not expressly declare that Rutherford “demanded” reinstatement or money damages. Such demands are, indeed, implicit. These demands are the obvious reason for the very filing of the DCR complaint, and, in the instant case, they resulted in the award of money to Rutherford. See Continental Casualty, supra, 66 Mich App 50-51. Consequently, we do not agree with the dissent or the trial court that the DCR charge is only a notice of Rutherford‘s intent to hold plaintiff liable. Bensalem Twp, supra at 1348.5
Finally, defendant‘s own actions support the conclusion that, originally, defendant considered the allegations in the DCR and the EEOC complaints as possible wrongful acts giving rise to a compensable claim — a claim as contemplated by both parties. Both plaintiff and defendant understood that Rutherford‘s filing of charges of discrimination with the DCR and the EEOC was essentially the beginning point of a claim against plaintiff, and for that reason, plaintiff immediately notified defendant of Rutherford‘s charges. Both parties originally believed that the claim was covered under defendant‘s policy. Moreover, both parties certainly knew that the EEOC complaint was the sole way to initiate a federal claim of employment discrimination, i.e., Rutherford had no right to file a lawsuit before raising the claim with the EEOC and obtaining a right-to-sue letter.
In acknowledging receipt of the charge of dis-
On appeal, defendant also argues that even if a timely claim were filed, it is excluded under paragraph IV(b)(6) of the Liberalization Endorsement, which provides in relevant part: “[T]he insurer shall not be liable to make any payments for loss in connection with any claim made against the Assureds for any amounts due under terms of any contractual obligation.” Defendant‘s argument that there is no coverage because plaintiff‘s payment to Rutherford was a loss arising from the breach of a contractual obligation is without merit. Although Rutherford stated in his charges of discrimination with the DCR and the EEOC that “he was unfairly denied a contractually provided
Additionally, although the issue of equitable estoppel was not fully raised or addressed in the trial court and it is not necessary for proper determination of this case, Swartz v Dow Chemical Co, 414 Mich 433; 326 NW2d 804 (1982), the evidence in the record regarding that issue is also relevant to show the parties’ reasonable expectations. Again, defendant‘s letters and conduct as previously described led plaintiff justifiably to believe that a claim under the policy had been made and that insurance coverage both for its defense and the loss was available. As a practical matter, had plaintiff not so believed, it certainly would have maintained the policy instead of allowing it to lapse; that is, had plaintiff known that defendant would not consider Rutherford‘s claims with the DCR and EEOC as “claims” under the insurance policy until the DCR either decided the matter or the EEOC issued a “right-to-sue” letter, it likely would have continued the policy in effect until such time as the matter was resolved. Allowing defendant to deny that the concurrent DCR and EEOC filings constituted a claim severely prejudiced plaintiff, because it has already paid all its premiums, its defense costs, and the award made by the DCR to Rutherford. Here, the record contains evidence of the essential elements of estoppel. This same evidence simultaneously reflects the parties’
Accordingly, we find that the trial court erred in granting defendant‘s motion for summary disposition pursuant to MCR 2.116(C)(10), because plaintiff properly submitted Rutherford‘s discrimination claim to defendant during the period when defendant‘s claims-made policy was in effect and the policy appears to cover both the claim and the costs of defense. Thus, genuine issues of material fact exist, and defendant is not entitled to judgment as a matter of law. Michigan Mutual, supra. We, therefore, reverse the order of the trial court and remand for further proceedings consistent with this opinion. We do not retain jurisdiction.
Reversed and remanded.
HOLBROOK, JR., J., concurred.
CAVANAGH, P.J. (dissenting). I respectfully dissent. Defendant‘s policy provided coverage only for claims made “during the policy period.” Thus, the policy is a “claims-made” policy. In general, a claims-made policy provides coverage no matter when the alleged error, omission, or act of negligence occurred, as long as the misdeed is discovered and the claim for indemnity is made within the policy period. Stine v Continental Casualty Co, 419 Mich 89, 97; 349 NW2d 127 (1984). The issue presented therefore is whether Rutherford‘s allegation of discrimination in 1981 constituted a claim for a wrongful act within the meaning of defendant‘s policy.
Defendant‘s insurance policy does not define the word “claim.” However, that fact alone is not conclusive evidence of the existence of an ambigu-
The Supreme Court has defined “claim” as “‘a demand of a right or alleged right; a calling on another for something due or asserted to be due.‘” Central Wholesale Co v Chesapeake & OR Co, 366 Mich 138, 149; 114 NW2d 221 (1962), quoting Allen v Bd of State Auditors, 122 Mich 324, 328; 81 NW 113 (1899). The Court further stated that the very essence of a claim is “a demand for payment, formal or informal.” Central Wholesale, supra at 150.
A review of the case law of other jurisdictions indicates that, for the purpose of determining coverage under a claims-made policy, a “claim” is defined as “a demand for something as a right” or “a demand for payment of some amount of money.” See, e.g., MGIC Indemnity Corp v Home State Savings Ass‘n, 797 F2d 285, 287 (CA 6, 1986); Ins Corp of America v Dillon, Hardamon & Cohen, 725 F Supp 1461, 1468 (ND Ind, 1988); Mt Hawley Ins Co v Federal Savings & Loan Ins Corp, 695 F Supp 469, 479 (CD Cal, 1987); Bensalem Twp v Western World Ins Co, 609 F Supp 1343, 1348 (ED Pa, 1985); Safeco Title Ins Co v Gannon, 54 Wash App 330, 334-335; 774 P2d 30 (1989).
In reaching its decision, the trial court relied on Bensalem Twp, supra. The facts of Bensalem Twp are similar to the present case, but the insurer and its insured were aligned on the opposite sides. The Equal Employment Opportunity Commission (EEOC) notified the township of the claimant‘s charge of age discrimination before the claims-made policy took effect, but did not file a lawsuit until after the policy was in force. The insurer argued that the claim was first made when the
The Bensalem Twp court held that the initial letter notifying the township of the claimant‘s charge of age discrimination did not constitute a claim. The court noted that case law generally supports the proposition that, for purposes of determining coverage under a claims-made policy, a “claim” is “a demand for something as a right.” Id. at 1348. The court then reasoned that the letter merely notified the township of the charge and the EEOC‘s intent to attempt to resolve the matter informally. While the letter informed the township that a demand for relief, based on a legal right, might ensue, neither the letter nor the initial claim purported to be such a demand. Id.
The majority concludes that the Bensalem Twp court‘s conclusion that the EEOC complaint was merely a notice of the employee‘s intent to hold the insurer responsible for a wrongful act constituted dicta. However, whether the court‘s discussion constituted dicta is immaterial in this case because this Court is not bound to follow the decision of a federal court in Pennsylvania. In addition, a court is not prohibited from finding the dicta of another court to be persuasive. See, e.g., Eyde Bros Development Co v Eaton Co Drain Comm‘r, 427 Mich 271, 286; 398 NW2d 297 (1986); Dykstra v Dep‘t of Transportation, 208 Mich App 390, 392; 528 NW2d 754 (1995). The proper question is whether the reasoning of the dicta is sound.
In fact, other courts have adopted the reasoning in Bensalem Twp and held that notification of a potential liability does not constitute a claim. See Winkler v Nat‘l Union Fire Ins Co of Pittsburgh, 930 F2d 1364, 1366-1367 (CA 9, 1991); Ins Corp of America v Dillon, Hardamon & Cohen, supra at
Simply becoming aware of an alleged injury is not enough to amount to a claim. Awareness is not a demand and the use of the word claim, unless modified by other language, requires that a demand be made.
Defendant‘s policy contains the following language:
VII. Notice of Claim
(a) If the School District or any Assureds shall receive written or oral notice from any party that it is the intention of such party to hold the Assureds responsible for a Wrongful Act which occurred during the policy period, they shall give written notice within one year to the Insurer of the receipt of such written or oral notice, then any claim made within the space of two years following the termination of this policy . . . shall, for the purposes of this policy, be treated as a claim made during the policy year in which the Wrongful Act occurred.
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(c) The School District, or the Assureds shall, as a condition precedent to their rights under this policy, give the Insurer notice in writing of any claim made and shall give the Insurer such information and cooperation as it may reasonably require.
Thus, the policy appears to distinguish between a “claim” and “notice from any party that it is the intention of such party to hold the Assureds re-
The majority asserts that Rutherford sought relief pursuant to the Civil Rights Act through his complaint filed with the Department of Civil Rights (DCR). The majority reasons that because the DCR had the authority to award damages to Rutherford in the event that he prevailed, Rutherford‘s charge of discrimination constitutes a “claim” against plaintiff.
However, the notice sent by the DCR to plaintiff in April 1982 merely informed plaintiff that it intended to investigate Rutherford‘s allegation of sex discrimination and requested plaintiff‘s cooperation in that investigation. I would find that Rutherford‘s charge of discrimination was not an actual claim, but rather notice of an alleged injury from which a claim could subsequently arise. An actual claim is distinguished from an “event” that could give rise to an actual claim in the future. Employers Ins of Wausau v Bodi-Wachs Aviation Ins Agency, Inc, 39 F3d 138, 143 (CA 7, 1994).
Under paragraph VII(a) of defendant‘s policy, plaintiff had three years following the termination of the policy to make the actual claim. It is undisputed that the policy expired on April 1, 1982, and that the actual claim, that is, a demand for something due as a right, was not made until May 10, 1989, when the DCR filed a formal complaint against plaintiff. Because the claim was not made within three years of the termination of the policy,
The majority relies on Continental Casualty Co v Enco Associates, Inc, 66 Mich App 46; 238 NW2d 198 (1975), for the proposition that this Court should not “split hairs” when determining whether the insured had submitted a claim. However, the majority misapplies Enco to the facts of this case. Enco merely stands for the proposition that oral notice of an insured‘s liability for a defect during the policy period is sufficient to constitute a claim. Id. at 51. There was no question in Enco that the insured was making a demand for payment in his telephone call.
I am aware that the Supreme Court recently held that a letter from the Environmental Protection Agency to an insured that it was potentially liable for environmental contamination constituted the initiation of a “suit” under the terms of the insurance policy at issue, thus triggering the insurer‘s duty to defend. Michigan Millers Mutual Ins Co v Bronson Plating Co, 445 Mich 558, 575; 519 NW2d 864 (1994). However, Bronson was decided within the particular context of environmental litigation. Moreover, it is well-settled that an insurer‘s duty to defend is broader than its duty to indemnify. Auto-Owners Ins Co v City of Clare, 446 Mich 1, 15; 521 NW2d 480 (1994); Allstate Ins Co v Freeman, 432 Mich 656, 662; 443 NW2d 734 (1989) (RILEY, J.). I would therefore decline to reach an analogous result.
Notes
The significant authority given to the EPA in such matters allows it essentially to usurp the traditional role of a court of law in determining and apportioning liability. Such matters are concluded by the EPA before the action is ever brought to court. [Emphasis in original.]