Vermont Mutual Insurance v. EveretteVermont Mutual Insurance v. Everette
OPINION AND FINAL ORDER
This matter is before the Court on Plaintiffs and Defendant Greenwood’s motions for summary judgment. For the reasons that follow, the Court GRANTS Plaintiffs motion for summary judgment and DENIES Defendant Greenwood’s motion.
J. Factual and Procedural History
Plaintiff Vermont Mutual Insurance Company (“Vermont Mutual”) brought this declaratory judgment action to determine its obligations for coverage of claims arising from the sexual molestation of Defendant Crystal Greenwood. 1 In June of 1991, Crystal Greenwood, who was nine years old at the time, visited her aunt, Ammie Everette, for an overnight stay. Ms. Everette’s adult son, Gary Lee Everette, was living in his mother’s house at this time. While Ms. Everette was at work, Gary Lee Everette sexually assaulted Crystal Greenwood. Police arrested Gary Lee Everette shortly after this incident, and he remained incarcerated until November 26, 1991, when he pled guilty to two counts of aggravated sexual battery in Hampton Circuit Court.
On April 29,1994, Crystal Greenwood filed suit against Ammie Everette and Gary Lee Everette in Hampton Circuit Court, alleging sexual assault and battery by Gary Lee Everette and negligent supervision by Ammie Everette. Ms. Greenwood seeks $300,000.00 in damages from the Everettes.
At the time of the assault, Ammie Everette held a homeowner’s policy from Vermont Mutual. On November 11, 1992, Crystal Greenwood’s attorney, John Ward Bane, telephoned Ms. Everette to inquire whether she held a homeowner’s insurance policy. That same day, Ms. Everette telephoned her homeowner’s insurance agent and reported that her son had molested her niece on August 1, 1990. McLain aff. at 1. Ms. Everette did not report a June 5, 1991 incident. Id. She told the agent that her sister’s attorney had contacted her, but that her niece had not yet brought an action against her son. Id.
On February 21, 1994, Ms. Everette received a letter from Mr. Bane, and a copy of a Motion for Judgment which he stated he intended to file in the near future. The letter suggested that Ms. Everette take the Motion for Judgment to her insurance company. On May 6, 1994, Ammie Everette and Gary Lee Everette were served with the Motion for Judgment. On May 9, 1994, Ms. Everette hand-delivered the February 21, 1994, letter from Mr. Bane to her insurance agent.
On May 25, 1994, Vermont Mutual mailed “reservation of rights” letters to Ammie Everette and Gary Lee Everette, and sent copies of the letters to Crystal Greenwood’s attorney. The letters stated that Vermont Mutual questioned whether the policy covered the sexual assault, and whether Ms. Everette had breached the policy by failing to provide Vermont Mutual with timely no
On July 20,1994, Plaintiff Vermont Mutual filed a Complaint for Declaratory Judgment in this Court, requesting this Court to declare that the Everettes are not entitled to coverage under the Vermont Mutual policy for claims arising from the sexual assault. Plaintiff contends that the policy does not require it to defend or indemnify the Everettes because (1) the policy excludes coverage of bodily injury “which is expected or intended by the insured;” (2) Ammie Everette did not give Vermont Mutual written notice of the incident “as soon as practical,” as required by the policy; and (3) Ammie Everette did not promptly forward documents relating to the lawsuit, as required by the policy.
Plaintiff moved for default judgment against Ammie Everette and Gary Lee Everette, based on their failure to answer or otherwise defend this action. This Court has found both Ammie Everette and Gary Lee Everette in default and, in a separate order, directed the clerk to enter default judgment against these Defendants.
Both Plaintiff and Defendant Greenwood have filed motions for summary judgment. The parties having submitted written briefs and presented oral argument to the Court, this matter is ripe for decision.
II. Jurisdiction
A Justiciability of the Case in the Absence of the Insured
As a threshold matter, this Court must determine whether a case or controversy exists between the injured third party, Crystal Greenwood, and the insurer, Vermont Mutual. If Crystal Greenwood’s interests in this case are entirely derivative of the Everette’s rights as the insured party, default judgment against the Everettes necessitates a judgment against Crystal Greenwood. On the other hand, if a case or controversy exists between Crystal Greenwood and Vermont Mutual, independent of the Everette’s rights under the policy, the Court has jurisdiction to address the substantive issues of this case in the absence of the Everettes.
In
Maryland Casualty Co. v. Pacific Coal & Oil Co.,
The Supreme Court held that a case or controversy existed between the injured third party and the insurer, and therefore the insurer was entitled seek declaratory relief against the injured third party.
Id.
at 274,
Citing
Maryland Casualty,
the Fourth Circuit has stated that “a dispute between a liability insurer, its insured and a third party with a tort claim against the insured over the extent of the insurer’s responsibility for that claim is an ‘actual controversy’ within the meaning of the federal Declaratory Judgment Act, even though the tort claimant has not yet reduced his claim against the insured to judgment.”
Nautilus Ins. Co. v. Winchester Homes, Inc.,
The Seventh Circuit ease of
Hawkeye-Security Insurance Co. v. Schulte
involved a collision between a car owned by the insured, John Schulte, Sr., and driven by his son, John Schulte, Jr., and a car driven by Joseph Ginley.
In
Federal Kemper Insurance Co. v. Rauscher,
the insurer brought a declaratory action against its insured and the injured third party to determine its obligations under an automobile insurance policy.
Similar to the Ohio statute allowing an injured third party to proceed against the insurer, which the Supreme Court found significant in
Maryland Casualty,
Section 38.2-2200 of the Virginia Code allows an injured third party to bring a direct action against an insurer when the injured third party has obtained a judgment against the insured and that judgment remains unsatisfied.
Considering the Supreme Court’s holding in
Maryland Casualty,
and the decisions of the Fourth, Third, and Seventh Circuits addressed herein, this Court likewise finds that Crystal Greenwood is entitled to remain in this action and defend her interests. The Court emphasizes the significance of Virginia Code
For these reasons, the Court finds that an actual controversy exists between Crystal Greenwood and Vermont Mutual, and that she is entitled to defend this action, regardless of the default judgment against the Everettes.
B. Jurisdiction Under the Declaratory Judgment Act
This Court exercises jurisdiction over this matter pursuant to
In the case at bar, Plaintiff Vermont Mutual seeks a declaration of its obligations to its insured. Undoubtedly, the declaratory relief Plaintiff seeks would be useful in determining the parties’ legal relationship and would terminate the issue of whether Vermont Mutual must defend and indemnify the Everettes in the state tort action. Furthermore, none of the factors listed weigh in favor of the Court declining to hear this declaratory judgment action.
First, as discussed above, determination of this case will serve the useful purpose of determining Vermont Mutual’s obligations to the Everettes. Second, although the substantive issues of this case involve state law, this alone is not sufficient reason for the Court to refuse to decide a declaratory judgment action.
Nautilus Ins. Co.,
III. Analysis
The court may grant summary judgment on an issue only when “the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.”
A Coverage Issues
Because the law of the state where an insurance contract is written and delivered controls as to issues of coverage, Virginia law governs questions of coverage in this dispute.
Buchanan v. Doe,
1. Breach of the Policy by the Everettes
Vermont Mutual alleges that Ammie Everette failed to timely notify the insurance company of the sexual assault. The policy provides that, after an accident or occurrence, the insured must:
give written notice to us or our agent as soon as is practical, which sets forth:
■ (1) the identity of the policy and the insured;
(2) reasonably available information on the time, place and circumstances of the accident or occurrence; and
(3) names and addresses of any claimants and witnesses.
Vermont Mutual policy at 14. The question of whether an insured has provided timely notice of an “occurrence” is determined by an objective reasonableness standard.
See Dan River, Inc. v. Commercial Union Ins. Co.,
The sexual assault on Crystal Greenwood occurred in June of 1991. Ms. Everette first contacted Vermont Mutual on November 11, 1992, when she telephoned Carol McLain. Crystal Greenwood contends that Ms. Everette did not realize her homeowner’s policy would be involved until Mr. Bane questioned her about the policy on November 11, 1992, and she therefore was reasonable in not notifying Vermont Mutual of this incident until this time. 2 Even assuming that Ms. Everette reasonably failed to realize that her homeowner’s insurance was related to the molestation incident, the Court finds that she failed to give timely notice of the incident, for the reasons that follow.
(a) adequacy of Ms. Everette’s phone call in satisfying the notice provision
The Court finds that Ms. Everette’s telephone call to her insurance agent on November 11, 1992 was insufficient to satisfy her obligation under the policy. First, Ms. Everette failed to comply with the requirement of a written notice, as specified in the policy. Additionally, Ms. Everette provided the insurance agent with inaccurate information about the incident, by informing the agent of a sexual assault in August of 1990, not in June of 1991, and by stating that her son had been spending the night when he molested her niece, when, in fact, he resided at her home.
Although the policy required written notice, Defendant argues that oral notice may suffice when an insurance company permits such notice in lieu of written notice. The only support Defendant provides for position is
Hitt v. Cox,
The information Ms. Everette provided was not in writing, nor was it sufficient regarding the sexual assault, and therefore her phone call failed to satisfy her obligation of notifying Vermont Mutual of the incident.
(b) timeliness of Ms. Everette’s first written notice of the incident
The first time Vermont Mutual received written notice regarding a June 1991 molestation incident was on May 9,1994, when Ms. Everette forwarded the Motion for Judgment that she received on May 6, 1994. Although timeliness is traditionally a question of fact', the Virginia Supreme Court has held that it may be decided as a matter of law where the facts are undisputed, and when reasonable minds should not differ on the proper inferences deductible from the facts.
Mason & Dixon Lines v. United States Casualty Co.,
At the latest, Ms. Everette should have known that her homeowner’s policy might cover the sexual molestation on November 11, 1992. Although she did contact her agent, the policy required her to provide written notice of the incident. Additionally, she informed the agent that a molestation occurred in August of 1990, rather than in June of 1991. Once she was aware that her homeowner’s policy might cover the molestation, Ms. Everette could have consulted the policy to determine what action it required her to take. Regardless of whether she did not read the policy, or whether she chose to ignore its requirements, Ammie Everette failed to provide proper notice.
(c) failure of Gary Lee Everette to give notice
The Vermont Mutual policy includes as an “insured” any relative of the named insured, if such relative is living in the named insured’s household. Vermont Mutual policy at 1. Thus, as Ammie Everette’s son residing in her home, Gary Lee Everette was also an “insured” under the policy at the time of the sexual assault, and could have provided notice. The record does not contain any evidence or allegation that he provided Vermont Mutual with any notice of the molestation. Therefore, Gary Lee Everette also breached the policy’s notice provision.
2. Vermont Mutual’s Obligations Under the Policy
In Virginia, timely notice is a condition precedent to coverage.
Norfolk & W. Ry. v. Accident & Casualty Ins. Co.,
Vermont Mutual presents two additional grounds for denying coverage to the Everettes. It contends that Ms. Everette failed to promptly forward suit documents. It also contends that the sexual molestation was an occurrence “expected or intended” by the
B. Notice to Claimant Pursuant to Virginia Code Section 38.2-2226
The Virginia Code requires that insurers notify injured third parties of their intent to deny coverage because of an insured’s breach of a policy within twenty days after discovery of the breach or the claim, whichever is later.
Crystal Greenwood alleges that Vermont Mutual failed to comply with this statutory notice requirement, and therefore Vermont Mutual cannot use the Everettes’ policy breach as grounds for refusing coverage. 3 Vermont Mutual mailed copies of the reservation of rights letters to Crystal Greenwood’s attorney on May 25, 1994, less than twenty days after it learned of both the claim and the breach. 4 Crystal Greenwood argues that Vermont Mutual should have provided her with a subsequent notice, informing her of its final decision on whether it would deny coverage.
Vermont Mutual contends that it is not subject to
If the statute required an insurer to give notice to a claimant of its final determination that it will deny coverage, Plaintiff is correct in its assertion that
However, the statute states that the insured must provide notice of its
intent
to deny coverage, not of its final decision. In
Liberty Mutual Insurance Co. v. Safeco Insurance Co. of America,
Likewise, this Court finds that Vermont Mutual satisfied the
TV. Conclusion
The Court finds, as a matter of law, that the Everettes breached their obligation to promptly and adequately notify Vermont Mutual of the June 11, 1991 sexual assault of Crystal Greenwood. Because the Everettes failed to satisfy a condition precedent to coverage, Vermont Mutual is not obligated to provide coverage for the claims arising out of this incident. Furthermore, the Court finds that Vermont Mutual satisfied Virginia Code
The Clerk is DIRECTED to send a copy of this Opinion and Final Order to all parties and/or counsel of record.
It is so ORDERED.
Notes
.
The Court also notes that service on Crystal Greenwood was defective. Rule 4(g), which governs service on infants, states that such service "shall be effected in the manner prescribed by the law of the state in which service is made.”
. Ms. Everette has not appeared in this case, and the Court has entered default judgment against her. See supra at 4.
. Plaintiff contends that reliance on
In pleading to a preceding pleading, a party shall set forth affirmatively accord and satisfaction, arbitration and award, assumption of risk, contributory negligence, discharge in bankruptcy, duress, estoppel, failure of consideration, illegality, injury by fellow servant, laches, license, payment, release, res judicata, statute of frauds, statute of limitations, waiver, and any other matter constituting an avoidance or affirmative defense.
Generally, when a party fails to raise an affirmative defense in its answer, it waives the defense.
Menendez v. Perishable Distributors, Inc.,
. As discussed above, Vermont Mutual's first notice of the June, 1991 incident was on May 9, 1994, when Ammie Everette delivered the motion for judgment to her insurance agent. See supra at 14.
.
Liberty Mutual
involved Virginia Code Section 38.1 — 389.1 (1968), the predecessor to