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Clearly Applicable Policy Exclusions and the Duty to Defend

by | Sep 17, 2024 | Construction Law, Decisions, Dispute Resolution, Events, Featured, Insurance Law, Misc., News & Updates, Professional Liability & Significant Injury Claims

On August 21, 2024, the Ninth Circuit Court of Appeals issued an unpublished opinion in Sec. Nat’l Ins. Co.  v. Urberg, Case No. 23-35228, 2024 U.S. App. LEXIS 21365, 2024 WL 3912582 (9th Cir. Aug. 21, 2024) affirming the dismissal of the appellants’ claims against Security National Insurance Company (SNIC) regarding SNIC’s duty to defend.

The underlying lawsuit in Urberg arose when the appellant-homeowners noticed damage to their properties several months after purchasing their homes. The homeowners filed suit against the builders and developers alleging breach of contract and breach of express and implied warranties. The general contractor filed a third-party complaint against the subcontractors, including LND Construction, who was insured by SNIC. LND Construction thereafter tendered the defense of the general contractor’s claims to SNIC and SNIC denied.

The United States District Court for the Western District of Washington (the “Western District”) granted summary judgment in favor of SNIC dismissing the appellants’ breach of contract and bad faith claims. The Western District found the appellants failed to establish that SNIC’s denial was unreasonable, frivolous, or unfounded. The Western District further dismissed LND Construction’s claims because aside from an unfounded timing argument, it failed to establish actual harm as a result of SNIC’s alleged bad faith denial.

Pursuant to Washington law, the duty to defend is triggered at the time a lawsuit is filed and “is based on the potential for liability.” Woo v. Fireman’s Fund Ins. Co., 161 Wn.2d 43, 164 P.3d 454, 459 (Wash. 2007) (quoting Truck Ins. Exch. v. VanPort Homes, Inc., 147 Wn.2d 751, 58 P.3d 276, 281 (Wash. 2002)). Additionally, despite insurers having a broad duty to defend in Washington, any alleged claims which are clearly not covered by the policy relieve an insurer of its duty. Kirk v. Mt. Airy Ins. Co., 134 Wn.2d 558, 951 P.2d 1124, 1126 (Wash. 1998).

The Ninth Circuit affirmed the Western District’s decision and likewise found that SNIC did not have a duty to defend. The Ninth Circuit also ruled that it was clear from the operative Complaint and the SNIC policy that the new construction exclusion clearly applied. In particular, the Ninth Circuit held that because it was certain that the claims alleged against LND Construction involved new construction, the exclusion directly applied and no further consideration of facts and/or Washington case law was necessary. Sec. Nat’l Ins. Co., 2024 U.S. App. LEXIS 21365 at *4.

On August 22, 2024, the Western District issued another unpublished opinion in Bitco Gen. Ins. Corp. v. Union Ridge Ranch, LLC & Inland Co., Case No. C22-05624 BHS, 2024 U.S. Dist. LEXIS 150604*; 2024 WL 3924715 (W.D. Wash., Aug. 22, 2024). Specifically, the Western District addressed the applicability of an impaired property exclusion and its exception involving the retaining wall/concrete work the insured, Inland Corporation (Inland Co.), was retained to perform.

Specifically, the Bitco General Insurance Corporation (Bitco) policy included an impaired property exclusion which excluded coverage for property that is rendered “less useful” due to the defective work by the insured. The exception would apply, however, if the insured could prove the “loss of use of other property arising out of sudden and accidental physical injury” to its work after it has been put to its intended use.

After the construction was finished, a prospective buyer retained a geotechnical expert who identified multiple defects with Inland Co.’s work. As a result, the prospective buyer did not purchase the property. Inland Co. later discovered that one of the retaining walls it constructed had failed. A second geotechnical expert further confirmed that the retaining walls were still defective after Inland Co. attempted to repair the defects. The property was eventually sold. However, a third geotechnical expert’s analysis revealed that the retaining walls were improperly constructed and were at risk of failure.

Inland Co. filed suit against Union Ridge Ranch (URR) in Clark County Superior Cout based upon URR’s alleged failure to pay. URR raised counterclaims against Inland Co. alleging breach of contract and negligence based upon Inland Co.’s faulty work which prevented it from selling the property for a profit. Inland Co. tendered the defense of URR’s counterclaims to BITCO and BITCO defended under a full reservation of rights. The parties reached a settlement for $2.66 million and URR agreed not to seek recovery against Inland Co. and Inland Co. assigned its insurance rights against BITCO to URR.

BITCO then filed a declaratory judgment coverage action against URR arguing that it did not owe coverage for the settlement under the commercial general liability and umbrella policies it issued to Inland Co. The Western District determined that the failure of one of the retaining walls was gradual and inevitable rather than sudden or accidental. When considering the impaired property exception, the Western District ruled that the exception did not apply because even if the failure of the retaining wall was “sudden and accidental”, Inland Co. could not show that URR’s damages arose from that failure.

Moreover, the Western District commented that the only thing surprising about the failed retaining wall is that it was the only retaining wall to visibly fail. The Western District heavily considered the three geothermal experts’ analysis revealing that the retaining walls, both before and after the single wall failed, were likely to fail. Ultimately, the Western District determined that it was clear the impaired property exclusion applied, without exception, to exclude coverage to Inland Co. because the property was “less useful” as a direct result of the improperly constructed retaining walls.

The Bitco and Urberg decisions evidence that Washington Courts broadly construe insurers’ duty to defend. Specifically, when there is any reasonable interpretation of the facts or law which could result in coverage, the insurer must defend. However, when it is uncontested that an alleged claim is not covered or clearly excluded by the policy, Washington Courts will oftentimes determine that the insurer is relieved of its duty to defend and/or indemnify.

Lether Law Group has represented and advised commercial general liability primary and excess insurers on all aspects of coverage, including the duty to defend, scope of coverage, and application of policy exclusions and their exceptions. If you would like to discuss the implications of the Bitco and/or Urberg decisions or coverage issues involving these types of claims, please feel free to contact our offices.

New Oregon Decision Will Affect Insurers in Many Ways

by | May 14, 2017 | Construction Law, Decisions, News & Updates

The Court of Appeals of the State of Oregon issued a decision on May 10, 2017 in the matter titled Hunters Ridge Condominium Assoc. v. Sherwood Cross, LLC, et al. that could potentially impact future Construction Defect cases in Oregon.

The Hunters Ridge appeal arose out of construction defect lawsuit.  The Plaintiff Condo Association filed suit against the developer and general contractor.  The general contractor then filed third-party claims against several subcontractors.

One subcontractor, Walter George Construction (“WGC”), was insured by American Family (“AmFam”).  WGC tendered the claim to AmFam, who denied coverage based upon a Multi-Unit New Residential Construction Exclusion. Thereafter, WGC failed to appear or answer the Complaint.

Default Judgments were entered against WGC by the developer and general contractor, which included damages, attorneys’ fees, and costs.  The remaining parties settled.  The developer and general contractor, as part of their settlements, assigned claims against WGC to the Plaintiff Condo Association.

A Garnishment Proceeding followed, during which the Condo Association sought to obtain the proceeds of the applicable AmFam policy. Several Motions for Summary Judgment were filed.  Those orders formed the basis of the appeal.

The Trial Court had granted AmFam’s Motion for Summary Judgment on the application of the Multi-Unit New Residential Construction Exclusion.  On appeal, the Condo Association argued the exclusion was ambiguous and therefore could not be construed in favor of coverage.

The subject condo was mixed use – each of the three buildings had dedicated commercial space on the ground floor with residential units above them.  The exclusion defined “multi-unit residential building” as “a condominium, townhouse, apartment or similar structure, each of which was greater than eight units built or used for the purpose of residential occupancy.”

AmFam argued that the condos, which contained more than eight residential units, were subject to the exclusion.  On appeal, the Condo Association argued the exclusion was unenforceable for ambiguity.  It claimed the exclusion could be read to either include or exclude multi-purpose buildings. The Court of Appeals agreed. Specifically, the Court determined the term “residential building” could be interpreted as either a multi-use building, or one that is purely residential.  In light of the ambiguity, the Court reversed the Trial Court’s grant of summary judgment on that issue.

The Court of Appeals also reviewed the Trial Court’s denial of AmFam’s Motion which argued there was no coverage for attorneys’ fees and costs awarded in the underlying judgments.

The awards of fees were based upon the contractual indemnity provisions in the subcontracts, which obligated WGC to indemnify both developer and general contractor.  The Trial Court held that the term “costs taxed against the insured” was ambiguous with respect to whether it included attorneys’ fees.  AmFam appealed.

The Court of Appeals reviewed the fees in two ways.  First, whether the fees were part of the “obligation to pay damages because of ‘property damage’ which the insurance applie[d].”  Second, whether the fees constitute “costs” under the “Supplementary Payments” provision.

The Court determined that attorneys’ fees and costs can potentially constitute covered damages.  The Court recognized that, under Oregon common law, when attorneys’ fees are claimed as consequential damages as a result of tortious or wrongful conduct by a defendant which causes a plaintiff to litigate with a third party, the standard American Rule does not apply.

The Court found that since the claims against the developer and general contractor arose in part from the WGC’s defective work, the insured was therefore liable for some portion of the fees incurred in defending those claims by the Condo Association. The Court concluded that such fees could qualify as consequential damages recoverable against the insured, even in the absence of a contractual indemnity provision.  As consequential damages, the Court reasons, they could be considered “damages because of property damage” within the meaning of the policy.

The Court notes, however, that fees incurred by the developer and general contractor in litigating claims directly against the insured would not qualify as such “damages.” Such fees are not subject to the third-party litigation rule set forth above.

The Court did, however, determine that the fees incurred by the developer and general contractor in pursuing the insured directly may qualify as “costs” under the “Supplementary Payments” provision.  The Court reasoned that since “costs” was not defined, it was required to interpret that term with the use of dictionary definitions.  The Court found that the common definitions of the term “costs” could be construed to either include or exclude attorneys’ fees.  Therefore, the Court held that the term was ambiguous, and ruled in favor of coverage. As a result, the term “costs” was construed to include attorneys’ fees, as well as expert expends, and the Trial Court’s denial of AFM’s Motion for Summary Judgment was upheld.

In addition the issues discussed above, the Court of Appeals reviewed the constitutionality of denying an insurer the right to a jury trial in the context of a Garnishment Proceeding. ORS 18.782 provides that, in a contested garnishment hearing at which the garnishee’s liability is determined, “[t]he proceedings against a garnishee shall be tried by the court as upon the trial of an issue of law between a plaintiff and defendant.” AmFam contended that this statute violated its constitutional right to a jury trial, pursuant to Article 1, Section 17 of the Oregon Constitution.

The Court agreed, and held that the insurer must be given the right to a jury trial as part of a full opportunity to litigate any coverage issues. As a result, the Court found that ORS 18.782 is unconstitutional to the extent it compels parties to a garnishment action to litigate coverage issues to the Court without the ability to elect a jury trial.

This decision obviously impacts several areas of law concerning insurance in the State of Oregon.  If you have any questions or concerns about how this decision may impact any pending or future claims, please feel free to contact our office at any time.