2535 (l)

Court of Appeals for the Second Circuit·Decided September 25, 2018·Published

Opinion

16‐2535 (L) Utica Mut. Ins. Co. v. Clearwater Ins. Co.

UNITED STATES COURT OF APPEALS

FOR THE SECOND CIRCUIT

August Term 2017

(Argued: October 18, 2017 Decided: September 25, 2018)

Docket Nos. 16‐2535 (L), 16‐2824 (XAP)

UTICA MUTUAL INSURANCE COMPANY, Plaintiff‐Counter‐Defendant – Appellant‐Cross‐Appellee,

v.

CLEARWATER INSURANCE COMPANY, Defendant‐Counter‐Claimant – Appellee‐Cross‐Appellant.

Before:

KEARSE, CABRANES, and WESLEY, Circuit Judges.

Utica Mutual Insurance Company and Clearwater Insurance Company both appeal from the district court’s summary judgment orders regarding Clearwater’s obligations to Utica under five facultative reinsurance policies. The United States District Court for the Northern District of New York (Sharpe, then‐C.J.) granted

partial summary judgment to Clearwater, ruling that the reinsurance company need not pay expenses beyond the limit of liability in the reinsurance contracts. The district court later granted summary judgment to Utica, concluding that Clearwater was obligated to indemnify Utica according to Utica’s reasonable and good‐faith settlement of a coverage dispute with its insured.

On appeal, Utica argues that Clearwater’s claim‐related expenses should not be subject to the reinsurance contracts’ limits of liability. On cross‐appeal, Clearwater argues that it is not obligated to indemnify Utica according to Utica’s coverage settlement with its insured because the reinsurance contracts do not obligate Clearwater to pay according to that settlement. Clearwater also argues that Utica’s settlement allocation with its insured is, in any event, unreasonable.

We conclude that because Clearwater’s obligations under the reinsurance contracts follow Utica’s expense‐supplemental obligations under the umbrella policies, Clearwater’s liability is expense‐supplemental. But we vacate and remand for the district court to determine whether this obligation encompasses certain expenses. We also vacate and remand on the cross‐appeal because Utica has not demonstrated its entitlement to a judgment that Clearwater was bound to indemnify Utica according to Utica’s settlement with its insured.

WILLIAM M. SNEED (Daniel R. Thies, on the brief), Sidley Austin LLP, Chicago, IL, for Plaintiff – Appellant‐Cross‐Appellee.

DAVID C. FREDERICK, Kellogg, Hansen, Todd, Figel & Frederick, P.L.L.C., Washington, D.C. (Jeremy S.B. Newman, Amelia I.P.

Frenkel, Kellogg, Hansen, Todd, Figel & Frederick, P.L.L.C., Washington, D.C.; John F. Finnegan, Chadbourne & Parke LLP, New York, NY, on the brief), for Defendant – Appellee‐Cross‐ Appellant.

WESLEY, Circuit Judge:

From the 1950s to the 1990s, Utica Mutual Insurance Company issued various liability insurance policies to Goulds Pumps, Inc. Clearwater Insurance Company reinsured several of these policies. The Utica‐Goulds policies proved valuable to Goulds when it started receiving thousands of asbestos bodily‐injury claims in the 1990s. The policies simultaneously proved costly to Utica, which had failed to include aggregate limits in certain years’ policies. After Utica and Goulds reached a settlement agreement regarding Utica’s liability under those policies lacking aggregate limits, Utica sued Clearwater seeking indemnification pursuant to its reinsurance contracts.

Utica now appeals from the district court’s grant of Clearwater’s partial motion for summary judgment on the scope of its coverage under the reinsurance contracts. Clearwater cross‐appeals from the district court’s grant of Utica’s motion for summary judgment on Clearwater’s liability under the Utica‐Goulds settlement.

BACKGROUND

I. Insurance and Reinsurance Generally This case involves several types of insurance with their own spheres of coverage; understanding them is essential to resolution of the case. Primary and excess insurers provide liability coverage. Primary insurance provides the first layer of coverage of an insured’s liability or loss. Ali v. Fed. Ins. Co., 719 F.3d 83, 90 (2d Cir. 2013); 1 Steven Plitt et al., Couch on Insurance § 1:4, at 12 (3d ed. 2009). Excess insurance provides the additional layer of coverage for an insured’s losses exceeding the primary insurance policy’s limits. Ali, 719 F.3d at 90. Umbrella policies blend primary and excess coverage by providing last‐resort excess coverage as well as gap‐filling primary coverage on claims not otherwise insured by primary policies. See, e.g., BASF AG v. Great Am. Assurance Co., 522 F.3d 813, 815 (7th Cir. 2008); Francis M. Gregory Jr. & Nicholas T. Christakos, Primary, Excess and Reinsurance Problems in Large Loss Cases, 59 Def. Counsel J. 540, 542 (1992). In this case, Utica Mutual Insurance Company provided both primary and umbrella policies to Goulds.

Insurers have insurance, too. Reinsurance occurs when a carrier (the “reinsurer”) agrees to cover losses experienced by an insurer for certain covered

risks. Here, Clearwater Insurance Company1 insured Utica (the “cedent” or “reinsured”) against loss or liability arising from its policies with Goulds (the “insured”). See generally Unigard Sec. Ins. Co. v. N. River Ins. Co. (Unigard), 4 F.3d 1049, 1053 (2d Cir. 1993) (describing “the business of reinsurance”). These reinsurance contracts allow the reinsured to distribute its risk of loss among reinsurers. Id. There are two types of reinsurance contracts: facultative and treaty. A facultative reinsurer insures part or all of a single insurance policy, with underwriting occurring as to each reinsured policy. Id. at 1054; N. River Ins. Co. v. CIGNA Reins. Co. (CIGNA), 52 F.3d 1194, 1199 (3d Cir. 1995) (“[A] facultative reinsurer ‘retains the faculty, or option, to accept or reject any risk.’” (quoting William G. Clark, Facultative Reinsurance: Reinsuring Individual Policies, in Reinsurance 117, 121 (Robert W. Strain ed., 1980)). A treaty reinsurer insures specified classes of a ceding insurer’s policies. Unigard, 4 F.3d at 1054. All five of Clearwater’s reinsurance policies at issue here are facultative.

Several types of clauses defining the resinsurer’s obligations in relation to the obligations of the reinsured commonly appear in facultative resinsurance contracts. Three types are relevant to this case.

1 Formerly Skandia America Reinsurance Corporation.

The standard follow‐the‐form or following‐form clause ensures that the reinsurance contract covers the same risks as those covered in the reinsured insurance policy. It provides that all the terms and conditions of the reinsured insurance policy are incorporated by reference into the reinsurance contract, except insofar as the reinsurance and insurance contracts conflict. CIGNA, 52 F.3d at 1199; Graydon S. Staring & Dean Hansell, Law of Reinsurance § 12:5, 258–63 (2017) (explaining that differences in premiums, limits, and period are the most common exceptions to congruence).

Some reinsurance contracts also contain what is called a follow‐the‐ settlements, following‐settlements, or loss‐settlement clause.2 When a reinsurance contract contains a follow‐the‐settlements clause, the reinsurer must indemnify the reinsured for losses settled reasonably and in good faith, even if the reinsured was not actually liable for those losses under the reinsured insurance policy. See Travelers, 419 F.3d at 189; U.S. Fid. & Guar. Co., 20 N.Y.3d at 418–20. If the contract

2 A “[f]ollow‐the‐settlements [obligation] . . . is [a] follow‐the‐fortunes [obligation] in the settlement context.” Travelers Cas. & Sur. Co. v. Gerling Glob. Reins. Corp. of Am. (Travelers), 419 F.3d 181, 186 n.4 (2d Cir. 2005) (citation omitted). We use the term “follow the settlements” in this opinion in keeping with the context of Clearwater’s alleged obligation to follow Utica’s settlement with Goulds and the terminology used recently by New York courts. See, e.g., U.S. Fid. & Guar. Co. v. Am. Re‐Ins. Co., 20 N.Y.3d 407, 418 (2013).

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