34-06 73 v. Seneca Insurance Company

New York Court of Appeals·Decided October 27, 2022·No. 81·Published

Opinion

State of New York OPINION Court of Appeals This opinion is uncorrected and subject to revision before publication in the New York Reports.

No. 81 34-06 73, LLC, et al., Respondents, v.

Seneca Insurance Company, Appellant.

Christopher R. Carroll, for appellant. Dennis T. D'Antonio, for respondents.

RIVERA, J.:

The question on this appeal is whether plaintiffs’ original complaint provides defendant with “notice of the transactions, occurrences, or series of transactions or occurrences, to be proved” in support of plaintiffs’ reformation claim, as required under CPLR 203 (f). At trial on this breach of contract action, plaintiffs sought to amend their complaint to include this otherwise untimely reformation claim based on mutual mistake

-2- No. 81 and a preexisting oral agreement. We conclude that plaintiffs’ initial pleading alleging that defendant breached the parties’ written insurance policy and that plaintiffs complied fully with all requirements contained therein fails to give defendant the requisite notice.

I.

Defendant Seneca Insurance Company issued plaintiffs 34-06 73, LLC, Bud Media, LLC, and Coors Media, LLC a multi-million dollar, written insurance policy covering several of plaintiffs’ vacant commercial properties. The parties do not dispute the contents of the policy, only whether plaintiffs’ complaint asserting breach of contract and seeking damages put defendant on notice of the transactions or occurrences underlying plaintiffs’ belated reformation claim.

As relevant to this appeal, the policy includes a Protective Safeguards Endorsement (“PSE”) that required plaintiffs, among other things, to maintain an automatic sprinkler device on the subject property. At the top of the page, the PSE states: “THIS ENDORSEMENT CHANGES THE POLICY” and advises to “READ IT CAREFULLY.” It further states that the PSE modifies the commercial property coverage of the policy so that defendant would “not pay for loss or damage caused by or resulting from fire if, prior to the fire, the policyholder . . . [k]new of any suspension or impairment in any protective safeguard . . . and failed to notify” defendant or otherwise “[f]ailed to maintain any protective safeguard . . . in complete working order.”

Approximately one month after the policy went into effect, defendant’s agent conducted an inspection of the premises and issued a report to plaintiffs’ principal and sole

-3- No. 81 owner, Mohammad Malik, advising him that there was no compliant sprinkler system on the premises and recommending that plaintiffs notify defendant of the system’s non-operability. A little more than four months later, there was a fire on the premises and plaintiffs requested payment under the policy for damages incurred. Defendant notified plaintiffs that it was denying the claim under the PSE because plaintiffs did not maintain a working sprinkler system.

Plaintiffs thereafter commenced this action against defendant for breach of contract, seeking over $2.4 million in damages based on defendant’s failure to cover the fire loss. The complaint made the following factual assertions: (1) defendant issued an insurance policy “bearing number FTZ 1000661” that provides property damage insurance on the covered property; (2) the fire on the premises “was a peril insured against under the Policy” which occurred “while the Policy was in full force and effect”; (3) plaintiffs complied “with all of the conditions precedent and subsequent pursuant to the terms of the subject policy”; and (4) defendant failed to indemnify plaintiffs for the property damage. In its answer, defendant admitted that it issued the referenced policy and had not made payment thereunder. Defendant raised several affirmative defenses, including one based on the PSE, asserting that, because plaintiffs failed to maintain the sprinkler system as required by the policy, they were not covered for the fire damage.

Following discovery, plaintiffs moved to dismiss the affirmative defense pursuant to CPLR 3211, arguing that defendant was aware that there was no functioning sprinkler system—as specifically noted in the inspection report to Malik—and thus waived its right

-4- No. 81 to disclaim coverage based on the PSE because it neither followed up to confirm whether an operational system was installed nor cancelled the policy. Defendant cross-moved for summary judgment on its PSE-based affirmative defense. Supreme Court denied the motions, concluding there were triable issues of fact as to waiver and there was conflicting evidence as to whether the sprinkler system was operational at the time of the fire.

At trial, for the first time, plaintiffs argued that the written policy did not reflect the parties’ agreement. Malik testified that he told his insurance broker that he did not want the policy to include a protective safeguard endorsement because the properties were vacant buildings or lots, and most did not have sprinklers. However, he admitted that he did not read the insurance policy. Defendant’s Vice President of Underwriting, Carol Muller, testified that an underwriting file disclosed during discovery did not contain documents referencing the PSE or the sprinkler system, that the premiums quoted for the Policy were for a non-sprinklered building, and that the inclusion of the PSE may have been a mistake.1 After plaintiffs rested, they orally moved to amend the complaint to conform the pleadings to the proof by adding a claim for reformation. The court reserved decision on the motion. At the charge conference, defendant opposed the proposed amendment,

1 The next day, the court denied defendant’s attempt to admit the routing sheet that Muller testified she did not see in the file, which, according to defendant, would have conclusively established defendant’s intent to include the PSE in the policy. Defendant further argued that whether the PSE was part of the policy did not arise until trial, prejudicing defendant. The court rejected this argument on the ground that the issue of the PSE’s inclusion bore on the issues of waiver and estoppel.

-5- No. 81 arguing that the reformation claim was time-barred and futile. The court granted plaintiffs’ motion, concluding that the claim related back to the complaint because it was “part of the whole thrust of the complaint originally” and the jury should decide whether the PSE’s inclusion resulted from a mutual mistake. Hence, in addition to charging the jury on the question of whether plaintiffs maintained a sprinkler system as required by the policy, the court also charged the jury on reformation, waiver, and estoppel.

Although the jury rejected plaintiffs’ waiver and estoppel arguments and found that plaintiffs did not prove due diligence in maintaining an automatic sprinkler system on the premises at the time of the fire, the jury returned a verdict in favor of plaintiffs on the reformation claim, finding that plaintiffs established by clear and convincing evidence that the parties’ true agreement was a policy without a PSE and it was a mutual mistake to include the PSE in the policy.

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