Brian Frye v. Erie Insurance Company (Justice Wooton, concurring, in part, and dissenting, in part)

CourtWest Virginia Supreme Court
DecidedJune 12, 2024
Docket22-0378
StatusSeparate

This text of Brian Frye v. Erie Insurance Company (Justice Wooton, concurring, in part, and dissenting, in part) (Brian Frye v. Erie Insurance Company (Justice Wooton, concurring, in part, and dissenting, in part)) is published on Counsel Stack Legal Research, covering West Virginia Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Brian Frye v. Erie Insurance Company (Justice Wooton, concurring, in part, and dissenting, in part), (W. Va. 2024).

Opinion

FILED No. 22-0378 – Frye v. Erie Insurance Co. June 12, 2024 released at 3:00 p.m. C. CASEY FORBES, CLERK WOOTON, Justice, concurring, in part, and dissenting, in part: SUPREME COURT OF APPEALS OF WEST VIRGINIA

I concur in the majority’s decision to vacate the order denying petitioner

Brian Frye’s motion pursuant to West Virginia Rule of Civil Procedure 59(e) and remand

for further proceedings. However, I dissent to the refusal to also reverse the circuit court’s

award of summary judgment to respondent Erie Insurance Company (“Erie”); that refusal

evades and improperly endorses the circuit court’s erroneous ruling that insureds like

petitioner Frye may not sue their insurer for alleged improper denial of mine subsidence

claims. As it stands, the majority has left in place a determination that mine subsidence

insureds in West Virginia cannot sue the party with whom they contracted for wrongful

denial of such coverage, and remands merely in the hope that the Attorney General of West

Virginia will intervene and explain what insureds are to do. That result cannot stand and

accordingly, I respectfully dissent in that regard.

As indicated, the majority’s resolution vacates only the order denying

petitioner’s Rule 59(e) motion and remands for notice to be given under West Virginia

Rule of Civil Procedure 24(c), thus allowing the Attorney General the opportunity to seek

intervention and defend the constitutionality of the mine subsidence insurance statutory

scheme. And while perhaps procedurally permissible, this resolution does both too much

and too little. It does too much in that it casts a pall of unconstitutionality over the mine

subsidence insurance statutory scheme where none actually exists. It is not these statutes

1 that unconstitutionally deprive petitioner of a remedy. Instead, it is the circuit court’s

ruling that an insured cannot sue his insurer for breach of contract arising from alleged

wrongful denial of coverage that deprives him of a remedy—a legal error we can and

should fix. In that regard, the majority’s resolution does too little. Despite wringing its

hands about an insured’s ostensible lack of recourse for an alleged wrongful denial of a

claim at the hands of the West Virginia Board of Risk and Insurance Management

(“BRIM”), the majority’s resolution evades the underlying error which, if corrected, would

solidify petitioner’s remedy and render the State’s Rule 24(c) intervention unnecessary.

Petitioner filed a breach of contract action, along with an Unfair Trade

Practices Act claim, against his first-party insurer, Erie. As with any insured/insurer or

other contractual relationship, petitioner and Erie’s relationship is governed by the terms

of their contract. Like any insured in West Virginia, petitioner may bring an action for

breach of contract if he believes his claim was wrongfully denied, and may seek first-party

damages resulting from that denial. Petitioner’s contract of insurance with Erie—even as

to the mine subsidence coverage added by endorsement—is governed by the terms and

conditions set forth in that policy. Endorsements for specific coverages are not novel and

are governed by ordinary contractual principles, as contemplated in the policy language

discussed below.

In that regard, the “Agreement” portion of petitioner’s insurance policy with

Erie provides: “[W]e agree to provide the coverages you have purchased.” The “Rights 2 and Duties” provision states that “[w]e will settle any claim for loss with you.” The term

“we” is one of “special meaning” under the policy which provides: “‘We’, ‘us’ or ‘our’

means the Erie Insurance Property & Casualty Company.” The policy further provides that

“[t]his important contract between YOU and The ERIE consists of this policy with

coverage agreements, limitations, exclusions and conditions, a Declarations, plus any

endorsements.”1 (Emphasis added). It states further that “[t]his policy, all endorsements

to it, and the Subscriber’s Agreement constitute the entire agreement between you and us.”

(Emphasis added). This language forms the boundaries of Erie’s agreement to provide

coverage to petitioner; where it wrongfully fails to do so, petitioner unquestionably has a

first party cause of action against it. Nowhere in this contract of insurance does petitioner

contract with BRIM for coverage, or agree to Erie’s delegation—or BRIM’s assumption—

of Erie’s obligations under the contract.

1 The mine subsidence coverage is set forth in an endorsement entitled “West Virginia Coal Mine Subsidence Coverage Part Endorsement” which outlines, inter alia, coverage, exclusions, and other sundry provisions including a lengthy arbitration provision which provides for arbitration only if BRIM and the insured “mutually consent[.]” Although this endorsement language includes an occasional reference to BRIM, it is always in conjunction with “the company” or not at all. “The company” is expressly defined as “the company providing this insurance as designated on the Declarations.”

As its final provision, that endorsement states that “ALL OTHER PROVISIONS OF THE POLICY APPLY.” Nowhere does the endorsement reflect an agreement by petitioner to Erie’s delegation of its contractual obligations, nor could it reasonably do so in light of all the other language unequivocally demonstrating that petitioner has contracted solely with Erie for the coverage outlined in the policy and as governed exclusively by the terms of that policy.

3 Therefore, the confounder in this case lies not in the insurance policy

between petitioner and Erie, but the significance of the statutory mine subsidence insurance

scheme and the reinsurance arrangement between Erie and BRIM. However, the circuit

court failed to analyze this scheme to any meaningful degree, deciding that simply because

the statutes grant claims handling and settlement authority to BRIM, any contractual

obligations owed by Erie to petitioner are nullified. The circuit court reached this

conclusion without examining the Reinsurance Agreement between Erie and BRIM or any

of the law applicable to reinsurance. If it had done so, it would have found that there is

nothing so fundamentally unusual about BRIM’s reinsurance arrangement with Erie as to

warrant concluding that petitioner’s contractual rights have been rendered unenforceable.

More importantly, the circuit court would have discovered that any significant differences

in the reinsurance arrangement actually inure to petitioner’s benefit, rather than destroy his

cause of action.

As evidence of the typicality of the reinsurance arrangement between BRIM

and Erie, the mine subsidence endorsement appended to Erie’s policy references the mine

subsidence insurance fund as providing “reimburse[ment] [of] the company[]”—just as

with any reinsurance. BRIM’s own Deputy Director stated in a letter to petitioner’s counsel

that BRIM “basically serves as a reinsurer for Erie[.]” Most importantly, however, the

statutory scheme itself requires that Erie execute a “Reinsurance Agreement” as set forth

in Appendix F to the governing regulations. See W. Va. Code R. § 115-1-3.9 (“Reinsurance

agreement. -- Each insurance company subject to this rule shall enter into a reinsurance 4 agreement with the Board. Refer to Appendix F for the wording of the Reinsurance

Agreement.”). Although not particularly extensive, the Reinsurance Agreement at its

essence functions conceptually as most reinsurance does.

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Bluebook (online)
Brian Frye v. Erie Insurance Company (Justice Wooton, concurring, in part, and dissenting, in part), Counsel Stack Legal Research, https://law.counselstack.com/opinion/brian-frye-v-erie-insurance-company-justice-wooton-concurring-in-part-wva-2024.