Estes v. Alaska Insurance Guaranty Ass'n

774 P.2d 1315, 1989 Alas. LEXIS 51
CourtAlaska Supreme Court
DecidedMay 26, 1989
DocketS-2408
StatusPublished
Cited by19 cases

This text of 774 P.2d 1315 (Estes v. Alaska Insurance Guaranty Ass'n) is published on Counsel Stack Legal Research, covering Alaska Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Estes v. Alaska Insurance Guaranty Ass'n, 774 P.2d 1315, 1989 Alas. LEXIS 51 (Ala. 1989).

Opinions

OPINION

COMPTON, Justice.

After fire destroyed his music store, Jack Estes filed a claim with his insurer, Union Indemnity Insurance Company of New York (Union Indemnity). Ten months later, Union Indemnity denied Estes’ claim on a number of grounds. One year and seven days after Union Indemnity’s denial of his claim, Estes filed suit against it.

[1316]*1316When Union Indemnity became insolvent, the Alaska Insurance Guaranty Association (AIGA) assumed Union Indemnity’s obligations on its policies. AIGA moved for summary judgment against Estes on the ground that Estes had failed to comply with a policy provision requiring any suit to be filed “within one year after the loss occurs.” The trial court granted summary judgment. We reverse.

I. FACTS AND PROCEEDINGS

Jack Estes operated a music store, Estes Music Studio, in Kenai, Alaska. On August 14, 1983, the store and its inventory were destroyed by fire. Soon after the fire, Estes submitted proof of loss to his insurer, Union Indemnity.

Union Indemnity completed its investigation of the loss in January 1984. On June 4, Union Indemnity denied Estes’ claim on the grounds that Estes had concealed facts related to the loss, had failed to provide certain documents, and had caused the loss or increased the risk of loss.

Estes did not communicate further with Union Indemnity until March 25, 1985, when Estes’ trial attorney, not of the firm that represented Estes during the investigation, wrote to Union Indemnity’s attorney asking to be advised of Union Indemnity’s position on the claim. There was no response to this letter, and on June 11, 1985, Estes filed a complaint against Union Indemnity. Default judgment was entered against Union Indemnity on October 24, 1985.

In July 1986 litigation in New York resulted in liquidation of Union Indemnity. Pursuant to the Alaska Insurance Guaranty Association Act, AS 21.80.010-.190, AIGA intervened and assumed Union Indemnity’s obligations under the policy. The action was amended to substitute AIGA in place of Union Indemnity as the defendant. The default judgment was set aside, and Union Indemnity was dismissed from the action.

AIGA moved for summary judgment on the ground that Estes had failed to comply with a policy provision requiring any suit on the policy to be commenced “within one year after the loss occurs.” The trial court granted the motion. Estes appeals.

II. DISCUSSION

On appeal Estes contends that in order to bar his claim for failure to comply with the one-year limit on commencement of suit clause, AIGA must show that it or Union Indemnity was prejudiced by his failure to comply. He also contends that Union Indemnity’s delay in processing his claim constitutes a waiver of the one-year time limit and, alternatively, that AIGA should be estopped from asserting the one-year time limit.

AIGA argues that waiver or estoppel arising from Union Indemnity’s actions cannot be asserted against AIGA.

When reviewing a grant of summary judgment this court must determine whether there exists a genuine issue of material fact and whether the moving party is entitled to judgment as a matter of law. Zeman v. Lufthansa German Air Lines, 699 P.2d 1274, 1280 (Alaska 1985). The party moving for summary judgment has the burden of proving the absence of issues of material fact. McGee Steel Co. v. State, 723 P.2d 611, 615 (Alaska 1986). “The party opposing summary judgment is not required to show it will prevail at trial. But if the movant establishes prima facie that it is entitled to judgment as a matter of law, the party opposing summary judgment must demonstrate that there exists a genuine issue of material fact to be litigated.” Wassink v. Hawkins, 763 P.2d 971, 973 (Alaska 1988).

A. AN INSURANCE COMPANY SEEKING TO ENFORCE A CONTRACTUAL MODIFICATION OF THE STATUTE OF LIMITATIONS MUST DEMONSTRATE THAT IT HAS SUFFERED PREJUDICE AS A RESULT OF THE CLAIMANT’S DELAY IN BRINGING SUIT.

The multi-peril policy issued to Estes by Union Indemnity includes a five-page list of conditions and definitions. At the bottom of the list’s second page, under [1317]*1317the heading “Conditions Applicable to Section I,” there appears the following provision:

15. Suit. No suit shall be brought on this policy unless the insured has complied with all the policy provisions and has commenced the suit within one year after the loss occurs.

Estes concedes that his suit was not commenced within one year after the loss occurred. But he contends that the limitation provision should be enforced only upon proof by AIGA that AIGA has suffered prejudice as a result of his failure to file suit within the period. Though we have not held heretofore that such proof is required, Estes argues that the reasoning of prior cases supports such a requirement.

AIGA argued successfully before the trial court that the court should enforce the contractual modification of the statute of limitations without regard to any question of prejudice.

This court and others have recognized that insurance policies differ from traditional private contracts. See Weaver Bros, v. Chappel, 684 P.2d 123, 125 (Alaska 1984); Brakeman v. Potomac Ins. Co., 472 Pa. 66, 371 A.2d 193, 196 (1977). “An insurance contract is not a negotiated agreement; rather its conditions are by and large dictated by the insurance company to the insured.” Id. An insured is charged with knowledge of these conditions not because he has read or understood them, but because business utility so demands. Cooper v. Government Employees Ins. Co., 51 N.J. 86, 237 A.2d 870, 873 (1968).

One commentator aptly characterizes conditions to an insurance policy as an exercise of “private lawmaking” by the insurance company. Oldfather, Toward a Usable Method of Judicial Review of the Adhesion Contractor’s Lawmaking, 16 U.Kan.L.Rev. 303 (1968). Oldfather argues that to enforce such provisions uncritically is, in effect, to sanction arbitrary lawmaking. He suggests that courts should adopt some uniform method for reviewing such provisions.

In Weaver Bros. v. Chappel, 684 P.2d 123 (Alaska 1984), we reviewed a policy provision requiring prompt notice of loss. We stated:

In short, the notice requirement is designed to protect the insurer from prejudice. In the absence of prejudice, regardless of the reasons for the delayed notice, there is no justification for excusing the insurer from its obligations under the policy. We recognize the strong societal interest in preserving insurance coverage for accident victims so long as the preservation is equitable for all parties involved.

Id. at 125 (emphasis added).

In Weaver Bros.,

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Estes v. Alaska Insurance Guaranty Ass'n
774 P.2d 1315 (Alaska Supreme Court, 1989)

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Bluebook (online)
774 P.2d 1315, 1989 Alas. LEXIS 51, Counsel Stack Legal Research, https://law.counselstack.com/opinion/estes-v-alaska-insurance-guaranty-assn-alaska-1989.