Garay v. National Grange Mutual Insurance

117 F. App'x 785
CourtCourt of Appeals for the Second Circuit
DecidedNovember 18, 2004
DocketNo. 04-0453-CV
StatusPublished
Cited by3 cases

This text of 117 F. App'x 785 (Garay v. National Grange Mutual Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Garay v. National Grange Mutual Insurance, 117 F. App'x 785 (2d Cir. 2004).

Opinion

SUMMARY ORDER

Plaintiffs-Appellants James and Michelle Garay appeal from an award of summary judgment in favor of Defendant-Appellant National Grange Mutual Insurance Company (“National Grange”). Plaintiffs sued National Grange pursuant to New York State Insurance Law § 3420 (McKinney 2000) to compel payment of an unsatisfied default judgment entered in New York State court against defendant’s insured, Riina Girardi Contracting Corp. (“Riina Girardi”), for work injuries sustained by Mr. Garay on February 28,1998, at a construction site operated by Riina Girardi. National Grange had disclaimed coverage on the ground of untimely notice, not having been advised of Mr. Garay’s accident until November 16, 2000, when Riina Girardi forwarded a copy of Garay’s state-court summons and complaint to its carrier. We assume familiarity with the record and proceedings before the district [787]*787court. We review the challenged judgment de novo. See Webster ex rel. Webster v. Mount Vernon Fire Ins. Co., 368 F.3d 209, 214 (2d Cir.2004).

A. Disclaimer of the Commercial Liability Policy

1. Notice to the Insurer

The Garays assert that National Grange’s disclaimer against its insured for untimely notice was insufficient to disclaim against them as injured claimants. We disagree. Although New York Insurance Law § 3420 provides an injured party with the statutory right to fulfill an insurance policy’s notice obligation directly instead of relying on the insured to provide timely notice, the “injured party has the burden of proving that he or she, or counsel acted diligently in attempting to ascertain the identity of the insurer and, thereafter, expeditiously notified the insurer.” American Home Assur. Co. v. State Farm Mutual Auto. Ins. Co., 277 A.D.2d 409, 410, 717 N.Y.S.2d 224, 225 (2d Dep’t 2000). The Garays cannot satisfy this burden for the simple reason that they never gave notice to National Grange. Service of their summons and complaint on the insured, Riina Girardi, does not qualify as notice to the insurer under New York law. See Matter of First Cent. Ins. Co., 3 A.D.3d 494, 495, 771 N.Y.S.2d 141, 142 (2d Dep’t 2004) (notice to insurance broker or other agent of the insured is not sufficient to constitute notice on the insurer); Agway Ins. v. Alvarez, 258 A.D.2d 487, 488, 684 N.Y.S.2d 635, 636 (2d Dep’t 1999) (finding no independent notice to the insurer where the injured claimant merely served the complaint on the insured). GA Insurance Co. of New York v. Simmes, 270 A.D.2d 664, 666, 704 N.Y.S.2d 700, 702 (3d Dep’t 2000), relied on by plaintiffs, is not to the contrary, as the claimant in that case sent his pleadings directly to the insurance company not simply to the insured. Where, as here, the injured party has not actually exercised his right to provide independent notice under the statute, the insurer’s disclaimer of coverage on the basis of the insured’s late notice is effective against the injured party as well. See Webster v. Mount Vernon Fire, 368 F.3d at 217; Viggiano v. Encompass Ins. Co./Fireman’s Ins. Co. of Newark, New Jersey, 6 A.D.3d 695, 775 N.Y.S.2d 533, 534 (2d Dep’t 2004).1

2. The Adequacy of National Grange’s Disclaimer

The Garays contend that National Grange’s disclaimer was ineffective even against its insured because (1) it disclaimed only with respect to untimely notice of “claim,” not untimely notice of “occurrence”; and (2) the event relied on by National Grange (a conversation between James Garay and John Riina) did not qual[788]*788ify as a claim. The argument is unconvincing as a matter of law.

(a) Disclaimer as to both the “Occurrence” and the “Claim”

Under its insurance policy with National Grange, Riina Girardi owed separate and distinct duties to give timely notice of an insured occurrence and timely notice of an insured claim. American Ins. Co. v. Fairchild Indus., Inc., 56 F.3d 435, 438 (2d Cir.1995). In disclaiming coverage, National Grange specifically referenced these dual requirements and reminded its insured of previous communication in which it reserved its rights “while we investigated the delay in reporting this accident to us.” Disclaimer Letter, Dec. 8, 2000. It noted Riina Girardi’s failure to “report [Garay’s] accident to us as soon as you learned the claimant intended to pursue a claim against you,” delaying notice until “served with a Summons and Complaint.” Id.

We conclude that this letter was sufficiently specific to put Riina Girardi on notice that National Grange disclaimed coverage for its insured’s failure timely to report both the occurrence (i.e., “the accident”) and the claim as required by the policy. See New York v. AMRO Realty Corp., 936 F.2d 1420, 1431 (2d Cir.1991); Realm Nat. Ins. Co. v. Hermitage Ins. Co., 8 A.D.3d 110, 111, 778 N.Y.S.2d 492, 493 (1st Dep’t 2004).

(b) Riina Girardi’s Awareness of a Possible Claim

Riina Girardi was obliged to give National Grange notice to its insured when “the circumstances known to [it] at that time would have suggested to a reasonable person the possibility of a claim.” Sparacino v. Pawtucket Mut. Ins. Co., 50 F.3d 141, 143 (2d Cir.1995); see Commercial Union Ins. Co. v. Int’l Flavors & Fragrances, Inc., 822 F.2d 267, 272 (2d Cir. 1987). John Riina, a principal of Riina Girardi, has acknowledged that, about “three months” before the insured gave National Grange notice of Garay’s accident, Garay had told Riina that he intended to “go[ ] after” Riina Girardi “for an injury.” Recorded Statement of John Riina, Nov. 29, 2000; see also Riina Deposition at 15-16.

Although James Garay attempts to re-characterize his conversation with Riina, his intentions and understandings are of no import. The only relevant inquiry with respect to an insured’s notice obligation is the insured’s understanding, i.e., whether he understood or should have understood that the injured party had sustained a compensable injury or intended to pursue a claim. Because the Garays stand in Riina’s shoes for purposes of satisfying the policy’s notice requirement (having failed to give notice to the insurer themselves), see D’Arata v. N.Y. Cent. Mut. Fire Ins. Co., 76 N.Y.2d 659, 665, 563 N.Y.S.2d 24, 27, 564 N.E.2d 634 (1990), they are bound by Riina’s own admissions, which clearly demonstrate that he knew a claim by Ga-ray was a distinct possibility, yet failed to notify the insurer. Such an omission supports National Grange’s disclaimer against Riina Girardi, and, derivatively, against the Garays as well.

3. Prejudice to the Insurer

The Garays submit that National Grange can only disclaim coverage if it demonstrates that it was prejudiced by the late notice. This argument is contrary to well-established New York law: “noncompliance with the notice provision of an insurance policy will vitiate the contract regardless of whether the insurer[] suffered any prejudice as a result of the delay. ” Reynolds Metal Co. v. Aetna Cas. & Sur. Co., 259 A.D.2d 195, 204-05, 696

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