Gerling Global Reinsurance Corp. v. Home Insurance

302 A.D.2d 118, 752 N.Y.S.2d 611, 2002 N.Y. App. Div. LEXIS 12519
CourtAppellate Division of the Supreme Court of the State of New York
DecidedDecember 17, 2002
StatusPublished
Cited by26 cases

This text of 302 A.D.2d 118 (Gerling Global Reinsurance Corp. v. Home Insurance) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gerling Global Reinsurance Corp. v. Home Insurance, 302 A.D.2d 118, 752 N.Y.S.2d 611, 2002 N.Y. App. Div. LEXIS 12519 (N.Y. Ct. App. 2002).

Opinion

OPINION OF THE COURT

Sullivan, J.

This appeal — from the grant of defendant’s motion to compel arbitration and stay this action seeking the recovery of approximately $3.1 million — presents the issue of whether a reinsurer’s claim in equity for restitution of monies had and received, mistakenly paid by the reinsurer, comes within the scope of an arbitration clause limited to disputes involving the interpretation of the reinsurance contracts.

Defendant, The Home Insurance Company, issued three successive excess insurance policies (first policy: $5 million, 1962-1965; second policy: $5 million, 1965-1968; third policy: $10 million, 1968-1971), providing liability coverage for environmental pollution claims against its insured, Federal Pacific Electric Company (FedPac). Home partially reinsured its liability under these policies pursuant to facultative certificates, including two certificates issued by plaintiff, Gerling Global Reinsurance Corporation, which reinsured Home’s second and third policies.

Each certificate issued by Gerling contained the following provision, section 9: “[T]he liability of [Gerling] * * * shall follow that of [Home] and except as otherwise specifically provided herein, shall be subject in all respects to all the terms and conditions of [Home’s] policy.” Section 11 of these certificates provided, “All claims involving this reinsurance, when settled by [Home], shall be binding on [Gerling], who shall be bound to pay its proportion of such settlements.” Each of the certificates also contained an arbitration clause stating, “Should an irreconcilable difference of opinion arise as to the interpretation of this [c]ontract, it is hereby mutually agreed that, as a condition precedent to any right of action hereunder, such difference shall be submitted to arbitration.”

FedPac sought indemnification from Home for claims arising at a number of pollution sites around the country. Since, under Home’s policies, environmental pollution claims arising from losses incurred at each separate site are typically deemed to [120]*120constitute a separate occurrence, the claim as to each qualifies as a separate claim against the policy limits. In FedPac’s case, Home, in terms of the decision whether to pay the claim and as to the amount to be paid in settlement, handled the various site claims seriatim. FedPac’s pollution claims all involved continuing damage/injury that occurred during the policy periods of each of the three policies, causing each of the policies’ coverage to be triggered. Each of Home’s settlement agreements with FedPac released all three of the Home policies in exchange for a single lump sum payment. None of the settlements allocated the loss among the various policies.

For purposes of billing its reinsurers, however, Home decided upon a methodology for allocating its settlement payment among its several policies, applied the methodology to the triggered policies and, from the resulting allocation, calculated the amount due from the reinsurers pursuant to the coverages provided under the applicable reinsurance contract.

At issue are Gerling’s reinsurance payment for the settlement of claims at three sites: New Bedford Harbor, Sullivan’s Ledge and Norwood. By July 1998, Gerling had paid Home a total of $3,099,996 in settlement of these claims and closed its files. According to Gerling, its auditors’ subsequent review of Home’s claim files in May 2000 revealed that Home had settled a FedPac claim with respect to an additional site, Santa Clara, but had not billed Gerling for a reinsurance payment. Further investigation revealed that Home would not have billed Ger-ling on the earlier New Bedford Harbor, Sullivan’s Ledge and Norwood sites either except for the fact that Home’s billings for those sites had been grossly miscalculated by incorporating incorrect factual data as to the number of policies actually triggered and the terms of the policies involved in Home’s loss allocation. Gerling alleges that by misapplying its own allocation methodology, Home incorrectly placed millions of dollars of loss in the wrong policy years, while failing to place other millions of dollars of loss in the years where they properly belonged. According to Gerling, proper calculation of Home’s allocation of the claims for the New Bedford Harbor, Sullivan’s Ledge and Norwood sites would have resulted, as in the case of the Santa Clara site, in no billing as to any of the sites.

The particulars of the erroneous billings paid by Gerling are as follows. Home paid $4,300,000 to settle FedPac’s environmental pollution claims in connection with the New Bedford Harbor site, receiving in exchange a release for all of Home’s FedPac policies. Home allocated the entire settlement payment [121]*121equally to all of the annual periods during which, without a pollution exclusion, it provided coverage to FedPac. According to Gerling, Home’s communications uniformly represented that it had issued policies without a pollution exclusion only for the six-year period of 1965-1971, that is, the years covered by the second and third policies. Accordingly, Home allocated $716,666 per year ($4,300,000 h- 6) to each of the six annual periods from July 1, 1965 through July 1, 1971, during which period Gerling provided annual reinsurance coverage, excess of $500,000, and submitted reinsurance billings to Gerling of $216,666 ($716,666 — $500,000) for each of the six years for a total of $1,299,996 ($216,666 X 6). Accepting as true Home’s representation that it provided coverage without a pollution exclusion in only six years, Gerling paid the $1,299,996 billing on or about August 31, 1992 and closed its file.

As Gerling later learned, contrary to Home’s billing representations, Home had, in fact, issued FedPac policies (the first, second and third) without a pollution exclusion covering nine, not six, years, for the period 1962 to 1971. Applying the loss properly against Home’s allocation methodology, i.e. to all the policy years without a pollution exclusion, would result in an annual allocation of $477,777 ($4,300,000 h- 9) per year, an amount below Home’s $500,000 retention under Gerling’s facultative reinsurance. Thus, Gerling seeks $1,299,996, which, it argues, it paid as the result of a factual mistake incorporated into Home’s computation of its own settlement allocation.

In connection with the Norwood site, while Home, unlike in New Bedford Harbor, did include the first policy in its allocation, it failed to identify which of its policies contained a “NonCumulation” clause, sometimes referred to as “Condition C.”

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Cite This Page — Counsel Stack

Bluebook (online)
302 A.D.2d 118, 752 N.Y.S.2d 611, 2002 N.Y. App. Div. LEXIS 12519, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gerling-global-reinsurance-corp-v-home-insurance-nyappdiv-2002.