Guillen Ex Rel. Guillen v. Potomac Ins. Co.

785 N.E.2d 1, 203 Ill. 2d 141, 271 Ill. Dec. 350, 2003 Ill. LEXIS 4
CourtIllinois Supreme Court
DecidedJanuary 24, 2003
Docket92056
StatusPublished
Cited by97 cases

This text of 785 N.E.2d 1 (Guillen Ex Rel. Guillen v. Potomac Ins. Co.) is published on Counsel Stack Legal Research, covering Illinois Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Guillen Ex Rel. Guillen v. Potomac Ins. Co., 785 N.E.2d 1, 203 Ill. 2d 141, 271 Ill. Dec. 350, 2003 Ill. LEXIS 4 (Ill. 2003).

Opinion

CHIEF JUSTICE McMORROW

delivered the opinion of the court:

Two principal issues are presented in this case: (1) whether an insurer who mails notice to its insured of a material change in an insurance policy, as required under section 143.17a(b) of the Illinois Insurance Code (215 ILCS 5/143.17a(b) (West 1992)), must maintain proof of the mailing on a recognized “U.S. Post Office” (hereinafter, Postal Service) form or form acceptable to the Postal Service or other commercial delivery service; and (2) whether the plaintiff, by virtue of an assignment given by the insured in this case, obtained a right to indemnification from the defendant insurance company.

BACKGROUND

In May 1996, the plaintiff, Denise Guillen (Guillen), a minor, by her father and next friend, Suamy Guillen, filed a complaint against her former landlords, Ezequiel and Maria Ortiz, in the circuit court of Cook County. In her complaint, Guillen alleged that she was a tenant in an apartment owned by the Ortizes for approximately the first two years of her life, from October 19, 1993, until September 1995. During this time, Guillen alleged, she was exposed to deteriorating lead-based paint and paint dust, which was present in the apartment. Guillen asserted that, as a result of this exposure, she suffered severe lead poisoning and permanent developmental injuries. Guillen further alleged that her injuries were proximately caused by the Ortizes’ negligent failure to inspect for or remove the lead-based paint.

Shortly after receiving Guillen’s complaint, the Ortizes tendered Guillen’s claims to their insurer, defendant Potomac Insurance Company of Illinois (Potomac). Potomac refused the tender and denied any obligation to defend or indemnify the Ortizes. According to Potomac, an endorsement that had recently been added to the Ortizes’ commercial liability policy contained a lead exclusion which precluded coverage for Guillen’s claims. After refusing the tender and denying coverage, Potomac took no further action with respect to Guillen’s complaint. Potomac did not defend under a reservation of rights or file suit seeking a declaration of the rights of the parties.

In July 1997, Guillen and the Ortizes entered into a settlement agreement. Under the terms of the settlement, the Ortizes agreed to pay Guillen the sum of $600,000 in exchange for a release from liability for any claims relating to Guillen’s lead poisoning. Importantly, however, the Ortizes’ obligation to pay the $600,000 was subject to the condition that it would “be satisfied solely through the assignment” to Guillen of the Ortizes’ right to payment from Potomac. The assignment of the Ortizes’ right to payment from Potomac was included within the terms of the settlement agreement. No other payment obligation was imposed upon the Ortizes and no judgment was entered against them.

In March 1998, Guillen, as the assignee of the rights of the Ortizes, filed an amended declaratory judgment complaint against Potomac in the circuit court of Cook County. In this action, which is the subject of the instant appeal, Guillen sought a declaration that Potomac was obligated to pay Guillen the $600,000 settlement amount agreed to by the Ortizes. Potomac filed an answer to Guillen’s complaint in which it raised numerous affirmative defenses. The parties thereafter filed cross-motions for summary judgment.

In her motion for summary judgment, Guillen alleged that Potomac had failed to comply with the statutory notice requirements that governed the addition of the lead exclusion. Guillen argued that, under section 143.17a(b) of the Illinois Insurance Code (Code) (215 ILCS 5/143.17a(b) (West 1992)), when an exclusion that materially alters insurance coverage is added to a renewal insurance policy, the insurer must give the policyholder 60 days written notice and must “maintain proof of mailing or proof of receipt [of notice]” to make the alteration effective. Guillen contended that Potomac had failed to maintain the required proof of mailing or proof of receipt and, as a result, could not establish that the Ortizes had been notified of the change in coverage affected by the lead exclusion. Thus, according to Guillen, the lead exclusion never became part of the Ortizes’ insurance policy. Because the lead exclusion was not part of the Ortizes’ insurance policy, Guillen maintained that Potomac had breached its duty to defend and should be estopped from raising policy defenses to coverage for Guillen’s claims against the Ortizes. Finally, Guillen alleged that Potomac’s wrongful refusal to defend made it responsible for any reasonable settlement amount agreed to by the Ortizes. And, since the Ortizes had assigned to Guillen their right to recovery from Potomac, Guillen argued that she was entitled to recover the $600,000 settlement amount from Potomac.

In its motion for summary judgment, Potomac disputed Guillen’s contention that it had not provided proper notice to the Ortizes regarding the addition of the lead exclusion. Potomac argued that it had notified the Ortizes in writing about the lead exclusion 75 days prior to renewal and that it had maintained sufficient proof of mailing. In support of this contention, Potomac provided the circuit court with an unsigned copy of a letter which was purportedly sent to the Ortizes, and an affidavit from an employee of Potomac that described Potomac’s custom and practice with respect to mailing notices of material changes in insurance policies to its insureds.

Potomac additionally argued in its motion for summary judgment that, even if it had breached its duty to defend, it was not required to pay the $600,000 settlement amount agreed to by the Ortizes. According to Potomac, it was under no obligation to pay Guillen because the Ortizes’ assignment to Guillen of their right to recovery against Potomac was invalid. Potomac pointed out that under the terms of the Ortizes’ insurance policy, Potomac was required to pay “those sums that the insured becomes legally obligated to pay as damages.” Potomac argued that the Ortizes were never “legally obligated” to pay anything under the terms of the settlement agreement with Guillen. In support of this contention, Potomac noted that, since the Ortizes’ payment obligation under the settlement agreement was limited solely to an assignment of the Ortizes’ right to recover under their insurance policy, the Ortizes were never personally obligated to pay any money and, indeed, were never placed in any personal financial risk by the agreement. Potomac argued, therefore, that the Ortizes were not “legally obligated” to pay damages to Guillen in any practical sense of the term and, thus, had no right to indemnification from Potomac. Potomac further noted that Guillen, as the assignee of the Ortizes’ rights against Potomac, “stood in the shoes” of the Ortizes. Therefore, Potomac argued, since the Ortizes had no right to recover from Potomac, neither did Guillen.

In a written order dated June 26, 2000, the circuit court found that, with respect to the lead exclusion, Potomac had not satisfied the notice requirements of section 143.17a(b) of the Code. The court concluded that the unsigned letter and employee affidavit offered by Potomac failed to show that Potomac had “maintain[ed] a contemporaneous proof of mailing” as required under the statute.

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Cite This Page — Counsel Stack

Bluebook (online)
785 N.E.2d 1, 203 Ill. 2d 141, 271 Ill. Dec. 350, 2003 Ill. LEXIS 4, Counsel Stack Legal Research, https://law.counselstack.com/opinion/guillen-ex-rel-guillen-v-potomac-ins-co-ill-2003.