IL School Dist Agenc v. Pacific Insur Co Ltd

CourtCourt of Appeals for the Seventh Circuit
DecidedDecember 5, 2006
Docket04-4147
StatusPublished

This text of IL School Dist Agenc v. Pacific Insur Co Ltd (IL School Dist Agenc v. Pacific Insur Co Ltd) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
IL School Dist Agenc v. Pacific Insur Co Ltd, (7th Cir. 2006).

Opinion

In the United States Court of Appeals For the Seventh Circuit ____________

Nos. 04-4147 & 05-1471 ILLINOIS SCHOOL DISTRICT AGENCY, an intergovernmental cooperative, Plaintiff-Appellant, v.

PACIFIC INSURANCE COMPANY, LIMITED, a Connecticut Corporation, Defendant-Appellee. ____________ Appeals from the United States District Court for the Central District of Illinois. No. 02 C 3173—Jeanne E. Scott, Judge. ____________ ARGUED FEBRUARY 7, 2006—DECIDED DECEMBER 5, 2006 ____________

Before BAUER, RIPPLE and WOOD, Circuit Judges. RIPPLE, Circuit Judge. The Illinois School District Agency (“Agency”) appeals the district court’s partial grant of summary judgment on behalf of Pacific Insurance Com- pany, Ltd. (“Pacific”). The district court held that Agency was not entitled to recover costs attributable to certain claims because those claims were not covered by an insurance policy Pacific issued to Agency. In our view, Agency came forward with sufficient evidence that Pa- cific’s policy should have covered an estoppel claim made 2 Nos. 04-4147 & 05-1471

against Agency in the underlying litigation. Because this evidence presents a genuine issue of material fact, we reverse the grant of summary judgment to Pacific and remand the case for further proceedings consistent with this opinion.

I BACKGROUND A. Facts Agency is an intergovernmental cooperative. It con- sists of member Illinois school districts and is organized to provide joint self-insurance for the member school districts. Essentially, Agency functions as an insurance provider for the member school districts. There are two insurance policies at issue in this case. The first is a general liability insurance policy (“General Liability Policy”) that Agency issued to one of its member districts, the East Moline School District (“East Moline”). The other policy is an errors and omissions policy (“E & O Policy”) which Agency purchased from Pacific. The E & O Policy was not a reinsurance policy; rather, it covered Agency’s own liability for its actions. First State Manage- ment Group, Inc. (“First State”) acted as Pacific’s agent in administrating claims Agency made on the Pacific policy, but is not a party to this appeal. The current dispute is best understood in light of a series of lawsuits among East Moline, Pacific, Agency and other parties concerning the interpretation of these insur- ance contracts. We therefore shall discuss briefly each of these actions. Nos. 04-4147 & 05-1471 3

1. The Mancilla Action In April of 1994, the Mancilla family sued East Moline for injuries that resulted when an East Moline student brought mercury home from school (“Mancilla action”). The suit was filed in the Circuit Court of Rock Island County, Illinois. Agency, through its third-party adminis- trator, Martin Boyer Company (“Martin Boyer”), initially agreed to defend East Moline. Martin Boyer determined that East Moline’s defense was covered by the General Liability Policy. Later, however, Agency hired a new third-party admin- istrator, Hinz Claim Management (“Hinz”). Hinz re- viewed the Mancilla action and concluded that the suit was not within East Moline’s coverage under the General Liability Policy because claims for mercury poisoning were excluded by an absolute pollution exclusion. In April of 1996, two years after the suit was initiated, Hinz notified East Moline that Agency would no longer provide a defense to the Mancilla action. In November of 1997, the Mancilla action was settled for $628,040 plus costs and fees.

2. The East Moline Action In June of 1996, East Moline filed a suit in Illinois state court (“East Moline action”). It sought a declaratory judg- ment against Agency that the General Liability Policy obligated Agency to reimburse East Moline for costs incurred in the defense of the Mancilla action. East Moline alleged that Agency had acted in “bad faith” under 215 ILCS 5/155, that Agency had waived its right to assert a defense under the General Liability Policy and that Agency was estopped from denying East Moline defense of the suit. 4 Nos. 04-4147 & 05-1471

In March of 1998, the district court granted summary judgment on the contract claim in favor of Agency. It held that the mercury claim fell within the pollution exclusion and thus was outside the scope of coverage. In 2001, the court granted Agency summary judgment on the bad faith and waiver claims. In July of 2001, the estoppel claim went to trial, and Agency prevailed.

3. The Martin Boyer Action Agency sued Martin Boyer in state court to recover defense fees and costs that it had incurred defending itself in the East Moline action (“Martin Boyer action”). Agency obtained a judgment in the amount of $564,000 from Martin Boyer in July of 2004. There is no evidence in the record that Agency has received this award.

4. The Current Action Agency next made a demand on Pacific under the E & O Policy. In this action, Agency likewise sought reimburse- ment of all costs in defending the East Moline action. Pacific refused to reimburse Agency for the full costs, and Agency then filed the present action. The complaint alleged four counts. Count I sought a declaratory judgment that Pacific was obligated to pay all of Agency’s costs for the East Moline action. Count II alleged that Pacific breached the policy by failing to pay the full costs and sought recovery of those costs. Count III alleged that Pacific vexatiously refused to pay these costs in violation of 215 ILCS 5/155.1

1 The Amended Complaint also alleged a count, Count IV, against Pacific’s agent First State alleging that First State had (continued...) Nos. 04-4147 & 05-1471 5

See R.23. In short, Agency sought declaratory and mone- tary relief for the cost of defending itself against each of the claims that East Moline brought against it in the East Moline action: the claim that Agency breached the con- tract with East Moline; the claim that Agency had acted in bad faith in violation of 215 ILCS 5/155; the claim that Agency was estopped from denying coverage; and the claim that Agency had waived the right to deny coverage. Pacific raised a number of affirmative defenses. One of those defenses was that a policy exclusion in the E & O Policy (“Exclusion (d)”) prevented Agency from obtain- ing declaratory and monetary relief on its claims against Pacific. The text of Exclusion (d), listed in the E & O Policy, reads as follows: This Insurance shall not indemnify the Insured for loss incurred from any claim: *** (d) for obligations or responsibilities assumed by the Insured under any contract unless liability there- fore would have attached to the Insured by reason of the Insured’s negligent acts, errors or omissions or by reason of the Insured’s actual or alleged breach of duty, neglect, error, misstate- ment, misleading statement or other act or omis- sion in the absence of such a contract com-

1 (...continued) breached its contract with the Agency on behalf of Pacific. See R.23 at 10-11. First State was dismissed from the action by the district court on July 13, 2004, after the district court granted summary judgment in First State’s favor, and Agency has not appealed that dismissal. See R.67 at 17. 6 Nos. 04-4147 & 05-1471

mitted in the Insured’s capacity as stated in the Insuring Agreements. R.1, Ex.A at 1-2. Pacific’s answer also included various other affirmative defenses, including: that Agency failed to allocate between covered and uncovered claims and that Agency did not provide timely notice to Pacific of the East Moline action as required by the E & O Policy. Pacific then moved for summary judgment.

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IL School Dist Agenc v. Pacific Insur Co Ltd, Counsel Stack Legal Research, https://law.counselstack.com/opinion/il-school-dist-agenc-v-pacific-insur-co-ltd-ca7-2006.