Illinois School District Agency, an Intergovernmental Cooperative v. Pacific Insurance Company, Limited, a Connecticut Corporation

471 F.3d 714, 2006 U.S. App. LEXIS 29717, 2006 WL 3490819
CourtCourt of Appeals for the Seventh Circuit
DecidedDecember 5, 2006
Docket04-4147, 05-1471
StatusPublished
Cited by22 cases

This text of 471 F.3d 714 (Illinois School District Agency, an Intergovernmental Cooperative v. Pacific Insurance Company, Limited, a Connecticut Corporation) 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
Illinois School District Agency, an Intergovernmental Cooperative v. Pacific Insurance Company, Limited, a Connecticut Corporation, 471 F.3d 714, 2006 U.S. App. LEXIS 29717, 2006 WL 3490819 (7th Cir. 2006).

Opinion

RIPPLE, Circuit Judge.

The Illinois School District Agency (“Agency”) appeals the district court’s partial grant of summary judgment on behalf of Pacific Insurance Company, 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 Pacific’s policy should have covered an estoppel claim made 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 consists 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 *716 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 & 0 Policy”) which Agency purchased from Pacific. The E & 0 Policy was not a reinsurance policy; rather, it covered Agency’s own liability for its actions. First State Management 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 insurance contracts. We therefore shall discuss briefly each of these actions.

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 administrator, 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 administrator, Hinz Claim Management (“Hinz”). Hinz reviewed 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 judgment 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.

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 reimbursement of all costs in defending the East Moline action. Pacific refused to reimburse Agency for the full costs, and Agency then filed *717 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 See R.23. In short, Agency sought declaratory and monetary relief for the cost of defending itself against each of the claims that East Moline brought against it in the East Mo-line action: the claim that Agency breached the contract 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 & 0 Policy (“Exclusion (d)”) prevented Agency from obtaining declaratory and monetary relief on its claims against Pacific. The text of Exclusion (d), listed in the E & 0 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 therefore 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, misstatement, misleading statement or other act or omission in the absence of such a contract committed in the Insured’s capacity as stated in the Insuring Agreements.

R.l, 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 & 0 Policy.

Pacific then moved for summary judgment.

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Bluebook (online)
471 F.3d 714, 2006 U.S. App. LEXIS 29717, 2006 WL 3490819, Counsel Stack Legal Research, https://law.counselstack.com/opinion/illinois-school-district-agency-an-intergovernmental-cooperative-v-ca7-2006.