Liberty Mutual Insurance v. Precision Valve Corp.

402 F. Supp. 2d 481, 2005 U.S. Dist. LEXIS 29911, 2005 WL 3271656
CourtDistrict Court, S.D. New York
DecidedNovember 30, 2005
Docket05 CIV. 3420(RWS)
StatusPublished
Cited by11 cases

This text of 402 F. Supp. 2d 481 (Liberty Mutual Insurance v. Precision Valve Corp.) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Liberty Mutual Insurance v. Precision Valve Corp., 402 F. Supp. 2d 481, 2005 U.S. Dist. LEXIS 29911, 2005 WL 3271656 (S.D.N.Y. 2005).

Opinion

OPINION

SWEET, District Judge.

Plaintiff Liberty Mutual Insurance Company (“Liberty Mutual”) has moved pursuant to Rule 12(f), Fed.R.Civ.P., to strike the Seventh, Ninth, and Tenth Affirmative Defenses of defendant Precision Valve Corporation (“Precision”). The motion is converted to a motion for summary judgment and for the reasons set forth below is granted with leave to the parties to make any additional submissions within twenty days or at such other time agreeable to the parties or the Court.

Prior Proceedings

Liberty Mutual filed its complaint on March 31, 2005 seeking to recover retrospective premiums alleged to have become due from Precision on several insurance policies. Notice of the retrospective premium was issued on January 17, 2005.

Precision filed its answer on June 6, 2005 and has opposed the Fourth Claim of Relief in the Liberty Mutual complaint, which seeks retrospective premiums based on the 1992-93 insurance policy in the amount of $376,227 for the policy period June 1, 1992 to June 1, 1993. Precision asserted a statute of limitations defense (Seventh Affirmative Defense) and has alleged that Liberty Mutual violated its duty of good faith and fair dealing (Ninth and Tenth Affirmative Defenses). It alleges that Liberty Mutual mistakenly under-reserved the claim of John Mazur, an employee of Precision, under Workers Compensation and Employers Liability policy No. WC1-121-057917-012 (the “Mazur Claims”) and that when Liberty Mutual caught its mistake in April 2004, it increased the reserves of the Mazur claim, which resulted in the retrospective premium at issue in the Fourth Claim for Re *483 lief. 1

The Liberty Mutual motion to strike with affidavit, the opposition with affidavit, and the reply with affidavit were marked fully submitted on July 27, 2005.

The Facts

The facts are set forth in the affidavit of Russell B. Dame, senior receivables analyst of Liberty Mutual, sworn to July 20, 2005 (the “Dame affidavit”) submitted in reply to certain correspondence and exhibits submitted by Christopher T. Bradley, Esq., counsel to Precision, in opposition to the motion. The facts are undisputed except as noted.

John Mazur suffered two separate heart attacks at work, the first on December 10, 1992, and another on April 5, 1993. The two heart attacks are listed as separate claims, each subject to separate $250,000 deductibles. On November 6, 1998, Liberty Mutual reduced its reserve on the Ma-zur claims after conducting a retrospective premium adjustment. The reserves were decreased by $229,398 for the first claim and $221,010 for the second claim resulting in a $321,437 credit.

On April 9, 2004, Liberty Mutual informed Precision of the computation of the medical reserves for the Mazur claims. According to Precision, Liberty Mutual incorrectly set reserves for the first 104 weeks following the occurrence of Mazur’s claims, the later of which occurred on April 5, 1993, and Liberty Mutual erroneously reduced its medical reserve on November 6, 1998. The 104 week period ended in April 1995.

According to the Dame affidavit, the premium agreement for policy No. WC1-121-057917-012 is included in the policy as the “Retrospective Premium Endorsement — One Year Plan — Multiple Lines,” which is endorsement No.-34.

As set forth on page two of the endorsement, under the heading “Retrospective Premium Formula,” the premium is determined by the following formula:

1. Retrospective premium is the sum of basic premium, converted losses, and taxes, plus the excess loss premium and retrospective. development premium elective elements if you chose them.

The formula includes “converted losses,” which the endorsement defines as follows:

4. A converted loss is an incurred loss multiplied by a percentage called the loss conversion factor. The loss conversion factor is. shown in the Schedule.

The endorsement defines “incurred losses,” in relevant part, as follows:

3. Incurred losses are all amounts we pay or estimate we will pay for losses and following expenses; ...

According to Liberty Mutual, the determination of retrospective premiums is not only based upon what Liberty Mutual “estimate[s] we will pay for losses” or “reserves,” but is also based upon “all amounts we pay.” These two amounts are added together to determine the “incurred losses.”

In two letters, both dated April 9, 2004, Liberty Mutual’s claims handler, Heppi Lauro, uses the word “reserves,” which, according to the Dame affidavit, includes paid amounts and estimates.

The premium calculation by Liberty Mutual was based on estimates and upon actual payments.

*484 As set forth under the heading “Premium Calculations and Payments,” pursuant to the endorsement, a retrospective premium is to be calculated using claims information valued as of the date six months after the end of the policy period, in this case, December 1, 1993, and annually thereafter. The endorsement provides, in relevant part, as follows:

1. We will calculate the retrospective premium using all incurred losses we have as of a date six months after the rating plan period ends and annually thereafter.

The endorsement provides the premium is not due until after calculation of the retrospective premium, stating as follows:

3. After each calculation of retrospective premium, you will pay promptly the amount due us, or we will refund the amount due you. Each insured is responsible for the payment of all standard premium and retrospective premium calculated under this endorsement.

Liberty Mutual’s Fourth Claim for Relief seeks recovery of premiums arising from the Twelfth Retrospective Premium Adjustment, which is based upon incurred losses valued as of December 1, 2004. The statement was issued on January 17, 2005.

The Liberty Mutual Claims Department did not include all of the medical costs related to John Mazur’s April 6,1993 heart transplant in the incurred losses until April 6, 2004, and they were not factored in the prior retrospective premium adjustments but were included in the incurred losses valued as of December 1, 2004.

The premium endorsement provides that the adjustments continue annually until both Liberty Mutual and Precision agree it is final, stating as follows:

2. After a calculation of retrospective premium, you and we may agree that it is the final calculation. No other calculation will be made unless there is clerical error in the final calculation.

There has been no agreement to terminate the retrospective premium adjustment statement calculations, and Precision has not complained about the prior eleven adjustments.

The Motion Is Converted To A Motion For Summary Judgment

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402 F. Supp. 2d 481, 2005 U.S. Dist. LEXIS 29911, 2005 WL 3271656, Counsel Stack Legal Research, https://law.counselstack.com/opinion/liberty-mutual-insurance-v-precision-valve-corp-nysd-2005.