Loftin v. United States Fire Insurance

127 S.E.2d 53, 106 Ga. App. 287, 1962 Ga. App. LEXIS 694
CourtCourt of Appeals of Georgia
DecidedApril 17, 1962
Docket39340
StatusPublished
Cited by70 cases

This text of 127 S.E.2d 53 (Loftin v. United States Fire Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Loftin v. United States Fire Insurance, 127 S.E.2d 53, 106 Ga. App. 287, 1962 Ga. App. LEXIS 694 (Ga. Ct. App. 1962).

Opinions

Hall, Judge.

Whether or not the plaintiff’s petition presented an issue as to the defendant insurance company’s obligation, under its insurance contract, to defend the claim and suits brought against the plaintiff is the only question before us. The contract provision in question is the following: “With respect to such insurance as is afforded by this policy for bodily injury liability and for property damage liability, the company shall (a) defend any suit against the insured alleging such injury, sickness, disease or destruction and seeking damages on account thereof, even if such suit is groundless, false or fraudulent, but the company may make such investigation, negotiation and settlement of any claim or suit as it deems expedient.” Similar or identical provisions are contained in most liability insurance policies. 7A Appleman, Insurance Law & Practice, 428, § 4682; 50 ALR2d 458, 461, 463.

In the usual case the facts alleged in the complaint brought against the insured and the trae facts relating to coverage or non-coverage will be the same, so that there will be no dispute Whether the insured’s liability is covered by the policy and whether the insurer has a duty to defend. Dispute has often arisen, however, when a complaint against the insured shows false facts within the coverage of the policy, but the true facts, of which the insurer has knowledge from information furnished by the insured or from its own investigation, are not within coverage. The insurer must defend these suits for the reason that it has expressly obligated itself to do so by the insurance contract containing the common provision that the insurer will defend even groundless, false or fraudulent suits. McGettrick v. Fidelity &c. Co. of N. Y., 264 F2d 883, 886 (2d Cir. 1959); Bloom-Rosenblum-Kline Co. v. Union Indem. Co., 121 Ohio St. 220 (167 NE 884, 886); London Guarantee &c. Co. v. Shafer, 35 FSupp. 647, 649; Summer & Co. v. Phoenix Indem. Co., 32 NYS2d 2 (177 Misc. 887), affirmed 38 NYS2d 800 (265 App. Div. 911), appeal denied 41 NYS2d 180; Grand Union [291]*291Stores v. General Accident Fire &c. Corp., 295 NYS 654, 657 (163 Misc. 451), affirmed 298 NYS 187, 251; 7A Appleman, Op. cit. 448, § 4684.

Webster’s New International Dictionary defines “groundless” as “without ground or foundation, wanting cause or reason for support.” The groundless suit which the insurer undertakes to defend is a suit containing unsupportable allegations which on their face show coverage by the policy of the liability asserted against the insured for “damages because of bodily injury, sickness or disease, including death at any time resulting therefrom, sustained by any person,” or “because of injury or destruction of property, including the loss of use thereof, caused by accident and arising out of the ownership, maintenance and use of the automobile.” Whether or not the insured could be liable to the injured claim'ant under the true facts is not determinative of the groundlessness of the suit. For example, a suit is brought alleging injury and damage arising out of the use of the insured automobile. In truth the automobile involved was another automobile owned by the insured and not covered by the policy. This is a groundless suit because the allegations show coverage, even though the insured may, or may not, be personally liable under the trae facts. Another example: The injured plaintiff alleges that the insured automobile was being driven by the wife of the insured, thus showing that the insured’s liability is covered by the policy. In truth the automobile was being driven by an employee in the insured’s business, under which facts the insured’s liability is excluded. This is a groundless suit in contemplation of the insurance contract. “But a distinction must be drawn between groundless suits and actions which, even if successful would not be within the policy coverage.” 7A Apple-man, Op. cit. 448, '§ 4684. A claim based on true facts not within coverage is not groundless within the meaning of the policy, but simply one for which liability insurance is not afforded and which the insurer did not undertake to defend (though the insured may be liable.)

Much rarer than actions involving “groundless” suits are the cases in which the insured seeks recovery for the expenses of defending a suit on the ground that the known or ascertainable [292]*292facts giving rise to a claim were covered by the policy, but the complaint against the insured alleged untrue facts showing non-coverage. In this class of cases, when the insurance contract contains a provision like the one now in issue, the insurer must defend for the reasons hereinafter stated.

As to the defense of a suit alleging untrue facts showing non-coverage, when the known or ascertainable facts are within coverage, the contract is ambiguous as to the rights and duties between the insured and the insurer. In such a case, “the rights of the parties must be determined by fairly construing the insurance contract in such a way as to carry out its intended purpose.” McGettrick v. Fidelity &c. Co. of N. Y., 264 F2d 883, 886, supra. The dubiousness of asserting the non-ambiguity of the contract provision in issue is well illustrated by the lack of agreement among the decisions throughout the country on this problem. 7A Appleman, Op. cit. 442-443, § 4683; 29A Am. Jur. 567, § 1454; 50 ALR2d 458, 497. Fairly construing the provision in question in light of the objects of the policy, We do not believe that the intent of the parties was to allow the insurer to ignore the true facts and to place the burden on the insured to enter into the defense of the suit to prove coverage already known to the insurer.

Liability insurance policies are usually prepared, as was the one in the present case, on a form contract which describes several coverages, each designated by a letter and descriptive words and each limited by a stated maximum amount of liability. Each individual policy is issued on the printed form for the coverages for which a premium is written in. Thus an individual policy will effect one or more coverages to the insured. The language “With respect to such insurance as is afforded by this policy for bodily injury liability and for property damage liability, the company shall (a) defend any suit against the insured alleging such injury, sickness, disease or destruction and seeking damages on account thereof, . . .” is a part of the form of contract upon which the coverages to the individual insured are to be filled in. It must be considered in this light to mean, “If this policy is issued for, or affords in[293]*293surance for, bodily injury liability or property damage liability, the company shall defend any suit alleging such injury, etc.” Furthermore, an interpretation of the words, “such insurance as is afforded by this policy” to mean other than “insurance afforded according to the true facts” would be unreasonable.

We must assume that the insurer’s undertaking to defend was intended to afford benefits to the insured. The undertaking to defend suits alleging facts within coverage, even though groundless, will benefit the insured only if he is sued for a sum in excess of the policy limits. Without such an express undertaking the insurer will defend suits, groundless or not, up to the limits of the policy to protect itself from an excessive or default judgment against the insured, which it would be liable to pay. But when untrue facts are alleged in the complaint showing an exclusion from coverage, the insurer need not defend in its own interest, as it would not be liable for a judgment based upon these untrue facts.

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Cite This Page — Counsel Stack

Bluebook (online)
127 S.E.2d 53, 106 Ga. App. 287, 1962 Ga. App. LEXIS 694, Counsel Stack Legal Research, https://law.counselstack.com/opinion/loftin-v-united-states-fire-insurance-gactapp-1962.