Macklin v. Lexington Insurance Company

CourtDistrict Court, S.D. New York
DecidedSeptember 30, 2022
Docket1:20-cv-05372
StatusUnknown

This text of Macklin v. Lexington Insurance Company (Macklin v. Lexington Insurance Company) 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
Macklin v. Lexington Insurance Company, (S.D.N.Y. 2022).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK TAMEAKE MACKLIN, Individually and as assignee of HAPPY CHILD TRANSPORTATION LLC, ALL STAR BUS SERVICE CO., LLC, and LEVANDER POLK, OPINION & ORDER Plaintiffs, 20 Civ. 5372 (ER) - against - SPARTA INSURANCE COMPANY, Defendant.

RAMOS, D.J.: Tameaka Macklin brings this action against Sparta Insurance Company (“Sparta”) to collect on the remainder of a $6 million judgment for injuries she sustained in a school bus accident. Pending before the Court are Macklin’s motions to strike certain of Sparta’s denials and affirmative defenses, and to quash third-party subpoenas issued by Sparta. For the reasons set forth below, Macklin’s motions are DENIED. I. BACKGROUND1 a. Sparta and the Accident Sparta, a liability insurance company that operates in New York, issued a package insurance policy (the “Policy”) to Happy Child Bus Service Co. LLC (“Happy Child”) for the period January 1, 2014 to January 15, 2015 (the “Policy”). ¶¶ 21–23. The Policy included a business auto coverage form (the “Business Auto Part”), providing $1,000,000 in coverage; a

1 Unless otherwise noted, citations to “¶ __” refer to the First Amended Complaint (“FAC”), Doc. 54. commercial general liability coverage form (the “CGL Part”), providing $1,000,000 in coverage; and personal injury protection benefits (the “PIP Benefits”), providing up to $50,000 in coverage. ¶¶ 24–26. The portion of the Policy concerning “Duties In The Event Of Accident, Claim, Suit Or Loss” provides: We have no duty to provide coverage under this policy if the failure to comply with the following duties is prejudicial to us: In the event of accident, claim, suit or loss, you or someone on your behalf must give us or our authorized representative notice as soon as reasonably possible of the accident or loss. Include: (1) [h]ow, when and where the accident or loss occurred; [t]he insured’s name and address; and (3) [t]o the extent possible, the names and addresses of any injured persons and witnesses. Written notice by or on behalf of the injured person or any other claimant to our authorized representative shall be deemed notice to us. Additionally, you and any other involved insured must . . . [s]end us copies of any request, demand, order, notice, summons or legal paper received concerning the claim or suit as soon as reasonably possible.

Doc. 81-44 at 9–10 (internal quotation marks omitted). On May 5, 2014, Macklin sustained injuries while riding as a bus attendant in a school bus (the “School Bus”) operated by Happy Child—and driven by Levander Polk, an employee of Happy Child—that collided with another vehicle driven by Jasmine T. Williams.2 ¶¶ 28–29. Macklin alleges that Happy Child leased the School Bus from Altfest Auto Leasing Inc. (“Altfest”) pursuant to a lease agreement (the “Lease Agreement”), Doc 54-18, and that Altfest owned the School Bus but that it was registered to Happy Child.3 ¶¶ 112–14. All Star Bus Service Co., LLC (“All Star”), who Sparta claims is Happy Child’s sister company, see Doc. 109 ¶ 6, provided transportation services to Happy Child, pursuant to a sub-contract. See Doc. 54-17.

2 Macklin also sued Williams but has already settled with her. ¶ 41. 3 Sparta contends that Macklin has not established that Altfest leased the School Bus to Happy Child. Doc. 61 ¶¶ 70–71. Sparta asserts that on December 27, 2013, it emailed Happy Child’s broker, Capacity Group of NY LLC (“Capacity”), to confirm that another vehicle (not the School Bus) was the only vehicle that Happy Child was leasing from Altfest. See Doc. 109-5 at 9. In response, Capacity advised that the other vehicle was indeed the only one that Happy Child was leasing from Altfest. Id. Sparta therefore claims that it had reason to believe that Happy Child was not leasing the School Bus from Altfest. See Doc. 108 at 25–26. Under the sub-contract, All Star was responsible for operating the buses that brought students and school attendants to and from school. Doc. 54-17 at 2. The following month, on June 3, 2014, Macklin’s counsel, Koenigsberg & Associates P.C. (“Koenisberg”), sent a demand to Sparta’s “Bodily Injury Claims Department,” requesting coverage for, inter alia, personal injuries she sustained as a result of the May 5, 2014 accident

(the “Bodily Injury Letter”); the letter attached a corresponding police report. See Doc. 54-3. Also on June 3, 2014, Koenisberg sent a separate letter to Sparta’s “No Fault Claims Department,” requesting coverage for personal injuries under the Policy (the “No Fault Letter,” together with the Bodily Injury Letter, the “June 2014 Letters”). See Doc. 54-2. The June 2014 Letters were received by Sparta. ¶ 49.4 The following week, on June 10, 2014, Gallagher Bassett-Capital City (“Gallagher”), a third-party administrator for Sparta, acknowledged receipt of Macklin’s claim.5 ¶ 51. According to Sparta, the following week, in a June 17, 2014 telephone call, Happy Child’s insurance broker, Capacity, told Gallagher that the School Bus was insured by Progressive Insurance Company (“Progressive”) and was not covered under the Policy.6 See

Doc. 110 at 13.

4 While Sparta concedes that the letters were received and signed for, its case file shows no record of the Bodily Injury Letter. See Doc. 108 at 15. 5 Sparta admits that Gallagher acted as its third-party administrator and, as such, had limited agency. Sparta argues, however, that Gallagher did not have the authority to act as Sparta’s agent for all purposes and asserts that the FAC overstates Gallagher’s authority. See Doc. 81-41 at 2. 6 National Continental Insurance Company (“National Continental”) is a subsidiary of Progressive Insurance Company (“Progressive”) and issued an insurance policy that provided coverage to All Star, Altfest, Happy Child, and Polk in connection to the Underlying Action. ¶ 28. One month later, on July 9, 2014, Macklin’s counsel called Gallagher to follow up on one, or both, of the June 2014 Letters.7 ¶ 54. As reflected in Sparta’s records, an employee of Gallagher stated that Macklin’s claim was reported to Gallagher in error and that the insurer of the claim was Progressive Insurance.8 See Doc. 54-6 at 23. Another month later, on August 7, 2014, Gallagher sent Macklin a “New York Motor

Vehicle No-Fault Insurance Law Denial of Claim Form,” see Doc. 54-7, which denied Macklin coverage for “Loss of Earnings,” “Health Service Benefits,” or “Other Necessary Expenses,” on the basis that: “The vehicle involved in this accident, is not a covered vehicle under the policy noted above. As such, there is no personal injury protection coverage afforded for this claim. The vehicle is not listed on [the Policy]. In addition, the Claimant is not a policyholder, is not a named insured or an eligible injured person under our insured’s policy. Claim is denied, the Claimant was not an occupant of the insured vehicle.”

Id. at 2.9 Although Macklin has taken the position in this action that the denial was improper, she has not made a claim for no fault benefits in this litigation. See Doc. 109 ¶ 8. b. The Underlying Action Four months later, on December 24, 2014, Macklin filed an action, Macklin v. All Star, Altfest, Happy Child, and Polk., Index No. 241/2015 (the “Underlying Action”), in the New York Supreme Court for the County of Kings. ¶¶ 28, 30. There, Macklin sued All Star, Altfest, Happy Child, and Polk (the “Underlying Defendants”), for injuries she sustained in the May 5,

7 Macklin alleges that the call was made in reference to its bodily injury claim; but Sparta argues that the evidence shows that the call could have been made, instead, with respect to the No Fault claim that, according to Sparta, Gallagher was actually handling. See Doc. 108 at 15–16. 8 The following year, on September 8, 2015, Macklin’s counsel called Sparta for the second time to follow up on her claim. ¶ 58.

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