Munich Reinsurance America, Inc. v. American National Insurance

893 F. Supp. 2d 686, 2012 WL 4475589, 2012 U.S. Dist. LEXIS 140334
CourtDistrict Court, D. New Jersey
DecidedSeptember 28, 2012
DocketCivil Action No. 09-6435 (FLW)
StatusPublished
Cited by2 cases

This text of 893 F. Supp. 2d 686 (Munich Reinsurance America, Inc. v. American National Insurance) is published on Counsel Stack Legal Research, covering District Court, D. New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Munich Reinsurance America, Inc. v. American National Insurance, 893 F. Supp. 2d 686, 2012 WL 4475589, 2012 U.S. Dist. LEXIS 140334 (D.N.J. 2012).

Opinion

OPINION

WOLFSON, District Judge:

This case involves complex retrocessional agreements between Plaintiff Munich Reinsurance America Inc. (“Munich”) and Defendant American National Insurance [689]*689Company (“ANICO”). Presently before the Court are two motions: Munich’s motion for partial summary judgment, pursuant to Federal Rule of Civil Procedure 56(e), on its breach of contract and declaratory judgment claims against ANICO and on ANICO’s rescission counterclaim, as well as ANICO’s cross-motion for summary judgment. Each of Munich’s claims, and the rescission counterclaim, relate to ANICO’s refusal to pay certain claims submitted for payment by Munich under the parties’ agreements.

Munich seeks partial summary judgment: (a) on ANICO’s rescission counterclaim, arguing that ANICO has waived its right to rescind and, alternatively, that its rescission counterclaim should be dismissed on the merits; (b) on ANICO’s untimely claim submission defense to Munich’s breach of contract claim, arguing that ANICO waived its defense and for judgment on the merits; (c) that, under the agreements, Munich’s “retention” is calculated on a “ground up” basis; (d) that claims issued by Everest Re1 are covered by the agreements; (e) that Munich’s “roofer” claims are covered by the agreements; and (f) that Munich’s use of bordereaux reporting did not breach the agreements. In its cross-motion, ANICO seeks summary judgment on its rescission counterclaim and, in the alternative, partial summary judgment on its untimely claim submission defense to payment.

The Court grants in part, and denies in part, Munich’s partial motion for summary judgment. With respect to ANICO’s rescission counterclaim, the Court denies Munich’s motion on the merits because there exists a genuine issue of material fact. With respect to ANICO’s untimely claim submission defense to payment, the Court grants Munich’s motion on the merits. The Court grants Munich’s motion on the retention issue, concluding that retention is calculated on a ground up basis. With respect to the Everest Re and roofer claims, Munich’s motion is denied. Finally, in light of the aforesaid ruling on the untimely claim submission defense, the Court does not reach Munich’s use of bordereaux reporting; hence summary judgment on that basis is denied. ANICO’s cross-motion on the rescission counterclaim and untimely claim submission defense is denied.

I. FACTS AND PROCEDURAL HISTORY

Before delving into the facts of this case, a brief overview of reinsurance and retrocessional insurance is helpful. Of course, an overview of such complex intersections of insurance law must be taken with a grain a salt. As an attorney with fifty years of reinsurance practice experience has explained, “[t]he minds that run the insurance and reinsurance industries are very clever, intelligent, and sophisticated, and they have devised almost an infinite number of variations on [the] basic categories [of reinsurance].... ” Interview with Eugene Wollan, Esq., in Zukerman, T., Environmental Ins. Litig.: Law and Practice Appx. 31A at 2 (2012) (“Wollan Interview”). Nevertheless, I provide a basic primer for the purpose of orienting the reader to this obtuse subject.

The Third Circuit, in Pacific Employers Ins. Co. v. Global Reinsurance Corp. of America, 693 F.3d 417, 421 (3d Cir.2012), describes reinsurance as

insurance for insurance companies. A reinsurer agrees to indemnify a reinsured for certain payments the latter makes under one or more of its issued [690]*690policies. In return, the reinsurer receives a share of the underlying premiums. Ceding a portion of an insured risk prevents a single catastrophic loss from hurling the reinsured into insolvency. It also allows the reinsured to in'vest more capital or to insure more risks.

Id. at 421. In short, “[a] reinsurance contract is essentially a contract of indemnity....” Christiania General Ins. Corp. of New York v. Great American Ins. Co., 979 F.2d 268, 271 (2d Cir.1992).

“The reinsurance of reinsurance is called a retrocession, and the reinsurers of reinsurers — that is, reinsurers who assume retrocession risk through retrocessional agreements — are called retrocessionaires.” Century Indem. Co. v. Certain Underwriters at Lloyd’s, London, subscribing to Retrocessional Agreement Nos. 950548, 950549, 950646, 584 F.3d 513, 519 (3d Cir. 2009) (emphasis added). Such retrocession agreements present considerably more complex legal and factual scenarios because “there is another layer of coverage created and another party thrown into the mix.” Plitt, et al., 1A Couch on Insurance § 9:3.

There are two overarching categories of reinsurance and retrocession — treaty and facultative; and the agreement here is the former. Through treaty reinsurance,

the reinsurer [or retrocessionaire] agrees to accept an entire block of business from the reinsured. Once a treaty is written, a reinsurer is bound to accept all of the policies under the block of business, including those as yet unwritten. Because a treaty reinsurer accepts an entire block of business, it does not assess the individual risks being reinsured; rather, it evaluates the overall risk pool.

Pacific Employers, 693 F.3d at 421.

As with primary insurance, reinsurance comes in several basic types, including proportion and excess of loss policies. An “excess of loss” policy is one that obligates the retrocessionaire to pay up to its “retention” amoifnt, i.e., the amount of “cover” the retrocessionaire agreed to provide the reinsurer, once the total claim amount has surpassed a set monetary limit or “layer” that the reinsurer must first pay. See Hartford Acc. and Indem. Co. v. Ace American Reinsurance Co., 284 Conn. 744, 750 n. 5, 936 A.2d 224 (2007).2 Excess of loss policies come in three forms: “per risk,” “annual aggregate” or “per occurrence.” See Orpett, et al., 3 LAW AND PRAC. OF INS. COVERAGE LITIG. § 41:10 (2012). These three methods differ in the manner in which risks “attach” to the reinsurance agreement. Under a per occurrence policy, like that at issue here, the retrocessionaire’s obligation is triggered by a particular incident, such as a personal injury. Id.

Turning now to the details of the retrocessional policy at hand, the following facts are undisputed unless otherwise noted. In this fact section, I also provide an outline of the parties’ agreement. As there are additional facts that aid my analysis of the [691]*691particular provisions that must be interpreted, I provide greater factual detail in the body of the Opinion where appropriate.

Munich entered into a reinsurance relationship with Everest National Insurance Company (“Everest”), whereby Munich agreed to reinsure Everest’s workers compensation insurance program for the period of January 1, 1998 through December 31, 2001 under an excess of loss reinsurance agreement.

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893 F. Supp. 2d 686, 2012 WL 4475589, 2012 U.S. Dist. LEXIS 140334, Counsel Stack Legal Research, https://law.counselstack.com/opinion/munich-reinsurance-america-inc-v-american-national-insurance-njd-2012.