North River Insurance v. United National Insurance

172 A.D.2d 46, 577 N.Y.S.2d 588, 1991 N.Y. App. Div. LEXIS 15274
CourtAppellate Division of the Supreme Court of the State of New York
DecidedDecember 3, 1991
StatusPublished
Cited by3 cases

This text of 172 A.D.2d 46 (North River Insurance v. United National Insurance) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
North River Insurance v. United National Insurance, 172 A.D.2d 46, 577 N.Y.S.2d 588, 1991 N.Y. App. Div. LEXIS 15274 (N.Y. Ct. App. 1991).

Opinion

OPINION OF THE COURT

Milonas, J.

In a prior appeal in this action, this court determined both insurers’ policies covered the third-party liability of the insured, Summit Hoisting Corp., to Starrett Brothers and Eken arising out of injuries suffered by Summit employee, Thomas Gilson. We remanded the matter for an apportionment of the loss [152 AD2d 500]. The personal injury action was settled by payment on July 26, 1982 by North River Insurance Co. (North River) of $588,245 to Gilson, plus waiver of its workers’ compensation lien of $79,839.57. Counsel for United National Insurance Company (United), having knowledge of North River’s contention that they were coinsurers of the same risk, was present at the time the settlement stipulation was read into the record and agreed that the settlement was fair and reasonable, without prejudice to United’s right to deny coverage. In defense of the insured, North River expended $6,826 in attorneys’ fees and disbursements and United expended $750. United’s general liability coverage had a limit of liability of $300,000 per person and per occurrence. North River’s workers’ compensation coverage had no fixed limitation on the amount thereof. Each policy contained an "other insurance” clause. North River’s provided: "If the insured has other insurance against a loss covered by this policy, the company shall not be liable to the insured hereunder for a greater proportion of such loss than the amount which would have been payable under this policy, had no such other insurance [49]*49existed, bears to the sum of said amount and the amounts which would have been payable under each such other policy applicable to such loss, had each such policy been the only policy so applicable.”

United’s "other insurance” clause provided:

"When both this insurance and other insurance apply to the loss on the same basis * * * the company shall not be liable under this policy for a greater proportion of the loss than that stated in the applicable contribution provision below:
"(a) Contribution by Equal Shares. If all of such other valid and collectible insurance provides for contribution by equal shares, the company shall not be liable for a greater proportion of such loss than would be payable if each insurer contributes an equal share until the share of each insurer equals the lowest applicable limit of liability under any one policy or the full amount of the loss is paid, and with respect to any amount of loss not so paid the remaining insurers then continue to contribute equal shares of the remaining amount of the loss until each such insurer has paid its limit in full or the full amount of the loss is paid.
"(b) Contribution by Limits. If any of such other insurance does not provide for contribution by equal shares, the company shall not be liable for a greater proportion of such loss than the applicable limit of liability under this policy for such loss bears to the total applicable limit of liability of all valid and collectible insurance against such loss.”

On cross motions for summary judgment, Supreme Court found prorated contribution based upon policy limits in this case, in which one insurer’s policy had no fixed limit of liability, would be inappropriate and arbitrary, and therefore, apportioned responsibility for insurers’ loss on an "equitable”, equal basis, up to the limit of United’s $300,000 coverage. It was also found that North River’s waiver of its workers’ compensation lien was an element of the cost of settlement, for which the general liability carrier United could be held responsible. Also on "equitable” grounds, albeit unelaborated, interest was assessed to run only from July 27, 1989, the date of this court’s order on the prior appeal determining United to be a coinsurer. With respect to attorneys’ fees, the decision of the court appears to have rejected an offset of North River’s expenses by United’s expenditure of $750 for such purposes on the ground that the amount of the proposed offset was de minimis. However, the order settled thereon did not address [50]*50the amount of defense costs at all, and merely directed entry of judgment in North River’s favor in the amount of $300,000 (United’s limit of liability) plus interest from July 27, 1989.

Preliminarily, it is necessary to clarify and limit the loss as to which the parties are coinsurers. This court has recently held that, in similar circumstances in which a general liability carrier and a workers’ compensation carrier are coinsurers of a loss which might include waiver of the workers’ compensation carrier’s lien, the general liability carrier, never having assumed the risk of workers’ compensation coverage, is not to be held responsible for any portion of the waived lien (Commissioners of State Ins. Fund v Insurance Co., 173 AD2d 423). Therefore, North River is solely responsible for the waiver of its $79,839.57 workers’ compensation lien. Defense costs are, of course, subject to apportionment in this instance of concurrent insurance, but the amounts of such expenditures traditionally are not included in calculating the insurers’ respective shares of liability, as such amounts are not subject to policy limitations. Instead, such defense costs should be apportioned by a percentage determined independently of such expenditures (see, Travelers Ins. Co. v General Acc., Fire & Life Assur. Corp., 28 NY2d 458, 462-463; Canal Ins. Co. v Ranger Ins. Co., 489 F Supp 492, 497-498).

The issue presented as to apportionment of these insurers’ liability for the $588,245 settlement payment is a novel one. North River’s "other insurance” clause plainly provides for pro rata, not equal, contribution. Moreover, despite the absence of any limit upon North River’s workers’ compensation coverage, the formula set out by its "other insurance” clause can be easily applied; indeed, it is apparent the clause was written with the fact that such coverage had no fixed limit in mind. Quite simply, it is not to be liable "for a greater proportion of such loss than the amount which would have been payable under this policy, had no such other insurance existed [$588,245], bears to the sum of said amount and the amounts which would have been payable under each such other policy applicable to such loss [$588,245 plus $300,000]”. This ratio results in the fraction .6623, which is North River’s share under its own "other insurance” clause.

United’s "other insurance” clause has two alternative parts, the first of which plainly does not apply as the "other valid and collectible insurance”, in this case, North River’s policy, does not provide for contribution by equal shares. Thus, the second alternative provision of United’s "other insurance” [51]*51clause applies and this too calls for pro rata, not equal, contribution. The problem arises from the formula set forth thereunder in the circumstances of the absence of any fixed limitation of liability of the other collectible insurance, the North River policy. United is not to be liable "for a greater proportion of such loss than the applicable limit of liability under this policy for such loss [$300,000] bears to the total applicable limit of liability of all valid and collectible insurance against such loss [$300,000 plus North River’s 'applicable limit of liability’].”

North River argues that United’s policy cannot be applied and/or is meaningless in these circumstances, so that the loss should be borne equally.

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Cite This Page — Counsel Stack

Bluebook (online)
172 A.D.2d 46, 577 N.Y.S.2d 588, 1991 N.Y. App. Div. LEXIS 15274, Counsel Stack Legal Research, https://law.counselstack.com/opinion/north-river-insurance-v-united-national-insurance-nyappdiv-1991.