Northwest Prosthetic v. Centennial Ins.

997 P.2d 972
CourtCourt of Appeals of Washington
DecidedApril 24, 2000
Docket44254-6-I
StatusPublished
Cited by14 cases

This text of 997 P.2d 972 (Northwest Prosthetic v. Centennial Ins.) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Northwest Prosthetic v. Centennial Ins., 997 P.2d 972 (Wash. Ct. App. 2000).

Opinion

997 P.2d 972 (2000)
100 Wash.App. 546

NORTHWEST PROSTHETIC & ORTHOTIC CLINIC, INC., a Washington corporation, Appellant,
v.
CENTENNIAL INSURANCE COMPANY, a foreign corporation, Respondent.

No. 44254-6-I.

Court of Appeals of Washington, Division 1.

April 24, 2000.

*973 Timothy R. Gosselin, Burgess Fitzer Leighton & Phillips Ps, Tacoma, for Respondent.

Bryan Patrick Coluccio, Short & Cressman, Seattle, for Appellant.

BECKER, A.C.J.

An insured's breach of insurance policy provisions will not result in denial of coverage unless the breach caused actual prejudice. In this case, the insured settled a debatable defamation claim before the insurer had a meaningful opportunity to investigate it. We affirm a summary judgment order excusing the insurer from its obligation to provide coverage because the loss of the opportunity to investigate amounted to actual prejudice.

In reviewing a summary judgment order, this court evaluates the matter de novo, engaging in the same inquiry as the trial court. Kruse v. Hemp, 121 Wash.2d 715, 853 P.2d 1373 (1993). All facts and reasonable inferences are considered in the light most favorable to the non-moving party. Mountain Park Homeowners Assn., Inc. v. Tydings, 125 Wash.2d 337, 341, 883 P.2d 1383 (1994). Summary judgment is proper if no genuine issue of material fact exists and the moving party is entitled to judgment as a matter of law. CR 56(c).

Northwest Prosthetic and Orthotic Clinic operated several successful clinics in the Puget Sound area. Fred Cato, Stephen Lund and David Osborne were equal shareholders. Each shareholder had an employment agreement with Northwest.

In January 1995, Lund and Osborne terminated Cato's employment on behalf of Northwest. Cato brought suit, alleging, among other claims, that Northwest breached a contract clause requiring reasonable cause for his termination.

After a status conference in March 1995, the court moved the trial date forward from July 1996 to July 10, 1995. On May 15, 1995, Cato moved to amend his complaint to add a claim of defamation. The defamation claim alleged that Osborne and Lund had harmed Cato by their remarks about him to Northwest employees and unspecified third parties. Northwest opposed amending the complaint and requested a trial continuance if the court granted the motion to amend. On May 25, the court granted the motion to amend. The court denied the continuance but extended the discovery cutoff date.

Counsel for Northwest became aware at some point that Northwest had a business insurance policy. Although Northwest did not have a copy of the policy, counsel knew that a typical business policy provides coverage for defamation, although not for breach of contract and the other claims initially asserted by Cato. Counsel sent a letter to the local insurance agent enclosing a copy of the amended complaint "which was recently filed in this matter." The letter, dated June 14, 1995, tendered the claim and defense of the lawsuit to the insurer. The letter did not include any information about the defamation claim, the status of the case, the impending trial date, or a settlement conference scheduled for June 27.

The agent transmitted the notice of the claim electronically to Centennial Insurance Company. Centennial received the notice on or about June 26 and assigned the claim to Jana Weber, a claims handler. On June *974 27, a paralegal working with Northwest's counsel telephoned Weber. The paralegal requested a copy of the policy from Weber, but did not mention the trial date of July 10 or the settlement conference scheduled for that very day.

On June 30, 1995, 10 days before trial was to begin, the parties signed a settlement agreement. Among the various provisions of the agreement, Northwest agreed to pay Cato $325,000, characterized as damages for Cato's personal injuries on account of defamation.

Meanwhile, Centennial was hiring lawyers to defend Northwest on the defamation claim. On July 18 Centennial's attorney sent a letter to Northwest, agreeing to defend under a reservation of rights. The same day, Centennial's attorney telephoned Northwest's attorney for information about the defamation claim and learned at that time that the case had settled almost three weeks earlier.

Northwest made a claim to Centennial for the $325,000 paid as defamation damages under the settlement. Centennial denied coverage based on Northwest's violation of policy provisions requiring notice, cooperation and consent to settle. Northwest sued Centennial for coverage. Both parties moved for summary judgment. The court granted Centennial's motion and dismissed Northwest's suit. Northwest appeals, and asks this court to hold that the right to coverage has been established as a matter of law, or alternatively to reinstate the complaint and remand for trial.

The insurance policy's notice provision requires the insured to notify Centennial "as soon as practicable" of an occurrence, claim, or lawsuit. The policy also requires the insured to cooperate with Centennial in the investigation, settlement or defense of the lawsuit. Additionally, the policy prohibits the insured from voluntarily making any payment, assuming any obligation or incurring any expense without Centennial's consent.

That Northwest breached these obligations is not seriously disputed. Northwest had notice of the potentially covered defamation claim at least by May 15, 1995. Northwest's letter notifying Centennial is dated June 14, 30 days later. Actual notice of the claim did not reach Centennial until June 26. Northwest's letter did not mention the impending trial date; did not ask for permission to settle; and gave no hint that time was short and the need for response urgent.

Northwest argues, however, that Centennial has not shown actual prejudice. Noncompliance with an insurance policy provision does not deprive the insured of the benefits of the policy unless the insurer demonstrates actual prejudice resulting from the insured's noncompliance. Oregon Auto. Ins. Co. v. Salzberg, 85 Wash.2d 372, 377, 535 P.2d 816 (1975). The burden of proof is on the insurer. Salzberg, 85 Wash.2d at 377, 535 P.2d 816. If insurers were allowed to avoid payment based on the insured's conduct even in the absence of prejudice, the public policy of risk spreading would be compromised and, in a sense, the insurer would receive a windfall. Salzberg, 85 Wash.2d at 376-77, 535 P.2d 816.

To establish actual prejudice, the insurer must demonstrate "some concrete detriment resulting from the delay which harms the insurer's preparation or presentation of defenses to coverage or liability." Canron v. Federal Insurance Company, 82 Wash.App. 480, 486, 918 P.2d 937 (1996), review denied, 131 Wash.2d 1002, 932 P.2d 643 (1997). Whether interference with the insurer's ability to evaluate and investigate a claim has caused actual prejudice is ordinarily an issue of fact. Tran v. State Farm Fire & Cas. Co., 136 Wash.2d 214, 228,

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Bluebook (online)
997 P.2d 972, Counsel Stack Legal Research, https://law.counselstack.com/opinion/northwest-prosthetic-v-centennial-ins-washctapp-2000.