Pacific Employers Ins Co v. Global Reinsurance Corp of Ame

693 F.3d 417, 2012 WL 3871588, 2012 U.S. App. LEXIS 18835
CourtCourt of Appeals for the Third Circuit
DecidedSeptember 7, 2012
Docket11-3234, 11-3262
StatusPublished
Cited by87 cases

This text of 693 F.3d 417 (Pacific Employers Ins Co v. Global Reinsurance Corp of Ame) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pacific Employers Ins Co v. Global Reinsurance Corp of Ame, 693 F.3d 417, 2012 WL 3871588, 2012 U.S. App. LEXIS 18835 (3d Cir. 2012).

Opinion

OPINION OF THE COURT

AMBRO, Circuit Judge.

In 1980 Pacific Employers Insurance Company (“PEIC”) purchased a certificate of reinsurance (the “Certificate”) from Constitution Reinsurance Corporation (“Constitution”), the predecessor of Global Reinsurance Corporation of America (“Global”). In this case, one sentence from that Certificate stands in the spotlight. That sentence reads, “As a condition precedent, the Company [ie., PEIC] shall promptly provide the Reinsurer [ie., Constitution, now Global] with a definitive statement of loss on any claim or occurrence reported to the Company and brought under this Certificate which involves a death, serious injury or lawsuit.”

When we read this sentence in the context of the entire Certificate, we agree with the District Court that it is fairly susceptible to only one reasonable interpretation. PEIC must provide Global with a definitive statement of loss (“DSOL”) on a subset of claims or occurrences, specifi *421 eally those that involve a death, serious injury or lawsuit. When must PEIC do this? We believe it is promptly after someone reports such a claim or occurrence to it, not promptly after it demands indemnity from Global. If PEIC dawdles, the consequences can be severe. PEIC’s compliance with this provision is a condition precedent to Global’s duty to rein-sure — that is, its duty to make indemnity payments relating to the underlying claim or occurrence — and not merely its duty to make such payments promptly.

Parting ways with the District Court, we hold that this provision is enforceable as written. Our choice-of-law analysis points to New York, not Pennsylvania, law. Under New York law, when a reinsurance contract expressly requires a reinsured to provide its reinsurer with prompt notice of a claim or occurrence as a condition precedent to coverage and the reinsured fails to do so, that failure excuses the reinsurer from its duty to perform, regardless whether the reinsurer suffered prejudice as a result of the late notice. For these reasons, and because no genuine issue of material fact remains, we reverse the District Court’s Final Order and Judgment and remand with instructions that it enter a judgment of non-liability in Global’s favor.

I. Factual and Procedural Background

A. Reinsurance Basics

A brief reinsurance primer is in order. 1 Put colloquially, reinsurance is insurance for insurance companies. A reinsurer agrees to indemnify a reinsured for certain payments the latter makes under one or more of its issued policies. 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 invest more capital or to insure more risks.

The reinsured may be either a primary or an excess insurer. Both cover policy holders directly, but excess coverage kicks in only after an insured’s primary coverage is exhausted. In contrast, reinsurers do not cover policy holders directly. 2 Instead, they issue “certificates” of reinsurance to their reinsureds.

There are two basic types of reinsurance: treaty and facultative.

Under a reinsurance treaty, the rein-surer 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.
Facultative reinsurance entails the ceding of a particular risk or policy. Unlike a treaty reinsurer who must accept all covered business, the facultative reinsurer assesses the unique characteristics of each policy to determine whether to reinsure the risk, and at what price. Thus, a facultative reinsurer re *422 tains the faculty, or option, to accept or reject any risk.

N. River Ins. Co. v. CIGNA Reinsurance Co., 52 F.3d 1194, 1199 (3d Cir.1995) (internal citations and quotation marks omitted).

B. Buffalo Forge Purchases Insurance; PEIC Purchases Reinsurance

Our story begins when the Buffalo Forge Company (“Buffalo Forge”), a manufacturing company located principally in Buffalo, New York, purchased insurance for itself and its affiliates. First, it bought a “comprehensive general liability insurance policy” (the “Primary Policy”) from Utica Mutual Insurance Company. That policy had a $1 million limit. It also purchased an “excess blanket catastrophe liability policy” (the “Excess Policy”), with the same policy period, from PEIC, then a California stock insurance company located in Los Angeles. The Excess Policy provided $9 million of coverage in excess of the Primary Policy’s $1 million.

Meanwhile, to spread some of the risk of the Excess Policy, PEIC purchased the Certificate (a facultative reinsurance contract) from Constitution, a New York corporation located in New York. Under the Certificate, PEIC retained the first $1 million of the Excess Policy and Constitution agreed to reinsure 25% of the next $4 million, with a $1 million limit.

It does not appear that there was any direct “negotiation” over the Certificate’s terms and conditions. While preparing to issue the Excess Policy, PEIC — through its Buffalo underwriting office — asked a broker in Minnesota to make inquiries about reinsurance coverage. The broker then communicated with several reinsurers, including Constitution. It sent a telex, dated May 30, 1980, to Constitution in New York to confirm that it was seeking binding reinsurance effective June 1, 1980, with PEIC retaining the first $1 million and Constitution reinsuring a 25% share of the next $4 million, in exchange for a $15,000 gross premium. Constitution replied by telex on June 5, 1980, confirming its acceptance of PEIC’s terms. The broker and Constitution had further exchanges in September 1980 about the payment of premiums and the issuance of the Certificate. Eventually Constitution caused the Certificate, according to its signature line, “to be signed by its President and Secretary at New York, New York,” and sent it to PEIC’s broker in Minnesota. In return, PEIC sent Constitution’s share of the premiums from Buffalo Forge to PEIC’s Minnesota broker, who forwarded it to Constitution in New York.

To offset further the risk of the Excess Policy, three other reinsurers also participated in Constitution’s reinsured layer. Of the four, two were New York companies, one an Illinois company, and one a Massachusetts company.

Eighteen and nineteen years after the issuance of the Certificate, respectively, PEIC and Constitution underwent corporate reorganization. In 1998, Gerling Global Reinsurance Corporation acquired Constitution and merged it into a newly formed corporation that is now Global Reinsurance Corporation of America, the appellant here. Like its predecessor, Global is a New York corporation with its principal place of business in New York. PEIC underwent a more significant change in 1999.

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Bluebook (online)
693 F.3d 417, 2012 WL 3871588, 2012 U.S. App. LEXIS 18835, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pacific-employers-ins-co-v-global-reinsurance-corp-of-ame-ca3-2012.