St. Paul Fire & Marine Insurance v. American Home Assurance Co.

514 N.W.2d 113, 444 Mich. 560
CourtMichigan Supreme Court
DecidedMarch 1, 1994
DocketDocket Nos. 95632, 95633, (Calendar No. 6)
StatusPublished
Cited by46 cases

This text of 514 N.W.2d 113 (St. Paul Fire & Marine Insurance v. American Home Assurance Co.) is published on Counsel Stack Legal Research, covering Michigan Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
St. Paul Fire & Marine Insurance v. American Home Assurance Co., 514 N.W.2d 113, 444 Mich. 560 (Mich. 1994).

Opinion

Mallett, J.

This is an action among three insurance companies: St. Paul Fire & Marine Insurance Company, Continental Casualty Company, plaintiffs-appellants, and American Home Assurance *562 Company, defendant-appellee. In this consolidated appeal, we granted leave to decide the legal effect to be given plaintiff-appellants’ pro-rata "other insurance” clause and defendant-appellee’s excess "other insurance” clause contained in their respective malpractice insurance policies.

More specifically, we must determine whether to adopt the Lamb-Weston doctrine 1 that views all "other insurance” clauses as irreconcilable and prorates liability among all insurers, or to adopt the majority rule that endeavors to reconcile the competing clauses if possible. We hold that the majority rule is the better approach to reconciling competing "other insurance” clauses.

i

From 1968 until 1974, John and Eileen Zatolo-kin were represented by attorney Frederic A. Grimm and his former law firm. 2 In September of 1974, Grimm was appointed a judge of the Mus-kegon Circuit Court. Following his appointment, Grimm advised the Zatolokins that he would be unable to continue representing their interests. Attorney Forsythe and the law firm in which he was affiliated succeeded Grimm and assumed representation of the Zatolokins.

In March of 1976, Forsythe apprised the Zatolo-kins that their claims on their earlier investments were no longer collectible. He recommended that the investments be written off as bad debts for federal income tax purposes. 3 Subsequently, the *563 Zatolokins brought suit against attorneys Grimm and Forsythe and their respective law firms. 4

Eventually, the case against Grimm and his law firm was settled. Plaintiffs in these actions defended the lawsuit on behalf of the insured and contributed to the settlement. However, pursuant to its contract with the insured, American Home neither defended the lawsuit nor contributed to the settlement.

Accordingly, plaintiffs brought suit seeking a proration of the defense and settlement costs among the three insurers on the basis of their respective policy limits. Judge Kolenda applying the Lamb-Weston rule found in favor of the plaintiff insurers and entered judgments of $120,254.25 for St. Paul, and $106,640.56 for cna. 5 The Court of Appeals reversed. 6

The Court of Appeals applied the majority rule and reasoned that pro-rata and excess "other insurance” clauses can be reconciled by assigning primary liability to the insurers whose policies contain pro-rata clauses and excusing the insurer whose policy contains an excess clause, unless liability exceeds the pro-rata insurer’s limits. 7 In the present case, the malpractice lawsuit was settled for less than the limits of plaintiffs’ policies. Therefore, the Court of Appeals ruled that American Home had no obligation either to defend or to indemnify. We subsequently granted leave to appeal and now affirm the Court of Appeals decision. On August 20, 1993, we granted leave. 8 _

*564 n

A

Before addressing the arguments some brief background may be instructive. Broadly defined, insurance is a contract by which one party, for a consideration, assumes particular risks of the other party. 9 The parties have the right to employ whatever terms they wish, and the courts will not rewrite them as long as the terms do not conflict with pertinent statutes or public policy. Auto-Owners Ins Co v Churchman, 440 Mich 560, 566-567; 489 NW2d 431 (1992). 10

Included in many of these contracts are "other insurance” clauses. These clauses originated in the area of property insurance and were designed to protect the insurer from the moral hazards of fraud and carelessness incident to the over-insurance of property. 11 "Other insurance” clauses are provisions inserted in insurance policies to vary or limit the insurer’s liability when additional insurance coverage can be established to cover the same loss. 12 Insurance companies continue to include these provisions as standard clauses in liability policies even though potential fraud through over-insurance in this context is remote. 13 _

*565 Justice Riley, writing for a unanimous Court, recognized that "other insurance” clauses fall into three general categories. The effect of each in the event of concurrent coverage is to reduce the insurer’s loss. They are:

1. A pro-rata clause, which purports to limit the insurer’s liability to a proportionate percentage of all insurance covering the event;
2. An escape or no-liability clause, which provides that there shall be no liability if the risk is covered by other insurance; and
3. An excess clause, which limits the insurer’s liability to the amount of loss in excess of the coverage provided by the other insurance. Federal Kemper Ins Co, Inc v Health Ins Administration, Inc, 424 Mich 537, 542; 383 NW2d 590 (1986). 14

*566 The central dispute revolves around the "other insurance” clause in each party’s respective malpractice policy. The St. Paul "other insurance” clause reads:

[I]f the Insured has other insurance against a loss covered by this Policy, the Company shall not be liable under this Policy for a greater proportion of such loss than the limit of liability stated in the Declarations bears to the total limit of liability of all valid and collectible insurance against such loss ....

Cna’s "other insurance” clause reads:

If the insured has other insurance against a loss covered by this policy the company shall not be liable under this policy to a greater proportion of such loss than the applicable limit of liability stated in the declarations bears to the total applicable limit of liability of all valid and collectible insurance against such loss . . . .[ 15 ]

St. Paul and cna’s "other insurance” clauses are commonly known as "pro rata” clauses for the *567

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Cite This Page — Counsel Stack

Bluebook (online)
514 N.W.2d 113, 444 Mich. 560, Counsel Stack Legal Research, https://law.counselstack.com/opinion/st-paul-fire-marine-insurance-v-american-home-assurance-co-mich-1994.