United States Fidelity & Guaranty Co. v. Lee Investments, LLC

551 F. Supp. 2d 1050, 2008 U.S. Dist. LEXIS 21267, 2008 WL 746545
District Court, E.D. California·Decided March 18, 2008·No. CV-F-99-5583 OWW/SMS·Published·Cited by 2 cases

Opinion

MEMORANDUM DECISION DENYING LEE INVESTMENTS LLC’S MOTION FOR JUDGMENT PURSUANT TO RULE 50(b), FEDERAL RULES OF CIVIL PROCEDURE (Doc. 703)

OLIVER W. WANGER, District Judge.

Lee Investments LLC (hereafter Lee) moves pursuant to Rule 50(b), Federal Rules of Civil Procedure, for judgment as a matter of law on the ground that no *1052 reasonable jury would have a legally sufficient evidentiary basis to find for United States Fidelity & Guaranty Company (hereafter USF & G) and Aon Risk Services Inc. of Central California Risk Services (hereafter Aon) in that:

1. As a condition or exception limiting coverage, Mr. Sackett’s August 11, 1998 letter (Exh. 833) was required to be, but was not, as a matter of law, clear, plain and conspicuous;
2. As a matter of law in this case, it was an element of USF & G’s claim for rescission that Lee have been provided with, completed, signed and returned, an application for the workers’ compensation policy issued by USF & G;
3. As a matter of law, USF & G and Aon failed to show that Lee’s employees engaged in activities that were outside of a water park workers’ compensation classification code; and
4. As a matter of law, Lee did not make a misrepresentation to Aon, Lee did not intend to induce any reliance by Aon on a misrepresentation, and no reliance of Aon was a substantial factor in causing harm to Aon.

A. Governing Standards.

The standards governing a motion for judgment as a matter of law pursuant to Rule 50, Federal Rules of Civil Procedure, are reiterated in Gibson v. City of Cranston, 37 F.3d 731, 735 (1st Cir.1994):

When confronted with a motion for judgment as a matter of law, whether at the end of the plaintiffs case or at the close of all the evidence, a trial court must scrutinize the proof and the inferences reasonably to be drawn therefrom in the light most amiable to the nonmovant ... In the process, the court may not consider the credibility of witnesses, resolve conflicts in testimony, or evaluate the weight of evidence ... A judgment as a matter of law may be granted only if the evidence, viewed from the perspective most favorable to the nonmovant, is so one-sided that the movant is plainly entitled to judgment, for reasonable minds could not differ in the outcome ....

Further, a party cannot raise arguments in a post-trial motion for judgment as a matter of law that it did not raise in its pre-verdict motion. Freund v. Nycomed Am-ersham, 347 F.3d 752, 761 (9th Cir.2003).

B. Was the Sackett’s August 11, 1998 letter (Exh. 888) A Condition or Exception Limiting Coverage, and Required To Be As a Matter of Law, Clear, Plain and Conspicuous?

Lee asserts that the August 11, 1998 letter “stated what USF & G claims was a condition to coverage that Lee’s employees (a) stay within their designated classification as water park employees and (b) that claims arising from ‘construction’ not be reported under the workers’ compensation policy”, and contends:

USF & G and ASI never made clear to Lee what was and was not included within the designated classification for water park employees, nor did USF & G and ASI inform Lee that they were interpreting ‘construction’ in a layperson’s terms instead of in the sense that would require a construction classification code under the Uniform Statistical Reporting Plan. Dr. Levine established that ‘designated classification’ and ‘construction’ in this context would be understood by persons in the insurance industry in their technical sense, but USF & G claimed that any activity that a layperson could call construction was impermissible. This was never clarified for Lee, which, like Mr. Lemasters, understood it was not unusual for water park maintenance employees to erect water slides as part of park operations.

*1053 Lee asserts that, because USF & G and American Specialty were not clear, plain and conspicuous in their statement of condition or exception to the policy, that condition or exception cannot be enforced. Lee cites Thompson v. Occidental Life Insurance Co., 9 Cal.3d 904, 912, 109 Cal.Rptr. 473, 513 P.2d 353 (1973):

[A]n insurance company is not precluded from imposing conditions precedent to the effectiveness of insurance coverage despite the advance payment of premium. However, any such condition must be stated in conspicuous, unambiguous and unequivocal language which an ordinary layman can understand.

Lee also cites E.M.M.I., Inc. v. Zurich American Ins. Co., 32 Cal.4th 465, 471, 9 Cal.Rptr.3d 701, 84 P.3d 385 (2004):

As we have declared time and again, ‘any exception to the performance of the basic underlying obligation must be so stated as clearly to apprise the insured of its effect.’ Thus, ‘the burden rests upon the insurer to phrase exceptions and exclusions in clear and unmistakable language.’ The exclusionary clause ‘must be conspicuous, plain and clear.’ This rule applies with particular force when the coverage portion of the insurance policy would lead an insured to reasonably expect coverage for the claim purportedly excluded.

Lee’s contention assumes that the August 11, 1998 letter imposed a condition or restriction on coverage. It did neither.

As USF & G responds, Lee’s contention that the August 11, 1998 letter constituted a condition modifying the terms of an integrated policy is “completely unfounded as a matter of law” and fact. The August 11, 1998 letter was not part of the insurance policy, did not address any term or provision of the insurance policy, and did not constitute a condition or exclusion to the policy itself. The cases upon which Lee relies discuss rules for the interpretation of an insurance policy that is in force, and not, as here, written representations made by the applicant before the written and fully integrated policy contract was issued or came into effect. As USF & G contends:

Sackett’s August 11, 1998 letter ... clearly was not part of the policy. Rather, it constituted only a request by the insurer in the course of the policy application process for confirmation that Lee would not use its employees to perform construction work. That inquiry was made to allow USF & G and American Specialty to determine whether they would be willing to issue the policy in the first place.

Furthermore, Lee, over the objections of USF & G, requested and obtained Jury Instruction No. 29:

Free access — add to your briefcase to read the full text and ask questions with AI

United States Fidelity & Guaranty Co. v. Lee Investments, LLC, 551 F. Supp. 2d 1050, 2008 U.S. Dist. LEXIS 21267, 2008 WL 746545 (E.D. Cal. 2008).

551 F. Supp. 2d 1050 (United States Fidelity & Guaranty Co. v. Lee Investments, LLC) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Pearson v. Deutsche Bank AG
S.D. Florida, 2023
Austrum v. Federal Cleaning Contractors, Inc.
190 F. Supp. 3d 1132 (S.D. Florida, 2016)