U.S. Underwriters Ins. Co. v. Image By J&K, LLC
This text of 335 F. Supp. 3d 321 (U.S. Underwriters Ins. Co. v. Image By J&K, LLC) is published on Counsel Stack Legal Research, covering District Court, E.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
Opinion
MARGO K. BRODIE, United States District Judge
Plaintiff United States Underwriters Insurance Company ("U.S. Underwriters") commenced the above-captioned action on November 7, 2016, against Defendants Image By J & K, LLC ("Image"), Sphinx Cleaning Systems, Inc. ("Sphinx"), and Margarita LeClerc, seeking a declaratory judgment that it has no duty to defend or indemnify Image in the state court action, Margarita LeClerc v. Image By J & K, LLC and Image Building Maintenance, Inc. , Index No. 703797/2014 (Sup. Ct.) (the "LeClerc Action " ), pursuant to the Declaratory Judgment Act,
I. Background
a. LeClerc Action
Plaintiff U.S. Underwriters is a North Dakota insurance company, with a principal place of business in Pennsylvania, conducting business in New York. (Compl. ¶ 7.)1 Defendant Image is a limited liability corporation with its principal place of business in Virginia. (id. ; Image Answer ¶ 7, Docket Entry No. 8.)
On March 4, 2010, Image entered into a "Floor Cleaning/Janitorial Services Agreement" (the "Agreement") with Walgreens Eastern Co., Inc. ("Walgreens"). (Pl. Statement of Material Facts Pursuant to Local R. 56.1 ("Pl. 56.1") ¶ 2, Docket Entry No. 35.) On March 23, 2011, Image subcontracted the services in the Agreement to Sphinx, a corporation with its principal place of business in New York. (Compl. ¶ 9; Pl. 56.1 ¶ 3.) Under the subcontract, Sphinx, inter alia , cleaned and waxed the floors of the Walgreens Pharmacy in Corona, New York (the "Premises"), upon the issuance of work orders by Image. (Subcontract Agreement between Sphinx and Image ("Subcontract Agreement") 2, annexed to Robert W. Muilenburg Decl. in Supp. of Pl. Mot. ("Muilenburg Decl."), *328Docket Entry No. 30-2 as Ex. D, Docket Entry No. 30-6.) The work orders detailed the "[s]ervices to be performed, the time frame of the [s]ervices to be performed, and the price to be paid to [Sphinx] for [its] [s]ervices." (Id. ) As part of its subcontract, Sphinx was also required to obtain general liability insurance naming Image as an additional insured. (Pl. 56.1 ¶ 7.) Sphinx thus obtained commercial liability insurance policy number CP 3554491 from U.S. Underwriters (the "Policy"). (Id. ¶ 14.)
On June 2, 2011, LeClerc, a Walgreens employee, fell and sustained bodily injuries at the Premises. (LeClerc Compl. ¶ 24, annexed to Image Mot. as Ex. A, Docket Entry No. 25-2.) LeClerc testified that on the day of the accident, the Premises opened at 7:30 AM, about forty-five minutes later than usual, because the cleaning crew had left later than usual. (LeClerc Dep. 44:2-23, 47:20-48:6, annexed to Image Mot. as Ex. R, Docket Entry No. 25-19.) Consequently, the floors allegedly had yet to dry and remained wet. (Id. at 48:15-16.) After the Premises were opened to the public, a customer fell down in aisle five. (Id. at 65:20-66:8.) About twenty to twenty-five minutes later, sometime between 8:00 and 9:00 AM, LeClerc also fell down in aisle five, suffering the complained of injuries. (Id. at 14:2-5; 67:12-15.) LeClerc alleges that Image or its agents were responsible for ensuring that the Premises were safe and their failure to properly dry the floors violated their duties of reasonable care and diligence, causing her injuries. (LeClerc Compl. ¶ 22-26.)
b. The Policy
The parties dispute whether Image qualifies as an additional insured under the Policy. Section II (A) of the Policy (the "Additional Insured Provision") provides the following definition of an additional insured:
Who is An Insured is amended to include as an additional insured the person(s) or organizations(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damages" or "personal and advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insure[s] at the location[s] designated above.
(Policy, annexed as Ex. K to Image Mot. Docket Entry No. 25-12.)
Section II (B) of the Policy (the "Exclusions Provision") also provides certain policy exclusions specific to additional insureds:
With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring after:
1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or
2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.
(Id. ) The parties agree the term "your" in these sections is a reference to Sphinx, the named insured of the Policy. (Pl. 56.1 ¶ 16.)
*329II. Discussion
a. Standards of review
i. Summary judgment
Summary judgment is proper only when, construing the evidence in the light most favorable to the non-movant, "there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(a) ; Wandering Dago, Inc. v. Destito ,
Free access — add to your briefcase to read the full text and ask questions with AI
MARGO K. BRODIE, United States District Judge
Plaintiff United States Underwriters Insurance Company ("U.S. Underwriters") commenced the above-captioned action on November 7, 2016, against Defendants Image By J & K, LLC ("Image"), Sphinx Cleaning Systems, Inc. ("Sphinx"), and Margarita LeClerc, seeking a declaratory judgment that it has no duty to defend or indemnify Image in the state court action, Margarita LeClerc v. Image By J & K, LLC and Image Building Maintenance, Inc. , Index No. 703797/2014 (Sup. Ct.) (the "LeClerc Action " ), pursuant to the Declaratory Judgment Act,
I. Background
a. LeClerc Action
Plaintiff U.S. Underwriters is a North Dakota insurance company, with a principal place of business in Pennsylvania, conducting business in New York. (Compl. ¶ 7.)1 Defendant Image is a limited liability corporation with its principal place of business in Virginia. (id. ; Image Answer ¶ 7, Docket Entry No. 8.)
On March 4, 2010, Image entered into a "Floor Cleaning/Janitorial Services Agreement" (the "Agreement") with Walgreens Eastern Co., Inc. ("Walgreens"). (Pl. Statement of Material Facts Pursuant to Local R. 56.1 ("Pl. 56.1") ¶ 2, Docket Entry No. 35.) On March 23, 2011, Image subcontracted the services in the Agreement to Sphinx, a corporation with its principal place of business in New York. (Compl. ¶ 9; Pl. 56.1 ¶ 3.) Under the subcontract, Sphinx, inter alia , cleaned and waxed the floors of the Walgreens Pharmacy in Corona, New York (the "Premises"), upon the issuance of work orders by Image. (Subcontract Agreement between Sphinx and Image ("Subcontract Agreement") 2, annexed to Robert W. Muilenburg Decl. in Supp. of Pl. Mot. ("Muilenburg Decl."), *328Docket Entry No. 30-2 as Ex. D, Docket Entry No. 30-6.) The work orders detailed the "[s]ervices to be performed, the time frame of the [s]ervices to be performed, and the price to be paid to [Sphinx] for [its] [s]ervices." (Id. ) As part of its subcontract, Sphinx was also required to obtain general liability insurance naming Image as an additional insured. (Pl. 56.1 ¶ 7.) Sphinx thus obtained commercial liability insurance policy number CP 3554491 from U.S. Underwriters (the "Policy"). (Id. ¶ 14.)
On June 2, 2011, LeClerc, a Walgreens employee, fell and sustained bodily injuries at the Premises. (LeClerc Compl. ¶ 24, annexed to Image Mot. as Ex. A, Docket Entry No. 25-2.) LeClerc testified that on the day of the accident, the Premises opened at 7:30 AM, about forty-five minutes later than usual, because the cleaning crew had left later than usual. (LeClerc Dep. 44:2-23, 47:20-48:6, annexed to Image Mot. as Ex. R, Docket Entry No. 25-19.) Consequently, the floors allegedly had yet to dry and remained wet. (Id. at 48:15-16.) After the Premises were opened to the public, a customer fell down in aisle five. (Id. at 65:20-66:8.) About twenty to twenty-five minutes later, sometime between 8:00 and 9:00 AM, LeClerc also fell down in aisle five, suffering the complained of injuries. (Id. at 14:2-5; 67:12-15.) LeClerc alleges that Image or its agents were responsible for ensuring that the Premises were safe and their failure to properly dry the floors violated their duties of reasonable care and diligence, causing her injuries. (LeClerc Compl. ¶ 22-26.)
b. The Policy
The parties dispute whether Image qualifies as an additional insured under the Policy. Section II (A) of the Policy (the "Additional Insured Provision") provides the following definition of an additional insured:
Who is An Insured is amended to include as an additional insured the person(s) or organizations(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damages" or "personal and advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insure[s] at the location[s] designated above.
(Policy, annexed as Ex. K to Image Mot. Docket Entry No. 25-12.)
Section II (B) of the Policy (the "Exclusions Provision") also provides certain policy exclusions specific to additional insureds:
With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring after:
1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or
2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.
(Id. ) The parties agree the term "your" in these sections is a reference to Sphinx, the named insured of the Policy. (Pl. 56.1 ¶ 16.)
*329II. Discussion
a. Standards of review
i. Summary judgment
Summary judgment is proper only when, construing the evidence in the light most favorable to the non-movant, "there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(a) ; Wandering Dago, Inc. v. Destito ,
ii. Declaratory judgment
The Declaratory Judgment Act provides, in pertinent part, that "[i]n a case of actual controversy within its jurisdiction ... any court of the United States, upon the filing of an appropriate pleading, may declare the rights and other legal relations of any interested party seeking such declaration, whether or not further relief is or could be sought."
Federal courts have "unique and substantial discretion in deciding whether to declare the rights of litigants" under the Declaratory Judgment Act. Wilton v. Seven Falls Co. ,
(1) whether the judgment will serve a useful purpose in clarifying or settling the legal issues involved; ... (2) whether a judgment would finalize the controversy and offer relief from uncertainty[;] ... (3) whether the proposed remedy is being used merely for procedural fencing or a race to res judicata; (4) whether the use of a declaratory judgment would increase friction between sovereign legal systems or improperly encroach on the domain of a state or foreign court; and (5) whether there is a better or more effective remedy.
New York v. Solvent Chem. Co., Inc. ,
b. Additional Insured Provision
Plaintiff disclaims coverage by arguing that Image is not an additional insured within the meaning of the Policy. Plaintiff contends that the terms "caused, in whole or in part" and "ongoing operations" in the Additional Insured Provision disqualifies Image from being an additional insured. The parties agree that Image must qualify as an additional insured in order to be covered by the Policy.
i. Caused in whole or in part
The Additional Insured Provision provides that an entity named in the "Schedule" of the Policy is an additional insured, "but only with respect to liability for 'bodily injury' ... 'caused, in whole or in part, by ... the acts or omissions of [Sphinx] ... or [t]he acts or omissions of those acting on [Sphinx's] behalf.' " (Policy.)
Relying on Burlington Insurance Co. v. New York City Transit Authority ,
Image argues that Sphinx's acts or omissions are the proximate cause of LeClerc's injuries because Sphinx had the sole contractual responsibility to ensure that the Premises were dry on the day of the incident. (Image Opp'n to Pl. Mot. ("Image Opp'n") 8-9, Docket Entry No. 27-2.) Image also contends that courts have "repeatedly analyzed" the same or similar language in the Additional Insured Provision and "found an extremely broad duty to provide [a]dditional [i]nsured coverage." (Id. at 9.) In addition, Image distinguishes Burlington on the grounds that the injured party in that case "was an employee of the [a]dditional [i]nsured ..., not a third-party stranger to the policy." (Id. at 11.)
Under New York law, an insurer's duty to defend policyholders is "exceedingly broad," and "broader than the ... duty to indemnify." Atl. Ave. Sixteen AD, Inc. v. Valley Forge Ins. Co. ,
"An insurer's duty to defend ... is ordinarily ascertained by comparing the allegations of a complaint with the wording of the insurance contract." Int'l Bus. Machs. Corp. v. Liberty Mut. Ins. Co. ,
1. Evaluating LeClerc's complaint
Plaintiff may not disclaim coverage based solely on LeClerc's complaint because it sufficiently alleges that Sphinx's actions or omissions proximately caused LeClerc's injuries. In her complaint, LeClerc alleges that Image or its agents had the "duty ... to use reasonable care and diligence" in providing their services, including "keeping the [Premises] in a reasonably safe condition." (LeClerc Compl. ¶ 23.) LeClerc alleges that Image and its agents violated their duties by failing to properly dry the floors, leaving the Premises "in a defective, dangerous and slippery condition." (Id. ¶ 24.) Image's or its agents' negligence allegedly "caused" LeClerc to sustain her bodily injuries. (Id. ¶ 26.) Accordingly, Plaintiff may not disclaim Image as an additional insured due to lack of proximate cause based on the allegations in LeClerc's complaint.
2. Extrinsic evidence
Plaintiff relies on extrinsic evidence beyond the four corners of LeClerc's *332complaint that impermissibly overlaps with the merits of the LeClerc Action. To disclaim coverage, Plaintiff argues that LeClerc and Walgreens are the proximate cause of LeClerc's injuries. (See Pl. Mem. 8-9 ("There is no dispute that it was Walgreen[s]'[ ] responsibility to ensure the floors were dry prior to allowing any employees into the store. Nor is there any dispute that the Walgreens manager and LeClerc were aware of wet areas at the Premises, but that Walgreens permitted employees onto the Premises nevertheless.").) However, if LeClerc or Walgreens are solely at fault, Image, by way of Sphinx, cannot be held liable in the underlying action. See Gilbane Bldg. Co. v. Admiral Ins. Co. ,
Contrary to Plaintiff's claim, the reasoning in Burlington does not require the consideration of the proffered extrinsic evidence. In Burlington , the New York Court of Appeals held that the defendants were not additional insureds where coverage was limited to bodily injuries "caused, in whole or in part" by the named insured. Burlington ,
ii. Ongoing operations
The Additional Insured Provision states in pertinent part that "bodily injur[ies] ... caused, in whole or in part, by: 1. [y]our acts or omissions or 2. [t]he acts or omissions of those acting on your behalf; "in the performance of [Sphinx's] ongoing operations for the additional insured[s] at the location[s] designated above." (Policy (emphasis added).)
Plaintiff also disavows Image as an additional insured because LeClerc did not sustain her bodily injuries during Sphinx's "ongoing operations." (Pl. Mem. 1.) Plaintiff contends that the term "ongoing operations" limits additional insured coverage to "injur[ies] occur[ing] before the work has been completed." (Id. at 10.) Because "Sphinx had finished its work and left the Premises prior to LeClerc's injury," Plaintiff argues that Image does not qualify as an additional insured. (Id. )
Image contends that the term "ongoing operations" is defined broadly under New York law, and should be understood as encompassing "circumstances where [the named insured] is not present" on the Premises. (Image Reply 7.) Rather than only encompassing days of active work, Image argues that ongoing operations covers the entire period during which its contracts with Walgreens and Sphinx were in effect. (Id. at 4-7.) Because the contracts were in effect at the time of the incident, Image contends that LeClerc's injuries occurred during ongoing operations. (Id. at 8.)
Under New York law, "insurance policies are interpreted according to general rules of contract interpretation."3
*334Intelligent Dig. Sys., LLC v. Beazley Ins. Co., Inc. ,
As an initial matter, Plaintiff misinterprets the Additional Insured Provision. Although acknowledging that Image's additional insured status is "limited to bodily injury caused by Sphinx's acts or omissions in the performance of ... ongoing operations," (Pl. Mem. 9 (emphasis added) ), Plaintiff argues that this standard requires that the "injury occur[ ] before the work has been completed," (id. at 10). Plaintiff's interpretation ignores the presence of a colon following "bodily injur[ies]," separating the phrase from language concerning "acts or omissions," and "ongoing operations."4 Rather than modifying "bodily injur[ies] which precedes the colon, "ongoing operations" appears best understood as modifying the clauses following the colon regarding Sphinx's "acts or omissions" or those undertaken "on [its] behalf." See Lockhart v. United States , 577 U.S. ----, ----,
Sphinx's acts or omissions at issue in the LeClerc Action occurred during ongoing operations. Although the parties dispute the meaning of "ongoing operations," they both agree that the term encompasses, at the very least, periods of active work. (See Pl. Mem. 10 (explaining that injuries sustained "while performing work" means that they occurred during ongoing operations).) LeClerc's complaint specifies that the responsible contractor failed to properly dry the Premises. An omission by definition occurs during periods of active work. Sphinx's omission or failure to dry the Premises therefore occurred during its ongoing operations.
For the foregoing reasons, Plaintiff cannot disclaim coverage to Image based on its status as an additional insured. Based on the allegations in LeClerc's complaint, Image qualifies as an additional insured because Sphinx's alleged failure to dry the Premises, an omission occurring during ongoing operations, proximately caused LeClerc's injuries.
c. Exclusions Provision
Regardless of Image's status as an additional insured, Plaintiff also argues that Image is excluded from coverage based on the Exclusions Provision. Plaintiff argues that the Exclusions Provision applies because LeClerc's bodily injuries occurred after Sphinx had completed all its work or the portion of Sphinx's "work out of which the injur[ies] arose had been put to its intended use." (Pl. Mem. 9.)
i. All Work Clause
Subsection 1 of the Exclusions Provision (the "All Work Clause") excludes from coverage "bodily injur[ies] ... occurring after ... [a]ll work ... on the project ... has been completed." (Policy.)
Plaintiff argues that the All Work Clause applies because "all work" had been completed prior to LeClerc's injury since Sphinx had left the Premises before LeClerc's entry onto the Premises. (Pl. Mem. 11.)
Image argues that the All Work Clause does not apply because the phrase "[a]ll *336work" should be understood as encompassing the entire period during which Image's contracts with Walgreens and Sphinx were in effect. (Image Reply 6.) Because both contracts were in effect at the time of the incident, Image contends Sphinx cannot be said to have completed all its work when the injury occurred. (Id. ) Image thus argues that Plaintiff is placing undue emphasis on the completion of an individual work day, rather than the ongoing nature of the relationship. (Id. at 13.)
An insurer may only be relieved of its duty to defend on the basis of a policy exclusion if it demonstrates:
that the allegations of the complaint [in the underlying action] cast the pleadings wholly within that exclusion, that the exclusion is subject to no other reasonable interpretation, and that there is no possible factual or legal basis upon which the insurer may eventually be held obligated to indemnify the insured under any policy provision.
E. Ramapo Cent. Sch. Dist. v. N.Y. Sch. Ins. Reciprocal ,
Plaintiff may not disclaim its duty to defend Image based on the argument that the injury occurred after "[a]ll work" on the "project" had been "completed." The sections in the Policy regarding additional insured do not define the terms "[a]ll work," "project," and "completed." In addition, the parties have not provided any extrinsic evidence of the parties' intent, established customs, or state or federal law for guidance as to the meaning of these terms. See CGS Indus., Inc. v. Charter Oak Fire Ins. Co. ,
The term "completed," however, is defined in the Products-Completed Operations Hazard Provision of the Policy. Although the Products-Completed Operation Hazard Provision is not directly related to the Additional Insured and Exclusions Provisions, the Court finds the definitions of "completed" provided in that portion of the Policy instructive. See CWC Builders, Inc. v. United Specialty Ins. Co. ,
Moreover, while "project" could be interpreted as connoting a subdivision of a contract, the term could also be reasonably interpreted as encompassing the entirety of any agreement for which the named insured sought coverage - in this case Sphinx's subcontract with Image. See CWC Builders ,
The Court therefore finds the All Works Clause inapplicable because one reasonable interpretation is that work was ongoing while the contracts were in effect.
ii. Intended Use Clause
Subsection 2 of the Exclusions Provision (the "Intended Use Clause") excludes coverage for bodily injuries if "[t]hat portion of ['Sphinx's] work' out of which the injury ... arises has been put to its intended use...." (Policy.)
Plaintiff argues that the Intended Use Clause is applicable because the work causing LeClerc's injuries had been "put to its intended use" since Sphinx had left the Premises and Walgreens had opened the store. (Pl. Mem. 11.)
Image appears to argue that the Intended Use Clause does not apply for the same reasons it contends that the All Works Clause does not apply. (See generally Image Opp'n; Image Reply.) Image does not directly explain why the portion of Sphinx's work causing LeClerc's injuries had not been put to its intended use.5 (Image Opp'n 14.)
In order to determine the applicability of the Intended Use Clause, the Court must determine the significance of the terms "[t]hat portion" and "intended use," particularly with regard to how they modify the term "[Sphinx's] work." The parties have provided little discussion as to the Intended Use Clause. Neither party offered any definitions for "[t]hat portion" or "intended use." Nor did they offer any extrinsic evidence of the parties' intent as to these terms or section or guidance in the form of established customs, and state or federal law. Nevertheless, the Court finds that the Intended Use Clause would have excluded Image from coverage regardless of how "[t]hat portion" and "intended use" is understood.
The use of the term "[t]hat portion" indicates that Sphinx's work can and should be subdivided in interpreting the Intended Use Clause. By its very definition, "portion" suggests that Sphinx's work "can ... take place in a piecemeal manner." See Nautilus Ins. Co. v. Bd. of Dirs. of Regal Lofts Condo. Ass'n ,
The phrase "put to its intended use," in the context of janitorial services, should encompass the opening of the Premises to customers, even if defined in a manner most forgiving to potential insureds. See Allegheny Design Mgmt., Inc. v. Travelers Indem. Co. of Am. ,
*339Based on the above understanding of the terms in the Intended Use Clause, the portion of Sphinx's work "out of which the injury ... ar[o]se" was put to its intended use prior to LeClerc sustaining her bodily injuries. The relevant portion of Sphinx's work is either all the required services on June 2, 2011, the date LeClerc was injured, and/or the area around aisle five of the Premises, the specific area where the incident occurred. Defined either way, that portion of Sphinx's work was put to its intended use by the opening of the Premises to customers. There is no dispute that the Premises, including aisle five, was open to the public without any reservation after Sphinx had cleaned and/or waxed the floors and left the Premises. LeClerc even testified that a customer had fallen down prior to her own injury near the area where she later fell. (See LeClerc Dep. 65:15-19 (explaining that she was at aisle five prior to her accident because a customer had fallen down).) Having considered the potential definitions for "[t]hat portion" and "intended use," the Court cannot decipher any reasonable interpretation such that the Intended Use Clause would not apply in this case. However, Plaintiff cannot rely on this exclusion because it failed to meet the disclaimer requirements set forth in New York Insurance Law § 3420(d)(2) as discussed below.
d. Common law estoppel
Image argues that Plaintiff is estopped from denying coverage regardless of the applicability of the Additional Insured and Exclusions Provisions. (Def. Mem. 20.) Beginning October 6, 2014, Plaintiff provided coverage to Image with certain reservations. (Id. ) Image contends that Plaintiff's expressly asserted reservations are unrelated to the additional insured policy endorsements and exclusions now relied upon. (Id. ) According to Image, Plaintiff's reservations were based solely on the "insured contract" and "Work Performed on Premises Open for Business" exclusions. (Id. ) In addition, Image argues that the lengthy delay in disavowing coverage counsels against allowing its withdrawal, "especially since [Plaintiff] has been controlling [Image's] defense since 2014." (Id. )
Plaintiff disputes Image's characterization of its reservations. Plaintiff contends that its multiple coverage positions plainly state that it only provided coverage initially because it was unclear "whether LeClerc's alleged bodily injuries took place during Sphinx's ongoing operations, such that coverage comes within the additional insured endorsement of the [Policy]." (Pl. Opp'n 13.) In addition, Plaintiff asserts that insurers may disclaim coverage and withdraw a defense at any time should a claim fall outside the scope of the insurance contract. (Id. ) Plaintiff therefore asserts that insurers cannot have waived or be estopped from disclaiming "coverage where none exists."8 (Id. at 13-15.) Further, *340Plaintiff contends that Image cannot show unreasonable delay or prejudice as required for estoppel. (Id. )
Common law estoppel requires prejudice as to the insured in addition to unreasonable delay. See Bluestein & Sander v. Chi. Ins. Co. ,
Image's arguments based on common law estoppel are inadequate. Image fails to provide any affirmative evidence of prejudice, and instead seeks to rely on its presumption based on Plaintiff's control over its defense. (See Pl. Reply 9 ("Plaintiff fails to state that it has been controlling Image's defense since 2014 or that it undertook Image's defense on which Image suffered the detriment of losing the right to control its own defense.").) Plaintiff, however, expressly reserved its right to disclaim coverage in its coverage letters. See Gelfman v. Capitol Indem. Corp. ,
e. New York Insurance Law § 3420(d)(2)
Both parties repeat the arguments they made as to common law estoppel with respect to the applicability of New York Insurance Law § 3420(d)(2).9 (See Image Letter Sur-reply dated July 27, 2018, ("Image Sur-reply") 1, Docket Entry No. 41; Pl. Letter Sur-reply dated July 27, 2018, ("Pl. Sur-reply") 1, Docket Entry No. 40.)10
Under New York Insurance Law § 3420(d)(2), "an insurer must notify an insured as 'soon as is reasonably possible' of its intention to disclaim coverage for bodily injury under a policy." U.S. Underwriters Ins. Co. v. City Club Hotel, LLC ,
"An insurer who delays in giving written notice of disclaimer bears the burden of justifying the delay." City Club Hotel ,
i. Plaintiff is required to comply with its disclaimer requirements
Plaintiff's argument that there can be no waiver or estoppel where no coverage exists is misplaced.11 Although a "disclaimer pursuant to section 3420(d) is unnecessary when a claim falls outside the scope of the policy's coverage portion," timely notice is "necessary when denial of coverage is based on a policy exclusion without which the claim would be covered."12 Worcester Ins. Co. v. Bettenhauser ,
To invoke the "intended use" policy exclusion , Plaintiff was required to disclaim coverage pursuant to section 3420(d).13 Although not dispositive on the issue, the Exclusions Provision styles itself as providing "additional exclusions " to "insurance afforded to ... additional insureds." Cf.
*344Ill. Union Ins. Co. v. Midwood Lumber & Millwork, Inc. , No. 13-CV-2466,
ii. Plaintiff fails to explain its delay in disclaiming coverage
Plaintiff fails to explain its delay in disclaiming coverage. (See Pl. Opp'n 6-7 (stating conclusorily that Plaintiff "promptly" disclaimed coverage following depositions of LeClerc and Voyles).)14 In order to invoke this exclusion, Plaintiff only needed information that after Sphinx had performed its work either for June 2, 2011 or aisle five specifically, the Premises, including aisle five, had been opened for business. All of this information was readily available, at the very latest, by the end of January 11, 2016, following the conclusion of LeClerc's deposition.15
While explaining the delay in obtaining the necessary facts from the filing of the LeClerc Action in 2014, Plaintiff provides no explanation as to its three and a half month delay in using that information to disavow coverage on April 26, 2016.16
*345Plaintiff's reliance on its stated reservation of rights or lack of prejudice as to Image is misplaced. See Phila. Indem. ,
Consequently, Plaintiff may not disclaim coverage based on the additional insured endorsements or exclusions and must defend Image in the LeClerc Action.
f. Plaintiff must indemnify
Plaintiff must also indemnify Image for any liability arising from the LeClerc Action because it can no longer disclaim coverage because of its failure to timely disclaim pursuant to section 3420(d)(2). See Montpelier ,
g. Reimbursement
Image seeks reimbursement of its costs in defending this action. (Pl. Mem. 22.) Image contends that it has been placed in a "defensive posture" by having to defend against Plaintiff's attempt to obtain declaratory relief. (Id. ) As a "prevailing policyholder" against its insurer seeking to avoid coverage, Image contends that it is entitled to reimbursement. (Id. )
Plaintiff contends that Image is not entitled to reimbursement because Scottsdale Insurance Company ("Scottsdale"), Image's insurer, is the real defendant in this action. (Pl. Opp'n 15.) Plaintiff asserts that Scottsdale is the entity that disputes its coverage position, has sent objections to the coverage position letters, and with whom it has corresponded regarding the duties to defend and indemnify in the LeClerc Action. (Id. ) Plaintiff also argues that Scottsdale, through Image, has asserted a counterclaim seeking a declaration as to the obligations under the Policy. (Id. ) Accordingly, Plaintiff argues that Image is not in a "defensive posture" because the dispute is "in reality between two insurers." (Id. at 16.) Plaintiff thus argues that Image must provide evidence that it, rather than Scottsdale, has "actually incurred costs in defending this action" in the event the Court requires reimbursement.
*347(Id. ) Plaintiff offers no support for its arguments.
Under New York law, "an insured 'cast in a defensive posture by the legal steps an insurer takes in an effort to free itself from its policy obligations' may recover attorneys' fees and expenses incurred in defending against the insurer's 'affirmative action ... to settle its rights' where the insured prevails in that action." Burlington ,
Image is entitled to attorneys' fees as it prevailed after being placed in a defensive posture by Plaintiff. By initiating this declaratory action, Plaintiff placed Image in the position of having to defend its rights to a defense and indemnification under the Policy. See City Club Hotel, LLC ,
Plaintiff's argument that Image is not entitled to any reimbursement because Scottsdale is the real defendant is also unavailing. As an initial matter, Plaintiff initiated this action against Image, not Scottsdale. (See generally Compl.); cf. Zurich Am. Ins. Co. v. Wausau Bus. Ins. Co. ,
III. Conclusion
For the foregoing reasons, the Court grants Image's cross-motion and denies U.S. Underwriters' cross-motion for summary judgment. Accordingly, the Court declares that U.S. Underwriters has a duty to defend and indemnify Image in the LeClerc Action. U.S. Underwriters must also reimburse Image for costs incurred in this action.
SO ORDERED.
Related
Cite This Page — Counsel Stack
335 F. Supp. 3d 321, Counsel Stack Legal Research, https://law.counselstack.com/opinion/us-underwriters-ins-co-v-image-by-jk-llc-nyed-2018.