Walbrook Insurance v. CTL Engineering, Inc.

604 N.E.2d 779, 78 Ohio App. 3d 295, 1992 Ohio App. LEXIS 649
CourtOhio Court of Appeals
DecidedFebruary 11, 1992
DocketNo. 91AP-749.
StatusPublished

This text of 604 N.E.2d 779 (Walbrook Insurance v. CTL Engineering, Inc.) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Walbrook Insurance v. CTL Engineering, Inc., 604 N.E.2d 779, 78 Ohio App. 3d 295, 1992 Ohio App. LEXIS 649 (Ohio Ct. App. 1992).

Opinion

Whiteside, Judge.

Defendant, CTL Engineering, Inc. (“CTL”), appeals from a judgment of the Franklin County Court of Common Pleas and raises two assignments of error, as follows:

“1. A deductible provision in an insurance policy wrought with ambiguities and capable of two interpretations is to be construed against the insurer and in favor of the insured, therefore the trial court erred in granting the motion for summary judgment in favor of the insurer, Plaintiff-Appellant, Walbrook Insurance Company, Ltd., and in denying the motion for summary judgment submitted by the insured, Defendant-Appellant, CTL Engineering, Inc.

“2. The trial court erred in not granting the motion of Defendant, CTL Engineering, Inc., for leave to amend its answer to include a counterclaim for *297 reformation of the insurance policy on grounds of mutual mistake and in failing to consider CTL Engineering, Inc.’s evidentiary material submitted with its motion for summary judgment.”

This matter originated as a declaratory judgment action seeking an interpretation of a deductible clause in a professional liability insurance policy issued to defendant CTL by plaintiff Walbrook Insurance Company, Ltd. (“Walbrook”). The first and only claim made by CTL under this policy was with respect to work performed for Bob Evans Farms, Inc. The claim was settled; however, Walbrook applied two deductibles in the total amount of $115,000, which CTL had to pay, with Walbrook paying the remainder of the settlement.

CTL contends that there is only one deductible under the policy, that being in the amount of $15,000, with the aggregate deductible during the year being $100,000. Walbrook, on the other hand, contends that both deductibles apply, so that the appropriate deductible was the $100,000 aggregate deductible in addition to the $15,000 individual loss deductible.

The trial court found for Walbrook and applied two deductibles, stating in part:

“Based on the language regarding deductibles in the policy, and especially the use of plurals and the word 'further,’ the Court concludes that Plaintiffs’ reading of the policy is correct. The applicable policy clauses create two separate layers of deductibles rather than a series of $15,000 deductibles subject to one overall cap. * * * The arguments regarding oral statements as to the size of the deductible do not rise to the level of a novation or other authorized modification.”

The first assignment of error raises the basic issue as to interpretation of the policy and as to whether it is ambiguous. At the outset, we must concur that there is ambiguity in the policy, the language being anything but clear when the policy is read in its entirety.

Walbrook essentially urges a superficial reading of the policy and ignoring of the word “aggregate” and most of Clause Y of the policy. The schedule portion of the policy provides in pertinent part, as follows:

“Item 4. Deductibles.

“Subject to clause V., the deductibles are:

“A. Each and Every Loss $15,000.

“B. Subject to the application of Each and Every Loss Deductible, a further Annual Aggregate Deductible of losses otherwise recoverable hereunder amounting to $100,000.”

*298 Said provision is neither clear nor complete in itself. The each and every loss deductible is clear on its face except the reference to being subject to Clause V. The annual aggregate deductible is anything but clear, being not only subject to Clause V of the policy but also subject to “application” of the each and every loss deductible. Walbrook ignores both this prefatory phrase as well as the word “aggregate” in its contention that the language is clear, focusing only upon the word “further.” The application of the policy under Walbrook’s contention adopted by the trial court would mean that paragraph B would be read, as follows: “A further annual deductible of losses otherwise recoverable hereunder amounting to $100,000.” Walbrook’s interpretation gives no meaning either to the prefatory clause or the word “aggregate” as indicated above.

Regardless of the conclusion, however, it is necessary to refer to Clause V, since both deductibles are expressly subject thereto. This clause reads in pertinent part, as follows:

“V. LIMITS OF LIABILITY AND DEDUCTIBLES

“A. After the Assureds have paid or been held legally obligated to pay claims made against them and/or incurred Legal Fees, Costs, and Expenses which after reduction by the Each and Every Loss Deductible as set forth in Item 4.A. of the Schedule, would but for the terms and conditions of the Annual Aggregate Deductible Clause as set forth in Item 4.B. of the Schedule be recoverable under this Policy the Insurers shall then be liable to pay the percentage of Loss, including claim expenses, set forth in item 3.B. of the Schedule up to the Limit of Liability set forth in Item 3.A. of the Schedule. It is warranted that the remaining percentage of Loss and the applicable deductible amount(s) shall be borne by the Assureds at their own expense.”

This paragraph is somewhat difficult to interpret. It does not explain in any way how the annual aggregate deductible clause should be applied but, instead, merely states that it must be considered in connection with the making of payments by the insurer to the assured under the policy. The next paragraph of Clause V(A), however, is more revealing and provides, as follows:

“Thereafter in respect of all claims otherwise recoverable under this Policy after the exhaustion of the Annual Aggregate Deductible as set forth in Item 4.B. of the Schedule, the Each and Every Loss Deductible as set forth in Item 4.A. of the Schedule shall apply and all such deductible amounts shall be borne by the Assureds at their own expense.”

This clause indicates that the annual aggregate deductible should be exhausted before the each and every loss deductible of the schedule shall apply. There is no language in the policy indicating that both the each and every loss *299 deductible and the annual aggregate deductible apply to the same claim. There is nothing in the policy indicating that there are two deductibles to be. applied at the same time. Further clarification is gleaned from Clause V(B), which provides in part, as follows:

“Claims involving the same Wrongful Act or Interrelated Wrongful Acts of one or more of the Assureds shall be considered a single Loss and only one Deductible shall be applied to each such single Loss * *

On the other hand, Clause V(D) provides in pertinent-part that:

“In the event of a single loss being covered in part by Insuring Clauses l.A. and/or l.B. and/or I.C., the Deductible Amounts stated in Items 4.A. and 4.B. should be applied to the total amount of such loss.”

CTL’s contention is that the meaning of the policy is that the $15,000 each and every loss deductible shall be applied only until the maximum aggregate of $100,000 is reached. This, however, is inconsistent with the second paragraph of Clause V(A), set forth above, which clearly states that the each and every loss deductible shall apply after exhaustion of the annual aggregate deductible.

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Bluebook (online)
604 N.E.2d 779, 78 Ohio App. 3d 295, 1992 Ohio App. LEXIS 649, Counsel Stack Legal Research, https://law.counselstack.com/opinion/walbrook-insurance-v-ctl-engineering-inc-ohioctapp-1992.