York Insurance of Maine, Inc. v. Superintendent of Insurance

2004 ME 45, 845 A.2d 1155, 2004 Me. LEXIS 45
CourtSupreme Judicial Court of Maine
DecidedApril 7, 2004
StatusPublished
Cited by17 cases

This text of 2004 ME 45 (York Insurance of Maine, Inc. v. Superintendent of Insurance) is published on Counsel Stack Legal Research, covering Supreme Judicial Court of Maine primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
York Insurance of Maine, Inc. v. Superintendent of Insurance, 2004 ME 45, 845 A.2d 1155, 2004 Me. LEXIS 45 (Me. 2004).

Opinions

ALEXANDER, J.

[¶ 1] The Superintendent of the Bureau of Insurance appeals from a decision of the Superior Court (Cumberland County, Croivley, J.), vacating decisions of the Superintendent in two appeals of nonrenewal of homeowner’s insurance policies. In each case, York Insurance of Maine had declined to renew a homeowner’s policy because the policyholders operated a daycare business at their home, even though each policyholder had a separate commercial liability policy covering the daycare business. After a hearing, the Superintendent found that York had not met its burden of proving that the reasons for [1157]*1157nonrenewal were “good faith reason[s] rationally related to the insurability of the property,” as required pursuant to 24-A M.R.S.A. § 3051 (2000). The Superior Court vacated the decisions, and the Superintendent filed this appeal. We affirm the judgment of the Superior Court.

I. CASE HISTORY

[¶ 2] The case involves two homeowner’s insurance policies issued by York Insurance Company. The policies contain identical business pursuits exclusions1 and endorsements 2 stating that a home daycare is an excluded business. There is no dispute that under both policies, York had no obligation to indemnify the insureds for losses arising from the daycare business. York’s concern is directed at the potential for exposure to claims pled against the homeowner’s policy by users of the daycare business.

[¶ 3] The first insured had homeowner’s insurance with York since 1994. They obtained a license to operate a home daycare in 1998, and opened the business in 1999. The homeowner asked York to provide coverage for the daycare. York refused. The homeowner then obtained commercial liability coverage for the daycare business from another carrier. According to York, it did not discover the first insured’s home daycare business until February 2002, in the course of collecting information related to their automobile policy. Shortly thereafter, York- sent a notice of nonrenewal, effective June 10, 2002.

Section II — Exclusions
1. Coverage E — Personal Liability and Coverage F — Medical Payments to Others do not apply to "bodily injury” or “property damage”:
b. Arising out of or in connection with a “business” engaged in by an "insured.”

[¶4] The second insured had homeowner’s insurance with York, or its predecessor, since 1984. They did not open their daycare business until 1999, at which time they obtained commercial liability coverage through another carrier. In May 2002, a York claims adjuster discovered the existence of the daycare business while investigating an unrelated claim. Shortly thereafter, York sent a notice of nonre-newal, effective December 14, 2002.

[¶ 5] The notice of nonrenewal, sent to both homeowners, stated:

The reason for nonrenewal is THE IN-SURABILITY OF THIS RISK IS THREATENED DUE TO THE DISCOVERY OF THE BUSINESS CONDUCTED ON THE PREMISES. THE INSURED IS CURRENTLY OPERATING A DAY CARE BUSINESS ON THE INSURED PREMISES SUBSTANTIALLY INCREASING OUR LIABILITY EXPOSURE.

Both policyholders made a timely request for a hearing before the Superintendent pursuant to 24-A M.R.S.A. § 3054 (2002), to contest York’s decision not to renew the policies.

[¶ 6] Hearings on these challenges were held before a hearing officer for the Superintendent of Insurance in the summer of 2002. In general, York presented the same evidence in both cases. Relying on [1158]*1158our opinion in Elliott v. Hanover Insurance Co., 1998 ME 138, 711 A.2d 1310, a York representative testified that the company could be required to defend lawsuits arising from the daycare business even though the policy excludes coverage for business-related losses because, under Maine law, an insurer’s duty to defend is broader than the duty to indemnify. In Elliott, we determined that the insurer of a homeowner’s policy with a business pursuits exclusion had a duty to defend a claim arising out of the homeowner’s on-premises business activity because, as pled, the action was potentially within the policy’s coverage. Id. ¶¶ 6-7, 711 A.2d at 1312.

[¶ 7] The York representative submitted York’s underwriting guidelines for homes with daycares. She stated that York is no longer issuing new policies if there is a daycare in the home, and will renew a homeowner’s policy only if York also writes the commercial liability policy for the daycare. She provided a communication from York’s in-house counsel stating that the presence of a daycare is related to insurability of the property and that “we do not insure daycare exposures.”

[¶ 8] The representative further testified that the home daycare business is not a market that York is targeting, and that the premiums for homeowner’s insurance do not take into account the increased exposure due to the presence of the daycare. York indicated particular concern about (1) liability exposure due to possible child sexual molestation claims that may lie dormant for years after the policy period expires, and (2) increased liability exposure under the homeowner’s policy for ordinary incidents such as slip-and-falls due to the greater number of people who come on to the property. York also submitted copies of summaries of cases from other jurisdictions showing that other insurance companies have had to pay claims arising from a home daycare business, even though the policies had business pursuits exclusions.

[¶ 9] At the first hearing, York’s representative testified about several homeowners’ claims that York had paid when there was a dispute as to whether the insured’s loss was personal or arose from a home daycare business. No documentation was provided regarding these claims, and none of the cases had been litigated. At the second hearing, the York representative provided records of defense costs paid by York for an insured who had been accused of dumping chemicals on his property, even though the policy contained a pollution exclusion. She did not provide specific information about the claim or whether another policy existed that might have covered the loss.

[¶ 10] Based on this evidence, the hearing officer found that York had not established a reason, “rationally related to the insurability of the property” for nonrenewal under 24-A M.R.S.A. § 3051. The hearing officer stated in findings in both cases that “[n]o evidence was submitted to suggest a lawsuit or claim has ever been brought under the policy in question, nor was any documentary proof submitted to demonstrate an increased likelihood of a suit being brought solely as a result of the existence of the daycare operations.” Because the policyholders each had a commercial liability policy covering the business, the hearing officer concluded that “a policy specifically covering the business exposure would respond to any daycare-related claims, thus shielding the homeowners policy, at least in part, from any duty to defend.” This finding recognized that “in part” the homeowner’s policy was not shielded and that the separately insured home daycare business could result in increased duty to defend exposure for the York homeowner’s policy. Pursuant to its authority under 24-A M.R.S.A. § 3054 [1159]*1159(2000), the hearing officer ordered York to renew the two policies on the same terms as the expiring policies.

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York Insurance of Maine, Inc. v. Superintendent of Insurance
2004 ME 45 (Supreme Judicial Court of Maine, 2004)

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Bluebook (online)
2004 ME 45, 845 A.2d 1155, 2004 Me. LEXIS 45, Counsel Stack Legal Research, https://law.counselstack.com/opinion/york-insurance-of-maine-inc-v-superintendent-of-insurance-me-2004.