Ruling Closes the Loop on Restrictive Additional Insured Endorsement – Reasonable Expectations of Insured Builder Prevails Over Intent of Insurer
July 31, 2019 —
Theodore L. Senet, Esq., Jason M. Adams, Esq. and Clayton Calvin - Gibbs GiddenOn June 5, 2019, the Court of Appeal in
McMillin Homes Construction, Inc. v. National Fire & Marine Insurance Company, 35 Cal. App. 5th 1042 (Cal. Ct. App. 2019) issued an important opinion on the scope of additional insured insurance coverage for developers and general contractors in California. Specifically, the “care, custody and control” (“CCC”) exclusion will be read to only exclude coverage for additional insureds who exercised exclusive control over the damaged property. Thus, general contractors who share control of the property with their subcontractors, as is typical on most projects, will not be denied coverage under this exclusion.
I. Facts & Procedural History
McMillin Homes Construction, Inc. was a Southern California developer and general contractor. In 2014, homeowners sued McMillin for roofing defects in a case called
Galvan v. McMillin Auburn Lane II, LLC. Pursuant to a subcontract, the roofer, Martin Roofing Company, Inc., provided McMillin with additional insured coverage under Martin’s general liability insurance policy. The insurer, National Fire and Marine Insurance Company, covered McMillin under an ISO Form CG 20 09 03 97 Additional Insured (“AI”) endorsement. After McMillin tendered its defense of the Galvan lawsuit under the AI endorsement, National Fire declined to provide McMillin with a defense to the homeowners’ lawsuit, relying on a CCC exclusion contained in the AI endorsement for property in the care, custody or control of the additional insured. McMillin then sued National Fire for breach of the policy, bad faith and declaratory relief in
McMillin Homes Construction, Inc. v. National Fire & Marine Insurance Company.
In
McMillin Homes, the trial court found the CCC exclusion in the AI endorsement applied and held in favor of the insurer, National Fire. The trial court found the exclusion for damage to property in McMillin’s “care, custody, or control” precluded coverage for the roofing defect claims, as well as any duty on the part of the insurer to defend the home builder, McMillin. McMillin filed an appeal from the trial court’s ruling.
II. Case Holding
The Court of Appeal reversed to hold in favor of McMillin, interpreting the CCC exclusion narrowly and finding a duty on the part of the insurer to defend the general contractor pursuant to the AI endorsement on the roofer’s insurance policy. It held that for the CCC exclusion to attach, it would require the general contractor’s exclusive control over the damaged property, but here, the general contractor shared control with the roofer. The Court of Appeal noted that where there is ambiguity as to whether a duty to defend exists, the court favors the reasonable belief of the insured over the intent of the insurer. Here, that reasonable belief was that the coverage applied and the exclusion was narrow.
The Court of Appeal relied upon
Home Indemnity Co. v. Leo L. Davis, Inc., 79 Cal. App. 3d 863 (Ct. App. 1978) (“Davis”), as a judicial interpretation of the CCC exclusion. That case synthesized a string of case law into a single conclusion: that courts may hold the exclusion inapplicable where the insured’s control is not exclusive. In the opinion in McMillin Homes, coverage turned upon whether control was exclusive: “[t]he exclusion is inapplicable where the facts at best suggest shared control.” The Court of Appeal stated the “need for painstaking evaluation of the specific facts of each case. Here, McMillin coordinated the project’s scheduling, but Martin furnished the materials and labor and oversaw the work; they therefore shared control.
Even if the rule in Davis did not apply and the exclusion was found to be ambiguous, the court stated that “control” requires a higher threshold than merely acting as a general contractor. Liability policies are presumed to include defense duties and exclusions must be “conspicuous, plain, and clear.” Furthermore, because “construction defect litigation is typically complex and expensive, a key motivation [for the endorsement] is to offset the cost of defending lawsuits where the general contractor’s liability is claimed to be derivative.” This is especially true because the duty to defend is triggered by a mere potential of coverage. Under the insurer’s construction of the exclusion, coverage would be so restrictive under the AI endorsement that it was nearly worthless to the additional insured.
III. Reasonable Expectation of the Insured Prevails over the Intent of the Insurer
Like most commercial general liability policies, National Fire’s policy excluded coverage for property damage Martin was contractually obliged to pay, with an exception for “insured contracts.” Typically, “insured contracts” include prospective indemnification agreements for third party claims. The National Fire policy contained a form CG 21 39 Contractual Liability Limitation endorsement, which deleted indemnity agreements from the definition of “insured contracts” to effectively preclude coverage for the indemnity provision between McMillin and Martin. National Fire argued that this endorsement demonstrated its intent to exclude coverage to McMillin for the homeowners’ defect lawsuit. The Court of Appeal stated that the insurer’s intent is not controlling and that the insureds reasonable expectation under the AI endorsement would control. As a result of its ruling, the Court also dealt a significant blow to the argument that the CG 21 39 endorsement is effective as a total bar to additional insured coverage for all construction defect claims.
IV. Conclusion
The decision is good news for developers and general contractors who rely on subcontractors to provide additional insured coverage. Unless the general contractor exercises exclusive control over a given project, the CCC exclusion in the CG 20 09 03 97 additional insured endorsement may not preclude the duty to defend. Demonstrating that a general contractor exercised exclusive control over the project would be extremely difficult to show under normal project circumstances because the any subcontractor participation appears to eliminate the general contractor’s exclusive control.
The case also highlights the need for construction professionals to regularly review their insurance programs with their risk management team (lawyers, brokers, and risk managers). As is often the case, a basic insurance policy review at the outset of the McMillin project could likely have avoided the entire dispute. For owners and general contractors, CG 20 10 (ongoing operations) and CG 20 37 (completed operations) additional insured forms are preferable to the CG 20 09 form at issue in the McMillin case because they do not contain the CCC exclusion. The CG 20 10 and 20 37 forms are readily available in the marketplace and are commonly added to most policies upon request. Had those forms been added, AI coverage likely would have been extended to McMillin without the need for litigation. Similarly, carriers will routinely delete the CG 21 39 Contractual Liability Limitation endorsement upon request. Deletion of the CG 21 39 would have circumvented National Fire’s second argument in its entirety.
Additionally, insurance policies, endorsements, and exclusions are subject to revision and are not always issued on standard forms. As a result, it is incumbent upon developers, contractors, and subcontractors to specify the precise overage requirements for construction projects and to review all endorsements, certificates, and policies carefully. Due to the difficulty in monitoring compliance with insurance requirements, project owners and general contractors are finding that it is better to insure projects under project specific wrap-up insurance programs which eliminate many of the issues pertaining to additional insured coverage. Wrap-up programs vary greatly as to their terms and conditions, so however a project is insured, insurance requirements and evidence of coverage should be carefully reviewed by experienced and qualified risk managers, brokers, and legal counsel to assure that projects and parties are sufficiently covered.
Gibbs Giden is nationally and locally recognized by U. S. News and Best Lawyers as among the “Best Law Firms” in both Construction Law and Construction Litigation. Chambers USA Directory of Leading Lawyers has consistently recognized Gibbs Giden as among California’s elite construction law firms. The authors can be reached at tsenet@gibbsgiden.com (Theodore Senet); jadams@gibbsgiden.com (Jason Adams) and ccalvin@gibbsgiden.com (Clayton Calvin). Read the court decisionRead the full story...Reprinted courtesy of
First-Party Statutory Bad Faith – 60 Days to Cure Means 60 Days to Cure
October 19, 2020 —
David Adelstein - Florida Construction Legal UpdatesIn a first party bad-faith lawsuit, such as a bad faith claim against an insured’s property insurer, there are three requirements that must be met before the bad faith lawsuit is filed: “‘(1) determination of the insurer’s liability for coverage; (2) determination of the extent of the insured’s damages; and (3) the required notice must be filed under section 624.155(3)(a).’” Fortune v. First Protective Ins. Co., 45 Fla. L. Weekly D2092a (Fla. 2d DCA 2020) (citation omitted).
The third requirement is for the insured to file a Civil Remedy Notice (known as a “CRN”) as a condition precedent to filing a statutory bad faith lawsuit giving the insurer 60 days’ notice of the bad faith violation and to cure the violation, i.e., pay the claim if the violation is payment.
A very common bad faith payment violation is the assertion that the insurer did NOT attempt “in good faith to settle claims when, under the circumstances, it could and should have done so, had it acted fairly and honestly towards its insured and with due regard for his or her interests.” Fla. Stat. s. 624.155(1)(b)(1).
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David Adelstein, Kirwin Norris, P.A.Mr. Adelstein may be contacted at
dma@kirwinnorris.com
Insurer Able to Refuse Coverage for Failed Retaining Wall
October 28, 2011 —
CDJ STAFFThe Eleventh District of the US Court of Appeals has ruled in the case of Nix v. State Farm Fire & Casualty Company. In this case, the Nixes filed a claim after a portion of the retaining wall in their home collapsed and their basement flooded. State Farm denied the claim “on the ground that the policy excluded coverage for collapses caused by defects in construction and for damage caused by groundwater.”
The court reviewed the Nixes’ policy and found that State Farm’s statement did specifically exclude both of these items. In reviewing the lower court’s ruling, the appeals court noted that State Farm’s expert witness, Mark Voll, determined that the retaining wall “lacked reinforcing steel, as required by a local building code, and could not withstand the pressure created by groundwater that had accumulated during a heavy rainfall.” Additionally, a french drain had been covered with clay soil and so had failed to disperse the groundwater.
The Nixes argued that the flooding was due to a main line water pipe, but their opinions were those of Terry Nix and the contractor who made temporary repairs to the wall. “Those opinions were not admissible as lay testimony. Neither Nix nor the contractor witnessed the wall collapse or had personal knowledge about the construction of the Nixes’ home.”
The lower court granted a summary judgment to State Farm which has been upheld by the appeals court.
Read the court’s decision…
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"Your Work" Exclusion Bars Coverage for Contractor's Faulty Workmanship
December 02, 2015 —
Tred R. Eyerly – Insurance Law HawaiiThe West Virginia Supreme Court of Appeals found there was no coverage for the contractor's faulty workmanship in constructing a home. State of W. Virginia ex rel. Nationwide Mut. Ins. Co. v. The Honorable Ronald E. Wilson, 2015 W. Va. LEXIS 963 (W. Va. Oct. 7, 2015).
In July 2009, Fred Hlad contracted to build a home for the Nelsons and complete construction by November 2009. The Nelsons sued when the house was not timely completed. Nationwide defended under a reservation of rights, but then filed a declaratory judgment action.The circuit court denied Nationwide's request for declaratory relief, determining that the defective workmanship was an "occurrence." Nationwide petitioned the Supreme Court for a writ of prohibition.
On appeal, Nationwide argued that eight of the nine counts in the Nelsons' complaint were not caused by his defective workmanship. These allegations included breach of contract claims and intentional torts. Nationwide submitted it was not obligated to indemnify Hlad for damages that may be recovered on those counts. The court agreed that Nationwide's duty to indemnify was limited only to those claims that triggered coverage. Accordingly, Nationwide had no duty to indemnify for the eight counts alleging breach of contract and intentional torts.
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Tred R. Eyerly, Insurance Law HawaiiMr. Eyerly may be contacted at
te@hawaiilawyer.com
California Case Adds Difficulties for Contractors & Material Suppliers
August 20, 2014 —
Beverley BevenFlorez-CDJ STAFFGarret Murai in his California Law Blog declared that “things just got a lot tougher for contractors and material suppliers in the Golden State.” In his blog, Murai analyzed the recent case Golden State Boring & Pipe Jacking, Inc. v. Eastern Municipal Water District, Case No. E054618 (July 23, 2014), in which “the California Court of Appeals for the Fourth Appellate District found that a subcontractor’s public works payment bond claim was time barred because its stop payment notice was served ‘before’ a notice of completion was recorded.”
Murai explained the importance of the ruling and how it changed the status quo: “Whereas before, it was commonly understood that you could serve a stop payment notice ‘during’ construction (after all, that was the point wasn’t it, to stop construction funds before they are paid out), now you may have only have a 30 day window (probably less) to serve a stop notice within 30 days after a notice of completion or notice of cessation is recorded.”
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Emergency Paid Sick Leave and FMLA Leave Updates in Response to COVID-19
April 06, 2020 —
Yvette Davis & Kyle R. DiNicola - Haight Brown & BonesteelThe Families First Coronavirus Response Act (“FFCRA”) was signed by the President on March 18, 2020 and will become effective no later than April 2, 2020. The law contains numerous updates to the country’s employment regulations in response to the Coronavirus pandemic of which employers should be familiar.
Of particular note, the FFCRA makes limited amendments to the Family and Medical Leave Act. Now, pursuant to the Emergency Family and Medical Leave Expansion Act (“EFMLEA”) employees may take up to 12 weeks of family and medical leave after having worked with the employer for 30 calendar days if the employee is unable to work (or telework) due to the employee’s need to care for a son or daughter under 18 years of age due to the child’s school closure or unavailability of a childcare provider due to a public health emergency, i.e., COVID-19. Unlike the FMLA, which does not apply to many small employers, this requirement applies to any employers with 500 or fewer employees. No mileage radius requirement exists under the EFMLEA.
When an employee utilizes leave pursuant to EFMLEA, the first 10 days of that leave may consist of unpaid leave, but the employee may elect to substitute any accrued paid vacation leave, personal leave, or medical or sick leave, including the Emergency Paid Sick Leave provided for by the Act and described below). All subsequent days of leave taken by the employee after the tenth day must be paid by the employer at a rate of not less than two thirds of the employee’s regular rate of pay and the number of hours the employee would otherwise normally be scheduled to work. The cap is $200 per day or $10,000 in the aggregate.
Reprinted courtesy of
Yvette Davis, Haight Brown & Bonesteel and
Kyle R. DiNicola, Haight Brown & Bonesteel
Ms. Davis may be contacted at ydavis@hbblaw.com
Mr. DiNicola may be contacted at kdinicola@hbblaw.com
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Pennsylvania: Searching Questions Ahead of Oral Argument in Domtar
October 08, 2014 —
Robert Caplan – White and Williams LLPIf you have been following our coverage of Liberty Mutual Insurance Company v. Domtar Paper Co., you will recall that the Supreme Court of Pennsylvania decided on May 29, 2014 to hear the subrogated insurer’s appeal,1 despite the Superior Court’s holding against the subrogated insurer—based primarily on its own defective case law2 —and its denial of reargument, presumably due to the insurer’s briefing follies.3
The parties in Domtar, as well as numerous amici curiae (friends of the court),4 have submitted their respective briefs over the last few months, and the Supreme Court has scheduled oral argument to take place on October 8, 2014 in Pittsburgh, Pa. The Court has framed the issue as: “Does Section 319 of the Pennsylvania Workers’ Compensation Act, 77 P.S. § 671, allow the employer/insurer to step into the shoes of the insured employee to subrogate against the tortfeasor?”5
There are three possible outcomes in Domtar.
The first (and easiest) possible outcome for the Supreme Court would be to punt to the Pennsylvania General Assembly for a decision on the issue. Workers’ compensation legislation, perhaps more than any other type of legislation, “creates a highly structured balancing of competing interests.”6 It is basic civics that the legislature has a “superior ability to examine social policy issues and determine legal standards so as to balance competing concerns.”7
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Robert Caplan, White and Williams LLPMr. Caplan may be contacted at
caplanr@whiteandwilliams.com
Type I Differing Site Conditions Claim is Not Easy to Prove
May 30, 2018 —
David Adelstein - Florida Construction Legal UpdatesA differing site condition claim will almost universally result in both a cost and time impact. There will be additional, unanticipated costs incurred. And there will likely be a delay requiring additional time to perform.
A Type I differing site condition claim is when the contractor encounters conditions at the site different than those indicated in the contract documents. That seems easy enough to prove, right. Nope. And, I mean nope! If you don’t believe me, consider the recent decision in Meridian Engineering Co. v. U.S., 885 F.3d 1351 (Fed.Cir. 2018).
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David Adelstein, Florida Construction Legal UpdatesMr. Adelstein may be contacted at
dadelstein@gmail.com
