| Marenco v Delight Constr. Corp. |
| 2013 NY Slip Op 50086(U) [38 Misc 3d 1212(A)] |
| Decided on January 3, 2013 |
| Supreme Court, Kings County |
| Schmidt, J. |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
| This opinion is uncorrected and will not be published in the printed Official Reports. |
Marlon
Marenco, Plaintiffs,
against Delight Construction Corp., et al., Defendants. |
The following papers numbered 1 to 13 read on this motion:Papers
Numbered
Notice of Motion/Order to Show Cause/
Petition/Cross Motion and
Affidavits (Affirmations) Annexed1 - 9
Opposing Affidavits (Affirmations)10
Reply Affidavits (Affirmations)11 - 12
Other Papers Transcript dated July 24, 201213
Upon the foregoing papers, motion sequence numbers 4 and 7 are consolidated for
disposition. Defendant/third-party plaintiff/second third-party plaintiff Delight
Construction Corp. (Delight) and defendants/second third-party plaintiffs Tompkins Park
North Homes Housing Development Fund Corporation (Tompkins) and Northeast
Brooklyn Housing Development Corporation (Northeast) (hereinafter collectively
referred to as movants) seek to obtain an order, pursuant to CPLR 3212, granting them
summary judgment on their causes of action in the second third-party action (the
Declaratory Judgment Action) for: (1) a declaration as to their insured status with the
second third-party defendant, Hermitage Insurance Company (Hermitage), with respect
to claims made in the underlying bodily injury action brought by plaintiff, Marlon
Marenco [*2](the Personal Injury Action); (2) for a
declaration as to the obligations of Hermitage to provide a defense and indemnification
to movants, based upon their status as additional insureds with respect to the claims made
against them by plaintiff in the Personal Injury Action; and (3) for reimbursement of
defense costs, attorneys' fees, disbursements and expenses incurred (motion sequence
number 4). Hermitage cross-moves for an order, pursuant to CPLR 3212, granting it
summary judgment dismissing the second third-party complaint and declaring that it is
not obligated to defend or indemnify second third-party plaintiffs for the claims made
against them in the Personal Injury Action (motion sequence number 7).
Plaintiff commenced the Personal Injury Action on December 14, 2009 against Delight, Tompkins and Northeast, seeking to recover damages for injuries allegedly sustained on January 28, 2008, when he fell from a scaffold at a construction site located at 875 Herkimer Street and Buffalo Avenue in Brooklyn. At that time, the subject residential property was owned by Tompkins and Northeast. Prior to the accident, Tompkins contracted with Delight to perform construction work at the property. Delight was insured by Mt. Hawley Insurance Company (Mt. Hawley); Mt. Hawley is a part of RLI. Delight subcontracted with Thomas Home Remodeling (Thomas) to perform carpentry work at the property. Plaintiff was employed by Thomas. At the time that plaintiff was injured, Thomas was insured by Hermitage pursuant to a commercial general liability policy that was issued with coverage effective December 27, 2007 (the Thomas Policy). Thomas obtained that policy from the Leo Agency and Brokerage, Inc. (the Leo Agency), which was a broker for Hermitage. The Leo Agency procured the policy from the Simon Agency NY, Inc. (Simon Agency), an agent for Hermitage.
By third-party summons dated June 11, 2010, Delight impleaded Thomas in the first third-party action. To date, Thomas has not appeared and is accordingly in default. By second third-party summons dated June 27, 2011, movants commenced the Declaratory Judgment Action against Hermitage.
To address Hermitage's contentions that the motion for summary judgment could not
be decided because discovery demands were outstanding and depositions had not been
taken, the court issued an order on May 17, 2012, on consent, that provided that
Hermitage could conduct a deposition of the Leo Agency and Grace O'Connor, a Claims
Examiner from Mt. Hawley. Additionally, files regarding the Thomas Policy were
produced by Mt. Hawley, the Leo Agency, the Simon Agency and RLI.
In support of their motion, movants claim that pursuant to the terms of its
subcontract with Delight, Thomas was obligated to indemnify and hold harmless Delight,
Tompkins and its agents and employees from all suits and actions; to secure a general
liability policy of insurance, including coverage for contractual indemnity, with a limit of
[*3]$1,000,000 per occurrence; and to include Tompkins,
Northeast and Delight as additional insureds on the policy. Movants contend that
Thomas complied with these provisions and provided a certificate of insurance from
Hermitage for the requisite coverage and that the policy was in effect on the date of the
alleged accident. Movants further contend that plaintiff's injury arose out of the
operations of Thomas, thereby triggering the additional insured coverage owed to them
under the policy. Movants accordingly seek indemnification for the moneys expended in
defending the Personal Injury Action and for prosecuting this Declaratory Judgment
Action.
Hermitage's Contentions
In opposition to the motion and in support of its cross motion, Hermitage contends
that movants are not insureds or additional insureds under the Thomas Policy. More
specifically, Hermitage contends that the policy required that Thomas receive prior
written consent from Hermitage to add an additional insured and insured location to the
policy and that it did not consent to adding movants. Hermitage further contends that
even if movants were insured, the company properly disclaimed coverage because it was
not given notice of the claim as soon as was practicable, as required by the terms of the
policy.
Movants' Opposition to Hermitage's Motion
In opposition to the cross motion, movants argue that Hermitage is now seeking to
disclaim coverage on grounds that were never before raised, i.e., that movants are not
covered under the Hermitage Policy, and that this contention is therefore deemed waived.
Movants further argue that Hermitage's assertion that it must give prior written consent
for a party to be covered as an additional insurer is not supported by the language of the
policy.
The court first finds that movants' contention that Hermitage waived the right to now argue that they are not covered under the Thomas Policy is without merit. In this regard, it is well settled that "an insurer who fails to issue a timely disclaimer is not prohibited from later raising the defense because the insurance policy does not contemplate coverage in the first instance, and requiring payment of a claim upon failure to timely disclaim would create coverage where it never existed'" (Hospital for Joint Diseases v Travelers Prop. Cas. Ins. Co., 9 NY3d 312, 318 [2007], quoting Matter of Worcester Ins. Co. v Bettenhauser, 95 NY2d 185, 188 [2000]). As is of particular relevance herein, the court explained that:
"[T]he denial of coverage under the additional insured endorsement constituted a
denial based upon a lack of inclusion' rather than by reason of exclusion' and, thus, the
defendant insurer was not required to deny coverage where none existed (Zappone v
Home Ins. Co., 55 NY2d 131, 137 [1982]). Therefore, to the extent that the
defendant insurer's denial of coverage was based upon lack of coverage as an additional
insured pursuant to the additional insured endorsement, a timely disclaimer was
unnecessary (see [*4]Markevics v Liberty Mut. Ins.
Co., 97 NY2d 646, 648 [2001]; Matter of Worcester Ins. Co. v Bettenhauser,
95 NY2d 185, 188 [2000]; see
e.g. KMAPS Corp. v Nova Cas. Co., 53 AD3d 1043 [2008]; Perkins v Allstate Ins. Co., 51
AD3d 647 [2008]; cf. Rael
Automatic Sprinkler Co., Inc. v Schaefer Agency, 52 AD3d 670 [2008])."
(Hargob Realty
Assoc. v Fireman's Fund Ins. Co., 73 AD3d 856, 858 [2010]).
In support of its claim, Hermitage argues that the policy covers those sums that the
insured becomes legally obligated to pay as damages resulting from bodily injury caused
by an occurrence, which it alleges that the policy defines as an accident (Additional
Insured Endorsement). Further, the policy has an endorsement that provides that "[t]his
insurance does not provide coverage for an additional insured unless the Company gives
their express written consent to add coverage for a specified entity to this policy"
(Additional Insured Limitation Endorsement). Hermitage avers that the this interpretation
is supported by the Additional Insureds Endorsement, which provides for unlimited
approved additional insureds listed with Hermitage Insurance Company for the policy
term. Hermitage contends that it never gave written consent to add movants as additional
insureds. Thus, applying the provisions of the policy, movants are not covered under the
Thomas Policy as additional insureds.
Movants' Contentions
In opposition, movants contends that although the insurer argues that it must give prior written consent for a party to be covered as an additional insured, the endorsement relied upon in so arguing pertains to "products and/or completed operations," which endorsement is not relevant to this personal injury claim. Instead, the coverage of an additional insured is controlled by the Schedule of Additional Insureds, which provides for "unlimited approval . . . [i]n the performance of ongoing operations." Movants thus conclude that no written consent was required for them to be covered as additional insureds.
Movants also rely upon the deposition testimony of Colin Leo, the president of the Leo Agency, who testified that Mr. Thomas came into his office in 2007 seeking to obtain an insurance policy naming Delight as an additional insured to cover work that it intended to do for that company. Mr. Leo accordingly submitted an application to the Simon Agency, who he believed was an agent for Hermitage; the application was submitted on paper bearing the letterhead "Hermitage Insurance Company" and indicated that Delight was to be named as an additional insured. Hermitage accepted the application and issued a price quote, also on paper bearing its letterhead. The quote stated that "Blanket Additional Insured's Is Included in Pricing." Hermitage subsequently issued the subject policy. Mr. Leo also testified that the inclusion of Delight, Tompkins and Northeast as additional insureds did not alter or amend that the policy, but reflected the coverage that [*5]was issued by Hermitage. Mr. Leo further identified the Certificate of Insurance, dated December 27, 2007, which listed Delight, Tompkins and Northeast as additional insureds and included 875 Herkimer Street as one of the job locations.
Mr. Leo also identified the Additional Insured Endorsement, which states "unlimited approved additional insureds listed with Hermitage Insurance Company for the policy term" and noted that it applied to "various locations." Mr. Leo also referred to a copy of the file received from the Simon Agency, which included the application requesting coverage for Delight as an additional insured. Mr. Leo stated that Hermitage charged Thomas $500 for the additional insured coverage. Finally, Mr. Leo testified that since Thomas had requested additional insured coverage for Delight, he would not have placed the policy with Hermitage if such coverage was not provided.
Movants thus conclude that since Hermitage issued the Thomas Policy with them
named as additional insureds, Hermitage consented in writing to the inclusion, assuming
that the court finds that such consent is necessary.
Hermitage's Reply
Hermitage argues that the application submitted by the Leo Agency establishes that
the application did not request that either Tompkins or Northeast be added as additional
insureds. With regard to Delight, Hermitage avers that the application did not list 875
Herkimer Street as a location where Delight was insured. Hermitage therefore contends
that it did not give its written consent for movants to be added as additional insureds at
the accident site, as is required pursuant to the terms of the Thomas Policy.
Discussion
"While it is true that policies of insurance are to be construed liberally in favor of the insured and strictly against the insurer, where the provisions of the policy are clear and unambiguous, they must be given their plain and ordinary meaning, and courts should refrain from rewriting the agreement" (Government Employees Ins. Co. v Kligler, 42 NY2d 863, 864 [1977], citing State Farm Mut. Auto. Ins. Co. v Westlake, 35 NY2d 587 [1974]; Johnson v Travelers Ins. Co., 269 NY 401 [1936]). Further, "the question of whether an insurance policy is ambiguous is a matter of law to be determined by the court" (140 Broadway Prop. v Schindler El. Co., 73 AD3d 717, 719 [2010], citing Breed v Insurance Co., 46 NY2d 351, 355 [1978]). In making such determination, under circumstances where neither party suggests that extrinsic evidence will aid in ascertaining the intended meaning, the question is one of law for the court to determine, and courts have consistently construed ambiguous policy provisions in favor of coverage and against the insurer who drafted the policy (City of New York v Evanston Ins. Co., 39 AD3d 153, 156 [2007], quoting Primavera v Rose & Kiernan, 248 AD2d 842, 843 [1998]).
Turning to the specific issue of whether movants are covered under the Thomas Policy as additional insureds, "[i]t is well settled that whether a third party is an additional insured under a policy is determined from the intention of the parties to the policy, as determined from the four corners of the policy itself'" (140 Broadway Prop., 73 AD3d at [*6]718, quoting I.S.A. In N.J. v Effective Sec. Sys., 138 AD2d 681, 682 [1988]). It is also well established that the party claiming insurance coverage bears the burden of proving entitlement (see e.g. Moleon v Kreisler Borg Florman Gen. Constr. Co., 304 AD2d 337 [2003]). Thus, "[a] party not named as an insured or additional insured on the face of the policy is not entitled to coverage" (Tower Ins. v Amsterdam Apts., 82 AD3d 465, 467 [2011], citing Sixty Sutton v Illinois Union Ins. Co., 34 AD3d 386, 388 [2006]; Moleon, 304 AD2d at 339).
Herein, an examination of the application submitted by the Leo Agency to the Simon
Agency and the acord issued by the Simon Agency indicates that Delight was named as
an additional insured. This evidence, when interpreted in conjunction with the above
discussed deposition testimony of Mr. Leo, establishes that Delight was intended to be
covered under
Thomas Policy, since Hermitage was advised and agreed to include Delight
as an additional insured when it quoted a price to the Leo Agency and issued the Thomas
Policy. Thus, this coverage is in compliance with the requirement of the Additional
Insured Limitation Endorsement that Hermitage give its written consent to add coverage
for an additional insured. As argued by Hermitage, however, there is no mention of either
Tompkins or Northeast in the application or in the papers returned to the Leo Agency by
the Simon Agency. Thus, the court concludes that only Delight is covered under the
Thomas Policy as an additional insured.[FN1]
Having so held, the language in the Hermitage correspondence stating that "Blanket Additional Insured's Is Included in pricing" does not alter this conclusion, since there is no support offered by movants that would allow the court to find that the price of the additional insureds' coverage demonstrates that all three of the movants were intended to be covered. Also implicit in this holding is the finding that the failure to identify the premises at which Delight was performing work is not sufficient to preclude coverage because Hermitage did not give written consent with regard to coverage for the 875 Herkimer Street property. As noted above, the Additional Insured Endorsement designated the locations of covered operations as "various locations." The Additional Insured Limitation Endorsement requires that written consent be obtained from Hermitage to add coverage for "a specified entity;" it does not provide that Hermitage must provide written consent with regard to specific location. "When an exclusion clause is relied upon to deny coverage, the burden rests upon the insurance company to demonstrate that the allegations of the complaint can be interpreted only to exclude coverage" (Town of Massena v Healthcare Underwriters Mut. Ins. Co., 98 NY2d 435, [*7]444 [2002], citing International Paper Co. v Continental Cas. Co., 35 NY2d 322, 325 [1974]; Technicon Electronics v American Home Assurance Co., 74 NY2d 66, 73-74 [1989]). Thus, since the Additional Insured Limitation does not specifically provide that coverage will not be provided for locations where a named additional insured performs work unless Hermitage approved the location in writing, it will not be so interpreted.
In so holding, the court also rejects movants' contention that the Additional Insured
Limitation Endorsement does not apply to the commercial general liability coverage
policy issued to Thomas. In this regard, the Endorsement states clearly that:
"THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER
THE FOLLOWING:
The certificate of insurance relied upon by movants to establish additional insureds
coverage for Tompkins and Northeast is similarly insufficient to do so. The certificate
states on its face that it was prepared by the Leo Agency. The certificate also states that
"THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY
THE POLICIES BELOW." The law is clear that an insurance broker is the agent of its
insured (see e.g. Inman Constr. v Cathedral Marble & Granite Co., 307 AD2d
955, 956 [2003]; Progressive Cas. Ins. Co. v Yodice, 276 AD2d 540 [2000]). It
is equally clear that a certificate of insurance issued by a broker listing a party as an
additional insured is insufficient to alter the language of the policy itself, especially
where the certificate recites that it is for informational purposes only; that it confers no
rights upon the holder; and that it did not amend, alter, or extend the coverage afforded
by the policy (see generally
School Constr. Consultants v ARA Plumbing & Heating, 63 AD3d 1029, 1030
[2009]; Home Depot v National
Fire & Mar. Ins. Co., 55 AD3d 671 [2008]; Cendant Car Rental Group v Liberty Mut. Ins. Co., 48 AD3d
397, 398 [2008]). Accordingly, reliance upon the certificate to establish that
movants were named as additional insureds under the Thomas Policy must fail.
The correspondence exchanged between the parties establishes the dates that plaintiff contacted movants, when movants submitted a claim to Hermitage and when Hermitage disclaimed coverage. More specifically, by letter dated September 5, 2008, plaintiff's counsel, Sanders, Sanders, Block, Woycik, Viener & Grossman, P.C., informed Delight that the office had been retained to pursue a personal injury action on [*8]behalf of plaintiff for injuries sustained on January 28, 2008. The letter further stated "[p]lease refer this letter to your insurance carrier immediately for further attention. Return the enclosed postcard with the name of the insurance company applicable to this claim, your policy number and policy limits."
By letter dated January 16, 2009, Mt. Hawley demanded that Hermitage defend, indemnify and reimburse movants, as additional insureds under the Thomas Policy, for the loss sustained by plaintiff in the Personal Injury Action. As is also relevant herein, the letter stated "Please contact attorney Belinda Boone at Sanders, Sanders, Block, Woycik, Viener & Grossman, P.C., at 516-741-5252."
By letter dated January 26, 2009, addressed to Thomas, Hermitage disclaimed coverage for plaintiff's injury under the policy, stating that:
"Please be advised that no coverage will be provided to Thomas Home Remodeling Co., and all other named insureds under the policy."
"This claim occurred on January 28, 2008, yet our first report of this loss was received on January 23, 2009. We find this to be late notice and in violation of your policy conditions. We also find notice from the plaintiff attorney and all other parties associated with this claim to be late as well and in violation of the following policy condition:
. . .
"You must see to it that we are notified as soon as practicable of an occurrence' or
an offense which may result in a claim."
Copies of this letter were mailed to the Simon Agency and to Mt. Hawley; a
copy was faxed to plaintiff's attorney.
By letter dated September 9, 2009, Ms. O'Connor of Mt. Hawley again wrote to Hermitage, explaining that the matter had been reassigned to her and stating that "I acknowledge receipt of your January 26, 2009 letter wherein you find all parties associated with this claim to be late in providing notice to Hermitage Insurance and in violation of policy conditions." Ms. O'Connor went on to dispute Hermitage's determination that Delight submitted a late notice of claim, arguing that Hermitage was notified of the accident as soon as Delight was able to identify plaintiff's employer. A copy of the letter was faxed to plaintiff's attorney. Hermitage did not reply to this letter.
Following the commencement of the Declaratory Judgment Action, Michael Shvartsbart investigated the claim on behalf of Hermitage. On July 20, 2010 and August 4, 2010, Mr. Shvartsbart obtained a written statement from Dean Thomas, principal of Thomas, and Ronald Thomas, the foreman, who confirmed that plaintiff had been injured on the day of the accident and that they took plaintiff to th hospital. By letter dated August 24, 2010 from the Liability Claims Supervisor at Tower Group Companies, as the [*9]liability insurer under the Thomas Policy, Thomas was notified that:
"As you are aware, by letter dated January 26, 2009 . . . we previously disclaimed
coverage of this matter. Please be advised that we reviewed this matter and determined
that it is not covered under your policy for the reasons set forth in our letter dated January
26, 2009, which is incorporated by reference herein and as set forth below. Accordingly,
we reiterate our disclaimer of coverage of this mater and will not defend or indemnify
you with respect thereto."
The letter went on to disclaim coverage on numerous other
grounds.[FN2]
Copies this letter were mailed to the Simon Agency, movants' attorney, plaintiff's
attorney, Tompkins and Northeast.
Movants' Contentions
In support of their motion, movants rely upon the testimony of plaintiff at his deposition, held on October 18, 2010, to establish that he did not know the name of the company that he was working for on the day that he was injured, although he knew the foreman and had worked for him before. Movants further allege that plaintiff explained that he was injured while he was cutting and installing wooden beams in the ceiling, which would become part of the floor above. In order to do this, he was standing on a scaffold that had been erected by him and the foreman. More specifically, plaintiff testified that he was caused to fall when something sticking out of the scaffold cut him. He also alleged that immediately after the accident, the boss came over and told him not to tell anyone who he was working for at the time.
Movants also rely upon the deposition testimony of Mohammed Aziz, who testified on behalf of Delight, and stated that he passed by the job only once or twice a week to check on the progress and quality of the work. Significantly, he only became aware of the accident months after it occurred, since no one had reported it to him at the time that it occurred. In this regard, movants further point out that the September 5, 2008 letter that Delight received from plaintiff's counsel advising it that plaintiff had been injured on January 28, 2008 did not indicate where the accident occurred, how it occurred or who employed plaintiff at the time.
Movants further rely upon an affidavit from Ms. O'Connor, in which she explains that when Delight received notice of plaintiff's claim for personal injury in the September 5, 2008 letter, it provided no details with regard to the alleged injury. At that time, Delight was involved in construction projects at seven sites in Brooklyn. Although some of the projects involved subcontractors, no subcontractor had reported an injury to Delight. Further, as noted above, at his deposition, plaintiff testified that he did not recall [*10]the address of the construction site where he was injured or who he was employed by at the time. In fact, it was not until December 2008 that plaintiff's counsel identified the site of the accident as 875 Herkimer Street. Delight was then able to identify the two subcontractors who were working at that site, Mesnaz Construction Corp., a masonry subcontractor, and Thomas. Immediately upon ascertaining the names of these subcontractors, Mt. Hawley sent letters to the insurance companies of both demanding that each defend and indemnify Delight, Tompkins and Northeast pursuant to the terms of the subcontracts and insurance policies. It was not until May 2009 that it was learned that plaintiff was performing carpentry work for Thomas at the time that he was injured.
Movants also argue that the file turned over by Mt. Hawley indicates that on November 12, 2008, the adjuster handling the claim, Michael Lucia, suggested that plaintiff may have been injured while he was working at 875 Herkimer Street. A notation dated November 21, 2008 indicates that the adjuster called plaintiff's attorney, who believed that the location of the accident could have been 874 Herkimer Street. A December 5, 2008 notation indicates that plaintiff's attorney told the adjuster that plaintiff may have been self employed. Movants argue that these notes indicate that as late as December 5, 2008, it was not known where plaintiff was injured; whether he was employed; and if so, by whom.
Movants go on to argue that the file from RLI indicates that plaintiff's counsel advised RLI on November 12, 2008 that the accident occurred at 874 Buffalo Avenue; Mr. Lucia speculated that the accident occurred at 875 Herkimer Avenue, since 874 Buffalo Avenue is not an address, but Herkimer Street does intersect with Buffalo Avenue. As of December 5, 2008, plaintiff's counsel had yet to confirm that the accident could have occurred at 875 Herkimer Street and had not determined whether plaintiff was self employed. On December 15, 2008, plaintiff's counsel advised RLI that plaintiff was injured when he feel off a scaffold; Delight's files did not indicate that any subcontractors were supposed to be performing work on a scaffold. The file further indicates that as late as December 22, 2008, RLI was not aware of the place of plaintiff's injury or if he was employed. Finally, movants note that Mr. Leo testified that he was first notified of plaintiff's accident on January 22, 2009, since Thomas had not notified Leo Agency of plaintiff's claim. Nonetheless, movants sent a notice of claim to Hermitage and the insurer of the other subcontractor working at 875 Herkimer Street on January 16, 2009.
Movants accordingly conclude that inasmuch as Hermitage was notified of the claim
as soon as was practicable after it was able to identity plaintiff's employer, Hermitage did
not receive a late notice of claim, since any delay in notification to Hermitage was not the
fault of movants, but was due to plaintiff's deliberate attempt to withhold information
concerning the details of his accident.
Hermitage's Contentions
Hermitage argues that movants' delay in notifying it of the claim by letter dated [*11]January 16, 2009 is not "as soon as is practicable" as a matter of law. Hermitage further notes that it was not until nine months later that it received a second letter from Mt. Hawley asserting that movants' late reporting should be excused because movants were not aware that plaintiff was employed by Thomas, since plaintiff's counsel would not provide the name of plaintiff's employer.
Hermitage further argues that nonetheless, the Mt. Hawley file unequivocally
establishes that Delight was first notified of plaintiff's claim as early as November 12,
2008, or 74 days before it notified Hermitage of the claim, and not December of 2008, as
previously represented. More specifically, the Mt. Hawley file reveals that Delight was
advised by Mt. Hawley on November 12, 2008 that the loss occurred at 875 Herkimer
Street, as is established by Ms. O'Connor's claim notes, which is further demonstrated by
a fax dated the same day and sent by Mr. Lucia to "Alana" at Delight, telling her that he
believed that the loss occurred at 875 Herkimer Street and requesting that she get the
contracts for that project. Hermitage concludes that the 74-day delay between the date
that Delight could have ascertained the identify of plaintiff's employer, using the
information provided by Mr. Lucia on November 12, 2008, and January 23, 2009, when
Hermitage received movants' letter advising it that a claim may be filed and demanding
coverage, is "not as soon as practicable" as a matter of law.
Discussion
Where a liability insurance policy requires that notice of an occurrence be given "as soon as practicable," such notice must be accorded the carrier within a reasonable period of time (Great Canal Realty Corp. v Seneca Ins. Co., 5 NY3d 742, 743 [2005]). "The duty to give notice arises when, from the information available relative to the accident, an insured could glean a reasonable possibility of the policy's involvement" (Paramount Ins. Co. v Rosedale Gardens, 293 AD2d 235, 239-240 [2002]). "The requirement that an insured comply with the notice provision of an insurance policy operates as a condition precedent to coverage" (Sputnik Realty v United Natl. Ins. Co., 62 AD3d 689, 689 [2009] [citations omitted]).
"Under the law as it existed at the time the subject insurance policy was issued, the plaintiffs had the burden of raising a triable issue of fact as to the existence of a reasonable excuse for the delay in opposition to the . . . prima facie showing" (McGovern-Barbash Assoc. v Everest Natl. Ins. Co., 79 AD3d 981, 983 [2010], citing Argentina v Otsego Mut. Fire Ins. Co., 86 NY2d 748, 750 [1995]).[FN3] "In order to excuse a failure to give timely notice, the excuse must be reasonable under all circumstances, and [*12]it may be relevant on the issue of reasonableness, whether and to what extent, the insured has inquired into the circumstances of the accident or occurrence'" (Tower Ins. Co. v Christopher Ct. Hous. Co., 71 AD3d 500, 501 [ 2010], citing Security Mut. Ins. Co. of NY v Acker-Fitzsimons, 31 NY2d 436, 441). " [W]here there is no excuse or mitigating factor, the issue [of reasonableness] poses a legal question for the court, rather than an issue for the trier of fact'" (SSBSS Realty Corp. v Public Serv. Mut. Ins. Co., 253 AD2d 583, 584 [1998], quoting Hartford Accident. & Indem. Co. v CNA Ins. Cos., 99 AD2d 310, 313 [1984]; accord Can-Am Roofing v American States Ins. Co., 229 AD2d 973, 974 [1996]).
In this case, Mr. Lucia provided Delight with sufficient information to allow Delight to identify the subcontractor for whom plaintiff worked on November 12, 2008, when he advised Delight that the accident had probably occurred at 875 Herkimer Street. At that time, Delight could have ascertained the name of the contractors employed at the site, even if plaintiff had been self employed, if it had checked its contracts. Thus, Delight's unexplained delay of 74 days thereafter to locate the contracts and to file a claim with Hermitage is found to be unreasonable as a matter of law (see e.g. Tower Ins., 82 AD3d at 466 [76-day delay]; Juvenex v Burlington Ins. Co., 63 AD3d 554 [2009] [two-month delay]; Young Israel Co-Op City v Guideone Mut. Ins. Co., 52 AD3d 245 [2008] [40-days delay]; Gotham Constr. Co. v United Natl. Ins. Co., 35 AD3d 289, 289-290 [2006] [50-day delay]; Pandora Indus. v St. Paul Surplus Lines Ins. Co., 188 AD2d 277, 590 NYS2d 471 [1992] [31-day delay]).
Thus, since Hermitage did not receive notice of the accident as soon as was
practicable after its occurrence, Hermitage is not obligated to defend or indemnify
movants under the Thomas Policy.
Movants go on to argue that although Hermitage admits that it received the letter
dated January 16, 2009 from Mt. Hawley demanding a defense and indemnification on
behalf of Delight, Tompkins and Northeast, Hermitage never responded to that demand,
but for a letter sent to its insured, Thomas, with copies sent to Mt. Hawley and plaintiff's
attorney. In this regard, movants further aver that it is significant that letter does not
address movants' claim for coverage as additional insureds, nor does it mention its
contention that movants provided late notice of claims. Movants also point out that it was
not until seventeen months following notice of movants' claim and after the
commencement of the Declaratory Judgment Action, by letter dated August 24, 2010,
sent to Tompkins and Northeast, Hermitage disclaimed coverage. No disclaimer was ever
sent to Delight. Further, Hermitage did not undertake an investigation into movant's
claim. Movants thus conclude that Hermitage never denied coverage to any additional
insureds under its policy, since it did not send a timely denial of coverage to them. They
also argue that it is well settled that late notice by a named insured is not necessarily
untimely [*13]notice by an additional insured.
Discussion
Insurance Law § 3420(d) (redesignated as § 3420[d][2] by L 2008, ch 388, § 5) requires a liability insurer to give the insured or the injured person written notice of disclaimer of a personal injury claim "as soon as is reasonably possible." In interpreting this provision, it has been explained that:
" An insurer's failure to provide notice as soon as is reasonably possible precludes
effective disclaimer, even [where] the policy holder's own notice of the incident to its
insurer is untimely' (First Fin.
Ins. Co. v Jetco Contr. Corp., 1 NY3d 64, 67 [2003])' (Matter of New York Cent. Mut.
Fire Ins. Co. v Aguirre, 7 NY3d 772, 774 [2006]). Where there is a delay in
providing the written notice of disclaimer, the burden rests on the insurance company to
explain the delay (see First Fin.
Ins. Co. v Jetco Contr. Corp., 1 NY3d 64 [2003]; Matter of Allstate Ins. Co. v
Cruz, 30 AD3d 511 [2006]; Pennsylvania Lumbermans Mut. Ins. Co. v D & Sons Constr.
Corp., 18 AD3d 843 [2005]). When the explanation offered for the delay is an
assertion that there was a need to investigate issues that will affect the decision on
whether to disclaim, the burden is on the insurance company to establish that the delay
was reasonably related to the completion of a necessary, thorough, and diligent
investigation (see Schulman v
Indian Harbor Ins. Co., 40 AD3d 957 [2007])."
(Quincy Mut. Fire
Ins. Co. v Uribe, 45 AD3d 661, 661-662 [2007]).
The court finds that while movants' statement of the law is correct, the facts do not
support its contention. In this regard, it is not disputed that Hermitage responded to Mt.
Hawley's demand for coverage approximately a week after receiving the letter. Although
the letter disclaiming coverage was addressed to Thomas, as Hermitage's insured, it
unequivocally stated that no coverage would be provided to Thomas "and all other
named insureds under the policy" and that "[w]e also find notice from the plaintiff
attorney and all other parties associated with this claim to be late as well." In this regard,
it must also be noted that the letter requested that Hermitage contact plaintiff's attorney,
which it did. Also significant is the fact that in her letter dated September 9, 2009, Ms.
O'Connor stated that she "acknowledge[d] receipt of your January 26, 2009 letter
wherein you find all parties associated with this claim to be late in providing notice to
Hermitage Insurance and in violation of policy conditions." Accordingly, movants will
not now be permitted to argue that Hermitage never disclaimed coverage.
For the above stated reasons, the cross motion by Hermitage seeking a judgment declaring that it is not obligated to defend and indemnify Delight, Tompkins or Northeast in the underlying Personal Injury Action pursuant to the subject insurance policy is [*14]granted and the second third-party complaint is dismissed.
The foregoing constitutes the order, decision and judgment of this court.
E N T E R,
J. S. C.