F I L E D
United States Court of Appeals
Tenth Circuit
PUBLISH
August 27, 2007
UNITED STATES CO URT O F APPEALS Elisabeth A. Shumaker
Clerk of Court
TENTH CIRCUIT
THE YAFFE COM PANIES, IN C.,
Plaintiff - Appellant,
v. No. 06-7057
GREAT AM ERICAN INSURANCE
COM PANY, IN C.,
Defendant - Appellee.
A PPE AL FR OM T HE UNITED STATES DISTRICT COURT
FO R TH E EASTERN DISTRICT O F O K LAH O M A
(D.C. NO . 05-CV-466-FH S)
Harvey D. Ellis, Jr. (Kevin D . Gordon and Jesse C. W hite, with him on the brief),
Crowe & Dunlevy, Oklahoma City, Oklahoma, for Plaintiff - A ppellant.
Edward J. M ain (James K. Secrest, II, and Roger N. Butler, Jr., with him on the
brief), Secrest, Hill & Butler, Tulsa, Oklahoma, for Defendant - Appellee.
Before BR ISC OE, HA RTZ, and GORSUCH, Circuit Judges.
HA RTZ, Circuit Judge.
This appeal arises out of a claim under a commercial umbrella insurance
policy. The district court entered summary judgment in favor of Great American
Insurance Company, Inc., denying the claim of the Yaffe Companies, Inc. on the
ground that the policy unambiguously precluded coverage. Yaffe Cos., Inc. v.
Great Am. Ins. Co., N o. C V-05-466-FHS, 2006 W L 1388448, at *3, *5 (E.D.
Okla. M ay 12, 2006). W e hold that the policy is ambiguous and reverse and
remand for further proceedings.
I. B ACKGR OU N D
On December 28, 2004, an explosion at Yaffe’s scrapyard in M uskogee,
Oklahoma, caused significant property damage and bodily harm. W hen it filed its
complaint, Yaffe had incurred $1,785,986.89 in liability on claims by numerous
parties. Two insurance policies cover Yaffe’s liability. One is a commercial
general-liability policy issued by ACE American Insurance Company (ACE). The
policy provides coverage up to $1,000,000 per occurrence, with a general
aggregate limit of $2,000,000 and a deductible of $10,000 per claim. The other
policy is a commercial umbrella policy with Great American. As a general
matter, umbrella policies provide two types of insurance coverage: (1) excess
coverage for events also covered by other underlying insurance policies that
provide primary protection and (2) primary coverage for events not covered by
other policies. See Com mercial Union Ins. Co. v. Walbrook Ins. Co., 7 F.3d 1047,
1053 (1st Cir. 1993). The Great American policy has a coverage limit of
$25,000,000. But its excess coverage does not begin until the amount that Yaffe
“becomes legally obligated to pay,” Great American policy § I, exceeds the
policy’s “Retained Limit,” which is “the total amounts stated as the applicable
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limits of the underlying policies [in the policy schedule],” id. § II.G.1. (Citations
to the Great American policy, Aplt. App. Vol. I at 73–132, will refer to sections
of the policy rather than pages of the appendix.)
The source of the difficulty in this case is the type of deductible in the ACE
policy. The deductible is $10,000 per claim. That the deductible is per-claim
rather than per-occurrence is apparently unusual. See 1 Barry R. Ostrager &
Thomas R. Newman, Handbook on Insurance Coverage Disputes § 9.02, at 557
(2006) (in commercial general-liability policies “there is typically one deductible
for each occurrence”). The nature of the deductible makes a substantial
difference in the A CE policy’s coverage of the M uskogee explosion. Because
most claims were under $10,000, the policy covers only $497,999.10 of Y affe’s
total liability of $1,785,986.89. If the $10,000 deductible had been per
occurrence, ACE would have had to pay $1,000,000, and there would be no
dispute that Great American must cover the total liability in excess of $1,000,000
(or perhaps $1,010,000).
Yaffe sought coverage from Great American in the amount of $785,986.89,
the difference between the total amount of the claims against it arising from the
explosion and $1,000,000. (Yaffe also raised a separate claim, but it is not
pursued on appeal.) Great American denied the claim, noting that ACE had paid
only $497,999.10 and asserting that the Great American policy does not provide
coverage until the $1,000,000 limit of the ACE policy has been exhausted.
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On October 14, 2005, Yaffe filed an action against G reat American in
Oklahoma state court, claiming that Great American had breached its insurance
contract and seeking a declaration of coverage. Great American timely removed
the case to the United States District Court for the Eastern District of Oklahoma
on November 21, 2005, claiming diversity jurisdiction under 28 U.S.C.
§ 1332(a)(1) because Yaffe is an Oklahoma corporation with its principal place of
business in Oklahoma and Great American is an Ohio corporation with its
principal place of business in Ohio. The next day Great American filed a
counterclaim against Y affe, seeking a declaration that it has no obligation to
provide coverage on claims arising from the M uskogee explosion until Yaffe has
exhausted the ACE policy’s $1,000,000 limit.
On M arch 28, 2006, Great American moved for summary judgment. Yaffe
responded and Great American replied. On April 21, shortly after Great
American filed its reply in support of summary judgment, Yaffe moved to compel
discovery, seeking information and documents from Great American regarding its
construction of its umbrella policies w ith similar language. Yaffe then filed its
own motion for summary judgment on M ay 5.
One w eek later, before G reat American had filed a response to Yaffe’s
summary-judgment motion, the district court granted Great American’s summary-
judgment motion while denying Yaffe’s motion. It ruled that the Great American
policy is unambiguous and that Great American is obligated to make payments
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under its policy only “when Yaffe becomes legally obligated to pay sums in
excess of or, stated another way, after exhaustion of, the $1,000,000 coverage
provided by the ACE policy.” Yaffe, 2006 W L 1388448, at *3. The district court
also denied Yaffe’s motion to compel discovery, reasoning that such information,
“while potentially relevant to a tort claim for bad faith,” had no relevance to the
contract claims because it had determined that the contract was to be interpreted
based on its language alone. Aplt. App. Vol. 2 at 519 (Op. & Order, M ay 12,
2006). Judgment was entered the same day.
Yaffe appeals the grant of summary judgment to Great American, the denial
of its own summary-judgment motion, and, in the alternative, the denial of its
motion to compel discovery.
II. D ISC USSIO N
A. Standard of Review
“[A]n order denying summary judgment is review able w hen . . . it is
coupled with a grant of summary judgment to the opposing party.” Padfield v.
AIG Life Ins. Co., 290 F.3d 1121, 1124 (9th Cir. 2002); see McIntosh v.
Scottsdale Ins. Co., 992 F.2d 251, 253 (10th Cir. 1993) (“W here we reverse a
summary judgment order in favor of one party, . . . we will review the denial of
the other party’s cross-motion for summary judgment under the same standards
applied by the district court so long as it is clear that the party opposing the
cross-motion had an opportunity to dispute the material facts.”); James W m.
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M oore et al., M oore’s Federal Practice § 56.41[1], at 56-284.1 (3d ed. 2006); 10A
Charles Alan W right et al., Federal Practice and Procedure § 2715, at 268 (3d ed.
1995). Thus, we review both the grant of summary judgment to Great American
and the denial of summary judgment to Yaffe. “W e review de novo a district
court’s grant or denial of summary judgment, and we apply the same legal
standard to be employed by the district court under Federal Rule of Civil
Procedure 56(c).” M aldonado v. City of Altus, 433 F.3d 1294, 1302 (10th Cir.
2006) (brackets and internal quotation marks omitted), overruled on other
grounds as recognized by Metzler v. Fed. Home Loan Bank of Topeka, 464 F.3d
1164, 1171 n.2 (10th Cir. 2006). Summary judgment is appropriate if “there is no
genuine issue as to any material fact and . . . the moving party is entitled to a
judgment as a matter of law .” Fed. R. Civ. P. 56(c).
B. M otions for Summary Judgment
Yaffe contends that summary judgment for Great American was improper,
and summary judgment for it was proper, because (1) the policy’s unambiguous
terms require Great American to provide coverage once Yaffe’s liability for the
explosion exceeded $1,000,000, and (2) even if the policy is ambiguous, that
ambiguity must be construed against the drafter and in favor of Yaffe’s
reasonable expectations of insurance coverage. Great American counters that
summary judgment was proper because the terms of its policy unambiguously
indicate that it is not obligated to provide coverage until the $1,000,000 per-
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occurrence limit of the ACE policy has been exhausted. It makes no alternative
argument in the event that we hold the policy to be ambiguous.
Oklahoma substantive law applies to this diversity action. See Air Liquide
Am. Corp. v. Cont’l Cas. Co., 217 F.3d 1272, 1275 (10th Cir. 2000). Its approach
to interpreting insurance policies is unremarkable:
The foremost principle is that an insurance policy is a contract.
Parties are at liberty to contract for insurance to cover such risks as
they see fit and they are bound by terms of the contract. It
necessarily follows that courts are not at liberty to rewrite the terms
of an insurance contract. The interpretation of the policy, with its
exclusions, is a law question, unless the facts necessary to apply the
decided law question are in dispute.
W hen addressing a dispute concerning the language of an
insurance policy, our first step is to determine as a matter of law
whether the policy language at issue is ambiguous. If it is not
ambiguous, we accept the language in its plain, ordinary and popular
sense. W e must construe the policy to give a reasonable effect to all
of its provisions, construing liberally words of inclusion in favor of
the insured and construing strictly words of exclusion against the
insurer.
Duensing v. State Farm Fire & Cas. Co., 131 P.3d 127, 134 (Okla. Civ. App.
2005) (citations omitted) (summarizing Oklahoma Supreme Court caselaw).
“Insurance contracts are ambiguous only if they are susceptible to two
constructions.” M ax True Plastering Co. v. U.S. Fid. & Guar. Co., 912 P.2d 861,
869 (Okla. 1996). W hen a contract is ambiguous, extrinsic evidence is necessary
to resolve the ambiguity. See Cam pbell v. Indep. Sch. Dist. No. 01 of Okmulgee
County, 77 P.3d 1034, 1039 (Okla. 2003). In considering ambiguous insurance
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contracts, courts “examine the policy language objectively to determine whether
an insured could reasonably have expected coverage. . . . [A ]mbiguities are
construed most strongly against the insurer.” M ax True, 912 P.2d at 865.
The parties rely on several different provisions of the Great American
policy. W e address them in turn. Section I states:
[G reat American] will pay on behalf of [Yaffe] those sums in excess
of the “Retained Limit” that [Yaffe] becomes legally obligated to pay
by reason of liability imposed by law or assumed by [Yaffe] under an
“insured contract” because of “bodily injury,” “property damage,”
“personal injury,” or “advertising injury” that takes place during the
Policy Period and is caused by an “occurrence” happening anywhere.
The amount we will pay for damages is limited as described below in
the Insuring Agreement Section II. LIM ITS OF INSURA NC E.
Great American policy § I. (Neither party suggests that the insured-contract
language applies in this case.) Subsection II.G defines Retained Limit. It states:
W e will be liable only for that portion of damages, subject to the
Each Occurrence Limit stated in the Declarations, in excess of the
“[R]etained [L]imit,” which is the greater of:
1. the total amounts stated as the applicable limits of the
underlying policies listed in the Schedule of Underlying
Insurance and the applicable limits of any other insurance
providing coverage to [Yaffe] during the Policy Period; or
2. the amount stated in the Declarations as Self-Insured Retention
as a result of any one “occurrence” not covered by the
underlying policies listed in the Schedule of Underlying
Insurance nor by any other insurance providing coverage to
[Yaffe] during the Policy Period;
and then up to an amount not exceeding the Each Occurrence Limit
as stated in the D eclarations.
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Once the Self-Insured Retention has been exhausted by actual
payment of “claims” in full by [Yaffe], the Self-Insured Retention
will not be reapplied or again payable by [Yaffe] for said Policy
Period.
Id. § II.G. (The parties agree that the latter of the two alternatives in
§ II.G— self-insured retention— is irrelevant to this appeal.) The Schedule of
Underlying Insurance lists a per-occurrence limit of $1,000,000 for the ACE
policy.
Great American contends that these provisions mean that its “obligation to
pay is limited to Yaffe’s liability in excess of the limits of the underlying policy,”
Aplee. Br. at 17, and consequently, “Great American has no obligation to pay
under its umbrella policy until the limits of the ACE Primary Policy have been
exhausted,” id. at 20. W e disagree. The natural meaning of the above provisions,
read together, is that the Great American policy provides coverage for liability of
Yaffe above the Retained Limit of $1,000,000. Because Yaffe has “become[]
legally obligated to pay” $1,785,986.89, Great American would be required to pay
the amount in excess of $1,000,000, or $785,986.89. The policy defines the
Retained Limit as the total of “amounts” that appear in the Schedule of
Underlying Insurance. This schedule sets forth numbers representing policy
limits of the underlying policies. If any other features of the underlying
policies— such as the size of the deductible or w hether the deductible is per-
occurrence or per-claim— were relevant to computation of the Retained Limit,
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certainly those features w ould be described in the schedule. But the schedule sets
forth only that the ACE policy has a general aggregate limit of $2,000,000 and a
per-occurrence limit of $1,000,000. Indeed, the underwriting file that Great
American created in preparing the policy does not include a description of the
nature of the deductible; it states only that the ACE policy had a $10,000
deductible, with no specification of whether it applied per claim or per
occurrence.
In our view the language in § I (Coverage) and § II.G (Retained Limit) of
the Great American policy implies that coverage begins once Yaffe has incurred
liabilities exceeding $1,000,000. Cf. U.S. Fire Ins. Co. v. Charter Fin. Group,
Inc., 851 F.2d 957, 959 & n.6, 963 (7th Cir. 1988) (when excess policy defined
“retained limit” as, in pertinent part, “the total of the applicable limits of the
underlying policies listed” and underlying policy provided coverage of $100,000,
court interprets excess policy as providing coverage for property damage
beginning at $100,000 (internal quotation marks omitted)); Fried v. N. River Ins.
Co., 710 F.2d 1022, 1024, 1026–27 & n.6 (4th Cir. 1983) (when excess policy
defined “retained limit” as “‘the total of the applicable limits of the underlying
policies listed in Schedule A hereof, and the applicable limits of any other
underlying insurance available to the insured,’” court interprets policy as
providing coverage “above the threshold level of the face value of the Schedule A
policies” and notes that “[t]o hold otherwise subjects the insurer to unforeseeable
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and variable risks depending upon the underlying insurance actually maintained
by any one of the potential insureds”). At oral argument Great American
suggested that Yaffe’s construction of these provisions would free Yaffe from the
bargain it made (at least implicitly) with ACE— namely, that in exchange for a
reduced premium on the ACE policy, Yaffe agreed that the deductible w ould
apply per claim rather than per occurrence and thereby risked having a much
larger deductible in some instances. But Yaffe’s bargain with ACE should be
irrelevant to the construction of the language of the Great American policy. And
in any event, Yaffe has clearly paid, through the nose, for the bargain it made.
Even under Yaffe’s construction of the Great American policy, a cheaper
insurance policy with ACE with a per-claim deductible has caused it to have to
pay more than $500,000 in deductibles before Great American starts to pay.
The dissent argues that our reading of §§ I and II.G must be w rong because
it renders irrelevant the actual coverage by the underlying policies. “[I]t would
have been far simpler,” says the dissent, “to establish a set deductible amount,
rather than to establish that amount by reference to the applicable limits of the
underlying insurance policies.” Op. (Briscoe, J., dissenting) at 7. W e are not
persuaded. The policy definition of Retained Limit is the sum of the limits of all
insurance policies providing coverage to Yaffe, not just the policies listed in the
Schedule of Underlying Insurance. See § II.G. If the policy stated simply “a set
deductible amount,” the Retained Limit would not be automatically increased, as
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it is under the present language, if Yaffe acquired additional underlying
insurance.
The dissent also asserts that there would be no need for § VI.I of the policy,
which requires Y affe to maintain its underlying insurance, if Great American’s
coverage depends only on amounts set forth on the Schedule of Underlying
Insurance. We note that G reat American itself has made no such argument. On
the contrary, its brief to this court chastises Yaffe for raising on appeal an
argument based on § VI.I that it had not raised below . It continues: “M oreover,
the argument is irrelevant as Yaffe did maintain underlying insurance, and ACE is
paying claims pursuant to its primary policy.” A plee. Br. at 42. In any event,
§ VI.I serves a clear purpose even under our interpretation of Retained Limit. For
one thing, the actual coverage provided by the ACE policy and the exhaustion of
the limits of that policy affect Great American’s duty (1) to defend Yaffe, see
§ III.A, discussed below , and (2) to make payments for appeal bonds,
prejudgment interest, and costs, see § III.B.3 (regarding litigation expenses).
Thus, § VI.I is not superfluous. Despite the dissent’s arguments, we believe that
the most reasonable reading of §§ I and II.G is that Great American is obligated
to pay once Yaffe has incurred liabilities exceeding $1,000,000.
Other provisions in the Great American policy, however, are less clear than
the above and provide at least some support for G reat American’s construction.
Subsection VI.P of the policy, entitled “When Loss is Payable,” sets independent
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conditions on if (as well as when) Great American must pay. It states, in
pertinent part:
Coverage under this policy will not apply unless and until [Yaffe] or
[Yaffe’s] underlying insurer is obligated to pay the “[R]etained
[L]imit.”
Great A merican policy § VI.P (emphasis added). Initially it may appear that the
plain meaning of the provision is that coverage under the policy begins when
either Yaffe or ACE is obligated to pay $1,000,000. W hen the Coverage
provision of the policy speaks of “sums . . . that [Yaffe] becomes legally
obligated to pay by reason of liability imposed by law,” id. § I, it is undoubtedly
including sums paid by underlying insurance coverage. Thus, when § VI.P refers
to what Yaffe “is obligated to pay,” it must be referring to Yaffe’s legal liability,
regardless of whether Y affe is protected by insurance coverage for that liability.
Because Yaffe has been obligated to pay more than $1,000,000 as the result of the
M uskogee explosion, there would seem to be coverage under the Great American
policy. But this construction of the provision renders the w ords “or [Yaffe’s]
underlying insurer” superfluous because Y affe’s underlying insurer, whose
obligation derives from Yaffe’s, w ould be obligated to pay only when Yaffe itself
would be obligated.
A possible alternative reading of § VI.P that avoids rendering the reference
to Yaffe’s insurer as surplusage would be based on the recognition that umbrella
coverage protects against identified gaps in underlying policies. “Umbrella
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policies differ from standard excess policies in that they are designed to fill gaps
in coverage both vertically (by providing excess coverage) and horizontally (by
providing primary coverage).” Commercial Union Ins. Co., 7 F.3d at 1053. It
may be, therefore, that § VI.P should be read to say that coverage under the Great
American policy applies only when either Yaffe (in the case of an event not
covered by other insurance) or Yaffe’s underlying insurer (in the case of an event
covered by other insurance) is obligated to pay the Retained Limit. Because the
M uskogee explosion is undoubtedly covered by the ACE policy, § VI.P would
then mean that Great American’s obligation is triggered only after ACE has
become obligated to pay $1,000,000— that is, only after the ACE coverage has
been exhausted.
A third reading, which arrives at the same conclusion, is proffered by Great
American and w as adopted by the district court. Under that reading the purpose
and effect of the reference to Yaffe’s obligation in § VI.P is merely to protect
Yaffe in the event of default by its primary insurer, ACE. If ACE, because of
insolvency or unjustified refusal to pay, does not pay its obligations and Yaffe is
forced to pay covered liabilities itself, Great American would count such
payments under § VI.P. This third reading avoids the surplusage problem with
the first reading, but neither Great American nor the district court has explained
how it derived this meaning from the language of the policy.
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Subsection VI.J, entitled “Other Insurance,” sets a further condition on
payment by Great American. It, too, is subject to more than one reasonable
construction. It states:
If other insurance applies to a loss that is also covered by this policy,
this policy will apply excess of the other insurance. Nothing herein
will be construed to make this policy subject to the terms, conditions,
and limitations of such other insurance. However, this provision will
not apply if the other insurance is specifically written to be excess of
this policy.
Great American policy § VI.J. The phrase “excess of the other insurance” is not
defined in the policy. There is support for Great American’s view that the phrase
means that the policy applies only “after the primary coverage limits have been
exhausted.” U.S. Fid. & Guar. Co. v. Federated Rural Elec. Ins. Corp., 37 P.3d
828, 831 (Okla. 2001) (“Primary insurance provides immediate coverage for the
insured upon the occurrence of a loss or the happening of an event which, under
the terms of the policy, gives rise to immediate liability. . . . An excess insurance
policy is one which by its terms provides coverage that is secondary to the
primary coverage; there is usually no obligation to the insured until after the
primary coverage limits have been exhausted.”).
But a general description of insurance policies, such as that in U.S. Fidelity
& Guaranty Co., must yield to the specific language of a particular policy.
Oklahoma law imposes coverage when “an insured could reasonably have
expected coverage” based on the policy language, M ax True, 912 P.2d at 865;
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and to a reasonable person looking only at this language, the phrase “excess of
the other insurance” could well mean “to the extent that the other insurance is not
required to pay (even if the other insurance applies to the loss).” Under this
reading, § VI.J w ould come into play to limit Great American’s duty to pay only
when both the Great American policy and another policy (in this case, the ACE
policy) require payment. This could happen if, for example, a new $50,000 claim
arising out of the explosion were added to the claims against Yaffe. Because of
the $10,000 per-claim deductible in the ACE policy, ACE would be obligated to
pay $40,000. Because under Yaffe’s construction of the policy the Great
American deductible had been exceeded, Great American would be obligated for
the entire $50,000. Great American would be the only insurer obligated to pay
the first $10,000, so it would owe that sum. As to the remaining $40,000, both
Great American and ACE would be liable, so § VI.J would presumably impose the
obligation on AC E. See Lee R. Russ, Couch on Insurance § 219:1 (3d ed. 2007)
(“‘Other insurance’ clauses govern the relationship between insurers[;] they do
not affect the right of the insured to recover under each concurrent policy.”).
Finally, both parties claim to find support for their positions in § III.A of
the G reat American policy, entitled “D efense.” (Yaffe has not claimed, however,
that Great American actually had any obligation to defend it against any of the
claims arising out of the explosion). It provides:
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[Great American] will have the right and duty to investigate any
“claim” and defend any “suit” seeking damages covered by the terms
and conditions of this policy when:
1. the applicable Limits of Insurance of the underlying policies
listed in the Schedule of Underlying Insurance and the Limits
of Insurance of any other insurance providing coverage to
[Yaffe] have been exhausted by actual payment of “claims” for
any “occurrence” to which this policy applies; or
2. damages are sought for any “occurrence” which is covered by
this policy but not covered by any underlying policies listed in
the Schedule of Underlying Insurance or any other insurance
providing coverage to [Yaffe].
Great American policy § III.A. Both parties seem to agree that this provision
requires (and permits) Great American to investigate and defend a claim when the
limits of A CE’s coverage have been exhausted. It would seem peculiar, however,
for the policy to require payment by Great American before G reat American’s
right and duty to investigate and defend arises. Great American should not be
required to pay on a claim against Yaffe without having the opportunity to protect
its interests by investigating and defending the claim. Yet that could be the case
under Yaffe’s interpretation of the policy because the duty to pay could arise
before exhaustion of ACE’s coverage, which is w hat triggers the right and duty to
investigate and defend. One could thus infer that the duty to pay must not arise
until the § III.A rights and duties arise— namely, upon exhaustion of the ACE
coverage.
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But Yaffe has a reasonable contrary argument. It argues that the language
of § III.A shows that the drafters of the policy could require “exhaustion” of
coverage w hen they wanted to. It contends that this section “shows precisely how
unambiguous language can and should provide for a requirement that underlying
insurance be ‘exhausted.’” Aplt. Br. at 27. The failure to use such language in
§§ I and II.G, it contends, therefore shows that the Retained Limit could be
exceeded before exhaustion of the underlying coverage. In our view § III.A does
not unambiguously indicate whether Great American’s obligation to pay begins
only when the ACE policy’s limits have been exhausted.
In sum, we believe that the G reat American policy is susceptible to more
than one reasonable construction; it is not unambiguous. Summary judgment in
favor of Great American on this ground was therefore improper. Furthermore,
Great American does not argue on appeal that it would be entitled to summary
judgment even if the policy were ambiguous, so we do not address such a
possibility and instead conclude that the grant of summary judgment to Great
American must be reversed.
In light of the above discussion, we also must conclude that the district
court’s ground for denying Yaffe’s motion for summary judgment— namely, that
the Great American policy unambiguously indicated that Great American had no
obligation to pay until the ACE policy was exhausted— was erroneous. This does
not mean, however, that Yaffe is now entitled to summary judgment. All we have
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decided is that the Great American policy is ambiguous. Yaffe would have us
take the next step. It contends that it is entitled to summary judgment because (1)
any ambiguity in the policy must be construed against the drafter of the policy,
Great American, and in favor of coverage; and (2) it had a reasonable expectation
that the policy w ould provide coverage. But at this stage of the proceeding w e
must disagree. Great American had no opportunity to respond to Y affe’s
summary-judgment motion, and entry of summary judgment against it would
therefore be improper.
“Federal Rule of Civil Procedure 56 implicitly requires the district court to
allow the nonmoving party an opportunity to respond before summary judgment is
entered against it.” See Beaird v. Seagate Tech., Inc., 145 F.3d 1159, 1163 (10th
Cir. 1998). But the district court granted G reat American’s motion for sum mary
judgment one week after Yaffe filed its motion for summary judgment, well
before Great American’s response was due. In its response Great American may
have pointed to extrinsic evidence that resolved any ambiguity in the policy and
would have defeated Yaffe’s motion. Given the district court’s grounds for its
ruling on the merits, proceeding to deny Yaffe’s motion was hardly improper.
Now that we have reversed that ruling, however, Great American is entitled to an
opportunity to respond to Yaffe’s motion. Accordingly, we must remand for
further proceedings. Cf. Doebele v. Sprint/United M gmt. Co., 342 F.3d 1117,
1139 (10th Cir. 2003) (district court abused its discretion in granting summary
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judgment when it relied on new materials in reply brief without giving the
nonmovant an opportunity to file a surreply; because appellate court was
reversing summary judgment for other reasons, “[a]ny prejudice flowing from
[appellant’s] inability to reply to this material may be corrected on remand”).
C. M otion to Compel Discovery
As an alternative to its argument that it be granted summary judgment,
Yaffe argues for reversal of the district court’s denial of its motion to compel
discovery. The district court denied the motion to compel on the ground that the
Great American policy was unambiguous. Because we have determined that the
relevant terms of the policy are ambiguous, we remand this issue to the district
court for reconsideration.
III. C ON CLU SIO N
W e REVERSE the district court’s grant of summary judgment to Great
American and REM AND for further proceedings.
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No. 06-7057, The Yaffe Companies, Inc. v. Great American Insurance Company
BRISCO E, Circuit Judge, dissenting:
I respectfully dissent. Although the majority concludes “that the district
court’s ground for denying Yaffe’s motion for summary judgment–namely, that
the Great American policy unambiguously indicated that Great American had no
obligation to pay until the ACE policy was exhausted–was erroneous,” M aj. Op.
at 18, in my view it is the majority’s own conclusion that is erroneous.
I.
Before detailing my differences w ith the majority’s decision, I believe it is
useful to briefly revisit the relevant facts of this case and, consistent with our
obligation under Oklahoma law to construe the policy as a whole, to review all of
the relevant Great American policy provisions together. See Bituminous Cas.
Corp. v. Cowen Constr., Inc., 55 P.3d 1030, 1033 (Okla. 2002) (holding that an
insurance policy must “‘be construed according to the entirety of its terms and
conditions set forth in the policy and as amplified, extended, or modified by any
rider, endorsement, or application attached to and made a part of the policy.’”)
(quoting Okla. Stat. tit. 36, § 3621).
Effective October 1, 2004, Great American issued to Yaffe, in exchange for
a premium of $272,310, a “Commercial Umbrella” policy with a policy period of
October 1, 2004, to October 1, 2005. App. at 74, 86. The Great American policy
provided total coverage of $25,000,000 for “[e]ach [o]ccurrence” and in the
aggregate. Id. at 86. The “INSU RING AGREEM ENTS” portion of the Great
American policy provided, in pertinent part, as follow s:
I. C OV ER AG E
W e will pay on behalf of the “Insured” those sums in excess of the
“Retained Limit” that the “Insured” becomes legally obligated to pay
by reason of liability imposed by law or assumed by the “Insured”
under an “insured contract” because of “bodily injury,” “property
damage,” “personal injury,” or “advertising injury” that takes place
during the Policy Period and is caused by an “occurrence” happening
anywhere. The amount we will pay for damages is limited as
described below in the Insurance Agreement Section II. LIM ITS OF
INSU RA NC E.
II. L IM IT S OF IN SU R ANCE
***
G . Retained Limit
W e will be liable only for that portion of damages . . . in excess of
the “retained limit,” which is the greater of:
1. the total amounts stated as the applicable limits of the
underlying policies listed in the Schedule of Underlying
Insurance and the applicable limits of any other
insurance providing coverage to the “Insured” during the
Policy Period; or
2. the amount stated in the Declarations as Self-Insured
Retention [which in this case was “$ -0-”] as a result of any
one “occurrence” not covered by the underlying policies listed
in the Schedule of Underlying Insurance nor by any other
insurance providing coverage to the “Insured” during the
Policy Period;
and then up to an amount not exceeding the Each
Occurrence Limit as stated in the Declarations [i.e.,
$25,000,000].
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App. at 88-89 (emphasis added).
The Great American policy’s “Schedule of Underlying Insurance,” w hich is
referenced in the policy’s definition of “Retained Limit,” listed three different
policies, including “ACE AM ERICAN PO LICY: D35980490” (Ace American
policy) w hich provided commercial general liability and employee benefit
liability to Yaffe for the policy period of October 1, 2004, to October 1, 2005. Id.
at 76. The Schedule of Underlying Insurance stated that the Ace American
policy, to the extent it provided commercial general liability coverage, had a
$2,000,000 general aggregate limit and a $1,000,000 “each occurrence” limit. Id.
Finally, the Great American policy contained the following three (I, J and
P) relevant “CONDITIONS” provisions (which are found in § VI):
I. M aintenance of Underlying Insurance
During the period of this policy, you agree:
1. to keep the policies listed in the Schedule of Underlying
Insurance in full force and effect;
2. that any renewals or replacements of the policies listed in
the Schedule of Underlying Insurance will not be m ore
restrictive in coverage;
3. that the Limits of Insurance of the policies listed in the
Schedule of Underlying Insurance will be maintained except
for any reduction or exhaustion of aggregate limits by payment
of “claims” or “suits” for “occurrences” covered by
“underlying insurance”; and
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4. that the terms, conditions and endorsements of the policies
listed in the Schedule of Underlying Insurance will not change
during the period of this policy such as to increase the
coverage afforded under the policy.
If you fail to comply with these requirements, we will only be liable
to the same extent that we would have been had you fully complied
with these requirements.
J. O ther Insurance
If other insurance applies to a loss that is also covered by this policy,
this policy will apply excess of the other insurance. Nothing herein
will be construed to make this policy subject to the terms, conditions
and limitations of such other insurance. However, this provision will
not apply if the other insurance is specifically written to be excess of
this policy.
***
P. W hen Loss Is Payable
Coverage under this policy will not apply unless and until any
“Insured” or an “Insured’s” underlying insurer is obligated to pay the
“retained limit.”
W hen the amount of loss has finally been determined, we will
promptly pay on behalf of the “Insured” the amount of loss falling
within the terms of this policy.
Id. at 99-100.
On December 28, 2004, an explosion occurred at Yaffe’s scrap yard in
M uskogee, Oklahoma. Id. at 47. According to Yaffe, it incurred approximately
$1,785,986.89 in total liabilities as a result of various claims resulting from the
explosion. Id. Because, however, a m ajority of those claims w ere for amounts
less than the $10,000 per-claim deductible set forth in the Ace American Policy,
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Ace American provided no coverage for those claims, leaving Yaffe responsible
to pay $1,287,987.79 worth of claims. Id. at 47-48. In other words, Ace
American, to date, has paid only $497,999.10 of the total liabilities incurred by
Yaffe as a result of the explosion, leaving over half-a-million dollars remaining
under the $1,000,000 “per occurrence” limit set forth in the Ace American Policy.
Id. at 48.
Yaffe filed suit against Great American in the District Court of M uskogee
County, Oklahoma. Yaffe’s complaint alleged that Great American had breached
its contract of insurance by failing to reimburse Yaffe for its deductible
obligations, and also sought a declaration that Great American would be obligated
to reimburse Yaffe “for all amounts not covered by Yaffe’s underlying policy [the
Ace American policy], including all deductible payments incurred by Yaffe.” Id.
at 14-17. Alternatively, Yaffe sought a declaration that Great American was
liable for all of Yaffe’s liabilities resulting from the accident that exceeded
$1,000,000, regardless of who paid the first $1,000,000 in claims. Great
American filed an answer, timely removed the action to federal district court, and
then filed a counterclaim seeking a declaration that it had no duty to pay under its
umbrella policy until and unless the limits of the Ace American primary policy
had been paid. The parties subsequently filed cross-motions for summary
judgment. The district court issued an opinion and order granting Great
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American’s motion for summary judgment and denying Yaffe’s cross-motion for
summary judgment.
II.
Turning to the majority’s decision, it is first suggested that “the language in
§ I (Coverage) and § II.G (Retained Limit) of the Great American policy implies
that coverage begins once Yaffe has incurred liabilities exceeding $1,000,000.”
M aj. Op. at 10. W ith this statement, the majority focuses on the phrase “total
amounts,” as employed in § II.G, and omits the introductory requirement that
limits Great American’s liability to only “that portion of damages . . . in excess of
the ‘retained limit.’” The majority then interprets the “total amounts” phrase to
simply refer to a mathematic total equivalent to the applicable limits of any
underlying policies maintained by the insured, in this case $1,000,000, omitting
any requirement that these limits must be paid by the underlying policy insurer(s).
In other words, the majority concludes that the sole purpose of § II.G’s reference
to the “the applicable limits of the underlying policies” is to establish a threshold
dollar amount, above which coverage under the umbrella policy will begin, and
regardless of whether Yaffe or the underlying insurer(s) paid or were liable for
the amounts below the threshold dollar amount.
In my view, this is a misreading of the policy. To begin with, it omits the
key introductory language of § II.G that states Great American “will be liable
only for that portion . . . in excess of the ‘retained limit,’ which is the greater of”
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(1) “the total amount stated as the applicable limits of the underlying policies
listed in the Schedule of Underlying Insurance” (i.e., the Ace American policy,
which had a per occurrence limit of $1,000,000) “and the applicable limits of any
other insurance providing coverage to the ‘Insured’ during the policy period”
(there were no such other policies in place in this case), or (2) “the amount stated
in the Declarations as Self-Insured Retention” (i.e., zero). Although § II.G could
perhaps be more clear, its reference to “the applicable limits of the underlying
policies” was obviously intended, particularly when considered in light of the
other relevant policy provisions, to mean that those limits have to be exhausted
before coverage begins under the Great American policy. To conclude otherwise,
as the majority does, effectively transforms the policy from its intended purpose
as an excess policy into a primary insurance policy with a large deductible. If
that is the proper interpretation, then one must ask why the policy repeatedly
refers to the underlying policies and their applicable limits, and why the policy
requires that those underlying policies be kept in full force and effect? If the
majority’s interpretation were correct, there would be no need to refer at all to
any underlying policies and their applicable limits. Stated differently, it would
have been far simpler for the policy to establish a set deductible amount, rather
than to establish that amount by reference to the applicable limits of the
underlying insurance policies maintained by Yaffe. Notably, the majority
concedes that the purpose of § II.G’s reference to underlying policies maintained
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by the insured is to ensure that the Retained Limit will be “automatically
increased” in the event that the insured “acquire[s] additional underlying
insurance.” M aj. Op. at 11-12. But this concession, with which I agree, makes
sense only if the Great American policy is interpreted as providing excess, rather
than primary, coverage.
The majority further errs in construing § VI.J (“Other Insurance”) of the
policy, which states: “If other insurance applies to a loss that is also covered by
this policy, this policy will apply excess of the other insurance.” Although the
majority acknowledges, as it must, that this language can reasonably be construed
to “mean[] that the policy applies only after the primary coverage limits have
been exhausted,” M aj. Op. at 15 (internal quotation marks omitted), it suggests
that “to a reasonable person . . . the phrase ‘excess of the other insurance’ could
well mean ‘to the extent that the other insurance is not required to pay (even if
the other insurance applies to the loss).’” Id. at 16. In my view , the plain
language of § VI.J has only one reasonable interpretation and that interpretation
clearly refutes the majority’s proposed alternative reading. Specifically, a
reasonable insured in the position of Yaffe could only have read § VI.J to mean
that the Great American policy would provide coverage for a loss only after the
limits of any applicable underlying policies were exhausted.
The majority also reads too much into § VI.P of the Great American policy.
That section, entitled “W hen Loss is Payable” and contained in the “Conditions”
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section of the policy, provides, in pertinent part, that “[c]overage under this
policy will not apply unless and until any ‘Insured’ or an ‘Insured’s’ underlying
insurer is obligated to pay the ‘retained limit.’” App. at 100. Although the
majority speculates on the possible meanings of this provision and its impact on
coverage, the fact is that § VI.P does not purport to modify or otherwise impact
the coverage provisions of the policy. Indeed, the second paragraph of § VI.P
confirms that the point of the subsection (as indicated by its title) is to specify
“when,” not “how much,” Great American is obligated to pay: “W hen the amount
of loss has finally been determined, we will promptly pay on behalf of the
‘Insured’ the amount of loss falling within the terms of this policy.”
Further, the majority all but overlooks § VI.I of the Great American
policy. 1 That section, entitled “M aintenance of Underlying Insurance,” required
Yaffe to keep the underlying policies listed in the schedule of insurance “in full
force and effect” and to maintain the same coverage restrictions, limits, and terms
and conditions during the life of the umbrella policy. Id. at 99. If, as the
majority effectively concludes, the policy’s “retained limit” is nothing more than
a mathematical liability amount that must be reached before coverage begins, then
why would it have been necessary for Yaffe to maintain any underlying policies
1
The majority complains that “G reat American itself” has not expressly
relied on § VI.I to supports its position. M aj. Op. at 12. That complaint,
however, carries no weight in light of our obligation under O klahoma law to
construe the policy “according to the entirety of its terms and conditions . . . .”
Bituminous Cas. Corp., 55 P.3d at 1033 (internal quotation marks omitted).
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during the life of the Great American policy? The only answer the majority can
muster is that “the actual coverage provided by the ACE policy and the
exhaustion of the limits of that policy affect Great American’s duty (1) to defend
Yaffe,” “and (2) to make payments for appeal bonds, prejudgment interest, and
costs . . . .” M aj. Op. at 12. Again, however, this is a grossly distorted, and
unnecessarily limited, reading of the policy language. In fact, the clear and
undeniable purpose of § VI.I’s maintenance of underlying insurance requirement,
consistent with the Great American policy as a whole, was to ensure that the
policy operated as intended, i.e., as an excess liability policy that provided
coverage only after exhaustion of the applicable limits of the underlying primary
policies maintained by Yaffe.
Finally, the majority effectively ignores the fact that the liability incurred
by Yaffe in this case resulted from the existence of multiple claims, and thus the
application of multiple corresponding deductibles, under the Ace American
policy. Although the majority suggests that the Great American policy can be
reasonably construed to operate as an excess policy to fill gaps in the underlying
insurance, it is clear that the deductible amounts that Yaffe was required to pay
under the Ace American policy cannot reasonably be considered “gaps” in that
policy. Rather, deductibles, “which [are] frequently referred to as self-
insurance,” function “to alter the point at which an insurance company’s
obligation to pay will ripen.” Int’l Bankers Ins. Co. v. Arnone, 552 So.2d 908,
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911 (Fla. 1989); see Beech Aircraft Corp. v. United States, 797 F.2d 920, 922
(10th Cir. 1986) (“If one having an insurable risk retains the risk of his own loss,
there is no risk transfer, and the arrangement is self-insurance.”). In other words,
Yaffe, by agreeing to the unusual deductible scheme set forth in the Ace
American policy, chose (presumably in return for a lower premium on that policy)
to accept the risk that it would be required to self-insure in the event of multiple
claims arising out of an occurrence. As the district court correctly noted, “it is
generally understood that ‘an excess insurer does not reimburse the insured for
the amount of the primary policy deductible,’” App. at 511 (quoting Couch on
Insurance, (3d Ed.), § 220:36), and that “[t]he rationale for not including
deductible payments as part of the limits of the underlying policy [wa]s grounded
in the insured’s decision to, in essence, become self-insured for the deductible
amount as a result of the bargain reached with the primary insurer . . . .” Id. at
511; see also Douglas R. Richmond, Issues and Problems in “Other Insurance,”
M ultiple Insurance, and Self-Insurance, 22 Pepp. L. Rev. 1373, 1399 (1995)
(“The purpose of excess coverage or an umbrella policy is to protect the insured
in the event of catastrophic losses in w hich liability exceeds available primary
coverage. Excess and umbrella policies are intended to expand the amount, but
not the scope of coverage. Therefore, only after the underlying primary policy
has been exhausted will any umbrella policies kick in.”) (internal quotation marks
omitted).
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Considering the Great American policy as a whole, I agree with the district
court that the policy cannot reasonably be construed to provide coverage for the
circumstances alleged in Yaffe’s complaint. Therefore, I agree with the district
court that Great American was entitled to summary judgment in its favor, and I
would affirm the judgment of the district court.
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