FILED
United States Court of Appeals
Tenth Circuit
March 27, 2008
PUBLISH Elisabeth A. Shumaker
Clerk of Court
UNITED STATES COURT OF APPEALS
TENTH CIRCUIT
AMERICAN CASUALTY COMPANY
OF READING PENNSYLVANIA, a
Pennsylvania insurance corporation,
Plaintiff - Appellee,
v. No. 06-6277
HEALTH CARE INDEMNITY, INC.,
a Colorado insurance corporation,
Defendant - Appellant.
APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF OKLAHOMA
(D.C. NO. CIV-05-356-L)
David A. Russell (Leslie C. Weeks with him on the brief), of Rodolf & Todd,
Tulsa, Oklahoma, for Defendant - Appellant
James Robert Hall of Meckler, Bulger & Tilson LLP, Chicago, Illinois, (Michael
M. Marick of Meckler, Bulger & Tilson LLP, Peter L. Wheeler and Larry G.
Cassil, Jr. of Pierce, Couch, Hendrickson, Baysinger & Green, L.L.P., Oklahoma
City, Oklahoma, with him on the brief) for Plaintiff - Appellee.
Before HARTZ and GORSUCH, Circuit Judges, and BRIMMER, * District
Judge.
*
Honorable Clarence A. Brimmer, United States District Judge, District of
Wyoming, sitting by designation.
HARTZ, Circuit Judge.
Mary Pat Rooks, a registered nurse, purchased professional liability
insurance from American Casualty Co. of Reading, Pennsylvania (ACC) with a
policy limit of $1 million per occurrence. She also qualified as an insured under
a policy issued by Health Care Indemnity, Inc. (HCI) to her employer with a limit
of $10 million per occurrence. In May 2004 she was named as a defendant in a
wrongful-death action filed in Oklahoma state court, and she sought coverage
under both policies. This litigation concerns the apportionment of liability
between the two insurers.
That apportionment depends on the nature of the two policies. The
pertinent definitions were provided by the Oklahoma Supreme Court in Equity
Mutual Insurance Co. v. Spring Valley Wholesale Nursery, 747 P.2d 947, 954
(Okla. 1987):
Primary coverage is provided when, under the terms of the policy,
the insurer is liable without regard to any other insurance coverage
available. Excess coverage or secondary coverage is provided when,
under the terms of the policy, the insurer is liable for a loss only
after any primary coverage—other insurance—has been
exhausted. . . . An escape clause, also known as a no liability
clause, disclaims any and all liability if other insurance is available.
(footnotes omitted). The district court held that both policies provided excess
coverage to Ms. Rooks for professional liability, and that the ACC policy did not
have an escape clause. Applying the doctrine of equitable contribution, the court
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ruled that each insurer should pay its pro-rata share of both the underlying loss
and the defense costs. We affirm, agreeing with the court’s characterization of
the policies and the application of equitable contribution.
The ACC policy’s “Coverage Agreement” is what would be expected for
primary coverage. It states:
We will pay all amounts up to the limit of liability which you
become legally obligated to pay as a result of injury or damage. In
addition to the limit of liability, we will also pay claim expenses.
The injury or damage must be caused by a medical incident arising
out of the supplying of, or failure to supply, professional services
by you, or by anyone for whose professional acts or omissions you
are legally responsible.
R. Vol. 1 at 32. The relevant “Limit of Liability” provision also reads as it would
in a primary policy:
Each Claim
The limit of liability stated on the certificate of insurance for each
claim is the limit of our liability for all injury or damage arising out
of, or in connection with, the same or related medical incident.
Id. at 37. So does the “Defense and Settlement” clause:
We have the right and will defend any claim. We will:
A. do this even if any of the charges of the claim are groundless,
false or fraudulent; and
B. investigate and settle any claim, as we feel appropriate.
Our payment of the limit of liability ends our duty to defend or
settle. We have no duty to defend any claims not covered by this
policy.
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Id. at 34. The “Other Insurance” clause, however, which precedes the above
policy provisions, limits coverage when other insurance applies:
Any loss resulting from any claim insured under any other insurance
policy or risk transfer instrument, including but not limited to, self-
insured retentions, deductibles, or other alternative arrangements,
which applies to this loss, shall be paid first by those instruments,
policies or other arrangements. This insurance will not serve as
primary insurance where there is other applicable insurance. It is the
intent of this policy to apply only to loss which is more than the total
limit of all deductibles, limits of liability, self-insured amounts or
other valid and collectible insurance or risk transfer arrangements,
whether primary, contributory, excess, contingent, or otherwise.
This insurance will not contribute with any other applicable
insurance. In no event will we pay more than our limit of liability.
These provisions do not apply to other insurance policies or risk
transfer arrangements written as specific excess insurance over the
limits of liability of this policy.
Id. at 27.
The HCI policy’s “Insuring Agreements,” like ACC’s “Coverage
Agreement,” suggests primary coverage:
[HCI] will pay on behalf of the insured all sums which the insured
shall become legally obligated to pay as damages because of . . .
Injury . . . to which the Policy applies, caused by an occurrence [that
is, an act or omission arising out of the provision of health care
services] during the policy period.
R. Vol. 2 at 242; see id. at 252–53 (defining occurrence). The provision also
states that HCI “shall have the right and duty to defend any suit against the
insured seeking such damages even if any of the allegations of the suit are
groundless, false, or fraudulent.” Id. at 242. Unlike ACC’s limit-of-liability
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provision, however, the HCI “Limits of Liability” section includes language
limiting coverage when there is other insurance:
[I]n any state or country where there exists a state fund or where
other primary insurance has been purchased for purpose of providing
compensation for patient injury and for which application has been
made and for which coverage is included in this policy, the limits of
liability shall apply excess over any other valid and collectible
insurance.
Id. at 248. The policy’s “Other Insurance” clause repeats the point:
If other insurance not afforded by the Company is available to any
insured covering an occurrence also covered hereunder, the
insurance afforded hereunder shall be excess of and not contribute
with such other insurance. Amounts collectible under a self-insured
trust plan or any other self-insured program are other insurance for
the purposes of this policy. This Article VI, Paragraph 7, does not
apply to excess insurance written specifically to be in excess of this
policy. Nothing contained herein shall be construed to make this
policy subject to terms, conditions, and limitations of any other
insurance.
Id. at 255.
ACC and HCI disagreed about their respective obligations under their
policies. ACC filed a declaratory-judgment action in the United States District
Court for the Western District of Oklahoma, claiming that the loss and expenses
should be split between ACC and HCI on a pro-rata basis. HCI responded (1) that
it provided excess coverage only; (2) that the ACC policy, whose other-insurance
clause was an “escape” clause rather than an excess-insurance clause, provided
primary coverage; and (3) that therefore ACC was not entitled to a pro-rata
contribution from HCI.
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On cross-motions for summary judgment, the district court concluded that
both policies provided excess coverage, that the other-insurance clauses in the
policies were irreconcilable, and that the indemnity payments and defense costs
must therefore “‘be shared on a pro rata basis according to the ratio each
respective policy limit bears to the cumulative limit of all concurrent
policies’”—that is, HCI is liable for 10/11 of defense costs and indemnity
payments and ACC is liable for the remaining 1/11. Id. at 309–310 (quoting
Equity Mutual, 747 P.2d at 954). HCI appeals.
I. DISCUSSION
We review de novo the district court’s grant of summary judgment,
applying the same legal standard that the district court was required to use. See
Carpenter v. Boeing Co., 456 F.3d 1183, 1192 (10th Cir. 2006). Summary
judgment is appropriate only “if the pleadings, depositions, answers to
interrogatories, and admissions on file, together with the affidavits, if any, show
that 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). The parties
agree that their dispute is governed by the substantive law of Oklahoma. See
Stickley v. State Farm Mut. Auto. Ins. Co., 505 F.3d 1070, 1076 (10th Cir. 2007).
A. Proration of Liability
If two policies cover the same risk for the same insured, but neither
provides primary coverage, “an excess clause controls over . . . an escape clause .
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. . and . . . conflicting ‘other insurance’ clauses cancel each other,” Equity
Mutual, 747 P.2d at 950, with the “loss shared by the insurers on a pro rata
basis,” id. at 954.
The district court interpreted both the HCI and ACC policies as providing
only excess coverage. There is no dispute on appeal that this is a proper
description of the HCI policy. But HCI challenges that description of the ACC
policy. It contends that ACC’s policy was a primary policy. It argues that unlike
its policy, the only language in ACC’s policy that limits coverage when another
policy applies is language “buried” in its other-insurance clause. Aplt. Br. at 11.
Alternatively, it argues that the limiting language in the ACC policy is an escape
clause. Following Oklahoma law regarding construction of insurance policies, we
disagree.
“An insurance policy is to be treated as a contract and will be enforced
according to its terms.” Equity Mutual, 747 P.2d at 953. Under Oklahoma law,
“‘[t]he whole of a contract is to be taken together, so as to give effect to every
part, if reasonably practicable, each clause helping to interpret the others.’”
Dodson v. St. Paul Ins. Co., 812 P.2d 372, 377 n.11 (Okla. 1991) (quoting Okla.
Stat. tit. 15 § 157). Accordingly, when determining a policy’s scope of coverage,
we interpret the policy as a whole. See id.
Applying these propositions to the ACC policy, we agree with the district
court. The policy’s other-insurance clause states that any loss “shall be paid
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first” by other policies that apply to the loss, that it “will not serve as primary
insurance where there is other applicable insurance,” and that it will “apply only
to loss which is more than the total limit of” those other policies, R. Vol. 1 at 27.
Nothing stated elsewhere in the policy suggests otherwise. A policy need not use
the word excess to be an excess policy. The definition of excess coverage in
Equity Mutual does not itself use the word excess, see 747 P.2d at 954; it looks to
the substance of the policy language, not whether any particular “magic word” is
used. To be sure, the other-insurance clause states that it does “not apply to other
insurance policies . . . written as specific excess insurance over the limits of
liability of this policy.” R. Vol. 1 at 27. But the HCI policy is not so written; it
makes no mention of the ACC policy. HCI’s limits-of-liability provision states
only that “where other primary insurance has been purchased . . . , the limits of
liability shall apply excess over any other valid and collectible insurance,” R.
Vol. 2 at 248; and its other-insurance clause states only that “[i]f other insurance
not afforded by [HCI] is available to any insured covering an occurrence also
covered hereunder, the insurance afforded hereunder shall be excess of and not
contribute with such other insurance.” Id. at 255. Although the first quoted
language appears in a limits-of-liability provision rather than an other-insurance
clause, we fail to see how the position of that language causes the HCI language
to prevail over the ACC language. Read as a whole, the two policies are
essentially identical with respect to priority of coverage.
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We also are not persuaded by HCI’s contention that ACC’s other-insurance
clause is an escape clause—that is, that it “disclaims any and all liability if other
insurance is available.” Equity Mutual, 747 P.2d at 954; see id. (if one policy has
excess coverage and a second has an escape clause, the first is excess over the
second). HCI contends that the clause imposes so many conditions that it is
effectively an escape clause. We disagree. The ACC policy does not “disclaim
any and all liability,” id.; nor does it accomplish that result indirectly. Like the
HCI policy, it provides coverage once the coverage of other policies has been
exhausted. Both policies provide real, not illusory, coverage even when there
may be other coverage. Neither policy has language comparable to what we
construed as creating escape clauses in State Farm Mutual Automobile Insurance
Co. v. Mid-Continent Casualty Co., 518 F.2d 292, 297 (10th Cir. 1979) (insurance
“‘shall not apply to any liability or loss against which the insured . . . has other
collectible insurance applicable thereto, in whole or in part’”; “‘insurance shall
not apply to the rentee if other valid and collectible automobile liability
insurance, either primary or excess, is available.’”).
In sum, both policies provide excess coverage. Accordingly, the other-
insurance clauses must be “disregarded, with the loss shared by the insurers on a
pro rata basis.” Equity Mutual, 747 P.2d at 954. Under Oklahoma law the
apportionment is determined “according to the ratio each respective policy limit
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bears to the cumulative limit of all concurrent policies.” Id. HCI does not
dispute that it must pay 10/11 of the loss if both policies provide excess coverage.
B. Proration of Defense Costs
The district court found that both ACC and HCI had contributed to
Ms. Rooks’s defense costs and attorney fees—ACC had spent $134,578.43 and
HCI $353,001.71. Recognizing that ACC had paid more than 3/11 of the total,
the court entered a judgment for ACC in the amount of $90,252.96, so that the net
payments by the parties would be in the same ratio as their liability limits.
HCI asserts that the district court erred in awarding the $90,252.96
judgment. It contends that each insurer must bear its own defense costs and
attorney fees because the doctrine of equitable contribution does not apply to
defense costs. “According to Oklahoma law,” it argues, “one insurance company
cannot require another to pay defense costs and fees unless there is a specific
contractual right as between the two insurance companies.” Aplt. Br. at 34.
Controlling precedent of this court, however, compels us to disagree. In St.
Paul Mercury Insurance Co. v. Underwriters at Lloyds of London, England, 365
F.2d 659, 662 (10th Cir. 1966), a diversity-case appeal from the Western District
of Oklahoma, we applied the doctrine of equitable contribution to apportion
defense costs and attorney fees when, as here, two policies insured the same
person for the same risk at the same level of coverage. John Bennett had been
involved in an accident while driving a vehicle owned by his employer. Liberty
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Mutual Insurance Company issued a policy to the employer that provided primary
coverage to both the employer and Bennett. The two parties on appeal provided
excess coverage: The St. Paul policy was issued to Bennett, but provided only
excess if he was driving a nonowned car and other insurance covered the loss; the
Lloyds policy (issued to the employer) covered the employer and Bennett, but
only for loss above the primary-insurance coverage. As the primary insurer,
Liberty Mutual defended the initial lawsuit and paid its policy limit in partial
satisfaction of a judgment against Bennett. St. Paul contributed to the judgment
and spent more than $20,000 defending later lawsuits against Bennett and settling
those claims. When Lloyds refused to pay anything, St. Paul sued for
contribution. We examined the policies and concluded: “Both [St. Paul and
Lloyds] undertook to provide excess coverage, and both were on an equal basis
once the primary coverage was exhausted. There is no reason to distinguish
between them.” Id. at 662. Accordingly, we prorated the excess loss between the
two insurers. Id. at 663. “The costs and expenses of defense,” we added, “must
likewise be prorated.” Id.; see also 14 Steven Plitt, et al., Couch on Insurance
§ 200:35 (3d ed. 2007) (“where two or more primary insurers’ policies contain
‘other insurance’ clauses purporting to make respective policy excess to the other,
the conflicting clauses will be ignored and the [defense costs] prorated among the
insurers on the ground the insured would otherwise be deprived of protection.”).
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HCI relies on two Tenth Circuit cases for the proposition that defense costs
cannot be apportioned. But in neither case did the two insurance policies cover
the same insured at the same level for the same risk. In United States Fidelity &
Guaranty Co. v. Tri-State Insurance Co., 285 F.2d 579, 582 (10th Cir. 1960), we
considered the respective defense obligations of two insurers that provided the
same insured different levels of coverage for the same risk and held that neither
was “entitled to divide the duty [to defend] nor require contribution from another
absent a specific contractual right.” The dispute arose out of an automobile
accident involving a truck owned by one Barsh and used by Kerr Glass Company
to make shipments. Tri-State Insurance Company provided primary coverage to
Barsh and “any person or organization legally responsible for the use (of the
truck), provided the actual use . . . is by the named insured or with his permission
. . . .” Id. at 580 (internal quotation marks omitted). It was not disputed that Kerr
was an additional insured under the policy. United States Fidelity and Guaranty
(USF&G), on the other hand, insured Kerr, but provided only excess coverage
“with respect to loss arising out of the use of any non-owned automobile . . . .”
Id. at 581. Unlike the insurers in St. Paul, USF&G and Tri-State were not on
equal footing; one provided primary coverage and the other was an excess insurer.
Likewise, in West American Insurance Co. v. Allstate Insurance Co., 295
F.2d 513 (10th Cir. 1961), the two insurers provided the same insured different
coverage for the same risk. John Fender wrecked a vehicle borrowed from
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Lawrence Blevins. West American issued Blevins a policy providing primary
coverage for him and “any other person using such automobile, provided the
actual use . . . is with the permission of the named insured.” Id. at 513–14
(internal quotation marks omitted). Allstate, in contrast, provided excess
coverage. It protected Fender’s family, except that “[w]ith respect to the use of
a . . . non-owned automobile Allstate limited its liability to excess insurance over
any other collectible insurance.” Id. at 514 (internal quotation marks omitted).
HCI also relies on authority from Oklahoma state courts. We are, of
course, bound by declarations of state law in decisions of the state’s highest
court. See TMJ Implants, Inc. v. Aetna, Inc., 498 F.3d 1175, 1181 (10th Cir.
2007). But we find no such holding contrary to St. Paul.
The most recent opinion cited by HCI, United Services Automobile Ass’n v.
State Farm Fire & Casualty Co., 110 P.3d 570 (Okla. Civ. App. 2004) (USAA),
would appear to support its position. The court in that case refused to apportion
defense costs between two insurers. Although the opinion acknowledged that the
Oklahoma Supreme Court in United States Fidelity & Guaranty Co. v. Federated
Rural Electric Insurance Corp., 37 P.3d 828, 832 (Okla. 2001), recognized that
the doctrine of equitable contribution generally applies when insurers cover the
same insured for the same risk at the same level of coverage, it went on to say:
However, in that case, the Supreme Court did not make a
determination that the doctrine of equitable contribution is the law in
Oklahoma. The law in Oklahoma is set forth in Fidelity & Casualty
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Co. of New York v. Ohio Casualty Insurance Company, [482 P.2d
924 (Okla. 1971)], wherein the Supreme Court held the duty of an
insurance company to defend lawsuits against the insured is personal
to each insurer, and that insurer is not entitled to divide the duty nor
require contribution from another insurer, absent a specific
contractual right.
USAA, 110 P.3d at 573.
For two reasons we do not follow USAA. First, a decision by a state
intermediate appellate court is not binding on us with respect to matters of state
law, see Occusafe, Inc. v. EG&G Rocky Flats, Inc., 54 F.3d 618, 622 n.1 (10th
Cir. 1995), and a panel of this court cannot overturn one of our precedents on
such authority, see Wankier v. Crown Equipment Corp., 353 F.3d 862, 866 (10th
Cir. 2003) (“when a panel of this Court has rendered a decision interpreting state
law, that interpretation is binding on . . . subsequent panels of this Court, unless
an intervening decision of the state’s highest court has resolved the issue.”
(emphasis added)).
Second, with respect to the issue before us, USAA is unpersuasive. Fidelity
& Casualty, 482 P.2d 924, on which USAA relied, considered a dispute between
insurers who covered different insureds—a contractor and its subcontractor.
Thus, it did not produce a holding regarding the propriety of equitable
contribution between two insurers who cover the same insured for the same risk at
the same level of coverage. And as for USAA’s treatment of Federated Rural, 37
P.3d 828, we do not think that the Oklahoma Supreme Court’s discussion of
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equitable contribution can be dismissed as lightly as the USAA opinion did. To be
sure, the discussion of equitable contribution was dictum because the holding was
that equitable subrogation does not apply between a primary and an excess
insurer before exhaustion of the primary-policy limits. But if it had been settled
law in Oklahoma that the doctrine of equitable contribution never applies, the
Federated Rural discussion of the matter seems peculiar. Nowhere in the opinion
does the Oklahoma Supreme Court express any discomfort with, much less
criticism of, the doctrine. On the contrary, the opinion appears to endorse the
“equitable principle[] underlying [its] . . . public polic[y].” Id. at 832. As it
describes that policy, “The aim of equitable contribution is to apportion a loss
between two or more insurers who cover the same risk so that each pays his fair
share of a common obligation, and one co-insurer does not profit at the expense
of the others.” Id. Contrary to the view of the USAA opinion, we would read the
following as a statement of Oklahoma law:
Equitable contribution is the right to recover, not from a party
primarily liable for the loss, but from a co-obligor or co-insurer who
shares common liability with the party seeking contribution. The
doctrine applies only when co-insurers have covered the same
insured and the same particular risk at the same level of coverage.
The right of contribution is not derivative of the rights of the insured,
but belongs to each insurer independently to seek reimbursement
from a co-insurer those sums which were paid in excess of an
insurer’s proportionate share of the common obligation.
Id. At the least, we do not read the Oklahoma Supreme Court’s decision as
undermining this court’s otherwise controlling precedent in St. Paul.
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Both ACC and HCI insured Ms. Rooks for the same risk at the same level
of coverage. Accordingly, we conclude that the district court properly applied the
doctrine of equitable contribution to apportion defense costs.
II. CONCLUSION
We AFFIRM the district court’s judgment.
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