[PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR TH E ELEV ENTH C IRCUIT FILED
________________________
U.S. COURT OF APPEALS
ELEVENTH CIRCUIT
No. 02-16511 October 28, 2003
________________________ THOMAS K. KAHN
CLERK
D. C. Docket No. 01-01058-CV-ORL-28
CAS T ST EEL PRO DUC TS, IN C.,
Plaintiff- Appe llant,
versus
ADM IRAL INSU RAN CE C OM PAN Y,
Defen dant-A ppellee.
________________________
Appeal from the United States District Court
for the Middle District of Florida
_________________________
(October 28, 2003)
Before BLACK and FAY, Circuit Judges, and JORDAN*, District Judge.
FAY, Circuit Judge:
*
Honorable Adalberto J. Jordan, United States District Judge for the Southern District of
Florida, sitting by designation.
Cast Steel Products, Inc. (“Cast Steel”) appeals an adverse summary
judgmen t granted to A dmiral Insur ance Com pany (“Ad miral”) on C ast Steel’s
action for a declaration that either (or both) of its 1999 and 2000 “claims-made”
professional liability policies with Admiral covered a defective product claim that
accrued at the conclusion of the 1999 policy period but was not reported until the
start of the 2000 policy period. The district court found that neither policy
provided coverage for the claim because the claim had not both accrued and been
reported to Admiral during the same policy period. Cast Steel argues on appeal
that the 1999 Professional Liability Policy (“99 Policy”) is ambiguous with respect
to coverage of the 1999 claim u pon renewal of the 99 Policy in 2000. Specifically,
Cast Steel contends that because the 99 Policy automatically extends the claims
reporting period upon cancellation or non-renewal of the po licy, but is sile nt as to
whether renewal of the policy would provide the same reporting extension, an
unresolved ambiguity exists in the policy that precluded the district court from
granting summ ary judg ment.
We agree that the 99 Po licy is ambiguous. We further find that, because
under Florida law an ambiguity in an insurance policy must be construed in favor
of the insured so as not to deny coverage, summary judgment should have been
granted to Cast S teel. Swire Pacific Holdings, Inc. v. Zurich Ins., Co., 845 So. 2d
2
161, 165 (Fla. 2003). Accordingly, we REVERS E the district court’s order
granting summary judgment in Admiral’s favor, and REMAND to the district court
with instruction to enter summary judgment in Cast Steel’s favor as to the 99
Policy.
I.
Cast Steel is a Florida corporation in the business of supplying castings and
components to the mining and waste energy industries. In early 1999, it purchased
professional liability insurance from Admiral, a surplus lines insurer headquartered
in Delaware, through Admiral’s designated surplus lines broker in the state of
Florida , Gary M arkel. 1 The 99 Policy had a retroactive effective date of January 6,
1999 and an expiration date of January 6, 2000, at 12:01 a.m. Cast Steel
subseq uently ren ewed th e 99 Po licy, and th e renew al policy h ad an eff ective date
of January 6, 2000, and expiration date of January 6, 2001 (“00 Policy”).2 Both
policies, by their terms, were “claims-made” policies, which meant that each policy
1
Cast Steel actually purchased the 99 Policy through Ayers/Sierra, a local insurance
broker. Because Ayers/Sierra was not in the business of selling surplus lines insurance, it sought
out Markel, a surplus lines agent for Admiral’s products in Florida.
2
Cast Steel also purchased a commercial general liability policy from Admiral in early
1999 (the “CGL Policy”), and it sought declaratory relief under that policy as well. The district
court ultimately determined that the CGL Policy, by its plain language, did not cover the claim at
issue. Cast Steel does not challenge that finding on appeal. Thus, in order to avoid confusion,
we focus only on the professional liability policies (which we refer to as the “99 Policy” and “00
Policy”) in this opinion.
3
purported to cover only those claims which had both accrued and were re ported to
Adm iral durin g the policy period indicated on the fa ce of the p olicy.
Sometime in early 1999, Cast Steel was awarded a contract to provide 130
pallet cars to Hibbing Taconite (“Hibbing”), an iron ore mine located in Hibbing,
Minn esota, for the purc hase pric e of $5.5 million. C ast Steel d elivered th e cars in
June 1999. Soon thereafter, in August 1999, Hibbing reported significant
problems with the wheels of the cars, which, after some investigation, Cast Steel
determined to be caused by defective design of the bearings. On October 21, 1999,
Hibbin g prepa red an in cident rep ort and f ormally r eported its claim to C ast Steel.
Cast Steel immediately advised Ayers/Sierra of the Hibbing claim and asked that
the proper claim paperwork be prepared. In an unfortunate twist of fate,
Ayers/Sierra failed to submit the Hibbing claim to Admiral until January 6, 2000 –
just hours after the 99 Policy had expired.
On February 10, 2000, Admiral sent Cast Steel a reservation of rights letter
and began investigating the Hibbing claim.3 After four months of investigation by
an independent claims adjuster, Admiral sent Cast Steel a letter denying coverage
3
Admiral sent the reservation of rights letter only as to the CGL Policy, and Cast Steel
argues that, as a result, Admiral never reserved its right to deny coverage under the 99 or 00
Policies. We find this argument unavailing, however, because Cast Steel only made a claim
under the CGL Policy, and Admiral took it upon itself to determine whether any of Cast Steel’s
three policies provided coverage.
4
under a ll policies.
This suit followed on July 25, 2001. Cast Steel originally brought the action
in Florid a state cou rt, seeking , inter alia, a declaration that at least one of the
various policies obligated Admiral to cover the Hibbing claim. Admiral removed
the action to the Middle District of Florida on diversity grounds and, in July 2002,
Cast Steel moved for summary judgment on the 99 Policy. Admiral’s own
summary judgment motion followed. On October 24, 2002, the district court
entertaine d oral arg ument a nd in N ovemb er grante d summ ary judgment to
Adm iral, findin g that no ne of the policies p rovided coverag e to Cast S teel.
Specific ally, the distr ict court d etermine d that Ca st Steel faile d to com ply
with the 99 Po licy’s notice requirem ent wh en it failed to report th e Hibb ing claim
during the 99 Policy period. As to the 00 Policy, the court held that because the
Hibbing claim accrued during 1999, and Cast Steel was undisputedly aware of the
claim when it renewed the policy, the plain language of the 00 Policy precluded
coverage.4 With re spect to C ast Steel’s a rgume nt that A dmiral w as on no tice of its
claim because Admiral (or Admiral’s surplus lines broker Markel) cloaked
Ayers/Sierra with apparent authority to receive claims on Admiral’s behalf, the
4
Section II(B)(2)(a) of the 00 Policy indicates claims arising prior to the effective date of
the policy are covered only if the insured had no knowledge of the claim as of the date of signing
the application for the policy.
5
district cou rt found that Cast S teel failed to show that Ad miral eve r represe nted to
Cast Steel that Ayers/Sierra was its agent in this regard and, moreover, the record
showed that Ayers/Sierra itself adamantly denied being Admiral’s agent or ever
making a represe ntation to Cast Ste el that it wa s Adm iral’s agen t.
Cast Steel asserts on appeal that the district court erred in granting summary
judgment to Admiral because issues of fact remained as to whether Ayers/Sierra
was cloaked with app arent authority to receive claims on behalf of Ad miral. Cast
Steel also argues that an unresolved ambiguity as to whether renewal of the 99
Policy extended the period in which it could report claims precluded summary
judgment on Admiral’s behalf.
II.
We review a district court’s granting of a motion for summary judgment de
novo, applying the same legal stand ards use d by the d istrict cour t. Hilburn v.
Murata Elecs. N. Am., Inc., 181 F.3d 1220, 1225 (11th Cir. 1999). We “view the
evidence and all factual inferences therefrom in the light most favorable to the
party opposing the motion.” Burton v. City of Belle Glade, 178 F.3d 1175, 1187
(11th Cir. 1999) (quoting Clemo ns v. Do ugherty Coun ty, 684 F.2d 1365, 1368
(11th Cir. 1982)). Denial of summary judgment is also reviewed de novo. Weeks
v. Harden Mfg. Corp., 291 F .3d 130 7, 1311 (11th C ir. 2002 ).
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III.
The district court’s decision presents a somewhat alarming scenario. Faced
with two consecutive insurance policies that created apparently seamless coverage
over tw o policy p eriods, th e court n everthele ss foun d that a claim accruing within
the two periods was somehow not covered by either policy. On the face of the 99
and 00 Policies, there appears to be no gap in coverage. Indeed, the 99 Policy was
effective u ntil 12:01 a.m. on J anuary 6 , 2000, a nd the 0 0 Policy was retr oactively
effective beginning on January 6, 2000 (presumably at 12:01 a.m.). At a glance,
one would be hard pressed to imagine how a claim accruing in the middle of the
two policy periods would not be covered by one of the policies. But because a
claims-made policy is designed to cover only claims both accruing and reported
during the specified policy period, the district court held that a claim which
accrued late in the first policy period but was not reported until early in the second
was co vered b y neither p olicy.
Cast Steel challenges the district court’s conclusion, and argues that because
the 99 Policy automatically extends (by thirty days) the period in which to report
1999 claims if the insured elects to cancel or non-renew the policy, there remains
an amb iguity as to wheth er renew al provid es a similar reportin g extens ion.
Subsection B of the “Extended Discovery Period” provision (Section IV) of the 99
7
Policy provides as follows:
If the policy is cancelled or not renewed by the Named
Insured an automatic thirty (30) day Claims Extension
Period shall apply to claims, provided such claims are not
covered under any subsequent insurance purchased by
the Named Insured, or that would be covered but for the
exhaustion of the amount of insurance applicable to such
claims.
99 Policy, Sect. IV (B). Cast Steel chose neither of the two options above, but
rather renewed the 99 Policy in the following year. Neither this section, nor any
section of the 99 Policy, however, discusses whether a similar reporting extension
accompanies renewal of the policy. Accordingly, Admiral counters that the
policy’s silence can only mean that the same reporting extension does not
accomp any rene wal.
The district court, siding with Admiral, did not find any ambiguity in the 99
Policy. Granting summary judgment in Admiral’s favor, the district court relied on
the Southern District of Florida’s 2001 Pantro pic decision in finding that renewal
of the 99 Policy d id not ex tend the tim e in wh ich Cast S teel could report its c laim.
Pantropic Power Prods., Inc. v. Firemen’s Fund Ins. Co., 141 F. Supp. 2d 1366
(S.D. Fla. 2001). In Pantro pic, which was affirmed by this Court in an
unpublished per curiam opinion, the plaintiff offered, and the district court
rejected, the identical argument to Cast Steel’s here. The court in Pantro pic, in
8
granting insurer’s motion for summary judgment, explained that because an insurer
undertakes a more limited risk in a claims-made policy, it typically charges a lower
premiu m. Id. at 1369. In exchange, the insured is only permitted to make and
report a claim during a narrow window of time. Significantly, in the policy at issue
in Pantro pic, that time included the expressed policy period plus a 60-day grace
period. Id at 1370. Because the Pantro pic plaintiff submitted its claim 16 days
after the 6 0-day g race perio d expire d, it was n ot entitled to coverag e even th ough it
had ren ewed its policy fo r consec utive year s with in surer. Id. at 1369–70.5
This Court was able to identify only one case in which a court, when faced
with a nearly-identical factual scenario, found in favor of the insured. In Helberg,
the Sixth District of Ohio determined that a claim accruing during Year 1 of a
claims-made policy, but not reported until the Year 2 policy period (which, like
here, was a renewal of Year 1), was covered by the Year 1 policy pursuant to the
5
This particular scenario has only been addressed by a few other district courts. In
Ehrgood, the court reached the same conclusion as the Southern District in Pantropic. Ehrgood
v. Coregis Ins. Co., 59 F. Supp. 2d 438 (M.D. Pa. 1998). However, in Ehrgood, as in Pantropic,
the Year 1 policy provided the insured a 60-day grace period in which to report claims accruing
during the first policy period, and insured reported its claim outside this window. Id. at 447.
The insurer prevailed in Checkrite as well, but the court noted that even if it were to give the
insured the benefit of the additional 60- or 90-day grace period contemplated by New York
insurance law, the insured reported its claim far outside this time frame. Checkrite Ltd., Inc. v.
Illinois Nat’l Ins. Co., 95 F. Supp. 2d 180, 191–194 & n.9 (S.D.N.Y. 2000); see also Westport
Ins. Corp. v. Mirsky, No. CIV A. 00-4367, 2002 WL 31018554, at *11 (E.D. Pa. Sept. 10, 2002)
(district court reached the same conclusion but was not faced with the extended reporting
provision present in this matter).
9
(albeit ambiguous) reporting extension clause contained therein. Helberg v. Nat’l
Union Fire Ins. Co., 657 N.E.2d 832, 833–35 (Ohio Ct. App . 1995).
Plaintiff in Helberg, an attorney, initiated litigation against his malpractice
insurer (“National”), when National refused to indemnify him in a malpractice
action br ought b y a form er client. Id. at 833. Plaintiff was undisputedly aware of
the claim a gainst him on Oc tober 21 , 1991, b ut failed to report th e claim to
National until January 21, 1992. His 1991 claims-made policy provided coverage
from D ecembe r 11, 19 90, to D ecembe r 11, 19 91 – thu s he did n ot repor t his claim
to Natio nal until six weeks after the co nclusion of the 19 99 cov erage pe riod.
However, plaintiff purchased a renewal of his 1999 policy, which had a retroactive
effective date of December 11, 1991, and therefore believed that he was covered by
malprac tice insura nce at all tim es with N ational. Id. National denied coverage,
asserting that the 1991 claim was not covered because it was not reported during
the 199 1 policy p eriod. Id.
The court, recognizing that a claims-made policy requires that notice of
action against the insured must be presented to the insurer within the designated
time period of the policy, nonetheless found that plaintiff’s claim was covered by
the 199 1 policy. F inding s uppor t in the po licy’s exten ded rep orting en dorsem ent,
the court explained:
10
In the present case, there was no cancellation of
coverag e, nor did the insur ed chan ge insur ance carr iers.
The ins ured m erely rene wed h is claims-m ade polic y.
Such a n event sh ould no t precipita te a trap w herein
claims spanning the renewal are denied.
Id. at 834 (emphasis added). The policy at issue in Helber g, like the policy in our
case, did not provide the insured with a grace-period after expiration of the policy
to report claims. Cf. Pan tropic, 141 F. Supp. 2d at 1369. But – and again similar
to the 99 Policy here – the Helberg policy’s ex tended r eporting clause set o ut only
two circ umstan ces wh en purc hase of a reportin g extens ion wa s necessa ry to
maintain coverag e – upo n cancella tion or n on-ren ewal. 6 Helberg, 657 N.E.2d at
835. The Ohio court continued:
Applying the time-honored maxim of construction,
expressio unius est exclusio alterius, the inclusion of
specific things implies the exclusion of those not
mentioned, this court can only conclude that the inclusion
of “non-renewal” of the p olicy as one of those
circumstances demanding the purchase of an extended
reporting endorsement exclud es a “renewal” as a
circumstance which demands such a purchase. Since
appellant’s position here was a renewal rather than a
“non-renewal” or “cancellation,” this court concludes
that the language of the contract does not deny coverage
in this con text.
Id. at 835.
6
Note that in Helberg the insured was entitled to purchase a reporting extension pursuant
to the extended reporting clause. Here, the extension was automatic upon non-renewal or
cancellation.
11
We concur with the reasoning set forth in Helberg. Though we are
sympathetic to the rationale of Pantro pic, and would generally agree that the lower
premium charged for a claims-made policy should entitle an insured to lesser
coverag e than a b roader, a nd mo re expen sive, occu rrence p olicy, we find it bo th
illogical an d inequ itable to de ny cove rage to th e insured who c hooses to renew its
claims-made policy for successive years with the same insurer – particularly in the
scenario we are faced with here. Cast Steel’s claim was reported to Admiral mere
hours after the expiration of the 99 Policy, and during a time period in which the
00 Policy had become effective. As the Helberg court noted, if choosing to cancel
or non -renew provid ed the ins ured w ith an exte nded re porting period, e lecting to
continue to do business with the same insurer by renewing the claims-made policy
certainly “should not precipitate a trap wherein claims spanning the renewal are
denied.” Helberg, 657 N.E.2d at 834.7
It seems to us that the most reasonable interpretation of the extended
reporting clause is that it automatically extends the reporting period through
7
It is also worth noting that Admiral, unlike the insurer in Pantropic, concedes that the 00
Policy was a renewal of the 99 Policy. Thus, the Pantropic court’s reason for rejecting the logic
of Helberg – that is, because the policy at issue in Helberg specifically contemplated continuous
renewal – is not availing here. Admiral does not contend, as the insurer in Pantropic did, that
the 00 Policy was a separate and distinct policy rather than a renewal of the 99 Policy. Indeed,
Admiral refers to the 00 Policy as a “renewal policy” throughout its briefs.
12
renew al. The cla use is clear ly ambig uous o n this po int. 8 Accordingly, because we
find a clear mandate in Florida law to construct a contract of insurance in favor of
the insured and strictly against the drafter, we hold that the ambiguity in the 99
Policy must be resolved so as not to deny coverage. Swire Pacific Holdings, 845
So. 2d at 165. We find that Cast Steel’s renewal of the 99 Policy in 2000 extended
the time in which to repor t the Hib bing claim . As Ca st Steel rep orted the claim
immed iately after th e expiratio n of the 9 9 Policy , the district c ourt erre d whe n it
denied coverage.9
III.
Finally, Cast Steel challenges the district court’s failure to require Admiral
to refun d Cast S teel a $25 00 ded uctible w hich A dmiral co llected un der the p olicy.
Althou gh the d istrict cour t determin ed the de ductible w as impro perly billed , it did
not award Cast Steel damages in this amount. However, because we find that the
99 Policy covers the Hibbing claim, a logical outcropping of our decision is that
8
Counsel for Admiral has been unable to explain what the reporting period would be for
claims accruing on the last day, or within a very short period, of the conclusion of the policy
period. Again, unlike the policy in Pantropic, the policy in question provides for no grace
period following its expiration for reporting claims.
9
In view of our holding it is not necessary for us to discuss the issue of whether or not
there existed genuine issues of material fact on the question of agency. However, for the sake of
completeness we state that a review of the record convinces us that such do exist. Based upon
the evidence in this record a jury could conclude that Admiral cloaked Ayers/Sierra with the
apparent authority to receive claims on its behalf.
13
Cast Steel would have been required to pay Admiral the deductible under the
policy. Accordingly, Cast Steel is not entitled to a refund of the deductible.
IV.
For the above r easons, w e reverse the district c ourt’s de cision an d reman d to
the district court with instruction to enter summary judgment in Cast Steel’s favor
on the 99 Policy.
REVE RSED and REM AND ED with instructions.
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