MEC&F Expert Engineers

Friday, December 15, 2017

Altman Contractors, Inc. v. Crum & Forster Specialty Ins. Co., No. 15-12816: The Florida Supreme Court ruled Thursday that a proceeding for resolving construction defect disputes prior to litigation constitutes a "suit" that may trigger a general liability insurer's duty to defend a policyholder, provided that the insurance company consents to the insured's participating in the process.


Defect Notice May Trigger Defense Coverage: Fla. Justices


 The Florida Supreme Court ruled Thursday that a proceeding for resolving construction defect disputes prior to litigation constitutes a "suit" that may trigger a general liability insurer's duty to defend a policyholder, provided that the insurance company consents to the insured's participating in the process.

Altman Contractors Inc. is challenging a Florida federal court ruling that Crum & Forster Specialty Insurance Co. need not cover the general contractor's costs to defend against a slew of notices issued under the Florida Statutes' Chapter 558.

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2017 CLM & Business Insurance Construction Conference
October 9-11, 2017 San Diego, CA
THERE’S NOTHING WRONG WITH THE CONSTRUCTION, BUT IT’S STILL YOUR FAULT!
The following discussion focuses on recent legal developments in Florida and overcoming challenges to claim resolution in a comparative fault state while navigating contractual indemnity and additional insured risk amid anti-indemnity and anti-contribution legislation. The advanced roundtable panelists will discuss recent legal developments and trends pertaining to claim resolution from the varying perspectives of the developer, general contractor, subcontractors and insurance industry. This diverse, often adverse, group will share their insights regarding what is working in defense and pursuit of these claims as well as strategies to resolve claims of both named and additional insureds, including avoiding pitfalls in partial or “late” resolution. The speakers will share their ideas leading to successful pre-suit resolution, the woes and wins of assignment of claims and debate the pros and cons of traditional litigation versus alternative dispute resolution.


I. Parties are often forced to pursue and defend cases before facts are developed


For General Contractors and subcontractors who do not self-perform all work, risk transfer evaluation must happen immediately, even if it appears claim is weak.


The challenges in defending against claims and pursuing risk transfer during the Chapter 558 Process


Chapter 558 of the Florida Statutes was enacted by the legislature as an alternative form of dispute resolution for certain construction defect cases in an effort to reduce litigation. Fla. Stat. § 558.001. Chapter 558 creates a notice and repair process whereby notice of a claim is filed with the “contractor, subcontractor, supplier, or design professional that the claimant asserts is responsible for the defect.” Id. Notice of the claim “should provide the contractor, subcontractor, supplier, or design professional, and the insurer[s] an opportunity to resolve the claim through confidential settlement negotiations.” Id.


Chapter 558 provides that a claimant alleging construction defects shall “serve written notice of claim on the contractor, subcontractor, supplier, or design professional, as applicable,” with the notice referring to Chapter 558. Fla. Stat. § 558.004(1)(a). Notice must be made “at least 60 days before filing any action, or at least 120 days before filing an action involving an association representing more than 20 parcels.” Id. Additionally, if the work was performed pursuant to a contract, the claimant must serve written notice on the contractor. Id. “The notice of claim must describe in reasonable detail the nature of each alleged construction defect and, if known, the damage or loss resulting from the defect.” Fla. Stat. § 558.004(1)(b). The claimant is required to “identify the location of each alleged construction defect sufficiently to enable the responding parties to locate the alleged defect without undue burden.” Id. Destructive testing is not required at this stage; however, the claim must be “[b]ased upon at least a visual inspection by the claimant or its agents.” Id.


While the law requires that the Notice of Claim set forth in “reasonable detail the nature of each alleged construction defect and, if known, the damage or loss resulting from the defects” the recipients of the Notice are forced to defend the case before the facts are actually developed. This places general contractors and subcontractors who do not self-perform all work in the difficult position of having to conduct a risk transfer evaluation immediately; even if it appears the claim is without merit. The question then becomes whether or not you should hold off on pursuing risk transfer efforts until you have more facts or whether you should secure indemnity rights before facts are further developed?


The importance of tendering early to secure a defense
In order to secure a defense from its insurer, an insured must tender to its primary carrier. There are different types of policies that may cover a contractor or subcontractor. They include: wrap policies; project specific policies; and direct policies. There are two types of wrap policies; they are contractor controlled insurance policies (CCIP) and owner controlled insurance policies (OCIP). Both types of wrap policies generally cover the owner, contractor and various subcontractors who are enrolled. Wrap policies are also generally project specific. Project specific polices are just that, project specific. Direct policies generally covered the insured for a specific period of time, regardless of the project.


Contractual Indemnity Tenders


While it is important to tender pursuant to an additional insured status or endorsement, it is equally important to tender pursuant to an indemnity provision in a contract. In Florida, many indemnity provisions in contracts provide for the indemnitor to “defend and indemnify” the indemnitee. The requirement to provide a defense pursuant to an indemnity provision is distinct from the requirement to provide a defense from an additional insured provision or endorsement. However, how the indemnity provision containing the obligation to defend is drafted may affect the obligation to defend and whether it is severable from the duty to indemnify. Barton Malow Co. v. Grunau Co., 835 So. 2d 1164 (Fla. 2d DCA 2002).


Additional Insured Tenders-Carrier Considerations and Right to Contribution
An insurance carrier’s duty to defend is triggered when a complaint contains allegations “within the general coverage provisions of the policy” and the allegations are not within the policy exclusions. Baron Oil Co. v. Nationwide Mut. Fire Ins. Co., 470 So. 2d 810, 812 (Fla. 1st DCA 1985). The Chapter 558 process creates an alternative to litigation, and there is not a complaint filed during this process, but rather a Notice of Claim sent to insurance carriers. The United States District Court for the Southern District of Florida, sitting in diversity, has held “the Chapter 558 mechanism does not constitute a ‘civil proceeding’, it is not a ‘suit’ under the [insurance policy provisions]. Therefore, [the insurance carrier] had no obligation under the terms of the insurance policies at issue to defend or indemnify.” Altman Contractors, Inc. v. Crum & Forster Specialty Ins. Co., 124 F. Supp. 3d 1272, 1282 (S.D. Fla. 2015). However, the rule enunciated in Altman is subject to change. Altman is on appeal and the United States Court of Appeals for the Eleventh Circuit has certified the question for the Supreme Court of Florida as to whether the Chapter 558 Notice of Claim triggers an insurance carrier’s duty to defend. Altman Contractors, Inc. v. Crum & Forster Specialty Ins. Co., 832 F.3d 1318, 1326 (11th Cir. 2016).

In Florida an insurance carrier does not have a right of contribution against another carrier. Argonaut Ins. Co. v. Maryland Cas. Co., 372 So. 2d 960, 963 (Fla. 3d DCA 1979). In Argonaut the plaintiff, an insurance company, brought an action against other insurers for costs incurred in the defense of a mutual insured. Id. at 962. The Third District Court of Appeals held “[c]ontribution is not allowed between insurers for expenses incurred in defense of a mutual insured.” Id. at 963. (citing Fidelity & Guaranty Company v. Tri-State Ins. Company, 285 F.2d 579 (10th Cir. 1960)). Additionally, the court stated “[t]he duty of each insurer to defend its insured is personal and cannot inure to the benefit of another insurer.” Id. (citing Thurston National Insurance Company v. Zurich Insurance Company, 296 F.Supp. 619 (W.D. Okl. 1968)).


An insured may permit the participating carrier to pursue recalcitrant carriers in its name; however, the defending carrier will not be able to recover defense costs if the defending carrier had a duty to defend. Pennsylvania Lumbermens Mut. Ins. Co. v. Indiana Lumbermens Mut. Ins. Co., 43 So. 3d 182, 188 (Fla. 4th DCA 2010). In Pennsylvania Lumbermens, the defendant insurance carrier did not defend or participate in the settlement of a prior construction defect case where the plaintiff insurance carrier settled with the plaintiff of the prior litigation. Id. at 184. The insured of the prior litigation assigned its cause of action to the plaintiff insurance carrier to seek reimbursement from other carriers. Id. The plaintiff insurance carrier was able to recover the indemnity costs from the previous settlement, but was unable to recover defense costs because the plaintiff insurance carrier had a duty to defend. Id. at 188. In light of the Argonaut decision, the question becomes whether the insured will pursue other additional insured carriers or authorize the participating carrier to pursue recalcitrant carriers in its name?


Deductible and self-insured retention considerations


For the insured client both the deductible and self-insured retention considerations emphasize the need to trigger the contractual and additional insured obligations. That is because both require the insured to pay out of pocket funds before the insurance policy kicks in and begins paying for the defense of the claim, typically.


The Next Hurdle: Stepping out and filing suit.


While it is preferable to wait for a clearer picture of actual liability prior to filing suit to secure risk transfer, there are cases where you cannot afford to wait until the facts are further developed. The decision of whether to wait for the claimant to file suit to initiate pass through claims via a third party complaint or independently file suit against third parties potentially implicated by the defect claims rests on the timing requirements set forth under Florida’s statute of repose.


Florida’s statute of Repose: Section 95.11(3)(c) Florida Statutes is a statute of repose that terminates a cause of “action founded on the design, planning or construction of an improvement to real property” when certain criteria are met. Under Section 95.11(3)(c) there are four dates necessary to determine when the statute of repose clock starts: (1) the date of actual possession by the owner, (2) the date of the issuance of a certificate of occupancy, (3) the date of abandonment of construction if not completed, or (4) the date of completion or termination of the contract between the professional engineer, registered architect, or licensed contractor and his or her employer, whichever date is latest. If the action does not involve a latent defect, a claimant has four years to bring their claim from the latest date of the aforementioned dates. Id. If the action involves latent defects, “the action must be commenced within 10 years” from the latest date of the aforementioned dates. Id. In litigation, the date of actual possession by the owner and the date of completion of the contract are highly contested. Actual possession can be difficult to determine and claimants may argue actual possession is physically living at the property not actual ownership of the property.


The date of completion of the contract is also highly contested in litigation, with some claimants arguing the date of completion means all outstanding contracts related to the property. In a case where the date of completion of the contract was argued, the court held “[c]ompletion of the contract is completion of performance by both sides of the contract, not merely performance by the contractor.” Cypress Fairway Condo. v. Bergeron Const. Co. Inc., 164 So. 3d 706, 708 (Fla. 5th DCA 2015). The court in Cypress found the date construction had finished by the contractor and a “Final Application for Payment” had been made was not the date of completion of the contract. Id. Instead the court held the final payment on the contract was the date of completion. Id. The courts holding resulted in a later date starting the statute of repose clock which allowed the plaintiffs cause of action, because the date of final payment on the contract was within the repose period. Id. Very recently the Fifth District Court of Appeals reversed an order granting a motion to dismiss with prejudice because it was “not conclusively establish[ed] that the contract was completed at closing.” Busch v. Lennar Homes, LLC, 5D16-1626, 2017 WL 1372085, at *2 (Fla. 5th DCA Apr. 13, 2017). In Busch, the contract contained language where the seller agreed to make repairs requested by the buyer “at Seller’s sole cost and expense prior to closing or at Seller’s option within a reasonable time after closing.” Id. The court held “[b]ecause the contract expressly contemplated that closing could occur even if work required by the contract remained incomplete, and the complaint did not allege that no work was completed after closing, the allegations of the complaint d[id] not conclusively establish that the contract was completed upon closing.” Id.


Statute of Repose and Indemnity Claims: There is a conflict in case law regarding the pursuit of indemnity claims that will eventually need to be resolved by the courts. The Second District Court of Appeal has held, “[t]he statute of limitations for an action seeking indemnity does not begin running until litigation against the third-party plaintiff has ended or the liability, if any, has been settled or discharged by payment.” Castle Const. Co. v. Huttig Sash & Door Co., 425 So. 2d 573, 575 (Fla. 2d DCA 1982). Castle essentially holds that the statute of limitations for indemnity does not run until an action for indemnity accrues. However, The Third District Court of Appeal has held, “the plain language of the statute . . . clearly applies to all actions ‘founded on the design, planning, or construction of an improvement to real property.’” State, Dept. of Transp. v. Echeverri, 736 So. 2d 791, 792 (Fla. 3d DCA 1999) (emphasis in original). In Echeverri, the plaintiff brought an action for wrongful death against several defendants involved in the construction of an exit ramp. Id. at 791. One of the defendants asserted a cross-claim seeking indemnity from the general contractor and designer-architect. Id. The defendant seeking indemnity argued 95.11(3)(c) “d[id] not apply to actions for indemnity.” Id. at 792. However, the court found that 95.11(3)(c) applied to “all actions ‘founded on the design, planning, or construction of an improvement to real property.’” Id.


The ruling in Echeverri can have a harsh result where a claimant brings an action at the end of the statute of repose and the defendant will not be able to seek indemnity from those responsible for injury and/or damage caused. The Colorado Supreme Court may have devised a better rule that Florida courts may adopt in the future. In Colorado, “third-party claims are timely irrespective of both the two-year statute of limitations and the six-year statute of repose so long as the claims are brought during the construction defect litigation or within ninety days following the date of judgment or settlement.” Goodman v. Heritage Builders, Inc., 390 P.3d 398, 402 (Colo. 2017). As such, you may be forced to secure indemnity rights even before you know if there is an indemnity damage to pursue.

II. The Legal Framework for Risk Transfer
The typical causes of action in a construction defect case where risk transfer is sought include: negligence; building code violations; express and implied warranties; contractual indemnity; and common law indemnity.


Common law causes of action


Of the causes of action listed above, three are common law causes of action. They include negligence, building code violations and common law indemnity.
Negligence: In many states the risk transfer through a negligence cause of action is unlikely because of the economic loss rule. The economic loss rule prohibits a plaintiff/third party plaintiff from recovering tort damages for purely economic damages. Casa Clara Condominium Association, Inc. v. Charlie Topino & Sons, Inc, 588 So. 2d 631 (Fla. 3d DCA 1991).


Building Code Violations: If a building code violation is found to exist, it may not automatically be construed as an admission of fault, thus transferring the risk. In Florida, § 553.84, Fla. Stat. provides a cause of action for violation of the building code. However, if certain conditions are met under § 553.84, (i.e. the person or party obtains the required building permits and any local government or public agency with authority to enforce the Florida Building Code approves the plans, if the construction project passes all required inspections under the code, and if there is no personal injury or damage to property other than the property that is the subject of the permits, plans, and inspections) then risk cannot be transferred unless the party knew or should have known of the violation. Fla. Stat. § 553.84. Depending on the circumstances and the specific defect alleged to exist, this can sometimes be difficult.


Common Law Indemnity: “The common law right of indemnity generally arises out contract, express or implied.” City of Clearwater v. L.M. Duncan and Sons, Inc., 466 So. 2d. 1116, 1118 (Fla. 2d DCA 1985). In some states, such as Florida, risk transfer pursuant to common law indemnity is difficult. In Florida, in order to prevail on a claim for common law indemnity the indemnitee must prove (1) a special relationship exists between it and the indemnitor such that the indemnitee is vicariously, technically or derivatively liable for the acts or omissions of the indemnitor; (2) that it is free from all fault; and (3) the indemnitor is solely at fault. Houdaille Indus., Inc. v. Edwards, 374 So. 2d 490 (Fla. 1979).


Contractual and statutory based causes of action
The remaining causes of action that are typically asserted in order to transfer risk include contractual indemnity claims and warranty claims, which include both express and implied warranties.


Contractual Indemnity: In order to transfer risk via an indemnification provision in a contract or vendor agreement, the provision must be valid and binding. Some states, such as Florida, have an anti-indemnity statute. Florida Statute § 725.06 provides in part that an indemnity agreement “shall be void and unenforceable unless the contract contains a monetary limitation on the extent of the indemnification that bears a reasonable commercial relationship to the contract and is part of the project specifications or bid documents, if any.” 

However, Fla. Stat. § 725.06 only applies if the indemnitee is seeking indemnification for its own negligence or wrong doing, even in part, in addition to that of the indemnitor. If an indemnity provision is valid and enforceable, risk will generally be transferred to the indemnitor. In addition, indemnity provisions often include recovery for attorneys’ fees and costs. Many times, subcontractor and/or vendor agreements also have stand-alone attorney fee provisions that must also be taken into consideration.

Express/Statutory Warranties: An express warranty is just that, one that is expressly provided, typically through a written instrument, such as a contract. Many, if not most, contracts between a contractor and general contractor contain an express warranty, whereby the subcontractor warrants that its work and materials are free from defect and have been installed in a good and workmanlike manner. Statutory warranties are similar in that they are expressly provided by statute. In Florida, the most common statutory warranties that are dealt with in construction litigation include the warranties provided under Chapter 720 and Chapter 718. Florida Statute § 718.203(1) is the warranty from the developer to the purchaser of a condominium unit. Pursuant to § 718.203, “the developer shall be deemed to have granted to the purchaser of each unit an implied warranty of fitness and merchantability for the purposes or uses intended…” Florida Statute § 718.203(2) is the statutory warranty provided by the contractor and subcontractors to the developer and purchaser of a condominium unit. Pursuant to § 718.203(2), “the contractor, and all subcontractors and suppliers, grant to the developer and to the purchaser of each unit implied warranties of fitness as to the work performed or materials supplied…”


Implied Warranties: Unlike express warranties, implied warranties are not expressly provided by a party; rather they are implied in law. The law over the years related to the purchase of real property has evolved, going from a “caveat emptor” attitude to the judicial creation of implied warranties. It was in Gable v. Silver, 258 So. 2d 11 (Fla. 4th DCA 1972) where the “modern view” was first adopted in Florida and thus the implied warranties of fitness and merchantability were created for purchasers of new homes.


Potential liability where facts are not fully developed or party fails to participate


There are different scenarios in which a party may still be liable if they fail to participate and/or defend a claim or the facts do not fully support a finding of liability. One such way is through “vouching in.” In Florida, the courts have consistently held that where an indemnitor has notice of the claim or suit against the indemnitee and is afforded an opportunity to appear and defend the claim or suit, a judgment rendered against the indemnitee is conclusive against the indemnitor as to all material questions determined by the judgment. Hoskins v. Midland Ins. Co., 395 So. 2d 1159 (Fla. 3d DCA 1981). However, the judgment must be rendered without fraud or collusion. Id. The courts often refer to the effect of this rule as “vouching in” the indemnitor. Hull & Co., Inc. v. McGetrick, 414 So. 2d 243 (Fla. 3d DCA 1982). In Georgia, the vouching statute provides that a defendant who may have a remedy over against another person can vouch the person into court merely by giving notice of the pendency of the action. It is a substantive and evidentiary law which makes the judgment rendered in the action against the defendant, conclusive and binding upon the vouchee as to the amount and right of the plaintiff to recover. Hardee v. Allied Steel Bldg., Inc., 182 Ga. App. 587 (1987).


Another way a defendant can still be liable if the facts do not completely support liability is through the application of the Substantial Contributing Factor Doctrine. While joint and several liability as to negligence claims has been abolished in Florida, courts have applied a similar approach holding parties jointly liable for damages of which they were a “substantial contributing factor” in causing damage with the other party(ies). The substantial contributing factor doctrine has been applied in breach of contract or tort cases to determine liability where multiple factors may have united in producing the plaintiff’s total injury. Tuttle White Constructors, Inc. v. Montgomery Elevator Co., 385 So. 2d 98 (Fla. 5th DCA 1980) (quoting Corbin on Contracts; Cedar Hills Properties Corp. v. Eastern Federal Corp., 575 So. 2d 673 (Fla. 1st DCA 1991)). Thus, even if other parties or non-parties are partially at fault, it is possible the court may not require a plaintiff to separate jointly caused damages if they find the particular defendant’s work was a substantial contributing factor in causing the alleged damages. The likelihood of the application of the substantial contributing factor test often depends on the specific causes of action alleged by the Plaintiff.

One reason to provide notice to parties and allow participation, even if potential liability is undetermined is to avoid a spoliation defense. The doctrine of spoliation arises when it is alleged that a crucial piece of evidence is unavailable because of the actions of one of the parties. Vega v. CSCS International, N.V., 795 So.2d 164 (Fla. 3d DCA 2001). Spoliation of evidence may be pled as an affirmative defense. Derosier v. Cooper Tire & Rubber Company, 819 So.2d 143 (Fla. 4th DCA 2002). Thus for instance, if destructive testing is performed without a party having notice and an opportunity to participate and inspect because they are not provided notice of a claim, they may have a spoliation defense.


Repairs are another non-monetary reason to provide a party notice. If repairs are made prior to a party being provided notice, not only may they have a spoliation defense but it will be more difficult to prove their work is faulty.


III. Alternatives to Traditional Litigation


Chapter 558 pre-suit notice
Chapter 558 is intended to serve as a pre-suit mechanism to resolve construction defect claims without the need for protracted and costly litigation; however, the statutory framework set forth is impractical by setting insufficient time to actually resolve claims. Under Fla. Stat. Chapter 558 the person served with the notice of the claim is able to inspect the property to assess the alleged defects “[w]ithin 30 days after service of the notice of claim, or within 50 days after service of the notice of claim involving an association representing more than 20 parcels.” “Within 45 days after service of the notice of claim, or within 75 days after service of a copy of the notice of claim involving an association representing more than 20 parcels, the person who was served the notice . . . must serve a written response to the claimant.” Id.


While this framework may allow you sufficient time to evaluate whether to make an offer of repair there is not enough time to meaningfully involve the trades who actually performed the work which may result in spoliation claims by implicated parties if a repair of their work is undertaken and they did not timely receive the opportunity to inspect and/or repair. The general contractor or subcontractors who did not self-perform all work are then left with the decision to pay and/or repair and then initiate risk transfer efforts. Consequently, carrier will argue that the payment was made voluntarily. Likewise, implicated subcontractors will argue the same while disclaiming liability and refusing to indemnify. Moreover, this process does not take into account the coverage issues without commencement of an action.


Tolling Agreements between the General Contractor and Subcontractors


One question to consider is whether a repose date can be tolled by agreement of the parties. In Florida, the legal framework suggests the repose date cannot be tolled for any reason, including by a tolling agreement. In Bauld v. J.A. Construction Company, 357 So. 2d 401, 402 (Fla. 1978), the Florida Supreme Court reiterated the fundamental difference in character between the statute of repose and statute of limitations, emphasizing the statute of repose cuts off the right of action after a specified time, regardless of the time of accrual of the cause of action or of notice of the invasion of a legal right. The Florida Supreme Court again emphasized the distinction in University of Miami v. Bogorff, 583 So. 2d 1000 (Fla. 1991). Because the courts have made it clear that the purpose of the statute of repose is to cut off the right of an action so that there is a definitive end to a potential cause of action, it is unlikely a tolling agreement would toll the statute of repose.

Defense Funding Agreements


In construction defect litigation, a joint defense agreement between the general contractor and subcontractors may provide for a strong defense against a claimant. A joint defense agreement allows for a united front among the defendants, instead of the typical cross-claims among co-defendants which plays right into the claimant’s hands. A joint defense agreement allows for more accurate fact gathering by allowing for the defendants to share facts among themselves. A joint defense agreement can also allocate costs by including language that if the defendant loses, the party not vouching in would pay a smaller sum rather than a large indemnity clause.


The Second District Court of Appeal recently dealt with the issue of attorney-client privilege when there is a joint defense agreement, finding there was not a requirement that the joint defense agreement be in writing. AG Beaumont 1, LLC v. Wells Fargo Bank, N.A., 160 So. 3d 510, 512 (Fla. 2d DCA 2015). The court held, “[g]enerally, the attorney-client privilege is waived when one holding the privilege makes a voluntary disclosure to a third party. But an exception to the waiver rule permits litigants who share unified interests in litigation to exchange privileged information in order to adequately prepare their cases without losing the protection afforded by the privilege.” Id. (citing Visual Scene, Inc. v. Pilkington Bros., 508 So.2d 437, 440 (Fla. 3d DCA 1987)). In Visual Scene, “the party claiming privilege produced ‘an affidavit attesting to a before-the-exchange agreement stating their intention to maintain confidentiality and to use the information only in preparation for trial on those issues common to both.’” Id. (citing Visual Scene, 508 So.2d at 441).


Proceeding with filing a third party complaint


Because the statute of repose bars actions by setting a time limit within which an action must be filed, in Florida, it is better to proceed with filing a third party action to preserve a claim and then subsequently stay the litigation or enter a tolling agreement. Florida courts make clear that statutes of repose are “legislative determination[s] that there must be an outer limit beyond which [claims] may not be instituted.” Hess v. Philip Morris USA, Inc., 175 So. 3d 687 (Fla. 2015).


Filing standalone complaint


Another option is to defend against the complaint and/or arbitration demand without filing a third party complaint and/or joinder and then filing a standalone complaint and/or arbitration demand trailing the underlying plaintiff’s action. However, rather than pursuing the action you would agree to enter into a tolling agreement or defense funding agreement.


Mediation


Timing: Pre-suit may be too soon to conduct mediation as the facts have not been fully developed; however, conducting mediation before engaging in litigation is cost-effective. The need for facts versus costs to obtain the facts that add to claim exposure and overall litigation expense further complicates the resolution process.


Global Resolution: Contractual indemnity and additional insured claims become the focus of mediation and often impede on the resolution of the underlying claim. In a multi-party case, it only takes one bad actor to prevent global resolution. Moreover, in a global resolution no one is released until a complete resolution can be achieved.

General Contractor’s Approach: The general contractor can choose to pursue different options when evaluating how best to settle a claim. The general contractor can carve out a settlement for itself leaving the plaintiff to pursue the third parties to resolve the entire claim. It can also stay in the case for all claims and carve out settlements with those third parties that are willing to resolve the indemnity claims against them and then continue to defend those issues on their behalf.


The general contractor may opt to pay a reduced amount based perhaps on its fault and non-delegable duties and assign its risk transfer rights to the plaintiff. “All contractual rights are assignable unless the contract prohibits assignment, the contract involves obligations of a personal nature, or public policy dictates against assignment.” Kohl v. Blue Cross & Blue Shield of Fla., Inc., 988 So.2d 654, 658 (Fla. 4th DCA 2008). The assignment of risk transfer rights from a general contractor to the plaintiff permits the plaintiff to pursue third parties directly for the indemnity provisions that were part of the agreements between the general contractor and the third parties. “Even when an insurance policy contains a provision barring assignment of the policy, an insured may assign a post-loss claim.” One Call Prop. Services Inc. v. Sec. First Ins. Co., 165 So. 3d 749, 753 (Fla. 4th DCA 2015) (citing W. Florida Grocery Co. v. Teutonia Fire Ins. Co., 77 So. 209, 210–11 (Fla. 1917)). In some instances, a subcontractor may prefer the approach where the general contractor pays/settles with a plaintiff and then assigns its rights against the subcontractor. One reason a subcontractor may prefer this approach is because its potential share of liability has been reduced by the general contractors “admission” of its own liability, rather than the contractor trying to pass all of the liability on to the subcontractor.


Plaintiff’s Approach: The plaintiff may be willing to only settle some of the claims. In this scenario, the question becomes whether subcontractors will pay to resolve the issues implicating their trade in exchange for a scope of work release for the benefit of both the general contractor and subcontractor.

LYDA SWINERTON BUILDERS, INCORPORATED, v. OKLAHOMA SURETY COMPANY: Fifth Circuit: Oklahoma Surety Co. had a duty to defend Lyda Swinerton Builders Inc., as well as a $1 million damages award to LSB.




 IN THE UNITED STATES  COURT OF APPEALS FOR THE FIFTH CIRCUIT
No. 16-20195

LYDA SWINERTON BUILDERS, INCORPORATED,
Plaintiff-Appellee/Cross-Appellant

v.

OKLAHOMA SURETY COMPANY,

Defendant-Appellant/Cross-Appellee

Appeals from the United States District Court for the Southern District of Texas

Before DAVIS, GRAVES, and COSTA, Circuit Judges. 

JAMES E. GRAVES, JR., Circuit Judge:

This case involves several issues of Texas law relating to an insurer’s duty to defend and the damages that an insured may recover when an insurer breaches that duty. The district court, after disposing of much of the case through a series of partial summary judgment rulings and conducting a bench trial on one remaining claim, issued a final judgment that largely (though not entirely)
favored the insured. The insurer and the insured now cross-appeal
from that judgment. 

We AFFIRM in part and REVERSE in part.

http://www.ca5.uscourts.gov/opinions/pub/16/16-20195-CV0.pdf

Parties Ask 5th Circuit To Determine Whether Duty To Defend Was Owed

(February 7, 2017, 3:41 PM EST) -- NEW ORLEANS — Parties in an insurance dispute recently asked the Fifth Circuit U.S. Courts of Appeals to determine whether a federal district court erred in determining that an insurer owed an additional insured a duty to defend in an underlying construction defects lawsuit (Lyda Swinerton Builders Inc. v. Oklahoma Surety Co., No. 16-20195, 5th Cir.).
Lyda Swinerton Builders Inc. (LSB) was a general contractor for a construction project and employed several subcontractors to assist with the work.  Each of the subcontractors was required to name LSB as an additional insured.

Oklahoma Surety Co. (OSC) insured subcontractor A.D. Willis Co. Inc. under a general liability insurance policy with a $1 million per occurrence limit, with general aggregate and products-completed operation aggregate limits of $2 million, respectively.  The policy also contained an additional insured endorsement naming general contractor “Lyda Builders & its parent & affiliate companies” as an additional insured under the policy.

Failure To Supervise

Adam Development Properties L.P. sued LSB and its parent, Swinerton Inc., in the 361st Judicial District Court, Brazos County, Texas, alleging that LSB failed to properly supervise its subcontractors and stating a claim for property damage.  Adam then filed a first amended petition adding claims for breach of contract, negligence, guaranty and negligent misrepresentation against LSB.  Adam later filed a second amended petition, stating the same claims and naming Willis as a third-party defendant.  Adam Development sought economic damages and attorney fees and costs.

LSB tendered the underlying lawsuit to more than a dozen insurance carriers for the subcontractors, and each carrier denied LSB a defense, causing LSB to tender the lawsuit to its own carrier and requiring LSB to pay a $500,000 deductible and other fees.

LSB then sued the subcontractor insurance carriers in the U.S. District Court for the Southern District of Texas, stating claims for breach of contract, violation of Section 541 the Texas Insurance Code, Tex. Ins. Code Ann. § 541, declaratory relief and attorneys’ fees.  A settlement was eventually reached with each of the subcontractor carriers except OSC.

Duty To Defend

LSB then filed a motion for partial summary judgment against OSC regarding OSC’s duty to defend it in the underlying lawsuit, and the District Court granted the motion in part, ruling that OSC owed LSB a duty to defend in the underlying lawsuit and that OSC had breached that duty.

The District Court then considered several other summary judgment motions filed by LSB and OSC, denying OSC’s cross-motion for partial summary judgment on OSC’s breach of the duty to defend and indemnify, granting LSB’s motions for partial summary judgment on OSB’s duty to defend based on the original petition in the underlying lawsuit and OSC’s violation of the Texas Prompt Payment of Claims Act (PPCA), Tex. Ins. Code Ann. § 542.051, based on the duty to defend, and determined that OSC was liable for damages for breach of the duty to defend in the amount of $655,600.27 and costs and prejudgment interest.  The District Court deferred the issue of whether OSC violated Chapter 541 of the Texas Insurance Code in refusing to defend LSB in the underlying lawsuit.

After a July 6, 2015, bench trial on the issue of whether OSC violated Chapter 541, the District Court determined that LSB failed to show that it suffered any injury separate from the denial of benefits it was owed under the OSC policy and, thus, failed to show any independent injury as required for recovery under Chapter 541.  The District Court also ruled that LSB could not recover the PPCA statutory interest but allowed LSB to supplement with evidence of the dates and amounts it paid for defense costs under the PPCA.

Final Judgment

The District Court entered final judgment, ruling that OSC owed LSB a duty to defend under the original petition in the underlying lawsuit and that OSC breached that duty and, thus, violated the PPCA.  The District Court awarded LSB $655,600.27 in damages, $296,209.69 in PPCA interest accrued through Aug. 20, 2015, plus $323.32 per day after Aug. 20, 2015, until the date of payment of the judgment.  Moreover, the District Court rendered judgment in favor of OSC on LSB’s claim for Chapter 541 violation.

After receiving post-judgment motions from both parties, the District Court, on Feb. 23, 2016, amended the final judgment to award LSB $84,881.10 in prejudgment interest and denied OSC’s motion to alter or amend the amended final judgment.

Each party then appealed the ruling to the Fifth Circuit, and OSC filed an appellant brief on Sept. 21.

(Appellant brief available.  Document #50-170209-012B.)

In its brief, OSC contends that the District Court erred in granting LSB’s motions for partial summary judgment on the duty to defend LSB in the underlying lawsuit, breach of the duty to defend and based on those rulings in violation of the PPCA.

Eight-Corners Rule

“Applying the eight-corners rule for determining the duty to defend, the allegations contained within the OP [original petition], FAP [first amended petition] and SAP [second amended petition] filed by ADP in the Underlying Lawsuit, considered in light of OSC’s policy, failed to trigger a duty to defend LSB in the Underlying Lawsuit.  Neither the OP nor FAP alleged ‘property damage’ required to trigger a duty to defend.  Further, neither the OP, FAP nor SAP alleged that property damage occurred during the policy term.  And, neither the OP nor FAP alleged property damage caused by OSC’s insured, Willis.  Instead, those petitions alleged that LSB’s deficient work under the Project caused ADP’s damages.  As a result of the petitions’ lack of factual allegations triggering a duty to defend, the District Court erroneously accepted LSB’s arguments to consider improper extrinsic evidence, including LSB’s own Third-Party Petition filed in the Underlying Lawsuit to fill in the petitions’ missing factual allegations,” OSC says.

“In doing so, the District Court erroneously applied a ‘12-corners rule’ analysis to trigger OSC’s duty to defend under the Original and First Amended Petitions and to determine that OSC’s breached the duty to defend.  Likewise, the District Court improperly considered other extrinsic evidence, including Willis’ Subcontract with LSB to perform certain work on the Project, to determine that OSC owed a duty to defend and breached that duty.

“Further, LSB failed to conclusively establish its status as an ‘additional insured’ where it failed to conclusively establish the existence of an ‘insured contract’ between LSB and Willis where LSB failed to countersign the Subcontract and the Subcontract’s indemnification language was insufficient to make it an ‘insured contract’ under OSC’s Policy’s definition.”

Anti-Stacking Rule

OSC also avers that the District Court erred in granting LSB’s motion and denying OSC’s motion on LSB’s breach of the duty to defend claim “where Texas’ anti-stacking or vertical exhaustion rule (providing that consecutive policies covering distinct policy periods cannot be stacked to multiply coverage for a single claim involving indivisible injury) applied here to preclude LSB’s claims for unreimbursed defense fees and costs LSB allegedly incurred as a result of OSC’s breach of its duty to defend.”

“Because OSC conclusively established that LSB selected the non-overlapping Willis policy under which it was afforded its complete defense and indemnity . . . the anti-stacking rule precluded LSB from attempting to stack Willis’ other non-overlapping policy — the OSC Policy — to collect unreimbursed defense fees and costs,” OSC states.

Moreover, OSC asserts that because LSB failed to show that OSC breach its duty to defend, it failed to show that there was a violation of the PPCA.  OSC also argues that, “even if the District Court properly determined OSC owed a duty to defend LSB in the Underlying Lawsuit and breached that duty, which is not conceded, the District Court erroneously granted LSB’s summary judgment for breach of the duty to defend damages and awarded $655,600.27 as actual damages for breach of the duty to defend.”

“Among others, LSB failed to conclusively establish entitlement to the deductible it paid to its carrier and unreimbursed attorney’s fees expended on LSB’s independent counsel.  Having failed to establish entitlement to the full amount of the award, PPCA interest assessed on these amounts was also erroneous,” OSC explains.

Manifest Error

OSC further contends that “if OSC’s liability for breach of contract and violation of the PPCA is affirmed, the District Court abused its discretion in denying OSC’s motion to alter or amend the Final Judgment and Amended Final Judgment.  OSC established a manifest error of law in the District Court’s determination of the accrual period for PPCA statutory interest to end only at the time the judgment is paid, rather than at the date of the judgment, as the Texas Supreme Court and this Court have determined is the proper accrual period.”

“The District Court’s interpretation improperly punishes OSC for any PPCA violation and violates OSC’s due process and right to appeal.  As a result, for this additional reason, the Amended Final Judgment should be reversed, and the case remanded for further proceedings or a modified judgment,” OSC says.

In its Nov. 8 appellee/cross-appellant brief, LSB argues that the OP, FAP and SAP each triggered OSC’s duty to defend and that OSC’s argument that the anti-stacking rule applies is erroneous because “the anti-stacking rule applies only to indemnify to be paid under the Policy.  The rule does not apply to the duty to defend when the Policy, as is the case here, had defense outside of limits.”

(Appellee/cross-appellant brief available.  Document #50-170209-011B.)

“In both the Final Judgment and Amended Final Judgment, the Court found the 18% penalty interest assessed against OSC would run until the date OSC actually pays the judgment.  The wording under the PPCA does not provide the 18% interest penalty ceases to accrue upon the entry of judgment.  OSC asks this Court to substitute its own judgment over the legislature which could have added a date of termination of the accrual of the interest had it intended to do so.  In the absence of legislative direction, authority, or intent to impose the limitation asserted by OSC, this Court should refrain from such judicial activism,” LSB says.

“In addition, no Texas court has substantively addressed or ruled in favor of OSC’s construction of the PPCA.  As such, the District Court was correct to construe the provision in accordance with the statute’s plain and ordinary meaning.  To rule otherwise would reward a recalcitrant carrier for its delay on paying the judgment for an indefinite future.”

Independent Injury

LSB also avers that the District Court erred in ruling that LSB was required to show an independent injury in order to trigger its right to extracontractual damages and that LSB failed to show a separate injury because the District Court’s reliance on the Fifth Circuit’s ruling in Great American Insurance Co. v. AFS/IBEX Financial Services Inc., 612 F.3d 800 (5th Cir. 2010), “is not followed by the Texas Supreme Court nor Texas state appellate decisions.”

“The Supreme Court of Texas has repeatedly confirmed LSB’s entitlement to pursue extracontractual damages without an ‘independent injury,’” LSB states.

Citing the Texas Supreme Court’s ruling in Republic Insurance Co. v. Stoker, 903 S.W.2d 338, 341 (Tex. 1995), LSB further claims that “[c]ontrary to the District Court’s ruling, a showing of extra-contractual damages is only required when an insurer engaged in questionable practices in handling uncovered claims under the terms of the policy.”

Legal Damages

“The standard in Stoker is inapplicable here as there was a duty to defend as the District Court conclusively adjudicated in LSB’s favor.  Therefore, LSB already demonstrated it sustained legal damages so as to be entitled to extracontractual damages for OSC’s violations of the Insurance Code and the DTPA.  As such, the District Court committed error in applying Federal law contrary to Texas state law regarding the entitlement of an insured to extracontractual damages,” LSB explains.

Moreover, LSB asserts, “Nevertheless, if the Fifth Circuit were to impose the additional requirement of an ‘independent injury’, LSB did introduce evidence of sustaining a separate injury.”

“First, separate injury was established by LSB having to pay a $500,000 deductible on its own direct policy.  Had OSC defended immediately from the date of tender as required on its policy, LSB would have avoided the $500,000 deductible.  Second, as a result of OSC’s breach of the duty to defend, LSB was forced to incur attorneys’ fees in this coverage litigation.  These two elements of damage are independent injuries separate and distinct from the OSC policy benefits awarded, which consisted of defense fees and costs incurred in the Underlying Action,” LSB says.

Trebled Damages

In its reply/cross-appellant response brief filed Dec. 22, OSC claims that “LSB failed to appeal (and has, thus, waived) the District Court’s failure to find all predicates for recovery of trebled damages under Chapter 541 of the Texas Insurance Code (knowing misrepresentation as defined within Subchapter B of Chapter 541).”

(Appellant reply/cross-appellee brief available.  Document #50-170209-014B.)

“But, to the extent the issue has not been waived, the District Court correctly concluded that independent injury is a predicate to recovery of treble damages under Chapter 541 of the Texas Insurance Code.  This Court should overrule LSB’s cross-appeal and should affirm the District Court’s take-nothing judgment on LSB’s Chapter 541 claims in its entirety,” OSC says.

LSB filed an appellee/cross-appellant reply brief on Jan. 20.

Counsel

OSC is represented by R. Brent Cooper, Diana L. Faust and Timothy M. Dortch of Cooper & Scully in Dallas.

LSB is represented by Joseph L. Oliva and Charles L. Fanning IV of Oliva & Fanning in San Diego and John L. Grayson of Cokino Bosien & Young in Houston.

SELECTIVE INSURANCE COMPANY OF THE SOUTHEAST, v. WILLIAM P. WHITE RACING STABLES, INC.: Because the basis for injured jockey James Rivera’s action against White Racing was for spoliation of evidence, it is not covered by the liability policy.





A Selective Insurance Group unit has no obligation to defend a racing stable charged with improperly disposing the body of a horse connected to a jockey’s injury, says a federal appeals court, in overturning a lower court ruling.

James Rivera was a professional jockey riding a two-year old filly, Flyfly Fly Delilah, during a workout in 2008 when the horse suddenly collapsed, taking Rivera to the ground and leaving him paralyzed from the neck down, according to Wednesday’s ruling by the 11th U.S. Circuit Court of Appeals in Atlanta. The case is Selective Insurance Co. of the Southeast v. William P. White Racing Stables Inc.; James Rivera, et al.

Mr. Rivera believed the horse was not fit to be exercised or raced due to an injury that had been concealed by steroids and other medications, according to the ruling.

Ensuing litigation included a claim of spoliation of evidence by Mr. Rivera, who charged that the Davie, Florida-based stable failed to preserve the horse’s remains after the accident so they could be tested for performance-enhancing drugs, thus impairing Mr. Rivera’s ability to prove his claims against the other defendants in his litigation.

The stable’s insurer, Selective Insurance Company of the Southeast, a unit of Branchville, New Jersey-based Selective Insurance Group, said it had no duty to defend White Racing Stables against Mr. Rivera’s lawsuit because it did not fall within the terms of its liability policy’s coverage for damages arising from “bodily injury from accident.”

The insurer filed suit in U.S. District Court in Miami, seeking a declaratory judgment it owed no duty to defend the stable.

The court ruled in the stable’s favor, entering a partial declaratory judgment requiring it to defend White Racing Stables against Mr. Rivera’s lawsuit.

On appeal, a three-judge appeals court panel unanimously reversed the lower court’s ruling.

“The Florida Supreme Court has held that a liability policy applying to ‘bodily injury by accident’ does not provide coverage for claims against an insured for breaching a duty to preserve evidence,” said the ruling, in holding the insurer had no duty to defend White Racing Stables.



[DO NOT PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT




No. 16-16248
Non-Argument Calendar


D.C. Docket No. 1:15-cv-21333-JAL
SELECTIVE INSURANCE COMPANY OF THE SOUTHEAST,
a Foreign Corporation,

Plaintiff - Appellant,
versus
WILLIAM P. WHITE RACING STABLES, INC.,
Florida corporation,

Defendant - Appellee,

JAMES RIVERA, et al.,
Defendants.
Appeal from the United States District Court
for the Southern District of Florida



Before HULL, WILSON, and ROSENBAUM, Circuit Judges. PER CURIAM:
This  is  an  action  by  an  insurer,  Selective  Insurance  Company  of  the

Southeast (“Selective”), seeking a declaration that it owes no duty to defend its insured, William
P. White Racing Stables (“White Racing”), against a lawsuit filed by one of White Racing’s former
employees, James Rivera. The district court found a duty to defend and entered a partial
declaratory judgment in favor of White Racing. After careful review, we reverse and remand for
entry of judgment in favor of Selective.
I.

Rivera was a professional jockey who was grievously injured by an accident at the Calder Race Track
in Miami Gardens, Florida, in November 2008. Rivera was riding a two-year-old filly named Flyfly
Fly Delilah at full gallop during a workout when the horse suddenly collapsed, taking Rivera to the
ground with it. The accident left Rivera paralyzed from the neck down. Rivera believes that Flyfly
Fly Delilah was not fit to be exercised or raced due to an injury, which had been covered up
through steroids and other medications.


After the accident, Rivera sued White Racing, the Calder Race Track, and several veterinarians.
Rivera alleged that the negligence of nearly all defendants caused  his  injuries.    


Significantly,  however,  Rivera  did  not  state  a  similar
negligence claim against White Racing. Instead, Rivera alleged that White Racing was liable for
damages caused by its failure to preserve Flyfly Fly Delilah’s remains after the accident so that
the horse could be tested for performance- enhancing drugs. In particular, Rivera’s fourth amended
complaint1 stated two specific counts against White Racing: (1) a claim under the Florida Worker’s
Compensation Statute for failure to cooperate in investigating and prosecuting Rivera’s claims
against a third-party tortfeasor, see Fla. Stat. § 440.39(7) (Count VIII); and (2) a claim for
spoliation of evidence (Count IX).


Selective insured White Racing under both a worker’s compensation policy and an employer’s
liability policy. Selective provided Rivera benefits under the worker’s compensation policy for his
injuries. But Selective maintained that it had no duty to defend White Racing against Rivera’s
lawsuit because it did not fall within the terms of the liability policy’s coverage for damages
arising from “bodily injury by accident.”


To that end, Selective filed this declaratory-judgment action seeking a declaration that it owed no
duty to defend. Selective argued that Rivera’s claims against White Racing were solely for economic
losses—not bodily injury— flowing from its alleged breach of its duties to preserve evidence after
the accident.

1 The fourth amended complaint was the operative pleading when this declaratory judgment action was filed. Although Rivera has since filed a fifth amended complaint, the parties represent that it is,
for present purposes, materially indistinguishable from the fourth amended complaint. Accordingly,
we refer to the fourth amended complaint as the operative pleading.


In response, White Racing conceded that the two specific counts stated against it were not covered
by the liability policy. Nevertheless, White Racing maintained that Selective owed a duty to defend
because the factual allegations in Rivera’s complaint could support a negligence claim against
White Racing for Rivera’s injuries.


On cross-motions for summary judgment, the district court agreed  with White Racing and entered a
partial declaratory judgment requiring Selective to defend White Racing against Rivera’s lawsuit.
Selective now appeals that decision.


II.

We review de novo the district court’s grant of summary judgment. Liebman v. Metropolitan Life Ins.
Co., 808 F.3d 1294, 1298 (11th Cir. 2015). Summary judgment is appropriate where, viewing the
evidence and drawing all reasonable inferences in favor of the party opposing summary judgment,
“there is no genuine issue of material fact and the moving party is entitled to judgment as a
matter of law.” Id.; Fed. R. Civ. P. 56(a).


Because this action was filed in federal court on the basis of diversity jurisdiction, state law
controls as to any issue not governed by the Constitution or treaties of the United States. 
Mid-Continent Cas. Co. v. Am. Pride Bldg. Co., LLC, 601 F.3d 1143, 1148 (11th Cir. 2010).  The parties agree, as do we, that Florida law governs this insurance-contract dispute.


“Our objective is to determine the issues of state law as we believe the Florida Supreme Court
would.” State Farm Fire & Cas. Co. v. Steinberg, 393 F.3d 1226, 1231 (11th Cir. 2004). We are,
therefore, bound by decisions of the Florida Supreme Court, as well as decisions from Florida’s
intermediate appellate courts unless there is some persuasive indication that the Florida Supreme
Court would decide the issue differently. Id.; Davis v. Nat’l Med. Enters., Inc., 253 F.3d 1314,
1319 n.6 (11th Cir. 2001). 


We are also bound by our own decisions interpreting state law “absent a
later decision by the state appellate court casting doubt on our interpretation of that law.”
EmbroidMe.com, Inc. v. Travelers Prop. Cas. Co. of Am., 845 F.3d 1099, 1105 (11th Cir. 2017).
Under Florida law, an insurer’s duty to defend is distinct from and broader than its duty to
indemnify. Mid-Continent Cas. Co., 601 F.3d at 1148–49. “The duty to defend depends solely on the
facts and legal theories alleged in the pleadings and claims against the insured.” Lawyers Title
Ins. Corp. v. JDC (Am.) Corp., 52 F.3d 1575, 1580 (11th Cir. 1995); see also Steinberg, 393 F.3d at
1230. For the duty to defend to arise, the initial pleadings must “fairly bring the case within the
scope of coverage.” State Farm Fire & Cas. Co. v. Tippett, 864 So. 2d 31,  35–36  (Fla.  Dist.  Ct.
 App.  2003).    That  is,  “[t]he  allegations  within  the complaint must state a cause of action that seeks recovery for the type of damages covered by the
insurance policy in question.” Id. “If the allegations in the complaint state facts that bring the
injury within the policy’s coverage, the insurer must defend regardless of the merit of the
lawsuit.” Amerisure Ins. Co. v. Gold Coast Marine Distribs., Inc., 771 So. 2d 579, 580 (Fla. Dist.
Ct. App. 2000). In other words, the “insurer must defend even if facts alleged are actually untrue
or legal theories unsound.” Lawyers Title Ins. Corp., 52 F.3d at 1580. Any doubt about the duty to
defend must be resolved in favor of the insured. Trizec Props., Inc. v. Biltmore Constr. Co., Inc.,
767 F.2d 810, 812 (11th Cir. 1985).


III.

Looking solely to the specific claims Rivera asserted against White Racing—(1) spoliation and (2)
failure to cooperate under Fla. Stat. § 440.39—no duty to defend arises, as both parties agree. The
Florida Supreme Court has held that a liability policy applying to “bodily injury by accident” does
not provide coverage for claims against an insured for breaching a duty to preserve evidence.
Humana Worker’s Comp. Servs. v. Home Emergency Servs., Inc., 842 So.2d 778, 781 (Fla. 2003). 

The
damage that flows from a breach of a duty to preserve evidence “is the resulting inability to prove
a cause of action.” Id. Such spoliation claims, according to the Court, “seek[] compensation not
for the bodily injury . . .
sustained in [the accident] but, rather, for [the] loss of a probable expectancy of recovery in the
underlying suit.” Id.
Rivera’s fourth amended complaint sought recovery against White Racing solely for breaching its
duties to preserve critical evidence and impairing his ability to prove his claims against the
other defendants. As a result, the liability policy applying to “bodily injury by accident” does
not provide coverage for these claims. See id. Because Rivera does not “seek recovery for the type
of damages covered by the insurance policy in question,” there is no duty to defend. See Tippett,
864 So.2d at 35–36.
Despite this straightforward and largely undisputed analysis, White Racing maintains that Selective
owed a duty to defend. According to White Racing, the duty to defend is determined by the totality
of the factual allegations in the complaint, irrespective of the specific counts pled, with all
doubts resolved in favor of the insured. The district court agreed, reasoning that the state of
facts alleged in the complaint could support a finding of negligence against White Racing for
Rivera’s injuries.
In response, Selective strenuously objects that the duty to defend cannot be based on a theoretical
claim that was not actually pled. Selective also asserts that no negligence claim against White
Racing could be pursued because of a worker’s compensation exclusion in the liability policy.

No case from this Court or the Florida courts is directly on point. Our review of relevant
authority indicates that, on the one hand, allegations that support alternative theories of
liability, some covered by the policy and some not, still trigger the duty to defend. See Baron Oil
Co. v. Nationwide Mut. Fire Ins. Co., 470 So. 2d 810, 813–14 (Fla. Dist. Ct. App. 1985) (“If the
complaint alleges facts showing two or more grounds for liability, one being within the insurance
coverage and the other not, the insurer is obligated to defend the entire suit.”); see also Lime
Tree Village Cmty. Club Ass’n, Inc. v. State Farm Gen. Ins. Co., 980 F.2d 1402, 1405 (11th Cir.
1993) (finding a duty to defend because “[t]he factual allegations set forth grounds, other than
intentional acts and discrimination, upon which Lime Tree could be held liable”). Moreover, courts
are not bound by the labels the third- party plaintiff places on her claims. See Tippett, 864 So.2d
at 35 (“[W]ording alone in a pleading does not create a duty to defend, regardless of its
artfulness.”).
But on the other hand, insureds generally may not trigger the duty to defend by invoking theories
of liability that were not alleged in the complaint. See Chicago Title Ins. Co. v. CV Reit, Inc.,
588 So. 2d 1075, 1076 (Fla. Dist. Ct. App. 1991) (“[W]hether or not a duty to defend exists arises
from the allegations of the complaint itself, not on some conclusions drawn by the insured based
upon a theory of liability which has not been pled.” (citations omitted)); cf. ABC Distrib., Inc.
v. Lumbermens Mut. Ins. Co., 646 F.2d 207, 209 (5th Cir. May 29, 1981) (rejecting an insured’s argument that the court could “examine whether an alternate theory at trial
might support a recovery within the coverage of the insurance policy,” but noting that a different
rule may apply in “the instance of a homedrawn, pro se complaint”)2; Nat’l Union Fire Ins. Co. v.
Lenox Liquors, Inc., 358 So.2d 533, 535–36 (Fla. 1977) (holding that an insurer was not required to
defend because, despite a stipulation that the case would have been tried on “negligence grounds
rather than willful conduct,” the complaint alleged only intentional acts of the insured, which
were not covered by the policy).


This case occupies somewhat of a middle ground between these two broad principles. The “state of
facts” alleged arguably could support a claim that White Racing’s negligence contributed to
Rivera’s bodily injuries. See Lenox Liquors, 358 So.2d at 535 (stating that the duty to defend
arises “where the complaint alleges a state of facts within the coverage of the insurance policy”).
Yet perhaps due to complications arising from Rivera’s receipt of worker’s compensation benefits,
the complaint quite clearly does not seek recovery against White Racing for those injuries. In
these circumstances, we cannot conclude that the Florida Supreme Court would find a duty to defend
based on the mere theoretical possibility that Rivera could seek recovery against White Racing for
his injuries at some later time. See Steinberg, 393 F.3d at 1231.


2   This Court adopted as binding precedent all Fifth Circuit decisions prior to October 1, 1981.
Bonner v. City of Prichard, 661 F.2d 1206, 1209 (11th Cir. 1981) (en banc).


Rivera’s counseled fourth amended complaint does not “fairly bring the case within the scope of
coverage.” See Tippett, 864 So. 2d at 35. Although the general rule for the duty to defend is often
phrased broadly, the inquiry focuses on whether the complaint “seeks recovery for the type of
damages covered by the insurance policy in question.” Id. at 35–36 (emphasis added). The insurer
must defend the lawsuit, regardless of its merit, only “[i]f the allegations in the complaint state
facts that bring the injury within the policy’s coverage.” Amerisure Ins. Co., 771 So. 2d at 580.
The insurer “is not required to defend if it would not be  bound  to indemnify the insured even
though the plaintiff should prevail in his action.” Capoferri v. Allstate Ins. Co., 322 So. 2d 625,
627 (Fla. Dist. Ct. App. 1975).
The fourth amended complaint makes clear that the injury for which Rivera sought to recover damages
was the inability to prove a cause of action, caused by White Racing’s alleged breach of its duties
to preserve evidence after the accident. As we have established above, and as both parties agree,
Florida law is clear that those damages are not covered by a liability policy that applies to
“bodily injury by accident.” See Humana Worker’s Comp. Servs., 842 So. 2d at 781. Because Rivera
does not seek recovery against White Racing for damages arising from “bodily injury by accident,”
Selective would not be bound to indemnify White Racing if Rivera prevailed in his lawsuit.
Accordingly, Selective has no duty to defend White Racing against Rivera’s claims.  See Capoferri,
322 So. 2d at 627.


The district court erred in finding a duty to defend “based upon a theory of liability which has
not been pled.” See Chicago Title Ins., 588 So.2d at 1076. The extraneous allegations that arguably
support a negligence claim relating to the accident do not bring the requested damages within the
scope of the policy. See Amerisure Ins. Co., 771 So. 2d at 580. Even accounting for caselaw that
allows courts to evaluate alternative theories of liability that are plausibly suggested by, but
not expressly alleged in, a complaint, that principle would not apply in this case. Cf. Baron Oil
Co., 470 So. 2d at 813–14. The possible negligence claim constructed by White Racing is entirely
distinct from, not an alternative to, the spoliation claims alleged in the complaint. See Humana
Worker’s Comp. Servs., 842 So. 2d at 781. The former seeks recovery for damages arising from bodily
injury based on actions before the accident, while the latter seek recovery “for [the] loss of a
probable expectancy of recovery in the underlying suit” based on actions or omissions after the
accident. Id. White Racing cites no authority, beyond restating the general rule, supporting its
view that the duty to defend arises in similar circumstances.
And if Rivera raised a bodily-injury negligence claim later in the proceeding, as suggested by the
district court, the duty to defend could arise at that
time.

3 See Grissom v. Commercial Union Ins. Co., 610 So. 2d 1299, 1307 (Fla. Dist. Ct. App. 1992)
(“If it later becomes apparent (such as in an amended complaint) that claims not originally within
the scope of the pleadings are being made, which are now within coverage, the insurer upon
notification would become obligated to defend.”); see also ABC Distrib., Inc., 646 F.2d at 209
(stating that the duty to defend could arise “when [an] alternate and arguably covered theory is
advanced”). But for the reasons explained above, we cannot conclude that Selective is required to
defend now based on that hypothetical possibility.


In sum, we conclude that the district court erred in finding a duty to defend based on Rivera’s
fourth amendment complaint. Because the basis for Rivera’s action against White Racing was for
spoliation of evidence, it is not covered by the liability policy.4 See Humana Worker’s Comp.
Servs., 842 So.2d at 781. And since there is no duty to defend, there is no duty to indemnify. See
Fun Spree Vacations, Inc. v. Orion Ins. Co., 659 So.2d 419, 422 (Fla. Dist. Ct. App. 1995) (“Since
Orion had no duty to defend the insureds, correspondingly, there is no duty to indemnify them nor
to pay the consent judgment.”).

3 We do not say that it would, as that question is not before us. We further note that the way in
which the claim was raised might determine the outcome: the Florida Supreme Court has held that it
may violate due process to raise a new theory of liability at trial that is “nowhere framed in the
pleadings.” Tamiami Trail Tours, Inc. v. Cotton, 463 So. 2d 1126, 1128 (Fla. 1985).


4 Because we conclude that there is no duty to defend based on the allegations in the complaint, we
need not consider Selective’s arguments that the worker’s compensation exclusion bar negated any
duty that it would have had to defend a possible negligence claim.

Accordingly, we REVERSE the partial declaratory judgment in favor of White Racing, and we REMAND for entry of judgment in favor of Selective.

 

Cal/OSHA has cited three contractors (Johnstone Moyer, Inc., Largo Concrete, Inc. and N.M.N. Construction, Inc.) $147,315 for safety violations after investigating the collapse of a temporary mold (formwork) and vertical shoring at an Oakland construction site that sent 13 workers to the hospital.






Cal/OSHA Cites Three Contractors More Than $145,000 for Oakland Structure Collapse

Oakland—Cal/OSHA has cited three contractors $147,315 for safety violations after investigating the collapse of a temporary mold (formwork) and vertical shoring at an Oakland construction site that sent 13 workers to the hospital.
On May 26, workers at 3039 Broadway, a 435-unit mixed-use project, were pouring concrete into elevated formwork when the shoring system supporting the formwork collapsed. The workers fell some 20 feet along with freshly poured concrete, reinforcing steel, timber framework, and tools and equipment. One worker’s injuries required surgery.
“Significant safety lapses caused injuries that could have been much worse if the workers hadn’t landed in freshly poured concrete,” said Cal/OSHA Chief Juliann Sum. “Employers must identify, evaluate and correct unsafe working conditions and follow all requirements to prevent employee injuries and illnesses.”
Cal/OSHA’s investigation found that the formwork and vertical shoring system that collapsed were not properly designed, installed or inspected. Cal/OSHA issued serious and serious accident-related citations to subcontractors Largo Concrete, Inc. and N.M.N. Construction, Inc. for $73,365 and $70,320, respectively, for failure to ensure that the formwork and vertical shoring were designed to safely withstand all intended loads, failure to have calculations and drawings approved by a California registered civil engineer as required for vertical shoring over 14 feet tall, and failure to ensure the shoring supports were erected on a level and stable base. General citations were issued to general contractor Johnstone Moyer, Inc. for $3,630 in proposed penalties.
Cal/OSHA addresses safety requirements for concrete construction and vertical shoring in its Cal/OSHA Pocket Guide for the Construction Industry.
Cal/OSHA, officially known as the Department of Industrial Relations’ (DIR’s) Division of Occupational Safety and Health, helps protect workers from health and safety hazards on the job in almost every workplace in California. Cal/OSHA’s Consultation Services Branch provides free and voluntary assistance to employers to improve their safety and health programs. Employers should call (800) 963-9424 for assistance from Cal/OSHA Consultation Services. Cal/OSHA has also published a wealth of helpful guides for employers and workers.
Employees with work-related questions or complaints may contact DIR’s Call Center in English or Spanish at 844-LABOR-DIR (844-522-6734). The California Workers’ Information line at 866-924-9757 provides recorded information in English and Spanish on a variety of work-related topics. Complaints can also be filed confidentially with Cal/OSHA district offices




NMN Construction Company Profile

For the last 20-years NMN Construction has been honing our craft with the goal of being the best shotcrete and gunite contractor in the region. By keeping up with the latest technologies and paying close attention to on-site safety and quality workmanship we have completed hundreds of shotcrete projects all across California with varying levels of difficulty. In 2012, shotcrete-veteran Ron Federico joined our team to oversee operations. With over 30-years of industry experience Ron has applied shotcrete to civil, structural, repair and architectural concrete construction.

Established: March 31, 1994 

Licenses: CA# 712842 Disadvantaged Business Enterprise: Minority (MBE) Union Affiliations: Shotcrete, Operators, Laborers Total Employees: 103
Financial Reference: US Bank
Insurance Providers: Alliant Insurance Services Surety: Zurich North American Surety Single Project Bonding Capacity: $40,000,000 Aggregate Bonding Capacity: $80,000,000
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12 Injured After Large Housing Project Under Construction Partially Collapses in Oakland, California

The proposed housing development project is being financed by the largest landlord in the U.S.

By Riya Bhattacharjee and Bigad Shaban
May 26, 2017



Twelve people suffered minor injuries when a building under construction partially collapsed in downtown Oakland Friday morning, burying workers under wet concrete and debris.

The workers were pouring concrete at about 9:30 a.m. when the floor fell out from under them, fire Battalion Chief Ian McWhorter said.

Oakland Fire Department Deputy Chief Darren White said all the workers were safely extricated after falling 10 to 15 feet into wet cement and getting buried in it and debris. Some workers were left hanging from scaffolding, McWhorter said.

Oakland fire and police crews responded to the site, located at 3093 Broadway, a large mixed-use housing project by developer CityView and its financial backer Blockstone Group, after a caller alerted them to the incident at 9:30 a.m.

Blackstone Group LP, is the largest landlord in the U.S.


All 12 workers were transported to local hospitals and were treated for minor injuries, which McWhorter described as scrapes and bruises.

"Right now we don't know what caused this incident to occur," White said.

"On-site workers did a great job with assisting those under small debris," McWhorter said.

Most workers were trapped up to their knee level, he added.


Cal-OSHA and a city engineer are on the scene investigating what caused the collapse.

"The company needs to know the safe way to do things," Peter Melton from Cal-OSHA said. "Their workers need to be properly trained on safe procedures. We want everyone to go home at the end of the day safe and sound."

The contractor for the proposed building is Johnstone Moyer, Inc. and the concrete contractor is listed as Largo Concrete, Inc.

According to federal inspection records reviewed by the Investigative Unit, both companies have been cited for safety violations in the past.

Largo Concrete, based in Tustin, was cited 5 times in the past 5 years, according to records from the Department of Labor. Two of those violations involved accidents. Largo Concrete was fined $8,655 for those violations, which were related to unsafe work conditions and the company’s injury prevention program. One violation was listed as “serious” and involved protocols that should have been in place to protect workers from being impaled by steel or other materials.

Johnston Moyer, based in San Carlos, was cited 6 times in the past 5 years for violations relating to safety conditions and permitting, according to federal inspection reports.

Neither company offered comment about the accident on Wednesday.

Johnston Moyer had a Cal-OSHA inspection at the site on March 22 due to a complaint about safety at the site, a former Bay City Chevy dealership.

The proposed housing project is expected to open in 2018, and according to a Bloomberg report, has a budget of $150 million. It's unclear if that number has changed.


According to a building permit filed with the City of Oakland, the seven-story structure will include 423 apartments and 21,000 square feet of commercial space on the ground floor. The site is located next to a large retail project called the Shops at Broadway.


NBC Bay Area's SkyRanger showed several people being wheeled away in stretchers following the collapse.

Witness Armando Morales feared the incident was much worse than what actually transpired.

"With all these problems (happening) right now, the first thing that I think is is somebody put a bomb," he said.


Julie Morton, who was working at the medical building on Broadway and Webster, which is located right next to the site on Pill Hill, as the neighborhood is referred to, said she heard a loud sound.

"Our building shook and it literally felt like an earthquake — we looked out of the window and started taking video," Morton said. "It looked like the cement support gave away and the wet cement came pouring down on the workers. It covered a lot of the workers. Police and ambulances started arriving."


Morton said the building has been under construction for a couple of months now.

"I'm really shook up, I'm praying for the workers safety," she said. "It's an awful sight to see."