SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
A-3987-96T2
CATHERINE STAFFORD AND WENDELL JONES,
Plaintiffs-Respondents,
-v-
T.H.E INSURANCE COMPANY, a corporation of
the State of New Jersey,
Defendant-Appellant,
PAT'S PIZZA AND PUB, t/a the Club Mirage,
a corporation of the State of New Jersey,
SABO PULLELLA, t/a the Club Mirage, and PRINCE
BAIN,
Defendants-Respondents,
and
ANTHONY D. PULLELLA, t/a the Club Mirage,
DON LUBIC, EUGENE LAWRENCE, t/a B. New York
Productions, VERNON LAWRENCE, t/a B. New York
Productions, and ACCURATE INSURANCE AGENCY,
a corporation of the State of New Jersey,
jointly, separately or in the alternative,
Defendants.
________________________________________________
Argued February l0, l998 - Decided March 5,
1998
Before Judges Long, Stern and Kleiner.
On appeal from Superior Court of New Jersey,
Law Division, Atlantic County.
Steven J. Polansky argued the cause for
appellant T.H.E. Insurance Company (Spector,
Gadon & Rosen, attorneys; Mr. Polansky, on the
brief).
Scott E. Becker argued the cause for
respondents Pat's Pizza & Pub, t/a the Club
Mirage, and Sabo Pullella, t/a the Club Mirage
(Mr. Becker, on the brief).
Edward R. Doughty argued for the cause for
respondents Catherine Stafford and Wendell
Jones (Mr. Doughty, on the brief).
Mark A. DeMarco argued the cause for
respondent Prince Bain (Mr. DeMarco, on the
brief).
The opinion of the court was delivered by
LONG, P.J.A.D.
On November 11, 1994, plaintiffs Catherine Stafford, Wendell
Jones and Prince BainSee footnote 1 were patrons at a nightclub known as Club
Mirage located in Atlantic City, New Jersey. At approximately 2:00
a.m. gunfire erupted in Club Mirage and all three patrons were
shot. The shots were fired by other patrons and not by Club Mirage
employees. Defendants, Pat's Pizza & Pub, Inc., Sabo Pullella and
Anthony D. Pullella are the owners of the nightclub.
At the time of this incident, Club Mirage was covered by a
commercial general liability policy (the "Policy") issued by T.H.E.
Insurance Company. The first page of the Policy states:
Various provisions in this policy restrict
coverage. Read the entire policy carefully to
determine rights, duties and what is and is not
covered.
The Policy also provides coverage for bodily injury and property
damage. Bodily injury is defined as "bodily injury, sickness or
disease sustained by a person, including death...." In an
endorsement, injury resulting from assault and battery is
specifically excluded. The exclusion states in full:
In consideration of the premium charged, it is
agreed that NO coverage of any kind (including
but not limited to cost of defense) is
provided by this policy for Bodily Injury
and/or Property Damage arising out of or
caused in whole or in part by an assault
and/or battery. Further, NO coverage is
provided if the underlying operative facts
constitute an assault and/or battery
irrespective of whether the claim alleges
negligent hiring, supervision and/or retention
against the insured or any other negligent
action.
This endorsement supplements any other
provision(s) of the policy to the extent it is
not inconsistent therewith. In the event this
endorsement is deemed inconsistent with any
other provision of the policy, then this
endorsement overrides and replaces that
provision.
On November 28, 1994, Club Mirage was advised of Stafford's
claim. On December 21, 1994, All Risk Claims Services, Inc., on
behalf of T.H.E. Insurance Company, acknowledged notice of
Stafford's claim to its insured, Club Mirage and subsequently
forwarded a reservation of rights letter to Club Mirage. A claims
adjuster advised Stafford that she was handling the case. Stafford
thus forwarded medical bills and other documentation.
All three patrons subsequently filed complaints asserting
various causes of action including inadequate security; negligent
hiring, training and supervision of employees; implied warranty and
public nuisance.
T.H.E. Insurance Company disclaimed coverage and on March 18,
1996, Stafford (later joined by Jones) filed the instant
declaratory judgment action, seeking a determination that the
assault and battery exclusion in the insurance policy did not apply
and that T.H.E. Insurance Company was required to defend and
indemnify the insured. T.H.E. Insurance Company answered, denying
the allegations and asserting various defenses. The three
underlying cases were stayed pending conclusion of the declaratory
judgment action.
In October 1996, Stafford, Jones and Bain filed motions for
partial summary judgment against T.H.E. Insurance Company seeking
to compel it to defend and indemnify Club Mirage. T.H.E. Insurance
Company, in turn, filed a motion for summary judgment on the
coverage issues seeking a determination that its exclusion
provision was applicable, and accordingly, it had no duty to defend
and indemnify.
The motion judge declared the assault and battery exclusion in
the T.H.E. Insurance Policy to be ambiguous:
In my opinion, had the paragraph, had the
... exclusion stopped after the first
question, I'm sorry, after the first sentence,
in my opinion, that would exclude this claim
from coverage. But for whatever reason the
drafter of this provision added a second
sentence. And the second sentence speaks in
terms of acts which could only be acts of
employees or could only pertain to employees,
I guess I should say.
As counsel had pointed out ... in the briefs, you can't hire a patron. I guess you can supervise a patron when a patron's inside the premises, you can't retain a patron. Well, I suppose you could give a patron ... a nice time so the patron comes back again, ... if that's retention, then I suppose you could retain a patron in that sense, but ... in my
view, the language of the second sentence here
refers to employees.
Now, I know perfectly well that ... a
problem area ... with a bar and those carriers
that write insurance policies with respect to
those bars is the action of the, in a
vernacular, the bouncers of the bars.
Bouncers, by their very nature, tend to be
large young men ... who are not afraid to ...
use their physicality to impose their will
upon patrons. they're not afraid to beat
people up, is what I mean.
There's lots of ... lawsuits where a
patron claims that a bouncer has roughed him
up or ... beaten him or otherwise injured the
... patron, and I can understand why an
insurance company would not want to make
itself responsible when a bouncer gets out of
hand and injures ... a patron.
It's difficult when the allegations of
such claims are that, well ... because a
plaintiff ... has to phrase it carefully in
order so ... that it's not an intentional act,
and therefore, excluded by, ... because of
it's ... intentional nature. He has to phrase
it in terms of negligence, well, the bouncer
negligently hit my client or negligently ...
there's ... an unintentional ... a negligent
and unintentional result that came about
because of an intentional act, or things of
that nature.
So, certainly an insurer has an interest
in excluding from coverage injuries that are
claimed to have ... resulted from assaults and
batteries. And there's nothing wrong with
that. Our ... cases say they can do that. I
think here, though, that the inclusion of this
second paragraph makes this exclusion
ambiguous as to whether or not it's ...
intended to cover anybody or just employees.
The language that I see in the Terranova case that Mr. Marconi was kind enough to supply for us here today seems pretty clear, and although ... Mr. Doughty may have tried to think of some way to ... divine coverage out of that, he really would have had a difficult time doing it because it very clearly says
that ... any assault and battery, no matter
how it comes about, is excluded. And you
could use language like that.
I don't subscribe to the proposition that
there are magic words that have to be used.
You don't have to say the word patron in order
to exclude the assault ... and ... battery by
a patron. But this exclusion, as I said
before, in my opinion, is ambiguous because
the second sentence could be read reasonably
... could be read as modifying or limiting the
action or the ... extent of the first
sentence, in that it's ... pretty clear that
the people whose actions are being talked
about in the second sentence are employees or
pretty clearly are employees.
So, if I conclude ... that the exclusion
is ambiguous, and ... I, therefore, conclude
that it does not cover assaults and batteries
by third parties, such as the unknown
assailants who fired the guns who injured the
claimants in this case. I, therefore, grant
the motion by plaintiffs Stafford and Jones,
defendant in this action, plaintiff in another
action, Bain, and I deny the motion for
summary judgment by T.H.E. Insurance Company.
He also rejected plaintiffs' estoppel argument concluding that
T.H.E. Insurance Company's reservation of rights letter was sent
within a reasonable period of time and that, despite the forwarding
of bills and other documentation by plaintiffs, there was no
reliance to their detriment on coverage. He ultimately entered
orders in favor of Stafford, Jones and Bain directing T.H.E.
Insurance Company to defend and indemnify Club Mirage. He denied
T.H.E. Insurance Company's summary judgment motion. T.H.E.
Insurance Company now appeals.
An insurer's "duty to defend comes into being when the
complaint states a claim constituting a risk insured against."
Voorhees v. Preferred Mut. Ins. Co.,
128 N.J. 165, 173 (1992)
(quoting Danek v. Hommer,
28 N.J. Super. 68, 77 (App. Div. 1953),
aff'd o.b.,
15 N.J. 573 (1954)). When the allegations in the
complaint and the language in the policy are compared, and when
they correspond, there is a duty to defend, regardless of the
merits of the claims. Ibid. Further, the duty to defend clause is
enforceable if there is a "potentially-coverable occurrence" that
would be indemnified if proved valid. Id. at 180. However, if the
insurer claims that the conduct in question falls within an
exclusion contained in the policy, then it is the insurer who bears
the burden of proving that issue. Sinopoli v. North River Ins.
Co.,
244 N.J. Super. 245, 251 (App. Div. 1990), certif. denied,
127 N.J. 325 (1991); Aetna Ins. Co. v. Weiss,
174 N.J. Super. 292, 296
(App. Div.), certif. denied,
85 N.J. 127 (1980).
Moreover, a policy of insurance will be enforced, as written,
when the terms are clear, in order that the parties' expectations
are fulfilled. Kampf v. Franklin Life Ins. Co.,
33 N.J. 36, 43
(1960); Scarfi v. Aetna Cas. & Sur. Co.,
233 N.J. Super. 509, 514
(App. Div. 1989). When the meaning of a provision is ambiguous,
however, the ambiguity is construed in favor of the insured and
against the insurer. Doto v. Russo,
140 N.J. 544, 556 (1995);
Schmidt v. Smith,
294 N.J. Super. 569, 582 (App. Div. 1996),
certif. granted,
148 N.J. 461 (1997). While coverage provisions
are given a broad interpretation by the courts, a strict
interpretation is required when there is an exclusion clause which
is also strictly construed against the insurer. Schmidt, supra,
294 N.J. Super. at 582; Aetna Ins. Co., supra, 174 N.J. Super. at
296. Despite this, the court should not ignore the clear meaning
and intent of exclusion provisions. Scarfi, supra, 233 N.J. Super.
at 5l4.
The issue on appeal is relatively straight-forward -- is the
assault and battery exclusion in T.H.E. Insurance Company Policy
ambiguous? As might be expected, T.H.E. Insurance Company argues
the exclusion in the Policy is "clear, concise and unambiguous" and
unequivocally excludes any claim in which "the underlying operative
facts could constitute an assault and/or battery" regardless of the
theory of liability advanced. Stafford, Jones, Bain, Pat's Pizza
& Pub and Sabo Pullella counter that the trial judge properly found
the exclusion to be ambiguous and thus the provision only excludes
assaults and batteries by employees. They argue that, although the
first sentence of the exclusion, standing alone, covers all
assaults and batteries, the second sentence is a "negation or
qualification" and limits the exclusion to assaults and batteries
perpetrated by employees; that the second sentence would be mere
surplusage if it did not limit the first; and that the words "any
other negligent action" should be read under the doctrines of
ejusdem generis and noscitur a sociis to mean other actions against
employees.
There appears to be no reported case in this State
interpreting the policy language here involved; none has been
brought to our attention and our own research has not disclosed
any. Counsel have cited many out of state and federal decisions
with exclusions, none of which contain a provision identical to the
instant provision. These citations do not aid in resolving this
matter.
We thus return to the Policy itself which provides coverage
for bodily injury and property damage. The Policy excludes
coverage for bodily injury or property damage arising from an
assault and battery:
In consideration of the premium charged, it is
agreed that NO coverage of any kind (including
but not limited to cost of defense) is
provided by this policy for Bodily Injury
and/or Property Damage arising out of or
caused in whole or in part by an assault
and/or battery. Further, NO coverage is
provided if the underlying operative facts
constitute an assault and/or battery
irrespective of whether the claim alleges
negligent hiring, supervision and/or retention
against the insured or any other negligent
action.
Contrary to the trial judge, we see no ambiguity whatsoever in the terms of the exclusion. Its language plainly indicates to the average reader that, no matter who commits the assault and battery, no coverage will be provided. The first sentence clearly excludes coverage for bodily injury or property damage "arising out of or caused in whole or in part" by an assault or battery. The second sentence does not limit the first sentence. Rather, the use of the word "further" in the second sentence (which means "in addition: moreover," "going or extending beyond what exists: additionally," Webster's Third New International Dictionary 924 (1971)) reminds the reader that the focus is on the nature of the injury alleged and not on a plaintiff's theory of liability. That the second sentence is not mere surplusage is underscored by its contrapuntal
use of the words "operative facts" and "claim." Regardless of how
a "claim" is framed, if the "operative facts" constitute an assault
and battery, the exclusion applies. Thus, by way of example, the
second sentence refers to "negligent hiring, supervision and/or
retention" which are obvious refuges for a plaintiff seeking to
avoid the assault and battery exclusion. See, e.g., Robert W.
Hayman, Inc. v. Acme Carriers, Inc.,
303 N.J. Super. 355, 356-57
(App. Div. l997) (finding provision in insurance policy which
excluded any fraudulent, dishonest or criminal acts committed by
the insured or its employees unambiguously excluded plaintiff's
claim of negligent supervision). However, the sentence goes on to
include "any other negligent action" thus placing the insured on
notice that it is the facts of the case and not the craft of the
plaintiff's lawyer which will determine the applicability of the
exclusion.
We recognize that if there is a second fair interpretation of
an exclusion available to an injured plaintiff, the insurance
policy will be construed for coverage against the insurer. Butler
v. Bonner & Barnewell, Inc.,
56 N.J. 567, 576 (l970); Sinopoli,
supra, 244 N.J. Super. at 25l; Aetna Ins. Co., supra, l74 N.J.
Super. at 296. This does not mean however that any far-fetched
interpretation of a policy exclusion will be sufficient to create
an ambiguity requiring coverage. In sum, we are satisfied that the
motion judge erred in declaring the assault and battery exclusion
in the Policy ambiguous.
Although there was no cross-appeal by plaintiffs from the
denial of their estoppel claim, we have nonetheless reviewed it and
have concluded that the motion judge properly rejected it based on
the evidence presented. R. 2:ll-3(e)(l)(A).
We thus reverse the grant of summary judgment to plaintiffs
and remand the matter to the motion judge for the entry of summary
judgment in favor of the T.H.E. Insurance Company.
Footnote: 1 Bain is actually a defendant in this action but a plaintiff in the underlying action.