SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
A-1316-95T2
A-2003-95T2
THE GRAND COVE II CONDOMINIUM
ASSOCIATION, INC., GRAND COVE I
APARTMENT CORPORATION, and
GRAND COVE MASTER ASSOCIATION,
INC.,
Plaintiffs-Respondents
-vs-
BARRETT ALLEN GINSBERG,
WILLIAM ATLAS ASSOCIATES,
WILLIAM ATLAS, VIRGONA &
VIRGONA, RAY VIRGONA, ALPINE
WOODS CONSTRUCTION CORP. OF
NEW JERSEY, ALPINE WOODS
CONSTRUCTION CORP., LAWRENCE
WECKER, BRUCE McPHEE, QUICK
MASONRY, INC., J.P. PATTI
COMPANY, INC., GRANDVIEW
ASSOCIATES WATERPROOFING,
K.M. GABEL COMPANY INC.,
VERMAAS COMPANY, INC.,
PHILIP FRITZE & SONS, INC., CAMBRIDGE
DRY WALL & CARPENTRY, CORP.,
F & G MECHANICAL CORP., TILCON
NEW JERSEY, INC., V.A.L. FLOORS,
INC., CUTRUPI & CO., INC.,
Defendants
and
WINDSOR COVE ASSOCIATES,
LIMITED PARTNERSHIP, S/A
ASSOCIATES, WINDJAMMER
CONSTRUCTION CORP., WINDJAMMER
CONSTRUCTION CORP. OF
NEW JERSEY, ANCHORAGE WOODS
CONSTRUCTION CORP.,
Defendants/Third-Party Plaintiffs-Respondents
-v-
NEWARK INSURANCE COMPANY,
FEDERAL INSURANCE COMPANY,
Third-Party Defendants-
Appellants,
and
NATIONAL UNION FIRE INSURANCE
COMPANY OF PITTSBURGH, PA and
NORTH RIVER INSURANCE COMPANY,
Third-Party Defendants.
Argued April 2, 1996 - Decided June 11, 1996
Before Judges Michels, Baime and Villanueva.
On appeal from Superior Court of New Jersey, Law
Division, Bergen County.
Virginia M. Sullivan argued the cause for
appellant Newark Insurance Company (Golden,
Rothschild & Spagnola, attorneys; Kenneth R.
Rothschild, of counsel; Ms. Sullivan, on the
brief).
Marilyn S. Silvia argued the cause for appellant
Federal Insurance Company (Hill Wallack,
attorneys; Gerard H. Hanson, of counsel; Ms.
Silvia, on the brief).
Michael S. Hanusek argued the cause for
respondents Windsor Cove Associates, Limited
Partnership, S/A Associates, Windjammer
Construction Corp., Windjammer Construction
Corp. of New Jersey and Anchorage Woods
Construction Corp. (Hirsch, Newman & Simpson,
attorneys; Daniel P. Simpson, of counsel; Mr.
Simpson and Mr. Hanusek, on the brief).
Robert C. Epstein argued the cause for respondents
The Grand Cove II Condominium Association, Inc.,
Grand Cove I Apartment Corporation and Grand Cove
Master Association, Inc. (Hannoch Weisman,
attorneys; Mr. Epstein, of counsel and on the
brief).
Respondents National Union Fire Insurance Company
of Pittsburgh, PA, and North River Insurance
Company did not file briefs.
The opinion of the court was delivered by
VILLANUEVA, J.A.D. (Retired and temporarily assigned on recall.)
We granted leave to appeal in two separate but related
appealsSee footnote 1 from a Law Division order compelling Newark Insurance
Company and Federal Insurance Company "at their own cost and
expense [to] fully defend" the developers of a residential
complex. Previously, we had denied both insurance companies'
motions for leave to appeal on the coverage issue. We now
reverse.
Windsor Cove Associates was the sole developer/sponsor of
Grand Cove, a condominium and cooperative development located on
the Hudson River in Edgewater, New Jersey. Grand Cove is now
plagued with major problems that include leaking and water
intrusion, settling of fill and backfill material which has
resulted in the cracking of concrete structures, and potential
defects in the sanitary sewer system.
This construction defect litigation was brought in 1989 by a
condominium association, a cooperative corporation and a master
association (collectively, the Associations) on behalf of the
owners of fifty-one residential condominium and cooperative units
in Grand Cove (the Project).See footnote 2 The Associations sought to
recover damages for design and construction defects from parties
who participated in the development, design and construction of
the Project. They allege that many of these problems began to
appear during construction.
In a Fourth Amended Complaint, the Associations asserted
that the DevelopersSee footnote 3 were liable for damages caused by "severe
design and construction deficiencies, defects, errors and
omissions." In their Third Amendment to the Fourth Amended
Complaint, the Associations asserted claims against the
Developers for negligence, statutory violations, breach of
contract and warranty, breach of fiduciary duty, and
misrepresentation. The Associations claim that the damages
allegedly sustained by them are "injury to the property of the
Associations and the loss of the use and/or beneficial use
thereof." The Associations' expert Carl F. Walter, III certified
that this property damage existed in 1987 and "occurred in part
in 1987"; the Associations make similar allegations.
The Developers filed a third-party complaint against four
insurers, including the two primary carriers Federal Insurance
Company (Federal) and Newark Insurance Company (Newark) (both
collectively, the insurers or carriers), seeking a declaration of
the insurers' obligation to defend and indemnify and alleging
breach of contract. The third-party complaint relies solely on
the underlying negligence claim. The issues involving Federal
and Newark arise from the Fourth Amended Complaint filed in May
1993, which named the Developers and others as direct defendants.
According to the insurance carriers, the trial court
permitted the plaintiff Associations to argue damages not
asserted in the complaint, i.e., "damage to work performed by
others on the project." In other words, the claims for coverage
are that these insured Developers allegedly caused damage to the
tangible property of other contractors on the Project. The
insured Developers, for example, "were performing construction
management services, . . . making design decisions, . . .
changing the quality of the work in many instances without the
knowledge or without the approval of . . . the design
professional."
The Developers filed a motion for partial summary judgment
for a declaratory judgment compelling Newark and Federal to
defend them and reimburse them for defense costs already
incurred. Newark and Federal filed separate cross-motions for
summary judgment seeking dismissal of the declaratory judgment
action. After oral argument the trial court granted the
Developers' motion for partial summary judgment, denied the
insurers' cross-motions, and ordered Newark and Federal to defend
the Developers in the underlying action by order dated April 12,
1995 (April 1995 order). The order provided, in part:
1. The third party defendants, Federal
Insurance Co. and Newark Insurance Company,
owe a duty to [the Developers] to defend with
respect to [the Associations'] Fourth Amended
Complaint;
2. Third party defendants, Federal Insurance
Co. and Newark Insurance Company, shall at
their own cost and expense fully defend third
party plaintiffs with respect to the Fourth
Amended Complaint . . . .
Federal and Newark filed separate notices of motion for
leave to appeal the April 1995 order. On June 19, 1995, we
denied the motions noting:
We emphasize that we deny leave to
appeal because we do not read or construe
paragraph 2 of the order of the Law Division,
dated April 12, 1995, to be a mandatory
injunctive order. Rather, we read and
construe this paragraph to be an
interlocutory declaration of the coverage
afforded by the third-party defendants
[Federal's and Newark's] policies of
insurance. Furthermore, this interlocutory
declaration does not resolve all issues as to
all parties in this matter and the granting
of leave to appeal from this interlocutory
order "runs counter to a judicial policy that
favors a[n] 'uninterrupted proceeding at the
trial level with a single and complete
review'", State v. Reldan,
100 N.J. 187, 205
(1985) (quoting In re Pennsylvania R.R.,
20 N.J. 398, 404 (1956)), and undoubtedly will
further delay this already unduly protracted
six-year old complex matter.
Federal's subsequent application for review by the New Jersey
Supreme Court was denied on October 2, 1995.
Thereafter, counsel for Newark advised the trial court at a
status conference that since the Appellate Division found that
the April 1995 order was not a mandatory injunctive order, Newark
had determined that it was not under an affirmative duty to
assume the defense of the named insureds until the underlying
claims had been settled or tried, at which time a trial on the
coverage issues could be held; if the court then determined that
coverage was afforded, Newark could pay or reimburse the defense
costs.
The trial court advised counsel for the insurers that the
intention of its April 1995 order was to direct the insurers to
defend the Developers immediately, stating:
You're either going to supply the direct
defense of the developers who have big
exposure or you're going to pay for their
counsel on an ongoing basis. You're not
going to wait to the end and assess whether
you're going to pay their counsel. You're
going to pay them now and that would be my
order.
Accordingly, on October 19, 1995, without benefit of a motion
from any party, the trial court entered an order directing the
insurers to assume the defense of the Developers or commence
payment of their attorneys' fees immediately and to pay within
thirty days all legal fees and disbursements incurred by the
Developers to date. Specifically, the order provided:
1. The Third Party Defendants, [Federal and
Newark], shall have until October 27, 1995 to
notify Daniel P. Simpson and Gordon Litwin,
Esqs. [attorneys for Developers] as to
whether or not [Federal and Newark] have
appointed new counsel to handle the direct
defense of Plaintiffs' claims in this action
subject to the right of Defendant/Third Party
Plaintiffs [the Developers] to apply to the
Court to designate their own counsel; in the
event [Newark and Federal] do not elect to so
notify Mr. Simpson and Mr. Litwin, their law
firms shall remain as counsel of record in
the litigation and [Federal and Newark] shall
be deemed to have consented to their
retention for such purpose;
2. [Federal and Newark] shall pay all
defense legal fees and disbursements incurred
by [the Developers] to date within thirty
(30) days of receipt of invoices for services
rendered by [the Developers'] attorneys in
connection with this litigation; in the event
[Federal and Newark] object to the
applicability and/or reasonableness of any
such invoices, [Federal and Newark] shall
file an application with the Court within
such thirty (30) day period with respect to
any such invoice or invoices to which
[Federal and Newark] object stating the
reasons for [their] objections to same or any
portion thereof;
3. Invoices rendered by counsel for [the
Developers] after the date of this Order
shall be paid by [Federal and Newark] within
thirty (30) days of their presentation to
[Federal and Newark]; and
4. In the event [the Developers] are
notified of a demand for settlement by
Plaintiff[] [Associations] which is deemed
acceptable to [the Developers], [the
Developers] shall immediately transmit notice
of same to counsel for [Federal and Newark];
upon receipt of such notice, [Federal and
Newark] shall have thirty (30) days in which
to object to such settlement being
consummated by making an application to the
Court for a hearing to determine the good
faith reasonableness of [Federal's and
Newark's] objection within such thirty (30)
day period; in the event no such application
is made within such thirty (30) day period,
[the Developers] shall be free to enter into
such settlement with Plaintiff[]
[Associations] and [Federal and Newark] shall
thereafter be bound by the terms and
conditions contained therein . . . .
In November 1995, Federal and Newark filed separate motions
for leave to appeal. Those motions were granted, as were
Federal's motions for a stay of the October 19 order pending
appeal and for leave to file a Supplemental Appendix.
The trial, which had been scheduled to commence on March 11,
1996, was postponed, but is now scheduled for June 17, 1996.
The Insurance Policies
Newark and Federal issued comprehensive general liability
(CGL) insurance policies in which the Developers are either the
named insureds or additional insureds.
The primary Federal policies of insurance each contain the
following express covenants:
We will pay damages the insured becomes
legally obligated to pay by reason of
liability imposed by law or assumed under any
contract or agreement because of: bodily
injury or property damage caused by an
occurrence; personal injury or advertising
injury covered by this insurance.
We will defend any suit against the insured
seeking such damages. We may investigate and
settle at our discretion any claim or suit.
We will not defend any suit or pay any claim
after we have used up the applicable Limit of
Insurance by payment of judgments or
settlements.
[Emphasis added.]
The Federal policies define property damage as
1. physical injury to or destruction of
tangible property which occurs during the
policy period, including loss of use thereof
at any time resulting therefrom; or
2. loss of use of tangible property which has not been physically injured or destroyed
provided such loss of use is caused by an
occurrence during the policy period.
The Federal policies define occurrence as "an event, including
continuous or repeated exposure to conditions which results in
bodily injury or property damage."
In its primary policy, Newark expressly covenants to insure
the Developers as follows:
The company will pay on behalf of the insured
all sums which the insured shall become
legally obligated to pay as damages because
of [A.] bodily injury or [B.] property damage
to which this insurance applies, caused by an
occurrence, and the company shall have the
right and duty to defend any suit against the
insured seeking damages on account of such
bodily injury or property damage, even if any
of the allegations of the suit are
groundless, false or fraudulent, and may make
such investigation and settlement of any
claim or suit as it deems expedient, but the
company shall not be obligated to pay any
claim or judgment or to defend any suit after
the applicable limit of the company's
liability has been exhausted by payment of
judgments or settlements.
[Emphasis added.]
Occurrence is defined as "an accident, including continuous or
repeated exposure to conditions, which results in bodily injury
or property damage neither expected nor intended from the
standpoint of the insured."
The Demands to Defend and the Third-Party Complaint
In 1993 after the Associations filed their Fourth Amended
Complaint against the Developers, they served Federal with
demands for a defense. Federal refused to defend. In June 1994
after the filing of the Third Amendment to the Fourth Amended
Complaint, counsel for the Developers made written demands for a
defense on both Federal and Newark based upon the claims set
forth in the Third Amendment. Both carriers admitted that they
issued the primary policies of insurance involved herein but
denied coverage and refused to defend and indemnify the
Developers.
Newark contended, first, that it was not obligated to
provide a defense or indemnification since the Project was
completed subsequent to the expiration of its policy and, second,
that the defects complained of during the policy period
constituted deficiencies in the "work in progress, rather than
property damage."
Federal asserted, among other defenses, that its policies
did not provide coverage for faulty workmanship of the insured or
for the consequences of negligently performed services. In
addition, it claimed that the "design and construction defects"
upon which the Associations based their claims do not constitute
property damage under a CGL policy.
The Agreement in Partial Settlement
On June 30, 1994, shortly after the Associations filed the
Third Amendment but before the Developers filed the third-party
complaint, the Developers entered into a comprehensive 47-page
"Agreement in Partial Settlement of Litigation" (Agreement) with
the Associations. The stated objectives of the Agreement are to
expedite resolution of the litigation and to limit the amount of
the plaintiffs' claims against the Developers. The Agreement
requires the Developers to:
1. Retain the law firm of Hirsch, Newman & Simpson to file
an action to join insurers in the underlying
litigation;
2. "Diligently and thoroughly" defend and/or prosecute all
claims, counterclaims and cross-claims involving the
contractors and sub-contractors ("Builder Defendants")
on the Project;
3. Consent to amendments to the plaintiffs' pleadings;
4. Retain the law firm recommended by plaintiffs' counsel,
Ansell, Zaro, Bennet & Grimm ("Ansell"), to represent
them in defense of the claims in the underlying
construction litigation;
5. Pay Ansell's fees, excluding any reimbursement obtained
from insurers, up to $100,000;
6. "Immediately execute," at the request of the
plaintiffs, general releases in favor of codefendant
Builder Defendants and their insurers, with "blank"
executed releases to be escrowed by plaintiffs'
counsel; and
7. Agree that the proceeds of all settlements will go to
the Associations; any claims of the Developers are
subordinate.
In addition, the Associations agreed to limit their recourse
against S/A Associates "to the amount of insurance, if any," and
against the other insureds to the sum of $15,000,000. However,
the Associations, at their sole discretion, may declare the
Agreement null and void if they determine that the Developers
have failed in any respect to perform their obligations under the
Agreement.
At the "closing" of the Agreement on June 30, 1994, the
Developers were required to execute releases, some in blank, in
favor of all codefendants and their insurers. Settlement with
two codefendants, Barrett Allen Ginsberg (architect) and
Grandview Waterproofing, Inc. became effective on that date. The
Developers executed releases to both Ginsburg and Grandview and
their insurers, and the Associations apparently received
settlement payments totalling $839,299.93.
Federal's brief denies that it had any notice of the
Agreement until October 13, 1995, and contends that the Agreement
was not presented to the trial court at the time of the October
11, 1995, conference.See footnote 4 Based upon receipt of filed Stipulations
of Dismissal, Federal believes that as of October 18, 1995, the
Associations had settled with all of the design professionals
(six named defendants), the first general contractor (Alpine
Woods), and five subcontractors. On December 18, 1995, default
judgments in amounts totalling $4,173,767 were entered against
four other subcontractors. Federal contends that it has no idea
how much the Associations have been paid to date or whether they
have been paid "in full" for their alleged damages.
Federal's Issues on Appeal
Federal seeks a reversal of the order for partial summary
judgment requiring it to assume control of the defense on behalf
of the third-party plaintiffs with respect to all claims asserted
in the underlying litigation; alternatively, if we determine that
it has such a duty to reimburse at some future date, its duty
should be limited to reimbursement of defense costs on ultimately
established claims for which it afforded coverage. Federal
argues that the trial court erred as a matter of law in
determining that it had a duty to defend because (1) its CGL
policies do not cover liability for faulty workmanship or
professional negligence; (2) the damages alleged do not
constitute "property damage" caused by an "occurrence" as defined
in the policies; (3) exclusions in its policies preclude
coverage; (4) it has no obligation to defend or indemnify third-party plaintiffs because they breached material provisions in the
CGL policies; (5) the trial court's order requiring it to assume
immediate control on the defense of all claims asserted against
its insureds constitutes reversible error because it had no duty
to defend claims not covered by the policies; and (6) the trial
court erred in refusing to treat Federal's defense obligation, if
any, as a duty to reimburse.
Newark's Issues on Appeal
Newark seeks a reversal of the order and a declaration that
it has no duty to defend third-party plaintiffs with respect to
the underlying litigation. Newark contends that (1) third-party
plaintiffs are not entitled to coverage because the property
damage alleged did not occur during its policy period; (2)
various exclusions set forth in the policy negate any obligation
to defend the third-party plaintiffs in the underlying action;
(3) coverage is excluded under the policy's broad form
comprehensive general liability endorsement; and finally, (4)
summary judgment should be granted in its favor pursuant to Brill
v. Guardian Life Insurance Co. of America,
142 N.J. 520 (1995).
Effect of Our Original Denial of Leave to Appeal
Although the Associations argue that our denial of leave to
appeal the April 1995 order effectively required the insurance
companies to defend the action, the subsequent decision of the
trial court in requiring the insurers immediately to assume
control of the defense of the underlying construction litigation,
reimburse their insureds for all defense costs incurred to date,
and potentially be bound by any settlement between its insureds
and the Associations causes us to have to review the insurance
companies' obligations.
The Duty to Defend
Federal argues that if it has a duty to defend, that duty is
limited to the allegations of negligence asserted against the
Developers in the Third Amendment. Newark argues, as it did
before the trial court, that the Developers are not entitled to
coverage on any of the counts in the Third Amendment.
The principles governing the insurer's duty to defend are
well settled. First, it is clear that the insurer's duty to
defend is typically broader than its duty to indemnify. As we
said in Hartford Insurance Group v. Marson Construction Corp.,
186 N.J. Super. 253, 257 (App. Div. 1982), certif. denied,
93 N.J. 247 (1983):
The insurer's obligation to defend is
triggered by a complaint against the insured
alleging a cause of action which may
potentially come within the coverage of the
policy, irrespective of whether it ultimately
does come within the coverage and hence
irrespective of whether the insurer is
ultimately obliged to pay.
The duty to defend is neither a product of statute nor
common law, "but is solely a contractual undertaking made in the
insurance policy." Horesh v. State Farm Fire & Casualty Co.,
265 N.J. Super. 32, 38 (App. Div. 1993). Therefore, an insurer is
charged with the duty to defend against claims which arise under
the contract of insurance. SL Industries, Inc. v. American
Motorists Ins. Co.,
128 N.J. 188, 215 (1992). The Supreme Court
has held that "the duty to defend extends only to claims on which
there would be a duty to indemnify in the event of a judgment
adverse to the insured." Hartford Accident & Indem. Co. v. Aetna
Life & Casualty Ins. Co.,
98 N.J. 18, 22 (1984). Accordingly, an
insurer's "duty to defend is determined by comparing the
allegations in the complaint with the language of the policy."
Voorhees v. Preferred Mut. Ins. Co.,
128 N.J. 165, 173 (1992).
As noted earlier, the Developers' third-party complaint
against the insurers relies solely on those allegations of
negligence asserted by the plaintiff Associations against the
Developers in the Third Amendment. The Third Amendment, by
contrast, asserts four additional causes of action, including (1)
violation of The Planned Real Estate Development Full Disclosure
Act, N.J.S.A. 45:22A-21 to -56, and the New Jersey Uniform
Construction Code, New Home Warranty and Builders Registration
Act, N.J.S.A. 46:3B-1 to -20; breach of contract and warranty;
breach of fiduciary duty; and misrepresentation. Nevertheless,
the trial court ordered the insurers to assume immediate control
of the defense with respect to all five causes of action asserted
against the Developers.
The claims for breach of contract and warranty and breach of
fiduciary duty clearly do not assert claims for which coverage is
provided. See Weedo v. Stone-E-Brick, Inc.,
81 N.J. 233 (1979).
Furthermore, the standard exclusion for intentional acts of the
insured precludes an obligation to defend and/or indemnify with
respect to the claims of misrepresentation and statutory
violations.
Although the duty to defend is broader than the duty to pay,
the duty "is not broader in the sense that it extends to claims
not covered by the covenant to pay." Horesh v. State Farm Fire &
Casualty Co., supra, 265 N.J. Super. at 38. It is only when the
allegation in the complaint and the language in the policy
correspond that the duty to defend against that claim arises.
See Voorhees v. Preferred Mut. Ins. Co., supra, 128 N.J. at 173
(emphasis added). "If an excluded claim is made, the insurer has
no duty to undertake the expense and effort to defeat it, however
frivolous it may appear to be." Horesh v. State Farm Fire &
Casualty Co., supra, 265 N.J. Super. at 39.
The five claims set forth in the Third Amendment do not
represent conflicting theories for the same claim, but rather
constitute separate claims for damages, some of which are based
on intentional acts of the insureds and thus are excluded from
coverage under Newark's and Federal's policies. The third-party
complaint, therefore, alleges only one covered claim, that of negligence.
There was no factual or legal basis for the trial court's
October 19, 1995, order that the insurers must assume
responsibility for defense of all claims. The insurers' legal
duty is "to pay only those defense costs reasonably associated
with claims covered under the policy." SL Industries, Inc. v.
American Motorists Ins. Co., supra, 128 N.J. at 215; see also
Burd v. Sussex Mut. Ins. Co.,
56 N.J. 383, 389 (1970) (explaining
that "the carrier's promise is to defeat or to pay a claim within
the policy coverage"). At a minimum, the trial court should have
held a hearing to more fully explore the coverage issues.
The Duty to Reimburse
Problems often arise with respect to the duty to defend
where, as here, the complaint against the insured alleges various
causes of action, some of which are not within the scope of the
insurance contract. For example, where a conflict of interest
exists between the insurer and the insured on the issue of
coverage, our courts have established procedures by which to
resolve some of those problems. See Hartford Accident & Indem.
Co. v. Aetna Life & Casualty Ins. Co., supra, 98 N.J. at 25-26;
Burd v. Sussex Mut. Ins. Co., supra, 56 N.J. at 391; Morton
Int'l, Inc. v. General Accident Ins. Co. of Am.,
266 N.J. Super. 300, 340-45 (App. Div. 1991), aff'd,
134 N.J. 1, 95 (1993), cert.
denied, ___ U.S. ___,
114 S. Ct. 2764,
129 L.Ed.2d 878 (1994).
Where a conflict exists between an insurer and its insured
by virtue of the insurer's duty to defend mutually-exclusive
covered and non-covered claims against the insured, the duty to
defend is translated into a duty to reimburse the insured for the
cost of defending the underlying action if it should ultimately
be determined, based on the disposition of that action, that the
insured was entitled to a defense. Burd v. Sussex Mut. Ins. Co.,
supra, 56 N.J. at 390.
Similarly, where an insurer did not undertake defense of the
case at the inception of the litigation, the duty to defend may
be converted into a duty to reimburse. SL Industries, Inc. v.
American Motorists Ins. Co., supra, 128 N.J. at 200. Moreover,
when the insurer wrongfully refused to defend an action but
ultimately was found liable for defense costs "its duty to
reimburse is limited to allegations covered under the policy,
provided that the defense costs can be apportioned between
covered and non-covered claims." Id. at 214-15; see also City
Council of Elizabeth v. Fumero,
143 N.J. Super. 275, 289 (Law
Div. 1976) (finding the insurer liable for only those defense
costs associated with the covered claim). Only when the defense
costs defy apportionment between covered and non-covered claims
will insurers be required to pay all of the defense costs,
including those costs associated with the non-covered claims. SL
Industries, Inc. v. American Motorists Ins. Co., supra, 128 N.J.
at 215-16.
There are appropriate instances where "an insured must
initially assume the costs of defense itself, subject to
reimbursement by the insurer if it prevails on the coverage
question." Hartford Accident & Indem. Co. v. Aetna Life &
Casualty Ins. Co., supra, 98 N.J. at 24 n.3. For example, in
Sands v. Cigna Property and Casualty Insurance Co.,
289 N.J.
Super. 344 (App. Div. 1995), we held that when insurance
companies failed to produce any facts to negate coverage (i.e.,
that the insured intentionally discharged a known pollutant) and
their claim of potential conflicts was illusory, the insurers
would not be permitted to turn their duty to defend into a duty
to reimburse. Id. at 350.
Here, there are many circumstances which militate against
the trial court's decision that the insurers immediately assume
defense of all causes of action and pay all legal fees and
disbursements to date incurred by the insureds. First, the trial
court conceded that some of the claims asserted against the
Developers are "clearly not covered" by the policies. Second,
there appears to be an inherent conflict by virtue of the fact
that the insurers will contest what they characterize as the
"late-raised, and factually unsupported, claims" by the
Associations and the Developers that the Third Amendment alleges
damage to the property of third persons (purportedly convincing
the trial court that the claims were covered by the policies).See footnote 5
Third, this case is more than six years old and involves
sophisticated parties most of whom have been represented by
counsel since inception of the law suit. Fourth, Newark is
obligated to defend the insured only if the property damage
occurred between January 9, 1987, and January 9, 1988; yet the
design and construction of the Project took place between 1985
and 1989.
Fifth, the underlying litigation will not resolve the
coverage issues in this case. We are also not certain what the
basis of the charges against third-party plaintiffs is that would
trigger coverage under Federal's policy. The charges appear to
be based on construction defects, that is, professional
negligence. If this is not an occurrence in the true sense,
there would be no coverage. Furthermore, whether any exclusions
are applicable is a question that cannot be resolved in the
underlying litigation.
Finally, and most importantly, if the Agreement between the
Developers and the Associations limits or extinguishes the rights
of the insurers to pursue contractual indemnification and
subrogation claims, then it appears that the insurers cannot
fairly be required to now take control of the defense of this
litigation. The Agreement apparently attempts to limit the
liability of the Developers and assure that the individual
Developers would not be at risk. Significantly, another
interesting feature of the Agreement is that it releases all
claims against individual defendants and Hannoch Weisman, all of
whom had potential liability. Thus, the Agreement may have
impaired the fundamental rights of the insurers.
In addition, the Developers must retain the law firm
recommended by plaintiffs' attorneys and pay plaintiffs' fees,
including any reimbursement obtained from insurers up to
$100,000. The Agreement also seeks to avoid a loss of recovery
by plaintiffs in the event that there is a bankruptcy or
insolvency of the Developers.
It further appears that the Developers executed releases to
co-defendants and their insurers and that plaintiffs received
settlement payments totaling more than $800,000. There is no
indication in the record as to whether plaintiffs have been paid
in full for their losses.
Moreover, there is a factual question whether the
Developers, by entering into the Agreement, violated the general
cooperation clause in the policies.
We reverse the order of October 19, 1995, and remand to the
trial court to have the coverage trial as to Federal and Newark
proceed prior to the action against the insureds.
Footnote: 1 Although the record does not reflect that the appeals were consolidated, they are being considered together. Footnote: 2 During the initial years of their existence, the Associations were dominated and controlled by Windsor Cove Associates. During this period, ownership of the common elements of Grand Cove was transferred by Windsor Cove Associates to the Associations, and residential units were offered for sale to the public pursuant to a private offering statement filed with the New Jersey Department of Community Affairs and other public agencies. Windsor Cove Associates, although now a defendant/third-party plaintiff in the underlying litigation, was a plaintiff in the initial complaint. Footnote: 3 The Developers -- Windjammer Construction Corp., Windjammer Construction Corp. of New Jersey, Windsor Cove Associates, S/A Associates and Anchorage Woods Construction Corp. -- are Defendants/Third-Party Plaintiffs-Respondents. Footnote: 4 We granted Federal leave to supplement the record on this appeal with the Agreement. Footnote: 5 The Associations state that "[a]lthough having no formal contracts to perform work or services, Federal's insureds acted in a variety of roles and performed an admixture of services on
the Project." Thus, the "precise nature and scope of the insureds' activities will be a central focus of the trial."