SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
A-3211-98T2
M&B APARTMENTS, INC.,
Plaintiff,
v.
MILTON TELTSER, BELLE TELTSER,
SYLVIA SHERMAN, MARGARET
SHARFSTEIN, 396 UNION AVENUE
ASSOCIATES, L.P., DAN SAWICKI,
GENERAL STAR INDEMNITY CO.,
HARTFORD FIRE INSURANCE COMPANY
and VIGILANT INSURANCE CO.,
Defendants,
and
FEDERAL INSURANCE CO.,
Defendant-Respondent,
v.
NORTH AMERICAN SPECIALTY
INSURANCE CO.,
Defendant-Appellant.
Argued December 13, 1999 - Decided February
16, 2000
Before Judges Havey, Keefe and Lintner.
On appeal from Superior Court of New Jersey,
Law Division, Essex County.
Paul A. Sandars, III, argued the cause for
appellant (Lum, Danzis, Drasco, Positan &
Kleinberg, attorneys; Mr. Sandars, of counsel
and on the brief with Lisa A. Firko and Julia
E. Romero).
Jeffrey M. Winn, admitted pro hac vice,
argued the cause for respondent (Gallo,
Geffner, Fenster, attorneys; Joseph K.
Powers, Anthony J. Andolino and Mr. Winn, on
the brief).
The opinion of the court was delivered by
HAVEY, P.J.A.D.
The central issue raised by this appeal is whether defendant
Federal Insurance Company (Federal), a second-tier excess
insurance carrier, owes a duty to defendant North American
Specialty Insurance (NAS), a third-tier excess carrier, to
negotiate and settle in good faith an insureds' first-party
property loss claim in accordance with the principles enunciated
in Rova Farms Resort, Inc. v. Investors Ins. Co. of Am.,
65 N.J. 474 (1974). We hold that no such duty exists in the context of a
first-party claim. Rather, to show a claim of bad faith, NAS
must demonstrate the absence of a reasonable basis for Federal's
refusal to settle. NAS fails to meet that burden. Accordingly,
we affirm the trial court's order dismissing NAS's cross-claim
for damages against Federal.
On February 11, 1994, an apartment complex in Irvington was
destroyed by fire. In May 1994, parties claiming an insurable
interest in the apartment complex instituted an action to recover
insurance proceeds for the loss. The property was insured by a
primary insurer and four tiers of excess coverage insurers:
(1) General Star Indemnity Company (General Star) issued the
primary policy with a coverage limit of $250,000; (2) Fireman's
Fund Insurance Company (Fireman's Fund) issued the first-tier
excess policy, covering up to $250,000 for losses exceeding
$250,000; (3) Federal issued the second-tier excess policy,
covering up to $1.5 million for losses exceeding $500,000; and
(4) NAS issued the third-tier excess policy covering up to $2.5
million for losses exceeding $2 million.See footnote 11
The policy issued by Federal provided for payment based on
the actual cash value of the subject property immediately prior
to the loss. However, the insureds had purchased optional
"replacement cost" coverage. Under the replacement cost
endorsement, Federal pays either the replacement cost of the
covered property or the cost actually expended in repairing it,
whichever was less. The policy provides that the insured could
recover based on the actual cash value basis and reserve its
right to make a further claim based on replacement cost. The
insured was required to satisfy the following condition precedent
in order to recover replacement cost:
3. The Company shall not be liable under
this endorsement for any loss unless and
until the damaged or destroyed property
is actually repaired or replaced by the
insured with due diligence and dispatch.
Federal was aware that the insureds were considering
purchasing, rather than rebuilding a replacement structure.
During discovery, the parties exchanged replacement cost
estimates ranging from $3.9 million to $5.2 million. Federal
acknowledged that these estimates exceeded its $1.5 million
coverage limit, and accordingly notified NAS of its potential
liability as the third-tier excess insurer. Federal suggested
settlement discussions with NAS.
On October 8, 1997, a court-appointed umpire and the
parties' appraisers issued their findings, fixing the actual cash
value of the property immediately before the fire at $800,000,
and the replacement cost at $3,337,200. General Star and
Fireman's Fund, the primary and first-tier excess carriers, paid
their respective policy limits of $250,000. On or about October
24, 1997, Federal paid $300,000, the balance of the actual value,
plus $7,325 for the cost of boarding up the property.
The insureds made a formal settlement demand of $2.3
million. Deducting the actual cash value already paid by General
Star, Fireman's Fund and Federal, Federal and NAS were called
upon to pay the balance. NAS agreed to the settlement, provided
Federal pay its policy limit of $1.5 million as the second-tier
excess insurer, with the balance to be paid by NAS. Federal
rejected the settlement offer.
In an order for judgment dated January 2, 1998, the insureds
were given the right "under the insurance policies issued by
Federal and NAS to replace the insured property by purchasing or
rebuilding" a comparable structure, without geographic
limitation. They were given until January 2, 1999, to purchase
or commence rebuilding.See footnote 22 Cross-claims between Federal and NAS
were preserved. In its cross-claim NAS alleged that Federal had
acted in bad faith by refusing to settle for $2.3 million. NAS
also alleged breach of contract, breach of fiduciary duty, and
tortious interference with NAS's contractual rights. It sought
both compensatory and punitive damages.
By summary judgment dated October 9, 1998, the trial court
dismissed NAS's cross-claims, concluding that Federal had not
acted in bad faith, and that NAS's remaining claims were legally
deficient.
In December 1998, the insureds entered into a written
contract to purchase a replacement residential apartment complex
in Hallendale, Florida, for $4,750,000. In January 1999, they
moved to compel Federal and NAS to pay the "replacement cost"
under the policies to be applied toward the purchase price of the
Florida property. The trial court ordered that the replacement
cost be paid, but only in the event that closing takes place on
or before February 27, 1999. The court directed that if the
insureds failed to close by that date, Federal and NAS would be
relieved of their duty to render payment under their policies.
The parties ultimately settled, and a timely closing took place.
Under the settlement, Federal paid $850,000 and NAS paid $1
million.
Citing Rova Farms, NAS argues that Federal breached its duty
of good faith and fair dealing to NAS as an excess insurer. As
NAS points out, it was undisputed that the subject property was
destroyed by fire, the loss was a covered risk, and the insureds
offered to settle for $2.3 million, approximately $1,337,200 less
than the replacement cost ultimately fixed by the court-appointed
appraiser. NAS claims that Federal acted in bad faith by
"assert[ing] complete control over the settlement process" and
"manipulating the insureds to go down to the wire to close on a
replacement property," knowing that the insureds' loss exceeded
Federal's $1.5 million policy limit. NAS reasons that Federal's
"wrongful and unsupportable actions" caused NAS ultimately to pay
$1 million toward the $1,850,000 settlement, or $700,000 more
than it would have paid had the parties settled the matter for
$2.3 million.
It is of course settled that an insurer reserving full
control under a policy for settling a claim against its insured,
becomes the insured's agent, and, in its fiduciary capacity, must
act in good faith. Rova Farms, supra, 65 N.J. at 492. This is
because the insured, by the terms of such a policy, is proscribed
from settling on his own behalf. Ibid. Consequently, the
insurer:
having contractually restricted the
independent negotiating power of its insured,
has a positive fiduciary duty to take the
initiative and attempt to negotiate a
settlement within the policy coverage. Any
doubt as to the existence of an opportunity
to settle within the face amount of the
coverage or as to the ability and willingness
of the insured to pay any excess required for
settlement must be resolved in favor of the
insured unless the insurer, by some
affirmative evidence, demonstrates there was
not only no realistic possibility of
settlement within policy limits, but also
that the insured would not have contributed
to whatever settlement figure above that sum
might have been available.
[Id. at 496.]
In Estate of Louis Penn v. Amalgamated Gen. Agencies,
148 N.J. Super. 419, 423 (App. Div. 1977), we held that the
principles enunciated in Rova Farms also apply between primary
and excess insurer on the basis of the general rule that an
excess insurer is subrogated to the insured's rights against the
primary insurer. We quoted Peter v. Travelers Ins. Co.,
375 F.
Supp. 1347, 1350-51 (D.C. Cal. 1974), which held:
Under the doctrine of equitable subrogation,
the duty owed an excess insurer is identical
to that owed to the insured. The excess will
not be able to force the primary into
accepting any settlement which his duty to
the insured would not require accepting. St.
Paul-Mercury Indemnity Co. v. Martin, supra,
at 457. In considering whether it will
settle a claim, the primary insurer may
consider its own interests, but it must
equally consider the interests of the
insured, which become the interests of the
excess insurer by subrogation.
While the interests of the primary
insurer are, for the most part, unaffected by
the existence of excess coverage, the
interests of the excess carrier are very much
affected by the actions of the primary. If
the primary carrier undertakes the
representation of the insured, then it has
the sole right to negotiate settlements. If
the primary carrier is relieved of its duty
to accept reasonable offers by the existence
of excess insurance, it would put an
additional financial liability on the excess
carrier which would be reflected in increased
premiums. It would also have the effect of
reducing the incentive of a primary insurer
to settle when the settlement offer is near
or over its policy limits. This is contrary
to the interests of the public and the
insured in obtaining prompt and just
settlement of claims.
[Estate of Louis Penn, supra, 148 N.J. Super.
at 423-24.]
See also, General Accident Ins. Co. v. New York Marine & Gen.
Ins. Co.,
320 N.J. Super. 546, 555 (App. Div. 1999) (the duty
owed an excess insurer from the primary insurer is identical to
that owed the insured); Baen v. Farmers Mut. Fire Ins. Co.,
318 N.J. Super. 260, 267 (App. Div. 1999) (same).
However, NAS has cited no New Jersey authority for the
proposition that the Rova Farms good-faith duty applies in the
context of first-party property claims. By the very terms of
first-party coverage, an insurer contracts to pay an insured the
actual loss suffered as a result of a covered peril; it does not
insure against exposure to third-party claims. Thus, neither an
insured nor its excess insurer is exposed to the uncertainties of
third-party claim valuations or to the potential for a primary
insurer's self-interested refusal to settle such claims.
Consequently, there is a recognized distinction between the
good-faith duty imposed by Rova Farms and the duty owed in the
context of first-party claims. In Pickett v. Lloyd's, 131 N.J.
457, 467 (1993), our Supreme Court held that an insurer owes a
duty of good faith to its insured in processing a first-party
claim. While the duty of good faith and fair dealing is implied
in every contract, Onderdonk v. Presbyterian Homes,
85 N.J. 171,
182 (1981), in the insurance field, "principles of equity, fair
dealing and good faith . . . breathed new lifegiving honesty into
the bare contractual relationship sometimes mentioned as existing
between insured and insurer." Rova Farms, supra, 65 N.J. at 491.
The Court in Pickett pointed to N.J.S.A. 17:29B-1 to -14, which
includes in its definition of unfair insurance, "[n]ot attempting
in good faith to effectuate prompt, fair and equitable
settlements of claims in which liability has become reasonably
clear . . . ." N.J.S.A. 17:29B-4(9)(f).
Pickett recognized a cause of action for bad-faith refusal
to pay an insured's claim, and adopted the "fairly debatable"
standard articulated by the Wisconsin Supreme Court in Anderson
v. Continental Ins. Co.,
271 N.W.2d 368, 376-77 (W.I. 1978), and
analyzed by the Rhode Island Supreme Court in Bibeault v. Hanover
Ins. Co.,
417 A.2d 313, 319 (R.I. 1980). The Bibeault court
stated the standard: "If a claim is 'fairly debatable,' no
liability in tort will arise." Ibid. In adopting this standard,
the Bibeault court quoted Anderson v. Continental at length:
"To show a claim for bad faith, a plaintiff
must show the absence of a reasonable basis
for denying benefits of the policy and the
defendant's knowledge or reckless disregard
of the lack of a reasonable basis for denying
the claim. It is apparent, then, that the
tort of bad faith is an intentional one.
. . .implicit in that test is our conclusion
that the knowledge of the lack of a
reasonable basis may be inferred and imputed
to an insurance company where there is a
reckless . . . indifference to facts or to
proofs submitted by the insured."
[Ibid. (quoting Anderson v. Continental Ins.
Co.,
271 N.W.2d 368, 376-77 (1978)).]
If the duty owed by a primary insurer to an excess insurer
is identical to that owed to an insured, it follows that the
rights of an excess insurer can rise no greater than those
enjoyed by the assured. See Standard Accident Ins. Co. v.
Pellecchia,
15 N.J. 162, 172 (1954) (The subrogee in effect steps
into the shoes of the insured and can recover only if the insured
likewise could have recovered"); Hartford Accident & Indem. Co.
v. Aetna Cas. & Surety Co.,
792 P.2d 749, 754 (Ariz. 1990) (under
equitable subrogation, a subrogee's rights are no greater than
the insured's). Consequently, NAS's argument that it has a
direct or equitable subrogation claim against Federal is
necessarily circumscribed by the "fairly debatable" standard
adopted in Pickett in the context of the good-faith duty owed by
a insurer to a first-party insured.
Applying Pickett, we agree with the trial court that NAS has
not demonstrated that Federal acted in bad faith. There is no
showing here of "the absence of a reasonable basis for denying
benefits" to the insureds, or of Federal's "reckless disregard of
the lack of a reasonable basis for denying the claim." Pickett,
supra, 131 N.J. at 473 (quoting Anderson, supra,
271 N.W 2d at
376-77). Stated differently, NAS failed to show that no
debatable reasons existed for Federal to reject the $2.3 million
settlement offer. The contrary is true.
Under the "replacement cost" coverage endorsement of
Federal's policy, Federal was not liable for any loss "unless and
until the damaged or destroyed property was actually repaired or
replaced by the insured with due diligence and dispatch."
(Emphasis added). Thus, Federal had absolutely no duty to tender
replacement cost or even settle the insureds' claim until the
destroyed property was "actually repaired or replaced." In June
1997, when the insureds made their settlement demand, they still
had not repaired or replaced the premises, and indeed had no firm
proposal on the table to do so. The settlement contemplated
payment of $1.5 million by Federal, but there was no obligation
on its part to pay the maximum coverage under the policy when the
insureds had not satisfied the condition precedent.
Moreover, when the final judgment was entered on January 2,
1998, fixing the replacement value at $3,337,200, the court
ordered the insureds to exercise their right to replace or
commence rebuilding the property within one year. The record is
clear that the structure destroyed by the fire was a
nonconforming use and therefore the insureds could not rebuild on
the subject lot. During 1998, the insureds negotiated two deals
for a replacement property, neither of which materialized. Even
on October 9, 1998, when the trial court dismissed NAS's cross
claim against Federal, the insureds had not consummated a deal to
replace the property.
It was not until December 1998, two months before expiration
of the extended deadline to replace the structure, that the
insureds entered into a written agreement to purchase the Florida
replacement apartment complex. At this point, when the insureds
moved to compel payment under the Federal and NAS policies in
December 1998, Federal and even NAS itself resisted payment
because they took the position that execution of a contract of
sale alone did not constitute "replacement" under the terms of
either policy.See footnote 33 In opposition to the insureds' motion, NAS
argued that: "It is clear from the undisputed facts in this case
that [the insureds] have not replaced the subject property to
date. Therefore, NAS has no obligation whatsoever to pay any
benefits to [the insureds] under the subject policy." In short,
Federal was entirely within its rights, consistent with the terms
of its policy, to reject the settlement offer and hold the
insureds to their obligation under the policy and the January 2,
1998 judgment to actually replace the structure before tendering
payment.
We have considered NAS's additional argument that the trial
court erred in dismissing its breach of contract, tortious
interference, and punitive damage claims and are satisfied they
are without merit and do not warrant extensive discussion by
formal opinion. R. 2:11-3(e)(1)(E).
Affirmed.
Footnote: 1 1Hartford Fire Insurance Company issued a fourth-tier policy, but was voluntarily dismissed from the case. Footnote: 2 2By consent order, the January 2, 1999 deadline was extended to February 22, 1999. Footnote: 3 3NAS also had a provision in its policy providing that no payment will be made "until the lost or damaged property is actually repaired or replaced."