IN THE SUPREME COURT OF
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No. 05-0261
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Mid-Continent Insurance Company, Appellant,
v.
Liberty Mutual Insurance Company, Appellee
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On Certified Questions from the United States
Court of Appeals for the Fifth Circuit
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Argued October 18, 2005
Justice Wainwright delivered the opinion of the Court.
Justice Willett filed a concurring opinion.
This dispute between one primary liability insurer and another primary insurer that also provides the applicable excess insurance policy comes to us on certified questions from the United States Court of Appeals for the Fifth Circuit. Pursuant to article V, section 3-c of the Texas Constitution and Texas Rule of Appellate Procedure 58.1, we answer the following questions:
1. Two insurers, providing the same insured applicable primary insurance liability coverage under policies with $1 million limits and standard provisions (one insurer also providing the insured coverage under a $10 million excess policy), cooperatively assume defense of the suit against their common insured, admitting coverage. The insurer also issuing the excess policy procures an offer to settle for the reasonable amount of $1.5 million and demands that the other insurer contribute its proportionate part of that settlement, but the other insurer, unreasonably valuing the case at no more than $300,000, contributes only $150,000, although it could contribute as much as $700,000 without exceeding its remaining available policy limits. As a result, the case settles (without an actual trial) for $1.5 million funded $1.35 million by the insurer which also issued the excess policy and $150,000 by the other insurer.
In that situation is any actionable duty owed (directly or by subrogation to the insured's rights) to the insurer paying the $1.35 million by the underpaying insurer to reimburse the former respecting its payment of more than its proportionate part of the settlement?
2. If there is potentially such a duty, does it depend on the underpaying insurer having been negligent in its ultimate evaluation of the case as worth no more than $300,000, or does the duty depend on the underpaying insured's evaluation having been sufficiently wrongful to justify an action for breach of the duty of good faith and fair dealing for denial of a first party claim, or is the existence of the duty measured by some other standard?
3. If there is potentially such a duty, is it limited to a duty owed the overpaying insurer respecting the $350,000 it paid on the settlement under its excess policy?
I. Background
In November 1996, an automobile
accident occurred in the construction zone of a State of
Kinsel was the named insured under Liberty Mutual Insurance Company’s $1 million comprehensive general liability (CGL) policy. Liberty Mutual also provided Kinsel with $10 million in excess liability insurance. Crabtree was the named insured under Mid-Continent Insurance Company’s $1 million CGL policy. Mid-Continent’s policy identified Kinsel as an additional insured for liability arising from Crabtree’s work. Kinsel, therefore, was a covered insured under two CGL policies, both of which provided Kinsel with $1 million in indemnity coverage for the underlying suit. The insurers had no contract between them that was implicated by the automobile accident.
The CGL policies contained identical “other insurance” clauses providing for equal or pro rata sharing up to the co-insurers’ respective policy limits if the loss is covered by other primary insurance:
4. Other Insurance.
If other valid and collective insurance is available to the insured for a loss we cover under Coverages A [‘Bodily Injury and Property Damage Liability’] or B of this Coverage Part, our obligations are limited as follows:
a. Primary Insurance
. . . If this insurance is primary our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in c. below.
. . .
c. Method of Sharing
If all of the other insurance permits contribution by equal shares, . . . each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first.
If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer’s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers.
Each policy also contained a “voluntary payment” clause,[1] a subrogation clause,[2] and a version of the standard “no action” clause.[3]
Liberty Mutual and Mid-Continent do
not dispute that each owed some portion of Kinsel’s
defense and indemnification. The insurers agreed that a total verdict for the Boutins against all defendants would be around $2 to $3
million, but they disagreed on the settlement value of the case against Kinsel. Initially both insurers estimated Kinsel’s percentage of fault between ten percent and
fifteen percent, but as the case progressed Liberty Mutual increased its
estimate to sixty percent. After repeated refusals by Mid-Continent to increase
its contribution to a settlement, Liberty Mutual agreed at a
mediation with the Boutins to settle on behalf
of Kinsel for $1.5 million (sixty percent of a $2.5
million anticipated verdict). Liberty Mutual demanded Mid-Continent contribute
half, but Mid-Continent continued to calculate the settlement value of the case
against Kinsel at $300,000 and agreed to pay only
$150,000. Liberty Mutual, therefore, funded the remaining $1.35 million, paying
$350,000 more than its $1 million CGL policy limit. Liberty Mutual reserved the
right to seek recovery against Mid-Continent for its portion of the settlement.
Sometime later, before trial, Mid-Continent settled the Boutins’
claim against Crabtree for $300,000. Liberty Mutual sued Mid-Continent in the
191st
Therefore, the district court
concluded that, whether apportioned pro rata or in equal shares, Mid-Continent
was liable in subrogation for $750,000, one-half of the $1.5 million settlement
with Kinsel.
II. Discussion
Liberty Mutual defends the district court’s $550,000 award on grounds that it is entitled to reimbursement through the contractual subrogation clause in its CGL policy and through the type of equitable subrogation applied in General Agents. Liberty Mutual argues it is subrogated to the contractual right of Kinsel to enforce language in Mid-Continent’s policy that places a duty on Mid-Continent to defend any claim or suit and pay an equal or pro rata share of settlement. Liberty Mutual also contends it is subrogated to the common law right of Kinsel to have Mid-Continent act reasonably when handling an insured’s defense—including reasonable negotiation and participation in settlement. The latter suggests we expand or create a modified Stowers duty in the circumstances of this case.
Mid-Continent contends that it did
not breach any recognized contractual or common law duty to Kinsel
to which Liberty Mutual may be subrogated. Mid-Continent further argues that it
owed no direct duty to Liberty Mutual upon which reimbursement may be based.
Any new duty in this context created by General Agents and adopted by
the district court, Mid-Continent continues, is contrary to
Specifically, with respect to subrogation, Mid-Continent denies that Kinsel has an enforceable contract right to which Liberty Mutual may be subrogated. Mid-Continent explains that because it complied with its contractual duty to timely assume defense of the suit against Kinsel and acknowledged policy coverage, Kinsel—and therefore Liberty Mutual—has no contract claim against Mid-Continent. Mid-Continent relies on the voluntary payment and no-action clauses in its policy to limit its liability to the amounts it consented to pay.
Mid-Continent adds that its only
common law duty to Kinsel in this third party context
was the Stowers duty to accept a
reasonable settlement offer within policy limits from the Boutins,
or else be liable for any excess judgment against Kinsel.
See G. A. Stowers
Furniture Co. v. Am. Indem. Co., 15 S.W.2d 544, 547 (Tex. Comm’n App. 1929, holding approved); Md. Ins. Co. v.
Head Indus. Coatings & Servs., Inc., 938 S.W.2d 27, 28 (
Asserting that no direct action
exists between co-insurers in Texas, Mid-Continent points to Traders &
General Insurance Co. v. Hicks Rubber Co., 169 S.W.2d 142 (Tex. 1943) and American
Centennial Insurance Co. v. Canal Insurance Co., 843 S.W.2d 480 (Tex.
1992). In Hicks Rubber, we held that a direct contribution action does
not exist between co-insurers when their policies contain other insurance
clauses. 169 S.W.2d at 148. Similarly in Canal,
the Court declined to recognize a direct action between an excess liability
insurer and a primary liability insurer. 843 S.W.2d at 483.
Mid-Continent adds that the lack of litigation in
Liberty Mutual’s claim for reimbursement involves the contractual and common law duties of an insurer in two distinct scenarios. The first scenario involves the ability of one co-insurer to compel a second co-insurer’s proportionate participation in the settlement of a third party claim. The second scenario, which arises from the first through Liberty Mutual’s claim of subrogation, involves the ability of an insured to compel an insurer’s proportionate participation in the settlement of a third party claim. Because no statute applies in the third party context, the scenarios are matters of common law contract and tort.
We agree with Mid-Continent and conclude that Liberty Mutual is not entitled to reimbursement because there is no direct duty of reimbursement between these co-primary insurers, and because Kinsel has no rights against Mid-Continent to which Liberty Mutual may be subrogated. We disapprove of General Agents to the extent it would provide recovery to an overpaying co-primary insurer in the context presented.
A. Contribution
Even though Liberty Mutual does not expressly argue for a right of contribution, its reliance on General Agents necessarily implies such. Thus, we analyze whether Liberty Mutual has a direct action for reimbursement under a right of contribution from Mid-Continent.
We recognized long ago in Hicks
Rubber “the general rule that, if two or more insurers bind themselves to
pay the entire loss insured against, and one insurer pays the whole loss, the
one so paying has a right of action against his co-insurer, or co-insurers, for
a ratable proportion of the amount paid by him, because he has paid a debt
which is equally and concurrently due by the other insurers.” Hicks Rubber Co. 169 S.W.2d at 148. The right of
action is one of contribution, the elements of which require that the several
insurers share a common obligation or burden, and that the insurer seeking
contribution has made a compulsory payment or other discharge of more than its
fair share of the common obligation or burden. Employers Cas. Co. v. Trans. Ins. Co., 444 S.W.2d 606, 609
(
We also recognized in Hicks
Rubber, however, that this direct claim for contribution between co-insurers
disappears when the insurance policies contain “other insurance” or “pro rata”
clauses. 169 S.W.2d at 148. A pro rata clause operates
to ensure that each insurer is not liable for any greater proportion of the
loss than the coverage amount in its policy
bears to the entire amount of insurance coverage available.
The CGL policies at issue here
contain pro rata clauses. Liberty Mutual and Mid-Continent contractually agreed
in their respective policies to pay a proportionate share of Kinsel’s covered loss up to $1 million. The co-insurers did
not, however, contract with each other to create obligations between themselves
or to pay each other’s proportionate share of Kinsel’s
loss. There is no contractual right of contribution between them, and the
presence of the pro rata clauses in the CGL policies precludes an equitable
contribution claim. In this situation, no contractual obligations exist between
co-insurers to apportion between themselves the payment on behalf of the
insured, and we are not persuaded to create such an obligation under the common
law.
This conclusion is contrary to the
holding of the San Antonio Court of Appeals in General Agents, which
appears to have recognized a new duty between co-insurers to reasonably
exercise their rights under an insurance policy given the totality of the
circumstances. 21 S.W.3d at 426. There, two insurers,
General Agents Insurance Company of America, Inc. (GAINSCO) and The Home
Insurance Company of
On GAINSCO’s
appeal, the San Antonio Court of Appeals reversed and remanded for a new trial,
holding that “[t]he trial court should have submitted a question to the jury
that inquired about the reasonableness of GAINSCO's
position and actions in exercising its rights under its policy given the
totality of the circumstances.”
The General Agents opinion
suggests that breach of this duty would provide, through subrogation, an
overpaying co-insurer with a right of reimbursement for the excess from the
breaching co-insurer.
B. Subrogation
Acknowledging that a right of contribution does not exist in this context, Liberty Mutual contends it can seek reimbursement through contractual or equitable subrogation to the rights of Kinsel. Both Hicks Rubber and Employers Casualty contain language suggesting that such an avenue of reimbursement could exist.
In Employers Casualty, after
precluding a right to contribution, we said that the co-insurers’ remedy for
reimbursement would lie in contractual or equitable subrogation. 444 S.W.2d at 610. In Hicks Rubber, a case relied
upon in Employers Casualty, we said that when several insurance policies
covering the same loss contain pro rata clauses, none of the co-insurers has a
right to contribution from the others, “nor will the payment of the whole loss
by any of them discharge the liability of the others.” 169
S.W.2d at 148. This languaage suggests
that payment of the insured’s entire loss by one co-insurer does not relieve
the other co-insurers’ contractual obligations to the insured to pay
their pro rata share of the loss.
Having a right to subrogation, however, is distinct from the ability to recovery under that right. See Esparza v. Scott & White Health Plan, 909 S.W.2d 548, 551 (Tex. App.—Austin 1995, writ denied) (“While an insurance contract providing expressly for subrogation may remove from the realm of equity the question of whether the insurer has a right to subrogation, it cannot answer the question of when the insurer is actually entitled to subrogation or how much it should receive.”). In Hicks Rubber and Employers Casualty we did not apply the particular facts to the elements of the suggested right to subrogation to determine if the overpaying co-insurer could actually recover. Doing so here, we determine that the facts preclude recovery because Liberty Mutual cannot meet the elements of subrogation.
There are two types of subrogation. See id. at 551. Contractual (or conventional) subrogation is created by an agreement or contract that grants the right to pursue reimbursement from a third party in exchange for payment of a loss, while equitable (or legal) subrogation does not depend on contract but arises in every instance in which one person, not acting voluntarily, has paid a debt for which another was primarily liable and which in equity should have been paid by the latter. Argonaut Ins. Co. v. Allstate Ins. Co., 869 S.W.2d 537, 542 (Tex. App.—Corpus Christi 1993, writ denied); see also Lee R. Russ & Thomas F. Segalla, 16 Couch on Insurance § 223:1 (3d ed. 2005).[5] In either case, the insurer stands in the shoes of the insured, obtaining only those rights held by the insured against a third party, subject to any defenses held by the third party against the insured. See Interstate Fire Ins. Co. v. First Tape, Inc., 817 S.W.2d 142, 145 (Tex. App.—Houston [1st Dist.] 1991, writ denied); Int’l Ins. Co. v. Med.-Prof’l Bldg. of Corpus Christi, 405 S.W.2d 867, 869 (Tex. Civ. App.—Corpus Christi 1966, writ ref’d n.r.e.); see also 16 Couch on Insurance § 222:5. Privity of contract between the insurers is not necessary. Phipps v. Fuqua, 32 S.W.2d 660, 663 (Tex. Civ. App.—Amarillo 1930, writ ref’d).
1. Kinsel’s Potential Contractual Rights
Liberty Mutual asserts a right to
subrogation in equity and through the subrogation clause found in its CGL
policy. In either case, Liberty Mutual must step into Kinsel’s
shoes to assert only those rights held by Kinsel
against Mid-Continent, subject to any defenses held by Mid-Continent against Kinsel. See Interstate Fire, 817
S.W.2d at 145; Med.-Prof’l Bldg. of
Liberty Mutual argues it is subrogated to the contractual right of Kinsel to enforce language in Mid-Continent’s policy imposing a duty upon Mid-Continent to defend and indemnify Kinsel and to pay a pro rata share of settlement. We agree that the co-insurers’ contractual duties to Kinsel were specified in the CGL policies and included, as discussed above, a several and independent duty to pay a pro rata share of a covered loss up to their respective policy limits. See Hicks Rubber, 169 S.W.2d at 147. But this duty cannot be viewed independent of the purpose of a pro rata clause, nor without consideration of the rules of indemnification. As Mid-Continent validly asserts, Kinsel has no right, after being fully indemnified, to enforce Mid-Continent’s duty to pay its pro rata share of a loss.
A liability policy obligates an
insurer to indemnify the insured against a covered loss arising from the
insured’s own legal liability. Members Mut.
Ins. Co. v. Hermann Hosp.,
664 S.W.2d 325, 327 (
[W]here there are several policies of insurance on the same risk and the insured has recovered the full amount of its loss from one or more, but not all, of the insurance carriers, the insured has no further rights against the insurers who have not contributed to its recovery. Similarly, the liability of the remaining insurers to the insured ceases, even if they have done nothing to indemnify or defend the insured.
Fireman’s
Fund Ins. Co., 77
Equity does not demand a different result here. We hold, therefore, that a fully indemnified insured has no right to recover an additional pro rata portion of settlement from an insurer regardless of that insurer’s contribution to the settlement. Having fully recovered its loss, an insured has no contractual rights that a co-insurer may assert against another co-insurer in subrogation.
2. Kinsel’s potential common law rights
Liberty Mutual also argues it is
subrogated to the common law right of Kinsel to
enforce Mid-Continent’s duty to act reasonably when handling an insured’s
defense—including reasonable negotiation and participation in settlement. An
insurer’s common law duty in this third party context is limited to the Stowers duty to protect the insured by
accepting a reasonable settlement offer within policy limits. See Stowers, 15 S.W.2d at 547.
Stowers is the only common law tort duty in
the context of third party insurers responding to settlement demands. Md.
Ins. Co., 938 S.W.2d at 28 (citing Tex. Farmers Ins. Co. v. Soriano, 881 S.W.2d 312, 318 (
Mid-Continent did not breach a Stowers duty to Kinsel because the Boutins did not make a settlement offer within Mid-Continent’s policy limits. See id. (settlement demand must be within policy limits to trigger Stowers duty). We decline to modify Stowers to create rights for Kinsel and therefore, Liberty Mutual, via subrogation. In addition, we note Liberty Mutual paid a debt for which it too was primarily liable, thus not satisfying the traditional subrogation requirement that the subrogee pay a debt for which another was primarily liable. See Argonaut Ins. Co., 869 S.W.2d at 542; see also 16 Couch on Insurance § 223:1; 44 Am. Jur. 2d Insurance § 1787, at 256 (2003) (“[T]he doctrine of subrogation is inapplicable if the liability insurer seeking subrogation is the one primarily liable; and the doctrine is inapplicable if the effect of the respective policies is to establish equal liability.” (footnotes omitted)).
The
present situation differs from the issue we addressed in Canal. 843 S.W.2d at 482. In Canal we recognized equitable
subrogation as a basis for an excess insurer’s recovery against a primary
insurer to prevent a primary insurer from taking advantage of an excess
insurer, acting solely as such, when a potential judgment approaches the
primary insurer’s policy limits.
III. Conclusion
In response to the first certified
question, we conclude there is no right of reimbursement in the context
presented. Therefore, we do not reach questions two and three. Kinsel has no common law cause of action against
Mid-Continent, nor does it have, after being fully indemnified, any contractual
rights remaining against Mid-Continent. Because Kinsel
has no rights to which Liberty Mutual may be subrogated, Liberty Mutual has no
right of reimbursement through subrogation. Of course, how our answer is
applied in the case before the Fifth Circuit Court of Appeals is solely the
province of that certifying court. See Amberboy v. Societe de Banque Privee, 831 S.W.2d 793, 798 (
________________________________________
J. Dale Wainwright
Justice
OPINION DELIVERED: October 12, 2007
[1] The “voluntary payment” clauses provided, “No insureds will, except at their own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent.”
[2] The subrogation clauses provided, “If the insured has rights to recover all or part of any payment we have made under this Coverage Part [‘Bodily Injury or Property Damage Liability’], those rights are transferred to us.”
[3] “A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured obtained after an actual trial; but we will not be liable for damages that are not payable under the terms of this Coverage Part [‘Bodily Injury or Property Damage Liability’] or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant’s legal representative.”
[4]
At trial the parties disputed how many policies should be considered in
apportioning the cost of the settlement, as Liberty Mutual also held a business
auto policy and excess policy in favor of Kinsel.
[5]
“In the context of equitable subrogation, ‘