FOR PUBLICATION
ATTORNEY FOR APPELLANT: ATTORNEY FOR APPELLEE:
MARK A. BATES ROBERT D. BROWN
Schererville, Indiana Spangler, Jennings & Dougherty, P.C.
Merrillville, Indiana
IN THE
COURT OF APPEALS OF INDIANA
THE PAINT SHUTTLE, INC. (Illinois ), )
THE PAINT SHUTTLE, INC. (Indiana ), )
JACQUELINE MILLER and PETER MILLER, )
)
Appellants-Third-Party Defendants, )
)
vs. ) No. 45A03-9911-CV-420
)
CONTINENTAL CASUALTY CO., d/b/a CNA, )
)
Appellee-Defendant-Third-Party Claimant, )
)
and )
)
BOSCH & BANASIAK, BYRON E. BAMBER, )
MICHAEL W. BOSCH, and JOSEPH BANASIAK, )
)
Plaintiffs-Third-Party Defendants. )
APPEAL FROM THE LAKE SUPERIOR COURT
The Honorable Jeffrey P. Dywan, Judge
Cause No. 45D01-9803-CP-242
August 11, 2000
OPINION - FOR PUBLICATION
ROBB, Judge
Paint Shuttle Inc. of Illinois, Paint Shuttle Inc. of Indiana, Jacqueline Miller, and
Peter Miller (collectively referred to as Paint Shuttle) appeal the trial courts grant
of summary judgment in favor of Continental Casualty Company (Continental). We affirm.
Issue
Paint Shuttle raises the following consolidated and restated issue for our review: whether
the trial court properly granted summary judgment in favor of Continental.
Facts and Procedural History
The facts most favorable to the judgment reveal that Continental issued a professional
liability policy (the malpractice policy) to the law firm of Bosch & Banasiak
See footnote
(the law firm) for the term of November 29, 1993 through November 29,
1994. The law firm consists of two partners, Michael W. Bosch and
Joseph Banasiak, both of whom were listed as insureds on the malpractice
policy. The law firm obtained the malpractice policy through Clyde Rector, an
insurance broker for the Hammond National Company.
Jacqueline and Peter MillerSee footnote retained the law firm for assistance in the licensing
of the Paint Shuttle business in Illinois and Indiana.See footnote On March 23,
1994, Paint Shuttle filed suit against the law firm in Will County, Illinois
alleging that the law firm was negligent in the rendering of, or in
the failure to render, professional legal services relating to the licensing of the
Paint Shuttle business. Subsequently, Paint Shuttle obtained a monetary judgment against the
law firm and Bosch.See footnote
On October 7, 1996, the law firm filed a declaratory action against Continental
and Paint Shuttle for relief under the malpractice policy.See footnote In addition, the
law firm provided written notice to Continental of the Paint Shuttle malpractice suit.
On November 17, 1997, Continental filed an answer, a counterclaim and a
third party complaint for declaratory relief under the malpractice policy.See footnote Thereafter, on
April 23, 1999, Continental filed a motion for summary judgment on the complaint,
third party complaint, and counterclaim. The trial court conducted a hearing on
the summary judgment motion on September 10, 1999. Thereafter, the trial court
granted summary judgment in favor of Continental.
On October 20, 1999, Continental filed a motion to correct error requesting that
the trial court amend the trial courts order granting summary judgment in favor
of Continental to reflect that the judgment was also entered against third party
defendant Martha Highland, as Special Representative of the Estate of Bryon E. Bamber.
On February 22, 2000, the trial court granted Continentals motion to correct
error. This appeal ensued.
Discussion and Decision
I. Standard of Review of Summary Judgment
The purpose of summary judgment is to terminate litigation about which there can
be no factual dispute and which may be determined as a matter of
law. Bastin v. First Indiana Bank, 694 N.E.2d 740, 743 (Ind. Ct.
App. 1998), trans. denied. When reviewing a grant or denial of summary
judgment, this court applies the same standard as does a trial court.
USA Life One Ins. Co. v. Nuckolls, 682 N.E.2d 534, 537 (Ind. 1997).
Summary judgment should be granted only if the designated evidentiary material shows
that there is no genuine issue of material fact and the moving party
is entitled to summary judgment as a matter of law. Ind. Trial
Rule 56(C); Hoskins v. Sharp, 629 N.E.2d 1271, 1276 (Ind. Ct. App.
1994). On review, we may not search the entire record to support
the judgment, but may only consider that evidence which had been specifically designated
to the trial court. North Snow Bay, Inc. v. Hamilton, 657 N.E.2d
420, 422 (Ind. Ct. App. 1995). The party appealing the denial of
summary judgment has the burden of persuading this court on appeal that the
trial court's ruling was erroneous. See Warner Trucking, Inc. v. Carolina Cas.
Ins. Co., 686 N.E.2d 102, 104 (Ind. 1997). We resolve any doubt
about a fact or any inference to be drawn from it in favor
of the nonmoving party. Claxton v. Hutton, 615 N.E.2d 471, 473 (Ind.
Ct. App. 1993). In summary judgment proceedings, as at trial, the burden
of establishing the existence of material affirmative defenses is on the defendant.
Celina Mut. Ins. Co. v. Forister, 438 N.E.2d 1007, 1009 (Ind. Ct. App.
1982). In order to meet this burden, a defendant must show that
a genuine issue of material fact exists as to each element of the
asserted affirmative defense. Schrader v. Mississinewa Community Sch. Corp., 521 N.E.2d 949,
952-53 (Ind. Ct. App. 1988), trans. denied. We will affirm a grant
of summary judgment if the defendant, in opposition to the plaintiffs summary judgment
motion, failed to designate any evidence from which the trial court could infer
the elements of the asserted affirmative defense. Huff v. Langman, 646 N.E.2d
730, 732 (Ind. Ct. App. 1995).
II. The Malpractice Policy
A. Condition Precedent to Insurance Coverage Under the Malpractice Policy
Paint Shuttle contends that the trial court erred in granting Continentals motion for
summary judgment because the law firm fulfilled its duty under the malpractice policy
of providing Continental with prompt written notice of Paint Shuttles lawsuit. We
disagree.
1. Notice Provision
Paint Shuttle argues that the law firm is entitled to coverage under the
malpractice policy because the law firm orally informed Continental about Paint Shuttles malpractice
lawsuit against the law firm shortly after it was filed in Will County,
Illinois. Continental argues that the law firm is not entitled to coverage
under the malpractice policy because it did not submit written notification of the
lawsuit to Continental until after the policy lapsed on November 29, 1994.
We must first determine whether the notice provision contained in the malpractice policy
was clear and unambiguous. The malpractice policy contained specific provisions regarding the
insureds duty to notify Continental after a loss. The malpractice policy under
the title V. Conditions provides in pertinent part that:
8. Your Duties
If, during the policy term, or any applicable extended reporting period:
you first become aware that a wrongful act has been committed, arising out
of your professional services; and
you give written notice to us of the:
specific wrongful act,
the injury or damage which has or may result from the wrongful act,
and
the circumstances by which you first become aware of such wrongful act,
then any subsequent claim made against you arising out of such wrongful act
shall be deemed to have been made during the policy term or extended
reporting period. No coverage for such claim shall exist under any subsequent
policy written by us to our affiliates.
R. 55 (emphasis in original).
See footnote We believe that the notice provision contained
in the malpractice policy is clear and unambiguous, and thus, the law firms
duty to provide written notice to Continental of a claim during the policy
period is a condition precedent to Continental providing coverage under the malpractice policy
for damages arising from a wrongful act. Because the notice provision is a
condition precedent to obtaining coverage under the malpractice policy, we must determine whether
the law firm satisfied its duty to provide the insurance company with written
notice of claim within the policy period.
We have held that the notice requirement is material, and of the essence
of the contract.
London Guarantee & Accident Co. v. Siwy, 35 Ind.App.
340, 66 N.E. 481, 482 (1903). The duty to notify an insurance
company of potential liability is a condition precedent to the companys liability to
its insured. Shelter Mut. Ins. Co. v. Barron, 615 N.E.2d 503, 507
(Ind. Ct. App. 1993), trans. denied. When the facts of the case
are not in dispute, what constitutes proper notice is a question of law
for the court to decide. Id.
The specific language of the malpractice policy provides that you must give written
notice to us of the: (1) specific wrongful act; (2) the injury or
damage which has or may result from the wrongful act, and (3) the
circumstances by which you first became aware of such wrongful act. R.
55. Paint Shuttle filed a malpractice suit against the law firm
on March 23, 1994. R. 174-78. Although the law firm provided
Continental with written notice of Paint Shuttles malpractice lawsuit, we believe that this
written notice was untimely.
The malpractice policy provides that a wrongful act must happen before the end
of the policy term stated on the Declarations and claim therefore must first
be made against you and reported to us during the policy period.
R. 52. The Declarations of the malpractice policy issued by Continental
to the law firm was for the policy term of November 29, 1993
to November 29, 1994. R. 294. In addition, the law firm
did not renew the malpractice policy with Continental. R. 216. Moreover,
the law firm did not provide Continental with written notice of Paint Shuttles
malpractice lawsuit until October 7, 1996, almost two years after the policys expiration.
R. 204. Thus, the law firm failed to provide Continental notice within
the time frame proscribed in the malpractice policy.
See footnote
In addition, we believe in the present case that the notice was insufficient
because the law firm voluntarily undertook the defense of the malpractice suit without
allowing Continental to exercise its rights of investigation and defense of a claim
under the malpractice policy. Notice is a term of art within the
insurance context and sufficient notice by an insured to an insurer involves more
than just promptly notifying an insurance company of a claim. Specifically, we
believe that notice also encompasses an insurers right to promptly investigate a claim
or to control the defense of a lawsuit with which it might be
subjected to liability as an insurer of an insurance policy.
We have previously held that cooperation clause provisions and notice provisions in insurance
policies have the same purpose and effect.
Indiana Ins. Co. v. Williams,
448 N.E.2d 1233, 1237 (Ind. Ct. App. 1983). A cooperation clause essentially
requires the insured to assist the insurance company in its preparation for settlement
or trial. Motorists Mutual Ins. Co. v. Johnson, 139 Ind. App. 622,
218 N.E.2d t 715, 717 (1966). An insureds responsibilities under the cooperation
clause of an insurance policy involve attending hearings and trials, assisting in effecting
settlement, securing and giving evidence, and obtaining the attendance of witnesses. Indiana
Ins. Co., 448 N.E.2d at 1237.
Similarly, notice provisions require the insured to assist the insurance company by giving
it an opportunity to make a timely and adequate investigation during its preparation
for settlement or trial. Motorists, 218 N.E.2d at 715. Noncompliance with
notice provisions and noncompliance with cooperation clause provisions constitute a failure to assist
the insurance company in its preparation for settlement or trial. Indiana Ins.
Co., 448 N.E.2d at 1237. Therefore, when an insured impedes or prohibits
an insurer from investigating or defending a claim, the insured can be found
to be in noncompliance with the notice provision of an insurance policy.
It follows that if an insured notifies an insurer of a claim, but
defends the claim in contravention of an insurance companys rights of investigation
and defense, the notice is insufficient for purpose of obtaining coverage
under an insurance policy. Thus, for notice to be proper under an
insurance policy it must be: (1) timely as proscribed by the language of
the insurance policy; and (2) true in the sense that the insured allows
the insurer to exercise its rights of investigation and defense of a claim
under the policy.
In the present case, although the law firm did immediately inform Continental of
the malpractice suit filed against it by Paint Shuttle after it received the
complaint and summons sometime around April 1, 1994, it made a strategic decision
to attempt to obtain a dismissal of the lawsuit on its own accord
without eliciting Continental for assistance. R. 221-222, 327. In fact, Bosch
entered his appearance on behalf of the law firm and unsuccessfully attempted
to obtain a dismissal of the lawsuit for lack of jurisdiction. R.
221-222. Because the law firm was unsuccessful in obtaining a dismissal of
the suit, on October 7, 1996, the law firm requested Continental to defend
the malpractice suit. R. 204. On October 18, 1996, Continental informed
the law firm that it would not defend the lawsuit because the firm
failed to provide sufficient notice of the claim, a condition precedent to
obtaining coverage under the policy. R. 205. Approximately ten months later
the law firm hired outside counsel to defend the firm from the malpractice
suit. R. 222.
We believe that the law firms voluntary act of defending the suit and
not allowing Continental to exercise its right to investigate or defend the claim
constitutes insufficient notice under the malpractice policy. Thus, the law firm was
in noncompliance with the notice provision of the policy because the notice was
untimely and the law firm voluntarily undertook the investigation and defense of the
claim in contravention of Continentals rights under the policy.
2. The Malpractice Policy is a Claims Made Insurance Policy
We believe that the type of policy issued by Continental to the law
firm supports our decision that the law firm failed to provide sufficient notice
under the malpractice policy Although not addressed in Indiana, other jurisdictions have
drawn an important distinction between occurrence insurance policies and claims made insurance policies
based on each policys essential purpose. See, e.g., Home Ins. Co. of
Illinois v. Adco Oil Co., 154 F.3d 739 (7th Cir. 1998), cert. denied,
526 U.S. 1017 (1999); Lexington Ins. Co. v. St. Louis Univ., 88
F.3d 632, 634 (8th Cir. 1996); United States v. A.C. Strip, 868
F.2d 181 (6th Cir. 1989); Tenovsky v. Alliance Syndicate, Inc., 677 N.E.2d
1144 (Mass. 1997); Bianco Professional Assn v. Home Ins. Co., 740 A.2d
1051 (N.H. 1999).
Conventional liability insurance policies are occurrence policies. National Union Fire Ins. Co.
of Pittsburg v. Baker & McKenzie, 997 F.2d 395, 306 (7th Cir. 1993)..
Occurrence policies link coverage to the date of the tort rather than
of the suit. Home Ins. Co. of Illinois, 154 F.2d at 742.
Thus, occurrence policies protect the policyholder from liability for any act done
while the policy is in effect. St. Paul Fire & Marine Ins.
Co. v. Barry, 438 U.S. 531, 565 n. 3 (1978). A claims
made policy links coverage to the claim and notice rather than the injury.
Home Ins. Co. of Illinois, 154 F.3d at 742. Thus, a
claims made policy protects the holder only against claims made during the life
of the policy. St. Paul Fire & Marine Ins. Co., 438 U.S.
at 565 n. 3.
See footnote
Both an occurrence and claims made insurance policies require the insured to promptly
notify the insurer of the possible covered losses.
Lexington Ins. Co., 88
F.3d at 634. The notice provision of a claims made policy is
not simply the part of the insureds duty to cooperate, it defines the
limits of the insurers obligation. Lexington Ins. Co., 88 F.3d at 634.
If the insured does not give notice within the contractually required time
period, there is simply no coverage under the policy. FDIC, 993 F.2d
at 158.
In the present case, Continental issued a professional liability policy to the law
firm, policy number LPC 3937579, which was effective from November 29, 1993 through
November 29, 1994. R. 159-71. The malpractice policy under the title
I. Coverage Agreements provides in pertinent part that:
We will pay all amounts, up to our limit of liability, which you
become legally obligated to pay as a result of a wrongful act by
you or by any entity for whom you are legally liable.[
See footnote ]
The
wrongful act, as described above, must happen before the end of the
policy term stated on the Declarations and claim therefore must first be made
against you and reported to us during the policy period.
Any claim or claims arising out of the same or related wrongful acts,
shall be considered first made during the policy term in which the earliest
claim arising out of such wrongful acts was made.
. . .
We have no duty to defend any claim not covered by this
Coverage Part.
R. 52 (emphasis in original). The unambiguous language of the malpractice policy
clearly limits claims made during the policy period. Thus, the malpractice policy
issued by Continental to the law firm was a claims made policy.
We believe that excusing a delay in notice beyond the policy period would
alter a basic term of the malpractice policy which is impermissible. See
Esmailzadeh, 869 F.2d at 424. An insurance policy is a contract between
the insurer and the insured. See Eli Lilly & Co. v. Home
Ins. Co., 482 N.E.2d 467, 470 (Ind. 1985). Consideration is an essential
element of every contract. Puetz v. Cozmas, 237 Ind. 500, 147 N.E.2d
227, 231 (1958). To constitute consideration, there must be a benefit
accruing to the promisor or a detriment to the promisee. A &
S Corp. v. Midwest Commerce Banking Co., 525 N.E.2d 1290, 1292 (Ind. Ct.
App. 1988). In other words, consideration consists of a bargained for exchange.
Burdsall v. City of Elwood , 454 N.E.2d 434, 436 (Ind. Ct.
App. 1983). Because we believe that the extension of notice period in
a claims made policy would create an unbargained for expansion of coverage, we
do not believe that Continental is required to show that it was prejudiced
by the untimely delay.
See footnote Because the law firm failed to satisfy
the condition precedent to obtaining coverage under the claims made policy, we believe
that the law firm is not entitled to coverage under the policy.
B. Innocent Partners Provision
Paint Shuttle contends that even if the law firm did not promptly comply
with the written notice provisions of the malpractice policy, the trial court erred
in granting summary judgment in favor of Continental because genuine issues of material
fact exist with regard to whether members of the law firm were entitled
to the Innocent Partners provision of the malpractice policy. We disagree.
Continental argues that this issue is waived for our review because the innocent
partnership provision is an affirmative defense that must be specifically pled and it
was not pleaded by any party. Brief of Appellant at 13.
Paint Shuttle argues that the innocent partnership provision is not listed as an
affirmative defense [under Indiana Trial Rule 8(C)], and thus, the trial rules do
not require that it be specifically pled. Reply Brief of Appellants at
3.
1. The Malpractice Policy Provision is an Affirmative Defense
Our initial inquiry is to determine whether the Innocent Partners provision of the
malpractice policy constitutes an affirmative defense. Indiana Trial Rule 8(C) lists
affirmative defenses that must be raised in responsive pleadings, but this list is
not exhaustive. Because the Innocent Partners provision of the malpractice policy is
not one of the defenses specifically listed in T.R. 8(C), we must decide
whether it constitutes an affirmative defense. The determination of whether a defense
is affirmative depends upon whether it controverts an element of a plaintiffs prima
facie case or raises matters outside the scope of the prima facie case.
Molargik v. West Enterprises, Inc., 605 N.E.2d 1197, 1199 (Ind. Ct. App.
1993). An affirmative defense is a defense upon which the proponent bears
the burden of proof and which, in effect, admits the essential allegations of
the complaint but asserts additional matter barring relief. Rice v. Grant Bd.
of Commrs, 472 N.E.2d 213, 214 (Ind. Ct. App. 1984), trans. denied. The Innocent
Partners provision of the malpractice policy provides in pertinent part that:
We agree that this policy will apply to any of you do not
agree to participate in, or remain passive, after learning about the failure to
give us notice because of concealment by another who is also defined as
you in this policy. All of you under this policy must immediately
comply, to the extent possible, with all policy provisions upon learning of such
concealment.
R. 164 (emphasis in original). You is defined in the malpractice policy
as:
the named insured and any predecessor firm;
the lawyers named in item 3 on the Declarations;
R. 163 (emphasis in original).
See footnote The Innocent Partners provision allows an insured
to obtain coverage under the malpractice policy even though the insured failed to
satisfy the written notice requirements of the policy, providing that the insured proves
that the claim or wrongful act was concealed from him by another.
Essentially, the provision converts Continentals denial of an insurance claim based on the
failure of an insured to satisfy his duties under the policy. Thus,
we believe that the Innocent Partners provision of the malpractice policy constitutes an
affirmative defense.
2. Waiver
Because we have determined that the Innocent Partners provision is an affirmative defense,
we must now determine whether the defense is waived for our review.
Indiana Trial Rule 8(C) provides that if a responsive pleading is necessary, the
party filing the pleading must include within that responsive pleading any affirmative defense
it seeks to assert.
Connell v. Connell, 583 N.E.2d 791, 792 (Ind.
Ct. App. 1991). Failure to do so results in waiver. City
of Hammond v. Northern Indiana Pub. Serv. Co., 506 N.E.2d 49, 51 (Ind.
Ct. App. 1987), trans. denied. Waiver applies even if the affirmative defense
is not listed among those defenses set out in Trial Rule 8(C).
United Farm Bureau Mut. Ins. Co. v. Wolfe, 178 Ind. App. 435, 382
N.E.2d 1018, 1019 (1978).
After review of all of the responsive pleadings, it is evident that none
of the parties raised the affirmative defense of the Innocent Partners provision of
the malpractice policy. See R. 108-09, 116-18, 120-21. However, Indiana Trial
Rule 15(B) provides an escape hatch for a defendant if an affirmative defense
has not been pled in responsive pleadings. Trial Rule 15(B) provides in
pertinent part that:
When issues not raised by the pleadings are tried by express or implied
consent of the parties, they shall be treated in all respects as if
they had been raised in the pleadings. Such amendment of the pleadings
as may be necessary to cause them to conform to the evidence and
to raise these issues may be made upon motion of any party at
any time, even after judgment, but failure so to amend does not affect
the result of the trial of these issues. If the evidence is
objected to at the trial on the ground that it is not within
the issues made by the pleadings, the court may allow the pleadings to
be amended and shall do so freely when the presentation of the merits
of the action will be subserved thereby and the objecting party fails to
satisfy the court that the admission of such evidence would prejudice him in
maintaining his action or defense upon the merits. The court may grant
a continuance to enable the objecting party to meet such evidence.
Thus, if an issue is tried by the implied consent of the parties
it is treated as if the issue was raised in the pleadings.
Elkhart County Farm Bureau Co-op Assn, Inc. v, Hochstetler, 418 N.E.2d 280, 282
(Ind. Ct. App. 1981). Therefore, we must examine whether the Innocent Partners
provision of the malpractice policy was litigated at summary judgment.
In the present case, Continental moved for summary judgment. R. 151-54.
Thereafter, the law firm filed with the trial court a Memorandum In Support
of Response To Motion For Summary Judgment in which it raised the affirmative
defense of the Innocent Partners provision of the malpractice policy. R. 267-70.
Paint Shuttle also filed with the trial court a Memorandum In Response
to Motion For Summary judgment in which it raised the affirmative defense of
the Innocent Partners provision of the malpractice policy. R. 314-24. Moreover,
the merits of the affirmative defense of the Innocent Partners provision of
the malpractice policy was addressed by both Paint Shuttle and Continental at the
September 10, 1999 hearing on Continentals motion for summary judgment. See R.
473-84, 490-92. Because the affirmative defense of the Innocent Partners provision of
the malpractice policy was argued extensively during summary judgment, we believe that the
defense has not been waived by the parties failure to raise the affirmative
defense in responsive pleadings.
3. Innocent Partners Provision Inapplicable to Banasiak
See footnote
Paint Shuttle argues that Banasiak is entitled to coverage under the malpractice policy
because he qualifies as an Innocent Partner under the policy. Continental argues
that Banasiak is not entitled to coverage because he was specifically aware of
the malpractice suit yet acquiesced in Boschs decision to not report the claim
to Continental until after Bosch attempted to obtain a dismissal of the suit
for lack of jurisdiction. Brief of Appellee at 13-14. Banasiak was
therefore specifically aware of the existence of the malpractice suit, had the contractual
obligation to report the claim, yet remained passive and agreed in his partners
decision to not immediately report the claim . . . Banasiak is not
innocent.
Id. at 14.
Paint Shuttle filed the malpractice suit against the law firm on March 23,
1994. R. 174-78. Banasiak stated in an affidavit that I became
aware of the lawsuit filed in the Paint Shuttle matter shortly after said
lawsuit was filed. R. 274. Therefore, Banasiak had almost eight months
in which to inform Continental of Paint Shuttles malpractice suit against the law
firm. Moreover, Banasiak was listed as a named insured under the malpractice
policy and thus, had a duty to provide prompt written notice of the
lawsuit to Continental. R. 158.
It is apparent that Banasiak did not promptly notify Continental of Paint Shuttles
malpractice suit because of his reliance on Boschs assertions. Banasiak stated in
his affidavit that:
Bosch appeared in the case and moved to get the case dismissed based
on lack of jurisdiction. He had informed me that if that failed,
he would turn the matter over to the insurance company and make an
appropriate claim.
R. 274. However, we do not believe that Boschs assertions relieved Banasiak
of his duty under the malpractice policy to promptly provide written notice to
Continental of Paint Shuttles lawsuit. In addition, Bosch fulfilled his promise to
Banasiak, he attempted to obtain a dismissal of the lawsuit, and when this
tactic was unsuccessful the insurance company was notified of the claim.
Moreover, the fact that Banasiak relied upon Bosch assertions that he would take
care of the matter does not entitle Banasiak to the affirmative defense of
the Innocent Partners provision of the malpractice policy. The provision specifically requires
that there exist concealment by another who is also defined as you in
this policy before an individual can invoke the affirmative defense contained in the
Innocent Partners provision of the malpractice policy. A concealment in the law
of insurance implies an intention to withhold or secrete information so that the
one entitled to be informed will remain in ignorance. Indiana Ins. Co.
v. Knoll, 142 Ind. App. 506, 236 N.E.2d 63, 70 (1968). After
reviewing the record, we found no evidence of concealment attributed to Bosch.
Because Banasiak had knowledge of Paint Shuttles lawsuit shortly after it was
filed and there exists no evidence of concealment of the lawsuit by Bosch,
we believe that the Innocent Partners provision of the malpractice policy is inapplicable
to Banasiak.
Conclusion
Based on the foregoing, we hold that the trial court properly granted summary
judgment in favor of Continental.
Affirmed.
SHARPNACK, C.J., and BAKER, J., concur.
Footnote:
We note that the law firm is listed as Bamber, Bosch,
& Banasiak in the malpractice policy. R. 158. The law firm
was originally known by this name when Byron E. Bamber was of counsel
with the firm. However, the law firms name changed to Bosch &
Banasiak after Bamber retired in 1995. Bamber died shortly after retiring from
the practice of law.
Footnote:
Jacqueline Miller is the officer and sole shareholder of Paint Shuttle.
Her husband, Peter Miller, is also an officer of Paint Shuttle.
Footnote: Paint Shuttle is an automotive repair paint business. R. 175.
Footnote: The record does not contain the judgment obtained by Paint Shuttle
against the law firm and Bosch in the circuit court located in Will
County, Illinois. However, testimony at the summary judgment hearing indicates that the
judgment totaled 1.4 million dollars. R. 482.
Footnote: We note that the law firm originally named CNA as the
insurer who issued the professional liability policy. After the trial court placed
the lawsuit on the Trial Rule 41(E) docket, the law firm filed an
amended complaint naming Continental Casualty Company as the insurer who issued the professional
liability policy. R. 19-21. We note that the name CNA is
on all of the correspondence from the insurance company to the law firm.
Thus, for our purposes we will assume that Continental and CNA are the
same entity.
Footnote:
Continental filed the counter claim against the law firm of Bosch
& Banasiak. Continental filed the third party complaint against the law firm
of Bamber, Bosch & Banasiak, Michael Bosch, Joseph Banasiak, Bryon E. Bamber, Paint
Shuttle, Jacqueline Miller, and Peter Miller. Because Bamber died during the course
of the litigation, Martha Highland as Special Representative of the Estate of Bamber,
was substituted as a third party defendant.
Footnote:
Claim is defined by the malpractice policy as the receipt of
a demand for money or services, naming you and alleging a wrongful act.
R. 53. Paint Shuttles malpractice lawsuit against the law firm clearly
constitutes a claim under the terms of the policy.
Footnote:
Paint Shuttle asserts that the law firm complied with the notice
requirements of the malpractice policy because a member of the firm, Bosch, orally
informed Rector of Paint Shuttles malpractice suit several weeks after Paint Shuttle filed
suit. Brief of Appellant at 16. Rector is the Vice President
of the Hammond National Insurance Company, the insurance broker who serviced the malpractice
policy with Continental. R. 325. However, even if Bosch orally informed
Rector of the lawsuit, it does not satisfy the
written notice requirements of
the malpractice policy. See R. 55. Bosch stated in an affidavit
that [w]hile I do not remember the substance of the conversation, I am
positive that I told Rector that I had been sued. I do
not remember his response or what, if anything, he told me to do.
R. 325. The law firm clearly failed to fulfill the condition
precedent to obtaining coverage under the malpractice policy. Moreover, the malpractice policy
specifically stated that after learning of a claim, an insured must notify us
[Continental] and your insurance agent in writing as soon as possible. R.
165. Thus, an insured has a duty to promptly notify in writing
both Continental and the insurance agent of the claim.
Footnote:
Insurance companies typically charge higher premiums for occurrence policies because they
are exposed to future indefinite liability.
See National Union Fire Ins. Co.
of Pittsburg, 997 F.2d at 306. Because of the increased costs of
insurance premiums, many consumers have opted for claims made policies. Although an
insured generally pays a lower premium under a claims made policy, the coverage
is less than that of an occurrence policy because an insurer is not
exposed to future indefinite liability. See National Fire Ins. Co. of Pittsburg,
997 F.2d at 306. Insurance companies favor claims madepolicies because such policies
allow the insurer to more accurately fix its reserves for future liabilities and
compute premiums with greater certainty. FDIC v. St. Paul Fire & Marine
Ins. Co., 993 F.2d 155, 158 (8th Cir. 1993).
Footnote:
Continental does not contest Paint Shuttles assertion that the law firms
acts or omissions with regard to the licensing of Paint Shuttle constituted a
wrongful act under the malpractice policy. Thus, we need not address of
whether the law firm committed a wrongful act under the malpractice policy.
However, we note that the malpractice policy defines wrongful act as any
negligent act, error or omission in: the rendering of or failure to render,
professional services. R. 53.
Footnote: We note when an insurance company has denied a claim under
an occurrence policy because of the insureds failure to provide reasonable notice of
a claim, the insurer must show that it was prejudiced by the unreasonable
delay.
Miller v. Dilts, 463 N.E.2d 257, 263 (Ind. 1984). The
Indiana Supreme Court stated in Miller that:
The requirement of prompt notice gives the insurer an opportunity to make a
timely and adequate investigation of all the circumstances surrounding the accident or loss.
This adequate investigation is often frustrated by a delayed notice. Prejudice
to the insurance companys ability to prepare an adequate defense can therefore be
presumed by an unreasonable delay in notifying the company about the accident or
about the filing of the lawsuit. This is not in conflict with
the public policy theory that the court should seek to protect the innocent
third parties from attempts by insurance companies to deny liability for some insignificant
failure to notify.
Id. at 465.
Even though we have determined that Continental was not required to show prejudice
as a result of the law firms untimely notice of Paint Shuttles malpractice
suit because the insurance policy was a claims made policy, we believe that
Continental has in fact shown such prejudice. Because there was an unreasonable
delay in notification, prejudice to Continentals ability to prepare an adequate defense can
be presumed.
See Miller, 463 N.E.2d at 265. The presumption of
prejudice essentially means that if the delay in giving the required notice is
unreasonable, the injured party or the insured has the burden to produce evidence
that prejudice did not actually occur in the particular situation. See id.
The record lacks any evidence that Paint Shuttle rebutted the presumption that
Continental had suffered prejudice to its right to conduct a timely and adequate
investigation of the law firms claim. See id. The Indiana Supreme
Court has stated that:
Once such evidence is introduced, the question becomes one for the trier of
fact to determine whether any prejudice actually existed. The insurance carrier in
turn can present evidence in support of its claim of prejudice. Thus,
both parties are able to put forth their respective positions in the legal
arena.
Id. at 265-66.
Although Continental may have had notice of the lawsuit before October 7, 1996,
the date the law firm submitted written notice to Continental, Continental was under
no duty to defend the lawsuit because the formal written notice from
the law firm was untimely and not in compliance with the specific provisions
of the malpractice policy. In addition, it is apparent that the law
firm hired outside counsel, attorney Scott Hoster, to defend the firm at trial.
R. 380. Hoster was not an attorney for Continental nor did
Continental pay Hosters legal fees. Although an attorney for Continental, Cory Lund,
occasionally monitored portions of the trial, he did not participate in the defense
of the law firm. R. 380. Lunds role during the trial
was that of a spectator only, viewing a few of the pre-trial hearings
and ninety minutes of the trial.
Id. Therefore, the record lacks
sufficient evidence to rebut the presumption of prejudice to Continental as a result
of the untimely notice.
Footnote:
We note that the Declarations of the malpractice policy lists Bamber,
Bosch, & Banasiak as the named insured under the policy. R. 158.
In addition, Michael W. Bosch and Joseph Banasiak were listed as lawyers
under item three of the Declarations.
Id.
Footnote:
We note that Paint Shuttle also contends that Bamber is entitled
to the affirmative defense of the Innocent Partners provision of the malpractice policy.
However, Paint Shuttle did not designate any evidence nor argue at summary
judgment that Bamber was entitled to the Innocent Partners provision of the malpractice
policy.
See R. 312-24. In response to a properly supported motion
for summary judgment, the adverse party may not rest upon the mere allegation
of his pleadings, but must designate to the trial court each material issue
of fact which the party asserts precludes summary judgment and the relevant evidence
pertaining to such issue or issues. T.R. 56(C), (E). In ruling
on a summary judgment motion, a trial court must rely upon the pleadings,
depositions, answers to interrogatories, admissions, affidavits, and other evidentiary materials designated by the
parties pursuant to Trial Rule 56(C). Parker by Parker v. State Farm
Mut. Auto. Ins. Co., 630 N.E.2d 567, 569 (Ind. Ct. App. 1994), trans.
denied. Appellate review is similarly limited. Abbott v. Bates, 670 N.E.2d
916, 921 (Ind. Ct. App. 1996). Thus, we may not reverse a
grant of summary judgment on the ground that there is a genuine issue
of material fact unless the material fact and the evidence relevant thereto shall
have been specifically designated to the trial court. T.R. 56(H); Parker,
630 N.E.2d at 569. Therefore, we decline to address this issue.