Pitzer College v. Indian Harbor Ins. Co.
Pitzer College v. Indian Harbor Ins. Co.
Opinion
**671
*97
California's notice-prejudice rule generally allows insureds to proceed with their insurance policy claims even if they give their insurer late notice of a claim, provided that the late notice does not substantially prejudice the insurer. (
Campbell v. Allstate Ins. Co.
(1963)
I. FACTS AND PROCEDURAL HISTORY
The Claremont University Consortium (CUC) is an umbrella entity that enters into insurance contracts on behalf of the Claremont Colleges, including plaintiff Pitzer College (Pitzer). (
Pitzer College v. Indian Harbor Ins. Co.
(9th Cir. 2017)
The Policy contains three provisions pertinent to our review. First, a notice provision requires Pitzer to provide oral or written notice of any pollution condition to Indian Harbor and, in the event of oral notice, to "furnish ... a written report as soon as practicable." 1 Second, a consent provision requires Pitzer to obtain Indian Harbor's written consent before incurring expenses, making payments, assuming obligations, and/or commencing remediation due to a pollution condition. 2 Pursuant to an emergency exception **672 to this consent provision, however, if Pitzer incurs costs "on an emergency basis where any delay ... would cause injury to persons or damage to property or increase significantly the cost of responding to any [pollution condition]," then Pitzer is not required to obtain Indian Harbor's prior written consent, but it is required to notify Indian Harbor "immediately thereafter." Third, a choice of law provision states that New York law governs all matters arising under the Policy. 3
On January 10, 2011, Pitzer discovered darkened soils at the construction site for a new dormitory on campus. ( Pitzer College , supra , 845 F.3d at p. 994.) "By January 21, 2011, Pitzer determined that remediation would be required." ( Ibid. ) With pressure to complete the dormitory prior to the start of the 2012-2013 academic year, Pitzer conferred with environmental consultants who determined that the least expensive and most expeditious option was to conduct lead removal onsite using a transportable treatment unit (TTU). Pitzer reserved one of the two TTUs that were licensed for use in *99 Southern California and began the treatment process. ( Ibid. ) Remediation work commenced on March 9, 2011 with the setup of the TTU and was successfully completed one month later at a total cost of nearly $2 million. Indian Harbor's expert later opined that the remediation could have been performed at a reduced cost using alternative methods, and that the manner of remediation waived subrogation rights against others who may have been responsible for the contaminated soil.
Pitzer did not obtain Indian Harbor's consent before commencing remediation or paying remediation costs. (
*705
Pitzer College,
"On August 10, 2011, Indian Harbor acknowledged receipt of Pitzer's notice of remediation." (
Pitzer College,
Pitzer sued Indian Harbor in Los Angeles County Superior Court for declaratory relief and breach of contract. ( Pitzer College , supra , 845 F.3d at p. 995.) Indian Harbor removed the case to federal court on the basis of diversity jurisdiction and moved for summary judgment, claiming that it had no obligation to indemnify Pitzer for remediation costs because Pitzer had violated the Policy's notice and consent provisions. The district court granted the motion. ( Ibid. )
The district court held that New York law applied, because although a state's fundamental policy can override a choice of law provision, Pitzer had "failed to establish" that California's notice-prejudice rule is such a policy. (
Pitzer College,
**673
*100
Additionally, the district court held that summary judgment was separately warranted because Pitzer did not comply with the Policy's consent provision. (
Pitzer College,
Pitzer timely appealed, and oral arguments were heard before the Ninth Circuit Court of Appeals. In issuing the certified questions to us, the Ninth Circuit observed: "Resolution of this appeal turns on whether California's notice-prejudice rule is a fundamental public policy for the purpose of choice-of-law analysis. If the California Supreme Court determines that the notice-prejudice rule is fundamental, the appeal then turns on whether, in a first party policy like Pitzer's, a consent provision operates as a notice requirement subject to the notice-prejudice rule. No
*706
controlling California precedent answers either question.
See
Cal. R. Ct. 8.548(a). Because the district court determined that '[i]f prejudice is required, [Indian Harbor] would not be able to prevail at summary judgment,' these questions are dispositive." (
Pitzer College,
II. DISCUSSION
A. Choice of Law Analysis
The crux of this case lies in the choice of law provision, designating that New York law should govern all matters arising under the Policy. California applies the principles set forth in section 187 of the Restatement Second of Conflict of Laws (section 187) in determining the enforceability of contractual choice of law provisions. (
Nedlloyd Lines B.V. v. Superior Court
(1992)
Regarding the first step of
Nedlloyd
's choice of law analysis, the parties agree with
**674
the district court's finding that there is at least a "reasonable basis" for the selection of New York law. (
Nedlloyd, supra,
3 Cal.4th at p. 466,
B. California's Notice-prejudice Rule
California's notice-prejudice rule requires an insurer to prove that the insured's late notice of a claim has substantially prejudiced its ability to investigate and negotiate payment for the insured's claim. A finding of substantial prejudice will generally excuse the insurer from its
*707
contractual obligations under the insurance policy, unless the insurer had actual or constructive knowledge of the claim. (See
Shell Oil Co. v. Winterthur Swiss Ins. Co.
(1993)
As one California Court of Appeal has recognized, there are no "bright-line rules for determining what is and what is not contrary to a fundamental policy of California. Comment g to Restatement section 187 itself says that '[n]o detailed statement can be made of the situations where a "fundamental" policy ... will be found to exist.' " (
Discover Bank v. Superior Court
(2005)
Initially, we note that the difference between a "strong" public policy and a "fundamental" one is essentially semantic when our goal is to protect those with inferior bargaining power in the insurance context. A policy such as the notice-prejudice rule may be considered fundamental because it is connected to concerns of fundamental fairness in the negotiation process. (See
Campbell, supra
, 60 Cal.2d at p. 307,
We can look to other courts for guidance on how to determine whether a policy is fundamental in the absence of legislative mandate. (See
Prince George's County. v. Local Gov't Ins. Trust
(2005)
**675
*708
2) 'the public policy objective of compensating tort victims'; and 3) 'the inequity of the insurer receiving a windfall due to a technicality.' " (
Century Sur. Co. v. Jim Hipner, LLC
(Wyo. 2016)
The first reason for establishing the notice-prejudice rule as a fundamental policy of our state is that the notice-prejudice rule cannot be contractually waived and, thus, restricts freedom of contract. When it applies, the rule prevents enforcement of a contractual term. It overrides the parties' express intentions for a defined notice term, preventing a technical forfeiture of insurance benefits unless the insurer can show it was prejudiced by the insured's late notice.
Such restriction on parties' freedom of contract has led to the adoption of fundamental policies in other contexts, including the constitutional right to a jury trial (
Rincon EV Realty LLC v. CP III Rincon Towers, Inc.
(2017)
Second, the notice-prejudice rule protects insureds against inequitable results that are generated by insurers' superior bargaining power. We have consistently recognized that insurance contracts typically are "inherently unbalanced" and "adhesive," which "places the insurer in a superior bargaining position." (
Egan v. Mutual of Omaha Ins. Co.
(1979)
Comment g to section 187 at page 568, also finds that policies "designed to protect a person against the oppressive use of superior bargaining power"
*104
may be considered fundamental and unwaivable. (See, e.g.,
In re DirecTV Early Cancellation Litigation
(C.D.Cal. 2010)
The third criterion for establishing a fundamental policy is also satisfied in this case: The notice-prejudice rule promotes objectives that are in the general public's interest because it protects the public from
*709
bearing the costs of harm that an insurance policy purports to cover. (
Campbell, supra,
60 Cal.2d at p. 306,
Indian Harbor's contrary argument that the notice-prejudice rule is not a fundamental policy is unpersuasive. Initially, it relies on
Gantt
for its contention that our declaration of a fundamental public policy must be "delineated in constitutional or statutory provisions" or a rule of unconscionability. (
**676
Gantt v. Sentry Insurance
(1992)
Although
Gantt
emphasized that while "[t]he employer is bound, at a minimum, to know the fundamental public policies of the state and nation as expressed in their constitutions and statutes" (
Gantt, supra,
1 Cal.4th at p. 1095,
Amicus curiae in support of Pitzer, United Policyholders, notes that comment g to section 187 makes the same point. Comment g observes that *105 for a policy to be considered fundamental, it must be "substantial" and " may be embodied in a statute which makes one or more kinds of contracts illegal or which is designed to protect a person against the oppressive use of superior bargaining power." (§ 187, com. g, p. 568, italics added.)
Application of the notice-prejudice rule as a fundamental public policy is also consistent with
Nedlloyd
's holding that the implied covenant of good faith and fair dealing is not a fundamental policy of California. (
Nedlloyd, supra,
3 Cal.4th at p. 468,
Based on the foregoing reasoning, we conclude that California's notice-prejudice
*710
rule is a fundamental public policy of California. The rule is based on the rationale that the essential part of the contract is insurance coverage, not the procedure for determining liability, and that " 'the notice requirement serves to protect insurers from prejudice, ... not ... to shield them from their contractual obligations' through 'a technical escape-hatch.' " (
Carrington Estate Planning Services v. Reliance Standard Life Ins. Co.
(9th Cir. 2002)
Because our review is limited to answering the Ninth Circuit's first question in the affirmative, we leave it to that court to decide the
**677
remaining issues concerning whether California has a materially greater interest than New York in determining the coverage issue, such that the contract's choice of law would be unenforceable because it is contrary to our fundamental public policy. (
Washington Mutual Bank v. Superior Court, supra,
24 Cal.4th at p. 917,
We begin by reviewing the Policy's requirements. As discussed above, the consent provision here provides that, in the absence of an emergency, "[n]o costs, charges, or expenses shall be incurred without the Company's written consent, which shall not be unreasonably withheld." There is no dispute that Pitzer failed to obtain Indian Harbor's prior written consent and that Pitzer notified Indian Harbor after it had remediated the pollution damage.
As we explain below, such a consent requirement serves a role beyond the requirement to give prompt notice of a coverage event. But both promises are, nevertheless, ancillary to the insured's "basic duty of paying the policy premium" in exchange for the insurer's basic duties of defense, indemnification, or coverage for loss or remediation expenses. (
Kransco
,
supra
, 23 Cal.4th at p. 404,
Courts have widely recognized that strict enforcement of a notice provision permits the insurer "to reap the benefits flowing from the forfeiture of the insurance policy" despite a lack of prejudice. (
Alcazar v. Hayes
(Tenn. 1998)
Much the same rationale applies to first party policy provisions requiring the insurer's consent before the policyholder incurs costs. Indian Harbor itself has suggested that a consent provision guards against the insured making unnecessary expenditures, allows the insurer to approve and control costs, and protects the insurer's subrogation rights. In the case of a pollution remediation policy, a consent requirement also avoids the potential destruction of evidence, through the insured's unilateral remediation efforts, that could permit the insurer to make more fully informed decisions about whether to approve certain expenses. Yet at core, these purposes **678 are much the same as those pertaining to notice provisions. They all facilitate the insurer's primary duties under the contract and speak to minimizing prejudice in performing those duties. For these reasons, the notice-prejudice rule makes good sense for consent provisions in first party policies just as it does for notice provisions.
We have no reason to believe imposing this rule on first party insurers will prove so unmanageable for those suffering actual prejudice to justify a contrary conclusion. (See
Campbell
,
supra
, 60 Cal.2d at p. 307,
Whereas first party coverage obligates the insurer to pay damages claimed by the insured itself, third party coverage obligates the insurer to defend, settle, and pay damages claimed by a third party against the insured. "[A] first party insurance policy provides coverage for loss or damage sustained directly by the insured (e.g., life, disability, health, fire, theft and casualty insurance). A third party liability policy, by contrast, provides coverage for liability of the insured to a third party who has been injured because of the insured's negligence. Examples of
*712
such coverage are typically found in (but not limited to) commercial general liability policies, a homeowner's liability policy, a directors and officers liability policy, or an errors and omissions policy. In the usual first party policy context, the insurer promises to pay money to the insured upon the happening of an event (also known as an occurrence), the risk of which has been insured against. In the typical third party liability
*108
policy context, the carrier assumes a contractual duty to pay judgments the insured becomes legally obligated to pay as damages because of bodily injury or property damage caused by the insured." (
Montrose Chemical Corp. v. Admiral Ins. Co.
(1995)
In third-party insurance policies, then, consent provisions, sometimes called "no voluntary payment" provisions, "are designed to ensure that responsible insurers that promptly accept a defense tendered by their insureds thereby gain control over the defense and settlement of the claim." (
Jamestown Builders
,
supra
, 77 Cal.App.4th at p. 346,
No California court has addressed whether the notice-prejudice rule should be extended to a consent provision in the context of first party coverage. In a true first party context, there is no claim of liability for the insurer to defend and hence no logical need for it to retain unimpaired control over the claims handling. Thus, the reasons courts have refused to apply the notice-prejudice rule to consent provisions in third party policies generally do not apply to first party coverage. Primarily, in a first party policy, the insurer's duty to defend and settle potential claims is not crucial to its coverage obligations. Compared with third party coverage, the insurer simply does not exercise the
*109
same contractual control over the potential loss
*713
or occurrence, which can happen long after the policy period has expired. (
Montrose
,
supra,
10 Cal.4th at p. 663,
For these reasons, failure to obtain consent in the first party context is not inherently prejudicial, and the usual logic of the notice-prejudice rule should control, in the absence of a coverage requirement for a third party claim or potential claim. Where the insurer owes no duty to defend against third party claims, the insured's failure to seek the insurer's consent to remediate a loss implicates risks that, while perhaps different in degree, are not so dissimilar to those in failing to provide notice of a loss to warrant departure from a case-by-case analysis of prejudice. For these reasons, we hold that California's notice-prejudice rule is applicable to a consent provision in a first party policy where coverage does not depend on the existence of a third party claim or potential claim.
Yet ultimately this case is not one where we can offer a definitive ruling on whether the notice-prejudice rule applies to the Policy's consent provision because the parties vigorously dispute whether Indian Harbor's policy provides first party or third party coverage. The Policy's insuring provisions are written in two parts: Section I.B. of the Policy describes the Insuring Agreement with respect to remediation liability, reads as follows: "The Company will pay on behalf of the INSURED for REMEDIATION EXPENSE and related LEGAL EXPENSE resulting from any POLLUTION CONDITION on, at, under or migrating from any COVERED LOCATION:
"1. for a CLAIM first made against the INSURED during the POLICY PERIOD which the insured has or will become legally obligated to pay; or
"2. that is first discovered during the POLICY PERIOD, provided that the INSURED reports such CLAIM or POLLUTION CONDITION to the Company, in writing, during the POLICY PERIOD or, where applicable, the EXTENDED REPORTING PERIOD." (Italics added.)
Pitzer argues that section 1.B.2 provides first party liability coverage. Pitzer points out that the insurer in part 1.B.2 is arguably promising to pay money to the insured upon the happening of an event that the insured itself discovers-and the typical claims-made third party policy does not have a "discovery requirement as a prerequisite of triggering coverage." (
Montrose
,
supra
, 10 Cal.4th at p. 664,
*110 Resolving the question whether the Policy's coverage should be considered first party or third party for purposes of the notice-prejudice rule is beyond the scope of the Ninth Circuit's question to us. (As originally framed, the federal court's question was only whether "a consent provision in a first-party claim insurance policy [can] be interpreted as a notice provision such that the notice-prejudice rule applies.") Without additional evidence regarding the intent of the parties in forming the Policy, we leave it to the Ninth Circuit to determine what type of policy is at issue, and the ultimate question of whether **680 the notice-prejudice rule applies to the consent provision here.
III. CONCLUSION
Based on the foregoing reasoning, we conclude that the notice-prejudice rule is a *714 fundamental public policy of our state and that it applies to consent provisions in first party insurance policies. Because the parties dispute the type of policy at issue here, we leave construction of the insurance contract to the Ninth Circuit. That construction will determine whether the notice-prejudice rule applies to the Policy's consent provision.
We Concur:
CANTIL-SAKAUYE, C. J.
CORRIGAN, J.
LIU, J.
CUÉLLAR, J.
KRUGER, J.
GROBAN, J.
The notice provision states in relevant part: "As a condition precedent to the coverage hereunder, in the event ... any POLLUTION CONDITION is first discovered by the INSURED that results in a LOSS or REMEDIATION EXPENSE [¶] ... [¶] The INSURED shall provide to the Company, whether orally or in writing, notice of the particulars with respect to the time, place and circumstances thereof, along with the names and addresses of the injured and of available witnesses. In the event of oral notice, the INSURED agrees to furnish to the Company a written report as soon as practicable."
The consent provision states in relevant part: "No costs, charges, or expenses shall be incurred, nor payments made, obligations assumed or remediation commenced without the Company's written consent which shall not be unreasonably withheld. This provision does not apply to costs incurred by the INSURED on an emergency basis, where any delay on the part of the INSURED would cause injury to persons or damage to property or increase significantly the cost of responding to any POLLUTION CONDITION. If such emergency occurs, the INSURED shall notify the Company immediately thereafter."
The choice of law provision states: "All matters arising hereunder including questions related to validity interpretation, performance and enforcement of this Policy shall be determined in accordance with the law and practice of the State of New York (notwithstanding New York's conflicts of law rules)."
Reference
- Full Case Name
- PITZER COLLEGE, Plaintiff and Appellant, v. INDIAN HARBOR INSURANCE COMPANY, Defendant and Respondent.
- Cited By
- 24 cases
- Status
- Published