Dolan v. Kemper Independence Ins. Co.
Dolan v. Kemper Independence Ins. Co.
Opinion
Arthur, J.
*613 This appeal stems from a declaratory judgment action in which appellee Kemper Independence Insurance Co. sought to establish that it had no duty to pay underinsured motorist (UIM) benefits to appellant Gary Dolan. In support of its position, Kemper cited Mr. Dolan's unwillingness to participate in an examination under oath (EUO). Kemper argued that, by refusing to submit to an EUO, Mr. Dolan had breached the insurance contract. Kemper also argued that, under its policy, submission to an EUO was a condition precedent to Mr. Dolan's ability to file suit against Kemper for breach of contract.
The Circuit Court for Anne Arundel County declared that Mr. Dolan was not entitled to UIM benefits under the policy. Mr. Dolan appealed. We affirm.
FACTUAL AND PROCEDURAL HISTORY
The parties stipulated to the relevant facts:
On October 27, 2010, Mr. Dolan was a passenger in a vehicle operated by Windy Marie Dolan. The vehicle was involved in an accident. Mr. Dolan sustained injuries as a result of the accident.
Mr. Dolan's parents had an automobile insurance policy with Kemper. Mr. Dolan claimed UIM benefits as a "family member" under his parents' policy. 1
Section III, Part E, of the policy that Kemper issued to Mr. Dolan's parents states, in pertinent part, as follows:
We have no duty to provide coverage under this policy unless there has been full compliance with the following duties:
* * *
B. A person seeking any coverage must:
*614 1. Cooperate with us in the investigation, settlement or defense of any claim or suit.
* * *
3. Submit, as often as we reasonably require:
* * *
b. To examination under oath and subscribe the same.
Under Section II, Part F, of the Kemper policy, "No legal action may be brought against [Kemper] until there has been full compliance with all the terms of this policy."
Sometime in late 2010 or early 2011, Kemper became aware of the accident in which Mr. Dolan was injured. Anticipating that Mr. Dolan might make a claim for UIM benefits, Kemper requested that he give a recorded statement. Mr. Dolan's counsel denied the request.
On March 10, 2011, Kemper sent a formal request for a recorded statement via a letter to Mr. Dolan's counsel. Counsel denied that request as well.
*744 On April 12, 2011, Kemper, through counsel, sent a written request for an EUO to Mr. Dolan's counsel. Two days later, Mr. Dolan's counsel responded by email, stating that Kemper was not entitled to an EUO until Mr. Dolan made a formal claim for UIM benefits.
On August 8, 2011, Kemper received a letter from Mr. Dolan's counsel. The letter represented that Ms. Dolan's insurer, Nationwide Mutual Insurance Co., had tendered its policy limits of $50,000 in settlement of Mr. Dolan's claims against her.
Under Md. Code (1996, 2006 Repl. Vol.), § 19-511 of the Insurance Article, as it read in 2011, Kemper had 60 days from August 8, 2011, to decide whether to consent to the settlement. If Kemper consented to the settlement, it would waive its right to "contest the issues of tort liability" in Mr. Dolan's action to recover on the policy.
Maurer v. Pennsylvania Nat'l Mut. Cas. Ins. Co.
,
*615
Woznicki v. GEICO Gen. Ins. Co.
,
On September 22, 2011, Kemper notified Mr. Dolan, in writing, that it would not consent to Nationwide's settlement offer. On the same day, Kemper advanced the $50,000 that it was required to pay to preserve its right to contest issues of tort liability. Mr. Dolan accepted Kemper's check, thereby triggering his UIM claim against the Kemper policy. 3
At some point after the claim was triggered, Kemper requested an EUO. The record does not reflect what response, if any, Kemper received.
On October 28, 2011, Mr. Dolan's counsel wrote to Kemper's counsel. The letter transmitted information about Mr. Dolan's injuries, requested information about the dollar amount of UIM coverage under the Kemper policy, and asked whether Kemper would tender the policy limits. The letter confirms that by that date Mr. Dolan had made a formal claim for UIM benefits.
On November 7, 2011, Kemper's counsel wrote to Mr. Dolan's counsel. In that letter, Kemper's counsel confirmed an agreement with Mr. Dolan's counsel that Kemper was entitled to an EUO. Kemper's counsel requested dates for the EUO.
On November 13, 2011, Kemper's counsel sent a follow-up email to Mr. Dolan's counsel, offering proposed dates for an EUO. Mr. Dolan's counsel did not respond to the email.
*616 Instead, on November 23, 2011, Mr. Dolan filed a complaint with the Circuit Court for Anne Arundel County. The complaint alleged a negligence claim against Windy Marie Dolan, the driver of the car in which Mr. Dolan was injured. The complaint also alleged a breach of contract claim against Kemper for failing to pay UIM benefits.
On December 5, 2011, counsel for Kemper spoke to counsel for Mr. Dolan to follow up on the scheduling of an EUO. Mr. Dolan's counsel said that an assistant at the firm would secure a date for the *745 EUO. Kemper's counsel confirmed the discussion in a letter of the same date.
On December 9, 2011, Mr. Dolan's counsel called Kemper's counsel to inform him that Mr. Dolan had filed suit. Mr. Dolan's counsel asserted that Mr. Dolan would submit to a deposition, but would not appear for an EUO.
In a conversation with Kemper's counsel on February 14, 2012, counsel for Mr. Dolan confirmed that his client would not submit to an EUO and that a deposition would give Kemper everything that it was entitled to receive. Kemper confirmed Mr. Dolan's refusal to submit to an EUO in a letter dated February 15, 2012. On the following day, Kemper formally denied Mr. Dolan's claim for UIM benefits.
At some point thereafter, Mr. Dolan was found to be incompetent to stand trial against criminal charges in an apparently unrelated case. As a result of that finding, the circuit court stayed Mr. Dolan's lawsuit against Ms. Dolan (the driver) and Kemper. Even after Mr. Dolan was later found to have regained his competence, the court continued the stay, so that Kemper could file a complaint for declaratory relief.
On May 11, 2016, Kemper filed its complaint. In brief, Kemper asked the court to declare that the policy required Mr. Dolan to submit to an EUO as a prerequisite to receiving UIM coverage and that Mr. Dolan had breached the contract with Kemper by refusing to submit to an EUO. Pending the adjudication of Kemper's complaint for declaratory relief, the circuit court continued the stay of Mr. Dolan's tort claim *617 against the driver and his breach of contract claim against Kemper.
Although the circuit court initially denied Kemper's motion for summary judgment, Kemper and Mr. Dolan eventually agreed upon a set of stipulations concerning the universe of relevant facts. The parties submitted the stipulations to the circuit court, along with legal argument on their respective positions.
On March 20, 2017, the circuit court conducted what was nominally a bench trial, but was really more in the nature of a hearing on a summary judgment motion, because no facts were in dispute. 4 After the hearing, the court issued a written declaratory judgment, in which it concluded:
that submitting to an EUO administered by Plaintiff Kemper was a condition precedent to him receiving UIM benefits under the insurance policy issued by Plaintiff Kemper, that Defendant Gary Dolan's failure to do so amounted to a material breach of the insurance contract, and that Defendant Gary Dolan is not entitled to receive UIM benefits under the insurance policy issued by Plaintiff Kemper.
Mr. Dolan noted a timely appeal.
QUESTION PRESENTED
Mr. Dolan presents one question for our review:
Did the trial [c]ourt err by finding that Appellant had breached his contract with Appellee by filing a law suit against Appellee before submitting to an Examination Under Oath?
Mr. Dolan's question misstates the circuit court's conclusion, as well as Kemper's coverage position.
Kemper did not deny coverage because Mr. Dolan had filed suit before submitting *746 to an EUO. Although the express language of the Kemper policy prohibits legal action against *618 Kemper unless the insured has complied with all of the policy terms (including the term requiring the insured to submit to an EUO), Kemper attempted to persuade Mr. Dolan to submit to an EUO even after he had filed suit. Kemper denied coverage because of Mr. Dolan's continued refusal to submit to an EUO, not because he had filed suit before submitting to an EUO.
Similarly, the circuit court did not conclude that Mr. Dolan breached the contract by filing suit against Kemper before he had submitted to an EUO. To the contrary, in remarks in open court, the circuit court recognized that even after he had filed suit, Mr. Dolan could have complied with the request for an EUO by dismissing the case without prejudice (which he could safely do, as the statute of limitations would not run for almost two years), submitting to the EUO, and then refiling.
The circuit court's conclusions, accurately characterized, were (1) that submitting to an EUO was a condition precedent to receiving UIM benefits under the policy and (2) that Mr. Dolan materially breached the policy by refusing to submit to an EUO-whether before or after he filed suit. Consequently, we shall rephrase the question presented to accurately reflect the court's conclusions:
Did the circuit court err in concluding that, by failing to submit to an EUO, Mr. Dolan failed to satisfy a condition precedent to receiving benefits under the Kemper policy and materially breached the insurance contract?
For the reasons set forth below, we answer that question in the negative and affirm.
STANDARD OF REVIEW
Maryland Rule 8-131(c) governs "[o]ur review of a trial court's declaratory judgment regarding the scope of coverage under an automobile insurance policy[.]"
Agency Ins. Co. v. State Farm Mut. Auto. Ins. Co.
,
*619 When an action has been tried without a jury, the appellate court will review the case on both the law and the evidence. It will not set aside the judgment of the trial court on the evidence unless clearly erroneous, and will give due regard to the opportunity of the trial court to judge the credibility of the witnesses.
Because the parties stipulated to the relevant facts, the court made no factual findings. The sole issue before us is the correctness of the conclusions of law. We conduct a
de novo
review of those conclusions.
Bartlett v. Portfolio Recovery Assocs., LLC
,
DISCUSSION
Automobile insurance policies commonly contain a provision requiring an insured to submit to an EUO. "Generally, during an EUO, an insurer is 'entitled to conduct a searching examination, though all questions should be confined to matters relevant and material to the loss.' "
Phillips v. Allstate Indemn. Co.
,
If a party commits a material breach of an insurance contract by appearing at an EUO but failing to answer some relevant and material questions, then the total failure to submit to an EUO at all must certainly constitute a material breach as well. Indeed, numerous courts from other states have held that the unexcused failure to appear at an EUO constitutes a material breach that permits an insurer to disclaim coverage.
Laine v. Allstate Ins. Co.
,
*621
Standard Mut. Ins. Co. v. Boyd
,
*748
Lorenzo-Martinez v. Safety Ins. Co.
,
It is also beyond any dispute that an insured cannot pursue a claim against an insurer if he or she has failed to satisfy a condition precedent to coverage. For example, in
Huntt v. State Farm Mut. Auto. Ins. Co.
,
In arguing that he did not breach the contract or fail to satisfy a condition precedent when he refused to submit to an EUO, Mr. Dolan focuses on Section III, Part E, of the Kemper policy. To reiterate, that section states, in pertinent part, that:
We have no duty to provide coverage under this policy unless there has been full compliance with the following duties:
* * *
B. A person seeking any coverage must:
1. Cooperate with us in the investigation, settlement or defense of any claim or suit.
* * *
3. Submit, as often as we reasonably require:
* * *
b. To examination under oath and subscribe the same.
Citing the first sentence of this provision ("We have no duty to provide coverage under this policy unless" etc.), Mr. Dolan argues that submitting to an EUO is a condition to recovering benefits under the policy, not to pursuing a lawsuit. One need *623 not read any farther than the next page of *749 the policy to see that his argument is incorrect.
On that next page, Section III, Part F, states, in pertinent part, that: "No legal action may be brought against us until there has been full compliance with all the terms of this policy." Section III, Part E, paragraph B(3)(b), requiring an insured to submit to an EUO, is obviously a "term" of the Kemper policy. Therefore, no legal action may be brought against Kemper until an insured has submitted to an EUO, if one has been requested.
Mr. Dolan posits a hypothetical scenario under which an insured submits to an EUO before filing suit, but the insurer properly requests a second EUO after suit has been filed. In his view, the insurer's right to require multiple EUOs, both before and after the commencement of litigation, demonstrates that submitting to an EUO cannot be a condition precedent to filing suit. We agree that submitting to a post-litigation EUO could not possibly be a condition precedent to filing a lawsuit that had already been filed. Under Section III, Part E, of the Kemper policy, however, it would be a condition precedent to Kemper's "duty to provide coverage": Kemper might have the right to deny coverage if an insured refuses to submit to a second EUO after he or she has filed suit. 8
Mr. Dolan contends that the language of the Kemper policy ("No legal action may be brought against [Kemper] until there has been full compliance with all the terms of this policy") does not create a condition precedent. In advancing that argument, Mr. Dolan acknowledges that " 'no particular form of words is necessary in order to create an express condition' " (Brief for Appellant at 10 (quoting
Chirichella v. Erwin
,
In an effort to establish that he did not fail to satisfy a condition precedent to bringing a legal action against Kemper, Mr. Dolan relies on
McCullough v. Travelers Cos.
,
In
McCullough
the insured's counsel informed Travelers that he would not be available for an EUO on the date that the insurer had unilaterally selected.
On appeal, the Supreme Court of Minnesota held that the language of the Travelers policy (" '[n]o suit or action on this policy for the recovery of any claim shall be
sustainable
in any court ... unless' ") (emphasis added) did not bar a suit or require an oral examination before the filing of a suit. "Under this policy," the court held, "an oral examination under oath is not a condition precedent to suit."
Nor was there any evidence that McCullough had refused to be examined under oath.
It would be something of an understatement to say that this case is unlike McCullough . First, unlike the Travelers policy (which said that an action on the policy was not "sustainable" unless the insured complied with all requirements of the policy), the Kemper policy plainly states that "[n]o legal action may be brought" at all "until there has been full compliance with all the terms of this policy." Therefore, the Kemper policy expressly creates a condition precedent to the commencement of a legal action, and not merely to a recovery under the policy. Second, unlike the insured in McCullough (who failed to attend an EUO only because the insurer had unilaterally selected a date on which his counsel was unavailable, and who had expressed his willingness to submit to an EUO), Mr. Dolan repeatedly failed to cooperate in the scheduling of an EUO and categorically refused to submit to an EUO after he had filed suit. McCullough does not advance Mr. Dolan's case.
Mr. Dolan claims that he did not actually refuse to submit to an EUO, because, he says, he never refused to appear for a
scheduled
examination. His claim is devoid of merit. The stipulated facts show that, on no fewer than four occasions after Mr. Dolan had made a formal claim against the policy, Kemper requested dates for an EUO. On one occasion, Mr. Dolan's counsel agreed that Kemper was entitled to an EUO. On another, Mr. Dolan's counsel said that an assistant at the firm would secure a date for the EUO. Yet, Mr. Dolan's counsel supplied no dates. Instead, Mr. Dolan filed suit against
*626
Kemper, and his attorneys took the position that the insurer was no longer entitled to an EUO. On these facts, it is inarguable that Mr. Dolan expressed a determination not to submit to an EUO-i.e., he refused.
See Webster's Encyclopedic Unabridged Dictionary of the English Language
1207 (1989). "[T]he record is indicative of a pattern of non-co-operation for which no reasonable excuse for noncompliance has been proffered[.]"
Bulzomi v. N.Y. Cent. Mut. Fire Ins. Co.
,
Finally, Mr. Dolan argues that Kemper was able to obtain the substantial equivalent of an EUO when it took his deposition. Nonetheless, he cites no legal authority for the proposition that a deposition can substitute for an EUO. The absence of authority is alone sufficient to allow us to deem the argument to have been waived and to decline to address it.
*751
Anderson v. Litzenberg
,
It is unsurprising that Mr. Dolan cites no legal authority for his position, because numerous cases hold that an insured cannot comply with the requirement of submitting to an EUO by submitting to a discovery deposition.
See, e.g.
,
Wingates, LLC v. Commonwealth Ins. Co. of Am.
,
Submitting to a deposition will not satisfy the requirement of submitting to an EUO, because "[a]n examination under oath and a pretrial deposition 'serve vastly different purposes.' "
Brizuela v. CalFarm Ins. Co.
,
In his reply brief, Mr. Dolan argues that the term "examination under oath" is ambiguous and, hence, that that ambiguity should be construed against the insurer. Ordinarily, we do not consider arguments that a party raises for the first time in a reply brief.
Jones v. State
,
In summary, the circuit court correctly concluded that, by refusing to submit to an EUO, Mr. Dolan breached the insurance contract with Kemper and failed to satisfy a condition precedent to the recovery of benefits.
JUDGMENT OF THE CIRCUIT COURT FOR ANNE ARUNDEL COUNTY AFFIRMED. COSTS TO BE PAID BY APPELLANT.
The policy defined "family member" to mean "a person related to [Mr. Dolan's parents] by blood, marriage or adoption who is a resident of [his parents'] household."
In 2012, section 19-511 was amended so that "an uninsured motorist insurer may consent to settlement with a tortfeasor without waiving its right to contest tort liability[.]"
Morse v. Erie Ins. Exch.
,
The parties did not make an express stipulation about the date on which Mr. Dolan accepted the check. Mr. Dolan posits that he accepted the check on the date when it was "paid," which he claims was September 29, 2011.
On pages 2 and 9 of his brief, Mr. Dolan agrees that "only legal findings were made" at the hearing.
Under § 19-110 of the Insurance Article, "[a]n insurer may disclaim coverage on
a liability insurance policy
on the ground that the insured or a person claiming the benefits of the policy through the insured has breached the policy by failing to cooperate with the insurer or by not giving the insurer required notice only if the insurer establishes by a preponderance of the evidence that the lack of cooperation or notice has resulted in actual prejudice to the insurer." (Emphasis added.) A liability insurance policy, however, is a policy issued to protect an insured against the claims of injured third parties.
See
Phillips v. Allstate Indemn. Co.
,
Mr. Dolan appears to argue that, in view of a public policy that favors the provision of compensation to innocent victims of motor vehicle accidents, a provision requiring submission to an EUO is "unenforceable." Mr. Dolan did not make that argument in the circuit court, so it is not before us. See Md. Rule 8-131(a). Even if it were before us, it would be completely untenable in light of this Court's decision in Phillips , which upheld the denial of coverage because of an insured's refusal to answer relevant questions at an EUO.
"PIP" refers to personal injury protection, a type of no-fault insurance that motor-vehicle liability insurance policies are required to contain. See Md. Code (1996, 2017 Repl. Vol.), § 19-505 of the Insurance Article.
The same would be true if Kemper did not request an EUO until after an insured had filed suit: submitting to a post-filing EUO would be a condition to the insured's right to recover benefits under the policy.
Some cases assert that in an EUO, unlike a deposition, an insured has an obligation to volunteer information.
See
,
e.g.
,
Brizuela v. CalFarm Ins. Co.
,
Reference
- Full Case Name
- Gary DOLAN, Et Al. v. KEMPER INDEPENDENCE INSURANCE COMPANY
- Cited By
- 4 cases
- Status
- Published