West Bend Mutual Ins. Co. v. Ixthus Medical Supply, Inc.
West Bend Mutual Ins. Co. v. Ixthus Medical Supply, Inc.
Opinion
*553 *586 ¶1 In this duty to defend case, West Bend Mutual Insurance Company asks us to reverse the court of appeals' decision holding that the allegations in Abbott Laboratories' complaint against Ixthus Medical Supply, Inc. alleged a potentially covered advertising injury, and as a result, triggered West Bend's duty to defend under the commercial general liability policy West Bend issued to Ixthus. 1 West Bend argues the court of appeals erred when it determined: (1) Abbott's complaint 2 alleged a causal connection between the advertising activity and injury; and (2) the knowing violation exclusion did not apply. West Bend further contends that the criminal acts exclusion applies, thereby removing any duty to defend, or alternatively that application of the fortuity doctrine, public policy, *587 and the reasonable expectation of an insured each independently eliminates its duty to defend.
¶2 We hold the allegations in Abbott's complaint fall within the initial grant of coverage under the "personal and advertising injury liability" provision of the commercial general liability insurance policy West Bend issued to Ixthus. We further hold that neither the knowing violation nor the criminal acts exclusions apply to remove West Bend's duty to defend. Finally, we do not address West Bend's argument that the fortuity doctrine, public policy, and the reasonable expectation of an insured eliminate its duty to defend because West Bend failed to adequately raise or develop these contentions. 3 We affirm the decision of the court of appeals.
I. BACKGROUND
¶3 Ixthus is a medical supply company operating in Wisconsin. At all times relevant to this action, Ixthus was insured under a commercial general liability insurance ("CGL") policy with West Bend, which provided coverage for "personal and advertising injury." Specifically, the CGL policy provided:
COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY
1. Insuring Agreement *588 a. We will pay those sums that the insured becomes legally obligated *554 to pay as damages because of "personal and advertising injury" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "personal and advertising injury" to which this insurance does not apply....
b. This insurance applies to "personal and advertising injury" caused by an offense arising out of your business but only if the offense was committed in the "coverage territory" during the policy period.
"SECTION V-DEFINITIONS" of the CGL policy defines "advertisement" and "personal and advertising injury" as:
1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition:
a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and
b. Regarding web-sites, only that part of a website that is about your goods, products or services for the purposes of attracting customers or supporters is considered an advertisement.
....
14. "Personal and advertising injury" means injury, including consequential "bodily injury," arising out of one or more of the following offenses:
*589 ....
f. The use of another's advertising idea in your advertisement," or
g. Infringing upon another's copyright, trade dress or slogan in your "advertisement."
Under "COVERAGE B," the CGL policy contains exclusions for both "Knowing Violation of Rights of Another" and "Criminal Acts":
2. Exclusions
This insurance does not apply to:
a. Knowing Violation of Rights of Another
"Personal and advertising injury" caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict "personal and advertising injury."
....
d. Criminal Acts
"Personal and advertising injury" arising out of a criminal act committed by or at the direction of the insured.
¶4 Abbott is a health care company that manufactures and sells blood glucose test strips in both the domestic and international markets. Abbott's strips are trademarked under the name "FreeStyle." The test strips are functionally identical regardless of the intended market, but the labeling and instructional inserts as well as price and available rebates are substantially different between the domestic and international packaged boxes. For a variety of reasons, Abbott sells test strips for use in international markets at a much lower cost.
*590 ¶5 In November 2015, Abbott filed a lawsuit in New York federal court against Ixthus and over 100 other defendants asserting thirteen federal statutory and common law claims for relief based on its belief that the defendants were "import[ing], advertis[ing] and subsequent[ly]
*555
distribut[ing]" boxes of Abbott's international test strips in the United States. The thirteen claims alleged were: (1) Federal Trademark Infringement under Section 32 of the Lanham Act;
¶6 Upon being served, Ixthus tendered its defense to West Bend. In a March 2016 letter to Ixthus, West Bend denied Ixthus's tender, and explained why it took the position that the Abbott lawsuit was not covered by the CGL policy. In August 2016, West Bend filed a complaint in the circuit court seeking a declaratory judgment that West Bend had no duty to defend or indemnify Ixthus in Abbott's lawsuit. In March 2017, West Bend filed a motion for summary judgment. The *591 circuit court granted West Bend's motion, concluding that although the allegations in Abbott's complaint fell within the initial grant of coverage, the knowing violation exclusion applied, thereby eliminating any duty West Bend had to defend Ixthus. 5
¶7 Both Ixthus and Abbott appealed to the court of appeals, which reversed the circuit court's decision. The court of appeals agreed with the circuit court that the allegations in Abbott's complaint fell within the initial grant of coverage, but disagreed with the circuit court as to the applicability of the knowing violation exclusion.
See
West Bend Mut. Ins. Co. v. Ixthus Med. Supply, Inc.
, No. 2017AP909, unpublished slip op., ¶¶ 10, 12-14,
¶8 West Bend petitioned for review by this court, which we granted.
II. STANDARD OF REVIEW
¶9 "We independently review a grant of summary judgment using the same methodology of the circuit court and the court of appeals."
*592
Water Well Sols. Serv. Grp., Inc. v. Consolidated Ins. Co.
,
III. ANALYSIS
A. General Insurance Principles-Advertising Injury
¶10 The sole issue presented is whether West Bend has the duty to defend its insured, Ixthus, under the terms of the CGL policy-specifically the "Personal and Advertising Injury Liability" provision. In assessing whether a duty to defend exists, we "compare the four corners of the underlying complaint to the terms of the entire insurance policy."
Water Well Sols. Serv. Grp.
,
¶11 We use a three-step process in duty-to-defend cases:
(1) "First, a reviewing court determines whether the policy language grants initial coverage for the allegations set forth in the complaint. If the allegations set forth in the complaint do not fall within an initial grant of coverage, the inquiry ends."
(2) Second, "if the allegations fall within an initial grant of coverage, the court next considers whether any coverage exclusions in the policy apply."
(3) Third, "[i]f any exclusion applies, the court next considers whether an exception to the exclusion applies to restore coverage."
Water Well Sols. Serv. Grp.
,
¶12 Additionally, in analyzing the first step of the duty-to-defend analysis when an insured seeks
*594
coverage under the advertising provision of a CGL policy, we ask three questions to determine whether the allegations in the complaint fall under the initial grant of coverage.
See
Acuity v. Bagadia
,
¶13 The second part of the duty-to-defend analysis involves determining whether any of the insurance policy's exclusions apply.
Water Well Sols. Serv. Grp.
,
¶14 "If the policy, considered in its entirety, provides coverage for at least one of the claims in the underlying suit, the insurer has a duty to defend its insured on all the claims alleged in the entire suit."
Water Well Sols. Serv. Grp.
,
B. Application
¶15 West Bend argues: (1) the complaint does not allege a causal connection and (2) even if it does, exclusions in the policy apply to eliminate its duty to defend. Because West Bend does not challenge the court of appeals' answers to the first or second questions of the advertising injury test, we need not specifically analyze whether the complaint alleges a covered offense under the advertising injury provision or whether the complaint alleges that the insured engaged in advertising activity. The court of appeals correctly held that the complaint sufficiently alleged both a covered offense and that Ixthus engaged in advertising activity. We adopt the court of appeals'
*596 analysis on those two questions. 8 See West Bend Mut. Ins. Co. , No. 2017AP909, unpublished slip op., ¶ 12-13.
1. Advertising Injury Coverage-Causal Connection
¶16 West Bend asserts the complaint lacks any allegations suggesting a *558 causal connection between Abbott's injury and Ixthus's actions. Specifically, West Bend argues the complaint does not allege any advertising activity by Ixthus that caused injury to Abbott. Instead, West Bend insists that the allegations in the complaint against Ixthus focused on importation and distribution, not advertising. Therefore, West Bend says the complaint's allegations as to Ixthus do not fall within the initial grant of coverage under the insurance policy's advertising provision. We reject West Bend's contentions and hold the complaint sufficiently alleges the required causal connection.
¶17 The test for whether a causal connection has been sufficiently alleged focuses not on "whether 'the injury could have taken place without the advertising,' "
*597
but whether the allegations sufficiently assert that "the advertising did in fact
contribute materially
to the injury."
Fireman's Fund Ins. Co.
,
¶18 First, in paragraphs 5 and 6, the complaint alleges that the "Defendants" "caused-and continue to cause-Abbott to pay out, wrongfully, millions of dollars in rebates." Second, in paragraph 15, the complaint alleges:
Defendants' unauthorized importation, advertisement and subsequent distribution causes, or is likely to cause, consumer confusion, mistake, and deception to the detriment of Abbott.... When such patients encounter the diverted international FreeStyle test strips, which bear certain of Abbott's trademarks but which are materially different from what U.S. patients expect, they are likely to be confused and, indeed, disappointed. ... And the advertisement and sales of diverted international FreeStyle test strips cause great damage to Abbott and the goodwill of Abbott's valuable trademarks.
Third, in paragraph 385, the complaint alleges: "Using Abbott's trademarks and trade dress, Defendants advertise to consumers and the marketplace their ability and willingness to sell FreeStyle test strips. These advertisements are made through, inter alia, websites, emails, facsimiles, point-of-sale displays and other media."
¶19 West Bend admits that the complaint's references to "Defendants" include Ixthus, but contends that Ixthus was not really an "advertising" defendant-but instead a "distributing" defendant who did not
*598
advertise or sell products directly to end users. As a result, West Bend argues that these causation paragraphs are insufficient to connect Ixthus's activity to the coverage afforded in the advertising provision of the CGL policy. West Bend's post-hoc spin on these causation paragraphs cannot eliminate coverage at the duty-to-defend stage. The insurer in
Ross Glove Co.
advanced a similar argument in that case, suggesting that the manufacturer of infringing packaged products could not also be viewed as having advertised those goods. The court of appeals rightly rejected this argument, concluding that the complaint alleged the manufacturer engaged in covered advertising activity because its packaging constituted a "published advertisement" notwithstanding the advertising activity of other defendants in the case.
Ross Glove Co.
,
¶22 The third question in the advertising-injury test on causation undoubtedly must be answered affirmatively: the complaint alleges a causal connection between Abbott's alleged injury and Ixthus's advertising activity. Given the allegations in the complaint, it is reasonable to infer that Ixthus's alleged advertising activity contributed materially to Abbott's alleged injuries. Accordingly, the allegations in the complaint fall within the initial grant of coverage.
2. Exclusions
¶23 Having concluded the allegations in the complaint fall within the initial grant of coverage under the personal and advertising provision of the CGL policy, we move to the second step in the duty-to-defend analysis to determine whether any of the exclusions *600 in the CGL policy apply to eliminate West Bend's duty to defend Ixthus.
¶24 West Bend's policy contains two exclusions it believes applies: (1) knowing violation and (2) criminal acts. We address each in turn.
a. Knowing Violation
¶25 West Bend argues the knowing violation exclusion applies to preclude its duty to defend because the complaint alleges Ixthus acted intentionally and with knowledge that it was defrauding Abbott by buying international test strips at the lower price and selling them domestically to increase profit. West Bend points to the repeated allegations in the complaint that the defendants knew what they were doing and that Ixthus had done this before.
¶26 The knowing violation exclusion in Ixthus's CGL policy says:
This insurance [meaning the coverage for personal and advertising injury] does not apply to:
a. Knowing Violation of Rights Of Another
"Personal and advertising injury" caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict "personal and advertising injury."
*560
¶27 The knowing violation exclusion has eluded review in this court, but our court of appeals has considered its application. In
Acuity v. Ross Glove Co.
,
¶28 The court of appeals reached a similar conclusion in
Air Eng'g, Inc. v. Industrial Air Power, LLC
,
¶29 The court of appeals' analyses in Air Engineering, Inc. and Ross Glove Co. were correct. It properly compared the allegations in each complaint to the language of the exclusion. The knowing violation exclusion will preclude coverage at the duty-to-defend stage only when every claim alleged in the complaint requires the plaintiff to prove the insured acted with knowledge that its actions "would violate the rights of another and would inflict 'personal and advertising injury.' " If the complaint alleges any claims that can be proven without such a showing, the insurer will be required to provide a defense.
¶30 West Bend urges us to apply the knowing violation exclusion based on the "story" this 156-page complaint tells-that Ixthus "deliberately and willfully" participated in a "fraudulent scheme." We do not base insurance coverage decisions on stories or themes. We apply the law, and applicable law in this case requires us to compare the allegations in the complaint to the words of the exclusion to ascertain
*561
whether Abbott makes any claims that do not base liability on a showing of a knowing violation of another's rights and
*603
infliction of advertising injury.
See
Air Eng'g, Inc.
,
¶31 A review of Abbott's ten remaining claims in the complaint quickly reveals that the complaint contains multiple claims that fall within West Bend's personal and advertising injury coverage provision and do not require proof that Ixthus acted with knowledge or with intent to violate Abbott's rights and inflict injury.
¶32 Abbott's claim for trademark dilution under Section 43(c) of the Lanham Act,
¶33 Likewise, Abbott's claim for trademark dilution under New York General Business Law § 360-l does not require Abbott to prove Ixthus acted knowingly or intentionally. Rather, Abbott must show "(1) its trademark 'is of truly distinctive quality or has
*604
acquired secondary meaning' and (2) 'there is a likelihood of dilution.' "
¶34 Both Abbott's federal and state law causes of action for trademark dilution include allegations that Ixthus infringed upon Abbott's trade dress in Ixthus' advertisements, thereby alleging covered claims for personal and advertising injury that do not require proof of knowing or intentional action on the part of Ixthus. Specifically, in paragraph 385 of the complaint, Abbott alleges that "[u]sing Abbott's trademarks and trade dress, Defendants advertise to consumers and the marketplace their ability and willingness to sell FreeStyle test strips." In paragraph 585, Abbott alleges that Ixthus "utilized marks that are likely to cause dilution by blurring and/or tarnishment of Abbott's famous FreeStyle Marks and FreeStyle Trade Dress." And in paragraph 590, Abbott alleges that Ixthus and the other Defendants "have diluted and are continuing to dilute the distinctive quality of the FreeStyle Marks and FreeStyle Trade Dress, in violation of state law." Because neither cause of action requires proof of intentional conduct, the knowing violation exclusion does not apply.
¶35 Similarly, Abbott's claim alleging deceptive business practices under New York General Business Law § 349 does not require Abbott to establish "intent to defraud or mislead" to prove its case, but allows the district court to award treble damages if Abbott proves the defendants' actions were done with such intent.
¶36 Even though the complaint generally asserts Ixthus acted wrongfully and with knowledge that it was defrauding Abbott, West Bend is not relieved of its duty to defend because this complaint alleges at least one potentially covered advertising-injury claim, which does not depend on whether Ixthus acted with knowledge that it was violating Abbott's rights or with knowledge that it was inflicting advertising injury.
9
When "even one covered offense is alleged in the underlying complaint, the insurance company has a duty to defend."
Ross Glove Co.
,
¶37 Despite Abbott's general allegations of knowing violations, Abbott could prevail on several covered advertising injury claims without establishing that Ixthus knowingly violated Abbott's rights. It is
*606
this possible coverage that triggers West Bend's duty to defend. "An insurer's duty to defend the insured in a third-party suit is predicated on allegations in a complaint which, if proven, would give rise to the possibility of recovery that falls under the terms and conditions of the insurance policy."
Fireman's Fund Ins. Co.
,
b. Criminal Acts
¶38 West Bend also argues the criminal acts exclusion precludes coverage. West Bend contends the complaint specifically alleges some of Ixthus's acts constituted crimes, such as illegal mail, wire, and insurance fraud. The criminal acts exclusion precludes coverage for " 'Personal and advertising injury' arising out of a criminal act committed by or at the direction of the insured." West Bend's policy does not define criminal act and this court has not yet decided whether a defendant must have been only charged with or actually convicted of a crime in order for the criminal acts exclusion to apply. This issue of first impression was not fully addressed in the courts below and West Bend's motion for summary judgment in the circuit court relied solely on the knowing violation exclusion. Accordingly, we decline to address it. 10
*607 ¶39 The application of the criminal acts exclusion, however, can be resolved without deciding the issue of first impression.
*563
The complaint alleges claims that are not dependent on a showing of criminal conduct. Lanham Act violations, for example, are not criminal. "[W]hen an insurance policy provides coverage for even one claim made in a lawsuit, the insurer is obligated to defend the entire suit."
Fireman's Fund Ins. Co.
,
IV. CONCLUSION
¶40 We hold the allegations in Abbott's complaint fall within the initial grant of coverage under the "personal and advertising injury liability" provision of the commercial general liability insurance policy West Bend issued to Ixthus. The claims in the *608 complaint are sufficient to allege a causal connection between Ixthus's advertising activity and Abbott's injuries. We further hold that neither the knowing violation nor the criminal acts exclusions apply to remove West Bend's duty to defend because the complaint alleges at least one potentially covered claim unaffected by either exclusion. We affirm the decision of the court of appeals.
By the Court. -The decision of the court of appeals is affirmed.
¶41 ANNETTE KINGSLAND ZIEGLER, J., did not participate.
For ease of reference, we refer to West Bend Mutual Insurance Company as "West Bend." We refer to Abbott Laboratories, Abbott Diabetes Care Inc., and Abbott Diabetes Care Sales Corporation collectively as "Abbott." We refer to Ixthus Medical Supply, Inc. and Karl Kunstman collectively as "Ixthus."
The court of appeals opinion in this case was an unpublished per curiam decision.
See
West Bend Mut. Ins. Co. v. Ixthus Med. Supply, Inc.
, No. 2017AP909, unpublished slip op.,,
All references to Abbott's "complaint" are to the Second Amended Complaint from the underlying lawsuit Abbott filed in federal district court in New York against Ixthus and many other defendants. See Abbott Laboratories, et.al. v. Adelphia Supply USA, et al. , No. 15 Civ. 05826 (E.D.N.Y. Nov. 2015).
See
State v. Dowdy
,
It is undisputed that the federal district court dismissed the two RICO claims and the unjust enrichment claim, leaving ten alleged claims.
The Honorable David W. Paulson of Racine County Circuit Court presiding.
All subsequent references to the Wisconsin Statutes are to the 2017-18 version unless otherwise indicated.
The final order from the circuit court both "adjudged and declared" that West Bend had no duty to defend. This judgment followed West Bend's motion for summary judgment within a declaratory judgment action. The circuit court merged the summary judgment and declaratory judgment into a single order, granting West Bend's summary judgment motion by issuing a declaration.
The court of appeals concluded both that Abbott's complaint alleged a covered offense under the advertising provision and that Ixthus engaged in an advertising activity:
[T]he complaint alleges a covered offense because it alleges that Abbott suffered an advertising injury caused by an offense arising out of Ixthus's business.... The complaint alleges that the test strips are functionally the same whether for domestic or international sale but that the diverted ones are not labeled to comply with FDA requirements and that there are numerous material differences between packaging intended for international and domestic markets. Packaging itself is an advertisement.
See West Bend Mut. Ins. Co. , No. 2017AP909, unpublished slip op., ¶¶ 12-13.
We are not persuaded by the argument attempting to analogize this case to
Talley v. Mustafa
,
See
Lamar Co., LLC v. Country Side Rest. Inc.
,
The third step of the duty-to-defend analysis-evaluating whether any exceptions to the exclusions apply-is not implicated in this case and therefore will not be addressed. Because we conclude that Abbott's complaint alleges covered claims and no coverage exclusion applies to remove coverage, logically we do not consider whether an exception to any exclusion would restore coverage. Once a court determines the policy provides an initial grant of coverage, the court must consider whether any exclusions apply; if none apply, the analysis stops and the insurer has a duty to defend its insured against all of the claims asserted in the complaint.
Reference
- Full Case Name
- WEST BEND MUTUAL INSURANCE COMPANY, Plaintiff-Respondent-Petitioner, v. IXTHUS MEDICAL SUPPLY, INC. and Karl Kunstman, Defendants-Appellants, Abbott Laboratories, Abbott Diabetes Care Inc. and Abbott Diabetes Care Sales Corp., Defendants-Co-Appellants.
- Cited By
- 10 cases
- Status
- Published