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Progressive Express Ins. Co. v. Tate Transp. Corp.

United States District Court for the Middle District of Florida, Fort Myers Division

November 16, 2022, Decided; November 16, 2022, Filed

Case No: 2:21-cv-198-JES-KCD

Reporter

2022 U.S. Dist. LEXIS 208183 *; 2022 WL 16963815

PROGRESSIVE EXPRESS INSURANCE COMPANY, an Ohio Corporation, Plaintiff, v. TATE TRANSPORT CORPORATION, a Florida Corporation, RENEE NIENOW, ISLARY MARTINEZ, ISLAMARTI LLC, a Florida Limited Liability Company, DENNIS NIENOW, and ALBERTO DANIEL HERRERA MARTINEZ, Defendants.

Core Terms

Trucking, insured, duty to defend, Transport, coverage, default, state court, dump truck, summary judgment, allegations, duty to indemnify, business purpose, Drive, bicycle, construction site, drivers, loaded, terms, sand, summary judgment motion, policy exclusion, alleged facts, bodily injury, pleadings

Counsel:  [*1] For Progressive Express Insurance Company, an Ohio Corporation, Plaintiff: Stuart J. Freeman, Freeman, Goldis & Cash, P.A., ST. Petersburg, FL.

For Tate Transport Corporation, a Florida Corporation, Defendant: Jeffrey Alan Blaker, Jeffrey A. Blaker, ESQ., West Palm Beach, FL.

For Renee Nienow, Defendant: Michael G. Heilmann, Michael G. Heilmann, PC, Taylor, MI.

Islary Martinez, Defendant, Pro se, Naples, FL.

Islamarti LLC, a Florida Limited Liability Company, Defendant, Pro se, Naples, FL.

For Dennis Nienow, Defendant: Michael G. Heilmann, Michael G. Heilmann, PC, Taylor, MI.

Alberto Daniel Herrera Martinez, Defendant, Pro se, Naples, FL.

Judges: JOHN E. STEELE, SENIOR UNITED STATES DISTRICT JUDGE.

Opinion by: JOHN E. STEELE

Opinion


OPINION AND ORDER

This matter comes before the Court on the plaintiff’s Motion for Final Summary Judgment/Motion for Default Judgment (Doc. #72). Defendant Tate Transport Corporation (Tate Transport) filed a Response (Doc. #80), and Plaintiff filed a Reply (Doc. #81). Defendants Dennis Nienow and Renee Nienow have not responded to the motion, and the remaining defendants are in default.

Progressive Express Insurance Company (Progressive or plaintiff) filed its Amended Complaint for Declaratory [*2]  Judgment (Doc. #49) seeking a declaration that it did not owe a duty to defend or a duty to indemnify in a particular motor vehicle versus bicycle accident case filed in state court. Defendant Tate Transport filed an Answer and Affirmative Defenses (Doc. #51); defendants Islamarti, LLC, Alberto Daniel Herrera Martinez (Alberto Martinez), and Islary Martinez filed Answers and Affirmative Defenses (Doc. #52); and defendants Dennis Nienow and Renee Nienow filed an Answer (Doc. #53). Ultimately, a Clerk’s Default was issued as to Alberto Martinez, Islamarti LLC, and Islary Martinez. (Docs. ## 69-71.)

Progressive now seeks summary judgment and/or default judgment against all defendants. Progressive argues that the Commercial Auto Policy it issued does not provide bodily injury or property damage liability coverage to any of the defendants in connection with the March 25, 2020, accident. Progressive maintains that the Policy provides only non-trucking liability coverage and contains a trucking-use exclusion. Progressive asserts the undisputed facts establish that all three insured vehicles were being utilized to deliver building materials (sand) to a construction site, and therefore fall [*3]  squarely within the terms of the exclusion. Therefore, Progressive argues, it has no duty to defend or indemnify.


I.

Summary judgment is appropriate only when the Court is satisfied that “there is no genuine dispute as to any material fact and that the movant is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). “An issue of fact is ‘genuine’ if the record taken as a whole could lead a rational trier of fact to find for the nonmoving party.” Baby Buddies, Inc. v. Toys “R” Us, Inc., 611 F.3d 1308, 1314 (11th Cir. 2010). A fact is “material” if it may affect the outcome of the suit under governing law. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S. Ct. 2505, 91 L. Ed. 2d 202 (1986). “A court must decide ‘whether the evidence presents a sufficient disagreement to require submission to a jury or whether it is so one-sided that one party must prevail as a matter of law.'” Hickson Corp. v. N. Crossarm Co., Inc., 357 F.3d 1256, 1260 (11th Cir. 2004) (quoting Anderson, 477 U.S. at 251).

In ruling on a motion for summary judgment, the Court views all evidence and draws all reasonable inferences in favor of the non-moving party. Scott v. Harris, 550 U.S. 372, 380, 127 S. Ct. 1769, 167 L. Ed. 2d 686 (2007); Tana v. Dantanna’s, 611 F.3d 767, 772 (11th Cir. 2010). However, “if reasonable minds might differ on the inferences arising from undisputed facts, then the court should deny summary judgment.” St. Charles Foods, Inc. v. America’s Favorite Chicken Co., 198 F.3d 815, 819 (11th Cir. 1999) (quoting Warrior Tombigbee Transp. Co. v. M/V Nan Fung, 695 F.2d 1294, 1296-97 (11th Cir. 1983) (finding summary judgment “may be inappropriate even where the parties agree on the basic facts, but disagree about the factual inferences that should be drawn from these facts”)). [*4]  “If a reasonable fact finder evaluating the evidence could draw more than one inference from the facts, and if that inference introduces a genuine issue of material fact, then the court should not grant summary judgment.” Allen v. Bd. of Pub. Educ., 495 F.3d 1306, 1315 (11th Cir. 2007).

“The defendant, by his default, admits the plaintiff’s well-pleaded allegations of fact, is concluded on those facts by the judgment, and is barred from contesting on appeal the facts thus established.” Nishimatsu Constr. Co. v. Houston Nat’l Bank, 515 F.2d 1200, 1206 (5th Cir. 1975) (citations omitted). “While a defaulted defendant is deemed to admit the plaintiff’s well-pleaded allegations of fact, he is not held to admit facts that are not well-pleaded or to admit conclusions of law.” Surtain v. Hamlin Terrace Found., 789 F.3d 1239, 1245 (11th Cir. 2015) (quotation marks and citation omitted). “The mere entry of a default by the clerk does not in itself warrant the entry of default by the Court. Rather the Court must find that there is sufficient basis in the pleadings for the judgment to be entered.” GMAC Commercial Mortg. Corp. v. Maitland Hotel Assocs., Ltd., 218 F. Supp. 2d 1355, 1359 (M.D. Fla. 2002) (citing Nishimatsu, 515 F.2d at 1206).


II.

Progressive issued a Commercial Automobile Insurance Policy (the Policy) (Doc. #73-1) to Islamarti, LLC for the policy period July 31, 2019, to July 31, 2020. The “Coverage Summary” for the Policy states that the Policy includes provisions for “Non-Trucking Liability to Others.” (Doc. #73-1, p. 4.) [*5]  Part I of the Policy, the “Insuring Agreement – Liability To Others” portion, committed Progressive to “pay damages, other than punitive or exemplary damages, for bodily injury, property damage . . . for which an insured becomes legally responsible because of an accident arising out of its ownership, maintenance or use of that insured auto.” (Id. at 22) (bold in the original, indicating terms defined in the Policy). An Endorsement to the Policy provides that the Policy was modified to add the following exclusion:

15. Trucking Use

Coverage under this Part I, including our duty to defend, does not apply to an insured auto or any attached trailer while operated, maintained, or used:

a. To carry property or while such property is being loaded and unloaded from the insured auto or an attached trailer; or

b. In any business or for any business purpose.

(Id. at 53-54.) The Policy provides this coverage for three dump trucks – a 2006 Volvo Vhd, a 2006 Volvo Vhd, and a 2004 Peterbilt 379. (Id. at 5.) Tate Transport (and others) was an additional named insured on the Policy. (Id. at 7.)

During the term of the Policy, Islamarti had a business relationship with Tate Transport. Islamarti would provide [*6]  drivers and trucks to Tate Transport to carry dirt to sites selected by Tate Transport along routes selected by Tate Transport. Tate Transport would make weekly payments to Islamarti for the loads transported during the prior week. On March 25, 2020, the Policy was in full force and effect, and all three insured trucks were hauling fill sand from the Youngquist Brothers Mine to Tate Transport’s Siena Lakes construction project.

On March 25, 2020, 74-year-old Dennis Nienow (Mr. Nienow) went for a bicycle ride and was struck by a dump truck, causing very serious bodily injury. The police accident report described the events, which occurred at approximately 7:19 a.m., as follows:

[A bicycle] was traveling westbound on the sidewalk on Orange Blossom Drive approaching the intersection of Siena Lakes drive. [A vehicle] was traveling southbound on Siena Lakes Drive approaching the intersection of Orange Blossom Drive. As [the bicycle] entered the intersection, [the vehicle] proceeded to turn left onto Orange Blossom Drive. The front right of [the vehicle] struck [the bicycle] causing the rider to become separate from the bicycle. The rider and the bicycle came to final rest in the westbound [*7]  lane on Orange Blossom Drive. [Vehicle] continued eastbound on Orange Blossom Drive.

(Doc. #80-1, p. 2.) No vehicle owner was identified, and the accident was labelled a hit and run. (Id.) Mr. Nienow did not see the driver of the dump truck, did not recognize any marks on the dump truck or any writing on it, and does not recall what part of the truck hit him.

Mr. Nienow and his wife filed a First Amended Complaint (Doc. #49-2) in Lee County Circuit Court against Tate Transport, Alberto Daniel Herrera Martinez (Alberto Martinez), Islary Martinez, and Islamarti, LLC seeking in excess of one million dollars. The Nienows claim that Alberto Martinez “mowed down” Mr. Nienow on March 25, 2020, while driving a dump truck owned by Islamarti and acting as Tate Transport’s agent in connection with pick-up and deliveries of sand for the Siena Lakes construction site.


III.

Progressive filed suit under the federal Declaratory Judgment Act, 28 U.S.C. § 2201, seeking to take advantage of the valuable role a declaratory judgment plays in clarifying an insurance companies’ liability quickly and directly. James River Ins. Co. v. Rich Bon Corp., 34 F.4th 1054, 1058 (11th Cir. 2022). Progressive’s Amended Complaint For Declaratory Judgment asserts that if the dump truck involved in the accident was one of the three trucks [*8]  covered by the Policy, coverage is excluded by the “Trucking Use” exclusion because the truck “was being used to carry property or for was [sic] being used in the business of ISLAMARTI or was being used for a business purpose of ISLAMARTI.” (Doc. #49, ¶ 22.) As a result, the Amended Complaint asserts, Progressive has no duty to defend or indemnify. (Id. at ¶ 23.)

Progressive’s summary judgment motion focuses on only one component of the Trucking Use exclusion. Progressive assumes for purposes of the motion that one of the three insured dump trucks was the truck involved in the accident. Nonetheless, Progressive argues that the Policy does not provide coverage because the truck was being used in a commercial context to carry dirt to Tate Transport’s Sienna Lakes construction site, and thus was being operated “in any business or for any business purpose” within the meaning of the Policy’s “Trucking Use” exclusion. All three insured trucks would be subject to the same exclusion.


A. Duty to Defend

(1) Florida Law Applies

Because federal jurisdiction in this case is premised on diversity of citizenship (Doc. #49, ¶ 2), the Court applies Florida’s substantive law. Westchester Gen. Hosp., Inc. v. Evanston Ins. Co., 48 F.4th 1298, 1302 (11th Cir. 2022). All responding parties also [*9]  rely on Florida law. (Doc. #72, P. 6; Doc. #80, p.4.)

(2) Florida Duty to Defend Principles

The Court starts with Progressive’s duty to defend because “[u]nder Florida law, an insurer’s duty to defend is separate and distinct from its duty to indemnify, and it is more extensive.” Advanced Sys., Inc. v. Gotham Ins. Co., 272 So. 3d 523, 526-27 (Fla. 3d DCA 2019) (citation omitted). As the Eleventh Circuit has recently summarized:

Under Florida law, “an insurer’s duty to defend its insured against a legal action arises when the complaint alleges facts that fairly and potentially bring the suit within policy coverage.” Jones v. Fla. Ins. Guar. Ass’n, 908 So. 2d 435, 442-43 (Fla. 2005). The duty to defend is a broad one, broader than the duty to indemnify, and “[t]he merits of the underlying suit are irrelevant.” Mid-Continent Cas. Co. v. Royal Crane, LLC, 169 So. 3d 174, 181 (Fla. 4th DCA 2015). We determine whether an insurer has a duty to defend its insured based only on “the eight corners of the complaint and the policy,” id. at 182, and only as the complaint’s alleged facts are “fairly read,” Fun Spree Vacations, Inc., 659 So. 2d at 421. The “facts” we consider in evaluating the duty to defend come solely from the complaint, regardless of the actual facts of the case and regardless of any later developed and contradictory factual record. Jones, 908 So. 2d at 442-43. “Any doubts regarding the duty to defend must be resolved in favor of the insured,” id. at 443, and “where a complaint alleges facts that [*10]  are partially within and partially outside the coverage of an insured’s policy, the insurer is not only obligated to defend, but must defend that entire suit,” Sunshine Birds & Supplies, Inc. v. U.S. Fid. & Guar. Co., 696 So. 2d 907, 910 (Fla. 3d DCA 1997). But of course, because the lawsuit must be for something covered by the insurance policy, “the insurer has no duty to defend” when “the pleadings show the applicability of a policy exclusion.” State Farm Fire & Cas. Co. v. Tippett, 864 So. 2d 31, 35 (Fla. 4th DCA 2003).

Travelers Indem. Co. of Connecticut v. Richard Mckenzie & Sons, Inc., 10 F.4th 1255, 1261 (11th Cir. 2021). See also Westchester Gen. Hosp., Inc., 48 F.4th at 1302 (“However, an insurer does not need to defend an insured if a policy exclusion applies,” citing Keen v. Fla. Sheriffs’ Self-Ins. Fund, 962 So. 2d 1021, 1024 (4th Fla. DCA 2007)).

An insurance policy can, without creating a conflict or ambiguity, both provide coverage and exclude some things that might otherwise fall within that coverage. Cynergy, LLC v. First Am. Title Ins. Co., 706 F.3d 1321, 1327 (11th Cir. 2013). On the other hand, an insurance policy’s coverage becomes illusory if it grants coverage in one provision and completely takes it away in another provision. Richard Mckenzie & Sons, Inc., 10 F.4th at 1265-66.

Because Progressive relies on an exclusion to deny coverage, “it has the burden of demonstrating that the allegations of the complaint are cast solely and entirely within the policy exclusion and are subject to no other reasonable interpretation.” Advanced Sys., Inc. v. Gotham Ins. Co., 272 So. 3d 523, 527 (Fla. 3d DCA 2019) (citation omitted). The Court focuses on the specifics of the state court pleading and the Policy’s terms of coverage and exclusion from coverage. Richard Mckenzie & Sons, Inc., 10 F.4th at 1261. If the state court [*11]  pleadings show the applicability of a policy exclusion, Progressive has no duty to defend or indemnify. Id. at 1262.

(3) Application of Duty to Defend Principles

As discussed earlier, Part I of the Policy committed Progressive to “pay damages, other than punitive or exemplary damages, for bodily injury, property damage . . . for which an insured becomes legally responsible because of an accident arising out of its ownership, maintenance or use of that insured auto.” (Doc. #73-1, p. 22) (emphasis in original). The “arising out of” language provides a broad coverage. Richard Mckenzie & Sons, Inc., 10 F.4th at 1263. The Trucking Use Endorsement to the Policy excluded some of this coverage under certain circumstances:

15. Trucking Use

Coverage under this Part I, including our duty to defend, does not apply to an insured auto or any attached trailer while operated, maintained, or used:

a. To carry property or while such property is being loaded and unloaded from the insured auto or an attached trailer; or

b. In any business or for any business purpose.

(Id. at 53-54) (emphasis in original).

Progressive’s summary judgment motion only relies upon the “in any business or for any business purpose” portion of the Trucking Use Exclusion. (Doc. #72, p. 8.) Thus, [*12]  for the exclusion to apply in this case, the state court pleadings must show that all claims involve an accident which occurred while an “insured auto” was “operated, maintained, or used” “in any business or for any business purpose.”

The state court Amended Complaint (Doc. #49-2) alleges that Tate Transport is a trucking company whose drivers perform ultra-hazardous activities, including using dump trucks to deliver sand from Youngquist Brothers Mine to a construction site. (Id. at ¶ 4.) On or about February 4, 2020, Tate Transport entered into a profit-making agreement with South Florida Excavation to deliver white fill sand from Youngquist Brothers Rock Mine and other mines to a construction project at Siena Lakes. (Id. at ¶¶ 12-13.) Alberto Martinez was one of the dump truck drivers in Tate Transport business operations and is alleged to be the driver who hit Mr. Nienow on March 25, 2020. (Id. at ¶¶ 15-19.) The Amended Complaint sets forth five counts: (1) Negligence by Tate Transportation in the operation of the dump truck on March 25, 2020 (Count I); (2) breach of duty on March 25, 2020, as owner of a dangerous instrumentality (Count II); (3) negligent selection of sub-contractors [*13]  on and before March 25, 2020 (Count III); (4) Strict Liability against Islamarti for the accident on March 25, 2020, as owner of the dump truck (Count IV); and (5) active negligence against Tate Transport as a broker by breaching various duties on and before March 25, 2020 (Count V).

There is no dispute that all three of the dump trucks were “insured autos” within the meaning of the Policy. The state court Amended Complaint alleges facts showing that the dump truck was being “operated, maintained, or used” within the meaning of the Policy’s Trucking Use exclusion. Finally, the state court Amended Complaint alleges facts showing that the truck was being operated, maintained or used “in any business or for any business purpose.” Indeed, Tate Transport agrees that on March 25, 2020, all three trucks listed on the Policy “were involved in hauling fill sand to and from the Siena Lakes construction project.” (Doc. #80, p. 2, ¶ 1.)

Tate Transport suggests that if one of the three vehicles was involved in the accident it would not have been under load, since it was leaving the construction site. (Id. at p. 4.) While this may be true, the summary judgment motion does not rely on “loaded and unloaded” [*14]  portion of the Trucking Use Exclusion.

Additionally, Tate Transport argues that

[t]he minimal evidence that exists at this time shows that the accident occurred at a time when the subject trucks were not being operated, maintained, or used in business – they were either traveling without any load at the construction site or somewhere else. The evidence simply does not show, to the extent required for summary judgment, what the trucks were actually doing at the time of the accident. The drivers could have been taking a personal break. The trucks could have been turned off waiting for someone at the quarry to do something. Many possibilities exist that would bring this accident within Progressive’s coverage, i.e., where the subject exclusion would be inapplicable factually.

(Doc. #80, p. 5.) But, as discussed earlier, the Court is limited to the allegations in the state court Amended Complaint to determine the duty to defend. Those factual allegations are sufficient to establish what the truck was doing at the time of the accident, and by any reasonable definition of the undefined terms showed that the truck was being operated, maintained or used “in any business” or “for any business purpose.” [*15] 

The difficulty with Progressive’s duty to defend position is not that allegations of the state court Amended Complaint do not fall within the terms of the Trucking Use exclusion. Rather, there is a duty to defend in this case because the state court Amended Complaint is not confined to the March 25, 2020 accident. Count III and V of the Amended Complaint include negligent conduct allegedly occurring before the March 25, 2020 accident, which falls within the broad scope of coverage and is not within the terms of the Trucking Use exclusion. Thus, Count III alleges that Tate Transport is liable for negligent selection of sub-contractors for breaching several its duties prior to March 25, 2020. Count V alleges that Tate Transport is liable for active negligence as a broker, breaching several duties prior to March 25, 2020. Both claims seek damages for bodily injury because of an accident arising out of its ownership, maintenance or use of an insured vehicle, but are not limited to the circumstances required by the Trucking Use Exclusion.

An insurer’s duty to defend an insured in a legal action under Florida law “arises when the complaint alleges facts that fairly and potentially bring the [*16]  suit within policy coverage.” Jones v. Fla. Ins. Guar. Ass’n, 908 So. 2d 435, 442-43 (Fla. 2005). Even if the allegations in the complaint are meritless, the duty to defend nonetheless arises. All doubts about whether the duty to defend applies are resolved in favor of the insured. Id. at 443. “If an examination of the allegations of the complaint leaves any doubt regarding the insurer’s duty to defend, the issue is resolved in favor of the insured.” Laws. Title Ins. Corp. v. JDC (Am.) Corp., 52 F.3d 1575, 1580-81 (11th Cir. 1995). The allegations in the state court Amended Complaint in Counts III and V satisfy this requirement, and therefore Progressive is not entitled to summary judgment on its duty to defend position.


B. Duty to indemnify

“While the duty to defend is broad and based on the allegations in the complaint, the duty to indemnify is determined by the facts adduced at trial or during discovery.” Pa. Lumbermens Mut. Ins. Co. v. Ind. Lumbermens Mut. Ins. Co., 43 So. 3d 182, 188 (Fla. 4th DCA 2010). See also Pub. Risk Mgmt. of Florida v. Munich Reinsurance Am., Inc., 38 F.4th 1298, 1306 (11th Cir. 2022) (quoting Pa. Lumbermens).

Therefore, unlike the duty to defend, the trial court must look beyond the allegations in the underlying complaint to decide whether an insurer has a duty to indemnify. The duty to indemnify arguably may not become fully ripened until the merits of the underlying litigation are resolved. Aetna Ins. Co. v. Borrell-Bigby Elec. Co., 541 So.2d 139, 141 (Fla. 2d DCA 1989).

As of the filing of the summary judgment motion, the state court case was still ongoing. The material facts are not undisputed, [*17]  and therefore summary judgment on the duty to indemnify is not appropriate. This portion of the motion will be denied.


C. Default judgment

Rule 55 requires that “[w]hen a party against whom a judgment for affirmative relief is sought has failed to plead or otherwise defend, and that failure is shown by affidavit or otherwise, the clerk must enter the party’s default.” Fed. R. Civ. P. 55(a). Nevertheless, there is a “strong policy of determining cases on their merits” and, therefore, “default judgments are generally disfavored.” Surtain v. Hamlin Terrace Found., 789 F.3d 1239, 1244-45 (11th Cir. 2015) (quoting In re Worldwide Web Sys., Inc., 328 F.3d 1291, 1295 (11th Cir. 2003)). Here, the defaulted defendants turn out to be in the same essential situation as the other defendants. Progressive’s pleadings incorporate the state court Amended Complaint, Progressive has a duty to defend, and there are material disputed facts as to the duty to indemnify. Progressive’s motion for default judgment is denied.

Accordingly, it is now

ORDERED:

Plaintiff’s Motion for Final Summary Judgment/Motion for Default Judgment (Doc. #72) is DENIED.

DONE AND ORDERED at Fort Myers, Florida, this 16th day of November 2022.

/s/ John E. Steele

JOHN E. STEELE

SENIOR UNITED STATES DISTRICT JUDGE


End of Document

Farid v. Gaskell

Court of Appeals of Georgia, First Division

November 1, 2022, Decided

A22A0899.

Reporter

2022 Ga. App. LEXIS 517 *; 2022 WL 16569408

FARID et al. v. GASKELL et al.

Notice: THIS OPINION IS UNCORRECTED AND SUBJECT TO REVISION BY THE COURT.

Disposition: Judgment affirmed.

Core Terms

truck, coverage, settlement agreement, uninsured, carrier, tractor trailer, limits, settlement, claimant, voluntary payment, summary judgment, collision, exhaust, surety, liability policy, motor carrier, trial court, reservation-of-rights, endorsement, scheduled, stipulate, supplied, insurer

Case Summary

Overview

HOLDINGS: [1]-Because the driver failed to exhaust the truck driver’s employer’s insurer’s limits as required by O.C.G.A.  33-24-41.1, the driver was precluded from making any recover from his uninsured/underinsured motorist (UM) carrier; [2]-The UM carrier was properly granted summary judgment because if the truck was uninsured, the driver failed to demonstrate that and if it was not uninsured, the driver’s agreement to settle for less than the employer’s insurer’s policy limits and release the insurer from its liability policy and obligations meant that the driver did not comply with the exhaustion requirements of § 33-24-41.1 before seeking UM payment.

Outcome

Judgment affirmed.

LexisNexis® Headnotes

Civil Procedure > Judgments > Summary Judgment > Burdens of Proof

Civil Procedure > … > Summary Judgment > Appellate Review > Standards of Review

Civil Procedure > Judgments > Summary Judgment > Entitlement as Matter of Law

Civil Procedure > … > Summary Judgment > Burdens of Proof > Movant Persuasion & Proof

Civil Procedure > … > Summary Judgment > Burdens of Proof > Nonmovant Persuasion & Proof

HN1  Summary Judgment, Burdens of Proof

Under Georgia law, summary judgment is proper if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law. Where a defendant moving for summary judgment discharges this burden, the nonmoving party cannot rest on its pleadings, but rather must point to specific evidence giving rise to a triable issue. In its de novo review of the grant of a motion for summary judgment, an appellate court must view the evidence, and all reasonable inferences drawn therefrom, in the light most favorable to the nonmovant.

Insurance Law > Claim, Contract & Practice Issues > Reservation of Rights > Notice to Insured Parties

Insurance Law > Claim, Contract & Practice Issues > Estoppel & Waiver > Reservation of Rights

HN2  Reservation of Rights, Notice to Insured Parties

A reservation-of-rights letter is not conclusive proof of a lack of insurance coverage. A reservation of rights is a term of art designed to allow an insurer to provide a defense while still preserving the option to later litigate and ultimately deny coverage; a reservation of rights is only available to an insurer who undertakes a defense while questions remain about the validity of the coverage.

Business & Corporate Compliance > … > Contracts Law > Types of Contracts > Settlement Agreements

Contracts Law > Contract Interpretation > Intent

Civil Procedure > … > Settlement Agreements > Enforcement > Breach of Contract Actions

Civil Procedure > Appeals > Standards of Review > Questions of Fact & Law

HN3  Types of Contracts, Settlement Agreements

A settlement agreement is a contract subject to the usual rules of contract construction. Construing the language of a contract presents a question of law for the court, unless the language presents an ambiguity that cannot be resolved by the rules of construction. The cardinal rule of construction is to ascertain the contracting parties’ intent, and where the terms of a written contract are clear and unambiguous, the court will look to the contract alone to find the intention of the parties. To determine the intent of the parties, all the contract terms must be considered together in arriving at the construction of any part, and a construction upholding the contract in whole and every part is preferred.

Insurance Law > … > Coverage > Underinsured Motorists > Exhaustion Requirements

Insurance Law > … > Coverage > Uninsured Motorists > Exhaustion Requirements

Insurance Law > … > Coverage > Underinsured Motorists > Mandatory Coverage

Insurance Law > … > Coverage > Underinsured Motorists > Liens & Setoffs

Insurance Law > … > Coverage > Underinsured Motorists > Stacking Provisions

HN4  Underinsured Motorists, Exhaustion Requirements

Pursuant to O.C.G.A. § 33-24-41.1, exhausting available liability coverage is a condition precedent to an uninsured/underinsured motorist (UM) claim. As a result, a carrier must offer and a claimant must accept an amount equal to the limit stated in the policy, not an amount less than the limit stated in the policy. Therefore, a claimant may seek recovery under a UM policy when the claimant’s damages exceed the limits of the tortfeasor’s liability policy, after first recovering those liability limits from the tortfeasor through settlement.

Headnotes/Summary

Headnotes

Georgia Advance Headnotes


GA(1) (1)

Insurance Law.  > Motor Vehicle Insurance.  > Uninsured Motorists Coverage.

The only support for the driver’s position in seeking uninsured/underinsured motorist benefits was a reservation-of-rights letter from a third-party administrator on the truck driver’s employer’s insurer’s behalf. However, such a reservation-of-rights letter was not conclusive proof of a lack of coverage.


GA(2) (2)

Insurance Law.  > Motor Vehicle Insurance.  > Coverage Generally.

Whether the insurer’s payment was made pursuant to an MSC-90 endorsement was not relevant because the Agreement released the insurer under both the policy and the MCS-90 endorsement.


GA(3) (3)

Insurance Law.  > Motor Vehicle Insurance.  > Uninsured Motorists Coverage.

The driver’s failure to exhaust the employer’s insurer’s limits as required by OCGA § 33-24-41.1, precluded any recovery from the driver’s uninsured/underinsured motorist carrier.


GA(4) (4)

Insurance Law.  > Motor Vehicle Insurance.  > Uninsured Motorists Coverage.

 If the truck was in fact uninsured, the driver failed to demonstrate that it was uninsured; therefore, the driver could not avail himself of the provisions of OCGA § 33-7-11. If the truck was insured, the Agreement clearly and unambiguously released the insurer from its motor carrier liability policy and MCS-90 obligations for an amount less than the $1,000,000 policy limit, meaning that the Agreement did not comply with the exhaustion requirements of OCGA § 33-24-41.1 before the driver sought additional payment from the uninsured/underinsured motorist carrier and it was entitled to summary judgment.

Judges:  [*1] HODGES, Judge. Barnes, P. J., and Brown, J., concur.

Opinion by: HODGES

Opinion

Hodges, Judge.

Mohammad Farid sued tractor trailer driver Beau Anthony Gaskell and a variety of other entities, including EMBA Transportation, Inc. (Gaskell’s employer) and Knight Specialty Insurance Company (EMBA’s insurer),1 after Gaskell’s tractor trailer caused a motor vehicle collision in which Farid and his two minor children were injured. Farid also served a copy of his complaint on Mid-Century Insurance Company (“Mid-Century”), his uninsured/underinsured motorist (“UM”) insurance carrier. Farid eventually settled his claims against Gaskell, EMBA, and Knight for a total of $450,000, and Mid-Century moved for summary judgment, arguing that Farid failed to satisfy the conditions of OCGA § 33-24-41.1 to exhaust Knight’s available $1,000,000 primary insurance coverage before proceeding against a UM carrier. The Superior Court of Rockdale County agreed and granted Mid-Century’s motion, and Farid appeals. Finding no error, we affirm.

HN1 Under Georgia law,

[s]ummary judgment is proper if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any [*2]  material fact and that the moving party is entitled to judgment as a matter of law. Where a defendant moving for summary judgment discharges this burden, the nonmoving party cannot rest on its pleadings, but rather must point to specific evidence giving rise to a triable issue. … In our de novo review of the grant … of a motion for summary judgment, we must view the evidence, and all reasonable inferences drawn therefrom, in the light most favorable to the nonmovant.

(Citations and punctuation omitted.) Barko Response Team, Inc. v. Sudduth, 339 Ga. App. 897, 898 (795 SE2d 198) (2016). So viewed,2 the record reveals that Farid and his two minor children were traveling southbound on Interstate 75 in Cobb County on September 10, 2018, when a tractor trailer driven by Gaskell suddenly changed lanes and struck a 2015 Kia, which then struck Farid’s vehicle, causing it to overturn. As a result, Farid and his passengers sustained injuries.

According to Farid’s counsel’s allegations,3 Gaskell “quit and had been terminated” by prior to the collision. Farid’s counsel claimed that Gaskell had been instructed to leave his truck “where it stood out on the road[,]” but that Gaskell did not trust the dispatcher not to report the truck abandoned and, instead, was driving the [*3]  truck to his residence in Georgia. In addition, Farid’s counsel alleged that the truck was not scheduled on EMBA’s insurance policy with Knight. A declarations page in the record demonstrates that, on the date of the collision, EMBA maintained a motor carrier liability policy issued by Knight in the amount of $1,000,000 covering 67 vehicles, but neither EMBA’s policy issued by Knight, nor a schedule of covered vehicles, is included in the record.

Farid sued Gaskell, EMBA, and Knight for damages. In an amended complaint that added Knight as a party defendant, Farid alleged that Knight issued a motor carrier liability insurance policy to EMBA covering Gaskell’s truck. Thereafter, Farid settled the case for $450,000 and executed a purported limited release; however, as noted, the policy limit in Knight’s policy amount was $1,000,000. In a document entitled “Settlement Agreement and Release” (the “Agreement”), Farid stated that

[t]his Settlement Agreement and Release results from a compromise payment by [Knight] pursuant to its purported surety obligations under the federal motor carrier Form MCS-90.4 ] The Undersigned agree and stipulate that this payment is made on a voluntary payment basis [*4]  only. The Undersigned agree and stipulate that [Knight] has maintained that it owes no insurance coverage over the Limited Releasees5 as a result of the incident giving rise to this case. The Undersigned agree and stipulate that [Knight]’s voluntary payment provided as consideration for this Settlement Agreement and Release is offered only as a means to avoid litigation and the costs of pursuing a declaratory judgment action in which [Knight] would set forth the legal basis for its absence of coverage and/or any MCS-90 surety obligation. In exchange for the voluntary payment set forth herein, the Undersigned agree and stipulate that [Knight] shall be fully released under its policy and under the Form MCS-90, and shall have no further obligation to the Undersigned under either Policy Number AFXIN000038-00 or the Form MCS-90. This Settlement Agreement and Release shall have the effect of a General Release as to [Knight] only.

(Emphasis supplied.) The Agreement further stated that:

in consideration for the sum paid above, the Undersigned grant this Settlement Agreement and Release. The force and effect of this Settlement Agreement and Release shall be as intended by … OCGA § 33-24-41.1 with respect to [*5]  [Gaskell] and [EMBA] only. This Settlement Agreement and Release shall operate as a release of [Gaskell] and [EMBA] except that this Settlement Agreement and Release shall not bar any claims the Undersigned have against [Gaskell] and [EMBA] to the extent that other insurance coverage is available which covers the claim or claims of the Undersigned against [Gaskell] and [EMBA].

In addition, the Agreement provided that “the Undersigned agree and stipulate that [Knight] shall be fully released under the Form MCS-90, and shall have no further obligation to the Undersigned under Policy Number AFXIN000038-00 or the Form MCS-90.” Finally, the Agreement stated that

[i]t is further understood and agreed that the payment of the consideration stated above is a compromise settlement of a disputed claim at an amount lower than the amount which might have been awarded by a court and jury. The purpose of said compromise and settlement is to avoid the uncertainties, expense and delay attendant upon a trial. It is stipulated that no sum is paid as punitive damages. It is further stipulated and agreed that the sums paid under this Settlement Agreement and Release do not fully and completely compensate [*6]  the Undersigned for the economic and non-economic losses they have suffered.

Farid also notified his UM carrier, Mid-Century, of the claim, and Mid-Century filed a motion for summary judgment arguing that Farid had failed to exhaust Knight’s available policy limits prior to seeking UM benefits. The trial court agreed and granted Mid-Century’s motion. This appeal follows.

In a single enumeration of error focused on the alleged lack of insurance for Gaskell’s tractor trailer, Farid contends that the trial court erred in granting summary judgment to Mid-Century because: (a) Knight’s payment pursuant to the MCS-90 endorsement was a surety payment rather than a liability insurance payment; (b) the evidence demonstrated that the tractor trailer was wholly uninsured in that: (i) the truck was not scheduled on the company’s liability policy; and (ii) the driver of the truck, Gaskell, had been fired at the time of the collision and was disobeying his former employer’s instructions not to drive the truck; and (c) Knight’s payment was a voluntary payment only since there was no coverage. We are not persuaded.

At the outset, each of Farid’s arguments depends largely on Farid’s counsel’s affidavit [*7]  concerning the purported circumstances underlying the Agreement. Attached to counsel’s affidavit are emails from a third-party administrator and Knight’s counsel suggesting that there was no coverage for the collision because Gaskell’s truck was not a scheduled vehicle on EMBA’s motor carrier policy with Knight and because EMBA was out of business. Farid’s counsel also included a second reservation-of-rights letter issued to EMBA from the third-party administrator stating that Gaskell’s truck was not scheduled on EMBA’s policy; an earlier reservation-of-rights letter is not included in the record.6 Furthermore, neither EMBA’s policy with Knight nor any schedule of covered vehicles is included in the record.

In short, then, GA(1) (1) the only support for Farid’s position is a reservation-of-rights letter from a third-party administrator on Knight’s behalf.7 HN2 However, such a reservation-of-rights letter is not conclusive proof of a lack of coverage. See generally American Safety Indemn. Co. v. Sto Corp., 342 Ga. App. 263, 267-268 (2) (802 SE2d 448) (2017) (“A reservation of rights is a term of art designed to allow an insurer to provide a defense while still preserving the option to later litigate and ultimately deny coverage[;]” “a reservation of rights is only available to an insurer who [*8]  undertakes a defense while questions remain about the validity of the coverage”) (citation and punctuation omitted; emphasis supplied). Moreover, we have not been asked to evaluate — nor could we, even had we been asked — the effect of the reservation-of-rights letter because this appeal does not arise from a declaratory judgment action or a motion to enforce the Agreement. See generally id. at 268 (2); see also LNV Corp. v. Studle, 322 Ga. App. 19, 21-22 (2) (743 SE2d 578) (2013) (“In considering the enforceability of an alleged settlement agreement, … a trial court is obviously limited to those terms upon which the parties themselves have mutually agreed.”) (citation omitted). Therefore, even when viewed in a light most favorable to Farid, the central tenet of Farid’s arguments on appeal is not supported by the record.

With that in mind, we will address each of Farid’s arguments in turn.

(a) MCS-90. In a somewhat convoluted argument, Farid contends that Knight’s settlement payment was made pursuant to its MCS-90 obligation under federal law, which is a surety obligation rather than a liability insurance obligation. As a result, according to Farid, Knight’s settlement payment did not constitute a payment from any available insurance coverage or even trigger the [*9]  application of Knight’s policy, and Gaskell’s truck therefore remained uninsured as that term is defined in OCGA § 33-7-11. We do not agree.

In response to Mid-Century’s summary judgment motion, Farid argued, based on his counsel’s affidavit concerning the circumstances of the settlement, that Knight’s payment was made “to avoid litigation on the applicability of the MCS-90 endorsement” and that “[t]here was no failure to exhaust the liability limits because there were no liability limits as there was no coverage.” The trial court concluded that “the issue of whether Knight … was liable under the policy itself or Form MCS-90, and the fact that the agreement was entered to avoid litigation over the applicability of its MCS-90 surety endorsement[,] is irrelevant” because the parties’ settlement agreement specifically provided that Knight “shall be fully released under its policy and under Form MCS-90. …”

HN3 “A settlement agreement is a contract subject to the usual rules of contract construction.” (Citation omitted.) Wood v. Wade, 363 Ga. App. 139, 146 (2) (a) (869 SE2d 111) (2022).

Construing the language of a contract presents a question of law for the court, unless the language presents an ambiguity that cannot be resolved by the rules of construction. The [*10]  cardinal rule of construction is to ascertain the contracting parties’ intent, and where the terms of a written contract are clear and unambiguous, the court will look to the contract alone to find the intention of the parties. To determine the intent of the parties, all the contract terms must be considered together in arriving at the construction of any part, and a construction upholding the contract in whole and every part is preferred.

(Citation omitted; emphasis supplied.) Id.

In this case, the language of the Agreement is clear and unambiguous. Despite Farid’s arguments to the contrary, the Agreement provides that Knight “shall be fully released under its policy and under the Form MCS-90, and shall have no further obligation to [Farid] under either Policy Number AFXIN000038-00 or the Form MCS-90.” (Emphasis supplied.) The Agreement further acknowledged that Knight “shall be fully released under the Form MCS-90, and shall have no further obligation to [Farid] under Policy Number AFXIN000038-00 or the Form MCS-90.” (Emphasis supplied.) As a result, and as the trial court concluded, GA(2) (2) whether Knight’s payment was made pursuant to an MSC-90 endorsement is not relevant because the Agreement [*11]  released Knight under both the policy and the MCS-90 endorsement. Therefore, this argument fails.

(b) Lack of Insurance for Tractor Trailer. Next, Farid contends that Gaskell’s tractor trailer was uninsured because the truck was not scheduled on EBMA’s liability policy and because Gaskell had been fired at the time of the collision and was disobeying EBMA’s instructions not to drive the truck. As we have already noted, these arguments are based, in whole, on Farid’s counsel’s affidavit reporting the purported circumstances underlying the Agreement. What is absent is any conclusive evidence in the record that Gaskell’s truck was uninsured as that term is defined in OCGA § 33-7-11, and we are not authorized to make such a determination in this case.

Moreover, notwithstanding Farid’s failure to demonstrate his entitlement to relief pursuant to OCGA § 33-7-11, Farid likewise failed to satisfy the exhaustion requirements of OCGA § 33-24-41.1 and is therefore precluded from asserting a claim against Mid-Century. OCGA § 33-24-41.1 (a) provides that

[i]n any instance where a claim arising out of a motor vehicle accident is covered by two or more insurance carriers, one such carrier may tender, and the claimant may accept, the limits of such policy; and, in [*12]  the event of multiple claimants, the settling carrier may tender, and the claimants may accept, the limits of the policy pursuant to a written agreement between or among the claimants.

HN4 Pursuant to OCGA § 33-24-41.1, then, “[e]xhausting available liability coverage is a condition precedent to a UM claim.” (Citation and punctuation omitted.) Holland v. Cotton States Mut. Ins. Co., 285 Ga. App. 365, 366 (1) (646 SE2d 477) (2007). As a result, “[a] carrier must offer and a claimant must accept an amount equal to the limit stated in the policy, not an amount less than the limit stated in the policy.” Id. Therefore, “[a] claimant may seek recovery under a UM policy when the claimant’s damages exceed the limits of the tortfeasor’s liability policy, after first recovering those liability limits from the tortfeasor through settlement.” Id.

In this case, Farid resolved his claims with Knight for $450,000, well short of Knight’s $1,000,000 policy limit.8 In addition, the Agreement makes clear that Farid granted Knight a general release rather than a limited release. See Rodgers v. St. Paul Fire & Marine Ins. Co., 228 Ga. App. 499, 500 (1) (492 SE2d 268) (1997) (holding that when a general release in favor of an uninsured motorist is signed, “the uninsured motorist carrier was also released as a matter of law because of the derivative nature of the insurance company’s liability”) (citation [*13]  and punctuation omitted). As a result, GA(3) (3) Farid failed to exhaust Knight’s limits as required by OCGA § 33-24-41.1, which precludes any recovery from Mid-Century, his UM carrier. See Holland, 285 Ga. App. at 366-367 (1).

(c) Voluntary Payment. Finally, Farid contends that Knight’s remittance constituted a mere voluntary payment “to avoid litigation expenses over the applicability of the [MCS-90] surety obligation” and that, as a result, there remained a lack of insurance coverage. However, Farid failed to support this argument with a single citation of authority, and it is therefore deemed abandoned. See Court of Appeals Rule 25 (c) (2) (“Any enumeration of error that is not supported in the brief by citation of authority or argument may be deemed abandoned.”); BB&T Ins. Svcs. v. Renno, 361 Ga. App. 415, 427 (4) (864 SE2d 608) (2021).

In short, Gaskell’s tractor trailer was either insured or uninsured.GA(4) (4)  If Gaskell’s truck was in fact uninsured, Farid has failed to demonstrate that it was uninsured; therefore, he cannot avail himself of the provisions of OCGA § 33-7-11. If Gaskell’s truck was insured, the Agreement clearly and unambiguously released Knight from its motor carrier liability policy and MCS-90 obligations for an amount less than Knight’s $1,000,000 policy limit, meaning that the Agreement did not comply with the exhaustion requirements of OCGA § 33-24-41.1 before [*14]  Farid sought additional payment from Mid-Century. Under either scenario, Mid-Century is entitled to judgment as a matter of law. Therefore, we affirm the trial court’s order granting Mid-Century’s motion for summary judgment.

Judgment affirmed. Barnes, P. J., and Brown, J., concur.


End of Document


See OCGA §§ 40-1-112 (c) (authorizing joinder of motor carrier and insurance carrier to cause of action against motor carrier) and 40-2-140 (d) (4) (same), collectively known as the “direct action statutes.”

Notably, the record does not contain any evidence — affidavits, deposition transcripts, discovery responses, and the like — concerning the circumstances of the collision.

The allegations are contained in an affidavit by Farid’s counsel filed in response to Mid-Century’s motion for summary judgment. As more fully described herein, attachments to the affidavit included emails from a third-party administrator and Knight’s counsel concerning coverage as well as a reservation-of-rights letter issued to EMBA from the third-party administrator.

We have noted that

[a]n MCS-90 endorsement to an automotive insurance policy obligates an insurer to cover an insured’s negligence involving “vehicles subject to the financial responsibility requirements of … the Motor Carrier Act.” The Motor Carrier Act, in turn, creates minimum levels of financial responsibility “for the transportation of property by motor carrier within the United States.” The purpose of a MCS-90 endorsement is to assure compliance with federal minimum levels of financial responsibility for motor carriers. The MCS-90 endorsement must be attached to any liability policy issued to for-hire motor carriers operating motor vehicles transporting property in interstate commerce. The endorsement creates a suretyship, which obligates an insurer to pay certain judgments against the insured arising from interstate commerce activities, even though the insurance contract would have otherwise excluded coverage.

(Citations and punctuation omitted.) Grange Indem. Ins. Co. v. Burns, 337 Ga. App. 532, 533-534 (788 SE2d 138) (2016).

Gaskell and EMBA were identified as the “Limited Releasees.”

The May 7, 2019 reservation-of-rights letter that is included in the record states that it “follows the Reservation of Rights letter that was sent … on December 7, 2018[,]” which is not included in the record.

But see LNV Corp. v. Studle, 322 Ga. App. 19, 21 (1) (743 SE2d 578) (2013) (finding that, in review of settlement agreement, “parol negotiations preceding the making of a written contract are merged in the written contract, and parol evidence is inadmissible to vary or contradict the terms of a written contract which is valid on its face”).

We are mindful of Farid’s apparent argument that OCGA § 33-24-41.1 does not apply because there was no coverage available and, therefore, there were no policy limits to exhaust. This argument fails because Farid failed to establish that Gaskell’s truck was uninsured under OCGA § 33-7-11.

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