Insurance--commercial general liability coverage--no duty to defend in lawsuit--no
occurrence
Defendant insurer, which provided commercial general liability insurance coverage for
plaintiff and agreed to defend plaintiff in any litigation in which an occurrence and either bodily
injury or property damage are allegedly involved, does not have a duty to defend plaintiff in a
lawsuit brought against plaintiff in Texas for fraudulent misrepresentations, breach of contract,
and deceptive trade practices stemming from an alleged leasing agreement between plaintiff and a
third party, because: (1) the ultimate focus is on the injury and whether it was expected or
intended, rather than upon the act and whether the act was intended; (2) the insurance policy
defined an occurrence as an accident, including continued or repeated exposure to substantially
the same general harmful conditions; and (3) the underlying Texas lawsuit did not involve an
occurrence since plaintiff's refusal to lease equipment to a newly-formed company after already
allegedly agreeing to do so was substantially certain to cause delays and other consequential
business injuries.
Parker, Poe, Adams & Bernstein, L.L.P., by Josephine H. Hicks
and John E. Grupp, for plaintiff-appellant.
Wilson & Iseman, L.L.P, by Urs R. Gsteiger, for defendant-
appellee.
LEWIS, Judge.
This appeal involves the issue of whether defendant United
States Fidelity & Guaranty Company ("USF&G") had a duty to defend
plaintiff Holz-Her U.S., Inc. ("Holz-Her") in a lawsuit brought
against Holz-Her in Texas. We conclude that defendant had no such
duty.
On 14 February 1996, South Bay Industries ("South Bay") and
Ralph Durden filed a complaint against, among others, Holz-Her forfraudulent misrepresentations, breach of contract, and deceptive
trade practices stemming from an alleged leasing agreement between
South Bay and Holz-Her. At the time of the suit, USF&G provided
commercial general liability insurance coverage for Holz-Her.
Under the terms of the insurance contract, USF&G agreed to defend
Holz-Her in any litigation in which Holz-Her was alleged to have
caused "bodily injury" or "property damage" as the result of an
"occurrence." USF&G refused to defend Holz-Her in the suit,
claiming that the Texas lawsuit involved neither an "occurrence"
nor "bodily injury" or "property damage." Holz-Her incurred
$213,422 in legal expenses defending the suit and eventually
settled with South Bay for $190,000. Holz-Her thereafter
instituted this cause of action to recover $403,422 (the legal
expenses plus the settlement cost) from USF&G for its refusal to
defend in the Texas lawsuit. The trial court granted summary
judgment in favor of USF&G, and Holz-Her now appeals.
In determining whether an insurer has a duty to defend the
underlying lawsuit, our courts employ the so-called "comparison
test." Smith v. Nationwide Mut. Fire Ins. Co., 116 N.C. App. 134,
135, 446 S.E.2d 877, 878 (1994). That test requires us to read the
pleadings in the underlying suit side-by-side with the insurance
policy to determine whether the alleged injuries are covered or
excluded. Id. The duty to defend is thus measured by the factsalleged in the pleadings. Waste Management of Carolinas, Inc. v.
Peerless Ins. Co., 315 N.C. 688, 691, 340 S.E.2d 374, 377 (1986).
When the pleadings state facts demonstrating
that the alleged injury is covered by the
policy, then the insurer has a duty to defend,
whether or not the insured is ultimately
liable. Conversely, when the pleadings allege
facts indicating that the event in question is
not covered, and the insurer has no knowledge
that the facts are otherwise, then it is notbound to defend.
Id. The ultimate focus, then, is on the facts that are pled, not
how the claims are characterized. See, e.g., Eubanks v. State Farm
Fire and Casualty Co., 126 N.C. App. 483, 488-89, 485 S.E.2d 870,
873 (refusing to distinguish between claims for intentional
infliction of emotional distress and negligent infliction of
emotional distress in analyzing a duty to defend provision because
the same alleged facts were used to support both claims), disc.
review denied, 347 N.C. 265, 493 S.E.2d 452 (1997).
As stated previously, the insurance policy here obligated
USF&G to defend Holz-Her in any suit in which it was alleged to
have caused "bodily injury" or "property damage" as the result of
an "occurrence." Thus, USF&G was only obligated to defend suits in
which (1) an "occurrence" is allegedly involved and (2) either
"bodily injury" or "property damage" is allegedly involved. We
only address the issue of occurrence as described in the policy
as neither bodily injury nor property damage are relevant in
this case.
Under the insurance policy, an "occurrence" is defined as "an
accident, including continued or repeated exposure to substantially
the same general harmful conditions." Although accident is not
further defined in the policy, that term is nontechnical in nature;
thus it will be given the same meaning it usually receives in
ordinary speech. Waste Management, 315 N.C. at 694, 340 S.E.2d at
379. According to its ordinary meaning, an accident is "'an
unforeseen event, occurring without the will or design of theperson whose mere act causes it; an unexpected, unusual, or
undesigned occurrence.'" Waste Management, 315 N.C. at 694, 340
S.E.2d at 379 (quoting Tayloe v. Indemnity Co., 257 N.C. 626, 627,
127 S.E.2d 238, 239-40 (1962)). Whether injuries are accidental
and thus satisfy the definition of an "occurrence" depends upon
whether they were expected or intended from the insured's point of
view. Id. at 696, 340 S.E.2d at 380.
On appeal, the parties have focused upon the alleged acts
involved in the underlying lawsuit. Specifically, they have
focused on whether the acts resulting in the injury were allegedly
negligent or intentional. This is an improper focus. The ultimate
focus is on the injury, i.e., whether it was expected or intended,
not upon the act and whether it was intended. Washington Housing
Auth. v. N.C. Housing Authorities, 130 N.C. App. 279, 285, 502
S.E.2d 626, 630 (1998). Even intentional acts can trigger a duty
to defend, so long as the injury was "not intentional or
substantially certain to be the result of the intentional act."
N.C. Farm Bureau Mut. Ins. Co. v. Stox, 330 N.C. 697, 709, 412
S.E.2d 318, 325 (1992).
With this background in mind, we now look to South Bay's
complaint in the underlying lawsuit to determine whether it alleged
an occurrence. In particular, it alleged the following. South Bay
was a newly-formed company set up to manufacture certain wood
components for furniture. To get its business under way, it sought
to lease certain equipment from Holz-Her needed to manufacture
these components. AT&T would provide the necessary financing forthe lease. After receiving South Bay's lease application,
financial statements, and business plans, Holz-Her agreed that it
would lease the equipment upon South Bay's payment of a one percent
commitment fee to AT&T. South Bay submitted the one percent fee.
In reliance upon Holz-Her's representations, South Bay negotiated
further contracts with other companies for the construction of
buildings needed to house the leased equipment and borrowed
$880,000 as a result. Subsequently, Holz-Her began to impose
additional requirements upon South Bay before it would lease the
necessary equipment. South Bay tried to accommodate these new
demands, but Holz-Her ultimately refused to lease the equipment.
As a result, Ralph Durden, South Bay's majority owner, was forced
to sell off much of his majority ownership interest in order to pay
off the $880,000 loan. Furthermore, South Bay was forced to lease
the equipment from elsewhere, causing delays in the start-up of its
business.
Based upon these allegations, we hold that the underlying
Texas lawsuit did not involve an occurrence within the meaning of
the insurance policy. The business injuries alleged here were
either expected or substantially certain to occur. A refusal to
lease equipment to a newly-formed company after already allegedly
agreeing to do so, even from the viewpoint of Holz-Her, was
substantially certain to cause South Bay delays and other
consequential business injuries.
In reaching this result, we find the case of Henderson v. U.S.
Fidelity & Guaranty Co., 124 N.C. App. 103, 476 S.E.2d 459 (1996),aff'd, 346 N.C. 741, 488 S.E.2d 234 (1997), to be instruct
ive. In
that case, the underlying cause of action involved alleged
misrepresentations and fraudulent concealment about the existence
of water problems on certain property caused by a severely-flooded
drainage area. Id. at 105, 476 S.E.2d at 460. In holding that the
underlying action did not involve an occurrence, this Court
reasoned:
Notwithstanding Hicks' assertions that he did
not intend or anticipate his
misrepresentations to injure or damage
plaintiffs, such purposeful and intentional
acts were so substantially certain to cause
injury and damage as to infer an intent to
injure as a matter of law. Accordingly, we
hold that any bodily injury or property damage
sustained by plaintiff as a result of Hicks'
intentional conduct was not caused by an
occurrence within the insuring agreements
contained in the USF&G and Great American
policies.
Id. at 111, 476 S.E.2d at 464. Here, as in Henderson, Holz-Her's
alleged misrepresentations were substantially certain to cause
South Bay the business injuries at issue. We therefore can infer
an intent to injure as a matter of law. As a result, no
occurrence was involved and USF&G had no duty to defend. See
also State Bancorp, Inc. v. United States Fidelity & Guar. Ins.
Co., 483 S.E.2d 228 (W. Va. 1997) (per curiam) (holding that
defendant had no duty to defend in a suit involving the alleged
refusal of a financing company to extend $75,000 in credit after
initially agreeing to do so because no occurrence was involved).
We therefore affirm the trial court's entry of summary judgment in
favor of USF&G. Affirmed.
Judges McGEE and HORTON concur.
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