Prejudice, Smejudice: Late Notice in the Face of a Condition Precedent
March 2010
Reinsurers know that raising the defense of
late notice to a late-noticed claim from a reinsured is very difficult to sustain
(see The Late Notice Defense in Reinsurance
and Late Notice in Reinsurance Claims: Does
Prejudice Matter?). Most states' laws require the reinsurer to show actual
prejudice to sustain the defense and avoid the late-noticed claim. Yet, the
defense may be sustained based on the terms and conditions of the reinsurance
contract.
by Larry
P. Schiffer
Dewey
& LeBoeuf LLP
The language used in the notice provision of the reinsurance contract may
impact how a court will interpret the clause. If the court interprets the notice
clause as a condition precedent, a showing of prejudice by the reinsurer may
not be required.
Late Notice in Various States
In Unigard Sec. Ins. Co. v. North River Ins. Co.,
79 N.Y.2d 576, 581 (1992), the New York Court of Appeals was asked to answer
a certified question posed by the Second Circuit Court of Appeals to resolve
a split of authority in the federal courts. The question presented was:
Must a reinsurer prove prejudice before it can successfully invoke the defense
of late notice of loss by the reinsured?
The court answered in the affirmative. The court reached its conclusion because
the prompt notice terms of the reinsurance contract were held not to be read
as an express condition precedent.
The Second Circuit, accepting this view, held that:
For a reinsurer to be relieved from its indemnification obligations because
of the reinsured's failure to provide timely notice, absent an express provision
in the contract making prompt notice a condition precedent, it must show
prejudice resulted from the delay.
Christiania Gen. Ins. Corp. v. Great Am. Ins. Co.,
979 F.2d 268, 274 (2d Cir. 1992).
The phrase, "absent an express provision making prompt notice a condition
precedent," opened the door for arguing that where there is an unambiguously
written express condition precedent, the reinsurer would not need to show prejudice.
Thus, where a notice provision is intended to serve as a condition precedent,
a reinsurer need not show prejudice to raise the late notice defense.
Constitution Reinsurance Corp. v. Stonewall Ins. Co.,
980 F. Supp. 124 (S.D.N.Y. 1997).
Various other courts have adopted a similar view:
- Keehn v. Excess Ins. Co. of Am., 129
F.2d 503, 504 (7th Cir. 1942)
- Liberty Mut. Ins. Co. v. Gibbs, 773 F.2d
15 (1st Cir. 1985)
- Insurance Co. of State of Pa. v. Associated
Int'l Ins. Co., 922 F.2d 516 (9th Cir. 1990)
- Newcap Ins. Co. v. Employers Reinsurance Corp.,
295 F. Supp. 2d 1229, 1242 (D. Kan. 2003)
When Is a Notice Provision a Condition Precedent?
But whether a notice clause is a condition precedent is often in the eye
of the beholder. In Folksamerica Reinsurance Co. v.
Republic Ins. Co., 03 Civ. 0402 (HB), 2003 U.S. Dist. LEXIS 21162 (S.D.N.Y.
Nov. 25, 2003), the court examined a notice provision almost identical to the
one found in Constitution Reinsurance, yet held
that the language should not be construed as an express condition. 2003 U.S.
Dist. LEXIS 21162 at *22. The court reasoned:
While the reinsurance Certificate there contained the identical notice provision,
the issue of how to interpret the notice clause was never raised, nor did
the Court discuss this issue in its Opinion….Therefore,
Constitution Reinsurance lends no support
to Folksamerica's argument that the notice clause is also a condition precedent.
Id. at *23, n.12.
In discussing what an ideal condition precedent should contain, the court
looked to Strain on Reinsurance and listed
four identifiers that would establish an unambiguous condition precedent: The
provision:
- specifies to what the condition precedent refers;
- sets out the number of days that suffice for prompt notice;
- expressly states that the Reinsurer need not establish prejudice; and
- clearly provides that the Reinsurer will be relieved of liability should
prompt notice not be provided.
Id. at *28–29. In other words, to merely
include the statement "as a condition precedent" in the notice clause may not
be good enough.
Thus, a notice provision that is ambiguous as to whether the parties intended
to make it a condition precedent will not relieve a reinsurer of the requirement
to show prejudice. But when there is clearly an unambiguous express condition
precedent in the notice provision, New York law will not require the reinsurer
to prove prejudice. See
Folksamerica, 2003 U.S. Dist. LEXIS 21162 at
*20, n.9 (citing to Unigard and
Christiania).
In Illinois, however, a more flexible approach in interpreting whether a
notice clause is a condition precedent appears to have prevailed. In
Keehn v. Excess Ins. Co. of Am., 129 F.2d 503,
504 (7th Cir. 1942), the court recognized that Illinois law provides that should
a condition precedent be present in the reinsurance contract, no proof of prejudice
would be required. Although the plaintiff contended that the provision should
not be effective because the contract "failed to designate this provision as
a condition precedent, nor did it contain a declaration of forfeiture for noncompliance,"
the court still affirmed the district court's opinion that recovery by the insured
is barred for failure to comply with the provision.
In 2005, an Illinois federal court reinforced the
Keehn holding regarding prompt notice provisions:
The law in Illinois, however, is clear that a notice requirement, such as
the one contained in the Treaty, is a condition precedent to coverage…. Consequently,
when the insured fails to comply with a prompt notice requirement, the insurer
may deny liability, regardless of whether it has been prejudiced by the delay.
Allstate Ins. Co. v. Employers Reinsurance Corp.,
441 F. Supp. 2d 865, 875 (N.D. Ill. 2005) (citations omitted). The treaty in
Allstate did not mention that the provision should
be deemed a condition precedent, nor did it contain the model language suggested
in Strain's; yet the court found that it was indeed a condition precedent and
that proof of prejudice would not be required.
But Is Prejudice a Requisite Regardless of Condition Precedent?
Under California law, prejudice still seems to be required regardless of
whether the notice provision is a condition precedent. In
National Am. Ins. Co. of Ca. v. Certain Underwriters
at Lloyd's of London, the court in interpreting California law explained:
A reinsurer may invoke the defense of late notice so long as it
immediately objects to the late notice, and suffers "actual and substantial
prejudice."
93 F.3d 529, 538 (9th Cir. 1996). The court emphasized that not only is a condition precedent subject to waiver
under California law, but the notice provisions in the case were not considered
conditions precedent:
because they lack[ed] the requisite "clear and unambiguous expression by
the parties … that they intended the notice provision to be a condition precedent....
Id. at 539 (citations omitted).
In British Ins. Co. v. Safety Nat'l Cas. Corp.,
335 F.3d 205, 215 (3d Cir. 2003), the court was asked to determine whether the
New Jersey Supreme Court would hold that proof of prejudice is required by late
notice of claims defenses in the reinsurance context. In coming to its decision,
the Third Circuit relied heavily on New York law, and concluded that:
under New Jersey law, a reinsurer must show the likelihood of appreciable
prejudice in order to prevail on a late notice defense asserted against its
reinsured.
The court, in explaining why prejudice must be shown, stated:
The New Jersey Supreme Court clearly frowns upon literal interpretation
of notice provisions in situations where it results in the insured forfeiting
coverage it has already paid for absent some countervailing consideration
(such as prejudice) on the part of the insurer that has accepted premiums
in return for offering coverage. We therefore conclude that the New Jersey
Supreme Court would require the reinsurer to demonstrate prejudice where,
as here, the reinsurer relies upon late notice as a defense against the
otherwise legitimate claims of its reinsured.
Id. at 213. The court also quoted
Christiania in holding that "[a] reinsurance
contract is governed by the rules of construction applicable to contracts generally."
Id. at 212 (citations omitted). The court
made it clear that the New Jersey Supreme Court "frowns upon literal interpretation
of notice provisions in situations where it results in the insured forfeiting
coverage," and would perhaps read prompt notice provisions solely as a covenant.
Conclusion
A majority of courts recognize the difference between reinsurers and direct
insurers regarding the notice-prejudice requirement. Because the failure to
perform under a prompt notice provision is perceived as being less important
to a reinsurer than a direct insurer, courts are comfortable in adding the prejudice
requirement in the reinsurance context. But courts will carefully analyze whether
a notice provision is indeed a condition precedent. Some courts have held that
a notice provision will not sufficiently act as a condition precedent when the
provision merely states that it is. If, however, the notice provision is found
to be an unambiguous express condition precedent, the majority of courts will
forgo the prejudice requirement and look solely to the failure of performing
the prompt notice provision itself as the ground for the reinsurer's defense
of late notice.
Careful attention should be paid when drafting notice provisions in reinsurance
contracts to make clear whether prompt notice of a claim is intended to be a
condition precedent to coverage under the reinsurance contract.
The author would like to thank 2009 Dewey & LeBoeuf
LLP Summer Associate Eli Lefkowitz for his research and contributions to
this Commentary.
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