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Smart Summary

Factual and Procedural Background

This case arises from a declaratory judgment action wherein plaintiff Alexandra Markevics seeks to compel defendant Liberty Mutual Insurance Co. to defend and indemnify Kerry O'Brien under a homeowner's insurance policy issued to O'Brien's parents. The underlying personal injury action involves an incident where O'Brien allegedly served alcohol to a visibly intoxicated individual, Sandro Perez, at a family-owned bar. Perez subsequently caused an accident that injured Markevics, a passenger in his vehicle.

Kerry O'Brien worked as a bartender at the family bar and lived at her parents' home. Liberty Mutual issued a deluxe homeowner's policy covering the insured premises and personal liability for insured individuals, subject to exclusions including injuries arising from business pursuits. Liberty Mutual disclaimed coverage based on the policy's business pursuits exclusion but failed to send a disclaimer notice to the injured party or her attorney.

Procedurally, the Supreme Court granted reargument and denied Liberty Mutual's motion for summary judgment dismissing the complaint, while granting plaintiff's cross motion for summary judgment declaring Liberty Mutual obligated to defend and indemnify O'Brien. The Appellate Division affirmed this decision with two dissenting justices and remitted the matter for entry of judgment accordingly. Liberty Mutual appealed to the Court of Appeals.

Legal Issues Presented

  1. Whether Liberty Mutual was obligated to defend and indemnify Kerry O'Brien under the homeowner's policy despite the business pursuits exclusion.
  2. Whether Liberty Mutual’s disclaimer of coverage was valid and timely under Insurance Law § 3420(d), particularly given the failure to notify the injured party or her attorney.
  3. Whether the alleged acts of Kerry O'Brien constituted an "occurrence" under the policy, affecting coverage applicability.
  4. Whether personal liability coverage under the policy is geographically limited to the insured premises.

Arguments of the Parties

Appellant's Arguments (Liberty Mutual)

  • The insurer argued that the business pursuits exclusion in the policy precludes coverage for O'Brien's alleged acts.
  • Alternatively, Liberty Mutual contended that the policy’s personal liability coverage does not extend to claims arising away from the insured premises.
  • On appeal, Liberty Mutual adopted the dissent’s position that O'Brien’s intentional act of serving alcohol was not an "occurrence" under the policy, hence no coverage existed from the outset.

Respondent's Arguments (Plaintiff Alexandra Markevics)

  • Plaintiff argued that Liberty Mutual’s disclaimer was defective and untimely because it did not provide written notice directly to Markevics or her attorney as required by Insurance Law § 3420(d).
  • Plaintiff maintained that the insurer was obligated to defend and indemnify O'Brien under the policy terms.

Table of Precedents Cited

Precedent Rule or Principle Cited For Application by the Court
Zappone v. Home Ins. Co., 55 N.Y.2d 131, 137 Distinguishes between denial of coverage due to exclusion versus lack of inclusion; failure to comply with Insurance Law § 3420(d) invalidates disclaimer based on exclusion. The court relied on this precedent to hold that Liberty Mutual’s disclaimer, based on a policy exclusion, was invalid because it did not comply with the statutory requirements for disclaimers.
Worcester Ins. Co. v. Bettenhauser, 95 N.Y.2d 185 A disclaimer is unnecessary when a claim falls outside policy coverage; a timely disclaimer is required when coverage applies but is denied based on exclusion. The court applied this principle to determine that because denial was based solely on an exclusion, a proper disclaimer was required but was not provided timely or properly.

Court's Reasoning and Analysis

The Court analyzed the nature of Liberty Mutual’s denial of coverage, concluding it was based on a policy exclusion rather than a lack of coverage. Under Insurance Law § 3420(d), a timely and proper disclaimer is required when coverage is denied on grounds of an exclusion. Liberty Mutual failed to provide written notice of disclaimer to the injured party or her attorney, rendering the disclaimer defective. The Court rejected Liberty Mutual’s argument that personal liability coverage was geographically limited, holding that the policy’s terms did not restrict coverage to the insured premises. Additionally, the Court declined to consider Liberty Mutual’s argument that O'Brien’s acts were not an "occurrence" because this issue was not preserved for review. As a result, the Court affirmed the Appellate Division’s grant of summary judgment in favor of the plaintiff, obligating Liberty Mutual to defend and indemnify O'Brien.

Holding and Implications

The order of the Appellate Division is affirmed with costs.

The Court held that Liberty Mutual’s disclaimer of coverage was ineffective due to its failure to comply with statutory notice requirements. Consequently, Liberty Mutual is obligated to defend and indemnify Kerry O'Brien under the homeowner’s policy. This decision directly affects the parties by enforcing insurer obligations under the policy and Insurance Law § 3420(d). The Court did not establish new precedent beyond the application of existing law regarding disclaimers and coverage exclusions.

ALEXANDRA MARKEVICS, Respondent, v. LIBERTY MUTUAL INSURANCE COMPANY, Appellant, et al., Defendant.

MEMORANDUM:

The order of the Appellate Division should be affirmed with costs.

In this declaratory judgment action, plaintiff Alexandra Markevics claims that defendant Liberty Mutual Insurance Co. must defend and indemnify Kerry O'Brien pursuant to a homeowner's policy issued to O'Brien's parents. The carrier disclaimed coverage based on a "business pursuits" exclusion contained in the policy. In the underlying personal injury action, Markevics alleges O'Brien served liquor to a visibly intoxicated Sandro Perez during his birthday party at O'Bie's Bar in Yonkers. After leaving the bar, Perez drove his automobile into a utility pole, injuring Markevics, who was a passenger in the car.

O'Bie's Bar was a family enterprise, owned by a closely held corporation and operated by Kerry's parents. Twenty-one year old Kerry worked there as a bartender and lived at her parents' home. Liberty Mutual wrote a "deluxe" homeowner's policy for the O'Briens. In addition to coverage for the "insured premises," the policy provides personal coverage for liability claims against an insured individual. Under the policy, the carrier agrees to indemnify and defend against any claim for damages caused by an "occurrence" to which coverage applies. Among the exclusions to personal liability coverage are injuries arising out of the business pursuits of the insured. The parties do not dispute that Kerry O'Brien is an insured under the policy.

After commencement of the personal injury action, Kerry's attorney tendered her defense to Liberty Mutual in a letter dated July 23, 1997. Receiving no response, on September 23, counsel sent a second letter requesting an answer. The carrier disclaimed coverage on November 7, 1997, relying on the policy's business pursuits exclusion. The company did not, however, send a disclaimer to Markevics or her attorney. Markevics then commenced this action.

In a motion for summary judgment, defendant-carrier argued that the policy expressly excluded Kerry O'Brien's alleged business pursuits and in the alternative that the policy did not provide personal liability coverage for claims arising away from the O'Brien home. Plaintiff contended that a disclaimer was necessary and that the failure to disclaim by giving written notice directly to Markevics or her attorney violated Insurance Law § 3420(d).

Supreme Court found that Liberty Mutual's denial of coverage was "by reason of exclusion" rather than a "lack of inclusion" and, as a result, the failure to comply with Insurance Law § 3420(d) invalidated the attempted disclaimer (Zappone v. Home Ins. Co., 55 N.Y.2d 131, 137). The Appellate Division affirmed, holding that a disclaimer was required and that the attempted disclaimer was both untimely and defective in that it was not sent to the injured party. Two Justices dissented on the ground that O'Brien's alleged violation of General Obligation Law § 11-101 (The Dram Shop Act) was not an "occurrence" within the meaning of the policy and, as a result, there was no coverage requiring a disclaimer.

On appeal to this Court, Liberty Mutual reiterates that there is no coverage because the claim did not arise on the insured premises and further adopts the Appellate Division dissent's position that no coverage exists ab initio because Kerry O'Brien's intentional act of providing alcohol to Perez was not an "occurrence" as defined in the policy. Under the policy, personal liability coverage applies to insured individuals without geographical limitation. Nothing in the terms of personal liability coverage can be read to confine coverage to the O'Brien residence. Additionally, the argument that Kerry O'Brien's alleged acts are not an "occurrence" was not made below and is not preserved for our review. Therefore we must proceed on the basis that the coverage terms of the policy apply.

A disclaimer is unnecessary when a claim does not fall within the coverage terms of an insurance policy (Worcester Ins. Co. v. Bettenhauser, 95 N.Y.2d 185). Conversely, a timely disclaimer pursuant to Insurance Law § 3420(d) is required when a claim falls within the coverage terms but is denied based on a policy exclusion (id., at 188). Because denial of coverage here was based solely on an exclusion, a disclaimer in conformity with Insurance Law § 3420(d) was required. We agree with the Appellate Division that Liberty Mutual's attempt to disclaim coverage did not meet these requirements in that the carrier did not give timely written notice of its disclaimer to the injured party. Under these circumstances, summary judgment was properly granted to plaintiff.

Order affirmed, with costs, in a memorandum.

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MARKEVICS v. LIBERTY MUT. INS. CO
(Nov 15, 2001)