In its recent decision in Zurich American Ins. Co. v. Diamond Title of
Sarasota, Inc., 2013 U.S. Dist. LEXIS 170981 (M.D. Fla. Dec. 4, 2013), the
United States District Court for the Middle District of Florida had occasion to
consider whether an insured’s guilty plea can be used as the basis for
rescission of a professional liability policy.
Zurich insured Diamond Title
under a title agent’s errors and omissions policy issued in 2007. The owner/operator of Diamond Title was later
indicted on several counts of mortgage fraud, conspiracy, bank fraud, wire
fraud, and making false statements in connection with a loan application. She later pled guilty to two counts,
including conspiring to make materially false statements to banks and that she
committed several acts of wire fraud.
Her plea agreement stated that the conspiracy ran from 2002 through
2008, the purpose of which was “to obtain loans secured by mortgages from
FDIC-Insured banks and mortgage lending businesses.”
Diamond Title was named as a
defendant in an underlying suit relating to its duties as an escrow agent
involving the purchase of distressed residential properties. The suit alleged that Diamond Title
negligently released money without prior authorization. Zurich, in turn, sought rescission of the
policy on the basis of material misrepresentations made in the insurance application. Among other things, the application asked:
Does the
Applicant or any prospective Insured know of any circumstances, acts, errors or
omissions that could result in a professional liability claim against the
Applicant? If "Yes", you must complete the attached claims addendum
for each circumstance.
Zurich contended that at the time
Diamond Title’s owner completed the application in 2007, and answered “No” in
response, she was knowingly committing mortgage fraud and that she confirmed as
much in her later plea agreement. As
such, Zurich maintained that Diamond Title should have answered “Yes” in
response to the question. The underlying
claimant (named as a party to the rescission action), however, argued that
Diamond Title’s response was truthful, since while at the time it was aware
that it was committing criminal misconduct, it could not necessarily foresee
civil liability for its actions. In this
connection, the claimant pointed out that the question inquired into acts that
could result in professional liability claims, not criminal acts that would not
come within the policy’s coverage in the first instance.
Noting that the misconduct
described in the plea agreement came within the policy’s definition of
professional services, the court rejected the attempt to distinguish criminal
misconduct from conduct that could give rise to a professional liability claim,
explaining:
… the Court
disagrees with the Defendant's assertion that criminal acts cannot result in
claims for professional liability. A single act can be a basis for both
professional and criminal liability. The Policy makes clear that it does not
cover liability for criminal acts, even if they are properly characterized as
professional liabilities. Rotolo [the owner of Diamond Title] was not relieved
of her duty in the application to report acts that could result in a
professional liability claim simply because the Policy may not have covered
those acts. The Court concludes that Diamond Title's answer to question 21 of
the Policy application, that it did not know of any circumstances that could
result in a professional liability claim, was a misrepresentation.
The court further reasoned that
the misrepresentation was material to the risk.
While the underlying claimant argued that Zurich failed to point to any
underwriting guidelines applicable to the facts, the court relied on common
sense reasoning that the insured’s failure to disclose a criminal conspiracy
was material. As the court explained:
The Court does
not need an underwriter or guidelines to appreciate how not knowing Rotolo and
her employee had been committing mortgage fraud in excess of five years left
Zurich unable to adequately estimate the nature of risk in issuing the Policy. …
As previously discussed, many of these acts could have resulted in claims
against the Policy. An objective insurer may not have issued a policy at all.
Certainly a policy would not have been issued under the same terms and pricing
knowing that Diamond Title was engaged in an ongoing scheme to commit mortgage
fraud.
A rule of conduct resulting from all these decisions, and resulting from others like them, is 'When in doubt, provide notice' to preserve and protect a Claim to Insurance Coverage. Steve R.
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