National Union Fire Insurance Co. of Pittsburgh, Pa. v. Crocker

In National Union Fire Insurance Co. of Pittsburgh, Pa. v. Crocker, 246 S.W.3d 603 (Tex. 2008), the supreme court considered, on certified questions from the United States Court of Appeals for the Fifth Circuit, "whether an insurer has a duty to notify an additional insured of available liability coverage." Id. at 604. Crocker, a nursing home resident, filed suit against a nursing home employee and the nursing home corporate owner for personal injuries that she sustained while at the home. Id. The corporation was covered by a commercial general liability policy and the employee, unbeknownst to him, qualified as an additional insured under the policy. Id. at 604-05. The insurer did not inform the employee that he was an additional insured, nor did it offer to defend him in the suit. Id. at 605. After the employee was served, he did not forward the suit papers to the insurer, did not request a defense from the insurer, did not answer the lawsuit, and did not appear at trial. Id. The trial court severed Crocker's claims against the non-answering employee, and the case was submitted to a jury, which returned a take-nothing verdict in favor of the corporation after finding that the corporation and its employees were not negligent. Id. The trial court, however, then entered a $ 1 million default judgment against the employee. Id. Crocker then brought a suit against the liability insurer to collect the judgment, asserting that she qualified as an additional insured under the insurer's policy and that she was a third party beneficiary under the policy. Id. at 605. The insurer argued that because the employee, its additional insured, had failed to comply with the policy's notice-of-suit provision, he had never invoked coverage or his right to a defense and Crocker, "who now purported to stand in the employee's shoes," could not collect under the policy. Id. Crocker responded that even though the employee had not complied with the policy's notice provision, the insurer was not prejudiced because it had actual knowledge of the suit. Id. Crocker asserted that the insurer's failure to notify the employee that he was covered as an additional insured under the policy, coupled with its actual knowledge of the suit, amounted to a breach of the insurer's duty to defend, making the insurer liable for the default judgment. Id. at 605-06. On these facts, the Fifth Circuit, in its first certified question, asked: "Where an additional insured does not and cannot be presumed to know of coverage under an insurer's liability policy, does an insurer that has knowledge that a suit implicating policy coverage has been filed against its additional insured have a duty to inform the additional insured of the available coverage?" Id. at 606. The Texas Supreme Court emphasized that "notice and delivery-of-suit-papers provisions in insurance policies serve two essential purposes: (1) they facilitate a timely and effective defense of the claim against the insured, and more fundamentally, (2) they trigger the insurer's duty to defend by notifying the insurer that a defense is expected." Id. at 606-08. The supreme court continued, "Mere awareness of a claim or suit does not impose a duty on the insurer to defend under the policy; there is no unilateral duty to act unless and until the additional insured first requests a defense--a threshold duty that the insured fulfills under the policy by notifying the insurer that the insured has been served with process and the insurer is expected to answer on its behalf." Id. at 608. The supreme court concluded that "an insurer that has not been notified that a defense is expected bears no extra-contractual duty to provide notice that a defense is available to an additional insured who has not requested one." Id. Thus, the supreme court answered the first certified question, "no." Id. In its third certified question, which is equally important to this case, the Fifth Circuit asked the Texas Supreme Court: "Does proof of an insurer's actual knowledge of service of process in a suit against its additional insured, when such knowledge is obtained in sufficient time to provide a defense for the insured, establish as a matter of law the absence of prejudice to the insurer from the additional insured's failure to comply with the notice-of-suit provisions of the policy?" Id. at 609. The supreme court also answered this question, "no." Id. The supreme court first noted that the insurer "was obviously prejudiced in the sense that it was exposed to a $ 1 million judgment." Id. The supreme court then stated, "The question, however, is not whether the insurer suffered exposure to a financial risk, but whether it should be estopped to deny coverage because it was aware that the employee, its additional insured, had been sued and served and had ample time to defend him." Id. The supreme court stated that the answer to this alternative question must also be "no," based upon its prior conclusion that the insurer had no duty to notify the employee of coverage and no duty to defend the employee until the employee notified the insurer that he had been served and expected the insurer to provide a defense on his behalf. Id. The supreme court reasoned that because the insurer was not under a duty to defend the suit against the additional insured when it received notice of the claim, it was not estopped from asserting that the additional insured's breach of the policy's notice provision barred the insurer's liability. Id. Most relevant to the issue in this case, the supreme court explained, "Absent a threshold duty to defend, there can be no liability to the additional insured, or to Crocker derivatively." Id. The supreme court concluded that "insurers owe no duty to provide an unsought, uninvited, unrequested, unsolicited defense." Id. at 610. It reasoned that because "insurers need not provide coverage to additional insureds who never seek it," the insurer at issue had no duty to inform the employee of coverage or to voluntarily undertake his defense and the insurer's "actual knowledge did not establish lack of prejudice as a matter of law." Id.