Batka v. Liberty Mut. Fire Ins. Co.

• Decision Date: 07 April 1983
• Docket Number: No. 82-1425,82-1425
• Parties: BATKA, Francis J., Appellant, v. LIBERTY MUTUAL FIRE INSURANCE COMPANY.
• Court: U.S. Court of Appeals — Third Circuit

Page 684

704 F.2d 684

BATKA, Francis J., Appellant, v. LIBERTY MUTUAL FIRE INSURANCE COMPANY.

No. 82-1425.

United States Court of Appeals, Third Circuit.

Argued Feb. 17, 1983.

Filed April 7, 1983.

Albert Ring, D'Aqui & Del Collo, Robert H. Malis (argued), Malis, Tolson & Malis, Philadelphia, Pa., for appellant.

Michael J. Izzo, Jr. (argued), Cozen, Begier & O'Connor, Philadelphia, Pa., for appellee.

Before GIBBONS, HUNTER and ROSENN, Circuit Judges.

OPINION OF THE COURT

GIBBONS, Circuit Judge.

Francis J. Batka, a policyholder of two insurance policies issued by Liberty Mutual Insurance Company, appeals from a judgment in favor of Liberty Mutual Fire Insurance Company in his diversity suit for recovery of the amount of a fire loss occurring to his home and automobile. Liberty Mutual asserted defenses of arson, fraud in the presentation of the fire loss claims, and fraud in the application for the policy. The jury's verdict was in Batka's favor on the arson and fraud in the loss claim, and that aspect of the case is not before us. The jury answered affirmatively, however, two special verdict interrogatories. These asked whether Liberty Mutual had proved by a preponderance of the evidence: (1) that Batka wilfully misrepresented or concealed material facts in the application for insurance when he answered "no" to the question "Has applicant or other occupant of the household had any property or casualty insurance declined or cancelled in the past three years (excluding auto)"; and (2) that Batka wilfully misrepresented or concealed material facts in the application for insurance concerning losses caused by burglary, robbery, theft, fire, wind, vandalism, and water damage, and that the defendant reasonably relied upon the material facts in issuing the policy. The trial court entered judgment in favor of Batka for loss of the automobile, but in favor of Liberty Mutual on the home fire loss. The court also denied Batka's motion for judgment notwithstanding the verdict and for a new trial. Because we conclude that the issue of fraud in the application was submitted to the jury under an erroneous legal standard of proof, we reverse the judgment and remand for a new trial.

I.

Batka's diversity action was filed in the United States District Court for the Eastern District of Pennsylvania. The fire loss occurred, however, on November 6, 1977 in Collingswood, New Jersey. Moreover it is undisputed that the fire insurance policy was issued in that state, and contains the standard provisions required by N.J.Stat.Ann. 17:36-5.20 (West Supp.1982). Most of the evidence offered by both sides in a protracted trial was addressed to the two issues, arson and false claim, which were decided by the jury in Batka's favor. We summarize the evidence with respect to Liberty Mutual's defense of fraud in the application.

On October 15, 1975 Batka was informed by American Policyholders' Insurance Company that it did not intend to renew its homeowners policy on his home, which would expire on December 13. Norman Krusen, a sales representative for Liberty Mutual, called Batka and arranged to meet him on December 10, 1975 to discuss insurance coverage. At this meeting Krusen asked Batka questions from the Liberty Mutual homeowners insurance application form, sometimes paraphrasing rather than quoting verbatim. Krusen entered Batka's answers on the form, which Batka signed. Question 13 on the application form reads:

Has applicant or other occupant of the household had any property or casualty insurance declined or cancelled by any company during the past three years excluding auto?

Krusen testified that he recalls asking if Batka had been "cancelled or non-renewed," and he checked off Batka's reply to Question 13 as no. There is no evidence that Krusen transmitted to the Liberty Mutual underwriting department information on his variation of the inquiry. On December 10, 1975 the no answer to Question 13 was literally true, because coverage had not been cancelled by American Policyholders' Insurance Company, and Batka's only application to it had not been declined. The American Policyholders' coverage was not "nonrenewed" until three days later, although an expression of intention not to renew had been sent earlier. Moreover Liberty Mutual, on this record, could not have relied on any representation Batka made about non-renewal, since only the answer to Question 13, as written, came to the attention of its underwriting department, and the question does not mention non-renewal.

Question 17 on the application reads:

During the past 3 years have you or other occupants of the household ever had a loss caused by any of these perils:

A. burglary, robbery, theft, holdup, etc.?

B. fire, wind, vandalism, riot or civil commotion, water damage, ruptured plumbing or heating, electrical wiring or appliances etc.?

* * *

D. other (except automobile losses)?

According to Krusen, he inquired whether Batka had any losses in the past three years. Batka's answer, as recorded by Krusen on the application, was that he had been the victim of a theft six months ago. There is evidence from which a jury could find that Batka had incurred five theft losses, one vandalism loss and one windstorm loss over three years. Question 17 is ambiguous in asking about "a loss caused by any of these perils," in that it might be construed as an inquiry as to a loss of the type listed, without regard to number. The question does inquire separately about types of loss, however, and a jury could find that Batka failed to reveal that there were vandalism and windstorm losses.

The application was forwarded to an underwriter for Liberty Mutual, Mr. Bax, who approved the issuance of a one year policy. When that policy expired on December 13, 1976 Liberty Mutual renewed it for another year. A Liberty Mutual underwriter testified that underwriting decisions were made on the basis of the inquiries in the application form.

Batka filed a claim following the November 6, 1977 fire, and Liberty Mutual rejected it. This lawsuit followed, with the results described above.

II.

Batka contends that the trial court erred when it denied his motion for judgment notwithstanding the verdict, because there was a complete failure of proof on a necessary element of Liberty Mutual's defense of fraud in the application. That element, it contends, is reliance on the alleged misrepresentation. We reject that contention. We agree that whether one applied Pennsylvania law or New Jersey law the insurer would have to establish such reliance.

With respect to the answer to question 13, we think Liberty Mutual's defense failed, since it never established that the response given to Krusen's inquiry about non-renewals as distinguished from cancellations or declinations was ever brought to the attention of the underwriting department which made the decision to issue the policy. Question 17, however, even if it is construed as inquiring about types rather than numbers of losses, evoked an answer which can be found to have concealed the windstorm and vandalism losses. That written answer was brought to the attention of the underwriting department, and there is testimony from which it could be found that prior loss experience is a material factor in making underwriting decisions.

Batka contends that because Liberty Mutual's renewal policy was a new contract, as a matter of law it could not have been issued in reliance on the information in the application for the original policy. We disagree. There is evidence from which a jury could conclude that renewals are made on the basis of the renewing company's loss experience with the policyholders. That evidence does not, however, preclude reliance on information in the original application as well. The general rule appears to be that in the absence of a new application renewal of a fire insurance policy is made on the assumption that the facts disclosed in the original application are true. See generally Annot., Avoidance of Renewed Fire Policy for Breach of Warranty or Representation First Made in Original Application or Policy, 62 A.L.R. 823 (1929). No authority has been called to our attention suggesting that either Pennsylvania or New Jersey would apply a different rule. Batka relies on Garrison v. Farmers' Mutual Fire Insurance Co., 56 N.J.L. 235, 28 A. 8 (S.Ct.1893), which holds that the risk assumed under the old contract expired with it, and that each renewal is the beginning of a new risk. The case does not speak, however, to representations made to induce the issuance of a policy, but to contractual warranties, which in Garrison were true for the time period covered by the policy in issue. More directly in point is United States Fidelity & Guarantee Co. v. Fridrich, 123 N.J.Eq. 437, 198 A. 378, 381-82 (Ch.1938), announcing the general rule that underwriters may, in making renewal decisions, rely on the contents of the original application.

There was on this record a jury question whether Liberty Mutual, in issuing the renewal policy, relied on the negative response to the inquiries about vandalism and windstorm losses. Thus the trial court did not err in denying Batka's motion for judgment notwithstanding the verdict.

III.

Batka also contends that his motion for a new trial should have been granted because the trial court erred in submitting the case to the jury with an instruction that Liberty Mutual need prove its fraudulent application defense only by a preponderance of the evidence rather than by clear and convincing evidence.

Pennsylvania requires that an insurer establish the defense of fraud in the application by "clear, precise and indubitable" evidence. Ratay v. Lincoln National Life Insurance Company, 378 F.2d 209 (3d Cir.1967), cert. denied, 389 U.S. 973, 88 S.Ct. 472, 19 L.Ed.2d 465 (1968), aff'd on remand, 405 F.2d 286 (3d Cir.1968); Highmont Music Corp. v. J.M. Hoffman Co., 397 Pa. 345, 155 A.2d 363, 366 (1959); Gerfin v. Colonial...