D&O insurance policyholders typically do not have to provide "fresh warranties" when they renew their policy of the kind they provided when they originally purchased the coverage – that is, they do not have to represent to the insurer that at the time of the renewal they are not aware of any facts or circumstances that could give rise to a claim. However, when policyholders increase their limits of liability at the time of renewal, they often are required to provide "fresh warranties" as to the increased limits, whether in the form of an increased limits application or in a separate warranty letter.
An October 26, 2009 Tenth Circuit opinion (here) illustrates the potential pitfalls for policyholders required to provide fresh warranties for increased limits. In its recent opinion, the Tenth Circuit held that an increased limits warranty exclusion precluded coverage for the defense fees of insured persons that fell within the amount of the increased limits. The Tenth Circuit held that the allegations in a later SEC complaint showed that at the time the policyholders’ representatives signed the letter, individual insured persons had knowledge of accounting improprieties that might (and subsequently did) give rise to claims.
Fisher Imaging carried $5 million of primary D&O insurance, as well as an excess D&O policy providing an additional $2.5 million of insurance. At the time of the company’s April 2002 D&O insurance renewal, the company sought to increase the excess policy’s limits of liability from $2.5 million to $5 million.
In order to obtain this additional $2.5 million of excess coverage, Fisher supplied the excess insurer with a warranty letter signed by the then-CFO and the CEO representing that "no person or entity for whom this insurance is intended has any knowledge of information of any act, error, omission, fact or circumstance which may give rise to a claim which may fall within the scope of the insurance." The warranty letter stated further that it was an "express warranty for all insureds." (This last sentence is capitalized in the original.)
In April 2003, Fisher was sued by its shareholders in two securities class action lawsuits, both of which were later dismissed. In addition, in June 2005, the SEC filed a civil enforcement action against five officers and directors of Fischer. The SEC amended its complaint in May 2008. The amended complaint alleges that from January 2000 through September 2002, the officials had engaged in a scheme to fraudulently inflate the company’s share price by improperly recognizing revenue, misstating financial reports and misleading the company’s outside auditors.
Defense expenses incurred in connection with these actions exhausted the primary $5 million as well as the first $2.5 million of the excess layer. (The primary insurer and the excess insurer advanced these amounts subject to a reservation of rights to challenge these payouts later) However, the excess insurer took the position that the allegations in the SEC’s complaint triggered the exclusionary language in the warranty letter and therefore that it had no obligation to advance defense fees that fell within the "top" $2.5 million layer.
The individual directors and officers who are defendants in the SEC enforcement action filed a separate action against the excess insurer seeking a judicial declaration of coverage for their fees within the top $2.5 million, or in the alternative for a declaration that the excess insurer had a duty to advance defense fees within the layer.
The parties cross moved for summary judgment. The district court held that the allegations in the SEC’s amended complaint triggered the warranty letter exclusion, because "when read together," the SEC complaint and the exclusion show that certain of the individual SEC enforcement action defendants "knew of the wrongful activities at Fischer that could give rise to a claim."
The court granted summary judgment in favor of the insurer and the plaintiffs appealed.
The Tenth Circuit’s Opinion
On appeal, the plaintiffs argued that in reaching its conclusion that the warranty letter exclusion had been triggered, the district court improperly considered matters developed in discovery in the underlying SEC action, and that therefore represented matter "extrinsic" to the question whether the SEC’s amended complaint triggered the exclusion. The Tenth Circuit rejected this argument, stating that "we … confident that the court confined its legal analysis to the allegations in the SEC’s amended complaint."
The plaintiffs next argued that the district court had improperly used an "objective" standard in determining that the exclusion had been triggered – that is, the plaintiffs argued, the district court based its decision on what the plaintiffs (or some of them) must have known, rather than what they subjectively knew. The Tenth Circuit found that the district court properly used the required subjective standard, rather than an improper objective standard. The Tenth Circuit noted:
While the district court did not use the term "subjective knowledge" when it recounted the allegations, its reliance on those allegations about each director’s or officer’s knowledge about and participation in Fischer’s irregular accounting practices establishes that the court properly applied a subjective knowledge standard.
The plaintiffs raised several additional arguments, each of which the Tenth Circuit rejected with a variation on its conclusion that "the district court correctly concluded that the SEC’s claims, when read together, compelled the conclusion that the SEC’s allegations were within the exclusion in the Warranty Letter."
Upon initial review, I found a number of things about the Tenth Circuit’s opinion puzzling. The first is that the opinion refers throughout to a warranty "exclusion" – yet there is nothing in the warranty letter language quoted in the Tenth Circuit opinion that would or even could affirmatively precludes coverage. Without any expressly exclusionary language, the excess carrier would lack any contractual basis to disclaim coverage within the top $2.5 million layer, even if there were warranty letter misrepresentation.
In order to try to answer to this puzzle, I tracked down the parties’ appellate briefs on PACER. Upon review of the briefs, it turns out that there was additional, critically important language in the warranty letter that the Tenth Circuit opinion neglects to even quote (a rather astonishing oversight, given that but for this exclusionary language in the warranty letter, there would have and could have been no coverage dispute).
That is, as described in the excess insurers’ appellate brief (here, see page 5), the warranty letter contains additional language, following the warranty statement in which the applicants disclaim the existence of knowledge of any facts or circumstances that may give rise to a claim, providing that "it is agreed that if such knowledge or information exists, any claim arising therefrom…is excluded from the proposed coverage." (The original is in all capital letters.)
So, you wouldn’t know it from the text of the Tenth Circuit’s opinion, but there was critically important exclusionary language in the warranty letter, and that language was in fact the language that the Tenth Circuit was deciding whether or not to apply.
The other thing that puzzled me about the Tenth Circuit’s opinion (and for that matter, the district court’s opinion) is that it seems to make an awful lot out of what are unproven allegations. Merely because the SEC has alleged some things doesn’t mean they are true. Yet the Tenth Circuit repeatedly says the district court properly relied on what the courts themselves both acknowledge were just pleading allegations. Both courts concluded that the mere allegations were enough for the excess insurer to withhold payment of defense fees that fell within the top $2.5 million.
A review of the plaintiffs’ appellate brief (here) did little to help clarify this puzzle. The plaintiffs never quite seem to get around to arguing that just because the SEC has thrown up a bunch of allegations that doesn’t mean that any of individual actually had knowledge of the facts or circumstances that might give rise to a claim at the time the warranty letter was signed.
Indeed, in its brief the excess insurer notes how far away from this argument the plaintiffs stayed, observing that the plaintiffs "understandably have nothing to say about the detailed litany of wrongdoing alleged in the SEC’s Amended Complaint" adding later that the plaintiff "never address this litany of facts." Instead, the plaintiffs seem (to me at least) to get hung up on arcane arguments about whether the objective or subjective standard should apply. It seems to me that only facts are sufficient to satisfy either an objective or a subjective standard, but that mere unproven allegations cannot suffice to satisfy either standard, regardless of which one applies.
This puzzling aspect of the opinion is all the more bewildering (to me at least) given the Tenth Circuit’s conclusion that the "subjective" test is the proper standard to apply. That is, the exclusion could be triggered only if the insured persons had subjective knowledge of the triggering facts. How can a test of subjective knowledge be satisfied by mere allegations rather than upon the proof of actual knowledge? Particularly if, as the Tenth Circuit further held, extrinsic matter is irrelevant — nothing outside the complaint can be relied upon to show that the allegations are true.
Claimants assert all sorts of bizarre things, but mere allegations alone should not be enough to trigger policy exclusions, particularly an exclusion that is triggered only by what insured persons subjectively knew. Readers who may be able to explain to why I should not be troubled by this aspect of the Tenth Circuit’s decision are strongly encouraged to clarify this for me and other readers using this blog’s comment function. I am particularly interested to know how mere allegations could possibly provide a sufficient basis to trigger an exclusion requiring subjective knowledge of the triggering facts.
One possible explanation does occur to me. It may well be that the plaintiffs did not make the argument that the SEC amended complaint represents mere allegations because they felt they simply couldn’t make an argument premised on the suggestion that they did not have knowledge of some or all of the facts described in the complaint.
Indeed, it probably should be noted in that regard that the company itself had in 2004 voluntarily entered a cease and desist order with the SEC (refer here).Among other things, the agreed order recited that the company, "acting through certain of its officers and personnel," had improperly recognized revenue, overstated inventory, improperly classified expenses, among other things. The plaintiffs may felt under these circumstances that there were limitations on how much they could argue that the SEC’s complaint against them represented "mere allegations."
However, the existence of the cease and desist order might (or then again, might not) explain why the plaintiffs’ may not have raised the argument that the SEC complaint represents mere alletgations; they don’t really explain why the Tenth Circuit concluded that mere pleading allegations were sufficient to trigger the exclusion.
It is worth noting that the circumstances involved in this coverage dispute may be a vestige of the time period in which these events took place. The excess insurer’s warranty letter used provisions that would be unlikely to be used today. Specifically, the excess insurer’s warranty letter was set up so that if any one insured had knowledge of the preclusive facts or circumstances, the top $2.5 million would be unavailable to any insured person, even those without knowledge.
A well-crafted increased limits application or increased limits warranty letter today would likely provide (or the policy to which it referred would provide) that no knowledge of any person would be imputed to any other person. This nonimputation language would operate to preserve coverage for those without knowledge of the preclusive facts, which is clearly a preferable arrangement from the standpoint of insured persons.