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Edmund J. Bergassi Agency, Inc. v. Employers Reinsurance Corp.

Citations: 247 A.D.2d 577; 669 N.Y.S.2d 345; 1998 N.Y. App. Div. LEXIS 1782

Court: Appellate Division of the Supreme Court of the State of New York; February 22, 1998; New York; State Appellate Court

Narrative Opinion Summary

In this appellate case, Employers Reinsurance Corporation contested a ruling from the Supreme Court, Westchester County, which denied its motion for summary judgment regarding its duty to defend and indemnify in an underlying lawsuit, Apollon Waterproofing Restoration Corp. Inc. v. Bergassi. The appellate court reversed the previous decision, asserting that Employers had no obligation to provide coverage due to the insured’s failure to comply with the policy's notification requirements. The individual plaintiff, president of the corporate plaintiff, delayed notifying Employers of the lawsuit alleging fraudulent activities concerning payment and performance bonds for a year, a contravention of the policy mandate to notify 'as soon as reasonably possible.' The court underscored that timely notice is a condition precedent to coverage and found that the insured's reasoning for the delay—believing the allegations were false—was unreasonable. The court also dismissed arguments regarding the notification of an alleged agency relationship as irrelevant to policy terms. Consequently, the matter was remitted for a judgment declaring Employers' lack of duty to defend or indemnify, with unanimous concurrence from the justices involved.

Legal Issues Addressed

Burden of Proof in Justifying Delay

Application: The court placed the burden on the insured to prove that a reasonable belief of no coverage justified the delay in notification, which was not met in this case.

Reasoning: Although an insured's reasonable belief of no coverage may justify a delay, the burden lies with the insured to prove such reasonableness.

Conditions of Insurance Policy

Application: The court rejected the insured's argument regarding the timing of an alleged agency relationship communication since it was not specified as a condition in the policy.

Reasoning: Additionally, his argument regarding the timing of an alleged agency relationship being communicated by Apollon’s counsel was also rejected, as it was not a condition specified in the insurance policy.

Insurance Policy Notification Requirement

Application: The court held that timely notification is a condition precedent to coverage under an insurance policy, and failure to notify the insurer as required negates the duty to defend or indemnify.

Reasoning: The court emphasized that timely notification is a condition precedent to coverage.

Reasonableness of Delay in Notification

Application: The court assessed the insured's justification for delayed notification and found the belief that allegations were false to be unreasonable, thus rejecting the argument for delayed notice.

Reasoning: Bergassi's claim that he delayed notification due to believing the allegations were false was deemed unreasonable as a matter of law.