Production of Pre-Denial Claim File Compelled

Tred R. Eyerly | Insurance Law Hawaii | November 20, 2017

The appellate court found that the claims file that existed before the insurer’s denial was discoverable. Cascade Builders Corp. v. Rugar, 2017 N.Y. App. Div. LEXIS 7357 (N.Y. App. Div.. Oct. 19, 2017).

Cascade Builders was the general contractor for the homeowners. In May 2011, Cascade subcontracted with John Rugar to perform certain exterior power washing on the residence. The contract between Cascade and Rugar required Rugar to indemnify and hold Cascade harmless for any work performed by Rugar and to obtain coverage naming Cascade as an additional insured. Rugar procured the required CGL policy from Utica First Insurance Company.

While pressure washing the residence, Rugar used a cleaning solution that allegedly caused damage to the exterior of the residence. Cascade submitted a demand to Utica for damages sustained. Utica denied coverage for both Cascade and Rugar. Cascade’s carrier subsequently paid the homeowners $600,000 for the damage sustained to the exterior of the residence. The homeowners released Cascade from any further liability and assigned their right to bring suit against Utica and Rugar.

Cascade sued Utica and Rugar, alleging  negligence by Rugar and breach of contract by Utica. Cascade requested Utica’s pre-denial claim file. Utica provided a portion of the claim file and a privilege log. Cascade then demanded production of the entire pre-denial claim file. Utica and Rugar moved for a protective order prohibiting disclosure of the documents in the privilege log because it listed materials prepared in anticipation of litigation. Rugar also sought a protective order.

The trial court denied the motions and ordered Utica to provide Cascade with the entire pre-denial claims file. On reconsideration, however, the court granted Rugar’s motion for a protective order.

The appellate division reversed. The payment or rejection of claims was a part of the regular business of an insurance company. Reports which aided the insurer in the process of deciding whether to pay or reject a claim were made in the regular course of business. Therefore, reports prepared by insurance investigators, adjusters, or attorneys before the decision was made to pay or reject a claim were not privileged and were discoverable.

Here, all the documents set forth in the subject privileged log were prepared prior to Utica’s May 9, 2012 disclaimer of coverage. Since Utica failed to establish that the withheld documents were prepared solely in anticipation of litigation, the burden did not shift to Cascade to demonstrate an undue hardship justifying disclosure of the pre-denial claim.

Leave a Reply

%d bloggers like this: