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Never trust an insurance policy



The complainants relied on an insurance certificate showing that Chipotle was an additional insured by an insurance issued to a seller. The insurer, RLI, proved that Chipotle was not listed as additional insured nor was it an additional insured due to an agreement with the seller. The district court upheld RLI's request for a summary judgment and the plaintiffs appealed.

I Chipotle Mexican Grill, Inc., et al. v. RLI insurance company; Fireman’s Fund Insurance Company, No. 2018-11057, 2018-11361, 2018-14847, 2019-00473. Index no. 700712/16, New York Supreme Court, Second Chamber (November 24, 2021), the issue of further insured status was transferred to a statement in an insurance certificate provided by the seller to Chipotle.

FACTS [19659005] The plaintiffs engaged defendant Piece Management, Inc. (hereinafter referred to as PMI), to perform rodent prevention services at its Roosevelt Field Mall restaurant. Afmat Wazadally was employed by PMI and was injured during his work when he fell from a ladder. Wazadally initiated personal injury proceedings against the plaintiffs and others (hereinafter the underlying action). The complainants sought insurance cover from PMI's insurer, RLI Insurance Company ('RLI'), claiming that they were further insured under the insurance. RLI denied coverage.

Shortly afterwards, the plaintiffs sued RLI and others for a judgment declaring RLI liable to defend and reimburse them as further insured in the underlying action. The underlying action was settled for $ 2,675,000. The plaintiffs sought judgment declaring RLI liable to defend and reimburse those further insured in the underlying action.

The district court upheld RLI's cross-claim and dismissed the plaintiffs' claim and concluded that the plaintiffs were not further insured. The RLI insurance because they were not listed as additional insured on the insurance and they were not entitled to coverage under the additional insured approval because there was no written agreement between the plaintiffs and the PMI.

ANALYSIS AND CONCLUSIONS

were not further insured on the RLI insurance. The insurance contained an additional insured endorsement, which added to the insured persons covered by the subject insurance "any person or organization for whom you perform operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is added as an extra insured on your insurance. "

The four corners of an insurance contract govern who is covered and the extent of the coverage. If a third party seeks the benefit of coverage, the terms of the insurance must clearly show such intent. The law in New York is well established that whether a third party is an additional insured under an insurance is determined based on the intent of the parties in the insurance, which is determined based on the four corners of the insurance itself.

Here, as mentioned., The additional insured gave the approval of RLI -insurance coverage to parties that PMI has agreed in writing in a contract or agreement at Do not add as an additional insured to the insurance. There was no such written agreement or agreement between the plaintiffs and the PMI that contained any requirement for the PMI to name the plaintiffs who further insured under the RLI policy. Therefore, RLI proved its prima facie right to a judgment under the law based on its submissions

The plaintiffs submitted an insurance certificate contrary to RLI's claim. The certificate listed the plaintiffs as further insured under the subject policy. However, the Court of Appeal concluded that the certificate was insufficient to change the language of the insurance itself, especially since the certificate stated that it was for informational purposes only, that it did not confer any rights on the holder and that it did not change, alter, or extend the coverage offered by the insurance. . In addition, the court rightly held that PMI's seller profile, which indicates that the customer is usually listed as an additional insured, does not constitute an agreement or contract between Chipotle and PMI to name Chipotle as an additional insured.

The Court of Appeal concluded that the district court should have rejected the cross-motion on the basis of the action for a declaratory judgment, and should instead have stated that RLI is not obliged to defend or reimburse the plaintiffs as further insured in the underlying action. As the court did not do so, the Court of Appeal amended the judgment accordingly.

The appeal of the decision adopted on 17 July 2018 was rejected; and a judgment was added to the judgment declaring that RLI Insurance Company is not obliged to defend or reimburse the plaintiffs as further insured in the underlying action.

This case is a perfect example of parties who have not read an insurance certificate and rely on on a statement in a certificate that was not in the insurance. Because the certificate clearly and unambiguously stated that it was for informational purposes only, that it did not give any rights to the holder and that it did not change, alter or extend the coverage provided by the insurance. If a party wants to be sure that it has been appointed as an extra insured, it must obtain a copy of the insurance and never trust the certificate. At best, if they could overcome the obvious disclaimer in the certificate, the parties could sue the person or entity that issued the certificate of negligence, deception or fraud to which the plaintiffs relied to their detriment.


© 2021 – Barry Zalma [19659009] Barry Zalma, Esq., CFE, now limits his practice to being an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders.

He also has. acts as arbitrator or media

for insurance-related disputes. He practiced law in California for more than 44 years as a lawyer for insurance coverage and claims management and more than 54 years in the insurance industry.

Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome.

He is available at http://www.zalma.com and zalma@zalma.com. Zalma is the first recipient of the first annual Claims Magazine / ACE Legend Award. For the past 53 years, Barry Zalma has devoted his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to enable insurers and their claimants to become professionals in insurance claims.

Go to the training available at https://claimschool.com; articles at https://zalma.substack.com, the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; Follow Mr Zalma on Twitter at https://twitter.com/bzalma ; Go to Barry Zalma videos at https://www.rumble.com/zalma; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ T the last two issues of ZIFL are available at https://zalma.com/zalmas-insurance-fraud- letter -2 / podcast now available at https://podcasts.apple.com/us/podcast/zalma-on-insurance/id1509583809?uo=4


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