CNA INSURANCE COMPANIES,
INCLUDING VALLEY FORGE INSURANCE COMPANY,
Intervenor Below, Appellant.
CNA INSURANCE COMPANIES,
INCLUDING VALLEY FORGE INSURANCE COMPANY,
Intervenor Below, Appellant.
JUSTICE DAVIS delivered the Opinion of the Court.
1. 'In reviewing challenges
to the findings and conclusions of the circuit court, we apply a two-prong
deferential standard of review. We review the final order and the ultimate
disposition under an abuse of discretion standard, and we review the circuit
court's underlying factual findings under a clearly erroneous standard. Questions
of law are subject to a de novo review.' Syllabus point 2, Walker
v. West Virginia Ethics Commission, 201 W. Va. 108, 492 S.E.2d 167
(1997). Syllabus point 1, Coordinating Council for Independent Living,
Inc. v. Palmer, 209 W. Va. 274, 546 S.E.2d 454 (2001).
2. '[T]he trial [court] . . . is
vested with a wide discretion in determining the amount of . . . court
costs and counsel fees, and the trial [court's] . . . determination
of such matters will not be disturbed upon appeal to this Court unless it
clearly appears that [it] has abused [its] discretion.' Syllabus point 3,
Bond v. Bond, 144 W. Va. 478, 109 S.E.2d 16 (1959). Syl.
Pt. 2, Cummings v. Cummings, 170 W. Va. 712, 296 S.E.2d 542 (1982).
Syllabus point 4, in part, Ball v. Wills, 190 W. Va. 517, 438
S.E.2d 860 (1993).
3. Under general principles
of equity, in the absence of statutory law or valid contractual obligations
to the contrary, an insured must be fully compensated for injuries or losses sustained (made whole) before the subrogation rights
of an insurance carrier arise.
4. 'It is well settled
law in West Virginia that ambiguous terms in insurance contracts are to be
strictly construed against the insurance company and in favor of the insured.'
Syl. pt. 4, National Mut. Ins. Co. v. McMahon & Sons, Inc., 177
W. Va. 734, 356 S.E.2d 488 (1987). Syllabus point 4, Riffe v.
Home Finders Associates., 205 W. Va. 216, 517 S.E.2d 313 (1999).
Davis, Justice:
In this appeal by CNA Insurance Companies, we are asked
to determine whether the circuit court erred in deciding that, pursuant to the
made-whole doctrine, CNA was barred from exercising its subrogation rights with
respect to monies recovered by its insured, Kanawha Valley Radiologists, in
connection with embezzlement losses suffered by Kanawha Valley Radiologists.
In addition, we are asked to consider whether the circuit court erred in awarding
attorney's fees to Kanawha Valley Radiologists without affording CNA an opportunity
to dispute the award. We conclude that CNA's insurance policy issued to Kanawha
Valley Radiologists embraces the made-whole doctrine. Consequently, CNA was
correctly prohibited from exercising its subrogation rights where Kanawha Valley
Radiologists had not been made whole. With regard to the circuit court's award
of attorney fees, we find that the circuit court erred in failing to conduct
a hearing prior to making its award.
On or about March 1, 1998, KVR had renewed its Business
Account Package Policy with CNA Insurance Companies (hereinafter CNA). The
renewed policy provided $50,000 in coverage for Employee Dishonesty.
The coverage period for this policy was March 1, 1998, through March 1, 2001.
KVR's investigation into Ms. Griffith's illegal activities revealed that $268,633.36
of the embezzled funds had been diverted during the policy period. After KVR's
submission to CNA of a Proof of Loss, CNA paid to KVR the policy
coverage limit of $50,000.
Thereafter, KVR, without assistance from CNA, began
liquidating the assets of Ms. Griffith and others, and also initiated two
separate civil actions in the Circuit Court of Kanawha County in an effort
to recover its stolen funds. One of these two civil actions, a suit for conversion
of funds brought against One Valley Bank (hereinafter One Valley),
is the case underlying the instant appeal.
(See footnote 2) KVR ultimately settled its
claim against One Valley for $750,000. In all, KVR has recovered a gross sum of
$1,381,309.25 from Ms. Griffith, One Valley, CNA, and others.
Shortly before the settlement was reached between KVR and One Valley, CNA filed a Motion to Intervene for Limited Purpose, asserting a claim for recovery of the $50,000 it had paid to KVR pursuant to the Employee Dishonesty provision of KVR's policy. After granting CNA's motion to intervene, the circuit court conducted a hearing on CNA's claims on October 17, 2000. At that hearing, the parties presented the court with their joint stipulation as to all the relevant facts, and proceeded to argue their respective positions as to the law. At this stage of the proceedings, CNA asserted as its sole basis of recovery a provision in the policy designated Condition J.2. At the conclusion of the hearing, the circuit court requested that the parties submit proposed findings of fact and conclusions of law in support of their respective positions. Such findings and conclusions were submitted to the court by both parties on November 17, 2000. By subsequent correspondence, dated November 22, 2000, CNA conceded that, as stated in KVR's proposed findings and conclusions, the policy provision upon which it had theretofore relied, Condition J.2, had been deleted from the policy and replaced by Section V.H.11 of the Umbrella Coverage Endorsement of the policy. Nevertheless, CNA asserted that it was entitled to recover its $50,000 under the subrogation clause of KVR's policy, properly designated as Section V.H.11.
On November 27, 2000, the circuit court entered its
Final Order Including Findings of Fact and Conclusion of Law, in
which it adopted KVR's proposed findings and conclusions and denied CNA's subrogation
claim based upon its ruling that the claim was barred by the made-whole doctrine.
Thereafter, KVR filed a Motion for Release of Escrow Funds and Attorneys'
Fees and Expenses, wherein it requested, inter alia, that it be
awarded its attorney's fees and expenses incurred in defending against CNA's
subrogation claim. KVR attached to its motion an original statement from its
lawyers outlining, without descriptive detail, the legal fees and expenses therein
claimed, which amounted to $21,922.77. In addition, the motion was accompanied
by a notice stating that the motion would be brought on for hearing on February
14, 2001. Nevertheless, the circuit court, sua sponte and without conducting
a hearing, entered an order dated January 16, 2001, granting KVR the relief
sought in its Motion for Release of Escrow Funds and Attorneys' Fees and
Expenses.
On January 18, 2001, CNA filed in the circuit court
its petition seeking this Court's review of the circuit court's order denying
CNA's subrogation claim. CNA then filed, on February 1, 2001, a Motion
to Vacate Judgment Pursuant to Rule 60 asking the circuit court to vacate
that portion of its order granting attorney's fees and expenses to KVR. On
February 14, 2001, the circuit court conducted a hearing on CNA's motion to
vacate and, at the conclusion of the hearing, entered an order staying the
enforcement of that order insofar as it related to attorney's fees and expenses, pending
this Court's resolution of CNA's appeal of the underlying subrogation claim.
On March 15, 2001, CNA filed a second petition for
appeal, this time seeking review of the circuit court's order granting attorney's
fees and expenses. By two separate orders entered on May 23, 2001, this Court
granted both of CNA's petitions for appeal and consolidated the same.
'[T]he trial [court] . . . is
vested with a wide discretion in determining the amount of . . . court
costs and counsel fees, and the trial [court's] . . . determination
of such matters will not be disturbed upon appeal to this Court unless it clearly
appears that [it] has abused [its] discretion.' Syllabus point 3, Bond v.
Bond, 144 W. Va. 478, 109 S.E.2d 16 (1959). Syl. Pt. 2, Cummings
v. Cummings, 170 W. Va. 712, 296 S.E.2d 542 (1982).
Syl. pt. 4, in part, Ball v. Wills, 190 W. Va. 517, 438 S.E.2d 860
(1993). Having reviewed the proper standards for our consideration of this case,
we proceed to address the issues raised.
The provision of the CNA insurance policy at issue
states the following:
11. Subrogation
In the case of any payments
by us under the coverages of this endorsement, we shall be subrogated to all
rights of recovery against any other party which you may have and will cooperate with you and all other interests. Amounts recovered shall be apportioned
in the following order:
a.
Amounts paid in excess of the payments under this policy shall first be reimbursed
up to the amount paid by those, including you, who made such payments;
b.
We are then to be reimbursed up to the amount we paid; and
c.
Any remainder shall be available to the interest of those over whom this coverage
is in excess and who are entitled to claim such remainder.
In its final order, the circuit concluded, in essence,
that because KVR had not been fully compensated for its losses, CNA was barred
from pursuing a subrogation claim against KVR, notwithstanding the foregoing
policy language, pursuant to the made- whole doctrine.
(See footnote 3)
CNA argues that the V.H.11 subrogation provision in
its policy is a valid contractual obligation contrary to the made-whole doctrine.
CNA asserts that the provision is plain and unequivocal, and must be given effect
without regard to the made-whole doctrine. In this respect, CNA argues that
under provision V.H.11(b) of the policy it is entitled to a favored position
to the insured with respect to amounts recovered. KVR replies that the circuit
court correctly found that CNA's claim for recovery was barred by the made-whole
rule. KVR asserts that section V.H.11 does not constitute a valid contractual
obligation contrary to the made-whole rule.
In defining the made-whole doctrine, this Court has previously explained, and we now hold, that '[u]nder general principles of equity, in the absence of statutory law or valid contractual obligations to the contrary, an insured must be fully compensated for injuries or losses sustained (made whole) before the subrogation rights of an insurance carrier arise.' Bush v. Richardson, 199 W. Va. 374, 378, 484 S.E.2d 490, 494 (1997) (some emphasis added) (citing Porter v. McPherson, 198 W. Va. 158, 162, 479 S.E.2d 668, 672 (1996)).
This Court has never before expressly addressed the
question of whether specific language contained in an insurance policy may operate
to override the made-whole doctrine.
(See footnote 4) We observe, however, that a
majority of jurisdictions addressing such a question have concluded that parties
may contract out of the rule.
(See footnote 5) Our statement of the made-whole
rule is in harmony with this majority.
While our rule expressly permits parties to contractually
alter the made-whole doctrine, it is important to note that the rule is not
overcome merely by the inclusion in an insurance policy of a general statement
that the insurer is entitled to subrogation. See Wine v. Globe
Am. Cas. Co., 917 S.W.2d 558, 564 (Ky. 1996) (We need not address
[the] issue [of whether the equitable principles of subrogation may be modified
by an insurance policy] because the three insurance policies in question contain no clause
which contravenes the equitable principles outlined earlier in this decision.
The policy language cited . . . only provides the insurance
carrier the right of subrogation, i.e., at some future time to be
substituted in the place of its insured.); Shelter Ins. Cos. v. Frohlich,
243 Neb. 111, 118, 498 N.W.2d 74, 79 ([I]f a contractual right of subrogation
is merely the usual equitable right which would have existed in any event
in the absence of a contract, equitable principles control subrogation.).
(See footnote 6)
Indeed, subrogation is an equitable principle and,
as such, the general rules of equity, including the made-whole rule, will
apply regardless of whether the subrogation arises from common law or by contract,
unless a contrary agreement is clearly and expressly stated. See Kittle
v. Icard, 185 W. Va. 126, 130, 405 S.E.2d 456, 460 (1991) ('Whether
legal or conventional, subrogation is an equitable remedy.' (quoting
State Farm Mut. Auto Ins. Co. v. Foundation Reserve Ins. Co., 78 N.M.
359, 363, 431 P.2d 737, 741 (1967)), superseded by statute on other grounds
as stated in Grayam v. Department of Health and Human Res., 201 W. Va.
444, 498 S.E.2d 12 (1997). See also Westendorf v. Stasson, 330
N.W.2d 699, 703 (Minn. 1983) ([S]ubrogation remains an offspring of
equity. Thus, even when the right to subrogation arises by virtue of an agreement, the terms of the subrogation will nonetheless be governed by
equitable principles, unless the agreement clearly and explicitly provides
to the contrary. (emphasis added)); Shelter Ins. Cos. v. Frohlich,
243 Neb. 111, 118, 498 N.W.2d 74, 79 ([U]nless a contract specifically
provides otherwise, equitable principles apply even when a subrogation right
is based on contract. (emphasis added) (citations omitted)).
In the instant case, we have examined the language
asserted by CNA as overcoming the made-whole rule. Contrary to CNA's conclusion,
we find that the policy language in question expressly adopts the made-whole
rule.
Provision V.H.11 of CNA's policy is titled Subrogation. With respect to amounts recovered after CNA's payment of a claim, Section V.H.11 of the policy asserts CNA's right to subrogation and establishes an order of distribution. Pursuant to subsection (a) of V.H.11, [a]mounts recovered shall be apportioned in the following order: (a) Amounts paid in excess of the payments under this policy shall first be reimbursed up to the amount paid by those, including you, who made such payments. (Emphasis added). (See footnote 7)
We recognize that subsection (a) refers to amounts paid by the
insured rather than to losses incurred. To the extent that the
clause refers to payments made by KVR, as opposed to its losses, the provision
is ambiguous as applied to the circumstances of this case. 'It is well
settled law in West Virginia that ambiguous terms in insurance contracts are
to be strictly construed against the insurance company and in favor of the
insured.' Syl. pt. 4, National Mut. Ins. Co. v. McMahon & Sons, Inc.,
177 W. Va. 734, 356 S.E.2d 488 (1987). Syl. pt. 4, Riffe v.
Home Finders Assocs., 205 W. Va. 216, 517 S.E.2d 313 (1999). Interpreting
the ambiguity in favor of KVR, we find subsection (a) directs that amounts
recovered in connection with KVR's losses shall first be distributed to KVR
to the extent of those losses. Accordingly, subsection (a) of provision V.H.11,
by its very terms, requires that KVR be made-whole before CNA may assert its
right to recover under subsection (b).
Based upon the foregoing analysis, we conclude that the made-whole doctrine applies to this case. Consequently, the circuit court correctly determined that, because KVR's losses sustained during the policy period exceeded the amount of its recovery attributable to that same period, CNA does not have a right to any of the funds recouped by KVR.
We have previously determined, on numerous occasions,
that a circuit court has erred failing to afford a party notice and the opportunity
to be heard prior to awarding attorney's fees. In Czaja v. Czaja, we
commented that
[i]n this case, the lower court decided to award attorney's
fees and then, without providing Appellant's counsel an opportunity to address
either Appellee's entitlement to fees or the reasonableness of the fee award
itself, the circuit court approved an order prepared by Appellee's counsel,
which directed that $6080.50 in cumulative fees and costs were to be paid
by Appellant's counsel within seven days.
In failing to accord Appellant's
counsel an opportunity to respond to the lower court's basis for assessing
fees and costs, the most basic of all protections inherent to our judicial
system has been violated.
208 W. Va. 62, 75-76, 537 S.E.2d 908, 921-22 (2000). Similarly, in Daily
Gazette Co. v. Canady, we observed that '[l]ike other sanctions,
attorney's fees certainly should not be assessed lightly or without fair notice and an opportunity for a hearing
on the record.' 175 W. Va. 249, 251, 332 S.E.2d 262, 264 (1985)
(emphasis added) (quoting Roadway Express, Inc. v. Piper, 447 U.S.
752, 766-67, 100 S. Ct. 2455, 2464, 65 L. Ed. 2d 488, 501-02
(1980)). Accordingly, we find the circuit court erred in awarding attorney's
fees to KVR without affording CNA notice and an opportunity to be heard.
(See footnote 9)