In an insurer’s action for a declaration that it owed no duty to indemnify its insured for sums the latter paid to settle a civil-rights suit, the insurer defeated the insured’s motions to dismiss by raising questions of fact.

The Insurer insured a school district and its officials (“School District”) under a primary CGL and School-District-and-Educators-Legal-Liability policy and an umbrella CGL policy.  In the underlying action, students alleged that the School District had violated the students’ civil rights by the School District’s deliberate indifference to anti-Semitic harassment and discrimination perpetrated by other students against the students.  More specifically, the students alleged that

• The School District deliberately ignored complaints and its own observations of student-on-student anti-Semitic harassment and discrimination, or responded in an unreasonable or inadequate manner to such complaints and observations;
• There were repeated and frequent incidents of anti-Semitic harassment and discrimination against the students by other students, which were reported to the School District on many occasions and directly observed on other occasions, which gave rise to an inference that the School District “intended for the harassment to occur” based upon the School District’s practices, policies, and customs in dealing with reports and observations of anti-Semitic harassment and discrimination;
• The School District “intentionally discriminated” against the students,
• The School District’s conduct “aided and incited” unlawful discrimination; and
• The School District’s acts and omissions were “undertaken recklessly and with the intent to engage in wrongful conduct.”

The Insurer defended the School District through the resolution of the underlying action but disclaimed any duty to indemnify the School District.  At mediation in the underlying action, the students and the School District settled the underlying action for $3,000,000 in compensatory damages and $1,480,000 for the students’ attorneys’ fees. A representative of the Insurer attended the mediation but the Insurer paid nothing toward the settlement.

Thereafter, the Insurer commenced the subject declaratory judgment action seeking a declaration that it owed the School District no indemnification for the settlement because (a) coverage for the claims in the underlying action were excluded by the Insurer’s exclusion for intentional discriminatory conduct and (b) the students’ claims were neither a covered “occurrence” nor “loss” as those terms were defined by the policies.

The School District moved to dismiss under CPLR 3211(a)(1) (defense founded on documentary evidence) and CPLR 3211(a)(7) (failure to state a cause of action) premised on the theory that intentional acts can have unintended consequences that constitute “accidents” which therefore must be covered “occurrences” or “losses” under the Insurer’s policies.

Policy exclusion for intentional discriminatory conduct exclusion.  The School District argued that because intentional acts can have unintended consequences that constitute covered “accidents”, the Insurer’s exclusions for intentional discriminatory conduct had to fail.  But the Second Department held that the insurance policies did not conclusively establish that the Insurer was obligated to indemnify the School District, and that unspecified “other evidence” submitted by the School District did not “utterly refute” the factual allegations set forth in the Insurer’s complaint.  Whether the incidents set forth in the students’ complaint were accidents was a “question of fact” that could not be determined on a motion to dismiss pursuant to CPLR 3211(a)(1) or (7)

A motion to dismiss pursuant to CPLR 3211(a)(1) (defense founded on documentary evidence) requires that the documentary evidence utterly refute plaintiff’s factual allegations, conclusively establish a defense as a matter of law, and be unambiguous and of undisputed authenticity.  Here, the insurance policies which the School District submitted as documentary evidence did not provide a complete defense to the Insurer’s claim that the Insurer owed no duty to indemnify the School District.

A motion to dismiss pursuant to CPLR 3211(a)(7) (failure to state a cause of action) requires the court to accept the facts alleged in the complaint as true, accord the plaintiff the benefit of every possible favorable inference, and determine only whether the facts as alleged fit within any cognizable legal theory.   Where, as here, evidentiary material was submitted and considered on a motion pursuant to CPLR 3211(a)(7) without the motion being converted to a motion for summary judgment, the question is whether the plaintiff has a cause of action, not whether the plaintiff has stated one.  Dismissal is warranted only where defendant shows that a claimed material fact is undisputedly not a fact at all.  Here, the insurance policies failed to show that plaintiff’s claims were invalid causes of action.

Covered “occurrence” or “loss”.  The CGL policy covered bodily injury caused by an “occurrence,” which was defined as “an accident, including continuous or repeated exposure to substantially the same general harmful conditions.” The School-District-and-Educators-Legal-Liability policy covered a “loss,” which excluded matters that may be deemed uninsurable under the law.

Insurance policies are to be construed according to the sense and meaning of the terms which the parties have used, and if they are clear and unambiguous the terms are to be taken and understood in their plain, ordinary and proper sense.   Whether an event or series of events qualifies as an accident is a question of fact, so that the issue of whether the incidents alleged by the students were accidents were “questions of fact” that could not be determined on a motion to dismiss pursuant to CPLR 3211(a)(1) or (7).

Graphic Arts Mut. Ins. Co. v Pine Bush Cent. Sch. Dist., 2018 NY Slip Op 01565

(2d Dep’t March 9, 2018) http://nycourts.gov/reporter/3dseries/2018/2018_01565.htm