RECOMMENDED FOR FULL-TEXT
PUBLICATION
Pursuant to Sixth Circuit
Rule 206
ELECTRONIC CITATION: 2000
FED App. 0412P (6th Cir.)
File Name: 00a0412p.06
UNITED STATES COURT OF
APPEALS
FOR THE SIXTH CIRCUIT
_________________
M/G Transport Services, Inc.,
Plaintiff-Appellant,
v.
Water Quality Insurance Syndicate,
Defendant-Appellee.
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No. 99-3889 |
Appeal from the United States
District Court
for the Southern District
of Ohio at Cincinnati.
No. 97-00316--Susan J. Dlott,
District Judge.
Argued: October 24, 2000
Decided and Filed: December
12, 2000
Before: KENNEDY, SUHRHEINRICH, and MOORE, Circuit Judges.
_________________
COUNSEL
ARGUED:
Todd M. Powers, SCHROEDER, MAUNDRELL, BARBIERE & POWERS,
Cincinnati, Ohio, for Appellant. George W. Taliaferro, Jr., McKINNEY
& NAMEI, Cincinnati, Ohio, for Appellee. ON BRIEF:
Todd M. Powers, SCHROEDER, MAUNDRELL, BARBIERE & POWERS,
Cincinnati, Ohio, for Appellant. George W. Taliaferro, Jr., McKINNEY
& NAMEI, Cincinnati, Ohio, Gary N. Levine, John M. Woods,
THACHER, PROFFITT & WOOD, New York, New York, for Appellee.
_________________
OPINION
_________________
SUHRHEINRICH,
Circuit Judge. Plaintiff M/G Transport Services, Inc.
("M/G"), appeals the grant of summary judgment to Defendant
Water Quality Insurance Syndicate ("WQIS"), and the
denial of summary judgment to M/G, in this action seeking a declaration
that WQIS breached its duty under a marine insurance policy to
defend and indemnify M/G in a qui tam action brought under
the False Claims Act ("FCA"), 31 U.S.C. §§
3729-33, as amended by the False Claims Amendments Act of 1986.
We AFFIRM.
I.
M/G, a
subcontractor for R. & F. Coal Co. ("R. & F."),
transported coal via inland waterway to the Tennessee Valley
Authority pursuant to a contract between R. & F. and the
United States. As a condition of the contract between R. &
F. and the United States, by which M/G was bound, M/G was obligated
to comply with the Federal Water Pollution Control Act ("Clean
Water Act"), 33 U.S.C. §§ 1251-1387.
From 1986
through 1996, M/G purchased and renewed on an annual basis specialized
marine pollution liability insurance from WQIS. The terms, conditions,
endorsements, and exclusions were initially governed by a document
titled the "1976 Form." From 1993 until 1996, coverage
was governed by a document titled the "1992 Form."
On December
23, 1993, Paul Byus and other former M/G employees filed a complaint
("the Byus Complaint") against M/G under the FCA. The
Byus Complaint asserted two claims: (1) the first pursuant to
31 U.S.C. § 3729(a)(2), alleging that M/G had knowingly
falsified records to hide violations of the Clean Water Act so
that it could obtain payment from the United States; and (2)
the second pursuant to 31 U.S.C. § 3729(a)(7), the "reverse"
false claims provision, alleging that M/G had knowingly falsified
records to conceal, avoid, or decrease an obligation to pay money
to the United States for fines or clean-up costs.(1)
M/G notified
WQIS of the Byus Complaint, and requested indemnity coverage
and a defense to the suit. WQIS refused to provide either. In
June 1996, M/G settled the Byus action for approximately $4.5
million. WQIS did not participate in the settlement conference,
nor provide any portion of the settlement. WQIS also refused
to reimburse M/G for its costs in defending the action.
Although
the United States did not assume control of the Byus Complaint,(2) it did commence a criminal investigation
and prosecution for the underlying Clean Water Act violations.
In October 1997, M/G was convicted of violating and conspiring
to violate the Clean Water Act.
In April
1997, M/G commenced this action against WQIS. In a three paragraph
opinion, the district court in this case granted WQIS' motion
for summary judgment, adopting the reasoning of McGinnis,
Inc. v. Water Quality Ins. Syndicate, No. C-1-97-6 (S.D.
Ohio, Feb. 3, 1998), which was a qui tam action brought
under the FCA by the same attorneys responsible for the Byus
Complaint, involving the same 1976 and 1992 insurance policy
forms at issue here. In McGinnis, the court reasoned that
neither policy obligated WQIS to defend or indemnify the plaintiffs
because the underlying complaint simply did not assert a Clean
Water Act violation, and because the 1992 form excluded intentional
conduct, which had been pleaded in connection with the FCA violations.
The McGinnis court thus granted summary judgment for WQIS.
M/G argues
that there is a genuine issue of material fact concerning whether
(1) WQIS had a duty to defend because the Byus Complaint arguably
stated a covered claim, and (2) WQIS should indemnify M/G because
the settlement was "by reason of or with respect to"
liability to the United States under the Clean Water Act, §
311(f)(1), (f)(4), and (g). In addition, M/G argues that the
district court should have granted its motion for summary judgment.
II.
The district court exercised admiralty jurisdiction
over M/G's complaint pursuant to 28 U.S.C. § 1333. See
Stanley T. Scott & Co., Inc. v. Makah Dev. Corp.,
496 F.2d 525, 526 (9th Cir. 1974) (holding that a marine insurance
policy is a "maritime contract" for purpose of admiralty
jurisdiction). This court has jurisdiction from the final order
of the district court under 28 U.S.C. § 1291.
III.
We review
the grant of summary judgment de novo, guided by the same
principles as the district court. See Rowley v. United States,
76 F.3d 796, 799 (6th Cir. 1996). A motion for summary judgment
should be granted if the evidence submitted to the court demonstrates
that there is no genuine issue as to any material fact and that
the movant is entitled to judgment as a matter of law. See
Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-48 (1986);
Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986).
A.
M/G argues
that there is a genuine issue of material fact concerning whether
WQIS had a duty to defend and indemnify M/G under the policies.(3) The parties agree that Ohio law governs the
substantive aspects of this dispute. See Wilburn Boat Co.
v. Fireman's Fund Ins. Co., 348 U.S. 310, 320 (1955) (holding
that in the absence of controlling federal maritime law principles,
state law determines an insurer's duties and responsibilities).
Because an insurer's duty to defend is generally broader than
its duty to indemnify, we will first determine whether WQIS had
a duty to defend M/G in the Byus action.
1.
Under Ohio
law, whether an insurer has a duty to defend an action against
an insured is initially determined by the scope of the pleadings.
See City of Willoughby Hills v. Cincinnati Ins. Co., 459
N.E.2d 555, 558 (Ohio 1984). The duty of the insurer to accept
the defense of a claim attaches whenever the complaint states
a covered claim, or potentially or arguably does so. See
id. In other words, where the insurer's duty to defend is
not apparent from the pleadings, no duty to defend exists unless
the complaint is "vague, ambiguous, nebulous or incomplete"
so that a "potential for coverage" exists. See Zanco,
Inc. v. Michigan Mut. Ins. Co., 464 N.E.2d 513, 514 (Ohio
1984) (finding no duty to defend where an exclusion placed the
claim beyond the policy's scope). When making this determination,
"insurance contracts must be examined in their entirety."
Id. at 514-15.
First,
M/G argues that the Byus Complaint states a claim that is at
least potentially or arguably covered under the plain language
of Section A in the 1976 Form.(4) M/G emphasizes
that Section A covers any amounts paid "by reason of or
with respect to" liability to the United States of America
under § 311(f)(1) or § 311(g) of the Clean Water Act
for costs incurred under § 311(c) of the Act.(5)
Specifically, M/G contends that its liability under the Byus
Complaint falls within the policy language because an FCA qui
tam action is brought on behalf of the United States, and
because proof of a Clean Water Act violation is a predicate to
establishing that any claim submitted to the United States by
M/G was false.
M/G's argument
fails because the Byus Complaint does not state a claim for liability
that is by reason of, or with respect to, liability under the
Clean Water Act. Nor is the Byus Complaint vague, ambiguous,
nebulous or incomplete such that it potentially does so. First,
the statement of jurisdiction contained in the Byus Complaint
is based solely on the FCA. Second, the Byus Complaint states
only two counts, both exclusively under the FCA. Third, the settlement
agreement arising from the Byus Complaint expressly reserved
potential Clean Water Act liability for the United States. Fourth,
the Clean Water Act does not contain a qui tam provision
authorizing private parties to sue for the government's cleanup
costs. Fifth, nothing in the record suggests that the United
States even incurred cleanup costs as a result of M/G's actions.
In short, M/G's arguments are thinly disguised attempts to bootstrap
liability for FCA violations into the coverage provided by the
environmental pollution policies. Under these circumstances,
we cannot conclude that M/G's liability under the Byus Complaint
was by reason of, or with respect to, liability to the United
States for cleanup costs under the Clean Water Act. An FCA action
is not converted into a Clean Water Act action simply because
a violation of the Clean Water Act is a predicate to establishing
the falsity of a claim, or may be used as a measure of damages
under the FCA.
Second,
M/G contends that language contained in both Section B of the
1976 Form, as well as in the 1992 Form, obligated WQIS to provide
a defense. Section B of the 1976 Form provided indemnity and
defense costs for "such amounts as the Assured . . . shall
pay, in consequence of the sudden and accidental discharge, emission,
spillage or leakage upon or into the seas, waters, land or air,
of oil, petroleum products, chemicals or other substances of
any kind or nature whatsoever." The 1976 Form expressly
excluded any loss, damage, cost, liability or expense arising
solely out of "willful negligence or willful misconduct
within the privity or knowledge of the Assured" and any
loss "for fines, penalties or punitive or exemplary damages."
Similarly, the 1992 Form applied only to "sudden and unintentional"
discharge, emission, spillage or leakage, and expressly excluded
fines, penalties and punitive damages.
M/G's argument
is unpersuasive. An element of a claim under the FCA is that
false claims were "knowingly" made. See 31 U.S.C.
§ 3729(a)(2). The Byus Complaint clearly alleged that M/G
had a "policy and regular practice" of dumping pollutants
into waterways. It is not possible to construe this language
as alleging "sudden and accidental" or "sudden
and unintentional" pollution within the coverage of either
policy. Nor, for that matter, is it possible for M/G to avoid
the 1976 Form exclusion for "willful negligence or willful
misconduct."
Finally,
Ohio law provides that where, as here, a policy does not obligate
an insurer to defend against frivolous claims, a court may consider
events outside the pleadings to determine the duty to defend.
See Preferred Risk Ins. Co. v. Gill, 507 N.E.2d 1118,
1124 (Ohio 1987). Here, M/G was convicted of conspiring to commit
a crime against the United States by knowingly discharging pollutants
in violation of the Clean Water Act. This state of mind is inconsistent
with any inadvertent, negligent, or accidental behavior.
Therefore,
we conclude that the Byus Complaint stated claims under the FCA
exclusively, and that it was not so vague, ambiguous, nebulous
or incomplete as to obligate WQIS to provide a defense under
either policy form.
2.
M/G contends
that WQIS, in addition to a duty to defend, has a duty to indemnify
M/G for the $4.5 million settlement. Under Ohio law, an insurer's
duty to indemnify is separate and distinct from its duty to defend.
See Lessak v. Metropolitan Cas. Ins. Co. of New York,
151 N.E.2d 730, 733 (Ohio 1958). "The duty to indemnify
is based on whether there is, in fact, liability under the policy."
Chemstress Consultant Co. v. Cincinnati Ins. Co.,
715 N.E.2d 208, 212 (Ohio Ct. App. 1998). Nothing in the terms
or circumstances of the underlying settlement demonstrates that
M/G's ultimate liability under the Byus Complaint was for anything
other than violations of the FCA, which we have concluded are
not covered by the policies. Thus, we conclude that WQIS has
no duty to indemnify M/G. We affirm the district court on this
issue.
B.
Finally,
M/G argues that it was entitled to summary judgment. Because
we conclude that WQIS was entitled to summary judgment, we need
not consider M/G's request.
IV.
Therefore,
we AFFIRM the judgment of the district court.
1 We need not decide here whether such a reverse
false claim remains viable in this Circuit. See American
Textile Mfrs. Inst., Inc. v. The Limited, Inc., 190 F.3d
729, 734 (6th Cir. 1999) (rejecting, in dictum, the possibility
of a reverse false claim action where a defendant has omitted
to disclose information to the Government that concealed or avoided
its obligation to pay cleanup costs for its discharges and the
associated fines for intentional dumping).
2 Under 31 U.S.C. § 3730(b)(4)(A)-(B),
the Government may take control of a private action under the
FCA within sixty days from when the complaint is filed.
3 Because the Byus Complaint alleged an ongoing
pattern or policy of pollution rather than specific dates on
which the pollution allegedly occurred, both the 1976 and 1992
forms are implicated.
4 Section A of the 1976 Form, as it applied
to M/G, provides, in pertinent part:
In consideration of the premium
set forth for SECTION A on the Declarations page hereof, and
subject to all of the terms, conditions and limitations contained
herein, the Insurers do hereby agree to indemnify the Assured
for such amounts as the Assured shall, as owner or operator of
the said Vessel, have become liable to pay and shall pay, by
reason of or with respect to:
FIRST: Liability to the United States
of America under Section 311(f)(1) or Section 311(g) of the Federal
Water Pollution Control Act Amendments of 1972 (Public Law 92-500)
(hereinafter called "the Act") for costs incurred under
Section 311(c) of the Act, and costs incurred under § 311(f)(4)
of the Act.
5 Section 311(c) of the Act, 33 U.S.C. §
1321(c), authorizes the United States to clean a polluted marine
environment. Section 311(f)(1), 33 U.S.C. § 1321(f)(1),
provides a mechanism by which the government may recover its
actual cleanup costs from a responsible party. Section 311(g),
33 U.S.C. § 1321(g), provides that an owner or operator
of a vessel who violates § 311(c), but who alleges that
the violation was caused by a third party, must pay the United
States' actual cleanup costs, and is thereby subrogated to the
rights of the United States.
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