defend its insured in the event of suit by the express terms of the insurance contract it has drafted, may unilaterally breach that contractual obligation to provide a defense without consequence. The majority position is contrary to, and unsupported by, existing case law, including decisions of our Supreme Court. While the majority says the result it reaches is necessary in order to avoid creating a conflict of interest for the insurer, this is factually incorrect. Any purported conflict can be avoided simply by the insurer hiring an independent attorney to defend the insured in the tort action, without the insurer managing or controlling the litigation. This would eliminate any potential conflict, would allow the insurer the right to litigate liability in the coverage suit, and, most importantly, would avoid the undesirable approach of the majority decision, which relieves the insurer of its duty to defend in any case in which the insurer believes the insured's intent is an issue. I. FACTS A recitation of the factual background, including certain key facts not mentioned by the majority, is essential to a complete understanding of the basis for the trial court's finding in the tort action that Paul did not act intentionally and the reasons the garnishment court held it was bound by this factual determination, just as it was bound by other factual determinations in the underlying tort action. On June 8, 1989, Robert M. Paul was insured through a policy of insurance with State Farm which provided, inter alia, personal liability coverage in the amount of $300,000 per occurrence. The coverage was described in the policy as follows: Coverage L - Personal liability. If a claim is made or a suit is brought against an insured for damages because of bodily injury or property damage to which this coverage applies, caused by an occurrence, we will: (1) pay up to our limit of liability for the damages for which the insured is legally liable; and (2) provide a defense at our expense by counsel of our choice. We may make any investigation and settle any claim or suit that we decide is appropriate. Our obligation to defend any claim or suit ends when the amount we pay for damages resulting from the occurrence equals our limit of liability.(FN1)
Under "Section II - Exclusions" the policy described those occurrences not covered: "(1) bodily injury or property damage which is expected or intended by an insured; or (2) to any person or property which is the result of willful and malicious acts of an insured...." The term "occurrence" was defined in the policy as "an accident, including exposure to conditions, which results in: a. bodily injury; or b. property damage during the policy period." A. TORT ACTION On February 9, 1992, Danny James filed an action against Paul in the Circuit Court of Jackson County alleging that Paul carelessly and negligently caused injury to James on June 8, 1989, and praying for an award of money damages. Paul forwarded the petition to State Farm on February 13, 1992, and State Farm responded by letter on February 24, 1992 reserving its right to deny coverage because it was questionable whether the allegations met the definition of "occurrence," whether the injury was expected or intended, and whether the injury was the result of a willful or malicious act.(FN2) State Farm's letter recommended that Paul retain an attorney to represent him against a possible judgment in excess of the policy limit or in the form of punitive damages. It did not indicate that Paul should seek representation to defend against a judgment of actual damages within the policy limit. However, State Farm informed Paul that it had not yet made a decision about coverage and would not defend the suit on his behalf until it made a decision, which it anticipated to be no later than March 6, 1992. As noted previously, the lawsuit was filed on February 9, 1992. State Farm did not provide a defense for Paul while conducting its coverage investigation. On March 12, 1992, and again on March 20, 1992, State Farm denied coverage for the lawsuit, citing the definition of "occurrence" and the company's decision that James' injury was either expected, intended, or the result of a willful and malicious act. At the same time, State Farm issued another letter to Paul, also dated March 20, 1992, acknowledging receipt of the lawsuit and reserving its rights under the policy, and stating that coverage was "questionable." On April 1, 1993, counsel for James submitted a settlement demand to State Farm, which was rejected on April 8,
- State Farm again instructed Paul to forward to it any amended petition he might receive for further review. On July
29, 1993, James filed a First Amended Petition, which was in one count and which State Farm concedes in its Brief alleged a cause of action based solely on negligence. The Amended Petition was forwarded to State Farm, and coverage was denied on August 23, 1993. However, on September 2, 1993, State Farm informed Paul's attorney that it might provide a defense to the lawsuit if Paul forwarded a copy of his deposition and allowed State Farm to take another recorded statement, to which counsel agreed. Hearing nothing further from State Farm, Paul subsequently entered into
settlement negotiations with James and notified State Farm on two occasions that he was doing so. State Farm did not bother to respond until November 16, 1993, at which time it advised that it had made no reaffirmation of any denial of coverage, but did not indicate whether it had decided to provide Paul a defense. There is no indication in the record of any further contact from State Farm. After more than a year of negotiations, on September 30, 1994, Paul entered into a settlement agreement and covenant not to execute with James pursuant to section 537.065.(FN3) On January 13, 1995, the case proceeded to trial in Jackson County Circuit Court. Evidence was presented, including expert medical evidence from doctors at Midwest Psychiatric Consultants regarding Paul's mental condition. At the conclusion of the trial, the court found in favor of James and entered judgment against Paul for $285,000 plus prejudgment interest of $45,886.31 and costs. Among its findings, the trial court stated: On June 8, 1989, Defendant, ROBERT M. PAUL, suffered from the medical conditions of alcoholism, adjustment disorder with depression, anxiety and obsessive disorder with the result of diminished mental capacity. On June 8, 1989, Defendant, ROBERT M. PAUL, sustained physical injuries and was intoxicated, which, together with his medical disorders then affecting him, caused him to be in shock, and rendered Defendant, ROBERT M. PAUL, unable to control or appraise the nature of his conduct. On June 8, 1989, Defendant, ROBERT M. PAUL, while incapacitated and unable to control or appraise his conduct, wounded Plaintiff, DANNY T. JAMES, in three places, with a knife. The violent events of June 8, 1989, during which Plaintiff was injured, were the result of ROBERT M. PAUL's sudden disinhibition and loss of control resulting from a combination of fragile borderline personality structure, acute adjustment reaction to emotional distress and intoxication with alcohol. At the time Plaintiff, DANNY T. JAMES, was injured, Defendant, ROBERT M. PAUL, was not capable of appreciating or comprehending the nature or consequences of his conduct. Defendant, ROBERT M. PAUL, did not intend or expect for Plaintiff, DANNY T. JAMES, to be injured (emphasis added). Thus, the trial court in the underlying tort action found that Paul did not act intentionally because he was unable to appreciate the nature or consequences of his conduct. Accordingly, the court entered judgment in favor of James based on the claim of negligence. B. GARNISHMENT AND COVERAGE ISSUES
James subsequently instituted a garnishment action against State Farm for the amount of the judgment. State Farm defended the action on the basis of its policy exclusion for intentional acts, as well as the definition of "occurrence." Both parties filed motions for summary judgment. On January 29, 1998, the garnishment court granted James' motion for summary judgment and denied that of State Farm, and ordered State Farm to pay the judgment amount of $330,886.31 plus post-judgment interest of $90,728.08. The court issued 52 findings of fact and conclusions of law, some of which incorporated the findings of the January 13, 1995 judgment. Among its findings, the court stated:
- The First Amended Petition filed by Plaintiff, DANNY T. JAMES, against Defendant, ROBERT M.
PAUL, on July 29, 1993, did state a claim that was a covered claim under the language of the homeowner's insurance policy issued by Garnishee, STATE FARM, to Defendant, ROBERT M. PAUL, which policy was in full force and effect on June 8, 1989.
- STATE FARM did have a duty to defend the First Amended Petition filed by Plaintiff, DANNY T.
JAMES, in the underlying tort action.
- ...The failure of STATE FARM to provide a defense of the Amended Petition was a breach of the duty
to defend owed by STATE FARM to Defendant, ROBERT M. PAUL, under the homeowner's insurance contract.
- STATE FARM had notice of the First Amended Petition filed by Plaintiff against Defendant, ROBERT
M. PAUL, and that it specifically contained a claim that Defendant, ROBERT M. PAUL, did not intend or expect to injure Plaintiff on June 8, 1989.
- STATE FARM did have an opportunity to defend and to control the defense of the Plaintiff's claim that
Defendant could not control or appraise the nature of his conduct at the time that he injured DANNY T. JAMES, and that the injuries were negligently inflicted, which was specifically plead and at issue in the First Amended Petition filed in the underlying action.
- STATE FARM did freely and voluntarily make the decision not
to defend the First Amended Petition filed by Plaintiff against Defendant, ROBERT M. PAUL, with full knowledge of the facts alleged, the terms and provisions by which it was bound in the homeowner's insurance contract, and its rights, duties and obligations as insurer of Defendant, ROBERT M. PAUL. The garnishment court also addressed the intent issue and how it affected coverage in its findings and conclusions, stating:
- In the underlying tort action it was necessary for this court to determine whether or not Defendant,
ROBERT M. PAUL, suffered from medical conditions of alcoholism, adjustment disorder with depression, anxiety and obsessive behavior with the result of diminished capacity; and whether or not, Defendant, ROBERT M. PAUL, suffered from physical injury that caused him to be in shock. The court was required to determine whether or not the medical conditions afflicting Defendant, ROBERT M. PAUL, prevented him from being able to control or appraise the nature of his conduct, and therefore whether or not he expected or intended to injure Plaintiff, DANNY T. JAMES, because the case was plead and submitted on the theory of unintentional conduct.
- ...ROBERT M. PAUL did not act willfully or maliciously at the time DANNY T. JAMES was
injured (emphasis added).
- From the perspective of Defendant, ROBERT M. PAUL, the injury to Plaintiff, DANNY T. JAMES,
was not expected or intended (emphasis added).
- The events of June 8, 1989, wherein Plaintiff, DANNY T. JAMES, was injured by Defendant,
ROBERT M. PAUL, do constitute an occurrence as that term is defined in Homeowner's Insurance Policy Number 25-62-6343-2. ROBERT M. PAUL did not intend or expect to cause injury to DANNY T. JAMES. The injury was accidental because ROBERT M. PAUL did not intend or expect to injure DANNY T. JAMES (emphasis added).
- The claim for personal injury brought by Plaintiff, DANNY T. JAMES, against Defendant, ROBERT M.
PAUL, in his First Amended Petition filed in the underlying tort action in this case which resulted in this Court's Judgment entered on the 13th day of January, 1995, is not excluded by the Exclusion to Coverage L contained in Homeowner's Insurance Policy Number 25-62-6343-2, which provides that coverage will not apply to bodily injury that is either expected or intended by an insured, or that is the result of willful and malicious acts of an insured (emphasis added).
- STATE FARM has a contractual duty of indemnity created by its Homeowner's Insurance Policy
Number 25-62-6343-2, which requires STATE FARM to pay the judgment entered by this court on the underlying tort claim that was entered in this action on the 13th day of January, 1995, together with accrued post-judgment interest. II. STANDARD OF REVIEW Our review of the summary judgment below is essentially de novo. ITT Commercial Fin. v. Mid-Am. Marine, 854 S.W.2d 371, 376 (Mo. banc 1993). We review the facts in the light most favorable to the party against whom summary judgment was entered, and accord that party the benefit of all reasonable inferences from the record. Bryan v. Missouri State Highway Patrol, 963 S.W.2d 403, 406 (Mo. App. W.D. 1998). We will affirm the trial court's ruling if we find that no genuine issues of material fact exist and the movant was entitled to a judgment as a matter of law. Blevins v. State Farm Fire & Cas. Co., 961 S.W.2d 946, 948 (Mo. App. W.D. 1998). If the trial court's ruling is correct as a matter of law under any theory, we will affirm the grant of summary judgment even though it may have been entered for the wrong reason. Barker v. Danner, 903 S.W.2d 950, 954 (Mo. App. W.D. 1995); Advance Concrete & Asphalt Co. v. Ingels, 556 S.W.2d 955, 958 (Mo. App. W.D. 1977). III. ANALYSIS A. DUTY TO DEFEND In this case, James' First Amended Petition was in one count. State Farm concedes in its Brief that the First Amended Petition alleged a cause of action based solely on negligence. As detailed, supra, State Farm was provided a copy of the First Amended Petition and was requested to provide a defense on several occasions. It refused. At the hearing, unrefuted evidence supporting the allegations of negligence was presented, including expert evidence from a medical doctor at Midwest Psychiatric Consultants. From the evidence, the trial court expressly found that Paul neither intended nor expected James to be injured, and accordingly found Paul liable in negligence for James' injuries and awarded damages.
In the subsequent garnishment proceeding, State Farm claimed that it was not liable for the judgment. It raised what it asserted were "coverage" issues, arguing that (a) the incident giving rise to the judgment was not an "occurrence" as defined in the policy and/or (b) the incident resulting in the judgment was encompassed within the policy exclusions because (1) the injuries were either expected or intended by the insured, or (2) the result of willful and malicious acts by the insured. The majority holds that the garnishment court erred in granting summary judgment to James because it deprived State Farm of the opportunity to present these "policy" defenses. In its brief reference to the duty to defend, the majority cites Travelers Ins. Co. v. Cole, 631 S.W.2d 661 (Mo. App. E.D. 1982) and several other Court of Appeals decisions, suggesting that the duty to defend is not dependent solely on the allegations of the petition. Maj. Op. at 11. In so doing, and contrary to the mandate of Art. V, section 2 of the Missouri Constitution that we follow our Supreme Court's most recent controlling decision, the majority wholly disregards the clear, cogent and concise teachings of our Supreme Court. Schumann v. Missouri Highway & Transp. Comm'n, 912 S.W.2d 548, 552 (Mo. App. W.D. 1995). An insurer's duty to defend is broader than its duty to indemnify. McCormack Baron Management Serv., Inc. v. American Guarantee & Liab. Ins. Co., 989 S.W.2d 168, 170 (Mo. banc 1999). Any suggestion '"that the insured must prove the insurer's obligation to pay before the insurer is required to provide a defense would make [the duty to defend] provision a hollow promise....'" Id. (quoting 13 John A. Appleman & Jean Appelman, Insurance Law and Practice, section 4684 (rev.vol. 1976)). "The duty to defend arises whenever there is a potential or possible liability to pay based on the facts at the outset of the case and is not dependent on the probable liability to pay based on the facts ascertained through trial." Id. The duty to defend is determined by comparing the language of the insurance policy with the allegations in the complaint. See Butters v. [City of Independence], 513 S.W.2d 418, 424 (Mo. banc 1974); Zipkin v. Freeman, 436 S.W.2d 753, 754 (Mo. banc 1968). If the complaint merely alleges facts that give rise to a claim potentially within the policy's coverage, the insurer has a duty to defend. See Butters, 513 S.W.2d at 424; Zipkin, 436 S.W.2d at 754. McCormack Baron, 989 S.W.2d at 170-71. Moreover, where a petition states some grounds of liability covered by a policy, the duty to defend is triggered even if some of the allegations or claims of the petition are uninsured or beyond the coverage. Butters, 513 S.W.2d at 424-25; Wood v. Safeco Ins. Co. of America, 980 S.W.2d 43, 47 (Mo. App. E.D. 1998); Scottsdale Ins. Co. v. Ratliff, 927 S.W.2d 531, 534 (Mo. App. E.D. 1996); Harold S. Schwartz & Assoc., Inc. v. Continental Cas. Co., 705 S.W.2d 494, 497 (Mo. App. E.D. 1985). When an insurer breaches its duty to defend, among other things, it is bound by the determinations of liability and damages made in the case it refused to defend. Lodigensky v. American States Preferred Ins. Co., 898 S.W.2d 661, 664-65 (Mo. App. W.D. 1995); Whitehead v. Lakeside Hosp. Ass'n, 844 S.W.2d 475, 480-82 (Mo. App. W.D. 1992);
Finkle v. Western Auto. Ins. Co., 26 S.W.2d 843, 849 (Mo. App. E.D. 1930). While the insurer may challenge any coverage finding made in the underlying tort action, it is, of necessity, bound by the factual determinations essential to a finding of liability and is not free to re-litigate those issues in a subsequent garnishment action. In applying these principles, the majority separates out the factual element of "intent" from other factual elements, and argues that intent can be decided separately and independently in the garnishment action because it is a coverage issue. It is erroneous to do so. Intent is a factual issue, and while it may be essential for proof of coverage, it is also essential for proof of liability in the tort action. Generally, where an insurer refuses to defend an action under circumstances where it has a duty to defend, the insurer is bound under the doctrine of collateral estoppel by the facts determined in the trial of such action which are essential to judgment of liability, unless the judgment was procured by the fraud and collusion of the insured and the injured parties, and bound by the underlying complaint in determining its duty to defend. However, a party will not be precluded from litigating policy coverage in a subsequent proceeding if the question of coverage turns on facts which are nonessential to judgment of tort liability. 14 Couch on Insurance 3d, section 202:12 (1999)(emphasis added). The majority would permit State Farm to re-litigate intent simply by saying that it was essential in both cases. If such were the law, issues such as causation and other individual facts which might affect coverage could also be re- litigated. Indeed, any issue relevant to both liability and coverage could be re-litigated. This would clearly conflict with and render void the promise that upon breach of the duty to defend, an insurer is bound by the determinations of liability and damages made in the case it refused to defend.The correct application of the principles relating to the effect of a breach of the duty to defend compels the conclusion that the garnishment court's grant of summary judgment was correct. In the instant appeal, State Farm's policy defined an "occurrence" as "an accident." "[W]hen a liability policy defines 'occurrence' as meaning ' 'accident'...Missouri courts [consider this] to mean injury caused by the negligence of the insured.'" Wood, 980 S.W.2d at 49 (quoting Great Am. Ins. Co. v. Pearl Paint Co., 703 S.W.2d 601, 602 (Mo. App. E.D. 1986). Accordingly, under Missouri case law, an "occurrence" for purposes of State Farm's policy means "'an injury caused by the negligence of the insured.'" Id. James' petition in the tort action was a single count based on negligence. Therefore, there could be no liability imposed on Paul in that case without a finding of negligence. The finding of liability in the tort case necessarily involved a determination of negligence by the trial court. Indeed, as noted supra, the trial court expressly found that Paul suffered from diminished capacity at the time of the incident and was not capable of appreciating or comprehending the nature and consequences of his conduct, and that he did not intend or expect for James to be injured. The garnishment court had before it, considered and relied on the pleadings, testimony and evidence presented
in the underlying tort action and the findings and judgment therein. As pointed out, supra, when an insurer breaches its duty to defend, among other things, it is bound by the determinations of liability and damages made in the case it refused to defend. Lodigensky, 898 S.W.2d at 664-65; Whitehead, 844 S.W.2d at 480-82; Finkle, 26 S.W.2d at 849. Since it chose not to defend in the underlying tort case, State Farm was bound by the determination of liability in that case which necessarily was dependent on the factual findings essential to a determination of negligence, including the findings of causation, diminished capacity and lack of intent. These findings of fact are the ones which were binding in the subsequent garnishment action. It was then up to the garnishment court to decide the coverage issue, i.e., whether, in light of these findings, the incident constituted an "occurrence." This coverage issue had not been previously decided. However, in ruling on the question, the garnishment court necessarily was bound by the facts found in the tort case that an incident occurred, caused by Paul, and it was not willful but the result of diminished capacity. These findings were essential to the judgment of liability and, as it turns out, were dispositive of the coverage issue, for it meant that the incident was an "occurrence" under State Farm's policy. See 14 Couch on Insurance 3d, section 202:12 (1999). Contrary to the majority's position, State Farm was given the opportunity to present its policy defense that the incident was not an occurrence in the garnishment. However, because of the applicable law, the garnishment court properly ruled the issue against it. James was entitled to summary judgment on that issue as a matter of law. For the same reason, James was entitled to summary judgment on the other coverage issues raised by State Farm in the garnishment court. First, State Farm contended that the policy exclusion for intentional conduct was applicable. It is axiomatic that "negligent" and "intentional" conduct are contradictory and mutually exclusive. Gallatin v. W.E.B. Restaurants Corp., 764 S.W.2d 104, 105 (Mo. App. W.D. 1988). Being bound by the negligence-based liability determination, the garnishment court could only decide State Farm's coverage claim based on the intentional conduct exclusion in favor of James. Similarly, State Farm's contention that the willful and malicious acts exclusion was applicable also fails. Depending upon the circumstances, an act may be negligent or it may be willful and malicious misconduct but it cannot be both "at one and the same time because the ultimate 'proof of negligence necessarily disproves willfulness and vice versa.'" Ervin v. Coleman, 454 S.W.2d 289, 291 (Mo. App. S.D. 1970) (quoting Agee v. Herring, 298 S.W. 250, 252 (Mo. App. W.D. 1927). As it is bound by the negligence-based liability determination, State Farm's coverage claim based on willful and malicious acts was properly ruled against it. Thus, contrary to the majority's and State Farm's assertions, State Farm was given an opportunity to present its
"coverage" defenses in the garnishment action. However, because it breached its duty to defend, it was precluded from contesting the factual determinations essential to the ultimate finding of liability made in the underlying tort action. Accordingly, as discussed above, James was entitled to judgment as a matter of law on State Farm's coverage issues, and the garnishment court did not err in granting James' motion for summary judgment. The rationale which compels the conclusions here reached has been developed in our case law over the last fifty or more years. In this case, State Farm was notified of James' action against Paul and provided with copies of the petition. Numerous requests were made for it to defend the action. Had it done so, it could have controlled the litigation. It refused, and in so doing breached its duty to defend. The decision by the insurer, as to whether it will refuse to defend because the claim upon which the action against the insured grounded is outside the coverage of the policy, is attended with risk. * * * Where the claim comes within the policy coverage, and so within the duty of the insurer to defend, the refusal of the insurer to do so is unjustified, and the insurer is guilty of a breach of contract. That the refusal of the insurer to defend on the ground that the claim is outside the policy is an honest mistake, nevertheless constitutes an unjustified refusal and renders the insurer liable to the insured for all resultant damages from that breach of contract. Whitehead, 844 S.W.2d at 481. When an insurer is bound to protect another from liability, it is bound by the result of the litigation to which such other is a party so long as it had the opportunity to control and manage the litigation. Drennen v. Wren, 416 S.W.2d 229, 234-35 (Mo. App. S.D. 1967) (quoting Listerman v. Day and Night Plumbing & Heating Serv., 384 S.W.2d 111, 118-119 (Mo. App. S.D. 1964)). "We recognize that certain issues between insurer and insured, e.g., fraud in the procurement of the policy or breach of an essential condition, are not litigable in the main case against the insured in a negligence action * * * and that such issues would survive inter partes an adverse judgment in the main suit." Grain Dealers Mut. Ins. Co. v. Quarrier 175 So.2d 83, 86 (Fla. App. 1965). "While the judgment will be conclusive on him as far as concerns the facts of the rendition of the judgment, its amount, and the cause of action on which it was rendered, it will not determine the question whether he is in fact responsible over; nor will it preclude him [the indemnitor] from setting up any defenses which from the nature of the action or the pleadings he could not have interposed in the first action * * *" 50 C.J.S. Judgments section 811b, pp. 362-363. Drennen, 416 S.W.2d at 235 (emphasis added). Had it chosen to defend Paul, State Farm could have interposed the defense that James' injuries were not caused by Paul's negligence, the proof of which would have defeated James' negligence action. Since it breached its duty to defend by its refusal to provide a defense, it was bound by the decision it made. B. CONFLICT OF INTEREST The conflict of interest issue addressed by the majority is more relevant, for in at least some cases a potential for
a conflict of interest could exist between an insured and its insurer. The majority is incorrect, however, when it says the only way to resolve such a potential conflict is to allow the insurer an opportunity for a second bite at the apple by giving it a chance to litigate the liability issue in the garnishment action despite the fact that it refused to defend the insured in the underlying tort suit. To the contrary, the insurer could still honor its contractual duty to defend while avoiding any conflict between itself and its insured by providing the insured with a defense at its expense without managing or controlling the litigation. In that instance, having fulfilled its duty to defend, but not being a party to the tort suit, it would not be bound by the result of the tort action and could separately litigate the issue of liability in the garnishment action. Where, as here, however, the insurer has chosen not to provide a defense, it has violated its contractual obligations and, as a result, is bound by the decision in the tort case and is not free to re-litigate liability in the garnishment action. Other courts have taken this approach, holding that a potential conflict of interest does not relieve an insurer of its contractual obligation to defend its insured. Howard v. Russell Stover Candies, Inc., 649 F.2d 620, 625 (8th Cir. 1981). "To avoid the potential conflict of interest, [the insurer] 'must either provide an independent attorney to represent the insured or pay the costs incurred by the insured in hiring counsel of [the insured's] own choice.'" Id. (quoting U. S. Fidelity & Guar. Co. v. Louis A. Roser Co., 585 F.2d 932, 939 n. 6 (8th Cir. 1978). Had State Farm followed this path, it would not have breached its contractual duty to provide Paul with a defense, and it would not have been bound by the determinations as to liability and damages because it did not manage or control the litigation. In other words, it would have performed under the contract while preserving its right to litigate its policy defenses, including the factual issues supporting the determinations as to liability and damages. State Farm chose not to do so. The majority nevertheless relies on Cox v. Steck & State Farm Gen. Ins. Co., 992 S.W.2d 221 (Mo. App. E.D. 1999) to support its position. In Cox, Cox and Steck were involved in an altercation. Id. at 222. Cox suffered a skull fracture. Id. He brought an action against Steck alleging assault, or in the alternative, negligence. Id. Steck filed an answer including a counterclaim against Cox alleging assault, or alternatively, negligence. Id. Steck was insured by State Farm, which initially undertook defense of Cox's action under a reservation of rights, and later withdrew representation and denied coverage on Cox's claims. Cox, 992 S.W.2d at 222-23. Thereafter, Cox and Steck entered into a section 537.065 agreement, limiting Cox's ability to recover on any judgment against Steck to the State Farm policy. Id. at 223. Trial was subsequently held. Id. The court found that Steck negligently injured Cox and awarded Cox $25,000 in damages. Id. Cox then brought a garnishment action against State Farm, which resulted in a judgment ordering it to pay the underlying tort damages. Id. On appeal, the Eastern District held that State Farm's theory that Steck's actions were intentional created a
conflict of interest between the insured and insurer because the underlying tort action was pled in two alternative counts, one in negligence and one for assault. Cox, 992 S.W.2d at 224. The Cox court confirms that a liability insurer's duty to defend a suit against its insured is measured by the language of the policy and the allegations in the petition. Id. at 224. It further states that where an insurer is bound to protect another from liability, it is bound by the result of litigation to which another is a party. Id. at 224-25. However, the court states that these principles "may not apply in situations where the insurer has an inherent conflict of interest with the insured." Id. at 225. Relying on Oates v. Safeco Ins. Co. of America, 583 S.W.2d 713 (Mo. banc 1979), the Cox court found such "inherent conflict of interest." Cox, 992 S.W.2d at 224. In Oates, the court found a conflict of interest in an uninsured motorist claim brought by the insured against its own insurer, where the insurer was simultaneously being called upon to defend a counterclaim arising out of the same incident against its insured. Oates, 583 S.W.2d at 719-21. Such conflict is inherent in the policy provisions, wherein "in order to comply with the terms of its insurance policy, [the insurer must] undertake to defend its insured in the tort action, while at the same time becoming an adversary against its insured to protect itself against the insured's establishing that he is legally entitled to recover against the uninsured motorist." Id. at 720 (emphasis added). The Cox court found an inherent conflict of interest because State Farm was being called upon to defend Steck in Cox's action for negligence when it believed and wanted to defend that action based on the conduct being intentional. However, if it did so, it would establish its insured's liability to Cox in his alternate count based on assault. Thus, the court considered the situation to be the same as that presented in Oates. The court held that "under the specific facts before us, State Farm is not barred from litigating the issue of liability and policy coverage since an inherent conflict of interest prevented it from raising these issues in the underlying action." Cox, 992 S.W.2d at 226 (emphasis added). I respectfully submit that the Cox court erred in finding that Oates was determinative of that issue. In Oates, as noted previously, a conflict of interest was inherent in the policy provisions, because "[I]n order to comply with the terms of its insurance policy, [the insurer was required to] undertake to defend its insured in the tort action, while at the same time becoming an adversary against its insured to protect itself against the insured's establishing that he is legally entitled to recover against the uninsured motorist." Oates, 583 S.W.2d at 720 (emphasis added). The conflict in the uninsured motorist situation is thus based on express alternative contractual obligations undertaken by the insurer. It has bound itself to defend the insured if he is sued for negligence on the one hand, and on the other, it has bound itself to pay him for injuries he sustained as a result of the negligence of an uninsured motorist. Accordingly, in that rare instance, such as under the facts in Oates, when the insurer is called upon to provide both benefits based on a single occurrence, an "inherent conflict of interest" exists.
However, the principle expoused in Cox, that the duty to defend will be negated whenever the insurer believes that it is likely that an exemption applies and there is no coverage, is different from that recognized in Oates and is inconsistent with and contrary to the principles underlying our Supreme Court's recent decision in McCormack Baron, 989 S.W.2d 168. In that case, McCormack Baron had purchased a comprehensive commercial insurance policy from American Guarantee which was in force at the time of the events in question. Id. at 169. Among other things, the policy provided coverage for injury arising out of "oral . . . publication of material that . . . disparages a person's . . . services." Id. at 170. It also contained a provision that excluded from coverage an injury "arising out of oral . . . publication of material, if done by or at the direction of the insured with knowledge of its falsity." Id. McCormack Baron was sued by a former employee of its security guard service under a count entitled "Tortious Interference with a Contractual Relationship," and in which the employee alleged that he was fired as a direct result of statements made by McCormack Baron's agent to the employee's supervisor. Id. at 169. McCormack Baron notified American Guarantee and called upon it to defend, but American Guarantee refused. McCormack Baron, 989 S.W.2d at 170. McCormack Baron then filed a declaratory judgment action seeking a declaration that American Guarantee was obligated to provide a defense to the suit and indemnification against liability. Id. The trial court entered summary judgment in favor of American Guarantee and McCormack Baron appealed. Id. In its analysis, our Supreme Court noted that the case involved "two separate duties, the duty to defend and the duty to indemnify." Id. It pointed out that "the duty to defend is broader than the duty to indemnify." Id. Based on its analysis of the employee's petition and the policy language, the Court found that American Guarantee had a duty to defend. McCormack Baron, 989 S.W.2d at 172. It then observed, however, that "[t]he duty to indemnify is determined by the facts as they are established at trial or as they are finally determined by some other means. . . ." Id. at 173. The Court then stated: "The insurer's duty to pay arises only after the suit by the third party is successful and the insurer becomes obligated to pay the resulting judgment." Appelman, section 4684. The facts before the Court, at this time, consist solely of Bennett's complaint. We cannot know what facts will be established at trial or whether those facts will fall within the coverage of the policy or trigger any policy exclusions. McCormack's claim for indemnity is not ripe for ruling at this time. Id. at 173-74. As noted previously, the American Guarantee policy contained a provision excluding from coverage an injury "arising out of oral . . . publication of material, if done by or at the direction of the insured with knowledge of its falsity." The employee's petition alleged, among other things, that McCormack Baron, through its agent, "acted 'willfully, maliciously, and without justification, in a conscious disregard of [the employee's] rights. . . .'" Id. at 169.
While conflict of interest was not argued in the case, it is apparent that a potential for a conflict might exist for American Guarantee because of the exclusion. However, the Court disregarded any potential conflict and held that American Guarantee had a duty to defend because of the allegations of the petition, and that any duty to indemnify could only be determined after it is known "what facts will be established at trial or whether those facts will fall within the coverage of the policy or trigger any policy exclusions." Id. at 173. The same potential conflict that existed in Cox and, according to the majority that exists in this case, was present in McCormack Baron, yet our Supreme Court found a duty to defend. Unlike the facts in Oates, the conflict of interest, if any, in Cox, McCormack Baron, and the instant case, was not inherent and could have been avoided quite easily. For these reasons, I believe Cox was incorrect in suggesting that the only method of avoiding the conflict was to allow the insurer to breach its duty to defend, and then be rewarded by being permitted to re-litigate liability in the subsequent garnishment action. This potential conflict could have been avoided if the insurer had simply hired separate counsel to represent the insured in the underlying tort case. This follows from the fact that in Cox, and McCormack Baron, as here, any conflict that exists arises only because the insurer is trying to defeat its liability to a third party based on exclusions or other provisions of the policy. The insurer makes a unilateral determination that the incident giving rise to the claim is based on intentional conduct. There is nothing inherent about such a conflict, as there was in Oates. The insurer can meet its duty to its insured by providing independent counsel and not managing or controlling the litigation, or even by defending under a reservation of rights. As noted supra, the duty to defend is of greater breadth than the duty to indemnify. McCormack Baron, 989 S.W.2d at 170. "[W]here an injured party's petition states some grounds of liability covered by a policy, the insurer has a duty to defend, despite its contention that some of the allegations of the petition state a claim beyond its policy coverage." Harold S. Schwartz & Assoc., Inc., 705 S.W.2d at 497.(FN4) The decision in Cox effectively eviscerates the insurer's duty to defend. The insured pays a premium for the insurer's agreement to provide the insured with a defense any time the insured is sued based on a claim of negligence. Under the reasoning of Cox, and the majority in this case, the insurer can avoid its contractual obligation to provide a defense by merely making a unilateral determination that the facts giving rise to the suit are not within the policy coverage, notwithstanding the allegations of the petition, and it can do so without assuming any risk. All risk is transferred to the insured.(FN5) He must retain counsel and undertake a defense that he has already paid a premium to receive. Yet if the insured is unsuccessful, the insurer can re-litigate the issue of liability in a subsequent garnishment proceeding. The insurer has received a windfall by receiving a premium for providing a defense, which it then refuses to provide, with absolutely no risk. Thus, I would decline to follow Cox because it results in an unjustified, unnecessary and unfair
transfer of risk and expense from the insurer to its insured, all of which could be avoided by the simple expedient of hiring independent counsel to undertake the insurer's admittedly existing contractual duty to defend. C. PUBLIC POLICY The majority also offers a public policy argument to support its decision. It points to our public policy prohibiting an insured from insuring against the consequences of his or her intentional acts and then proceeds to hold that the trial court erred when it determined as a matter of law that the findings and decision of the default hearing that Paul acted negligently were binding on State Farm in the later garnishment proceeding. Maj. Op. at 15. In reaching this conclusion, the majority totally disregards, as it does throughout, that State Farm had a duty to defend which was broader than its duty to indemnify, McCormack Baron, 989 S.W.2d at 170, and that State Farm breached that duty, resulting in it being bound by the determinations of liability and damages made in the underlying tort action. This case has nothing to do with violating the public policy against insuring oneself against intentional acts. Rather, it has everything to do with State Farm being required to abide by the terms of the insurance contract it drafted and sold to Paul. As found by the courts below, State Farm is not required to provide coverage for intentional acts. However, it is obligated to live up to its bargain of providing coverage for negligent ones. Nonetheless, the majority not only reverses the garnishment court's grant of summary judgment, but takes the unusual step of holding that State Farm is entitled to summary judgment and directing that same be entered. In doing so, it blatantly substitutes its own conclusions that any reasonable person must understand the natural and probable consequences of his acts, for the considered holding of the trial court that Paul did not understand the consequences of his acts. The majority does not claim that a person unable to appreciate the wrongfulness of their conduct is considered to have acted intentionally or willfully. It simply does not believe Paul fits in that category. However, that is not for this court to decide. The issue was in the province of the tort court and was decided by it. There is no claim of fraud or bad faith. Rather, State Farm has belatedly decided that it did not anticipate the result and does not like it, so it wants to contest it now. It is too late. The only bases for litigating a section 537.065 settlement are bad faith, collusion and reasonableness of damages. Gulf Ins. Co. v. Noble Broadcast, 936 S.W.2d 810, 815 (Mo. banc 1997). State Farm is not entitled to re-litigate the liability determination. The majority's doubts about whether the proper result was reached in this specific case does not provide a reasoned basis to upset Missouri law by ruling that intent issues can be re-litigated in the context of coverage in every case even if they were already decided as factual issues in the underlying tort litigation which the insurer chose not to defend.
IV. CONCLUSION The majority's decision in this case will work a dramatic and significant change in existing law. The decision goes far beyond any of the cases on which the majority relies and which generally state that an insurer has the right to litigate its policy defenses in a garnishment proceeding. See Augspurger v. MFA Oil Co., 940 S.W.2d 934 (Mo. App. W.D. 1997); Lodigensky, 898 S.W.2d 661; Whitehead, 844 S.W.2d 475. Those cases involve true coverage issues, such as whether the claim was made within the term of a claims made policy, Whitehead, 844 S.W.2d at 477, whether the insured obtained the policy through misrepresentation or violated the cooperation conditions of the contract, Drennen, 416 S.W.2d at 235, and breach of the policy condition requiring cooperation. Finkle, 26 S.W.2d at 849. In the instant case, the issue goes much further. It involves the ultimate issue of the insured's liability. I have found no case which permits the insurer to refuse to provide a defense and then re-litigate the issue of liability in the garnishment proceeding. I respectfully decline to join the majority in setting such a new and dangerous precedent. Accordingly, I would affirm the trial court's grant of summary judgment. Footnotes: FN1. Reference to State Farm's policy is to the Homeowner's Extra policy, form FP-7195 (6/86). FN2. Shortly after the incident of June 8, 1989 which formed the basis of James' suit, Paul had filed a claim with State Farm seeking liability coverage for himself for any injury claims made by James. State Farm responded on June 27, 1989, reserving its right to deny coverage to Paul based on questions of whether the bodily injury was expected or intended by an insured, and whether it was the result of a willful and malicious act of any insured. On September 26, 1989, State Farm again reserved its right to deny coverage based upon the two reasons previously cited, with the additional reason that any injury James received was not caused by an "occurrence" as defined in the policy. After receiving a letter from counsel representing James dated October 19, 1989, State Farm finally denied coverage for the claim on October 24, 1989. In a letter to Paul, it stated that the facts determined by its investigation did not meet the insuring agreement with respect to the definition of an "occurrence," and the bodily injury alleged by James was either expected or intended by an insured or the result of a willful or malicious act caused by an insured. The letter went on to request that Paul submit lawsuit papers to the insurance company should he receive any in the future. FN3. This and all subsequent statutory references are to RSMo (1994) unless otherwise indicated. Section 537.065 states in pertinent part: Any person having an unliquidated claim for damages against a tort-feasor, on account of bodily injuries or death, may enter into a contract with such tort-feasor or any insurer in his behalf or both, whereby, in consideration of the payment of a specified amount, the person asserting the claim agrees that in the event of a judgment against the tort-feasor, neither he nor any person, firm or corporation claiming by or through him will levy execution, by garnishment or as otherwise provided by law, except against the specific assets listed in the contract and except against any insurer which insures the legal liability of the tort-feasor for such damage and which insurer is not excepted from execution, garnishment or other legal procedure by such contract. FN4. See also Superior Equip. Co., Inc. v. Maryland Cas. Co., 986 S.W.2d 477, 482 (Mo. App. E.D. 1998) ("The presence of some potentially insured claims in complaint gives rise to a duty to defend, even though claims beyond coverage may also be present."); Union Pacific Railroad Co. v. American Family Mut. Ins. Co., 987 S.W.2d 340, 345- 46 (Mo. App. E.D. 1998) ("This duty [to defend] exists without regard to the merits of any claim, and is present without diminution notwithstanding alternate statements of the plaintiffs' claims."); Ratliff, 927 S.W.2d at 534 ("The presence of some insured claims in the homeowners' petition gives rise to a duty to defend, even though uninsured claims or claims
beyond the coverage may also be present."). FN5. In the instant case, State Farm delayed a decision on coverage for four months until the claimant hired legal counsel, at which time it denied coverage. When suit was filed, State Farm informed its insured that it would not provide a defense until it made a decision on coverage, which would be sometime in the future. The insured was helpless to obtain a commitment from the company as to whether it would uphold its obligations. Eighteen months later, State Farm informed its insured that it might defend him if he submitted to further demands. When he agreed, they did not respond. By that time, the insured was left with few options. This slip opinion is subject to revision and may not reflect the final opinion adopted by the Court.