NIGEL WATTS FASHION AGENCIES PTY LTD v GIO GENERAL LTD [1994] NSWCA 365
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NIGEL WATTS FASHION AGENCIES PTY LTD v GIO GENERAL LTD
SUPREME COURT OF NEW SOUTH WALES COURT OF APPEAL
KirBY P, MAHONEY and HANDLEY JJA
24 May 1994, 22 December 1994
[1994] NSWCA 365
INSURANCE — insurers' duty of utmost good faith — lawyers retained by insurer
conduct proceedings — possible conflict of interest and duty not drawn to notice of
insured — whether estoppel by representation — held: There is.
LEGAL PRACTITIONERS — conflict of interest of duty — solicitors retained by
insurer- duty to scrutinise and alert insured as to any possible limitation of indemnity
provided.
ESTOPPEL- conventional estoppel — estoppel by representation — insurer
conducts legal proceedings — held: estopped from denial of indemnity.
INSURANCE — employers' indemnity — workers' compensation extension — claim
by worker against occupier of building in respect of injury received when he falls in
lift — fall accepted to be the consequence of the occupier's negligence — occupier
joins employer as third party claiming indemnity — indemnity claimed is based upon
(a) joint liability of employer and occupier as joint tortfeasors; and (b) provisions of
a lease affording occupier complete indemnity by contract in respect of claims of
injury to employees of employer — trial judge (Madgwick DCJ) finds in favour of
worker against occupier but in favour of occupier against employer under terms of
lease — insurer denies indemnity under workers' compensation policy on ground
that the employer's liability rests solely on contract to which the insurance did not
respond — primary judge (Windeyer J) rejects claims based upon (i) terms of policy;
(ii) estoppel; and (iii) election by insurer to provide indemnity by conducting
employer's defence
INSURANCE — duties of insurer — duty of utmost good faith — reciprocal duty of
insurer and insured — limited liability of insurer under policy of indemnity —
insurer exercises right to take over defence of insured — fails until during trial to
bring to insured's notice relevant limitation of indemnity and risk, in the pleadings
and relevant facts that insured will be exclusively liable to meet claim without
indemnity — possible conflict of interest and duty of insurer's retained solicitors —
failure to bring conflict to notice of insured
LEGAL PRACTITIONERS — conflict of interest and duty — obligation to avoid —
duty of frankness to client — legal representatives retained by insurer — failure to
alert insured of conflicting claims against it under one only of which the insurer
would be liable to indemnify the insured — duty of candour and good faith by
insurer to insured
ESTOPPEL — conventional estoppel — estoppel by representation — insurer
conducts legal proceedings
WORDS AND PHRASES — "iability independently of the Act"
Held:
2 UNREPORTED JUDGMENTS
(1) The claims for liability of the insurer based upon the terms of the extended coverage
of the workers' compensation policy issued by it to the employer were rightly dismissed
by the primary judge;
(2) Although the estoppel relevant to the facts may more properly have been one of
conventional estoppel, the representational estoppel alleged was made out and detriment
to the employer was shown in the failure of the insurer earlier to alert the insured employer
of the risk that its indemnity would not extend to the employer in the circumstances which
ensued;
(3) The claim based upon election did not require to be determined.
Austral Standard Cables Pty Ltd v Walker Nominees Pty Ltd (1992) NSW Conv R55,
630 (CA) referred to;
(4) Appeal allowed and declaration made that insurer was liable to indemnify the
employer on the basis of estoppel.
Held: Insurer liable to insured not on the basis of policy but on the basis of
representational estoppel.
Held: Insurer liable to insured on the basis of estoppel by representation - detriment
proved is deprivation of opportunity to withdraw proceedings or negotiate favourable
settlement.
Held: estopped from denial of indemnity.
Hansen v Marco Engineering (Aust) Pty Ltd [1948] VLR 198 (SC); CE Heath
Underwriting Pty Ltd v Campbell [1992] 1 VR 386 (CA) considered.
Workers Compensation Act 1987.
ORDERS
1. Appeal allowed;
2. Set aside the judgment of Windeyer J;
3. In lieu thereof, declare that the plaintiff Nigel Watts Fashion Agencies Pty Ltd is
entitled to indemnity from the defendant GIO General Ltd in respect of a judgment of
$37,274 and costs ordered by his Honour Judge Madgwick in the District Court
proceedings number 791 of 1992 between Nigel Kevin Watts and John Shorter Pty Ltd;
4. Order that the respondent pay to John Shorter Pty Ltd the judgment of $37,274 and
costs ordered by his Honour Judge Madgwick in the said proceedings;
5. Order that the defendant pay the costs of the proceedings in the Equity Division; and
6. Order that the respondent pay the costs of the appeal but have, if otherwise so
qualified, in respect thereof, a certificate under the Suitors' Fund Act 1951.
Kirby P This appeal from the Equity Division of the Supreme Court
(Windeyer J)concerns an aspect of the duty of good faith owed by an insurer to
an insured. It is well known that the insured owes to the insurer a duty to act in
the utmost good faith (uberrimae fidei). The reciprocal duty, which is also a
feature of insurance contracts, is less well appreciated, as the facts of the present
case demonstrate.
AN INSURER DEFENDS PROCEEDINGS FOR AN INSURED
GIO General Ltd (the insurer) issued a workers' compensation policy in the
ordinary form to the appellant, Nigel Watts Fashion Agencies Pty Ltd (the
employer). By its policy, the insurer promised to pay compensation for which the
employer was liable under the Workers Compensation Act 1987. The policy had
the extension usual at the relevant time:
"\.. Or to pay any other amount in respect of [the Employer's] liability
independently of the Act for any injury to any such person THEN, and in every
such case, the insurer shall indemnify the Employer against all such sums for
which the Employer shall be so liable..."
The employer carried on its business in a building in the city of Sydney owned
and occupied by John Shorter Pty Ltd (the occupier). The employer leased certain
premises on the fifth floor of the occupier's building. It provided stairs and
elevators to permit access to the leased premises.
URJ NIGEL WATTS FASHION AGENCIES PTY LTD v GIO GENERAL LTD (Kirby P) 3
Mr Nigel Watts (the worker) was an employee of the employer. He was also
an officer of the employer and apparently its principal. In some of the
documentation he was described as a "partner". In the course, and for the
purposes, of his employment he required daily access to the premises leased by
the employer in the occupier's building. On 17 May 1991 at about 7.45 pm he
was injured when he was getting into an elevator on the fifth floor of the building.
It seems that the elevator stopped at a point several centimetres higher than the
floor landing. The worker stumbled as he entered the elevator. He fell heavily
striking his head on a wall. He was 71 years of age at the time of this accident.
As a result of his fall he fractured his hip. Some "impressive hardware" was
inserted in the hip to give him a measure of stability. His recovery was impeded
by an unrelated but debilitating condition of prostate cancer which has required
extensive chemotherapy.
The worker recovered benefits from his employer under the Workers
Compensation Act. However, he then sued the occupier in the District Court
claiming damages at common law for negligence. The occupier, in turn, issued
a third party notice joining the employer as third party to the worker's
proceedings. By the third party notice, the occupier alleged an entitlement to a
complete indemnity or, in the alternative, contribution pursuant to s5(1)(c) of the
Law Reform (Miscellaneous Provisions) Act 1946. It based this claim upon two
grounds: 1. The breach by the employer, as third party, of the duty which it
owned to the worker to provide him with a proper and safe place of work and safe
access to and egress from such place of work; and 2. The express terms of the
lease between the occupier and the employer.
THE PRIMARY JUDGE UPHOLDS THE WORKER'S CLAIM AND THE
CLAIM FOR INDEMNITY
The proceedings came before Madgwick DCJ. His Honour found negligence
on the part of the occupier. This finding is not now in dispute. He also found that
the worker was entitled to damages on the basis of the occupier's negligence.
This finding is likewise not challenged. However, Madgwick DCJ found that the
occupier had proved contributory negligence on the part of the worker.
Accordingly, he reduced the damages by 15 per cent for that purpose. The total
damages judgment was found in the sum of $43,146. When 15 per cent was
deducted, and interest of $600 was allowed on past economic damages, that left
a judgment for the worker against the occupier in the sum of $37,274.
That judgment was not the subject of appeal. Madgwick DCJ then turned to the
third party claim. He found that the employer was not in breach of the duty of
care which it owed to the worker as its employee. However, he held that the
employer was obliged to indemnify the occupier upon the terms of the lease by
which the employer was permitted to occupy the leased area of the fifth floor of
the occupier's building.
That lease contained the following rather draconian provision:
"5. The Lessee further covenants with the Lessor as follows:
(cc) INDEMNITY
The Lessee will and does hereby indemnify the lessor from and against all
actions claims demands losses damages costs and expenses for which the lessor
shall or may be or become liable in respect of or arising from:
(i)...
(ii)...
4 UNREPORTED JUDGMENTS
(iii) Loss damage or injury from any cause whatsoever to... person caused or
contributed to by the use of the demised premises or the building by the Lessee
or any servant invitee agent subtenant or other person as aforesaid; (iv) Loss
damage or injury from any cause whatsoever to... person within or without the
demised premises or the Building occasioned or contributed to by any act
omission neglect breach or default of the Lessee or any servant invitee agent
contractor or subcontractor subtenant or other person as aforesaid. "
The "building" referred to in para(iv) is defined in the interpretation clause
(CL8):
"(d) "he "Building" (where the demised premises do not comprise the whole
of the structures on the land described in the Lease) shall mean where appropriate
the structure and curtilage of which the demised premises form part.":
This is an exceptionally widely drawn indemnity. It purports to shift to the
employer all liability for any injury to the person of an employee ("a servant")
including any employee who suffered loss damage or injury from any cause
whatsoever to his person caused or contributed to by the use of the occupier's
premises or building.
Madgwick DCJ held that it was clear that the employer was obliged to
indemnity the occupier under the lease in respect of the amount of the judgment
which the worker recovered against the occupier. Accordingly, he gave judgment
in the third party claim against the employer. There was no appeal by the
employer from this judgment which therefore stands.
The occupier sought to recover from the employer the amount of the judgment
which it had paid to the worker. The employer claimed indemnity from the
insurer in respect of that judgment. The insurer denied indemnity. The occupier,
meanwhile, took steps seeking to wind up the employer for non-payment of the
judgment in the third party proceedings. This led to proceedings in the Equity
Division for an injunction to restrain the winding up of the employer until the
resolution of the employer's claim against the insurer. The injunction was
granted. The winding up proceeding therefore lies in abeyance pending the
resolution of the employer's claim against the insurer.
Windeyer J at first instance dismissed the employer's claim for indemnity.
From his Honour's order of dismissal, the employer has appealed to this Court.
It rests its claim upon three bases - contract, election and estoppel:
1. The promise of the extended term contained in the workers' compensation
policy;
2. The fact that the insurer, which took over the defence of the employer's
interests in the third party proceedings, by its conduct of the employer's defence,
had elected to indemnify the employer as its insured; and
3. The fact that the insurer was, in the facts and circumstances proved,
estopped from denying indemnity to the employer having (as it was alleged)
represented that it would provide indemnity. Upon the basis of that promise, it
was argued the employer acted to its detriment.
THE POLICY DOES NOT IN ITS TERMS PROVIDE INDEMNITY
The first argument of the employer can quite readily be dismissed. It was put
to the Court with proper diffidence and brevity by counsel for the employer.
The argument was that the extended terms of the promise "to pay any other
amount in respect of [the employer's] liability independently of the Act for any
injury to [a worker]" was wide enough to cover the liability in respect of the
injury to the worker in respect of which the employer was liable as third party.
URJ NIGEL WATTS FASHION AGENCIES PTY LTD v GIO GENERAL LTD (Kirby P) 5
This claim must be rejected. The phrase in the policy is of long standing. Its
purpose is plain. It is to provide indemnity to an employer for common law
liability to a worker qua worker. It is not to provide indemnity to the employer
in respect of every other way in which the employer might be liable to other
persons, as by a promise in a contract of lease. The judgment against the
employer as third party rested entirely upon the employer's contractual liability
under the lease. It was based on the exceptional provisions of that document. The
workers' compensation policy issued by the insurer to the employer did not
respond to such a liability.
For the employer it was put that the outcome might not have been the
"aspiration" of the drafter of the workers' compensation policy but liability arose
nevertheless from the words actually used in the policy which would be
construed in favour of the insured. I do not agree. So to hold would extend
unreasonably, and beyond its purpose, the indemnity provided by the insurer
under the workers' compensation policy.
The employer, alternatively, argued that an insured, reading the document in
circumstances analogous to the one in which the present insured found itself,
could easily be lulled into a false confidence that the insurer which had taken over
the defence of the proceedings would indemnify it in respect of the liability
independently of the Workers Compensation Act, such as the occupier asserted in
its third party notice addressed to the employer. This might be a consideration
relevant to the case framed in terms of estoppel. But it cannot be permitted to
distort the plain language of the insurance policy, understood in the light of its
purpose. The first basis of challenge to the decision of Windeyer J must therefore
be rejected.
THE CLAIM OF ESTOPPEL AT FIRST INSTANCE
It is convenient to deal next with the employer's claim that the insurer was
estopped, in the circumstances, from denying indemnity for the liability found
against it in the third party proceedings.
The workers' compensation policy issued by the insurer to the employer
contained the usual provision in respect of the defence of proceedings:
"4. The Insurer shall in respect of anything indemnified under this policy,
including the bringing, defending, enforcing or settling of legal proceedings for
the benefit of the Insurer, be entitled to use the name of the Employer. The
Employer shall give all necessary information and assistance and forward all
documents to enable the Insurer to settle or resist any claim as the Insurer may
think fit. "
The occupier filed its third party claim against ie employer on 9 October 1992.
On 13 October 1992, it caused its solicitors to send a letter to ie employer serving
the third party notice. The sealed copy of the notice was served on ie worker's
solicitors on 15 October 1992. The following day they caused copy of the notice
to be sent to counsel advising the worker seeking advice on behalf of the
employer. Because of the comparatively small size of the employer and the role
of the worker as an officer and principal of the company, this course of conduct
is unsurprising.
On 16 October 1992, counsel for the worker advised that the third party notice
should be sent to the workers' compensation insurer of the employer. Again, this
was sensible and reasonable advice given that the first basis of claim in the third
party notice was stated to be upon the footing that the employer and the occupier
6 UNREPORTED JUDGMENTS
were joint tortfeasors, in that the employer was liable to the worker on the basis
of its negligence (presumably in failing to provide him with a safe place of and
egress from work).
On 27 October 1992, pursuant to this advice, the third party notice was sent by
the employer to the insurer with instructions to file a defence. The letter said: "We
note that the Government Insurance Office is the third party's workers'
compensation insurer and accordingly a defence to the third party notice should
be filed as a matter of urgency... [It] should be filed by 12 November 1992. Please
attend to this matter as a matter of urgency."
I reproduce the terms of this letter as the insurer sought to take comfort from
them.
On 4 February 1993 a defence to the third party notice was filed on behalf of
the insurer in the name of the employer. It was filed by solicitors retained by the
insurer. The solicitors did not (nor did the insurer) then draw to the attention of
the employer, as the insured, the limit of the insurer's indemnity as relevant to,
the dual basis upon which the third party notice claimed indemnity or
contribution. Nor did the insurer or its solicitors warn the employer of the risk
that the employer would be denied indemnity if the basis of recovery against it
were ultimately held to be the second claim (framed in terms of the contract of
lease) and not the first claim (framed in terms of liability in negligence as a joint
tortfeasor).
Before Windeyer J, the estoppel relied upon for the employer was an estoppel
by representation. No case was presented that the facts lent themselves to
classification as an instance of conventional estoppel, ie one arising from two
parties proceeding upon a common assumption accepted by both and
subsequently shown to have been wrong. The reality of the present case would
appear to be that neither party, nor any of those acting for them, turned their
attention to the problem which is now presented. At least none did until virtually
the very last moment. Only then did the problem loom up as an unexpected
iceberg in a dark litigious sea. Had only the parties turned their attention to the
pleading of the third party notice and the terms of the insurance policy,
comparing one to the other, the correct course would have been obvious. After
all, the problem presented was not entirely unique to the field of insurance. It is
by no means unknown for insurance policies to provide limitations which expose
the insured to the risk of an obligation itself to find part of any judgment
recovered. In such circumstances, it is usual (the insurer exercising the right
provided by the policy to take over the defence in the name of the insured) to
consult most closely with the insured or its separate legal advisers to ensure that
the separate position of the insured and insurer are taken into account in the
conduct of the litigation. The insurer's legal representatives may, by the contract,
have the carriage of the proceedings. But that entitlement does not absolve them
from their duties as legal practitioners acting in a particular interest. Nor does it
absolve the insurer of the obligation of good faith to the insured and specifically
the obligation to avoid the giving of instructions to the solicitors which would
involve a conflict of interest and duty.
Proper lawyerly attention to the terms of the third party notice and a reflection
upon the extremely wide language of the indemnity provided in paraS(cc) of the
lease, would have driven those retained on behalf of the employer by the insurer
had they been alert to warn the employer of the risks which it ran in the third
party proceedings. It seems clear enough that this was not done. The problem
which lay in waiting for the judgment of Madgwick DCJ in the third party
URJ NIGEL WATTS FASHION AGENCIES PTY LTD v GIO GENERAL LTD (Kirby P) 7
proceedings was simply not noticed until the trial. Only then did counsel for the
employer focus his attention on the issue. Only then did he alert counsel for the
worker about the risk which was run. That risk was a real one. It was of
considerable importance to the worker. If, in fact, the occupier could effectively
recover a complete indemnity from the employer, the judgment in favour of the
worker would eventually have to come out of the company in which the worker
is a director and the effective principal. In short, the worker's judgment would
come, in whole or (as I would infer) in large part, out of the worker's own pocket.
The Court is not in these proceedings looking at the matter in terms of the
obligations of the legal practitioners who acted for the employer, taking their
instructions from the insurer. They are not parties to the present proceedings.
They have not been heard in respect of any accusations of default on their part.
Accordingly, it is inappropriate to make any finding of default against them. It is
arguable that the legal representatives retained by the insurer were faced with an
actual or potential conflict of interest and duty. It was in the interests of the
insurer that the litigation be conducted so that, if it went against the insured
employer, it did so on the lease point and not on the joint tortfeasor point. But it
was the duty of the representatives of the employer, as such, to achieve the
opposite result. The problem which arose in the instant case appears to have
come about because those legal representatives who were retained by the insurer
to act for the insured employer failed to bring the potential conflict to the
employer's notice. At least they did not do so in a timely way. The problem was
only really addressed when the trial was underway. It seems virtually inescapable
that the true interpretation of the facts is that the legal representatives did not at
first notice the problem which arose. But it would have been plain had they
turned their attention to the third party notice, the terms of the lease and the
limited indemnity provided by their client insurer to their nominal client, the
insured employer.
The case seems more suitable to be dealt with as one of a conventional
estoppel. However, it was not so presented in the Equity Division. Although the
matter proceeded without pleadings, it is important for this Court to ensure
against any procedural unfairness which might come from an attempt to recast
the matter on appeal - presenting in effect a new case: one different from that
tried. Normally, a party will be held to the manner in which it presents its case
before the primary judge. If there is any possibility of procedural unfairness in
recasting the case on appeal, such a course must be denied by the appellate court.
See Coulton and Ors v Holcombe and Ors (1986) 162 CLR 1, 7f.
In the circumstances of this case, I think it is safer to hold the parties to the
manner in which the case was presented before Windeyer J. I would not be
inclined to reconsider the case in terms of the duty of the solicitors or a
conventional estoppel not pleaded, particularised or fought. I therefore turn to a
consideration of the basis upon which the employer contended at trial that it was
entitled to recover against the insurer, viz upon the basis of estoppel by
representation.
THE REPRESENTATIONAL ESTOPPEL
In order to make out a representational estoppel, it is necessary for the party
asserting it to establish, relevantly, that its reliance upon a representation made to
it has occasioned it to suffer detriment. However, it is sufficient, in proving
detriment, for the representee to establish that its reliance caused it to lose a real
chance of avoiding the detriment which has ensued. See Austral Standard Cables
Pty Ltd v Walker Nominees Pty Ltd [1992] NSW Conv R55, 630 (CA), 59589.
8 UNREPORTED JUDGMENTS
The employer's case was the insurer, by its conduct, represented to the
employer that it would indemnify the employer with respect to the entirety of the
claim made against the employer in the third party proceedings brought by the
occupier. Such representation, it was argued, caused the employer to act to its
detriment. Thereby, it suffered loss. Upon that footing, even if the insurer were
not bound by the terms of the policy to indemnify the employer, it was obliged
to do so because it was now estopped from denying the obligation to indemnify.
The employer relied upon three considerations to establish the relevant
detriment. They were:
1. The consent which the insurer instructed its solicitors on behalf of the
employer to give to pay the occupier's costs of defending the worker's
proceedings on a solicitor and client basis and to indemnify the occupier in
respect of the costs which it was obliged to pay to the worker pursuant to the
judgment in his favour in the action. For reasons which it is not necessary to
elaborate, the representatives of the employer before Madgwick DCJ,
presumably taking their instructions from the insurer, consented to such orders;
2. In pursuing the proceedings in the way they did up to the trial and in failing
to alert the employer, as the insured, concerning the risk which it was running,
it is said that the employer lost a real chance of persuading the worker to
discontinue his proceedings against the occupier (which was entitled to the
complete indemnity under the lease) and instead to pursue the entitlements which
the worker had against the employer under the Workers Compensation Act. In
respect of the last mentioned entitlements, the insurer would be obliged to
indemnify the employer. This, so it was said, represented a benefit to the insurer,
secured as a result of the course of conduct which was followed. Although a
benefit need not be shown (and fraud was not alleged) it was urged that this was
the counterpart to the detriment which the employer had suffered from the
representation held out, until the last moment, that the insurer would indemnify
the employer in the third party proceedings; and
3. By the course which was followed, the employer also lost a chance of
negotiating a settlement which would have secured a contribution by the insurer
to a complete settlement which would dispose of the insurer's potential workers'
compensation liability.
FINDINGS BY THE PRIMARY JUDGE
Windeyer J rejected these arguments for an estoppel. He heard evidence from
counsel who had appeared before Madgwick DCJ on behalf of the worker and the
employer. There was a difference between them in their recollection of the alert
which had been sounded by counsel for the employer at the trial. Windeyer J
preferred the recollection of counsel for the employer. This involved his saving
to counsel for the worker, words to the effect:
"As I see this case, I do not think there is any evidence of negligence on the
part of the company. The only risk, as it seems to me, is that the company will
be liable on the indemnity in the lease to the landlord.... If the company is not
negligent and is liable on the indemnity then the GIO may well have to decline
to indemnify the company. I have taken instructions this morning and have been
told to convey this. I can do this by speaking to Mr Watts direct as the managing
director of the company but because you are appearing for him I thought it
appropriate for me to raise the matter with you so that you may take it up with
him.... I do not know what his insurance position is. It may well be that he has
some public risk or other insurance that would cover this situation... I will leave
it to you to take the matter up with him."
URJ NIGEL WATTS FASHION AGENCIES PTY LTD v GIO GENERAL LTD (Kirby P) 9
This was a proper warning. But it was given most belatedly. As I have said, it
should have been a matter considered when the solicitors retained by the insurer
first examined the extent of their client's obligation to indemnify the employer in
respect of the matters pleaded in the third party notice.
After considering the facts from the standpoint of his preference for the
evidence of counsel for the insurer/employer, Windeyer J accepted that, in some
cases, an insurer, undertaking a defence for the insured, will be estopped from
denying indemnity to an insured. However, he concluded that in this case the
insurer had not made a representation to the insured that it was liable to
indemnify it in respect of the WHOLE of the claim. The conduct of the defence
was authorised by the action of the employer, as insured, in forwarding the third
party notice to the insurer. The insurer was obliged to accept the obligation to
undertake the defence. One at least of the bases upon which the third party notice
made its claim against the employer was in terms of the allegedly tortious
conduct for which the insurer was undoubtedly liable to indemnify it.
Furthermore, under the Rules of the District Court, only one party may appear in
a single interest. His Honour went on:
"T do not consider there was such a representation.... The GIO did what it was
asked to do and entitled to do, it conducted a defence. No doubt it could and
probably should have advised the company that it was not entitled to indemnity
under the policy in respect of all claims in the third party notice but I do not
consider failure to do so amounted to a representation that cover was available...
The estoppel claim made here... fails."
The employer challenges this conclusion upon the three bases which I have
mentioned.
REPRESENTATION AND DETRIMENT ARE ESTABLISHED.
With respect to Windeyer J, it is my view that a relevant representation by the
insurer was established on the facts accepted by his Honour. Detriment, in the
sense at least of loss of opportunity, was made out.
The duty of good faith which the insurer owed to the insured obliged it to be
candid in its dealings with the employer, as insured. Cf Gibson v Parkes District
Hospital (1991) 26 NSWLR 9 (SC), 17f. It required it, in the circumstances of
this case, to make clear to the insured:
* the limit of the obligation;
* the differential liability of the insured; and
* the risk which the insured thereby ran in respect of which it might need to
secure its own separate advice.
Cf Distillers Company Biochemical (Australia) Pty Ltd v Ajax Insurance Co
Ltd (1974) 130 CLR 1, 14; Carter v Boehem (1766) 3 Burr 1905, 1909; Spencer,
Bower, Turner and Sutton Actionable Non-Disclosure, 2nd ed, 101. This was not
a case where the insurer was entitled to remain silent. At least it was not entitled
to do so if the product of the silence was a relevant detriment to the insured. I
consider that the representation made was unequivocal - it was that indemnity
would be provided. It remained so until after the insured had suffered loss. Cf
Waltons Stores (Interstate) Ltd v Maher (1988) 164 CLR 387, 428f; The
Commonwealth of Australia v Verwayen (199) 170 CLR 394, 422, 502.
In my view there was relevant detriment. I pass over the consent to the order
for costs. Much more relevant to the whole conduct of the proceedings was the
loss of the real chance that the worker would have been persuaded by the
employer (whose principal he was) - being alert to the risks presented by the
claim for indemnity in the lease - of the wisdom of abandoning the common law
10 UNREPORTED JUDGMENTS
rights and pursuing his rights under the Workers Compensation Act or settling
both together. It was suggested that the worker's rights were chimerical. I cannot
agree. The worker had suffered a serious injury to his hip. At the least that injury
gave rise to a potential claim under s66 and s67 of the Workers Compensation
Act 1987. By pursuit of the common law claim the worker stood to lose that
entitlement. Had he been alerted to the risk of what ensued, he might well have
been persuaded to avoid the hollow victory achieved in the District Court and to
pursue, instead, his entitlements under the Workers Compensation Act.
Even more clear is the fact that, in the way the proceedings were conducted,
the employer lost the opportunity of negotiating a settlement which would have
secured a real contribution by the insurer to the total payment to the worker
which avoided the Phyrric victory which, in the circumstances, eventuated.
Negotiations did, in fact, occur between the occupier and the employer through
their solicitors. Of course, those negotiations were effectively between the
occupier and the insurer, not the employer itself. As appears from the
correspondence, the occupier was prepared to settle the third party claim upon the
basis that the insurer contributed $10,000 to a settlement by "leaving in" $10,000
of the $12,198 workers' compensation payments which would otherwise have to
be repaid following judgment in favour of the worker. The solicitor retained by
the insurer indicated that there would be a reduction of the claim for repayment
of workers' compensation benefits. But this was only to the extent that the insurer
received $7,500 in recoupment.
Had the employer been alerted to its true position of considerable peril by
reason of the terms of the lease, it takes little imagination to realise that it would
have sought to protect its own separate position vis-a-vis the insurer. Instead, it
lost that opportunity. It thereby suffered detriment which could not then be
repaired. That detriment arose from the false expectation into which the employer
had been lulled. This was an expectation, almost to the last minute, that the
insurer was representing the entirety of the interests of the employer in the third
party proceedings. Cf Hansen v Marco Engineering (Aust) Pty Ltd [1948] VLR
198 (SC), 211. Only at the very end did counsel, nominally appearing for the
employer (but actually retained by the insurer), realise, and express, the risk
which the employer ran from the limits of the indemnity provided by the insurer's
policy.
It is the lesson of this case that where there are such differential and alternative
claims, they must be brought to the notice of the insured immediately and now
at the heel of the litigious hunt.
CONCLUSIONS AND ORDERS
The foregoing conclusion relieves me of the obligation to deal with the other
way in which the employer presented its case, viz on the footing of an election.
I am not convinced that that case was made out or that Windeyer J erred in his
conclusion on this issue. My reasons are similar to those now expressed by
Handley JA. However, I refrain from resolving this point finally as it is
unnecessary for my orders.
In the result, I would set aside Windeyer J's orders upon the footing that,
contrary to his Honour' s inclination, the employer made out its claim in estoppel.
I would therefore propose the following orders:
1. Appeal allowed;
2. Set aside the judgment of Windeyer J;
URNIGEL WATTS FASHION AGENCIES PTY LTD v GIO GENERAL LTD (Mahoney JA) 11
3. In lieu thereof, declare that the plaintiff Nigel Watts Fashion Agencies Pty
Ltd is entitled to indemnity from the defendant GIO General Ltd in respect of a
judgment of $37,274 and costs ordered by his Honour Judge Madgwick in the
District Court proceedings number 791 of 1992 between Nigel Kevin Watts and
John Shorter Pty Ltd;
4. Order that the respondent pay to John Shorter Pty Ltd the judgment of
$37,274 and costs ordered by his Honour Judge Madgwick in the said
proceedings;
5. Order that the defendant pay the costs of the proceedings in the Equity
Division; and 6. Order that the respondent pay the costs of the appeal but have,
if otherwise so qualified, in respect thereof, a certificate under the Suitors' Fund
Act 1951.
Mahoney JA In this proceeding the plaintiff seeks a declaration that its
worker's compensation insurer, the second defendant, is obliged to indemnify it
in respect of moneys payable by it to the first defendant.
Mr Nigel Watts was the managing director and the substantial shareholder in
Nigel Watts Fashion Agencies Pty Ltd ("the employer'). The employer leased
offices on the fifth floor of a building. The lessor to it was John Shorter Pty Ltd
("the lessor').
On 17 May 1991 Mr Watts went to enter the lift in the building. The lift was
not stopped precisely at floor level. As the result he fell and suffered injuries. Mr
Watts did not sue the- employer. He received worker's compensation payments
from the employer's workers' compensation insurer, GIO General Ltd ("GIO").
Mr Watts sued the lessor, claiming that the fact that the floor of the lift was not
correctly aligned with the fifth floor resulted from the negligence of the defendant
and was a breach of its duty as occupier of the building.
The lessor claimed that, if it was liable to Mr Watts, it should have a
contribution or indemnity from the employer. Its claim was based on two
contentions: that the employer was liable to Mr Watts for the relevant injuries as
a tort feasor and that, by virtue of the Law Reform (Miscellaneous) Provisions
Act 1946, it was liable to make a contribution or provide an indemnity for the
damages; and (alternatively) that by the terms of the lease given by the lessor to
the employer, the employer was obliged to indemnify the lessor for any damages
payable to Mr Watts.
Mr Watts sued the lessor in the District Court. The lessor served a third party
notice on the employer, and that notice specified the two bases of its claim. The
solicitors for the employer were Gye Perkes and Stone. They were also the
solicitors for Mr Watts. The third party notice was sent to the employer. Evidently
it was given to such solicitors. The solicitors were acting for Mr Watts in the
District Court litigation. The solicitors wrote a letter to: "Workers Compensation
Department, Government Insurance Office of New South Wales" in the following
terms:
"RE: NIGEL KEVIN WATTS v JOHN SHORTER PTY LTD RE: NIGEL
WATTS FASHION AGENCIES PTY Ltd - THIRD PARTY RE: WORKERS
COMPENSATION POLICY NO. W257045 We refer to the above matter and
advise we act for the Plaintiff Mr Nigel Kevin Watts. Mr Watts is a partner in the
Third Party joined by the Defendant in these proceedings Nigel Watts Fashion
Agencies Pty Ltd We enclose a letter from the Defendant's solicitors Messrs
Moray and Agnew dated 13 October 1992 enclosing by way of service the Third
Party Notice addressed to Nigel Watts Fashion Agencies Pty Ltd We note that the
Government Insurance Office is the Third Party's workers compensation insurer
12 UNREPORTED JUDGMENTS
and accordingly a defence to the Third Party Notice should be filed as a matter
of urgency. We are advised by Mr Watts that the letter and Third Party Notice
enclosed were served by security post and were received on 14 October 1992.
Accordingly the defence to the Third Party Notice should be filed by 12
November 1992. Please attend to this matter as a matter of urgency."
GIO appointed PW Turk and Associates its solicitors in the matter and those
solicitors filed a defence to the third party claim. (There were subsequent parties
in the District Court proceeding but it is not necessary to pursue that aspect of the
matter).
On 17 March 1993 Mr Watts' claim was heard in the District Court. On 22
March 1993 Madgwick DCJ gave judgment for the plaintiff Mr Watts against the
lessor. On the third party claim his Honour found for the lessor against the
employer on the lease claim and gave judgment effectively indemnifying the
lessor in respect of ie amount to be paid to Mr Watts. Upon the claim that the
employer was liable to Mr Watts as a tort feasor, his Honour found for the
employer. Accordingly, the liability of the employer to indemnify the lessor was,
in the judgment, based only upon the lease basis.
Following judgment, the employer requested GIO to indemnify it against its
liability to the lessor. GIO indicated that, in its opinion, it was not liable to do so
and refused the employer's claim. Its contention was that under the workers
compensation insurance policy no indemnity was given in respect of liability
arising upon the leasehold basis. The employer therefore brought the present
proceeding against GIO. On 4 November 1993, Windeyer J held that the
employer was not entitled to an indemnity under the insurance policy. The
employer has appealed to this Court against his Honour's judgment.
No appeal was brought against the judgment of Madgwick DCJ. This
proceeding has, before this Court being dealt with upon the basis that the findings
made by Madgwick DCJ bind the present parties in respect of the matters here
relevant. The contrary has not been argued.
Mr Emmett QC, for the employer, submitted that the employer was entitled to
an order against GIO on any of three bases: the construction of the policy;
estoppel; and the election of GIO to accept liability under the policy.
1. THE CONSTRUCTION OF THE POLICY:
The policy is one in common form issued in respect of workers compensation
liability and common law liability in respect of the employer's "liability
independently of the Act for any injury to" the injured worker. The relevant
portion of the policy provides:
"... the Employer shall be liable to pay compensation under the Act to or in
respect of any person who is or is deemed by the Act to be a worker of such
Employer, or to pay any other amount in respect of his liability independently of
the Act for any injury to any such person, THEN, and in every such case the
Insurer will indemnify the Employer against all such sums for which the
Employer shall be so liable...".
Mr Garling, for GIO, has submitted that the judgment in question creates a
liability to pay an amount which is not "for any injury to any such person"; the
amount is not in respect of his liability for any injury to Mr Watts but in respect
of the employer's promise, embodied in the lease, to indemnify the lessor against
liability arising from (as pleaded in this case) the lessor's negligent injury to Mr
Watts.
URNIGEL WATTS FASHION AGENCIES PTY LTD v GIO GENERAL LTD (Mahoney JA) 13
The term "for" is, of course, one which has a wide operation: see Robert G
Nall Ltd v Federal Commissioner of Taxation (1937) 57 CLR 695 at 711. The
extent of it in each case is to be determined by the context in which it is used.
I do not think that the employer's liability in the present case, though arising
because Mr Watts was injured, is a liability "for" that injury. It is, in the relevant
sense, a liability arising under the indemnity which, by the terms of the lease, was
contracted to be given. I agree with the conclusion of Kirby P on this aspect of
the matter.
2. ESTOPPEL:
The estoppel advanced for the employer is, in substance, that GIO represented
to the employer that it would accept liability under the policy if the outcome of
the litigation was against the employer. I agree with Kirby P that this is
substantially the basis of estoppel which remained open to the employer.
I confess to finding difficulty with this estoppel. The difficulty arises from the
position occupied by the solicitor and counsel appointed by GIO to act for the
employer in the litigation. At some stage, both knew that the insurer was
reserving its right to renounce the policy obligations if the litigation went against
the employer on the "lease" claim. Ordinarily, the knowledge of the solicitor and
counsel of this fact would be imputed to the employer. If imputed as actual
knowledge, the result would be that the employer knew that the substance of the
suggested representation was either not made or not true. Accordingly, it could
not rely upon the suggested estoppel.
I have had the benefit of the observations of Kirby P. As his Honour's
judgment suggests, it is by no means clear at what point the solicitor and counsel
appointed for the employer became aware of the fact that GIO had adverted to
this aspect of the matter or had reserved its rights in that regard. All that is known
is that, at some time during the course of the proceeding itself, they must have
been aware of it because of what counsel said to the counsel appearing for the
plaintiff. The effect of what has been said for the employer in support of the
estoppel is, as I understand it, that the representation was made and that, by the
time of the conversation between counsel, the employer had acted upon it to its
detriment in a way which could not then be repaired. On this basis, it is said, it
was no longer open to GIO to refuse to adhere to the representation it had made.
It is not clear that the suggested representation was made. What the employer
was given to understand depends, of course, essentially upon the particular
circumstances of this case. In the end, I think the better view of the facts is that
taken in this regard by Kirby P. I shall accept that what was done by GIO gave
the employer to understand that if the litigation went against it, GIO would
provide the appropriate indemnity. On this basis, the argument for the employer
is to the effect that it became aware of GIO's attitude when it was too late for it
to alter its position, and therefore GIO is estopped from departing from its
representation. Again, the matter depends essentially upon the facts. The mere
fact that an insurer appoints solicitor and counsel to conduct litigation for the
insured does not produce such a representation or estoppel. In the present case,
the facts went further. Workers compensation had been paid to the plaintiff by
GIO as the employer's insurer. GIO may be inferred to have known the
circumstances of the case. It may be that in the context it would know that the
employer had left the matter in its hands and that it would assume that, if the
litigation went against it, GIO would provide the anticipated indemnity. With
14 UNREPORTED JUDGMENTS
some doubt, I am content to accept the conclusion of Kirby P in this regard. In
these circumstances it is not necessary to review the decisions to which counsel
have referred the Court.
3. ELECTION:
Upon my acceptance of the conclusions of Kirby P in relation to estoppel, it
is not necessary to consider this matter. It is sufficient to indicate that I am not
convinced that the matter turns upon the doctrine of estoppel.
I agree with the orders proposed by Kirby P.
Handley JA In this appeal I have had the advantage of reading the reasons for
judgment of Kirby P and Mahoney JA in draft form. They have set out the
relevant facts and the history of these proceedings. I agree with my brethren that
the employer's claim based on the terms of the common law extension in the
compulsory Workers' Compensation policy fails. There is no need for me to add
anything on that issue but I will do so on the issues of election and estoppel by
representation.
ELECTION
My brethren have not found it necessary to decide this question but in my
opinion it is without substance. The doctrine, in its application to contracts of
insurance, prevents an insurer from adopting inconsistent positions under the
same policy. An insurer receiving a claim who is entitled to avoid the policy or
reject the claim for breach of condition must make an election. In the first case
the insurer must either affirm or avoid the policy and in the second it must waive
the breach and accept the claim or rely on the breach and reject it. If, having the
requisite knowledge of the facts, it asserts rights which would only exist if the
policy was in force and covered the claim it will be taken to have elected to treat
the policy as valid and applicable to the claim. See Yorkshire Insurance v Craine
[1922] 2 AC 541, Khoury v GIO (1984) 165 CLR 622 at 633 and Reid v
Campbell Wallis Moule (1990) VR 869 per Tadgell J at 868-869, 872-875 and the
cases there cited. This decision was reversed on other grounds which do not affect
his Honour's conclusions on the present point. See (1992) 1 VR 386.
The third party proceedings by the landlord were based on two distinct claims,
one of which fell within the Workers' Compensation policy, while the other did
not. The District Court, unlike the Compensation Court, has no power under its
Act and rules to allow separate legal representation for the same party in a single
proceeding where there are underlying conflicts of interest created by insurance
arrangements. The GIO was therefore entitled to take over the conduct of the
third party proceedings. In doing so it was relying on the policy, and when it later
sought to deny liability to indemnify the appellant it was still relying on the
policy. It did not adopt inconsistent positions with respect to the policy. The
position was comparable with that which applies where an insured is sued for
more than the amount of the cover. In such a case the insurer is entitled to take
over the conduct of the proceedings without losing the benefit of its limitation of
liability. See Hansen v Marco Engineering (1948) VLR 198 at 210. In my opinion
therefore the GIO was not bound by election from disputing its liability to
indemnify the employer.
ESTOPPEL BY REPRESENTATION
The appellant's principal contention was that the GIO was prevented or
estopped by its conduct from denying its liability to indemnify the appellant. The
solicitors for Mr Watts, acting as agents for the insured, sent the third party notice
to the GIO under cover of the letter quoted in the other judgments. Condition 4
bound the insured to do this.
URUIIGEL WATTS FASHION AGENCIES PTY LTD v GIO GENERAL LTD (Handley JA) 15
The GIO was entitled under Condition 4 to take over the conduct of the third
party proceedings because they included a claim for contribution under the Law
Reform (Miscellaneous Provisions) Act 1946 based on the insured's liability in
tort to its worker, Mr Watts. However the GIO was in a position of some delicacy.
It was liable to indemnify the insured against any judgment for contribution but
not for any judgment based on the lease. It had already paid compensation and
medical expenses totalling $12,198. Under s151Z(1)(b) of the Workers'
Compensation Act 1987 it would be entitled to reimbursement from any
judgment recovered by Mr Watts from the landlord. It seems that, subject to
subs(4), the whole of the compensation would be recoverable from Mr Watts
without any abatement because of his contributory negligence. The position was
otherwise prior to the 1987 Act. See Law Reform (Miscellaneous Provisions) Act
1965 s10(1)(c), s10(1)(d), and s10(1)(e), and GIO v CE McDonald (NSW) Pty
Ltd (1991) 25 NSWLR 492.
When common law rights against employers were abolished in 1987 s10 was
amended to ensure that workers who recovered damages from third parties
reduced for their contributory negligence only had to repay the same proportion
of their compensation. See s10(1)(d). However that section was not amended
when common law rights against employers were restored by the Workers'
Compensation (Amendment) Act 1989 It is not clear that s68 of the Interpretation
Act 1987 enables the reference in s10(1)(d) of the 1965 Act to s150 of the
Workers' Compensation Act 1987 to be read as a reference to s151Z(1)(b)
inserted in 1989. However on any view the worker was bound to repay at least
85 per cent of the compensation from the damages recovered from the landlord.
If the landlord was not entitled to contribution but was entitled to indemnity
under the lease the insured would end up paying the whole of Mr Watts' damages
and all the costs of the proceedings but the GIO would be reimbursed for at least
85 per cent and possibly 100 per cent of the compensation it had paid. The
insured would therefore lose the practical benefit of its policy in relation to this
claim. Mr Watts who owned 80 per cent of the shares in the insured would thus
end up paying 80 per cent of his damages, and the costs of the District Court
proceedings.
If the insured was not liable or only liable for contribution Mr Watts would be
entitled to damages and costs which would be paid by the landlord and possibly
the GIO. As events turned out Mr Watts would have been better off had he
discontinued his District Court proceedings. By doing so he could have retained
the compensation he had already received. He also probably had rights to lump
sum compensation under s66 and s67 of the Workers' Compensation Act 1987
which he could have pursued in the Compensation Court. These rights would be
lost if and when he recovered damages from the landlord. See s151Z(1)(c).
The insured was not alerted to these risks until after the judgment. As Kirby
P has stated it would not be proper for this Court to say anything about the
position of the solicitors then acting for the insured. However the judgment
produced the worst possible result for Mr Watts and the insured.
The third party notice was sent to the GIO on 27 October 1992. Settlement
negotiations took place early in March 1993 and then ceased. The hearing before
Madgwick DCJ commenced on 17 March. Windeyer J found that on the second
or third day of the trial counsel for the insured, briefed by the solicitors taking
their instructions from the GIO, raised with counsel for Mr Watts the possibility
that the insured may only be liable to the landlord under the lease, and in that
event the GIO "may well decline to indemnify the company". He left it to Mr
16 UNREPORTED JUDGMENTS
Watts' counsel to speak to Mr Watts. Windeyer J found that notice to Mr Watts'
counsel was not "in any way notice to the company".
I will consider later the question raised by Mahoney JA as to whether the
knowledge of the solicitor and counsel acting for the insured on the instructions
of the GIO should be imputed to the insured. In any event it seems to me that
disclosure to the insured at that time would have come far too late. Such
disclosure should have been made at the latest when the settlement negotiations
commenced.
The third party notice was a statement of third party claim. Paral and para2
pleaded formalities. Para3 pleaded the lease, para4, para5, para6 and para7
pleaded the claim for contribution under the 1946 Act, and para8, para9, paral0
and paral! pleaded the claims under the lease. The notice included a claim for
"a complete indemnity".
The solicitors instructed by the GIO filed and served notice of grounds of
defence on 8 February 1993. The third party notice should have alerted the
solicitors to the contractual claims and caused them to obtain a copy of the lease.
Whoever prepared the grounds of defence should have read the relevant clause.
The GIO and the legal advisers it instructed knew that its interest arose under
a workers' compensation policy. The letter of 27 October 1992 enclosing the third
party notice was addressed to the GIO's workers' compensation department and
quoted the policy number. ParaS and para6 of the grounds of defence raised
issues under s151Z(1)(d) and s151Z(2) of the Workers' Compensation Act. The
policy was that prescribed by the Workers' Compensation (General) Reg1987 but
that continued with only formal modifications the prescribed form of policy
under the 1926 Act. It covers the insured against liability under the Act and for
many years has included what is commonly referred to as "the common law
extension". The general effect of this extension is well understood. On that
understanding it does not cover liability under a contractual indemnity such as
that contained in the lease.
The insured does not merely rely on the GIO's silence as an implied
representation. An estoppel by silence can only arise where a legally enforceable
duty to speak is owed to the party relying on the estoppel. See Morgate
Mercantile Co Ltd v Twitchings [1977] AC 890, and Thomas Australia
Wholesale v Marac Finance Australia (1985) 3 NSWLR 452. It also relies on the
GIO's conduct of the third party proceedings from 27 October 1992 until 24
March 1993 when final orders were made. The GIO was in complete control of
the litigation and acted as if the proceedings and settlement negotiations were of
no concern to the insured.
Ever since Pickard v Sears [1837] 6 Ad and E 469 (112 ER 179) it has been
clear that an estoppel can be created where one person "by his words or conduct"
causes another to believe the existence of a certain state of things and to act on
that belief. In Greenwood v Martins Bank [1933] AC 51 at 57 Lord Tomlin
referred to the need for "a representation or conduct amounting to a
representation".
The basis for estoppel by conduct has recently been extensively re-examined
by the High Court in a series of decisions. See Waltons Stores v Maher (1988)
164 CLR 387 at 398, 413, 445, 449, 450, 451, 452, and 453, Foran v Wight
(1989) 168 CLR 385 at 411,434-436, 457; and Commonwealth v Verwayen
(1990) 170 CLR 394 at 409-413, 415, 443-446, 453-454 and 480-481.
URMIIGEL WATTS FASHION AGENCIES PTY LTD v GIO GENERAL LTD (Handley JA) 17
The estoppel relied on would preclude the GIO from disputing its liability to
indemnify the insured. It could be expressed an estoppel against denying that the
insured was liable to indemnify the landlord under the 1946 Act. It would be
better expressed as an estoppel against denying the assumption that the policy
covered all the claims in the third party notice. An assumption of this nature can
support an estoppel. As long ago as 1912 Isaacs J said in Ferrier v Stewart (1912)
15 CLR 32 at 44 that:
"\.. a person's conduct has reference to an existing fact, if a given state of
things is taken as the assumed basis on which another is induced to act."
More recently in Waltons Stores v Maher at 452 Deane J said: "The doctrine
of estoppel by conduct must now be accepted as applying to preclude departure
from a represented or assumed future state of affairs in at least some categories
of case."
Then, in Commonwealth v Verwayen Deane J said at 445:
"Tn some cases, the estoppel may operate to fashion an assumed state of affairs
which will found relief... which gives effect to the assumption itself (eg where the
defendant in an action for a declaration of trust is estopped from denying the
existence of the trust)."
In the same case Dawson J said at 454:
The result of an estoppel at common law was... to preclude the party estopped
from denying the assumption upon which the other party acted to his detriment.
It followed that the party who acted to his detriment was,..., given the benefit of
the assumption.... an estoppel in equity may not entitle the party raising it to the
full benefit of the assumption upon which he relied.... To avoid the detriment
may, however, require that the party estopped make good the assumption.
The relationship between insured and insurer is an unusual one. Under the
general law each owes the other a duty to act with the utmost good faith. In most
classes of insurance this duty is now to be found in Pt2 of the Insurance Contracts
Act 1984 (C' wlth) operating of its own force or as adopted by State law. See, for
example, Insurance (Application of Laws) Act 1986 (NSW). S9(1)(e) of the
Insurance Contracts Act provides that that Act does not apply to workers'
compensation insurance. The present case is therefore governed by the general
law.
It is well known that the insured is under this duty when proposing for
insurance. The duty continues after contract for other purposes. These include
disclosure of information under a warranty relating to war risks and additional
premium (The Litsion Pride (1985) 1 Lloyds R 437 at 507-512), and the making
of claims. Thus fraudulent claims result in a forfeiture of benefits (Britton v
Royal Insurance Co [1866] 4 F and F 905 (176 ER 843) and NZ Insurance v
Forbes (1988) 5 ANZ Ins Cases 75449 (NZCA) and the insured is bound to
supply full information in connection with any claim (Leon v Casey [1932] 2 KB
576 at 579-580, 582, and Trans Pacific v Grand Union (1989) 6 ANZ Ins Cas
76252 at 76272-76273 (SCNSW Giles J)). Compare NSW Medical Defence
Union v Transport Industries Insurance (1985) 4 NSWLR 107.
The insurer owes the same duty to the insured and this also continues after
contract. See Banque Keyser v Skandia [1990] 1 QB 665 at 769-770 (CA), Bank
of Nova Scotia v Hellenic Mutual [1990] 1 QB 818 at 888-890 (CA), and Gibson
v Parkes District Hospital (1991) 26 NSWLR 9 at 34-35. The insurer thus owes
an obligation of good faith in the management of litigation conducted pursuant
to rights given by the policy. In Groom v Crocker [1939] 1 KB 194 at 203 Greene
MR said with reference to such a situation: "The effect... is,..., to give to the
18 UNREPORTED JUDGMENTS
insurers the right to decide upon the proper tactics to pursue in the conduct of the
action, provided that they do so in what they bona fide consider to be the common
interest of themselves and their assured."
Similarly, Scott LJ said at 223:
"... the Society were given... an absolute right to control their assured's
defence; but the scope of this right was... subject to certain implied... limitations.
It was not one which they would be entitled to exercise arbitrarily. They were
bound to exercise a real discretion upon each question as it arose in the conduct
of the defence, making each decision after due consideration of the circumstances
of the particular case; not, of course, consulting the wishes of the assured as if he
were an uninsured person, but taking their decisions with their minds on the facts
of the particular allegations made against him, whilst not forgetting their own
rights arising from... the policy."
This question was also considered by Stephen J in The Distillers Company v
Ajax Insurance (1974) 130 CLR 1 at 29, 31 where he said: "Where conflicts of
interest arise as between an insured and an insurer,..., the insurer must exercise
its powers under the policy with due regard for the interests of the insured... an
insurer must act in good faith towards the insured and must have regard to his
interests both in the defence of actions against the insured and in their
settlement."
Hansen v Marco Engineering (1948) VLR 198 illustrates the operation of an
estoppel against an insurer arising from its conduct of litigation which precluded
it from relying on an exclusion clause. The insurer had exercised a right to settle
the claim which would only exist on the basis of a certain assumption and the
Judge held that it would be unjust to permit the insurer to depart from that
assumption (210). At 211 Fullagar J said:
"... 1t could be said that the insurer did not intend the insured to act upon any
assumption. But it asserted a right, and the insured, because it believed itself to
be regarded as indemnified, acquiesced in the assertion of that right. That in my
opinion is sufficient. In the third place it could be said that nothing done by the
insurer induced the insured to do or abstain from doing anything. BUT THE
INSURER IN EFFECT INVITED THE INSURED TO LEAVE THE WHOLE
MATTER OF HANSEN'S CLAIM TO ITS DISCRETION, AND THE
INSURED ACCEPTED THE INVITATION." (emphasis supplied) The Judge
held that the insured had acted to its detriment because it had been "deprived of
an opportunity to do better... The insured was entitled, if it was not indemnified,
to see what it could do for itself."
It is this aspect of the decision which has attracted subsequent criticism. See
MacGillivray and Parkington on Insurance Law 8th ed. 1988 at 896-899.
However, in my respectful opinion, the criticism relates to the finding of fact
rather than to the Judge's statement of principle.
Hansen's Case was disapproved in Soole v Royal Insurance [1971] 2 Lloyds
R332 by Shaw J in dicta on the basis that there could be no "claim" covered by
a liability policy until after judgment or settlement; that the conduct of the
proceedings by the insurer was equivocal; that any representation was one of law;
and that the insured must have been aware of the terms of the policy. The first
ground has since been rejected by the Appeal Division of the Supreme Court of
Victoria in C E Heath Underwriting v Campbell (1992) 1 VR 386 at 394 and,
with respect, I agree with the Appeal Division. The view that the conduct of the
proceedings by the insurer was equivocal depended on Shaw J's conclusion that
there was no claim within the policy until its validity had been determined by
URMIIGEL WATTS FASHION AGENCIES PTY LTD v GIO GENERAL LTD (Handley JA) 19
judgment or settlement. If that is not the case then the insurer's conduct in taking
over the proceedings is not equivocal. The third point was that any implied
representation was one of law. In my respectful opinion that has no validity for
the reasons given by Jessel MR in Eaglesfield u Marquis of Londonderry [1875]
4 Ch D 693 at 702-703 especially at 702 where His Lordship said:
"\.. a misrepresentation of law is this: when you state the facts, and state a
conclusion of law, so as to distinguish between facts and law... but when you state
that as a fact which no doubt involves, as most facts do, a conclusion of law, that
is still a statement of fact and not a statement of law."
Shaw J's final reason was that the insured "must" have been aware of the terms
of the policy. There could be no detrimental reliance if the insured was
consciously aware of the terms of the policy but Fullagar J made no such finding.
If His Lordship meant that the insured had the means of knowledge then, with
respect, the statement is irrelevant because estoppels are not defeated because the
party acting to his detriment had the means of knowing the truth.
Hansen's Case and the later authorities in which it has been discussed were
fully considered by the Court of Appeal for the Northern Territory in Territory
Insurance Office v Adlington (1992) 7 ANZ Ins Cas 77,776, 109 FLR 124. The
appellant conducted proceedings brought against the respondent between May
1985 and January 1987 and then withdrew. The trial did not take place until June
1991. The trial judge was not satisfied that the insured had suffered any specific
or identifiable pecuniary loss, but held that Hansen's Case was authority for the
proposition that detriment was established because the insured had been deprived
for a time of the opportunity of doing better. The detriment relied upon was
therefore only a theoretical possibility.
With respect, I agree with the Court of Appeal that Hansen's Case is not
authority for the proposition that a real detriment, in the sense explained by
Dixon J in Thompson v Palmer (1933) 49 CLR 507 at 547, is not an essential
element in estoppel. It is clear that detrimental reliance was not established in
Adlington's Case and the finding that it was established in Hansen's Case is
debatable. Nevertheless, as the Court of Appeal recognised, the loss of a real
chance is sufficient. This must be right since damages can be awarded for such
a loss (Chapman v Hicks [1911] 2 KB 786 and Sellars v Adelaide Petroleum
(1994) 179 CLR 332) and the point was actually decided in Foran v Wight (1989)
168 CLR 385 at 413, 431-432, 436-437, and 454 followed by this Court in
Austral Standard Cables v Walker Nominees (1992) NSW Conv R59 582.
If these are the relevant principles, then it is clear that this insured will suffer
a real detriment if the GIO is permitted to depart from the assumption it induced.
There can be no doubt that the insured lost "a real chance" of achieving a better
result in the settlement negotiations than it ultimately suffered as a result of the
judgment. On 9 March 1993 the landlord's solicitors indicated to the solicitors
acting for the insured on the instructions of the GIO that the proceedings could
be settled if the GIO would contribute $10,000. This involved the GIO receiving
a payback of $2,198 from its workers' compensation payments. The GIO insisted
on a payback of $7,500. The parties were only $5,302 apart. If the insured had
been advised of the negotiations and that it was not insured against liability under
the lease it may well have agreed to contribute this amount to achieve an overall
settlement. It would have been most unwise for it not to do so. It may also have
been able to negotiate a higher contribution from the GIO in the light of the
potential liability for lump sum payments to Mr Watts under s66 and s67. In my
opinion, therefore, all the ingredients for an estoppel were present in this case.
20 UNREPORTED JUDGMENTS
The duty of the insurer in the conduct of litigation against the insured where
there is a conflict of interest in the circumstances of the present case created a
duty to speak, that is to consult the insured. To adapt the language of Fullagar J
in Hansen at 211 the GIO "in effect invited the insured to leave the whole matter
to its discretion", inducing an assumption by the insured that it was fully
indemnified, and the GIO never said or did anything to correct that assumption
until it was too late.
Mahoney JA has referred to the possibility that the insured may not be able to
establish detrimental reliance because the knowledge of the legal advisers then
acting on the instructions of the GIO could be imputed to it. In my opinion,
imputed knowledge cannot be relied upon to establish performance of a duty to
speak or a duty to correct an assumption induced by one's conduct. See generally
Moodie v Cox [1917] 2 Ch 71.
Moreover, the legal advisers instructed by the GIO only acted in the fullest
sense for both insurer and insured where they had "common interests". See
Groome v Crocker at 203. The parties had conflicting, not common, interests
with respect to the insured's liability under the lease and the legal advisers had
no authority to compromise that claim at the expense of the insured without its
actual instructions.
There are difficulties in the operation of the doctrine of imputed knowledge in
cases where an agent is acting for two principals in the same transaction. The
solicitors acting on the instructions of the GIO did not communicate with their
nominal client until after judgment. Whatever may have been their duty to the
insured, they were in fact acting at the relevant times for the GIO, and the
knowledge they acquired was not acquired in any practical sense for or in the
service of the insured. See North and South Co v Berkeley [1971] 1 WLR 470
at 484-486. In such circumstances, it seems to me that knowledge so acquired
should not be imputed to the other principal. Compare Bowstead on Agency 15th
ed. 1985 at 412-414.
In my opinion, therefore, the appeal should be allowed and orders made as
proposed by Kirby P.
1. Appeal allowed;
2. Set aside the judgment of Windeyer J;
3. In lieu thereof, declare that the plaintiff Nigel Watts Fashion Agencies
Pty Ltd is entitled to indemnity from the defendant GIO General Ltd in
respect of a judgment of $37,274 and costs ordered by his Honour Judge
Madgwick in the District Court proceedings number 791 of 1992
between Nigel Kevin Watts and John Shorter Pty Ltd;
4. Order that the respondent pay to John Shorter Pty Ltd the judgment of
$37,274 and costs ordered by his Honour Judge Madgwick in the said
proceedings;
5. Order that the defendant pay the costs of the proceedings in the Equity
Division; and
6. Order that the respondent pay the costs of the appeal but have, if
otherwise so qualified, in respect thereof, a certificate under the Suitors'
Fund Act 1951.
Counsel for the Appellant: AR Emmett QC/DP O' Dowd
Instructed by: Gye Perkes and Stone
URUIIGEL WATTS FASHION AGENCIES PTY LTD v GIO GENERAL LTD (Handley JA) 21
Counsel for the Respondent: PR Garling
Instructed by: Phillips Fox