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Bracero Martinez v. US Fidelity Guaranty, 93-1791 (1994)

Court: Court of Appeals for the First Circuit Number: 93-1791 Visitors: 5
Filed: Jun. 15, 1994
Latest Update: Mar. 02, 2020
Summary:  USF G denied coverage, asserting that the policy listed the law firm as the named insured and did not cover Fieldman when he was vacationing in Puerto Rico, was utilizing a rented car, and was not engaged in partnership business.
USCA1 Opinion









June 14, 1994
[NOT FOR PUBLICATION]

UNITED STATES COURT OF APPEALS
FOR THE FIRST CIRCUIT
____________________

No. 93-1791

SYLVIA BRACERO MARTINEZ, ET AL.,

Plaintiffs, Appellees,

v.

PUERTO RICAN CARS, INC., ET AL.,

Defendants, Appellees.

__________

UNITED STATES FIDELITY & GUARANTEE CO.,

Defendant, Appellant.

____________________

APPEAL FROM THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF PUERTO RICO

[Hon. Gilberto Gierbolini, U.S. District Judge]
___________________

____________________

Before

Selya, Cyr and Boudin,

Circuit Judges.
______________

____________________

Richard A. Sherman, Rosemary B. Wilder, Law Offices of Richard A.
__________________ __________________ _________________________
Sherman, P.A., Armando Lasa and Lasa, Escalera & Reichard on brief for
_____________ ____________ _________________________
appellant.
Dario Rivera-Carrasquillo, Cordero, Miranda & Pinto, Ramon L.
__________________________ __________________________ _________
Walker-Merino, Reichard, Calaf & Walker, Marcos Valls-Sanchez and
_____________ __________________________ _____________________
Cobian & Valls on joint brief for appellees.
______________

____________________


____________________















BOUDIN, Circuit Judge. This case involves a dispute
_____________

about insurance coverage arising out of a motor vehicle

accident in Puerto Rico. The appellant United States

Fidelity & Guaranty Company ("USF&G") is an insurance carrier

which, along with other carriers, was held liable for a

portion of the judgment in favor of the victims. USF&G

contends that its policy did not cover the accident at all

and, alternatively, disagrees with the apportionment of

liability among insurers. On both issues--liability and

apportionment--we conclude that the district court reached

the right result on the unusual record before it and affirm.

I.

In August 1987, George Fieldman, a resident of New

Jersey, went on vacation to Puerto Rico with his family,

including his stepdaughter, Theresa Blacketor. Fieldman

rented a car from Puerto Rican Cars, Inc., and allowed

Blacketor to drive it as well. On August 30, 1987, Blacketor

was driving the car with Fieldman in the passenger seat when

she collided with a car driven by Luis Cordova Munoz

("Cordova"). Cordova and two of his passengers were

seriously injured. Another passenger was killed.

In August 1988, Cordova, the injured passengers and

representatives of the deceased passenger ("the plaintiffs")

filed lawsuits against Blacketor, Fieldman, Puerto Rican

Cars, and three insurance companies. The insurers were



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Farmers' Insurance Exchange ("Farmers"), Blacketor's insurer;

CNA Casualty of Puerto Rico ("CNA"), which insured Puerto

Rican Cars and had also issued a policy to Fieldman when he

rented the car; and USF&G, which had issued a policy to

Weiner, Ostrager, Fieldman, and Zucker, the New Jersey law

firm in which Fieldman is a partner.

After the cases were consolidated, Fieldman filed a

claim against USF&G, contending that he was covered under the

law firm's automobile insurance policy. USF&G denied

coverage, asserting that the policy listed the law firm as

the named insured and did not cover Fieldman when he was

vacationing in Puerto Rico, was utilizing a rented car, and

was not engaged in partnership business. The meaning of the

USF&G policy, as written and as allegedly implemented, is the

main subject of this appeal.

On April 9, 1990, Fieldman moved for summary judgment

against USF&G. He was joined by Blacketor, who argued that

she too was covered by the USF&G policy because she was

driving Fieldman's rented car with his permission. Fieldman

included with his motion a statement of uncontested material

facts, asserting that USF&G had regularly paid claims under

the policy for family members of individual partners in

accidents unrelated to partnership business. USF&G did not

contest this portion of the statement, but opposed summary





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judgment on the ground that the insurance policy did not

cover the non-business accident in this case.

The magistrate judge to whom the case was referred

issued his report on June 13, 1990, recommending that summary

judgment be entered in favor of Fieldman. He concluded that

the USF&G policy was ambiguous and, applying Puerto Rico law,

he construed the policy in favor of Fieldman. Alternatively,

the magistrate judge said that because of USF&G's prior

payment of claims for partners' family members, USF&G was

estopped from arguing that coverage was limited to

partnership-related activities. The district judge adopted

the report on July 5, 1990.

Both USF&G and Blacketor filed motions for

reconsideration under Fed. R. Civ. P. 59(e). USF&G again

argued that the policy did not cover the accident, while

Blacketor asked for a ruling that she, like Fieldman, was

covered by the USF&G policy. Both requests were denied on

February 4, 1991, and the district court entered judgment in

favor of Fieldman on February 20, 1991. On May 31, 1991,

USF&G filed a motion to modify the judgment under Fed. R.

Civ. P. 60(b)(6), relying upon new evidence to explain

USF&G's past practice. The magistrate judge recommended a

denial of this motion on December 10, 1991, and the district

judge concurred on April 1, 1992.





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In the meantime, the parties reached a global settlement

as to most issues. It provided that (1) the plaintiffs would

receive a total of $750,000 to be divided among themselves,

and (2) the insurance carriers together would contribute that

sum and then litigate among themselves to apportion shares.

On April 18, 1991, the district judge approved the

settlement. The court ordered Farmers and CNA to contribute

$300,000 each, and USF&G to contribute $150,000. These

payments were provisional. The court reserved final decision

on how the $750,000 liability should be shared among the

insurers.

Finally, on June 17, 1993, the district judge ruled that

each insurer should bear a share of the settlement allocated

in proportion to its own policy's upper liability limit.

This placed the greatest burden on CNA, which had issued two

policies, each with a $300,000 limit. USF&G, however, also

bore a greater burden than its initial contribution because

its policy carried a limit of $500,000; based on the upper

limits of the policies, USF&G's policy represented 5/14ths of

the total coverage; and its share of the total settlement was

5/14th of $750,000 or $267,857.14. The court's final tally

was as follows:



Carrier Policy Limit Insured Liability Share
_______ ____________ _______ _______________

USF&G $500,000 Fieldman $267,857.14



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CNA $300,000 Fieldman $160,714.29

CNA $300,000 PR Cars $160,714.29

Farmers $300,000 Blacketor $160,714.29
__________

$1,400,000 $749,999.91
__________



The court ordered USF&G to reimburse Fieldman for legal

expenses. In addition, the court ruled that Blacketor was

also covered under the partnership policy and ordered USF&G

to reimburse Farmers for expenses incurred by Farmers in

defending Blacketor. A final judgment was entered the same

day. This appeal by USF&G followed.1

II.

In this court, USF&G's main argument is that its policy

did not cover either Fieldman or Blacketor for the accident

in question. In substance it contends that the policy

clearly excluded coverage, that any past practice suggesting

coverage for non-business accidents was adequately explained,

and that no estoppel has been made out against USF&G. In

this quite unusual case, we think that USF&G has left the

record in such a posture that liability could properly be


____________________

1Following the appeal, it appears that CNA advised the
district court that its Puerto Rican Cars policy limit was
$500,000, rather than the $300,000 assumed by the district
court. A motion to adopt amended figures has been filed
without opposition but has not yet been granted. The
substitution of the asserted new figures--CNA ($375,000),
USF&G ($234,375) and Farmers ($140,625)--would not affect the
issues presented on this appeal.

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imposed upon it and that its efforts to correct the situation

came too late.

We start, as is proper in contract cases, with the

policy language. The USF&G insurance contract was entitled

"Business Auto Policy," and Fieldman's law firm was listed in

item 1 as the "named insured," the firm's business address

being given as the named insured's address. The policy

stated that "you are an insured for any covered auto," and

that "`you' and `your' mean the person or organization shown

as the named insured . . . ." For liability coverage,

defined in detail elsewhere in the policy, USF&G promised

that it "will pay all sums the insured legally must pay"--up

to the policy limit--on accidents involving covered

automobiles.

Which automobiles were "covered" was the subject of item

2 of the policy, entitled "Schedule of Coverages and Covered

Autos." The definition of covered auto depended on the type

of insurance coverage. For liability coverage, "covered

autos" were said to include "ANY AUTO." Putting items 1 and

2 together with the basic definition of liability coverage,

the policy by its terms insured the law firm of Weiner,

Ostrager, Fieldman and Zucker against liability for accidents

involving any automobile. Nothing else in the lengthy policy

casts much light on the issue before us.





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If the language of the policy were taken in isolation,

we would agree with USF&G that the policy would not cover

liability incurred by a partner in the course of

transportation unrelated to the partnership's business. The

reason is that the policy insures the partnership against

liability due to automobile accidents. In the normal case

the partnership would be liable for automobile accidents

growing out of the conduct of its law firm business, but no

one suggests that Fieldman's Puerto Rico vacation trip falls

into that category or that the partnership bears any

liability in this case. See Burnsed v. Florida Farm Bureau
___ _______ ____________________

Cas. Ins. Co., 549 So. 2d 793 (Fla. App. 5th Dist. 1989).
____________

But Fieldman and Blacketor have a second string to their

bow. They argue that whatever the bare language of the

policy, its actual implementation by USF&G was broader; that

USF&G in fact regularly had extended coverage in the past to

any family member driving a partner's car with his permission

regardless of whether partnership business was being

conducted at the time of the accident. This allegation

underpins two doctrinally separate arguments. One argument

is that the policy, properly interpreted in light of actual

performance, has this wider meaning; and the other is that

USF&G is estopped to claim otherwise.

To show past practice Fieldman's summary judgment filing

asserts that when the USF&G policy was issued, Fieldman was



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given to understand that it covered all the automobiles of

the partners; that these included three of his own cars, two

of which were used by his wife and himself but never on

partnership business; that insurance coverage certificates

were furnished for these cars as required by New Jersey law;

and that USF&G paid claims without question on accidents,

unrelated to partnership business, where his wife was the

driver.

Remarkably, when USF&G filed its opposition, it did not

trouble to address these contentions directly. Rather, it

asserted that the policy did not cover non-business

accidents, adding cryptically:

"In this particular case, the law firm
did not hire the vehicle, nor did one of
the partners hire the vehicle for the law
firm. However, the autos described in
the schedule of covered autos are assured
under the insurance policy
notwithstanding the purpose of the use
given to them."

The first question that arises in considering Fieldman

and Blacketor's "past practice" argument is whether the USF&G

policy so clearly excluded coverage that no extrinsic

evidence is admissible to construe it. Extrinsic evidence

comes in different types and weight, and ambiguities vary

both in kind and degree. In truth, the law on questions of

ambiguity and extrinsic evidence is clouded in confusion:

courts often do not agree with one another and what they




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assert as doctrine cannot always be squared with what they do

in practice. 3 A. Corbin, Contracts 542A (1960).
_________

The precedents in the jurisdictions concerned2 leave

us doubtful whether in the first instance New Jersey or

Puerto Rico courts would admit evidence as to how the policy

was actually implemented in order to vary the meaning of this

seemingly clear policy (estoppel is another matter). The

"practical construction" of contract language, as evidenced

by the parties' actions, is often said to deserve "great

weight," A. Farnsworth, Contracts 7.13 at 535 (1990). But
_________

while the New Jersey and Puerto Rico courts often consider

past practice, courts in both jurisdictions have said that

insurance policies should be construed according to their

language unless they are found to be ambiguous.3

In all events, we need not definitively resolve the

extrinsic-evidence issue because in this case we face a


____________________

2We say "jurisdictions" because this appeal has been
briefed on the premise that Puerto Rico law governs the
interpretation of the USF&G agreement. This assumption is at
least doubtful: the policy was made in New Jersey to provide
automobile insurance for a New Jersey law firm. There is no
indication that Puerto Rico has any connection with either
the insurer or the law firm that would lead its courts to
apply Puerto Rico law to the policy.

3Compare Flint Frozen Foods, Inc. v. Firemen's Ins. Co.,
_______ ________________________ __________________
86 A.2d 673, 674 (N.J. 1952) (terms of policy govern) and
Velez-Gomez v. SMA Life Assur. Co., 8 F.3d 873 (1st Cir.
___________ _____________________
1993) (same under Puerto Rico law) with Kearny PBA Local No.
____________________
21 v. Town of Kearny, 405 A.2d 393, 400 (N.J. 1979)
__ ________________
("polestar" is intent of parties descended by any means
including "the parties' conduct"), and Merle v. West Bend
_____ _________
Co., 97 P.R.R. 392, 399 (P.R. 1969) (same).
___

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singular circumstance: USF&G has admitted that the policy
________

does not mean what its language seems to say. After

reconsideration had been denied by the district court,

someone at USF&G apparently woke up and realized that the

record did not reflect an adequate explanation of USF&G's

past payment of non-business claims under the policy. On May

31, 1991, USF&G filed a motion for relief from judgment under

Fed. R. Civ. P. 60(b)(6). This motion for the first time

spelled out a possible explanation by USF&G to Fieldman's

claim relating to USF&G's past practice. The motion prefaced

this answer by saying blandly that previously "the evidence

supporting USF&G's position could not be obtained for reasons

beyond [USF&G's] control. Finally, it was obtained."

The evidence, USF&G's motion asserted, showed that prior

claims paid under the policy, to cover accidents by Fieldman

family members unrelated to the partnership's business, were

paid because the policy covered certain listed automobiles,

additional premiums were paid for this coverage, and "[o]nly

in these circumstances did USF&G paid (sic) claims not

related to the business." Attached were several pages from

the policy and some documents relating to family member

claims previously submitted to USF&G pertaining to specific

cars.4


____________________

4The pages from the policy show that certain cars were
listed as owned by "the insured" but the policy does not
explain that these are actually owned not by the insured (the

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The USF&G motion, read generously, may be taken to claim

that the insurance policy provided two different categories

of liability coverage: first, it covered "any" automobile

(owned or rented or borrowed) being used in connection with

partnership business; and second, based on an additional

premium, the policy covered listed automobiles (apparently

owned by individual partners) for all accidents, whether

driven by a partner or family member and whether or not the

use had any connection with the partnership's business.

Based on the information we have today--it still may not be

complete--one might guess that the insurer "pancaked" a

second layer of coverage on the underlying business policy

but did not spell out this coverage in precise language.

Thus the policy covered some non-business automobile

liability but did not clearly define the limits of that

coverage.

However one might construe the policy language judged in

a vacuum, we think that it would be patently unjust in this

unusual case to conclude that the policy language limits

liability to business-related accidents where, as here, the

insurer has admitted that the policy does cover non-business

accidents in some circumstances. If we limit our

consideration of actual practice to the statements of


____________________

law firm) but by individual partners. Nor does the policy
provide explicitly that these cars are covered for non-
business use.

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Fieldman in his summary judgment motion--statements not

unexpectedly very favorable to his interpretation--then past

practice resolves the matter in his favor.5 The question

remains whether the Rule 60(b) motion should have been

granted, entitling USF&G to the benefit of its description of
___

actual performance and therefore to a trial to resolve the

factual conflict.

The Rule 60(b) motion was vigorously opposed, Fieldman

claiming that it was untimely and denying by affidavit that

any additional premiums had been paid. The motion was

referred to the magistrate judge who on December 10, 1991,

recommended that it be denied: he said that USF&G had had

the duty to controvert Fieldman's contentions at the time it

answered his summary judgment motion; that USF&G had

possessed then the documents now belatedly offered; and that

nothing in the Rule 60(b) motion disproved USF&G's payment of

claims unrelated to the partnership business. On review, the

district court summarily upheld the magistrate judge.





____________________

5We ignore the possibility that what Fieldman might have
been entitled to is a jury trial and not a summary judgment
in his favor. When and whether the district court should
take a contract issue to be a matter for the judge rather
than the jury where the contract is ambiguous but the
illuminating extrinsic evidence is undisputed and presents
issues of some difficulty. USF&G has not sought reversal on
the ground that the issue of policy interpretation on
undisputed facts was for the jury rather than the judge, and
we will not pursue this possibility further.

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The USF&G argument and supporting documents offered in

the Rule 60(b) motion might, if timely offered, have required
_________________

the district court to deny Fieldman's summary judgment

motion. One could argue that the policy language does not

directly spell out USF&G's theory of coverage and that at the

very least an affidavit should have been supplied to show

that an extra premium was paid and that the only non-business

claims ever paid were for listed automobiles. On the other

hand, a cautious district judge would likely have declined to

grant summary judgment for Fieldman once USF&G had coherently

explained its payment of past non-business claims.

But the explanation by USF&G, and the limited support

for it, came too late. The time for USF&G to submit its

opposition was in April 1990, not in May 1991, long after the

summary judgment motion had been granted. Nothing in this

record even begins to show due diligence by USF&G, or to

explain why it did not offer its rationale and documents at

the proper time. Teamsters v. Superline Transp. Co., 953
_________ ______________________

F.2d 17 (1st Cir. 1992).6 The notion that after several

years of litigation the district court should start over to

consider this new submission is without basis. Thus, we need
___


____________________

6The motion, although filed under Rule 60(b)(6), appears
more properly based on "excusable neglect" under Rule
60(b)(1), although the neglect here has not been excused. In
any event the motion certainly does not demonstrate the
"extraordinary circumstances" required for a motion under
Rule 60(b)(6). See Gonzalez v. Walgreens Co., 918 F.2d 303,
___ ________ ____________
305 (1st Cir. 1990).

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not reach the estoppel claim asserted by Fieldman, a claim

whose reliance requirement might prove to be a considerable

obstacle for Fieldman (given his own purchase of insurance

from CNA when renting the car in question).

Blacketor, as well as Fieldman, is entitled to coverage

under the USF&G policy for legal expenses. In light of the

construction of the policy achieved by Fieldman, Blacketor is

covered under the "omnibus clause" of the insurance policy.

That clause, with irrelevant exceptions, extends coverage to

"[a]ny one . . . using with your permission a covered auto

you own, hire or borrow". USF&G has not denied that

Blacketor was driving the auto with Fieldman's permission.

Whether some division of the expenses between USF&G and
________

Farmers should have been ordered has not been argued on this

appeal.

This outcome may appear at first blush to be a harsh one

for USF&G, for it could well have deserved to prevail on the

literal language of the policy, had it not admitted that the

policy goes beyond business use. At the same time, if given

the full benefit of its Rule 60(b) assertions, it might at

least be entitled to a remand for a trial on the factual

issues posed by the conflict between the Fieldman affidavit

and the Rule 60(b) motion. See generally U.S. Fire Ins. Co.
_____________ ___________________

v. Producciones Padosa, Inc., 835 F.2d 950, 953 (1st Cir.
__________________________





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1987). It has managed instead to achieve the worst of both

worlds.

Few tears should be shed for USF&G. Its original

assertions could easily have led a court to believe that the

policy was limited to business use although USF&G now admits

that the policy was not so limited. Its quite different

description of the situation occurred only after it had lost

before both the magistrate judge and the district court, and

even then the explanation is poorly supported. There is no

reason why other parties should be forced in these

circumstances to face the expense of further litigation to

determine whether USF&G's belated explanation is correct.

III.

USF&G contends that even if it is liable under its

policy, the insurance coverage should not be apportioned

according to the upper coverage limits of each policy.

Instead, it argues inter alia that each insurer should pay
_____ ____

equally up to the policy limits of that insurer's policy,

with the higher-limit insurer making up the balance. On this

issue, we follow the parties in treating Puerto Rico law as

determinative.7


____________________

7This issue, unlike the question of USF&G's policy
coverage, involves a rule to apportion liability where
several different contracts (including two made in Puerto
Rico) conflict as applied to an accident occurring in Puerto
Rico. Since all parties agree that Puerto Rico law controls,
we forego an independent choice of law analysis. See, e.g.,
___ ____
Commercial Union Ins. v. Walbrook Ins. Co., 7 F.3d 1047, 1048
_____________________ _________________

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Each of the policies, we are told, contains an "other

insurance" clause which provides that for this accident the

insurer's liability will only be in excess in amounts due

under other policies.8 See generally Hennes Erecting Co. v.
_____________ ___________________

National Underwriters Fire Ins. Co., 813 F.2d 1074, 1077
______________________________________

(10th Cir. 1987). This "after you, Alfonse," tactic has not

impressed the courts, which often nullify "other insurance"

clauses when they conflict. See R. Keeton & A. Widiss,
___

Insurance Law 3.11(a)(3), at 258-59 (1988). The district
_____________

court properly refused to take these clauses literally, and

the parties do not directly dispute this refusal.

The question, then, is how a court in Puerto Rico would

apportion liability among carriers where liability is less

than the total amount of coverage provided by those policies.

The other insurance carriers rely upon the rule, followed in


____________________

n.1 (1st Cir. 1993).


8The "other insurance" clause of the USF&G policy, the
only policy furnished to us on appeal, states:

1. For any covered auto you own this policy
auto you
provides primary insurance. For any
covered auto you don't own, the insurance
auto you
provided by this policy is excess over
any other collectible insurance . . . .

2. When two or more policies cover on the
same basis, either excess or primary, we
we
will pay only our share. Our share is
our Our
the proportion that the limit of our
our
policy bears to the total of the limits
of all the policies covering on the same
basis.

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a majority of jurisdictions, that liability should be

prorated according to the upper limits of the policies. See,
___

e.g., St. Paul Mercury Ins. Co. v. Underwriters at Lloyds of
____ _________________________ _________________________

London, 365 F.2d 659 (10th Cir. 1966); R. Keeton & A. Widiss,
______

supra, 3.11(a)(3). USF&G offers several theories aimed at
_____

reducing its share. The district court followed the majority

rule.

Interestingly, the USF&G policy (quoted above) itself

provides that the majority rule, apportioning liability based

on the upper limit of each policy, should be applied where

two or more policies cover the accident on the same basis,

either excess or primary. If (as represented to us) each of

the policies at issue here treats its coverage as excess,

then arguably USF&G has contracted for the very apportionment

rule applied by the district court in this case. Cf. Aviles
___ ______

v. Burgos, 783 F.2d 270, 282 (1st Cir. 1986) (where the
______

policies adopt the same apportionment rule it governs

automatically).

The parties have not cited to us any caselaw from Puerto

Rico courts that directly governs the apportionment issue.

The majority rule has been questioned, see Reliance Ins. Co.
___ _________________

v. St Paul Surplus Lines Ins. Co., 753 F.2d 1288 (4th Cir.
________________________________

1985) (adopting the so-called equal shares rule); and a

leading treatise has said that the majority rule is "open to

question in a number of contexts." Keeton & Widess, supra,
_____



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3(11)(e). In truth, we have little basis for saying

confidently how Puerto Rico would resolve the issue.

In the present case, we are not disposed to look beyond

the majority rule invoked by the district court. It is still

the governing rule in most jurisdictions, and none of the

alternatives proposed appears to be without some

shortcomings. The majority rule is also the rule stipulated

by the USF&G policy for cases where each of the conflicting

policies purports to disclaim primary coverage. Absent

guidance from the Puerto Rico courts or a more persuasive

case for reexamining that rule, we think that Puerto Rico

should be assumed to follow the majority rule.

Affirmed.
________



























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Source:  CourtListener

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