Ensham Resources Pty Limited v AIOI Insurance Company Limited
[2012] FCA 537
At a glance
Source factsCourt
Federal Court of Australia
Decision date
2012-03-23
Before
Emmett J
Catchwords
- Number of paragraphs: 79
Source
Original judgment source is linked above.
Catchwords
Judgment (8 paragraphs)
REASONS FOR JUDGMENT 1 The applicant, Ensham Resources Pty Limited (Ensham), owns and operates an open-cut coal mine on the flood plain of the Nogoa River, near Emerald in Queensland. Heavy rainfall between 17 and 20 January 2008 caused the Nogoa River and Old Winton Creek to overflow and breach earth levees surrounding pit B, pit C and pit D of the mine, with consequent inundation of those pits by water on 19 and 20 January 2008. There was resultant loss and destruction of, and damage to, certain of Ensham's property and consequent interruption of its business. Ensham suffered loss as a consequence. 2 On 22 January 2008, Ensham gave notice to the respondents (the Insurers) of a potential claim under a policy of industrial special risks insurance entered into between Ensham and the Insurers on 17 September 2007 (the Policy). Between 18 August 2008 and 8 April 2010, Ensham made claims under the Policy. No payments have been made by the Insurers, and, on 21 September 2010, the Insurers declined cover under the Policy. On 24 September 2010, Ensham commenced this proceeding for recovery of loss alleged to be suffered as a consequence of the Insurers' failure to indemnify Ensham under the Policy. 3 The Insurers filed a defence on 9 November 2010 alleging, inter alia, that: the Policy does not cover the losses claimed; Ensham failed to comply with its duty of disclosure under the Act and made misrepresentations before the Policy was entered into; and by the operation of s 28(3) of the Act, the liability of the Insurers under the Policy is nil by reason of the prejudice suffered by the Insurers as a consequence of the misrepresentation and non-disclosure. 4 The Insurers' refusal to provide cover was made in reliance on s 28 of the Insurance Contracts Act 1984 (Cth) (the Act). Section 28 applies where a person who became the insured under a contract of general insurance upon the contract being entered into either failed to comply with the duty of disclosure or made a misrepresentation to the insurer before the contract was entered into. The duty of disclosure, under s 21 of the Act, is a duty to disclose to the insurer, before the relevant contract of insurance is entered into, every matter that is known to the insured, being a matter: that the insured knows to be a matter relevant to the decision of the insurer whether to accept the risk and, if so, on what terms; or that a reasonable person in the circumstances could be expected to know to be a matter so relevant. 5 Under s 28(2), if the failure to comply with the duty of disclosure was fraudulent or a misrepresentation made to the insurer was made fraudulently, the insurer may avoid the contract. Under s 28(3), if the insurer is not entitled to avoid the contract or, being entitled to do so, has not done so, the liability of the insurer is reduced to the amount that would place the insurer in the position in which the insurer would have been if the failure had not occurred or the misrepresentation had not been made. 6 The defence of 9 November 2010 was subsequently amended in respects that are not presently relevant. Neither in the defence of 9 November 2010, nor in any amendment, did the Insurers allege fraudulent non-disclosure or misrepresentation on the part of Ensham. However, by interlocutory application dated 25 January 2012, as amended on 7 February 2012 and 5 March 2012, the Insurers now seek leave to amend their current defence to allege that they have avoided the Policy under s 28(2) of the Act, by reason of fraudulent non-disclosure or misrepresentation on the part of Ensham. They rely on material discovered by Ensham and material produced in response to subpoenas in late 2011 and early 2012. 7 In July 2011, the Court heard an application on behalf of Ensham for orders that certain preliminary questions be heard and decided before other questions raised in the proceeding. After substantial argument, Ensham indicated that it would not press for preliminary determination of issues if an early final hearing on all issues were available. The parties agreed that they would be ready for a full final hearing to commence on 19 March 2012, and that date was fixed for the hearing. 8 The hearing of the application for leave to file a third further amended defence began on 1 February 2012, together with other interlocutory applications. The hearing was adjourned to 7 February 2012. The hearing did not finish then and was adjourned to 9 February 2012. At the end of the hearing on 9 February 2012, counsel for the Insurers foreshadowed the possibility of reformulating the proposed third further amended defence to accommodate criticisms of the pleading in its then current version. I indicated that the Insurers should provide any further version of the proposed third further amended defence to Ensham by 2pm on 10 February 2012. I gave leave to the parties to raise any problems at short notice on the afternoon of 10 February 2012, and otherwise stood over the interlocutory hearing to 16 February 2012. 9 The parties took up the invitation to raise difficulties late in the afternoon of 10 February 2012. Senior counsel for the Insurers indicated that they had not been in a position to finalise a further version of the proposed third further amended defence. However, part of that explanation was that further documents had been received by way of discovery earlier in the week. Those documents were said to have a bearing on the form of the proposed pleading. Possible further evidence in support of the application for leave to amend was foreshadowed, and the further interlocutory hearing for 16 February 2012 was confirmed. 10 On 16 February 2012, the Court was informed that both parties were of the view, possibly for different reasons, that the fixture for the final hearing commencing on 19 March 2012 was no longer feasible. Accordingly, that fixture was vacated by consent and directions were given for the further hearing of all necessary interlocutory applications, including the Insurers' application for leave to file a proposed third further amended defence, on 19 March 2012. 11 The second further amended defence of the Insurers, as it presently stands, relies on s 28(3) of the Act. Thus, paragraph 29 asserts that, as at 17 September 2007, the date that the Policy was entered into, Ensham was aware of certain matters. Paragraph 30 asserts that each of those matters was relevant to the decision of the Insurers whether to accept the insurance and, if so, on what terms, and was known to Ensham to be so relevant or, alternatively, was such that a reasonable person in the circumstances would be expected to know it to be so relevant. Next, paragraph 31 asserts that none of those matters was disclosed to the Insurers before the Policy was entered into. Paragraph 35 then asserts that, in the circumstances set out in paragraphs 29, 30 and 31, Ensham failed to comply with its duty of disclosure under s 21 of the Act. Finally, the second further amended defence asserts that, if the failure to disclose had not occurred or the misrepresentation had not been made, the Insurers would not have been liable to make any payment under the Policy and, accordingly, under s 28(3) of the Act, their liability for Ensham's claims is reduced to nil. 12 The amendments proposed include the insertion of additional matters in paragraph 29 and the insertion of paragraphs 31A, 34A and 40A. I shall set out what I understand to be the essence of the relevant allegations that would be made in the proposed third further amended defence. The language below is not a direct quotation, but is a paraphrase of my understanding of the effect of the proposed paragraphs: As at 17 September 2007, the date when the Policy was entered into, Ensham was aware of the following matters (the Relevant Matters): (b) Ensham had not finished construction of a proposed interim B pit levee in the area west of the B pit and that levee was not at a level to protect against a 1 in 100 year flood. (c) There would not be effective levee protection for the B pit in the area west of that pit at or before the time of the onset of the 2007-2008 wet season. (c1) Ensham's plan of operations for the period 1 June 2007 to 31 May 2008 (the Mining Plan) contemplated that, in that period, the interim B pit levee would be penetrated by mining activity or, alternatively, that there would be mining activity carried out in the area west of the interim B pit levee. (c7) There was a possibility that Ensham would conduct mining operations in the area west of the interim B pit levee without adequate levee protection of those mining operations from the risk of flood. (c8) There was a possibility that Ensham would temporarily remove the interim B pit levee, or part of it, in the period covered by the Policy in order to gain access to the area west of the interim B pit levee. (c9) It was possible that Ensham would carry out mining activities in the B pit area without effective levee protection from the risk of flood. (d) The levee banks around B pit were not continuous or at the height required to provide protection from a 1 in 100 year flood. 31A. The failure by Ensham to disclose the Relevant Matters or any one or more of them was fraudulent within the meaning of s 28(2) of the Act, in that the failure occurred with an intention to deceive the Insurers, or a reckless indifference as to whether or not proper disclosure to the Insurers had been made, with an intention that the Insurers act upon the disclosure provided by Ensham, in that: (b) … (i) The state of mind and knowledge of Ensham was constituted by the knowledge of one or more of Messrs Graham Morris, Peter Westerhuis, Colin Moffatt and John Seedhouse. (ii) The relevant intention to deceive or reckless indifference is to be inferred from the combination of each of: (A) The roles and responsibilities that each of Messrs Morris, Westerhuis, Moffatt and Seedhouse performed and assumed within Ensham's operations; (B) Their respective responsibility for, or participation in, the provision of disclosure to the Insurers for insurance risk assessment purposes; and (C) The obvious significance, which must have been appreciated by each of Messrs Morris, Westerhuis, Seedhouse and Moffatt, of any one or more of the Relevant Matters to the Insurers' decision to insure Ensham against the risk of damage from flood. (iii) The relevant intention to deceive or the relevant reckless indifference may be inferred from the combination of each of the following matters: (A) The fact that Ensham had strong commercial reasons to mine in the area on the west side of the interim B pit levee (the relevant area) in the period of cover of the Policy. (B) If any of the Relevant Matters had been disclosed to the Insurers, there was a real risk that the Insurers would have declined to provide cover, would have required that the Policy include an exemption or an exclusion in respect of flood, would have refused to provide cover unless until either or both of the B pit and the relevant area had adequate flood protection or would have only offered renewal on materially different terms adverse to the interests of Ensham. (C) If the risk referred to in paragraph (B) had materialised, Ensham would either have had to defer mining in the relevant area, contrary to what it had planned for the period covered by the Mining Plan, and thus would have lost the revenue that it had expected to achieve from that mining activity, or, alternatively, proceed with mining in the relevant area without the benefit of insurance, or insurance for flood cover, or with cover on materially different terms, which would have exposed it to the risk of catastrophic and uninsured loss leading to flood, which it did not wish to occur. (D) Each of Messrs Morris, Westerhuis, Moffat and Seedhouse had knowledge of each of the matters referred to in paragraphs (A), (B) and (C). 34A. By reason of the matters referred to in paragraph 31A, the Insurers were entitled to, and have, avoided the Policy under s 28(2) of the Act, by letter dated 25 January 2012 from the solicitors for the Insurers to the solicitors for Ensham. 40A. By reason of the Insurers' avoidance of the Policy, the Insurers are not liable to indemnify Ensham. 13 Each of the matters referred to in paragraph 29(b), (c) and (d) was in the second further amended defence. Proposed paragraphs 29(c1), (c7), (c8) and (c9), however, are additions. 14 Paragraph 31A(b)(iii) above is an addition to the proposed third further amended defence that was propounded by the Insurers following matters raised in the course of argument on 20 March 2012. Clearly, a distinction is to be drawn between fraudulent intent, on the one hand, and the motive for such fraudulent intent. While fraudulent intent in making a misrepresentation or failing to disclose is an essential element, the motive for making the misrepresentation or failing to disclose is not an essential element. On the other hand, in so far as motive is relied upon as a basis for drawing an inference as to fraudulent intent, the motive should be particularised in relation to any relevant state of mind. Hence, in paragraph 31A(b)(iii), the Insurers particularise the motive of Ensham that they say gives rise to an inference of fraudulent intent in relation to the alleged non-disclosure. 15 The basis for the application to amend at this late stage is that, until certain documents that were received in late 2011 and in early 2012 had been examined by the solicitors for the Insurers, the Insurers were not in a position to allege fraudulent or reckless non-disclosure or misrepresentation. Ensham asserts, on the other hand, that all of the essential facts that now give rise to the allegation of fraudulent non-disclosure were known to the Insurers at the time when the original defence was filed on 9 November 2010. That being so, it says, there is no explanation for the delay. Delay is particularly serious where a party seeks to plead fraud at a late stage in a proceeding. An amendment to add an allegation of fraud should not normally be permitted where the facts giving rise to the plea of fraud were all known at the time of the original pleading. Fraud is a very serious allegation to make against a person and may, if not raised at the outset, be difficult to investigate properly at a later stage in the proceeding. The more serious the allegation that is made, the more clearly satisfied must the Court be that no prejudice will be caused that cannot be compensated for in some satisfactory way, before allowing a proposed amendment (see Atkinson v Fitzwalter [1987] 1 WLR 201 at 210 and 219).