On March 16, 2017, the U.S. District Court for the Northern District of Georgia released its decision in InComm Holdings, Inc. v. Great American Insurance Company. The Court held that Great American's computer fraud coverage did not respond where holders of prepaid debit cards used multiple simultaneous telephone calls to exploit a coding error in the insured's computer system, thereby fraudulently increasing the balances on the cards. The Court also applied the recent appellate decisions in Apache (see our October 24, 2016 post) and Pestmaster (see our August 4, 2016 post) in holding that the loss scenario did not meet the direct loss requirement in the computer fraud insuring agreement.
InComm was a debit card processor. Individuals could purchase prepaid debit cards issued by banks and then utilize InComm's system to load funds onto those cards. InComm's processing system consisted of an Interactive Voice Response (IVR) system and an Application Processing System (APS). The IVR system permitted cardholders, using telephone voice commands or touchtone codes, to load credit onto their cards. The APS provided transaction processing in respect of transaction instructions received through the IVR system. After the APS carried out the requested instruction, it would communicate the result to the IVR system, which would then report the result to the cardholder.
To add value to a card, a cardholder could purchase a chit from a retailer, which would then relay the funds to InComm by transferring them to an account maintained by InComm with Wells Fargo. To redeem the chit, the cardholder would call the IVR system and provide the unique PIN printed on the chit. The IVR system would then relay the information to the APS, which would verify the data and then add the value of the chit to the card.
After a chit is redeemed, InComm transfers the equivalent amount of funds to the bank that issued the card. The funds are then maintained by the issuing bank for the benefit of the cardholder until the cardholder makes a purchase, at which point the issuing bank remits funds to the vendor. InComm is not involved in payments by banks to vendors.
InComm contracted with Bancorp to serve as program manager for cards issued by Bancorp. When a Bancorp cardholder redeemed a chit, InComm would transfer the equivalent dollar amount from its Wells Fargo account to a special settlement account held at Bancorp in Bancorp's name. The InComm-Bancorp contract provided that "[Bancorp] shall hold all Cardholder Balances in a fiduciary or custodial manner on behalf of [InComm] as holder[ ] of the Cardholder Balances for the benefit of Cardholders" and that "all Cardholder Balances shall be held in trust for the benefit of the Cardholders".
For a period of several months in 2013 and 2014, there was a coding error in the IVR system which permitted a chit to be redeemed multiple times. Cardholders could exploit the coding error by making multiple simultaneous telephone calls to the IVR system, redeeming their chit multiple times, and obtaining multiples of the value of the chits, which were then used by the cardholders to make purchases. As a result of the misuse of the IVR system, InComm wired $10,769,039 to Bancorp in connection with these fraudulent transactions. Bancorp transmitted most of these funds to vendors, but currently retains $1,880,769 of the wrongfully-redeemed funds in its trust account.
The Computer Fraud Coverage
InComm submitted a claim under its computer fraud coverage, which provided that Great American would:
... pay for loss of, and loss from damage to, money, securities and other property resulting directly from the use of any computer to fraudulently cause a transfer of that property from inside the premises or banking premises:
a. to a person (other than a messenger) outside those premises; or
b. to a place outside those premises.
Great American reasoned that the cardholders had not engaged in computer fraud within the meaning of the policy, as they had utilized telephones, not computers, to make the calls. Great American also took the view that any loss to InComm was not a loss "resulting directly" from computer fraud. The Court accepted Great American's position on both issues.
Relying on the Ninth Circuit's recent Pestmaster decision, the Court held that the cardholders' telephone usage could not be construed as the "use" of a computer, notwithstanding that their telephones were ultimately communicating with a computer system:
"Use" also is not defined in the Policy. The word commonly is defined as to "take, hold, or deploy (something) as a means of accomplishing or achieving something; ... A person thus "uses" a computer where he takes, holds or employs it to accomplish something. That a computer was somehow involved in a loss does not establish that the wrongdoer "used" a computer to cause the loss. To hold so would unreasonably expand the scope of the Computer Fraud Provision, which limits coverage to "computer fraud." Cf. Pestmaster ... ("Because computers are used in almost every business transaction, reading [a computer fraud insurance policy] provision to cover all transfers that involve both a computer and fraud at some point in the transaction would convert this Crime Policy into a 'General Fraud' Policy."). It also would violate the Court's obligation to read the Policy "as a layman would read it and not as it might be analyzed by an insurance expert or an attorney." ... Lawyerly arguments for expanding coverage to include losses involving a computer engaged at any point in the causal chain — between the perpetrators' conduct and the loss — unreasonably strain the ordinary understanding of "computer fraud" and "use of a[ ] computer". ...
The Policy does not cover InComm's losses resulting from the unauthorized redemptions, because the cardholders used telephones, not computers, to perpetrate their scheme. [emphasis added]
The Court also held that InComm had not established that it had sustained a loss "resulting directly" from the cardholders' conduct. The Court observed that, under the terms of InComm's contract with Bancorp, InComm retained an interest, as trustee, in the funds so long as they continued to be held by Bancorp. Consequently, a transfer from InComm's Wells Fargo account to Bancorp was not itself a loss. The earliest that a loss could occur was when funds were paid out by Bancorp to vendors to settle the cardholders' expenditure of the fraudulently-redeemed chits.
The Court continued:
This conclusion is underscored by the fact that funds wired to Bancorp, as a result of the fraudulent chit redemptions, are still in the Bancorp Account almost three years after the chits were wrongfully redeemed. That is, these funds have not been lost. InComm's loss thus did not result "directly" from the fraudulent redemptions, because it occurred only after InComm wired money to Bancorp, after the cardholder used his card to pay for a transaction, and after Bancorp paid the seller for the cardholder's transaction. ... The losses here did not occur when funds were sent to Bancorp's premises. They occurred when funds were sent, by Bancorp, to the premises or accounts of merchants from which cardholders purchased goods or services. [emphasis added]
The Court also observed that, even if the loss had occurred earlier in the process (i.e., when the funds left Wells Fargo), the loss still did not result directly from the chit redemptions. Great American pointed out that those fraudulent redemptions did not automatically transfer funds to issuers like Bancorp. A redemption did not reduce the available assets in InComm's hands; instead, a redemption only triggered InComm's contractual obligation to an issuer to fund the redemption.
The Court agreed. Relying on Pestmaster and Apache, the Court held that:
... InComm's loss resulted directly — that is, immediately — from InComm's decision to wire the funds to Bancorp, not from the cardholders' redemptions. Apache, and the cases it discusses, warn that to find coverage based on the use of a computer, without a specific and immediate connection to a transfer, would effectively convert a computer fraud provision into a general fraud provision. ... To accept InComm's argument that the cardholders' fraudulent redemptions resulted directly in the transfer of funds from InComm to Bancorp — where InComm itself chose to make the transfer — would violate the admonition in Apache and the other cases addressing computer fraud coverage.
The computer fraud insuring agreement in InComm's policy is identical to the one at issue in Apache. Apache involved a social engineering fraud where someone impersonating a representative of Apache's vendor sent "new" bank information to Apache via email, resulting in invoice payments being misdirected. In that case, the Fifth Circuit pointedly used language to lay the loss at the feet of the insured:
Doubtless, had the confirmation call been properly directed, or had Apache performed a more thorough investigation, it would never have changed the vendor-payment account information. Moreover, Apache changed the account information, and the transfers of money to the fraudulent account were initiated by Apache to pay legitimate invoices ... Arguably, Apache invited the computer-use at issue, through which it now seeks shelter under its policy, even though the computer-use was but one step in Apache's multi-step, but flawed, process that ended in its making required and authorized, very large invoice-payments, but to a fraudulent bank account.
Similarly, the Court in InComm noted that:
InComm chose to wire funds to Bancorp because it was contractually required to do so and because, despite any reconciliation or verification process it had in place, it believed the redemptions were legitimate.
Then, borrowing language from Apache, the Court stated:
As in Apache, "the authorized transfer was made to the [Bancorp] account only because, after receiving [notice of the duplicate chit redemptions], [InComm] failed to investigate accurately new, but fraudulent, information provided to it." [emphasis added].
Not only did the Apache and InComm courts refuse to find an "immediate" relationship between the alleged conduct and the claimed losses, they each observed that investigatory lapses on the part of the insureds could be considered intervening and superseding causes of their losses.
Although it arises from a rather complicated set of facts and legal relationships, InComm provides helpful general guidance on both the "use of a computer" and the "direct loss" requirements found in computer fraud insuring agreements.
The courts in Apache and Pestmaster recognized that computers are involved in virtually every business transaction, and that interpreting computer fraud coverage to cover every loss that involves both a computer and fraud at some point in the transaction would turn such coverage into a "general fraud policy". The Court in InComm built on this insight by interpreting "the use of any computer to fraudulently cause a transfer" to require the fraudster's use of a computer, not the use of a telephone to interact with the insured's computer.
Further, the Court implicitly applied a "direct means direct" causation approach in finding that the loss was not one resulting directly from the cardholders' conduct. This is underscored by the Court's requiring a "specific and immediate connection" between the conduct and the loss, which could not be established, given the intervening steps which occurred here.
[Editors' Note: Our guest co-author, John Tomaine, is the owner of John J. Tomaine LLC, a fidelity insurance and civil mediation consultancy in New Jersey. After over thirty-one years with the Chubb Group of Insurance Companies, he retired as a Vice President in 2009. He is an attorney admitted in Connecticut and New Jersey, and holds a Master's Degree in Diplomacy and International Relations. He is available to serve as an expert witness in fidelity claim litigation and to consult on fidelity claim and underwriting matters.]
InComm Holdings, Inc. v. Great American Insurance Company, 2017 WL 1021749 (N.D. Ga.)
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