Acadia Insurance Company v. Hinds County School Di

582 F. App'x 384
Court of Appeals for the Fifth Circuit·Decided September 17, 2014·No. 13-60286, 13-60481·Unpublished·Cited by 6 cases

Opinions

PER CURIAM: *

This case involves the scope of two different insurers’ obligations to defend and indemnify Hinds County School District (“HCSD”) -with respect to the Coward family’s claims. The two insurers are called Ace American and Acadia. Both insurers filed motions for summary judgment arguing that their respective insurance policies did not cover the Coward family’s claims. The district court granted both motions. The district court also denied HCSD’s motion for leave to amend its pleading to include a counterclaim against Acadia for a breach of the duty of good faith and fair dealing.

As explained below, we affirm the district court’s grant of Ace American’s motion for summary judgment. By contrast, we reverse the district court’s grant of Acadia’s motion for summary judgment. Finally, we affirm the district court’s denial of HCSD’s motion for leave to amend because its proposed counterclaim against Acadia would have been futile.

I.

The Coward family’s daughter, M.L.C., is confined to a wheelchair and lacks control over her arms. The Coward family alleges that while incapacitated, M.L.C. was injured between 2008 and 2009 by a schoolteacher, Louise Miley Johnston, who was employed by HCSD. According to the Coward family, Johnston dropped M.L.C. out of her wheelchair on at least one occa[386] sion. Based on this incident and a number of other acts allegedly committed by Johnston, the Coward family brought claims against HCSD under Mississippi tort law and 42 U.S.C. § 1983. The Coward family’s lawsuit is still pending before the district court. In the present appeal, HCSD argues that two insurers, Ace American and Acadia, are obliged to defend and indemnify HCSD as to the Coward family’s claims.

The first insurer, Ace American, insured HCSD under Scholastic Advantage Educators Legal Liability Policy No. EON G23640806001 (“Ace American Policy”). This insurance policy sets forth a number of exclusions, one of which states that “the Insurer shall not be liable for Damages or Claims Expenses on account of any Claim ... alleging, based upon, arising out of or attributable to any ... Bodily Injury, other than Mental Distress arising out of a Wrongful Employment Practice.” In its order of June 13, 2013, the district court concluded that although the Coward family’s claims for bodily injury did include claims for “Mental Distress,” such claims did not “aris[e] out of a Wrongful Employment Practice.” The district court therefore reasoned that the Ace American Policy did not cover the allegations in the Coward family’s lawsuit and Ace American had no duty to defend HCSD under Mississippi law.

The second insurer, Acadia, insured HCSD during the relevant time under Commercial General Liability Policies CNA 4235393-11 and CNA 4235393-12 (“Acadia Policy”), the relevant provisions of which are identical. In its order of March 29, 2013, the district court concluded that the Coward family’s claims fell outside the scope of the Acadia Policy for three reasons.

First, the Acadia Policy provides that any covered “bodily injury” must be the consequence of an “occurrence,” which the policy further defines as “an accident, including continuous or repeated exposure to substantially the same general harmful conditions.” As the district court explained, discovery had produced “no evidence” that M.L.C.’s drop from the wheelchair was accidental, rather than the result of an intentional act by Johnston.

Second, the Acadia Policy also excludes from coverage any “expected or intended” injury and any injury arising from “abuse or molestation.” According to the district court, however, the Coward family alleged “a pattern of abuse, which is intentional conduct.” The Coward family’s claims were therefore excluded from coverage under these provisions of the Acadia Policy as well.

Third, the district court found that the Coward family was unable to prove any “bodily injury” that would be covered by the policy. As the district court acknowledged, “the plaintiffs certainly alleged in their complaint that M.L.C. had suffered a variety of bodily injuries.... ” The record, however, contained “no evidence about treatment by doctors for physical injuries or any physical limitations M.L.C. will suffer from the alleged abuse.... Any physical injuries she suffered must be inferred from the fact that she fell to the ground, and even then they appear to be de minimis.” Accordingly, the district court concluded that Acadia was entitled to summary judgment based on the absence of evidence regarding M.L.C.’s injuries.

HCSD appealed the district court’s orders granting summary judgment in favor of Ace American and Acadia. We consolidated HCSD’s two appeals and consider each in turn.

II.

This court reviews a district court’s order granting or denying summary judg[387] ment de novo, applying the same standards as the district court.1 Summary judgment is proper under Rule 56 of the Federal Rules of Civil Procedure if the “materials in the record, including depositions, documents, electronically stored information, affidavits or declarations” and other materials do not establish a “genuine dispute as to any material fact.”

We look to state law for rules governing contract interpretation.2 Under Mississippi law, an insurance policy is subject to the general rules of contract interpretation.3 In Mississippi, construction of an insurance policy presents a question of law, which we review de novo.4

The duty of an insurance provider to defend its insured depends upon the language of the policy.5 “ ‘The traditional test’ for whether an insurer has a duty to defend under the policy language ‘is that the obligation of a liability insurer is to be determined by the allegations of the complaint or declaration’ ” in the underlying action.6 If the factual allegations in an underlying complaint state a claim that is within or arguably within the scope of coverage provided by a policy, then the insurance provider is obligated to defend the insured.7 Additionally, as held by the Supreme Court of Mississippi in Automobile Insurance Co. of Hartford v. Lipscomb, 75 So.3d 557, 559 (Miss.2011), “the insurer must provide a defense until it appears that the facts upon which liability is predicated fall outside the policy’s coverage.” In Mississippi, therefore, an insurer is relieved of its duty to defend where “no genuine issue of material fact” remains as to coverage based on the “language of the policy, the complaint, and the relevant deposition testimony.”8

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Acadia Insurance Company v. Hinds County School Di, 582 F. App'x 384 (5th Cir. 2014).

582 F. App'x 384 (Acadia Insurance Company v. Hinds County School Di) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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