American Home Assurance Co. v. Stephens

943 F. Supp. 703, 1996 U.S. Dist. LEXIS 19767
CourtDistrict Court, S.D. Texas
DecidedJanuary 5, 1996
DocketCivil Action H-95-3282
StatusPublished

This text of 943 F. Supp. 703 (American Home Assurance Co. v. Stephens) is published on Counsel Stack Legal Research, covering District Court, S.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
American Home Assurance Co. v. Stephens, 943 F. Supp. 703, 1996 U.S. Dist. LEXIS 19767 (S.D. Tex. 1996).

Opinion

MEMORANDUM AND OPINION

ROSENTHAL, District Judge.

Pending before this court are the following motions:

• a motion for summary judgment filed by plaintiff American Home Assurance Company (“American Home”) (Docket Entry No. 7);
• a cross-motion for summary judgment filed by defendant Rory Ross (“Ross”) (Docket Entry No. 8);
• a cross-motion for summary judgment filed by defendant Billy Carl Stephens (“Stephens”) (Docket Entry No. 10);
• American Home’s motion to strike Stephens’ counterclaims (Docket Entry No. 18); and
• Stephens’ motion for leave to file counterclaims (Docket Entry No. 20).

Based on a careful review of the pleadings and submissions, the summary judgment record, and the applicable law, this court GRANTS American Home’s summary judgment motion; DENIES the cross-motions filed by Stephens and Ross; DENIES as moot American Home’s motion to strike Stephens’ counterclaims; and DENIES as moot Stephens’s motion for leave to file counterclaims.

I. BACKGROUND

This is a Declaratory Judgment Act insurance coverage suit. The plaintiff insurer, American Home, and the defendants, Stephens, the insured, and Ross, the plaintiff in the underlying case, dispute whether a $25,-000 insurance policy limit applies to an arbitration award confirmed by a state court judgment.

In August 1992, American Home issued a claims-made policy of social worker’s professional liability insurance to Stephens, a therapist. The insurance policy, number SWL-7940395, (“the Policy”), set a limit of $25,000 in the aggregate for a claim against the insured that included allegations of sexual misconduct. The Policy otherwise set limits of $3,000,000 in the aggregate and $1,000,000 for each wrongful act or series of wrongful acts or occurrences that did not fall within the sexual misconduct provision.

The declaration page for the Policy included a statement that Policy limits are reduced in cases where sexual misconduct is alleged. The same language appeared at the top of the front page of the Policy.

The sexual misconduct provision provided as follows:

SPECIAL PROVISIONS
1. SEXUAL MISCONDUCT — The total limit of the Company’s liability hereunder shall not exceed $25,000 in the aggregate for all damages with respect to the total of all claims against any Insured(s) involving any actual or alleged erotic physical contact, or attempt thereat or proposal thereof:
(a) by any Insured or by any other person for whom any Insured may be legally liable; and
(b) with or to any former or current patient or client of any Insured, or with or to any relative of or member of the same household as any said patient or client or with or to any person with whom said patient or client or relative has an affectionate personal relationship.
In the event any of the foregoing are alleged at any time, either in a complaint, during discovery, at trial or otherwise, any and all causes of action alleged and arising out of the same or related wrongful acts and/or occurrences and/or relationships shall be subject to the aforesaid $2,000 aggregate limit of liability and to all other provisions of this clause. The aforesaid $25,000 aggregate limit of liability shall be part of, and not in addition to, *705 the limits of liability otherwise afforded by this policy.
The Company shall not be obligated to undertake nor continue to defend any suit or proceeding subject to the aforesaid $25,-000 aggregate limit of liability after said $25,000 aggregate limit of liability has been exhausted by payments for damages.

(Docket Entry No. 7, Ex. 1, at 4) (emphasis added).

Between March 1988 and June 1992, Stephens was Ross’s therapist. In January 1994, Ross sued Stephens in the 280th Judicial District Court of Harris County, Texas, in Cause No. 94-01341 (the “Ross Action”). Ross alleged that Stephens was negligent in failing properly to diagnose or treat her condition. Ross’s state court petitions did not refer to sexual misconduct.

During discovery,.Ross filed pleadings in which she alleged that Stephens was in a sexual relationship with her and sexually exploited her during the therapist/patient relationship. Ross also testified in her deposition that Stephens had engaged in numerous acts of sexual misconduct and exploitation, which formed a basis of her claims against him.

Pursuant to the Policy, American Home provided a defense to Stephens in the Ross Action, subject to a reservation of rights. American Home hired the law firm of Hirsch, Robinson, Sheiness & Glover to defend Stephens in the Ross Action. On July 10, 1995, the case was called to trial by the state court judge. Stephens asked that his appointed counsel withdraw and that his personal counsel, Robert Bates, be substituted in his place. (Docket Entry No. 11, Ex. F,) transcript of hearing held on July 10, 1995. Ross’s counsel and Stephens’ personal counsel confirmed their agreement to pass the trial setting and submit the case to binding arbitration. Id. American Home informed Stephens that American Home did not agree to submit the case to binding arbitration and did not agree to be bound by the outcome. (Docket Entry No. 11, Ex. G). American Home continued to offer Stephens a defense. Id.

Ross and Stephens submitted to arbitration on August 3, 1995. Opening statements and closing arguments were not recorded, nor was there a record of the pre-arbitration conference with the arbitrator. ' Stephens and his personal counsel essentially did not contest Ross’s claims of misdiagnosis and mistreatment. Stephens’ personal counsel asked his own client.only two pages of questions during the entire proceeding.

The arbitration hearing record contains no evidence of Stephens’ sexual exploitation of Ross. There was testimony that Stephens sexually exploited other patients, introduced in connection with Ross’s request for punitive damages. The arbitrator awarded Ross $2,903,698.62 in actual damages.

American Home filed this declaratory judgment action, seeking a declaration that its limits of liability to the insured, Stephens, are $25,000, pursuant to the sexual misconduct provision in the Policy. Ross and Stephens filed a response to the motion for summary judgment, as well as cross-motions for summary judgment, seeking a declaration that the sexual misconduct provision does not apply or is unenforceable, and seeking the $3,000,000 policy limit.

II. THE APPLICABLE LEGAL STANDARDS

A. Summary Judgment

Summary judgment is appropriate if no genuine issue of material fact exists and the moving party is entitled to judgment as a matter of law. Fed.R.Civ.P. 56. Under Fed. R.Civ.P. 56

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Little v. Liquid Air Corp.
37 F.3d 1069 (Fifth Circuit, 1994)
Cicciarella v. Amica Mutual Insurance
66 F.3d 764 (Fifth Circuit, 1995)
Anderson v. Liberty Lobby, Inc.
477 U.S. 242 (Supreme Court, 1986)
Amica Mutual Insurance Company v. Donna Moak
55 F.3d 1093 (Fifth Circuit, 1995)
American Home Assurance Co. v. Smith
462 S.E.2d 441 (Court of Appeals of Georgia, 1995)
American Home Assurance Co. v. Cohen
881 P.2d 1001 (Washington Supreme Court, 1994)
American Home Assurance Co. v. Stone
864 F. Supp. 767 (N.D. Illinois, 1994)
Chicago Insurance v. Griffin
817 F. Supp. 861 (D. Hawaii, 1993)
Barnett v. Aetna Life Insurance Co.
723 S.W.2d 663 (Texas Supreme Court, 1987)
Cranford Ins. Co., Inc. v. Allwest Ins. Co.
645 F. Supp. 1440 (N.D. California, 1986)
Continental Casualty Co. v. Hall
761 S.W.2d 54 (Court of Appeals of Texas, 1988)
McConaghy v. RLI Insurance
882 F. Supp. 540 (E.D. Virginia, 1995)
St. Paul Fire & Marine Insurance Co. v. Love
459 N.W.2d 698 (Supreme Court of Minnesota, 1990)

Cite This Page — Counsel Stack

Bluebook (online)
943 F. Supp. 703, 1996 U.S. Dist. LEXIS 19767, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-home-assurance-co-v-stephens-txsd-1996.