AMHS Insurance v. Mutual Insurance

258 F.3d 1090, 2001 Daily Journal DAR 7853, 2001 Cal. Daily Op. Serv. 6390, 2001 U.S. App. LEXIS 16953
CourtCourt of Appeals for the Ninth Circuit
DecidedJuly 30, 2001
DocketNos. 99-15703, 99-15704
StatusPublished
Cited by2 cases

This text of 258 F.3d 1090 (AMHS Insurance v. Mutual Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
AMHS Insurance v. Mutual Insurance, 258 F.3d 1090, 2001 Daily Journal DAR 7853, 2001 Cal. Daily Op. Serv. 6390, 2001 U.S. App. LEXIS 16953 (9th Cir. 2001).

Opinions

Opinion by Judge SNEED; Dissent by Judge GRABER

SNEED, Circuit Judge:

Appellant AmHS Insurance Company, Risk Retention Group (“RRG”) and Appel-lee Mutual Insurance Company of Arizona (“MICA”) provided professional liability insurance to Dr. Wesley Romberger (“Dr. Romberger”). ' Following a jury trial, Dr. Romberger was found negligent in his care and treatment of Christina Beery. RRG defended Dr. Romberger and satisfied the $7,897,543.18 judgment against him. The parties dispute how much MICA should contribute to the payment of this judgment.

RRG appeals the district court’s determination that it failed to state either a direct or subrogated bad-faith claim against MICA. Both parties appeal the district court’s decision on summary judgment ordering MICA to pay RRG an equitable contribution in the amount of $445,013.83. RRG also appeals the district court’s order establishing that prejudgment interest did not begin to accrue until September 19,1997.

We address each order of the district court in turn. We affirm the dismissal of both the direct and subrogated claims. We reverse the district court’s calculation of MICA’s contribution and remand for further proceedings. We affirm the district court’s determination of the date from which prejudgment interest began to run.

FACTS

Dr. Romberger delivered Christina Beery on September 1, 1986. He subsequently provided care, treatment, and evaluations of Christina through September 23, 1988. In July 1990, Christina Beery was diagnosed with a ventricular septal defect. In March 1992, Christina Beery, by and through her mother, sued Dr. Romberger, alleging negligent failure to detect and diagnose Christina’s heart defect.

The Beery case proceeded to trial in August 1993. MICA contributed 10% of the cost of defending Dr. Romberger while a third insurance carrier, Samaritan, contributed 90%. MICA was continually updated on the Beery litigation, but (other than its commitment to pay 10% of the defense costs) played no role in the defense of Dr. Romberger. The jury returned a verdict in favor of Christina Beery. Through two lump sum payments, RRG paid $7,897,543.18 in complete satisfaction of the judgment. The first of these payments was made in July 1996 in the sum of $4.3 million. The second payment was made in June 1997 in the amount of $3.6 million. RRG informed MICA that it had satisfied the judgment and requested contribution. Both during the Beery litigation and after RRG satisfied the full judgment, MICA offered a maximum of $150,000 toward the total settlement of the [1093]*1093case. RRG brought this action for bad faith and contribution against MICA.

I.

Both the viability of the bad-faith claims and the correct computation of MICA’s contribution depend upon whether the competing insurance carriers are primary, excess, or co-excess insurers of the Beery judgment. And, more broadly, on the intended application of the insurance policies. We must review the language of the policies to determine the status of each insurer so as to properly apportion the loss. We begin, therefore, with a brief summary of the principles and purposes of excess insurance. We then identify the relevant portions of the competing insurance policies and categorize them with reference to the “overall insuring scheme.” United Servs. Auto. Ass’n v. Empire Fire & Marine Ins., 134 Ariz. 64, 658 P.2d 712, 714 (1982).

A. Excess Insurance Policies

An “excess” or “umbrella” insurance policy serves a different purpose than a primary policy. A “true” excess policy protects the insured “in the event of a catastrophic loss in which liability exceeds the available primary coverage.” 16 Couch on Insurance § 220:32 (3d ed.1995); See also 8C Insurance Law and Practice § 5071.65 at 107 (1981) (“In this day of uncommon, but possible, enormous verdicts, [excess policies] pick up this exceptional hazard at a small premium”). A primary policy, alternatively, provides coverage from “dollar one” for a given loss.

This clear distinction can be muddied by the inclusion of an “other insurance” clause in an otherwise primary policy. The inclusion of such a clause will not convert a primary policy into “true” excess coverage. The underlying purpose of the primary policy remains the same and it must contribute to an insured’s loss before “true” excess coverage attaches. However, determining whether a given policy is primary (with an other insurance clause) as opposed to excess can sometimes be difficult. 16 Couch on Insurance § 220:32 (“[I]t is extremely difficult to draw any black letter rules of law. There is usually no way ... to avoid doing a time-consuming, complete coverage analysis.”)

Because the instant controversy arises under Arizona law, we rely on the Arizona Supreme Court’s standards for determining when a particular policy is “true” excess insurance. Under Arizona law, a “true” excess policy applies “when the same insured has purchased underlying coverage for the same risk.” St. Paul Fire & Marine Ins. Co. v. Gilmore, 168 Ariz. 159, 812 P.2d 977, 980 (1991). The underlying primary policy “operate[s] as a kind of deductible and ‘an insured pays a reduced premium to the excess carrier expressly because that carrier will be obligated to pay a claim only after a certain amount has been paid’ by the insured’s primary carrier.” Id. (quoting Maricopa County v. Fed. Ins. Co., 157 Ariz. 308, 757 P.2d 112, 114 (1988)). In addition, “true” excess coverage is “written under circumstances where rates were ascertained after giving due consideration to known existing and underlying ... primary policies.” Id. (quoting Loy v. Bunderson, 107 Wis.2d 400, 320 N.W.2d 175, 179 (1982)).

With these standards in mind, we turn to the policies at issue in this appeal.

B. Competing Policies

1. The Samaritan Policy

The Samaritan Policy provided primary insurance to Dr. Romberger. The relevant portion of the Samaritan Policy reads:

(7) Other Insurance: The insurance afforded by this policy is primary insurance, except when stated to apply [1094]*1094in excess of or contingent upon the absence of other insurance
b. With regard to physician Insureds, the insurance provided by this policy shall be primary, and it shall not be reduced by the amount of any other insurance the physician Insured may have.

The Samaritan Policy’s coverage of Dr. Romberger commenced October 1, 1986. It contained a policy limit of $1 million per occurrence, $12 million in the aggregate. It is undisputed that the Samaritan Policy provided the first layer of coverage applicable to the Beery judgment. It is also undisputed that Samaritan’s total liability with regard to the Beery judgment is $1 million (including costs of litigation) and that Samaritan has contributed its policy limit.

2. The MICA Policy

The MICA Policy is entitled a “Modified Claims Made Insurance Policy.” It provided coverage to Dr. Romberger from September 1, 1983 through October 25, 1986.

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258 F.3d 1090, 2001 Daily Journal DAR 7853, 2001 Cal. Daily Op. Serv. 6390, 2001 U.S. App. LEXIS 16953, Counsel Stack Legal Research, https://law.counselstack.com/opinion/amhs-insurance-v-mutual-insurance-ca9-2001.