Benson v. Casa De Capri Enterprises LLC

District Court, D. Arizona·Decided April 11, 2023·No. 2:18-cv-00006·Unknown

Opinion

1 WO 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA

9 Jacob Benson, et al., No. CV-18-00006-PHX-DWL

10 Plaintiffs, ORDER

11 v.

12 Casa De Capri Enterprises LLC, et al.,

13 Defendants. 14 15 INTRODUCTION 16 Jacob Benson is a disabled vulnerable adult who received skilled nursing care at a 17 now-defunct facility called Casa de Capri Enterprises LLC (“Capri”). In December 2012, 18 Benson and other family members (together, “Plaintiffs”) brought a negligence action 19 against Capri in Arizona state court. 20 At the time, Capri had a “claims paid” insurance policy issued by Defendant 21 Continuing Care Risk Retention Group, Inc. (“CCRRG”). Under this unusual type of 22 policy, the insurer is only responsible for indemnifying the insured against claims that 23 become payable while the policy remains in effect. In contrast, under an “occurrence” 24 policy or a “claims made” policy (which are more common), the insurer becomes 25 responsible for indemnification so long as the liability-generating event occurred (or was 26 disclosed to the insurer) during the policy term. 27 CCRRG initially assumed the defense of Plaintiffs’ lawsuit against Capri pursuant 28 to Capri’s insurance policy. However, after Capri became insolvent, stopped paying its 1 premiums, declared bankruptcy, and cancelled the policy, CCRRG withdrew the defense. 2 Years later, after the bankruptcy stay was lifted, Plaintiffs obtained a $1.5 million judgment 3 against Capri and then initiated this garnishment action against CCRRG. 4 In February 2023, after years of complicated litigation, the Court issued a lengthy 5 order resolving the parties’ cross-motions for summary judgment, holding that CCRRG 6 had no duty under the relevant insurance policies to indemnify Capri for the judgment. 7 (Doc. 149.) However, in a footnote, the Court noted that it was unclear whether the 8 summary judgment ruling was sufficient to fully dispose of the case, given that Plaintiffs 9 had asserted during oral argument that they “also seek to recover under the theory that 10 CCRRG breached its duty to defend Capri in the underlying lawsuit.” (Id. at 15 n.4.) 11 Accordingly, the Court ordered the parties to submit supplemental briefing on “whether 12 Plaintiffs may separately pursue relief in this garnishment action under a breach-of-the- 13 duty-to-defend theory.” (Id. at 41.) 14 Now pending before the Court are the parties’ supplemental briefs. (Docs. 156, 15 157.) For the following reasons, the Court concludes that Plaintiffs adequately disclosed 16 their intention to pursue relief under a breach-of-the-duty-to-defend theory. To the extent 17 the parties attempted, in their supplemental briefs, to go beyond the disclosure issue and 18 address the merits of Plaintiffs’ alternative theory, that briefing is undeveloped and 19 premature. Accordingly, and in an effort to ensure that the issues are presented in a 20 procedurally appropriate format, the Court will authorize the parties to file a second round 21 of summary judgment motions. 22 BACKGROUND 23 I. Relevant Facts 24 The background details of this case are set forth in the February 2023 summary 25 judgment order. (Doc. 149.) An abbreviated summary is provided below to set the stage 26 for the disputed disclosure issue. 27 On December 10, 2012, Plaintiffs filed suit in Maricopa County Superior Court 28 against Capri, alleging abuse and neglect of a vulnerable adult and negligence. (Doc. 65 1 ¶ 1.) At the time the lawsuit was served, Capri was insured under a “professional liability 2 insurance policy” issued by CCRRG. (Doc. 65 ¶ 3.) The policy (the “2012 Policy”) 3 provided coverage from January 1, 2012 to January 1, 2013 and had a policy limit of $1 4 million. (Doc. 56-1 at 36.) Capri renewed its policy with CCRRG the following year (the 5 “2013 Policy”). (Doc. 65 ¶ 4.) The 2013 Policy provided coverage from January 1, 2013 6 to January 1, 2014. (Doc. 13-1 at 5.) 7 The 2012 and 2013 Policies are “claims paid” policies. (Doc. 132 ¶ 1.) In the 8 “Coverages” section of each policy, under the subheading “Insuring Agreement,” CCRRG 9 agreed to pay “amounts within the policy limits for ‘Damages,’ [and] ‘Cost of Defense’ 10 . . . on behalf of a ‘Member’ who becomes legally obligated to ‘Pay’ ‘Damages’ and ‘Cost 11 of Defense’ during the time they are a CCRRG ‘Member.’” (Doc. 13-1 at 13, emphasis 12 added.) In the subscription agreement, CCRRG elaborated that “[t]he terms and conditions 13 of this type of coverage differ significantly from a typical occurrence or claims made 14 indemnification insurance policy. In essence, . . . CCRRG has no responsibility for any 15 portion of a claim not actually paid during the contract period. Under the Claims Paid 16 policy losses are only covered by the Company if the insured is a Member of CCRRG when 17 the payment is made . . . .” (Id. at 58.) 18 Before the 2013 renewal, CCRRG offered Capri two renewal options: (1) to 19 continue with the existing “claims paid” policy for $256,169.32; or (2) to switch to a 20 “claims made” policy for $292,345.45. (Doc. 132 ¶ 17.) Capri chose the less expensive 21 “claims paid” option. (Id.) 22 On December 28, 2012, Capri was served in the Arizona state court lawsuit. (Doc. 23 65 ¶ 2.) It is undisputed that Capri timely reported the lawsuit to CCRRG, as it was required 24 to do under the 2012 Policy. (Id. ¶ 20.) It is also undisputed that CCRRG accepted Capri’s 25 tender under the 2012 Policy and appointed defense counsel to defend the lawsuit without 26 a written reservation of rights. (Id. ¶¶ 21, 23.) 27 Regarding CCRRG’s duty to defend, the 2012 Policy states: “Our right and duty to 28 defend ends when we have exhausted the applicable limit of insurance by the payment of 1 ‘Cost of Defense’. . . under this Policy or, when this policy is cancelled or not renewed for 2 any reason, provided however, in the event CCRRG is paying ‘Cost of Defense’. . . 3 CCRRG shall continue to pay ‘Cost of Defense’. . . for all such ‘Claims’ for a period of 4 time not to exceed thirty (30) days to enable such former ‘Member’ to assume its own legal 5 defense.” (Doc. 56-1 at 2.) The relevant language in the 2013 Policy is identical. (Doc. 6 13-1 at 13.) 7 After CCRRG began providing a defense of the lawsuit, Capri defaulted on its 8 obligation to pay certain deductibles. (Doc. 65 ¶ 24.) As a result, Magnolia,1 through 9 Bates, sent Capri a letter on July 15, 2013 informing Capri of its “seriously delinquent” 10 status “in meeting its insurance deductible payment obligations.” (Doc. 56-6 at 1-2.) The 11 letter stated that CCRRG’s board of directors could terminate Capri’s membership for the 12 outstanding delinquencies, in which case “Capri’s right to continued coverage of existing 13 open claims . . . may be at risk if the outstanding default in payment is not cured to the 14 satisfaction of the [board].” (Id. at 1.) 15 On July 19, 2013, CCRRG and Capri agreed to a payment plan concerning the 16 outstanding deductible obligation. (Doc. 65 ¶ 25.) However, less than one month into that 17 plan, Capri again defaulted. (Id.) As a result, CCRRG again threatened action against 18 Capri. (Id.) 19 On August 13, 2013, CCRRG issued a notice of intent to cancel the 2013 Policy, 20 which stated that the Policy would be cancelled if Capri did not pay $22,270.03 by August 21 27, 2013. (Doc. 56-8 at 1; Doc. 65 ¶ 26.) 22 On August 19, 2013, Capri filed for bankruptcy. (Doc. 65 ¶ 27.) Afterward, 23 Plaintiffs’ lawsuit against Capri was stayed. (Doc. 1-1 at 54-55, 58-59, 62.) 24 By August 22, 2013, CCRRG received notice of the bankruptcy. (Doc. 65 ¶ 33.) 25 That same day, the bankruptcy court authorized a debtor in possession loan for Capri “to 26 immediately pay the . . .

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