Certain Underwriters at Lloyd's, London Subscribing to Policy No. AH00000154-01 v. Edenfield

District Court, S.D. Georgia·Decided March 23, 2023·No. 4:22-cv-00035·Unknown

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF GEORGIA SAVANNAH DIVISION

CERTAIN UNDERWRITERS at LLOYD’S, LONDON SUBSCRIBING TO POLICY NO. AH00000154-01,

Plaintiff, CIVIL ACTION NO.: 4:22-cv-35

v.

CHERYL EDENFIELD, as mother and legal guardian of Quincy Edenfield, an incapacitated adult, SADIE EDWARDS, as mother and legal guardian of Adam Edwards, an incapacitated adult, and CATHERINE MOORE, as next of kin and legal guardian of Jonathan Moore, an incapacitated adult,

Defendants.

O RDER Plaintiff Certain Underwriters at Lloyd’s, London Subscribing to Policy No. AH00000154-01 (“Underwriters”) brought this action for a declaratory judgment that it does not owe coverage for default judgments entered against non-party Healthcare Staffing, Inc. in the State Court of Liberty County. (Doc. 1.) Presently before the Court is Defendants Cheryl Edenfield, Sadie Edwards, and Catherine Moore’s (collectively, “Defendants”) Motion to Dismiss, (doc. 12), and Second Motion to Dismiss or Stay in favor of state proceedings, (doc. 21). For the reasons stated below, the Court DENIES as moot Defendants’ initial motion, (doc. 12), and GRANTS Defendants’ Second Motion, (doc. 21). BACKGROUND I. Parties, Relevant Non-Parties, and HCS’s Insurance Policy with Underwriters

Underwriters is an insurance company whose sole member is Hiscox Dedicated Corporate Member Limited, a corporation located in the United Kingdom. (Doc. 1, p. 2.) Cheryl Edenfield is the mother and legal guardian of Quincy Edenfield, an incapacitated adult. (Id.) Sadie Edwards is the mother and legal guardian of Adam Edwards, an incapacitated adult. (Id.) Catherine Moore is the next of kin and legal guardian of Jonathan Moore, an incapacitated adult. (Id.) Quincy, Adam, and Jonathan (at times, “Defendants’ wards”) resided at Gateway Behavioral Health Services (“Gateway”). (Id. at pp. 4–5; see docs. 1-2, 1-3, 1-4.) Healthcare Staffing, Inc. (“HCS”) is a staffing agency which had a contract with Gateway to provide employees to Gateway who would provide services to Gateway’s patients. (Id. at p. 4; see doc. 1-1, pp. 4–5.) According to the Complaint, Underwriters issued a policy of insurance to HCS which included both commercial general liability (“CGL”) and professional liability (“PL”) coverages, policy number AH00000154-01 (the “Policy”). (Doc. 1, p. 7; see doc. 1-9 (the Policy’s

“Certificate of Insurance” or “Certificate”).) However, based upon the materials Underwriters attached to the Complaint, the precise identity of the entity responsible for issuing the Policy is not totally clear.1 In any event, the Policy had per-claim liability limits of $1,000,000.00 and an

1 As the Court has recognized in (now-terminated) cases brought by each Defendant, there is a genuine dispute of fact as to whether Underwriters or an entity named “Hiscox, Inc.” issued the Policy. See, e.g., Edenfield v. Hiscox, Inc., No. 4:22-cv-146, 2022 WL 17102348, at *4–5 (S.D. Ga. Nov. 22, 2022). The Certificate of Insurance states that the Policy is “[e]ffective with UNDERWRITERS AT LLOYD’s, London.” (Doc. 1-9, p. 1 (emphasis in original).) Furthermore, the Certificate states, In [a]ccordance with the authorization granted to Hiscox[,] Inc[.] under [c]ontract . . . by certain Underwriters at Lloyd’s, London . . . and in consideration of the premium specified herein, the said Underwriters do hereby bind themselves . . . to insure as follows in accordance with the terms and conditions contained or endorsed [in the Certificate].

(Id.) However, the Certificate does not indicate that Underwriters issued the Policy, (see generally doc. 1- 9), which is a requisite for status as an “insurer” under Georgia law. See O.C.G.A. § 33-1-2(5) (defining aggregate limit of $3,000,000.00 for both its CGL and PL coverages and was effective during the period from July 24, 2015, to July 24, 2016. (Doc. 1-9, p. 1.) The Policy’s CGL coverage applies to “those sums that the insured becomes legally obligated to pay as damages because of ‘bodily injury’ . . . to which this insurance applies.” (Id. at p. 12.) However, pursuant to Endorsement

E9979.1 to the Policy, entitled, “Abuse or Molestation Exclusion,” the Policy’s CGL coverage does not apply to “bodily injury” arising out of “the actual or threatened abuse or molestation by anyone of any person while in the care, custody or control of any insured,” or the negligent employment, supervision, or retention of a person who abuses or molests a person in the care of an insured. (Id. at p. 38.) Under the Policy’s PL coverage, Underwriters agrees to pay all damages and claim expenses (beyond the deductible and subject to applicable liability limits) that the insured becomes legally obligated to pay as a result of any covered “claim.” (Id. at p. 3.) To be entitled to coverage, however, the claim must be “first made against the Insured during the Policy Period . . . for any Wrongful Act by the Insured or by anyone for whom the Insured is legally responsible.” (Id.)

Additionally, the “wrongful Act” must have been “committed or allegedly committed on or after the Retroactive Date set forth in . . . the Declarations.” (Id.) Finally, the Insured must have “had no knowledge of the actual or alleged Wrongful Act” prior to the Policy’s inception date. (Id.) II. Defendants’ Abuse Suits, Defendants’ Demand Letters, and the Denial Letters

On September 6, 2017, Cheryl Edenfield filed a tort suit on behalf of Quincy against HCS in the State Court of Liberty County, Georgia. (Doc. 1, pp. 3–4; see doc. 1-1 (Edenfield’s state

an “insurer” to include a corporation “engaged as indemnitor, surety, or contractor who issues insurance”) (emphasis added). Indeed, the Certificate provides that it is “[b]y Hiscox, Inc.” (Doc. 1-9, p. 1 (emphasis added).) Moreover, the Certificate is written on Hiscox letterhead, (see doc. 1-9), and lists Hiscox, Inc.’s address at the bottom of each page of the CGL Coverage Form, (id. at pp. 12–29). complaint).) In the lawsuit, Edenfield alleged that Quincy, who had been residing at Gateway since May 2012, had been physically abused by Errol Wilkins, an employee of HCS. (See doc. 1- 1.) Edenfield brought four counts against HCS: (1) failure to train and supervise Wilkins; (2) negligent retention of Wilkins; (3) negligent breach of contract; and (4) assault and battery. (Id.

at pp. 12–16.) Edenfield attached to her complaint an “Investigative Report” produced by Mitch Sweeney, Gateway’s QUM Coordinator, in response to a complaint by another Gateway instructor who had observed Wilkins hitting Quincy and other individuals. (Doc. 1-1, pp. 19–29.) The report concluded that the allegations of abuse inflicted by Wilkins were substantiated. (Id. at p. 27.) A week later, Edenfield’s counsel sent HCS a demand to settle Defendants’ claims against it for $12 million. (Doc. 1-2.) Pertinently, the demand letter identified Wilkins as an “HCS Social Service Aide.” (Id. at p. 2.) Edenfield’s counsel sent similar letters to HCS on October 7, 2017, and November 13, 2017, on behalf of Sadie Edwards and Catherine Moore, respectively, contending that their wards had also been physically abused by Wilkins, and seeking payment of $8 million to settle each of their claims. (Doc. 1, p. 5; see doc. 1-4 (Moore’s demand letter).)2

In letters dated December 18, 2017, representatives from an entity named “Hiscox” sent letters to HCS advising it that Defendants’ claims against it were not covered by the Policy.3 (Docs. 1-5, 1-6, 1-7.) The letters (the “Denial Letters”) stated that Defendants’ allegations were

2 Underwriters purported to attach Edwards’ demand letter to the Complaint. (See doc. 1-3 (titled “Edward’s Demand”).) However, this exhibit is actually just a copy of Moore’s demand letter, (doc.

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