CRITERION CLAIM SOLUTIONS, INC. v. SCOTTSDALE INDEMNITY COMPANY

CourtDistrict Court, D. New Jersey
DecidedMarch 1, 2021
Docket3:20-cv-06225
StatusUnknown

This text of CRITERION CLAIM SOLUTIONS, INC. v. SCOTTSDALE INDEMNITY COMPANY (CRITERION CLAIM SOLUTIONS, INC. v. SCOTTSDALE INDEMNITY COMPANY) is published on Counsel Stack Legal Research, covering District Court, D. New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
CRITERION CLAIM SOLUTIONS, INC. v. SCOTTSDALE INDEMNITY COMPANY, (D.N.J. 2021).

Opinion

NOT FOR PUBLICATION UNITED STATES DISTRICT COURT DISTRICT OF NEW JERSEY

CRITERION CLAIM SOLUTIONS, INC., et al., Plaintiffs, Civil Action No. 20-6225 (MAS) (ZNQ) “ MEMORANDUM OPINION OTTSDALE INDEMNITY COMPANY, et al., Defendants.

SHIPP, District Judge . This matter comes before the Court upon Defendants Scottsdale Indemnity Company (“Scottsdale”) and Capitol Specialty Insurance Corporation’s (“Capitol”) (collectively, “Defendants”) Motions to Dismiss Plaintiffs Criterion Claim Solutions. Inc. (“Criterion”) and Thomas Mulligan’s (“Mulligan”) (collectively. “Plaintiffs") Complaint. (ECF Nos. 17, 27.) Plaintiffs opposed Scottsdale’s Motion and filed a Cross-Motion for Partial Summary Judgment. (ECF No. 33.) Scottsdale replied and opposed. (ECF No. 41.) Plaintiffs also opposed Capitol’s Motion (ECF No. 34), and Capitol replied (ECF No. 40). The Court has carefully considered the parties’ submissions and decides the matter without oral argument pursuant to Local Civil Rule 78.1. For the reasons set forth herein, Defendants’ Motions to Dismiss are granted and Plaintiffs” Cross-Motion for Partial Summary Judgment is denied.

I. BACKGROUND Criterion is a claims management company organized under the laws of, and maintains its principal place of business, in Nebraska. (Compl. £ 11, ECF No. I.) Mulligan is a New Jersey resident and Criterion’s sole member and Chief Executive Officer. (fc § 12.) Scottsdale is an insurance company organized under the laws of Ohio and maintains its principal place of business in Arizona. (/d. J 13.) Capitol is an insurance company organized under the laws of Wisconsin and maintains its principal place of business in Arizona. (/d. 7 14.) Criterion previously served as a third-party administrator for Spirit Commercial Auto Risk Retention Group, Inc. (“Spirit”), and performed claims management services under an agreement in which Criterion had professional liability insurance. (Nevada Compl. 79 8, 14. Ex. A to Scottsdale’s Moving Br.. ECF No. 17-3.)' “Spirit was an association captive insurance company” that “transacted commercial auto liability insurance business and specialized in serving commercial truck owners.” (/e. ©] 6, 8.) In 2019, Criterion purchased a multi-layered insurance policy program with a $10,000,000 coverage limit for the policy period March 2019 to March 2020. (Compt. 4 18-20.) Scottsdale issued the primary policy with a $5,000,000 limit of liability (“Scottsdale Policy”), and Capitol issued the excess policy with a $5,000,000 limit of liability ("Capitol Policy”). (/d. {J 19-20.)

' Although generally “a district court ruling on a motion to dismiss may not consider matters extraneous to the pleadings,” a “document integral to or explicitly relied upon in the complaint may be considered without converting the motion [to dismiss] into one for summary judgment.” In re Burlington Coat Factory Sec. Litig., 114 F.3d 1410, 1426 (3d Cir. 1997) (alteration in original) (citations omitted). Similarly, when resolving “a 12(b)(6) motion, a court may properly look at public records including judicial proceedings, in addition to the allegations in the complaint.” S. Cross Overseas Agencies, Inc. v. Wah Kwong Shipping Grp.. 181 F.3d 410, 426 (3d Cir. 1999).

A. Scottsdale Policy The Scottsdale Policy provides coverage under a Miscellaneous Professional Services Coverage Section (“MPS Coverage Section”). (See Scottsdale Policy *10-17,7 Ex. 1 to Compl., ECF No. 1-2.) Criterion and Mulligan qualify as Insureds under the MPS Coverage Section. (Compl. { 21; Scottsdale Policy *11, § B(5).) The MPS Coverage Section provides that Scottsdale “shall pay on behalf of the Insureds, Loss which the Insureds have become legally obligated to pay by reason of a Claim first made against any Insureds . . . for a Wrongful Act[.]*? (Compl. { 22; Scottsdale Policy *10, § A(1} (emphasis in original).) Under the policy, it is “the right and duty of [Scottsdale] and not [Criterion or Mulligan] to defend any Claim.” (Scottsdale Policy *16, § F(1} (emphasis in original).) The MPS Coverage Section also contains a provision that, as amended, excludes from coverage any claim: alleging, based upon, arising out of, attributable to, directly or indirectly resulting from, in consequence of, or in any way involving the insolvency, receivership, bankruptcy, liquidation or financial inability to pay of any Insured. or any insurer, self-insurer trust, insurance plan or other vehicle or instrumentality which provides services [(the “Insolvency Exclusion”)]. (Scottsdale Policy *14, § C(14), as amended by *26—27, § C(14),) B. Capitol Policy The Capitol Policy “follows form” to the Scottsdale Policy and provides that Capitol will provide coverage in excess of the underlying limits, (Compl. § 3; Capitol Policy *3, *5 § ICA). Ex.

* Page numbers preceded by an asterisk refer to the page number on the ECF header. 3 The MPS Coverage Section defines wrongful act as “any actual or alleged error, omission, misleading statement, misstatement, neglect, tibel, slander or other defamatory or disparaging material, breach of duty or act allegedly committed or attempted by the Insureds, which occurs solely in connection with the Insureds rendering of, or actual or alleged failure to render. Professional Services.” (Scottsdale Policy *12. § B(I 1) (emphasis in original).)

2 to Compl., ECF No. |-3.} The Capitol Policy contains an exhaustion clause which provides that the policy “will only apply after all Underlying Insurance Polices ... have actually paid the full amount of the Underlying Limit of Liability[.]” (Capitol Policy *6, § 1V(C) (emphasis in original).) In addition, the Capitol Policy states its obligations “will not be increased, expanded or otherwise changed as a result of . . . [a]ny positions taken by the Underlying Insurers with respect to coverage ... or the inability or refusal to pay by any of the Underlying Insurers[.]" (/d. at *6, § V(F)(2) (emphasis in original).) As to a duty to defend, the Capitol Policy states: “the limit of liability will be reduced and may be exhausted by the payment of defense expenses. The issuing company does not assume any duty to defend.” (/d. at *3.) Under the Limit of Liability/Exhaustion of Underlying Insurance section, the policy states the $5,000,000 limit of liability “is the most [Capitol] will pay for all amounts (including defense expenses) from all Claims[.]” (/d at *6, § IV(A) (emphasis in original).) The section also repeats that “[p]ayment of defense expenses . . . will reduce and may exhaust the [IJimit of [Iiability.” (/d. at *6, § [V(B).) Under the Coverages section, the policy contains a subsection titled “NO DUTY TO DEFEND” that states Capitol “does not assume any duty to defend.” (/d. at *5, § 1(B).) Plaintiffs allege that Defendants have improperly denied coverage under the policies in connection with two actions: the Kentucky Suit and the Nevada Suit (the “Underlying Actions”). Cc. Underlying Actions 1. Kentucky Suit The Kentucky Suit was filed by George Gillett (-Gillett™). (Compl. 4 31.) According to the Kentucky Suit, in March 2017, Gillett’s vehicle was struck by a truck owned by Sarman Trucking,

LLC (“Sarman”). (Kentucky Compl. § !2, Ex. B to Scottsdale’s Moving Br., ECF No. 17-4.)" Following the accident, Gillett filed a different lawsuit against Sarman in which Gillett obtained a $750,000 judgment in January 2019. (/d. i] 29, 35.) Gillett, however, was not able to collect the judgment from Sarman because Sarman had dissolved. (/d. §] 36-37.) At the time of the accident, Sarman was insured by Spirit and Criterion served as Spirit's third-party administrator. (/e. [J 38.

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CRITERION CLAIM SOLUTIONS, INC. v. SCOTTSDALE INDEMNITY COMPANY, Counsel Stack Legal Research, https://law.counselstack.com/opinion/criterion-claim-solutions-inc-v-scottsdale-indemnity-company-njd-2021.