Evanston Insurance Company v. Brady

CourtDistrict Court, N.D. Alabama
DecidedMarch 4, 2024
Docket4:23-cv-00106
StatusUnknown

This text of Evanston Insurance Company v. Brady (Evanston Insurance Company v. Brady) is published on Counsel Stack Legal Research, covering District Court, N.D. Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Evanston Insurance Company v. Brady, (N.D. Ala. 2024).

Opinion

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF ALABAMA MIDDLE DIVISION

EVANSTON INSURANCE COMPANY, Plaintiff,

v. Case No. 4:23-cv-106-CLM

LISA BRADY, et al., Defendants.

MEMORANDUM OPINION Inmate Trenton Gartman successfully sued healthcare provider QCHC, Inc. (“QCHC”) and some individual caregivers, including Lisa Brady (“Brady”), for heart problems he suffered while in the Autauga County jail. This case is about who pays Gartman’s attorney’s fees: QCHC’s insurer or Brady.

A policy issued to QCHC by Evanston Insurance Company (“Evanston”) covered Gartman’s lawsuit. Under the policy, Evanston has paid Gartman’s compensatory and punitive damage awards. Evanston filed this lawsuit under 28 U.S.C. § 2201, seeking a declaration that the Policy does not require it to also pay Gartman’s attorney’s fees on behalf of Brady. (Doc. 1). In response, Brady counterclaimed against Evanston, (doc. 7), and a third-party complaint against QCHC, (doc. 10; doc. 29). Evanston and QCHC move to dismiss those complaints for failure to state claims under Federal Rule of Civil Procedure 12(b)(6).

As explained below, the court DENIES Evanston’s Motion to Dismiss Count I and Count III of Brady’s counterclaims and GRANTS Evanston’s Motion to Dismiss Count II of Brady’s counterclaims. Because Brady cannot plead facts that would establish bad faith refusal, the court will dismiss Count II with prejudice. The court GRANTS QCHC’s Motion to Dismiss both counts of Brady’s Amended Third-Party Complaint, (doc. 40), but because it may be possible to sufficiently plead both counts, the court will dismiss Count I and Count II without prejudice. The court will allow Brady to amend her Complaint on or before March 25, 2024.

BACKGROUND

Because Brady is the non-moving party, the court takes these facts from Brady’s complaints and assumes all alleged facts are true. Fed. R. Civ. P. 12(b)(6); Hishon v. King & Spalding, 467 U.S. 69, 73 (1984) (at the motion-to- dismiss stage, “the complaint is construed in the light most favorable to the plaintiff, and all facts alleged by the plaintiff are accepted as true”).

A. Gartman’s lawsuit

QCHC contracted with the Autauga County Sheriff to provide healthcare to Autauga County inmates. (Doc. 29, ¶ 4). Brady worked for QCHC as a nurse in the Autauga County jail. In May 2018, inmate Gartman sued QCHC, Brady, and others under 42 U.S.C § 1983, alleging deliberate indifference to his medical needs. See Gartman v. Brady, et al., ALMD Civil Action No. 2:18-cv- 534-MHT (“the Underlying Action”).

B. The Policy

Evanston covered QCHC and employees like Brady against such lawsuits. The Policy’s Insuring Agreement provides:

INSURING AGREEMENT A. Professional Liability and Claims Made Clause: The Company shall pay on behalf of the Insured all sums in excess of the Deductible amount stated in the Declarations, which the Insured shall become legally obligated to pay as Damages as a result of a Claim . . . for Professional Personal Injury: 1. By reason of any act, error or omission in Professional Services arising out of the conduct of the Insured’s Professional Services rendered or that should have been rendered by an Insured; . . . . (Doc. 1-1 (Form MESM 5010 08 15) at 15)). Relevant Definitions include:

B. Claim means the Insured’s receipt of: 1. A written demand for Damages or Professional Services; or 2. The service of suit or institution of arbitration proceedings against the Insured seeking Damages.

C. Claim Expenses means reasonable and necessary amounts incurred by the Company or by the Insured with the prior written consent of the Company in the defense of that portion of any Claim for which coverage is afforded under this Coverage Part, including costs of investigation, court costs, costs of bonds to release attachments and similar bonds, but without any obligation of the Company to apply for or furnish any such bonds, and costs of appeals; provided, however, Claim Expenses shall not include: 1. Salary, wages, overhead, or benefit expenses of or associated with Employees or officials of the Named Insured or employees or officials of the Company; or 2. Salary, wages, administration, overhead, benefit expenses, or charges of any kind attributable to any in-house counsel or captive out-of-house counsel for the Named Insured or the Company.

D. Damages means the monetary portion of any judgment, award or settlement; provided, however, Damages shall not include: 1. Punitive or exemplary damages or multiplied portions of damages in excess of actual damages, including trebling of damages; 2. Taxes, criminal or civil fines, or attorneys’ fees of a party other than an Insured or other penalties imposed by law; 3. Sanctions; 4. Matters which are uninsurable under the law pursuant to which this Coverage Part shall be construed; 5. The return, withdrawal, reduction or restitution or payment of fees, profits or charges for services or consideration and/or any expenses paid to the Insured; or 6. The cost of complying with an award or order for declaratory, equitable or injunctive relief or remedy.

(Doc. 1-1 (Form MESM 5010 08 15) at 16)) (highlighting added). The court highlights the exclusion of “attorney’s fees of a party other than an Insured” as covered “Damages” because this case, at its core, asks the court to determine whether Evanston must pay Gartman’s attorney’s fees.

C. Evanston’s Declaratory Judgment Action

Attorney’s fees are relevant because a jury found Brady guilty of deliberate indifference and awarded Gartman compensatory and punitive damages. (Doc. 1, ¶ 10). The district court then awarded Gartman his attorney’s fee of $143,552 and legal expenses of $19,716.25. (Doc. 1, ¶ 11). Evanston paid the compensatory and punitive damages (Doc. 1, ¶ 12), and filed this lawsuit seeking a judicial determination of its obligation to cover Brady’s liability for Gartman’s attorney’s fees. (Doc. 1).

D. Brady’s Counterclaim against Evanston

Brady responded (in part) by filing a three-count Counterclaim against Evanston. (Doc. 7). Brady claims Evanston breached the enhanced obligation of good faith owed to Brady (Count I) because (1) Evanston failed to tell Brady or her attorney about policy exclusions or that they undertook the defense of Brady under a reservation of rights; and (2) Evanston failed to consult Brady before offers on her behalf were extended or before offers of settlement from the plaintiff were rejected. (Doc. 7, ¶ 17). Brady thus argues that she was not given an opportunity (1) to demand settlement by Evanston within policy limits; (2) to offer some amount from her personal resources to settle the case; or (3) to retain an attorney of her own choosing. (Doc. 7, ¶ 17). Brady also argues that Evanston, having undertaken the defense of Brady without properly reserving its purported non-coverage rights, cannot deny coverage for the attorneys’ fees and costs for which a judgment has been issued against Brady, so Evanston’s refusal to cover and pay the attorneys’ fees and costs was a breach of the insurance contract, and Evanston intentionally failed to determine whether there was a legitimate or arguable reason to deny coverage (Count II). (Doc. 7, ¶ 19). Brady’s last count (Count III) states:

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Evanston Insurance Company v. Brady, Counsel Stack Legal Research, https://law.counselstack.com/opinion/evanston-insurance-company-v-brady-alnd-2024.