Federal Insurance v. Sammons Financial Group, Inc.

595 F. Supp. 2d 962, 2009 U.S. Dist. LEXIS 8376, 2009 WL 252096
CourtDistrict Court, S.D. Iowa
DecidedFebruary 4, 2009
Docket4:08-cv-00288
StatusPublished
Cited by17 cases

This text of 595 F. Supp. 2d 962 (Federal Insurance v. Sammons Financial Group, Inc.) is published on Counsel Stack Legal Research, covering District Court, S.D. Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Federal Insurance v. Sammons Financial Group, Inc., 595 F. Supp. 2d 962, 2009 U.S. Dist. LEXIS 8376, 2009 WL 252096 (S.D. Iowa 2009).

Opinion

ORDER ON DEFENDANTS’ MOTION TO DISMISS, STAY, OR TRANSFER

ROBERT W. PRATT, Chief District Judge.

On August 21, 2008, Sammons Financial Group, Inc. (“Sammons”), Midland Nation *965 al Life Insurance Company (“Midland”), and North American Company for Life and Health Insurance (“NACOLAH”) (collectively “Defendants”) filed a Motion to Dismiss for Failure to State a Claim upon Which Relief Can be Granted or in the Alternative to Stay Action or in the Alternative to Transfer Venue (hereinafter “Motion”) in the present action. Clerk’s No. 11. Plaintiff, Federal Insurance Company (“Federal”), resisted the Motion on September 8, 2008. Clerk’s No. 19. Defendants filed a Reply on September 19, 2008 and requested an oral hearing. Clerk’s No. 29. A hearing was held on December 17, 2008. Clerk’s No. 35. The matter is fully submitted.

I. FACTUAL AND PROCEDURAL BACKGROUND

Sammons is a financial services holding company that owns stock in insurance subsidiaries. Horvat Deck ¶ 3. Sammons itself has no employees, and it is not licensed to and does not conduct insurance business in any jurisdiction. Id. ¶¶ 3-4; Compl. ¶2. Sammons is incorporated in Delaware with its principal office and place of business in South Dakota. Horvat Deck ¶ 3. Sammons’ insurance subsidiaries include Midland and NACOLAH. Id. ¶¶ 3-4; Compl. ¶¶ 2-4. Midland and NACO-LAH are both corporations organized under the laws of Iowa; Midland’s principal place of business is Iowa and NACOLAH’s principal place of business is Illinois. Hor-vat Deck ¶¶ 3-4.

Federal is a stock insurance company incorporated in New Jersey with its principal place of business is Chicago, Illinois. Compl. ¶ 1. Federal issued an excess insurance policy (“Excess Policy”) to Sammons, which supplements a professional liability insurance policy (“Primary Policy”) issued by Indian Harbor Insurance Company (“Indian Harbor”) to Sammons. 1 Id. ¶ 46; Compl. Ex. B.; Defs.’ Reply at 4-5. Defendants have filed claims with Federal for coverage under the Excess Policy. Federal filed the present action to clarify its obligations regarding these claims. The parties’ dispute over coverage is based on several portions of the Primary and Excess Policies, set forth below.

A. Relevant Contract Provisions

The terms of the Excess Policy’s coverage are largely established by the Primary Policy, incorporated into the Excess Policy by reference. See Compl. Ex B; see also Compl. ¶¶ 34, 40. The Primary Policy provides coverage for “Insured Loss from Claims first made against the Insured during the Policy Period or ... for Wrongful Acts first committed on or after the Retroactive Date.” Compl. ¶ 16. “Wrongful Act” includes “any actual or alleged act, error, omission, misstatement, misleading statement, or breach of fiduciary or other duty committed by an Insured in rendering, or failing to render Professional Services,” as well as “any actual or alleged act, error, or omission of an Outside Service Provider ... [or] Independent Insurance Agent for which the Insurance Company is alleged to be liable----” Id. ¶ 18. “Loss” is defined, in pertinent part, by Section II(I) of the Primary Policy:

“Loss” means damages, judgments, awards, settlements, and the Defense Expenses which an Insured is legally obligated to pay as a result of a Claim. Loss includes punitive or exemplary damages when insurable under the law pursuant to which this Policy shall be construed.... Loss shall not include:
*966 (1) fines, sanctions, taxes, penalties imposed by law or any multiplied damage award which is in excess of the damages award so multiplied;
(2) matters which are uninsurable under the law pursuant to which this Policy shall be construed;
(3) salaries, wages, fees, or other compensation, overhead, or benefit expense of any insured;
(4) fees, commissions, compensation, or interest charged to or due from clients or customers of the Insurance Company;
(5) the cost of complying with any settlement for, or award of, non-monetary relief; or
(6) any amount due under any contract or policy of insurance or reinsurance underwritten, issued, assumed, or subscribed to by the Insurance Company.

Compl. Ex. B at 6. Thus, both the Primary and Excess Policies provide indemnification for settlements and damages arising from a lawsuit against the Defendants, as well as compensation for reasonable legal fees incurred by Defendants in their defense of such lawsuits. The payment of Defense Expenses may be subject to “a written undertaking ... guaranteeing the repayment ... if it is finally determined that Loss incurred by such Insured would not be covered.” Compl. Ex. A at 13. The defense costs alone may exhaust the Limit of Liability, which is $10 million under the Excess Policy. Compl. ¶¶21, 25; Compl. Ex. B at 4.

The Excess Policy, by its own terms and by incorporating the terms of the Primary Policy, contains four coverage exclusions relevant to this Declaratory Judgment: (1) the Fraudulent Act exclusion; (2) the Intentional Act exclusion; (3) the Profit or Advantage exclusion; (4) and the Representation of Performance or Value exclusion. Compl. ¶¶ 101-120. The Fraudulent Act, Intentional Act, and Profit or Advantage exclusions, set forth in Section III(A)(l)-(3) of the Primary Policy, as amended by Endorsement Number 7, provide in pertinent part as follows:

The Coverage under this Policy does not apply to any Claim ... brought about or contributed to in fact by:
(1) [Fraudulent Act exclusion — ] any dishonest, fraudulent or criminal act or omission by an Insured, Independent Insurance Agent, or Outside Service Provider;
(2) [Intentional Act exclusion — ] any willfull [sic] or intentional violation of any statute, rule or law by an Insured, Independent Insurance Agent, or Outside Service Provider; or
(3) [Profit or Advantage exclusion — ] the gaining of any profit, remuneration or advantage by an Insured, Independent Insurance Agent, or Outside Service Provider to which the Insured, Independent Insurance Agent, or Outside Service Provider was not legally entitled;
provided, that this EXCLUSION (A) shall not apply to (i) any Claim for fraud and/or bad faith in claims handling or adjusting or (ii) an Insured unless it is established that the Insured participated in or acquiesced in the dishonest, fraudulent or criminal act or omission, the willful or intentional violation, or the gaining of profit, remuneration or advantage as determined by a final adjudication in the underlying action or in a separate action or proceeding.

Compl. Ex. A at 8, 26. The Representation of Performance or Value exclusion, set forth in Section III(J) of the Primary Policy, provides:

The Coverage under this Policy does not apply to any Claim ...

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Bluebook (online)
595 F. Supp. 2d 962, 2009 U.S. Dist. LEXIS 8376, 2009 WL 252096, Counsel Stack Legal Research, https://law.counselstack.com/opinion/federal-insurance-v-sammons-financial-group-inc-iasd-2009.