For Senior Help, LLC v. Westchester Fire Insurance Company

CourtDistrict Court, M.D. Tennessee
DecidedMarch 31, 2020
Docket3:19-cv-00126
StatusUnknown

This text of For Senior Help, LLC v. Westchester Fire Insurance Company (For Senior Help, LLC v. Westchester Fire Insurance Company) is published on Counsel Stack Legal Research, covering District Court, M.D. Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
For Senior Help, LLC v. Westchester Fire Insurance Company, (M.D. Tenn. 2020).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF TENNESSEE NASHVILLE DIVISION

FOR SENIOR HELP, LLC, ) ) Plaintiff, ) ) NO. 3:19-cv-00126 v. ) ) JUDGE CAMPBELL WESTCHESTER FIRE INSURANCE ) MAGISTRATE JUDGE HOLMES COMPANY, ) ) Defendant. ) MEMORANDUM Pending before the Court Defendant’s Motion for Summary Judgment (Doc. No. 15). Plaintiff filed a Response (Doc. No. 19) and Defendant filed a Reply (Doc. No. 23). In Support of the Motion, Defendant filed a Statement of Undisputed Material Facts (Doc. No. 15-12), to which Plaintiff responded (Doc. No. 21).1 For the reasons discussed below, Defendant’s Motion for Summary Judgment (Doc. No. 15) is DENIED. I. BACKGROUND The case arises out of dispute over insurance coverage. Plaintiff For Senior Help, LLC (“FSH”) alleges Defendant Westchester Fire Insurance Co. (“Westchester”) wrongfully denied insurance coverage for an arbitration award in favor of FSH. FSH bring claims for breach of

1 On March 16, 2020, Plaintiff filed a Motion for Partial Summary Judgment (Doc. No. 26) and Statement of Undisputed Material Facts (Doc. No. 27). Defendant has not yet responded to Plaintiff’s motion. As Plaintiff’s motion is not fully briefed, the Court now considers only Defendant’s Motion for Summary Judgment (Doc. No. 15). the insurance contract, bad faith refusal to pay, and bad faith failure to settle within policy

limits. (Compl., Doc. No. 1). The following facts are taken from Defendant’s Statement of Undisputed Material Facts as responded to by Plaintiff (Doc. No. 21), and the Final Award issued by the American Arbitration Association (Doc. No. 1-5). A. The Underlying Claim On February 27, 2015, FSH entered into a franchise agreement with Medex Patient Transport Services, LLC (“Medex”),2 a franchisor for the operation of businesses that provide non-emergency transportation and related patient-care services. FSH paid Medex a franchise fee of $78,363.15 and an additional $70,000 for an Area Developer Agreement (“ADA”). The ADA gave FSH the right to solicit, qualify, train, and assist other franchises within an exclusive territory and to receive a percentage of royalties paid by franchises within the covered area.

Pursuant to the franchise agreement, FSH paid Medex a 10% operations fee for “Outsourced Operations Support,” which including call center support, centralized dispatch, route management, certain office functions, and billing. Medex did not provide the operations support as required by the contract and FSH began providing some of its own operations support functions. On April 6, 2016, FSH sent Medex a formal notice of its material breaches of the franchise agreement. Medex responded by terminating the franchise agreement and the ADA on May 25, 2016. As reason for the termination, Medex alleged FSH materially breached the

2 Medex also operated under the tradename “Caliber.”

2 franchise agreement by, among other things, providing its own call center intake, dispatch, and

route management. Medex also claimed FHS misused its trademark by creating “unauthorized return call cards.” (See Notice of Termination, Doc. No. 19-1). The same day it received the notice of termination from Medex, FSH sent its own notice of termination citing Medex’s failure to cure the defaults contained in the Notice of Default. (Arbitration Claim, Doc. No. 19- 3, ¶ 73). FSH brought suit against Medex in state court alleging various claims of fraud and breach of contract.3 In March 2017, after initial litigation in Chancery Court for Davidson County, Tennessee, FSH filed an arbitration demand with the American Arbitration Association. (See Doc. No. 19-2). The arbitration statement of claim alleged the following against Medex: (1) fraud in the inducement; (2) breach of the franchise agreement; (3) breach

of the ADA; (4) violation of the Tennessee Consumer Protection Act; (5) slander; and (6) civil conspiracy. (See Statement of Claim, Doc. No. 27-2). B. The Arbitration Award The arbitrator ruled in favor of FSH on the claims of breach of the franchise agreement, breach of the ADA, fraud in the inducement, intentional misrepresentation, and violation of the Tennessee Consumer Protection Act and denied recovery on the claims for slander and civil conspiracy. (Award, Doc. No. 1-5).

3 FHS’s state-court complaint against Medex alleged the following claims: intentional misrepresentation/fraud/fraud in the inducement, negligent misrepresentation, breach of contract, breach of the covenant of good faith and fair dealing, violation of the Tennessee Consumer Protection Act, misrepresentation by concealment; and sought the following relief: injunctive relief, rescission, declaratory relief, punitive damages, attorneys’ fees, and pre- and post-judgment interest.

3 The arbitrator found that Medex materially breached the franchise agreement by failing

to provide operational support as required by the agreement and by wrongfully terminating the franchise agreement without cause. The arbitrator also found that Medex breached and wrongfully repudiated the ADA. The arbitrator found that Medex made material misrepresentations regarding the availability and quality of the operations support services to be provided under the contract and that Medex “knew they were false at the time they were made and did not intend to perform as represented.” The arbitrator found that not only did Medex make knowingly false statements about the level and quality of operations support to induce FSH to enter into the franchise agreement, it continued to make false statements to induce FSH to continue to perform. The arbitrator stated:

Prior to FSH signing the Agreement, [Medex] minimized or blamed any problems on the franchisees with whom FSH has spoken, or stated that they had been fixed when they had not, evidencing [Medex’s] knowledge of the problems with its operations, failures to disclose the deficiencies in Medex’s “outsourced operations support” and the continuation of those problems and deficiencies for months which is evidence of [Medex’s] intention not to provide the products and services they represented to FSH at the time FSH signed the Agreement and continued to do so to induce FSH to perform and generate money for Medex.

(Doc. No. 1-5, ¶ 19). In sum, the arbitrator concluded that “Respondents breached and wrongfully repudiated and terminated the Agreement and ADA and defrauded Claimant by intentional and knowing conduct causing damages to claimant.” (Id., ¶ 12). The arbitrator awarded $120,461.00 for breach of the franchise agreement, and $452,065.00 for breach of the ADA. For fraud, misrepresentation, and violation of the

4 Tennessee Consumer Protection Act, the arbitrator awarded $613,702.00,4 jointly and severally

against Medex and Medex’s owners, Kyle and Klein Calvert. The arbitrator held: “The awards for violation of the Tennessee Consumer Protection Act and for fraud and misrepresentation represent damages for the same conduct, and thus the awards are not cumulative.” (Award, Doc. No. 1-5, ¶ 47). The arbitrator also awarded Plaintiff attorneys’ fees, expenses, and costs of $244,718.00 and arbitration costs of $34,200.01, jointly and severally against Medex, Kyle Calvert, and Klein Calvert. Davidson County Chancery Court confirmed the arbitration award and entered final judgment on February 18, 2019. (Doc. No. 19-3). C. The Professional Liability Policy Westchester issued a Miscellaneous Professional Liability Policy to Medex (the “Policy”) effective May 27, 2015 to May 27, 2016. (Doc. No. 1-1). The Policy includes the

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