Four Seasons Healthcare, Inc. v. Willis Insurance Services of Georgia, Inc.

682 S.E.2d 316, 299 Ga. App. 183, 2009 Fulton County D. Rep. 2531, 2009 Ga. App. LEXIS 853
CourtCourt of Appeals of Georgia
DecidedJuly 15, 2009
DocketA09A0785
StatusPublished
Cited by6 cases

This text of 682 S.E.2d 316 (Four Seasons Healthcare, Inc. v. Willis Insurance Services of Georgia, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Four Seasons Healthcare, Inc. v. Willis Insurance Services of Georgia, Inc., 682 S.E.2d 316, 299 Ga. App. 183, 2009 Fulton County D. Rep. 2531, 2009 Ga. App. LEXIS 853 (Ga. Ct. App. 2009).

Opinions

ANDREWS, Presiding Judge.

Four Seasons Healthcare, Inc., Healthfield Holdings, Inc., Healthfield, Inc., and Rodney Windley sued their insurance broker, Willis Insurance Services of Georgia, Inc., alleging that they hired Willis to procure directors and officers (D & O) liability insurance sufficient to cover any claim that might arise out of a pending business transaction, and that Willis negligently failed to procure insurance sufficient to cover the claim that later arose. All four insureds appeal from the trial court’s grant of summary judgment in favor of Willis. For the following reasons, we affirm.

The suit involved two AIG insurance policies procured by Willis. One was a new policy that provided D & O coverage for Four Seasons effective March 9, 2001, and the second was an existing D & O policy for Healthfield Holdings (which also named Healthfield, Inc. and Windley as additional insureds) that was extended for three years to provide additional D & O coverage. After the insureds’ pending business transaction was finalized, a claim arose out of the transaction, and the insureds called on AIG to provide D & O coverage for the claim under both policies.

The business transaction and the resulting claim involved all four insureds. Windley was the chief executive officer of Healthfield Holdings and the chief executive officer and chairman of the board of directors of Healthfield, Inc. Healthfield Holdings’ only substantial asset was ownership of all of Healthfield, Inc.’s stock, which was in foreclosure after Healthfield Holdings defaulted on a note for which the stock was collateral. Windley incorporated Four Seasons for the purpose of buying Healthfield, Inc.’s stock at foreclosure. After Four Seasons bought the stock at the foreclosure sale on March 9, 2001, a [184]*184group of Healthfield Holdings shareholders (owning more than 5 percent of the voting stock) filed suit on November 21, 2001, against Four Seasons, Healthfield Holdings, Healthfield, Inc., and Windley, alleging that they were wrongfully frozen out by the stock purchase and transfer of corporate assets to Four Seasons. See APA Excelsior III, L.P v. Windley, 329 FSupp.2d 1328 (N.D. Ga. 2004).

AIG denied D & O coverage under both policies for the claim asserted in the shareholders’ suit. As to the policy insuring Four Seasons, AIG relied on the fact that the policy excluded coverage for prior acts (acts occurring prior to the March 9, 2001 effective date of the policy). As to the policy insuring Healthfield Holdings (and naming Healthfield, Inc. and Windley as additional insureds), AIG relied on the fact that the policy excluded coverage for claims brought by shareholders owning more than 5 percent of the insured’s voting stock (the 5 percent major shareholder exclusion). None of the insureds challenged AIG’s denial of coverage, and it is undisputed that the policies excluded coverage for the shareholders’ claim. The negligence suit brought by the insureds against Willis sought damages for amounts paid to the shareholders to settle the uncovered claim plus attorney fees paid to defend the claim.

Willis moved for summary judgment on various grounds, and the trial court summarily granted the motion without setting forth reasons. The record shows that Willis was entitled to summary judgment on at least two of the grounds asserted in its motion. First, even assuming that Willis was negligent because it failed to procure the requested insurance coverage or to adequately explain the coverage, recovery was barred because Four Seasons knew about and requested the prior acts exclusion in its policy, and Healthfield Holdings, Healthfield, Inc., and Windley failed in their duty to read and discover the plain and unambiguous 5 percent major shareholder exclusion in their policy. Second, because there is no evidence in the record that Willis could have procured the Healthfield Holdings D & O policy without the 5 percent major shareholder exclusion, there is an absence of evidence to prove an essential element of the negligence claim — that Willis’ alleged negligence proximately caused the lack of coverage.

Despite specific recommendations by Willis that Four Seasons include “prior acts” coverage in its D & O policy, Four Seasons rejected this advice and refused “prior acts” coverage because it concluded that there was no need for the coverage. Accordingly, Four Seasons was well aware that its D & O policy excluded coverage for claims based on acts that the shareholders’ suit alleged occurred prior to the March 9, 2001 effective date of the policy. The other D & O policy insuring Healthfield Holdings (and naming Healthfield, Inc. and Windley as additional insureds) included a “5% major share[185]*185holder exclusion,” which provided:

In consideration of the premium charged, it is hereby understood and agreed that the Insurer shall not be liable for any Loss in connection with any Claim(s) made against any Insured(s) which are. brought by any individual(s) or entity(ies) that own or control (whether beneficially, directly or indirectly) 5% or more of the outstanding voting stock (hereinafter “Major Shareholder”); or by any security holder of the Company whether directly or derivatively, unless such security holder’s Claim(s) is instigated and continued totally independent of, and totally without the solicitation of, or assistance of any Major Shareholder.

This provision plainly excluded coverage for any “Loss” (defined under the policy to include damages from judgments, settlements, and defense costs) connected with a claim against an insured brought by shareholders owning 5 percent or more of the voting stock, or by any security holder of the “Company.” Under the policy, the term “Company” referred to the named insured, Healthfield Holdings and additional subsidiary insureds. The provision clearly excluded coverage for any loss connected with the suit brought by over 5 percent of Healthfield Holding’s shareholders. The' policy insureds do not contest the plain effect of this exclusion. In fact, they virtually conceded this point by making no challenge to AIG’s denial of coverage. Rather, they claim that they were unaware of the exclusion and that Willis negligently failed to obtain a policy without the exclusion or to adequately advise them about the contents of the policy.

The general rule applicable to the insureds’ claims is set forth in this Court’s whole court decision in Atlanta Women’s Club v. Washburne, 207 Ga. App. 3, 4 (427 SE2d 18) (1992). “[Wjhere the agent does procure the requested policy and the insured fails to read it to determine which particular risks are covered and which are excluded, the agent is thereby insulated from liability, even though he may have undertaken to obtain ‘full coverage.’ ” Washburne, 207 Ga. App. at 4 (citation and punctuation omitted). The rule is based on the requirement that

[an insured] who has the policy in his possession prior to the uninsured loss is charged with the knowledge of the terms and conditions of the policy, namely and in particular that the policy coverage was not as contracted for between the parties. Consequently the [insured] being, under the law, charged with knowing the terms and conditions of the [186]*186policy, any negligence, if any, on the part of the defendant in failing to procure the amount or type of insurance coverage contracted for could have been avoided by the [insured] and therefore a finding for the defendant is demanded.

England v. Georgia-Florida Co., 198 Ga. App.

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Four Seasons Healthcare, Inc. v. Willis Insurance Services of Georgia, Inc.
682 S.E.2d 316 (Court of Appeals of Georgia, 2009)

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Bluebook (online)
682 S.E.2d 316, 299 Ga. App. 183, 2009 Fulton County D. Rep. 2531, 2009 Ga. App. LEXIS 853, Counsel Stack Legal Research, https://law.counselstack.com/opinion/four-seasons-healthcare-inc-v-willis-insurance-services-of-georgia-inc-gactapp-2009.