United States Court of Appeals For the First Circuit
No. 24-1323
JACQUELINE GARCÍA-NAVARRO,
Plaintiff, Appellant,
v.
UNIVERSAL INSURANCE COMPANY,
Defendant, Appellee,
HOGAR LA BELLA UNIÓN, INC., d/b/a Bella Unión; INSTITUTO MÉDICO FAMILIAR DEL ESTE, PSC; INSTITUTO MÉDICO FAMILIAR, INC.; MARÍA M. BETANCOURT; DR. OSCAR GARCÍA-ROMÁN; DR. IVONNE MAESTRE-GARCÍA; JOHN ROE, husband of Maria M. Betancourt; ABC INSURANCE CO.; ADMIRAL INSURANCE COMPANY; PUERTO RICO MEDICAL DEFENSE INSURANCE COMPANY; SIMED; CONJUGAL PARTNERSHIP ROE-BETANCOURT,
Defendants.
APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF PUERTO RICO
[Hon. John A. Woodcock, Jr.,* U.S. District Judge]
Before
Barron, Chief Judge, Gelpí and Hamilton,** Circuit Judges.
Paúl Rodríguez-Vélez, with whom PRV Law Office was on brief, for appellant.
* Of the District of Maine, sitting by designation. ** Of the Seventh Circuit, sitting by designation. José A. Andreu-Collazo, with whom José A. Andréu-Fuentes and Andrew & Sagardia were on brief, for appellee.
April 10, 2026 BARRON, Chief Judge. This appeal arises out of a suit
that Jacqueline García-Navarro ("García-Navarro") brought under
Puerto Rico law after her mother died while residing in an assisted
living facility in the Commonwealth. García-Navarro filed the
suit in the United States District Court for the District of Puerto
Rico based on diversity jurisdiction. She named as defendants,
among others, the assisted living facility and its insurer,
Universal Insurance Company ("Universal").
García-Navarro eventually settled her claims against all
the defendants other than Universal and her claims against the
insurer then proceeded to judgment on a stipulated record. The
District Court ultimately entered judgment in favor of Universal
based on a Puerto Rico Supreme Court decision that came down while
García-Navarro's claims against the insurer were still pending.
On appeal, García-Navarro contends that, in doing so, the District
Court improperly gave that Puerto Rico Supreme Court decision
"retroactive" effect and thus that we must reverse the judgment in
favor of Universal.1 For the reasons that follow, we disagree and
so affirm the challenged judgment.
1 García-Navarro's notice of appeal challenged: (1) the judgment entered in favor of Universal Insurance Company as to "whether there is indemnity coverage" found in ECF No. 571; (2) "the legal determinations and analysis" in the section "Evaluating Jacqueline García-Navarro's Arguments" of the Opinion and Order on Motion for Judgment on a Stipulated Record found in ECF No. 567, pages 49-53; (3) "the legal determinations and
- 3 - I.
García-Navarro filed her suit on February 23, 2017. In
her third amended complaint, she named as defendants, in relevant
part, Hogar La Bella Unión, Inc. ("Hogar"), an assisted-living
facility; and Universal. The complaint set forth Puerto Rico law
claims that stemmed from events that occurred while
García-Navarro's mother, Carlina Navarro-Ayala ("Navarro-Ayala"),
resided at Hogar. Specifically, it set forth claims for
negligence, commercial liability, commercial liability due to
negligent clerical mistake, negligent staffing and hiring, and bad
faith by Universal in denying coverage to Hogar under Hogar's
general liability insurance policy.
The complaint alleges, in relevant part, the following.
Navarro-Ayala suffered from anemia while at Hogar. María
Betancourt ("Betancourt"), the licensed practical nurse who opened
Hogar, incorrectly informed the doctors that Navarro-Ayala was a
Jehovah's Witness. Based on that erroneous information, the
analysis" in the "Issue Preclusion" and "Law of the Case and Coverage Exclusions" portions of the Order on Cross Motions for Partial Summary Judgment found in ECF No. 473, pages 71-76; and (4) "the legal determinations and analysis" in portions of the "Application of the Settlement Agreement" section of the Opinion and Order on Pending Motions found in ECF No. 427, pages 46-58. Appellant's opening brief, however, only specifically mentions the judgment entered in Universal's favor, the Order on Cross Motions for Partial Summary Judgment, and the Judgment on a Stipulated Record. Because the basis for her argument as to all three of those orders is the same, we proceed in the opinion without delineating between the three specific orders.
- 4 - doctors treating Navarro-Ayala while she was at Hogar did not order
a blood transfusion for her, even though she had chronic anemia.
As a result, Navarro-Ayala died from heart failure on
March 26, 2016. Universal was Hogar's insurer at all relevant
times but, in bad faith, denied Hogar's claim for coverage under
its insurance policy for its alleged liability to García-Navarro.
On August 15, 2018, Universal filed a motion for summary
judgment to dismiss García-Navarro's claims against it. The motion
argued that there was no genuine dispute of material fact that
Universal's general commercial liability insurance policy with
Hogar excluded from its coverage all bodily injury or property
damage that resulted from Hogar rendering "professional services."
The motion further argued that García-Navarro's claims against
Universal were all predicated on Hogar having engaged in acts and
omissions that constituted the rendering of "professional
services." Accordingly, the motion contended, Universal was
entitled to summary judgment on García-Navarro's claims against it
because it had no obligation under Hogar's insurance policy to
provide coverage to the assisted living facility for any of its
alleged liability to García-Navarro, as that liability was based
entirely on Hogar having rendered "professional services."
In opposing Universal's motion for summary judgment,
García-Navarro identified at least three actions by Hogar on which
her claims against Universal rested that she contended were
- 5 - ministerial and so did not constitute "professional services"
within the meaning of the insurance policy at issue. Those actions
were Hogar's: (1) failure to keep proper records; (2) failure to
call 911; and (3) failure to drive Navarro-Ayala to the hospital.
Accordingly, García-Navarro argued, the "professional services"
exclusion in Hogar's policy with Universal could not provide the
basis for Universal's denial of Hogar's claim for coverage and
therefore also could not provide the basis for Universal's defense
against García-Navarro's claim that Universal had denied Hogar
coverage in bad faith.
In its reply to García-Navarro's opposition to its
motion for summary judgment, Universal responded that the three
actions by Hogar that García-Navarro contended were
ministerial -- and so did not constitute "professional
services" -- did constitute "professional services" under Hogar's
insurance policy. In doing so, Universal relied on the Puerto
Rico Supreme Court's decision in Viruet v. SLG Casiano-Reyes, 2015
TSPR 160, which stated that "the failure to provide services
derived from the obligation to secure the wellbeing and security
of the elderly patients constitutes a professional service."
On December 11, 2018, the judge assigned to
García-Navarro's case at the time, Judge William G. Young, granted
summary judgment in favor of Universal as to "any allegations
arising out of" the failure by Hogar to call 911, including the
- 6 - failure to drive Navarro-Ayala to the hospital. He denied summary
judgment to Universal, however, "as it relates to the failure to
keep records of personal information . . . on file" and "to
miscommunicating to the treating physician about the blood
transfusion" because "[t]hose allegations are not professional
services and . . . the case will go forward as to those against
the facility."
Judge Young reasoned that Universal was "stretching
[Viruet] too far" in seeking summary judgment on the ground that
those specific actions also were "professional services." He
concluded that if, under Viruet, those actions were professional
services, "then virtually everything that a geriatric nursing
facility does would be intertwined with professional services and
you're not insuring anything, except perhaps a fire or something."
Thus, Judge Young ruled, Hogar's failure to keep records of
personal information and miscommunicating to the treating
physician about the blood transfusions did not involve the
rendering of "professional services," which meant that those
actions were not encompassed by the "professional services"
exclusion in Hogar's policy with Universal. He therefore concluded
that the policy's "professional services" exclusion could not
provide the basis for Universal's defense to García-Navarro's
claims against it.
- 7 - In 2019, the case was reassigned to a different judge,
Judge John A. Woodcock, Jr., who reaffirmed Judge Young's ruling
on Universal's summary judgment motion. Judge Woodcock concluded
that "if the jury determines that [Hogar] was negligent for failing
to keep proper records or for miscommunicating information and
that those failures caused injuries to Carlina Navarro-Ayala,
Universal will owe a contractual duty of indemnification."
On October 28, 2019, Judge Woodcock ordered a jury trial
on García-Navarro's claims against Hogar and Betancourt in which
Universal would participate only as to the issue of what its
insurance policy with Hogar covered. Judge Woodcock ordered for
that trial to be held prior to a jury trial that would be held
separately on García-Navarro's "bad faith" claim against
Universal.
Later that day, García-Navarro informed the court that
she and Hogar had reached a settlement agreement in which Hogar
and Betancourt accepted liability for the tort claims in the
operative complaint, waived liability apportionment, and assigned
and transferred their cross-claim rights against Universal to
García-Navarro. A few days later, on October 31, 2019, Judge
Woodcock issued an order ruling that there would be a damages-only
jury trial as to the claims between García-Navarro, Hogar, and
Betancourt. Judge Woodcock offered Universal the opportunity to
participate (in its own name) in the damages-only trial between
- 8 - García-Navarro, Hogar, and Betancourt, but Universal declined. On
November 5, 2019, the jury issued a verdict in favor of
García-Navarro and against Hogar and Betancourt, awarding
García-Navarro $950,000 in damages.
On August 12, 2021, Judge Woodcock filed an order
allowing Universal and García-Navarro to file summary judgment
motions as to the claims that remained to be resolved. He noted
that Universal's summary judgment motion should explain not only
the merits of the coverage issue, but also why the law of the case
doctrine did not bar Universal from relitigating the issue of
whether it was entitled to summary judgment as to all the claims
against it based on the "professional services" exclusion in
Hogar's insurance policy.
On November 1, 2021, Universal filed a second motion for
summary judgment. It argued in that motion that an intervening
decision from the Puerto Rico Supreme Court, Rivera-Matos v.
Commonwealth, 2020 TSPR 89, compelled reconsideration of the
ruling in favor of García-Navarro on its prior motion for summary
judgment. Rivera-Matos, Universal argued, adopted the "intricate
part doctrine," under which acts or omissions that "are an
intricate part or are otherwise related to the rendering of
professional services" are excluded from coverage by a
"professional services" exclusion in an insurance policy.
Rivera-Matos, certified translation at 20.
- 9 - In opposing Universal's second motion for summary
judgment, García-Navarro argued that Rivera-Matos considered and
rejected an interpretation of the "professional services"
exclusion that would be so broad as to "render the policy
ineffective, since it would automatically exclude all of the works
of the [insured]" (quoting Rivera-Matos, certified translation at
19). García-Navarro also argued that the decision was issued on
August 24, 2020, which long postdated the events at issue.
Judge Woodcock granted Universal's partial summary
judgment request "insofar as it requests an order that the law of
the case doctrine does not prohibit re-litigation of its indemnity
coverage defense in light of Rivera-Matos." But, he also ruled,
the record of undisputed facts before it was too sparse for it to
undertake the task of comparing "the facts of the case against the
language of the issued policy as illuminated by the Supreme Court
of Puerto Rico" to determine if the professional services exclusion
applied.
On November 22, 2022, Judge Woodcock scheduled a jury
trial on the indemnity coverage issue for April 2023. Following
additional motion practice as to how to proceed, he offered the
parties four separate options. On April 10, 2023, the parties
filed a joint motion (1) waiving the right to a jury trial and
opting instead for an order on whether the professional services
exclusion applied based on a motion for judgment on a stipulated
- 10 - record and (2) attaching the stipulated record to the joint motion.
Each party filed a memorandum of law on the stipulated record on
May 31, 2023. The issues addressed in each memorandum were whether
the professional services exclusion in Hogar's insurance policy
with Universal excluded coverage for either (1) Hogar and
Betancourt's "failure to keep accurate records" about
Navarro-Ayala's "religious beliefs" or (2) Hogar and Betancourt's
"communication of inaccurate information to" the "treating
physician."
Judge Woodcock acknowledged that Judge Young had ruled,
based on his understanding of Viruet, that Hogar's inaccurate
records and inaccurate communications did not constitute
professional services and thus that Universal was not entitled to
summary judgment as to the claims against it that were predicated
on those actions by Hogar. He explained, however, that
Rivera-Matos had adopted the intricate part doctrine in the
interim. He then made the following factual findings based on the
stipulated record.
"Navarro-Ayala's treating physician, Dr. García-Román,
decided against sending her to the hospital after being told,
incorrectly, that she was a Jehovah's Witness." "Betancourt was
the source of the miscommunication to Dr. García-Román that Ms.
Navarro-Ayala was a Jehovah's Witness," and she "took it upon
herself to inform Dr. García-Román that Ms. Navarro-Ayala was a
- 11 - Jehovah's Witness to influence Dr. García-Román's treatment plan."
It was "a critical part of" Betancourt's responsibilities to
coordinate information relevant to Navarro-Ayala's treatment, and
thus the District Court found that Betancourt "was acting within
the scope of her responsibilities when she miscommunicated" to
García-Román. "Betancourt's responsibilities were critical to
Hogar's overall mission."
Judge Woodcock then pointed to the portion of Hogar's
insurance policy with Universal that stated that "[w]ith respect
to any professional services shown in the Schedule, this insurance
does not apply to 'bodily injury,' 'property damage,' 'personal
injury,' or 'advertising injury' due to the rendering of or failure
to render any professional service." Because the policy does not
define "professional services," he determined, the legal
definition of the term controlled. He then further determined
that, under Rivera-Matos, whether an act or omission is a
professional service turns, as discussed, on the intricate part
doctrine. Judge Woodcock thus boiled this case down to "whether
Hogar's failure to keep proper records and Ms. Betancourt's
miscommunication with Dr. García-Román were an intricate part of
the rendering of medical services" and concluded that "they were."
On that basis, Judge Woodcock entered judgment on a stipulated
record in favor of Universal. García-Navarro thereafter filed this
timely appeal from that ruling.
- 12 - II.
García-Navarro argues that the grant of judgment on a
stipulated record to Universal improperly relied on Rivera-Matos
without first evaluating whether, as a matter of Puerto Rico law,
that decision had retroactive application. Universal responds,
however, that García-Navarro never made this argument in the
proceedings below and thus that we must reject it on that basis
alone.
García-Navarro seems to suggest at times in her briefing
to us that she did raise the argument that she now advances on
appeal in the proceedings below. But she also argues that, even
if she did not, we are still "duty-bound to apply and follow
binding authority" because "the law cannot be forfeited."
Our review of the record leads us to conclude that
García-Navarro did not make the argument that she now advances on
appeal in the proceedings below. In her opposition to Universal's
second motion for summary judgment and in her memorandum of law
for judgment on a stipulated record, she argued only that
Rivera-Matos did not control because the insurance contract at
issue should be governed by the Puerto Rico Insurance Code and the
Puerto Rico Civil Code. And, under the Puerto Rico Civil Code,
García-Navarro argued, judicial interpretation "must seek to
establish the mutual intent of the parties on the date the contract
is entered into" (emphasis omitted).
- 13 - Judge Woodcock disagreed with that argument. He ruled
that, as a federal court sitting in diversity, its job was to
"adhere[] to the legal principles outlined by the Supreme Court of
Puerto Rico" and not to "apply general principles of contract
interpretation." In further support of this conclusion, Judge
Woodcock observed that the "Rivera-Matos Court made no suggestion
that its decision should be applied only prospectively to insurance
contracts entered into after the decision," and he also made clear
that "García-Navarro supplied no authority suggesting that
decisions of the Puerto Rico Supreme Court do not apply
retroactively" and that he was also not "aware of any."
On appeal, García-Navarro is now making the very
argument that Judge Woodcock noted that she had not advanced or
attempted to support in the proceedings before the District Court.
She is contending that Rivera-Matos does not apply retroactively
as a matter of Puerto Rico law and that it was error not to first
analyze whether to apply Rivera-Matos using a set of "binding
directives" from the Puerto Rico Supreme Court.
García-Navarro responds in part by asserting that
although both she and Universal "sought a ruling about the temporal
efficacy of the Rivera-Matos decision," neither party provided the
District Court with the applicable Puerto Rico law on determining
the temporal efficacy of a decision. But it is not clear why
Universal's failure in that regard demonstrates that she did not
- 14 - forfeit the argument she now makes on appeal by failing to make it
below. Moreover, García-Navarro did not just fail to supply case
law to the District Court. She affirmatively made an entirely
different argument from the one that she makes to us on appeal.
We also are not persuaded by García-Navarro's
alternative contention that, even if she did not make the argument
that she now presses on appeal in the proceedings below, "the law
cannot be forfeited." As we have repeatedly warned, arguments
that were not raised below are forfeited and will only lead to
reversal upon a showing of plain error. See United States v.
Leahy, 473 F.3d 401, 409-10 (1st Cir. 2007) (citing United States
v. Gomez, 255 F.3d 31, 37 (1st Cir. 2001)). That is no less true
for claims of erroneous interpretations of law.
Our conclusion, that García-Navarro forfeited the
argument that she now advances on appeal is significant, because
she does not, at any point in her briefing to us, explain how the
application of Rivera-Matos was plain error. She has thereby
waived any argument on appeal that such an error occurred. See
United States v. Castillo, 158 F.4th 257, 277 (1st Cir. 2025)
("When an appellant 'fails to even attempt to explain how the plain
error standard has been satisfied,' he waives the argument."
(quoting United States v. Severino-Pacheco, 911 F.3d 14, 20 (1st
Cir. 2018))).
- 15 - Even if we were to reach the question of whether the
claimed error is plain despite García-Navarro's failure to argue
that it is, we do not see how it would be. García-Navarro does
not dispute that Viruet, despite having been decided after she
filed her claims against Universal, constitutes a controlling
precedent in her case. And, in that case, the Puerto Rico Supreme
Court noted that "a professional service depends on whether the
person acts using inventive and special training, proper of a
professional." Viruet, certified translation at 5 (citation
omitted). In addition, Viruet noted that "the activities involving
simply physical, manual or clerical tasks are excluded." Id.
(emphasis added). Yet, in thereafter deciding Rivera-Matos, the
Puerto Rico Supreme Court did not either ignore Viruet or purport
to overrule it. Rather, it favorably cited to Viruet in stating
that "acts simply involving physical, manual or clerical tasks are
excluded." Rivera-Matos, certified translation at 13. It then
went on to explain that "there are acts, even though they do not
require specialized knowledge, to which this exclusion applies for
being an intricate part of [the] professional services rendering
process." Id. at 13-14.
Thus, it is hardly evident that Rivera-Matos did
anything more than clarify its prior precedent. And, if that is
all that Rivera-Matos did, then it would not be clear or obvious
that the general presumption against retroactive application on
- 16 - which García-Navarro's appeal depends would have any application
to Rivera-Matos. After all, it is not clear or obvious under
Puerto Rico law that a decision of the Puerto Rico Supreme Court
that merely applies or clarifies one of its prior precedents is
subject to such a presumption. See, e.g., Rosario Domínguez v.
Commonwealth, 2017 TSPR 90, certified translation at 10
(clarifying, in its application of Puerto Rico law, "that this
Opinion is not intended to displace an old rule of law or establish
a new one. We merely limit ourselves to explaining the current
state of law. Consequently, we rule that the foregoing has
retroactive effect.").
We therefore must reject García-Navarro's
retroactivity-based challenge to the judgment in favor of
Universal. And, because we must, we need not address any of
Universal's alternative grounds for affirming that judgment.
III.
The judgment is affirmed.
- 17 -