HCA, Inc. v. American Protection Insurance Co.

174 S.W.3d 184, 2005 Tenn. App. LEXIS 37, 2005 WL 147766
CourtCourt of Appeals of Tennessee
DecidedJanuary 24, 2005
DocketM2003-02065-COA-R3-CV
StatusPublished
Cited by13 cases

This text of 174 S.W.3d 184 (HCA, Inc. v. American Protection Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
HCA, Inc. v. American Protection Insurance Co., 174 S.W.3d 184, 2005 Tenn. App. LEXIS 37, 2005 WL 147766 (Tenn. Ct. App. 2005).

Opinions

OPINION

WILLIAM B. CAIN, J.,

delivered the opinion of the court,

in which FRANK G. CLEMENT, JR., J., joined. WILLIAM C. KOCH, JR., P.J., M.S., filed a concurring opinion.

HCA, Inc. appeals the action of the trial court in granting summary judgment to the insurer/ defendants based upon an “inventory exclusion” provision in the policies of insurance. We reverse the action of the trial court and remand the case for further proceedings.

I. The Parties — the Insurance Policies and the Language of the Inventory Exclusion Clause

Plaintiff HCA, Inc. is the parent company of a number of subsidiaries and other [187]*187affiliates that operate over 200 proprietary hospitals and a variety of other health care facilities throughout the United States. The claims which are involved in this appeal arise from the daily operation of 105 of these hospitals and 20 other surgical facilities.

Defendants are American Protection Insurance Company (“Kemper”), and various insurance companies which may be divided into two groups. First are the Winterthur defendants collectively consisting of Win-terthur International America Insurance Company (now known as XL Insurance Global Risk), Lexington Insurance Company, RLI Insurance Corporation, General Star Indemnity Company, Commonwealth Insurance Company, Continental Insurance Company, Sirius Insurance Corporation, Zurich Reinsurance Company, Royal Indemnity Company, and Employer’s Insurance of Wausau. The second group of insurers, (collectively the “IRI defendants”) are Allianz Insurance Company, The Travelers Indemnity Company of Illinois, certain underwriters of Lloyds, London, and IRI.

The policies of insurance in issue are what is known in the industry as “all-risk” policies. All of the policies contained deductible clauses providing: “All losses, damages, or expenses arising out of any one occurrence shall be adjusted as one loss, and from the amount of such adjusted loss shall be deducted the sum of U.S. $250,000.”

Each of the policies also contained an “inventory exclusion” clause providing:

This Policy does not insure against:

A. Loss or damage caused by infidelity or dishonesty of the Insured; embezzlement of the Insured’s property by any of the Insured’s employees; nor loss or damage resulting from the Insured voluntarily parting with title or possession of any property if induced to do so by any fraudulent scheme, trick, device or false pretense; nor any unexplained loss, mysterious disappearance, or loss or shortage disclosed on taking inventory, except this exclusion does not prohibit proving the amount of any loss otherwise provable by inventory;

In describing an all-risk policy the trial court stated:

Unlike typical property loss policies which are structured to cover specified losses for which the parties contract, an all-risk policy automatically covers any loss unless the policy contains a provision expressly excluding the loss from coverage. As explained by Couch in his insurance treatise, “In recent years, so-called ‘all-risk’ insurance policies have been used with increasing frequency. An ‘all-risk’ policy creates coverage of a type not ordinarily present under other types of insurance, and recovery is allowed for fortuitous losses unless the loss is excluded by a specific policy provision....” Couch on Insurance 3d § 147:50 (3d ed.1998).
The effect of an all-risk policy is to broaden coverage. A policy of insurance insuring against all risks creates a special type of insurance “extending to risks not usually contemplated, and recovery under the policy will be generally allowed, at least for all losses of a fortuitous nature, in the absence of fraud or other intentional misconduct of the insured unless the polic[y] contains a specific provision expressly excluding the loss from coverage.” Lyons Diecasting Co. v. NEC, Inc., 1990 WL 51809, at *5 (Tenn.Ct.App. April 27, 1990). Under an all-risks policy the plaintiff need only prove that a fortuitous event caused the loss. Persian Galleries, Inc. v. Transcontinental Insurance Co., 38 F.3d 253, [188]*188257 (6th Cir.1994). A fortuitous event is “an event which so far as the parties to the contract are aware, is dependant upon chance.” Persian Galleries, 38 F.3d at 257. A fortuitous event may be beyond the power of any human to bring the event to pass or it may be within the control of third persons or even be a past event provided the fact is unknown to the parties. Id. It is not necessary for the plaintiff to show how the property came to be lost or the methods or means by which the property came to be lost. It is sufficient if the plaintiff shows the property is lost and covered by the physical loss provision of the contract of insurance. Id.

Since we cannot improve on this statement by the chancellor we adopt it.

At the outset we must acknowledge and applaud the skill and industry of all counsel in this case. The briefs and the appendices to briefs filed in this court are in the highest tradition of superlative appellate practice. No effort, however laborious and tedious, has been spared by counsel in deep and comprehensive analysis of this complex case and in exposition of applicable case law. This court is much appreciative of such efforts.

II. The History of the Case

In the day-to-day operation of its 105 separate hospitals and 20 surgical centers, HCA uses massive quantities of linens including bed sheets, pillow slips, and surgical gowns. Laundering, maintenance, and constant supply to the various facilities is a major undertaking. On January 22, 1996, HCA entered into a contract with FDR Services Corporation whereby FDR agreed to provide services including but not limited to laundering of linens, supplying of linens to various HCA medical facilities, and management of the linen inventory, including the ordering of additional linen as needed. -FDR operated pursuant to this contract from January 22, 1996 until May 1, 1998 when the contract was assigned by FDR to Tartan Textiles, Inc. In September of 1998, HCA conducted a physical inventory of linen stocks in its surgical and medical facilities. Thereafter HCA determined that during the period of its contractual relations with FDR it had suffered a loss of linen stock at a value of somewhere between eight and twelve million dollars which it determined to result from mismanagement of inventory by FDR and other acts of misfeasance and malfeasance on the part of FDR.

Following the September 1998 inventory HCA demanded payment of its losses under the various “all-risk” policies issued by the defendant insurance companies. All of the insurance companies declined to pay the alleged loss, and HCA filed suit.

III. Issues Drawn by the Pleadings

By its third amended complaint, HCA asserts claims against all of the insurance company defendants for breach of contract in that they failed to pay for losses allegedly occurring between January 22, 1996 and May 1, 1998, for the value of linens “either lost or stolen while in the possession or care of FDR” which were no longer physically available to HCA. HCA alleged the loss, notice to the insurers, proper proof of loss, demand for payment, and refusal of the insurers to pay.

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HCA, Inc. v. American Protection Insurance Co.
174 S.W.3d 184 (Court of Appeals of Tennessee, 2005)

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Bluebook (online)
174 S.W.3d 184, 2005 Tenn. App. LEXIS 37, 2005 WL 147766, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hca-inc-v-american-protection-insurance-co-tennctapp-2005.