Health First, Inc. v. Capitol Specialty Insurance Corp.

230 F. Supp. 3d 1285, 2017 WL 589113, 2017 U.S. Dist. LEXIS 20320
CourtDistrict Court, M.D. Florida
DecidedFebruary 14, 2017
DocketCase No: 6:15-cv-718-Orl-41DCI
StatusPublished
Cited by2 cases

This text of 230 F. Supp. 3d 1285 (Health First, Inc. v. Capitol Specialty Insurance Corp.) is published on Counsel Stack Legal Research, covering District Court, M.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Health First, Inc. v. Capitol Specialty Insurance Corp., 230 F. Supp. 3d 1285, 2017 WL 589113, 2017 U.S. Dist. LEXIS 20320 (M.D. Fla. 2017).

Opinion

ORDER

CARLOS E. MENDOZA, UNITED STATES DISTRICT JUDGE

THIS CAUSE is before the Court on the Motion for Summary Judgment (Doc. 41) filed by Defendants Executive Risk Indemnity, Inc. and Executive Risk Specialty Insurance Co. (collectively, “Executive Risk”), to which Plaintiffs filed a Response (Doc. 49). Executive Risk filed a Reply (Doc. 51) as well as two Notices of Supplemental Authority (Doe. Nos. 70, 97). This cause is also before the Court on the Motion for Summary Judgment (Doc. 45) filed by Defendants Capitol Insurance Corporation, Darwin National Assurance Company, and Darwin Select Insurance Company (collectively, “Allied World”). Plaintiffs filed a Response (Doc. 50), and Allied World filed a Reply (Doc. 53) as well as two Notices of Supplemental Authority (Doc. Nos. 69, 96). Additionally, before the Court is Plaintiffs’ Motion to Strike (Doc. 54) and Executive Risk’s Response (Doc. 57). For the reasons stated herein, Plaintiffs’ Motion to Strike will be denied and Defendants’ Motions for Summary Judgment will be granted.

I. Factual Background

Plaintiff Health First, Inc. (“Health First”) was first formed in 1995 when two Brevard County hospitals, Plaintiff Holmes Regional Medical Center and Plaintiff Cape Canaveral Hospital, merged to form a non-profit organization to provide integrated healthcare services. (Doc. 49 at 9).1 In 2011, Health First opened another hospital in Viera, Florida. (Id.). Health First also operates a physician group, “Health First Physicians, Inc.,” and has its own network of managed care health plans offered through Plaintiff Health First Health Plans, Inc. (“HFHP”) and Plaintiff Health First Insurance, Inc. (Mathias Aff. [1289]*1289in Resp. to Executive Risk’s Mot. for Summ. J., Doc. 49-17, ¶¶ 4-9). Plaintiffs were named as defendants in several lawsuits between 1998 and 2018. The current dispute centers around whether multiple insurance contracts issued by Defendants provide coverage for claims arising from litigation instituted against Plaintiffs.

A. The Underlying Insurance Policies

Health First and HFHP have purchased numerous insurance policies from Defendants. As relevant to this suit, Health First purchased from Executive Risk Indemnity, Inc. (“ERI”) a Directors, Officers, and Trustees Liability Insurance Policy (“1997 Executive Risk D&O Policy,” Doc. 41-2), effective 1997-1998,2 and a Managed Care Organization Errors and Omissions Liability Policy (“1998 Executive Risk E&O Policy,” Doc. 41-1), effective 1998-1999. Health First subsequently purchased two Directors, Officers, and Trustees Liability Policies from ERI—one providing coverage from 2004-2005 (“2004 Executive Risk D&O Policy,” Doc. 49-3) and another for 2006-2007 (“2006 Executive Risk D&O Policy,” Doc. 49-4). In 2004, HFHP purchased a Managed Care Organization Errors and Omissions Liability Policy (“2004 Executive Risk E&O Policy,” Doc. 49-2), effective 2004-2005, from Executive Risk Specialty Insurance Company.

In addition to the 2004 Executive Risk E & O Policy, HFHP purchased an Excess Insurance Policy (“2004 Capitol Excess E & O Policy,” Doc. 50-1) from Defendant Capitol Specialty Insurance Corporation (“Capitol”), effective 2004-2005. HFHP also obtained from Capitol a Managed Care Organizations Errors and Omissions Liability Policy (“2006 Capitol E&O Policy,” Doc. 50-2), effective 2006-2007. In 2012, HFHP purchased a Managed Care Organization Errors and Omissions Liability Policy (“2012 Darwin Select E&O Policy,” Doc. 50-4) from Darwin Select Insurance Company (“Darwin Select”), effective 2012-2013. Additionally, Darwin National Assurance Company (“Darwin National”) issued a Health Care Organization Directors and Officers Liability Insurance Policy (“2012 Darwin National D&O Policy,” Doc. 50-3) to Health First, effective 2012-2013.

All of the abovementioned policies are “claims made policies,” meaning that coverage is triggered under each policy for claims that are first made during the respective policy period. (Doc. 41-2 at 26; Doc. 41-1 at 15; Doc. 49-2 at 5; Doc. 49-3 at 45; Doc. 49-4 at 5; Doc. 50-1 at 2; Doc. 50-2 at 4; Doc. 50-3 at 61; Doc. 5041 at 28). All of the policies also contain a related claims provision, which provides that all related claims are treated as a single claim and are deemed to have been made when the earliest of the related claims was made. (Doc. 41-1 at 22; Doc. 41-2 at 29-30; Doc. 49-2 at 14-15; Doc. 49-3 at 49; Doc. 49-4 at 9; Doc. 50-2 at 7-8; Doc. 50-3 at 72; Doc. 50-4 at 32; see Doc. 50-1 at 4 (providing under the 2004 Capitol Excess E&O Policy that excess coverage would “apply in conformance with the terms and conditions of’ the 2004 Executive Risk E & O Policy)). According to the policies, related claims include “all Claims for Wrongful Acts based on, arising out of, directly or indirectly resulting from, in consequence of, or in any way involving [1290]*1290the same or related facts, circumstances, situations, transactions, or events or the same or related series of facts, circumstances, situations, transactions, or events.”3 (Doc. 41-1 at 17; Doc. 49-2 at 8; accord Doc. 41-2 at 29-30; Doc. 49-3 at 17; Doc. 49^1 at 36; Doc. 50-2 at 14; Doc. 50-3 at 64; Doc. 50-4 at 39).

Also relevant is the prior/pending litigation exclusion. This exclusion, which is found in all of the policies, provides that coverage is barred for claims “based on, arising out of, directly or indirectly resulting from, in consequence of, or in any way involving any fact, circumstance or situation ... underlying or alleged in any prior and/or pending litigation as of the [policy’s] Inception Date.” (Doc. 41-2 at 28; Doe. 49-3 at 47; Doc. 49-4 at 7; accord Doc. 41-1 at 20; Doc. 49-2 at 12; Doc. 50-2 at 6; Doc. 50-3 at 67; Doc. 50-4 at 30; see also Doc. 50-1 at 4 (explaining that coverage under the 2004 Capitol Excess E&O Policy would apply in conformance with the terms and conditions of the primary policy)).

B. The Underlying Litigation

Between 1998 and 2013, Health First and other Health First entities were named as defendants in several lawsuits. In February 1998, Wuesthoff Health Systems, Inc. (“Wuesthoff’) filed suit (“Wuesthoff /”) against Health First, Holmes Regional Medical Center, Inc., and Cape Canaveral Hospital, Inc. in the U.S. District Court for the Middle District of Florida. (See Wuesthoff I Compl., Doc. 41-3). Wuesthoff alleged that Health First had engaged in anticompetitive behaviors to promote its own hospital to the detriment of Wuesthoffs Rockledge hospital, Wuesthoff Memorial Hospital, in central Brevard County (Id. ¶¶ 2, 7). Wuesthoff voluntarily dismissed the case, (Apr. 7, 1999 Order, Doc. 49-5, at 4), and, in July 1999, refiled the case (“Wuesthoff II”) in state court, adding HFHP as a defendant. (Wuesthoff II Compl., Doc. 49-6). The parties settled the case in 2000. (Doc. 49-17 ¶ 17; see also Settlement Agreement, Doc. 49-7; Mutual Release, Doc. 49-8). Wuesthoff again filed suit (“Wuesthoff III”) against Health First in the Middle District of Florida in September 2005. (Wuesthoff III Compl., Doc. 41-5). The suit named the same defendants as Wuesthoff II and added Health First, Physicians, Inc. as a party. (Compare Doc. 49-6 at 2, with Doc. 41-5 at 2).

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230 F. Supp. 3d 1285, 2017 WL 589113, 2017 U.S. Dist. LEXIS 20320, Counsel Stack Legal Research, https://law.counselstack.com/opinion/health-first-inc-v-capitol-specialty-insurance-corp-flmd-2017.