Hospital Sisters Health System v. Great American Insurance Company

CourtDistrict Court, C.D. Illinois
DecidedAugust 17, 2021
Docket1:20-cv-01295
StatusUnknown

This text of Hospital Sisters Health System v. Great American Insurance Company (Hospital Sisters Health System v. Great American Insurance Company) is published on Counsel Stack Legal Research, covering District Court, C.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hospital Sisters Health System v. Great American Insurance Company, (C.D. Ill. 2021).

Opinion

IN THE UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF ILLINOIS, PEORIA DIVISION

HOSPITAL SISTERS ) HEALTH SYSTEM, ) ) Plaintiff, ) ) v. ) Case No. 20-cv-1295 ) GREAT AMERICAN ) INSURANCE COMPANY, ) ) Defendant. )

OPINION TOM SCHANZLE-HASKINS, U.S. MAGISTRATE JUDGE: This matter comes before the Court on Defendant Great American Insurance Company’s (Great American) Motion to Compel Production of Privileged Communications Pre-Dating March 8, 2018 (d/e 18) (Motion). For the reasons stated below, the Motion is ALLOWED in part. BACKGROUND Great American issued an insurance policy (Policy) to Hospital Sisters. The term of the Policy began on July 1, 2017 and ended on July 1, 2018. Motion, Ex. 1, Policy Excerpts, at 1. The Policy covered losses resulting directly from dishonest acts committed by an employee of Hospital Sisters and discovered during the term of the Policy. Id., at 2, ¶ B.1. The Policy required Hospital Sisters to notify Great American as soon as possible after “The Risk Management Department and/or Corporate Legal Department and/or Officer discover(s) a loss or a situation that may result

in a loss . . ..” Id., at 5, Endorsement No. 5. Hospital Sisters further agreed to “Cooperate with us in the investigation and settlement of any claim.” Id., at 4, Condition E.7.

On November 8, 2018, Hospital Sisters submitted a Proof of Loss on the Policy to Great American. Motion, Exhibit 2, Proof of Loss. The Proof of Loss stated, in part, “We hereby make claim for Loss of $5,161,500, occurring through fraudulent act(s) with the loss occurring in January 2015

and discovered on March 8, 2018.” Id. From November 2012 through October 2015, Jeffrey Ogletree was Hospital Sisters’ Vice President of Revenue Cycle. Hospital Sisters alleges that Ogletree conspired with an

entity called Free Choice to fraudulently induce Hospital Sisters to donate $5,161,500 to Free Choice to fund the payment of premiums for medical insurance policies for uninsured individuals. Ogletree and his co- conspirators at Free Choice absconded with the money. See Complaint for

Declaratory Judgment, Breach of Contract, and Extra-Contractual Relief (d/e 1) (Complaint) ¶¶ 17-28. Great American denied the claim, at least in part, because Great

American determined that Hospital Sisters discovered the loss long before March 8, 2018 and even before the Policy term began on July 1, 2017. See Motion, attached Great American Insurance Company’s Memorandum

in Support of Its Motion to Compel Production of Privileged Communications Pre-Dating March 8, 2018, at 1. Hospital Sisters brought this action to enforce its claim for the $5,161,500 loss (Loss).

Great American served Hospital Sisters with interrogatories and requests for production of documents. Interrogatory No. 3 asked for the following information: Interrogatory No. 3: State the date on which you discovered the alleged loss described in the complaint, identifying in your answer the person who discovered the alleged loss, what was discovered, and how it was discovered.

Motion, Ex. 7, Hospital Sisters Supplemental Answer to Interrogatory No. 3. Hospital Sisters responded, in relevant part: Hospital Sisters first “discovered” the loss on March 8, 2018. On March 8, 2018, Mark Novak, Hospital Sisters’ Vice President, System Responsibility Officer, received an email from Paul Libassi, an Investigator with the District Attorney’s Office in Riverside County, California. That email attached a news release announcing that four men had been arrested in a case involving health care fraud, money laundering and tax evasion. The news release identified the four men as Brian Andrew La Porte, Dennis Davin Bonavilla, Jeffrey D. Ogletree, and Babar Igbal, and stated that the Riverside County District Attorney’s office had filed a 33-count complaint against the four men that included charges of conspiracy, health care fraud, grand theft, money laundering, tax evasion, and identity theft. The news release stated that Mr. La Porte had created Free Choice Health Care Foundation (“Free Choice”) and referenced Hospital Sisters’ payments to Free Choice that were supposed to be used to buy health insurance, but that some of these funds allegedly had been used for other purposes, including “paying Ogletree $1 million and additional money so he could pay cash” for a home in Idaho and that other “funds were paid to limited liability companies owned by La Porte, Ogletree, and Bonavilla.” Mr. Novak emailed the news release to Michael Cottrell, Chief Financial Officer, Mary Starmann-Harrison, President and Chief Executive Officer, Amy Bulpitt, Vice President and General Counsel, Brian Reardon, Vice President, External Relations, Caitie Sheehan, Vice President, Advocacy and Communications, and Krista Rock, System Director of Managed Care.

Id. Mark Novak, Hospital Sisters’ Vice President, System Responsibility Officer, verified the supplemental answer to Interrogatory 3: VERIFICATION I, Mark A. Novak, declare as follows:

I am acting as agent for Plaintiff/Counterclaim-Defendant Hospital Sisters Health System ("Hospital Sisters") in connection with the foregoing PLAINTIFF/COUNTERCLAIM- DEFENDANT'S SUPPLEMENTAL OBJECTIONS AND RESPONSES TO GREAT AMERICAN INSURANCE COMPANY'S FIRST SET OF INTERROGATORIES, and in my role as such, I hereby certify that the responses provided therein are true and correct to the best of my know]edge, information, and belief based upon information and documents available to me after reasonable investigation. I declare under penalty of perjury that the foregoing is true and correct.

Dated this 26 day of March 2021 s/Mark A. Novak Id. (emphasis in the original).1 In response to Great American’s document production request,

Hospital Sisters produced many documents, and also produced a log of responsive documents withheld on claims of privilege (privilege log). Great American separately served a subpoena on Hospital Sisters’ counsel

McDermott, Will, and Emery LLP (McDermott). McDermott also provided Great American with a privilege log of withheld responsive documents. Great American moves to compel Hospital Sisters and McDermott to produce 493 documents listed on the Hospital Sisters and McDermott’s

privilege logs that pre-date March 8, 2018 (Withheld Documents). Great American asserts that the privilege claims have been waived as to these documents. Hospital Sisters opposes the Motion.

ANALYSIS Great American moves to compel on the grounds that Hospital Sisters waived its attorney-client and work product privileges (Privileges) for the Withheld Documents.2 Great American argues that Hospital Sisters

contractually agreed in the Policy to disclose when its Corporate Legal Department discovered the Loss. The Policy covered losses discovered

1 The date of the month that Novak signed is unclear. The date may be March 6, 2021. 2 Great American does not dispute that the Withheld Documents meet the definition of documents subject to either the attorney-client privilege or the work product privilege. during the Policy term. The Policy stated that Hospital Sisters discovered a loss when “The Risk Management Department and/or Corporate Legal

Department and/or Officer discover(s) a loss or a situation that may result in a loss . . ..” Policy Excerpts, Endorsement No. 5. Thus, the Corporate Legal Department’s discovery of the Loss could determine whether

Hospital Sisters discovered the Loss during the Policy term and whether Hospital Sisters notified Great American of the Loss as soon as possible. Hospital Sisters further agreed to cooperate in the investigation of the Proof of Loss. Great American argues that Hospital Sisters thereby agreed to

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Hospital Sisters Health System v. Great American Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hospital-sisters-health-system-v-great-american-insurance-company-ilcd-2021.