James River Insurance Company v. Gear

District Court, D. Arizona·Decided October 13, 2021·No. 2:20-cv-01052·Unknown

Opinion

WO

James River Insurance Company, No. CV-20-01052-PHX-DGC

Plaintiff/Counterdefendant, ORDER

v.

Wendee Thompson, et. al,

Defendants/Counterclaimants. The parties dispute the scope of Phase 1 discovery in this case. The issues are fully briefed. Docs. 72-75. This order resolves the dispute. I. Background. Plaintiff James River Insurance Company issued a medical professional insurance policy to Dr. Phillip Gear and Just for Kids, P.L.C. Wendee Thompson and her parents, Joseph and Mildred, sued Dr. Gear and Just for Kids in state court, asserting medical malpractice claims based on Dr. Gear’s alleged failure to diagnose and provide appropriate care for Wendee’s pregnancy, which resulted from sexual abuse at a long-term care facility. See Thompson v. Gear, No. CV2019-057584 (Maricopa Cty. Super. Ct. Dec. 24, 2019). Plaintiff brought this declaratory judgment action against Dr. Gear and Just for Kids to establish that there is no coverage for the Thompsons’ state court tort claims. Doc. 1. Plaintiff added a recission claim in its amended complaint. Doc. 56. The Court allowed the Thompsons to intervene as Defendants after they dismissed Just for Kids from the state court case and Dr. Gear assigned to the Thompsons his rights under the policy pursuant to a Morris agreement. Docs. 15, 17, 24; see United Servs. Auto. Ass’n v. Morris, 741 P.2d 246 (Ariz. 1987).1 Defendants have filed counterclaims for declaratory relief, breach of contract, and bad faith. Docs. 26, 60. In July 2021, the Court entered a case management order governing Phase 1 of the litigation, which is limited to coverage issues raised in the complaint and counterclaims. Doc. 65.2 On August 23, 2021, the parties informed the Court that they had a dispute regarding the scope of Phase 1 discovery. Doc. 68. A telephone conference was held on September 1. Doc. 71. The Court directed the parties to file memoranda addressing: (1) what evidence a court may consider in deciding what is covered by an insurance policy; (2) what additional information the reasonable expectations doctrine makes available for a court to consider in deciding coverage issues; and (3) what additional information a court may consider when a policy provision is ambiguous. Id. The parties have filed their respective memoranda and response briefs. Docs. 72-75. II. Discussion. Plaintiff alleges in count one that a “sexual act” exclusion in the policy bars coverage for the tort claim against Dr. Gear. Doc. 56 ¶¶ 31-35. That exclusion states that the policy does not apply to any claim: Based on or directly or indirectly arising out of or resulting from any sexual act or acts including but not limited to undue familiarity, excessive influence or power, molestation, assault, battery or harassment, including “claims” of improper or negligent hiring, employment or supervision, failure to protect or warn the other party, failure to prevent the sexual abuse and/or physical abuse, failure to prevent assault and battery and failure to discharge the employee[.]

1 When Plaintiff refused to settle Defendants’ tort claims for the $1 million policy limit, Dr. Gear settled with Defendants and agreed to the entry of a $15 million judgment. The state court has found the $15 million to be a reasonable settlement amount. See Docs. 64 at 5, 72 at 2. 2 If a finding of coverage is made during Phase 1, Phase 2 of the litigation will include Plaintiff’s rescission claim and Defendants’ bad faith claim and request for punitive damages. See Doc. 64 at 10. Id. ¶ 29 (quoting policy § I.2.e). Plaintiff alleges that this sexual act exclusion bars coverage for the claim against Dr. Gear because that claim is based on, directly or indirectly arises out of, or results from the sexual assault of Wendee Thompson. Id. ¶ 34; see id. ¶¶ 19-23; Doc. 60 at 57-58. Defendants dispute that the tort claim against Dr. Gear arises from “sexual assault.” Doc. 75 at 5. Defendants contend that the sexual act exclusion does not bar coverage because Dr. Gear never sexually assaulted Wendee and the claim against him alleges only medical malpractice – his failure to diagnose Wendee’s pregnancy and to provide her prenatal and other appropriate medical care. Id.; see also Docs. 60 at 6-7, 19-25; 64 at 6; 72 at 2. Defendants have served discovery requests on Plaintiff that seek information and documents concerning the policy and the sexual act exclusion, including drafting histories, claims manuals and files, and underwriting materials. See Doc. 72 at 132-57. Specifically, Defendants seek information on when and why the exclusion was drafted, how it has been applied to other claims and interpreted internally, and what was said between Plaintiff and Dr. Gear (who is now deceased) about the meaning of the exclusion or the scope of coverage. See id. Defendants argue that the information sought is relevant to coverage issues and discoverable under Arizona law and Federal Rule of Civil Procedure 26(b)(1). Id. at 3-10. Plaintiff contends that discovery of extrinsic evidence is not appropriate because the only facts relevant to a coverage determination are the policy itself and the underlying complaint. Doc. 73 at 1-2. Plaintiff believes the case should proceed directly to summary judgment on the coverage issue with no discovery allowed during Phase 1. Id. at 2. A. The Court May Consider Extrinsic Evidence in Deciding What Is Covered by the Policy. In Arizona, courts should interpret and enforce insurance policies according to the parties’ intent. See Taylor v. State Farm Mut. Auto Ins., 854 P.2d 1134, 1138 (Ariz. 1993). The court must decide what evidence, other than the policy itself, “is admissible in the interpretation process, bearing in mind that the parol evidence rule prohibits extrinsic evidence to vary or contradict, but not to interpret, the agreement.” Id. (citing 3 Arthur L. Corbin, Corbin on Contracts § 543, at 130-34 (1960)). If, after considering relevant extrinsic evidence, the court finds that the policy language “is ‘reasonably susceptible’ to the interpretation asserted by its proponent, the evidence is admissible to determine the meaning intended by the parties.” Id. at 1140 (citing Restatement (Second) of Contracts § 215 cmt. b (1979)); see also Doneson v. Farmers Ins. Exch., 431 P.3d 198, 200 (Ariz. Ct. App. 2018) (same, citing Taylor, 854 P.2d at 1140); Smith v. Melson, Inc., 659 P.2d 1264, 1266 (1983) (“A contract should be read in light of the parties’ intentions as reflected by their language and in view of all the circumstances. . . . When interpreting an agreement, the court may always consider the surrounding circumstances.”) (citing Restatement § 212). In holding that the parol evidence rule is not violated where extrinsic evidence is used to interpret, not contradict, the policy language, the Arizona Supreme Court provided this explanation: The meaning that appears plain and unambiguous on the first reading of a document may not appear nearly so plain once the judge considers the [extrinsic] evidence. In such a case, the parol evidence rule is not violated because the evidence is not being offered to contradict or vary the meaning of the agreement. To the contrary, it is being offered to explain what the parties truly may have intended. Taylor, 854 P.2d at 1140 (noting that “this rule embodies the concepts endorsed by Corbin and adopted by this court ten years ago in Melson”); see also Darner Motor Sales, Inc. v. Universal Underwriters Ins. Co., 682 P.2d 38

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James River Insurance Company v. Gear, (D. Ariz. 2021).

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