Jenkins v. Prime Insurance

Court of Appeals for the Tenth Circuit·Decided September 4, 2024·No. 23-4113·Unpublished

Opinion

FILED

United States Court of Appeals UNITED STATES COURT OF APPEALS Tenth Circuit

FOR THE TENTH CIRCUIT September 4, 2024

Christopher M. Wolpert

Clerk of Court

HAL JENKINS, as the assignee of certain of the claims of CLJ Healthcare, LLC; CLJ HEALTHCARE, LLC, as to certain non-assigned claims,

Plaintiffs - Appellants

v. No. 23-4113 (D.C. No. 2:21-CV-00130-DAK)

PRIME INSURANCE, CO.; PRIME (D. Utah)

HOLDINGS INSURANCE SERVICES, INC., d/b/a Claims Direct Access; DAVID McBRIDE, ESQ.; EVOLUTION INSURANCE BROKERS, LC,

Defendants - Appellees.

ORDER AND JUDGMENT *

Before HARTZ, BACHARACH, and ROSSMAN, Circuit Judges.

This appeal grew out of a medical malpractice action against a physician’s company (CLJ Healthcare, LLC). CLJ had liability insurance

*

This order and judgment does not constitute binding precedent except under the doctrines of law of the case, res judicata, and collateral estoppel. But the order and judgment may be cited for its persuasive value if otherwise appropriate. Fed. R. App. P. 32.1(a); 10th Cir. R. 32.1(A).

through a wasting policy, where the amount for indemnity is reduced by the amount spent on defense costs. See SEC v. DeYoung, 850 F.3d 1172, 1177 n.2 (10th Cir. 2017) (defining a wasting policy).

The policy limit gave rise to a dispute, which stymied settlement negotiations with the plaintiff in the malpractice action. But the insurer (Prime Insurance Co.) then obtained a favorable declaratory judgment on the policy limit.

When the settlement negotiations fell apart, the malpractice action resulted in a large excess judgment against CLJ. By then, however, Prime had exhausted the policy limit. So Prime stopped providing a defense, which led CLJ to sue Prime, its former attorney (Mr. David McBride), and the company that had sold the policy (Evolution Insurance Brokers, LC).

These suits give rise to four sets of appellate issues:

1. Effect of the declaratory judgment on the contract claim.

CLJ claimed that Prime had breached the insurance contract because the policy limit had been $100,000; Prime claimed that the policy limit had been only $50,000. A state court issued a declaratory judgment stating that the policy limit had been only $50,000. CLJ denies that it’s bound by the declaratory judgment, arguing that the state court lacked jurisdiction and didn’t allow full and fair litigation of the issue. We disagree.

The court did have jurisdiction, and CLJ had notice and an opportunity to contest Prime’s characterization of the policy limit. So CLJ is bound by the declaratory judgment.

2. Timeliness of the bad faith claim. CLJ also sued Prime for bad faith. This claim could involve either a contract or tort.

CLJ asserts a tort theory, and Prime urges a right to summary judgment on the ground that the tort claim is time-barred. We disagree with Prime. A tort claim wouldn’t accrue until final

disposition of the underlying malpractice claim. With that disposition as the accrual date, CLJ sued for bad faith within the limitations period. So the bad faith claim is timely and should have withstood a summary-judgment motion.

3. Timeliness of the claims for legal malpractice and breach of fiduciary duty. CLJ also sued its former attorney. The district court properly dismissed these claims based on timeliness because CLJ could have sued when the former attorney withdrew.

4. The existence of a cause of action for unauthorized sale of insurance. CLJ also sued Evolution Insurance under a state statute. In district court, however, CLJ hadn’t adequately briefed the availability of a cause of action under the statute.

By failing to adequately develop this argument in district court, CLJ failed to preserve the issue.

Background

I. Prime unsuccessfully negotiates with the victim and stops defending CLJ.

CLJ’s policy was triggered when a woman died after getting liposuction surgery. The death led the woman’s father, Mr. Hal Jenkins, to sue CLJ for malpractice. In turn, CLJ submitted a claim to Prime. Prime then retained Mr. David McBride to represent CLJ in the malpractice action.

In an effort to settle, Prime offered $50,000 to Mr. Jenkins, stating that this amount was the policy limit. Mr. Jenkins counter-offered with $100,000, stating that this was the actual amount of the policy limit. By the time he counter-offered, Prime had spent roughly $11,000 in the litigation, reducing the policy limit. So Prime offered the remaining policy

limit (about $39,000) to Mr. Jenkins. He counter-offered with $100,000, insisting that this was the actual policy amount. The negotiations collapsed.

As the litigation continued, Prime said that it had spent the entire $50,000 in defense, leaving nothing to indemnify CLJ in the event of an adverse judgment. So Prime withdrew its defense of CLJ and requested a release.

II. Prime gets a declaratory judgment, and Mr. Jenkins gets an excess judgment.

CLJ declined to release Prime, arguing that the policy limit had been $100,000. Prime disagreed and sued in Utah state court for a declaration discontinuing any further duty to defend CLJ. But CLJ didn’t appear, so the court granted a default judgment to Prime, declaring that the policy limit had been $50,000—not $100,000. Mr. Jenkins later obtained a judgment for $60 million against CLJ.

III. CLJ unsuccessfully sues Mr. McBride, Evolution Insurance, and Prime.

CLJ sued in Georgia, 1 and the Georgia federal district court dismissed the claims against Mr. McBride and Evolution Insurance. The action was then transferred to Utah federal district court. That court

• concluded that Prime’s default judgment had prevented CLJ from relitigating the amount of the policy limit and

1 In the Georgia case, there were two plaintiffs:

• dismissed the claims for breach of contract and negligence.

The dismissals left the bad-faith claim against Prime.

But the Utah federal district court then granted summary judgment to Prime on the bad-faith claim. In granting summary judgment, the court adopted all of the rulings previously made by the Georgia federal district court.

CLJ’s Claims Against Prime

I. The declaratory judgment prevented liability for breach of contract.

CLJ questions the district court’s reliance on the declaratory judgment, arguing that (1) the state court lacked jurisdiction and (2) the entry of a default judgment didn’t entail full, fair litigation of the amount of the policy limit. We reject both arguments.

A. We apply the standard for dismissal.

When reviewing this ruling, we conduct de novo review based on the standard that applied in district court. See Cty. of Santa Fe v. Pub. Serv.

1. CLJ

2. Mr. Jenkins as the assignee of some of CLJ’s claims.

Mr. Jenkins does not assert any of his own claims, and the complaint does not say which claims are CLJ’s and which are Mr. Jenkins’s.

Both plaintiffs have appealed, but Mr. Jenkins appeals only as the assignee of some of CLJ’s claims. So we refer to the plaintiffs collectively as CLJ.

Co., 311 F.3d 1031, 1034 (10th Cir. 2022) (“Because the district court dismissed [a] complaint under Rule 12(b)(6), we review the dismissal de novo, applying the same standards as the district court.”). The district court had to determine whether allegations in the complaint stated a facially plausible claim. See Ashcroft v. Iqbal, 556 U.S. 662, 679 (2009).

B. Utah law governs the preclusive effect of the declaratory judgment.

In addressing the preclusive effect of the declaratory judgment, we apply Utah law. 28 U.S.C. § 1738; see Marrese v. Am. Acad. of Orthopaedic Surgeons, 470 U.S. 373, 380 (1985) (“This statute directs a federal court to refer to the preclusion law of the State in which judgment was rendered.”). In applying Utah law, we predict how the Utah Supreme Court would decide the issue. Wade v. Emcasco Ins. Co., 483 F.3d 657, 665–66 (10th Cir. 2007).

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