Jenkins v. Prime Insurance Co.

CourtDistrict Court, D. Utah
DecidedMarch 3, 2021
Docket2:21-cv-00130
StatusUnknown

This text of Jenkins v. Prime Insurance Co. (Jenkins v. Prime Insurance Co.) is published on Counsel Stack Legal Research, covering District Court, D. Utah primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jenkins v. Prime Insurance Co., (D. Utah 2021).

Opinion

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF GEORGIA ATLANTA DIVISION

HAL JENKINS, as assignee of certain of the claims of CLJ HEALTHCARE, LLC, and CLJ HEALTHCARE, LLC, as to certain non-assigned claims, Plaintiffs, v. CIVIL ACTION NO. 1:20-cv-01263-JPB PRIME INSURANCE CO., PRIME

HOLDINGS INSURANCE SERVICES, INC. d/b/a CLAIMS DIRECT ACCESS, DAVID MCBRIDE, ESQ. and EVOLUTION INSURANCE BROKERS, LC, Defendants. ORDER Before the Court is Defendants Prime Insurance Company (“Prime”),1 Prime Holdings Insurance Services, Inc. d/b/a Claims Direct Access (“Claims Direct”), David McBride, Esq. (“McBride”) and Evolution Insurance Brokers, LC’s (“Evolution”) (collectively “Defendants”) Motion to Dismiss (“Motion”). ECF No. 4. Having reviewed and fully considered the papers filed therewith, the Court finds as follows:

1 Prime is designated in the case style as “Prime Insurance Co.” I. BACKGROUND Plaintiffs Hal Jenkins, as assignee of certain claims of CLJ Healthcare, LLC (“CLJ”), and CLJ, as to certain non-assigned claims, (collectively “Plaintiffs”) filed a complaint against Defendants in connection with their sale and

administration of an insurance policy. As alleged in the Complaint, Prime issued a professional liability insurance policy to CLJ effective December 22, 2012, to December 22, 2013 (the “Policy”),

which covered CLJ and Nedra Dodds, M.D. (“Dodds”).2 The Policy was sold through Evolution, and the declarations page reflected $50,000 in professional liability and $100,000 in aggregate coverage.

2 Defendants attach a copy of the Policy to their Motion. While a court is typically limited to allegations in the complaint in ruling on a motion to dismiss, it “may consider an extrinsic document if it is (1) central to the plaintiff’s claim, and (2) its authenticity is not challenged.” SFM Holdings, Ltd. v. Banc of Am. Sec., LLC, 600 F.3d 1334, 1337 (11th Cir. 2010). See also Harris v. Ivax Corp., 182 F.3d 799, 802 (11th Cir. 1999) (“[A] document central to the complaint that the defense appends to its motion to dismiss is . . . properly considered, provided that its contents are not in dispute.”); Brooks v. Blue Cross & Blue Shield of Fla., Inc., 116 F.3d 1364, 1369 (11th Cir. 1997) (“[W]here the plaintiff refers to certain documents in the complaint and those documents are central to the plaintiff’s claim, then the Court may consider the documents part of the pleadings for purposes of Rule 12(b)(6) dismissal, and the defendant’s attaching such documents to the motion to dismiss will not require conversion of the motion into a motion for summary judgment.”). Because Plaintiffs have not objected to Defendants’ proffer of the Policy, and the Court finds it is central to the claims in this case, the Court will consider the Policy as necessary to make the rulings herein. In February 2013, April Jenkins, a patient under the care of Dodds, died after receiving liposuction treatment. Hal Jenkins, as representative of April Jenkin’s estate, thereafter submitted a claim to Prime as a result of the incident. McBride, Prime’s attorney and Senior Vice President, responded in April 2013 that

the Policy limit was $50,000. In August 2013, Hal Jenkins filed suit against CLJ and Dodds in the State Court of Cobb County for damages sustained as a result of April Jenkins’ death

(the “Jenkins Claim”). McBride, allegedly acting as CLJ’s counsel, tendered $50,000 to Hal Jenkins as settlement for the Jenkins Claim. Prime also wrote a letter to CLJ stating that the Policy provided $50,000 in coverage for the claim. The Complaint alleges that at no time prior to the filing of the Jenkins Claim

did Prime inform CLJ that it could challenge Prime’s determination of the Policy limit. Further, Prime allegedly did not inform CLJ that the cost to defend the Jenkins Claim would quickly exceed $50,000 or that CLJ could tender its own

funds to help resolve the claim. McBride eventually retained counsel to represent CLJ and Dodds in October 2013. In April 2014, Hal Jenkins made a settlement demand to Prime of $100,000 with certain contingencies. Prime tendered $39,000 in response but allegedly did not discuss the tender with CLJ.3 CLJ asserts that had McBride properly advised it of its options, it would have arranged to pay the difference between Hal Jenkins’ demand and Prime’s tender. In May 2014, McBride informed CLJ that the Policy limit of $50,000 had

been depleted and that Prime would no longer defend CLJ and Dodds. In July 2014, the Cobb County court allowed counsel hired by Prime to withdraw from CLJ and Dodds’ representation. Around that time, while allegedly acting as CLJ’s

counsel, McBride attempted to obtain a waiver from CLJ and Dodds that the Policy limit was $50,000 and that the available funds had been depleted through the defense of the Jenkins Claim. Hal Jenkins subsequently dismissed Dodds from the action, leaving CLJ as

the only defendant. A default judgment was issued against CLJ, and a jury awarded damages against CLJ in the amount of $60 million in December 2018 (the “Jenkins Judgment”).

At the heart of Plaintiffs’ claim in this case is their contention that the Policy provided $100,000 in coverage. They assert that Prime’s incorrect determination that the Policy limit was only $50,000 resulted in Prime’s wrongful rejection of

3 Apparently, the amount of coverage available had been diminished by legal expenses related to the ongoing representation of CLJ and Dodds. Hal Jenkins’ settlement demand and the premature withdrawal of CLJ and Dodd’s defense. Plaintiffs also claim that certain expenses were improperly charged to the Policy. In short, Plaintiffs presume that had Prime tendered $100,000 to settle the Jenkins Claim or if CLJ had been informed that it could contribute its own

resources to meet the settlement demand, the Jenkins Claim would have been resolved quickly. II. ANALYSIS

A. Motion to Dismiss In evaluating a motion to dismiss under Federal Rule of Civil Procedure 12(b)(6), the court “accept[s] the allegations in the complaint as true and constru[es] them in the light most favorable to the plaintiff.” Traylor v. P’ship

Title Co., LLC, 491 F. App’x 988, 989 (11th Cir. 2012). “[A] plaintiff’s obligation to provide the grounds of his entitlement to relief[, however,] requires more than labels and conclusions, and a formulaic recitation of the elements of a cause of

action will not do.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007) (internal punctuation omitted). See also Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (A complaint does not suffice “if it tenders naked assertions devoid of further factual enhancement.”) (internal punctuation omitted) (quoting Twombly, 550 U.S. at

557). Moreover, “[f]actual allegations must be enough to raise a right to relief above the speculative level.” Id. “This standard does not require a party to plead facts with such particularity to establish a significant probability that the facts are true, rather, it requires a party’s pleading of facts to give rise to a ‘reasonable

expectation that discovery will reveal evidence [supporting the claim].’” Burch v. Remington Arms Co., LLC, No. 2:13-cv-00185, 2014 WL 12543887, at *2 (N.D. Ga. May 6, 2014) (quoting Twombly, 550 U.S. at 555) (alteration in original). See

also Twombly, 550 U.S. at 570 (dismissing complaint because the plaintiffs did not state facts sufficient to “nudge[] their claims across the line from conceivable to plausible”).

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