Karla Villa v. Applied Medico-Legal Solutions Risk Retention Group Inc

CourtDistrict Court, C.D. California
DecidedAugust 28, 2023
Docket2:22-cv-06913
StatusUnknown

This text of Karla Villa v. Applied Medico-Legal Solutions Risk Retention Group Inc (Karla Villa v. Applied Medico-Legal Solutions Risk Retention Group Inc) is published on Counsel Stack Legal Research, covering District Court, C.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Karla Villa v. Applied Medico-Legal Solutions Risk Retention Group Inc, (C.D. Cal. 2023).

Opinion

1 2 3 4 5 JS-6, O 6 7 UNITED STATES DISTRICT COURT 8 CENTRAL DISTRICT OF CALIFORNIA 9 10 KARLA VILLA, Case No.: 2:22-cv-06913-MEMF (AFMx) 11 Plaintiff, 12 v. ORDER GRANTING DEFENDANT APPLIED MEDICO-LEGAL SOLUTIONS 13 RISK RETENTION GROUP, INC.’S MOTION TO COMPEL ARBITRATION 14 APPLIED MEDICO-LEGAL SOLUTIONS [ECF NO. 10] RISK RETENTION GROUP, INC., AND 15 DOES 1 THROUGH 50, 16 Defendants. 17 18

19 Before the Court is the Motion to Compel Arbitration filed by Defendant Applied Medico- 20 Legal Solutions Risk Retention Group, Inc.1 ECF No. 10. For the reasons stated herein, the Court 21 hereby GRANTS the Motion and STAYS all litigation in this case pending the outcome of the 22 arbitration proceedings. 23 / / / 24 / / / 25

26 1 It appears to the Court that the Defendant’s name is “Applied Medico-Legal Solutions Risk Retention 27 Group, Inc.,” but it appears that the case was filed in the name of “Applied Medico-Legal Solutions Risk Retention Group Inc.” (without a comma). The Court will leave the caption as is but will refer to the 28 1 I. Factual Background2 2 This case began with a doctor’s sexual assault of his patient—which led to an insurance 3 coverage dispute between the patient, on the one hand, and the doctor’s insurer, on the other. 4 Plaintiff Karla Villa (“Villa”) is a resident of Los Angeles, California, and a former patient of 5 Dr. Jeko Behfarin (“Behfarin”). Tort Compl. ¶¶ 1, 8. Behfarin is a physician employed by 6 Performance Care Sports Medicine & Rehabilitation Center (“Performance Care”). Id. ¶ 2. 7 Defendant Applied Medico-Legal Solution Risk Retention Group, Inc. (“AMS”) is a medical 8 professional liability insurer. Mot. at 6.3 A. Behfarin Sexually Assaults Villa, Which Leads to a Tort Action in Los Angeles 9 Superior Court 10 On or about January 6, 2017, Villa visited Behfarin at Performance Care in Toluca Lake, 11 California for a consultation for treatment relating to injuries Villa sustained in a car accident. Tort 12 Compl. ¶ 8; Opposition to Motion to Compel Arbitration, ECF No. 19 (“Opposition” or “Opp’n”), at 13 6. During the appointment, Behfarin touched Villa inappropriately and without her consent: “rubbing 14 her back, then pulling down her underwear and using his hands, spread [Villa’s] butt cheeks apart 15 and rubbed down to her anus,” and touched Villa in her bikini and genital areas. Tort Compl. ¶ 8. 16 On January 4, 2018, Villa filed a tort action in Los Angeles Superior Court against Dr. 17 Behfarin and Performance Care alleging the five following causes of action arising from the injuries 18 she sustained from Behfarin’s actions: (1) sexual battery; (2) intentional infliction of emotional 19 distress (“IIED”); (3) negligence against Behfarin; (4) negligence against Performance Care; and (5) 20 21 22 23 2 Unless otherwise indicated, the following facts are derived from the complaint in this case and the complaint in the underlying tort action by Plaintiff Karla Villa against Dr. Jeko Behfarin in Los Angeles Superior Court. 24 The complaint in this case is found at ECF No. 1-1, and will be referred to as “Complaint” or “Compl.” It is Exhibit A to the Defendant’s Notice of Removal, ECF No. 1. The complaint in the underlying tort action is 25 First Amended Complaint for Damages in Case Number BC689183. It is Exhibit A to the Complaint, ECF 1- 1, (which itself is Exhibit A to the Notice of Removal). It will be referred to as the “Tort Complaint” or “Tort 26 Compl.” For the purposes of this Motion, the Court treats these factual allegations as true, but at this stage of the litigation, the Court makes no finding on the truth of these allegations and is therefore not—at this stage— 27 finding that they are true. 3 Citations to “Motion” or “Mot.” are to the Memorandum of Points and Authorities, ECF No. 10-1, which 28 1 sexual harassment pursuant to Cal. Civ. Code § 51.9. See generally Tort Compl. Behfarin denied all 2 allegations of sexual misconduct. Compl. ¶ 12. 3 B. AMS and Behfarin’s Insurance Policy 4 Behfarin was covered by a professional liability policy issued by AMS from July 30, 2017, to 5 June 5, 2018 (the “Policy”). Mot. at 6. The Policy contains the following arbitration provision: 6 O. Arbitration and Interpretation 7 Any dispute between you and us relating to this policy will be resolved by arbitration 8 in accordance with the rules and procedures established by the American Arbitration Association. 9 10 See Policy Form AMS002 (3/15) Professional Liability Policy, ECF No. 10-3 (“Policy”), at 11–12 11 (“Arbitration Provision”). 12 The Policy also contains a “Physical Professional Liability Coverage Part.” Policy at 18. That 13 Coverage Part includes the following exclusions provision:

14 D. Exclusions

15 We will not defend or pay under this Coverage Part for: 16 . . . . 17 6. Any injury or damages resulting from your liability arising out of your own sexual 18 misconduct or the sexual misconduct of those for whom you are legally responsible. This exclusion applies whether the sexual misconduct is done under the guise of 19 treatment or otherwise and with or without the consent of the individual. However, we 20 will defend any claim until such time as there is an admission of such activity, relations or contact or they have otherwise been found to have occurred in our reasonable 21 judgment. . . . .

22 Policy at 22–23. 23 In addition, the Policy contains a Sexual Misconduct & Molestation Expense Reimbursement 24 Endorsement (“Sexual Misconduct Endorsement” or “Endorsement”), ECF 10-3, which states as 25 follows: 26 [AMS] agrees to reimburse an Insured for Legal Expense incurred by the Insured 27 because of an Insured Event Instituted against such Insured during the Policy 28 Period . . . . 1 . . . . 2 Maximum Amount Reimbursable per Insured Event: $25,000

3 . . . .

4 [AMS] does not assume any duty to defend the Insured under this Endorsement . . . . 5 . . . . 6 Insured Event shall mean and shall be limited to the Institution of any: 7 a) written demand for payment; or b) lawsuit in a court of general jurisdiction 8 against an Insured by or on behalf of any person alleging bodily injury and/or personal 9 injury because of: a) the actual or threatened abuse or molestation of such person while in the care, 10 custody or control of any Insured . . . .

11 Endorsement at 1–3. The Endorsement also contains a separate arbitration clause (“Endorsement 12 Arbitration Provision”) which states, “Any dispute between the Insured and [AMS] relating to this 13 Endorsement shall be submitted to binding arbitration in accordance with the then current rules of 14 the American Arbitration Association . . . .” Id. at 4. 15 The Policy further contains an Assignment and Transfer clause, Policy at 10, and a provision 16 regarding “Lawsuits Against Us,” Policy at 8. 17 C. Resolution of Villa’s Tort Action Against Behfarin in Los Angeles Superior Court 18 Although under the Policy’s terms, AMS was obligated to defend Behfarin against Villa’s 19 fourth cause of action—because negligence is covered under the Policy—AMS refused to defend 20 Behfarin against the lawsuit. Compl. ¶¶ 13–14. On September 16, 2020, Villa served Behfarin with 21 an Offer to Compromise pursuant to California Code of Civil Procedure section 998 (“Offer to 22 Compromise” or “Offer”), offering to settle the Tort Action for the Policy demand limit of $1 23 million. Compl. ¶¶ 13–15; Opp’n at 7. AMS did not respond to the Offer, and it subsequently 24 expired. Compl. ¶ 15. 25 The parties entered into court-ordered settlement negotiations, which resulted in a settlement 26 agreement (“Settlement Agreement,” Exhibit C to Complaint, ECF No. 1-1) in December 2020. Id. ¶ 27 16.

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Karla Villa v. Applied Medico-Legal Solutions Risk Retention Group Inc, Counsel Stack Legal Research, https://law.counselstack.com/opinion/karla-villa-v-applied-medico-legal-solutions-risk-retention-group-inc-cacd-2023.