Medical Protective Company of v. American International Specia

990 F.3d 1003
CourtCourt of Appeals for the Seventh Circuit
DecidedMarch 9, 2021
Docket20-1831
StatusPublished
Cited by15 cases

This text of 990 F.3d 1003 (Medical Protective Company of v. American International Specia) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Medical Protective Company of v. American International Specia, 990 F.3d 1003 (7th Cir. 2021).

Opinion

In the

United States Court of Appeals For the Seventh Circuit ____________________ No. 20-1831 THE MEDICAL PROTECTIVE COMPANY OF FORT WAYNE, INDIANA, Plaintiff-Appellee,

v.

AMERICAN INTERNATIONAL SPECIALTY LINES INSURANCE COMPANY, now known as AIG SPECIALTY INSURANCE COMPANY Defendant-Appellant. ____________________

Appeal from the United States District Court for the Northern District of Indiana, Fort Wayne Division. No. 13-cv-357 — Holly A. Brady, Judge. ____________________

ARGUED DECEMBER 8, 2020 — DECIDED MARCH 9, 2021 ____________________

Before EASTERBROOK, KANNE, and HAMILTON, Circuit Judges. KANNE, Circuit Judge. The Medical Protective Company of Fort Wayne (“MedPro”) sued its insurer, American Interna- tional Specialty Lines Insurance Co., now known as AIG 2 No. 20-1831

Specialty Insurance (“AISLIC”),1 for breach of contract after AISLIC refused to indemnify MedPro for payment that it made to settle a claim. The jury handed down a verdict in fa- vor of MedPro. AISLIC now appeals two of the district court’s decisions that allowed the case to go to trial at all. In AISLIC’s view, our earlier interpretation of the policy at issue requires us to hold that MedPro never committed a “Wrongful Act” necessary to invoke coverage. Further, AISLIC contends that MedPro cannot invoke coverage be- cause the claim that it settled was brought before the policy period began. We disagree. The district court properly interpreted the policy in MedPro’s favor, and it did not err when it concluded that MedPro’s claim was timely brought. Thus, the verdict in MedPro’s favor stands. I. BACKGROUND The background of this case was comprehensively de- tailed in our prior opinion, Medical Protective Co. of Fort Wayne, Indiana v. American International Specialty Lines Insurance Co., 911 F.3d 438 (7th Cir. 2018). We repeat only the pertinent facts here. A. Factual and Procedural History The events that sparked the underlying suit began in Oc- tober 2002, when Dr. Benny Phillips performed a laparoscopic hysterectomy on thirty-six-year-old Vicki Bramlett, and she died from complications a few days later. In 2003, Bramlett’s

1 Recognizing that this court in its prior opinion and the parties in their filings refer to AIG Specialty Insurance as “AISLIC,” we continue that practice for consistency. No. 20-1831 3

husband and children brought a wrongful death suit in Texas state court against Dr. Phillips, his clinic, and the healthcare system where Bramlett had been hospitalized. At the time, Dr. Phillips and his clinic held a $200,000 healthcare professional liability insurance policy with MedPro. Dr. Phillips notified MedPro, and MedPro defended the lawsuit. The hospital settled with the Bramletts for about $2.3 mil- lion, and the litigation continued with Dr. Phillips and his clinic as the remaining defendants. On December 17, 2003, the Bramletts made their first “Stowers” demand to settle the re- maining claims for $200,000. (Under G.A. Stowers Furniture Co. v. American Indemnity Co., an insurer who rejects a settlement demand within policy limits that a reasonably prudent in- surer would accept will later be liable for any amount awarded in excess of the policy limit. 15 S.W.2d 544 (Tex. 1929).) MedPro refused to settle. On March 23, 2004, the Bram- letts made a second Stowers demand for $200,000, and MedPro again did not settle. Meanwhile, discovery continued, and evidence was mounting in favor of the Bramletts. In January 2005, counsel for Dr. Phillips advised MedPro that there was a twenty- percent probability of success, and an adverse jury verdict would likely be $3 million. MedPro then extended offers to settle the case with the Bramletts—first for $100,000, then for $200,000. The Bramletts had rejected both of those offers when they met with MedPro for court-ordered mediation in February 2005. And at that time, the Bramletts demanded $2.3 million to settle the case. MedPro declined but sought advice from outside counsel to assess its own liability to pay for a jury ver- dict in excess of Dr. Phillips’s policy limit. 4 No. 20-1831

The case against Dr. Phillips went to trial in August 2005, and the jury returned a surprise $14 million verdict for the Bramletts—$11 million in actual damages and $3 million in punitive damages.2 Dr. Phillips’s counsel wrote to MedPro, demanding that MedPro indemnify Dr. Phillips or else Dr. Phillips could assign his Stowers claim to the Bramletts. MedPro agreed to indemnify Dr. Phillips and appealed the verdict. In 2009, the Supreme Court of Texas reviewed the case and capped Dr. Phillips’s liability at $1.6 million—the state’s stat- utory limit for physicians. But the court also held, for the first time, that the Bramletts could sue MedPro directly for the dif- ference between the statutory cap and the jury verdict by step- ping “in[to] the shoes” of the insured physician and suing un- der a Stowers theory for MedPro’s failure to settle. Phillips v. Bramlett, 288 S.W.3d 876, 882 (Tex. 2009). MedPro upheld its end of the indemnity agreement with Dr. Phillips and paid the Bramletts the amount awarded un- der the statutory cap. The Bramletts then sued MedPro for the rest of the award. See Bramlett v. Med. Protective Co., 855 F. Supp. 2d 615 (N.D. Tex. 2012). After the court denied MedPro’s motion for summary judgment (but before trial), the parties settled for a confidential amount. MedPro then asked its insurer, AISLIC, to cover the settlement. AISLIC re- fused, setting up the case today.

2 Later, the trial court entered judgment awarding the Bramletts $9,196,364.50 in actual damages and $2,972,000 in punitive damages to ac- count for prejudgment interest and the hospital’s settlement. Phillips v. Bramlett, 258 S.W.3d 158, 164 & n.3 (Tex. App. 2007). No. 20-1831 5

B. The Instant Coverage Dispute MedPro first purchased a $5 million insurance policy from AISLIC in June 2005, and it renewed that policy for July 1, 2006, to July 1, 2007. The 2006 Policy is at issue here. On June 28, 2007—just before the expiration of the policy period—MedPro reported to AISLIC a notice of occur- rence/potential claim based on the Bramlett lawsuit. But AISLIC ultimately refused to cover MedPro’s settlement with the Bramletts. In December 2013, MedPro sued AISLIC for breach of con- tract in federal court on the basis of AISLIC’s refusal to cover the settlement as allegedly required by the 2006 Policy. AISLIC moved for summary judgment, in part, on the ba- sis of the policy’s Clause 4(m), known as “Exclusion M.” Ex- clusion M bars coverage for “any claim arising out of any Wrongful Act” that occurred before the policy began if “any Insured knew or could have reasonably foreseen that such Wrongful Act could lead to a claim or suit.” The district court agreed because it determined that MedPro’s rejections of the two Stowers demands were Wrongful Acts, for purposes of Exclusion M, that MedPro could have reasonably foreseen would lead to a claim. MedPro appealed, and as detailed in our prior opinion, we agreed with MedPro’s interpretation of “Wrongful Act” in Exclusion M—only actual Wrongful Acts precluded coverage. We further held that it should have been left to a jury to de- cide whether MedPro’s rejections of the Stowers demands were such actual Wrongful Acts. So we partially reversed the judgment and remanded the case for further proceedings. Med. Protective Co., 911 F.3d at 449. 6 No. 20-1831

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990 F.3d 1003, Counsel Stack Legal Research, https://law.counselstack.com/opinion/medical-protective-company-of-v-american-international-specia-ca7-2021.