Scottsdale Ins. Co. v. Seven Cntys. Servs., Inc.

Court of Appeals for the Sixth Circuit·Decided September 9, 2026·No. 25-6059·Published

Opinion

RECOMMENDED FOR PUBLICATION Pursuant to Sixth Circuit I.O.P. 32.1(b)

File Name: 26a0258p.06

UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT

SCOTTSDALE INSURANCE COMPANY; MENTAL HEALTH │

RISK RETENTION GROUP, │

Plaintiffs-Appellees, > Nos. 25-5806/6059 │ │

v. │ │

SEVEN COUNTIES SERVICES, INC., │ Defendant-Appellant. │ ┘

Appeal from the United States District Court for the Western District of Kentucky at Louisville.

No. 3:23-cv-00357—David Jason Hale, District Judge.

Argued: July 23, 2026

Decided and Filed: September 9, 2026

Before: DAVIS, MATHIS, and RITZ, Circuit Judges.

COUNSEL

ARGUED: Sean G. Williamson, BRICKER GRAYDON WYATT, LLP, Louisville, Kentucky, for Appellant. Palmer G. Vance II, STOLL KEENON OGDEN PLLC, Lexington, Kentucky, for Appellees. ON BRIEF: Sean G. Williamson, David A. Calhoun, Victoria Boland Fuller, WYATT, TARRANT & COMBS, LLP and BRICKER GRAYDON WYATT, LLP, Louisville, Kentucky, for Appellant. Palmer G. Vance II, Lilian W. Ball, STOLL KEENON OGDEN PLLC, Lexington, Kentucky, for Appellees.

OPINION

RITZ, Circuit Judge. Seven-year-old J.T. choked to death after behavioral care workers physically restrained him. The child’s estate sued the care center where J.T. lived and its

Nos. 25-5806/6059 Scottsdale Ins. Co., et al. v. Page 2 Seven Cntys. Servs., Inc.

management company, Seven Counties Services, Inc., which asked its insurers for defense and indemnity. The insurers refused coverage. At summary judgment, the district court held that the insurers had a duty to defend Seven Counties in the wrongful death action but had no duty to indemnify.

Seven Counties appeals the district court’s indemnification decision. It disputes that the restraint used on J.T. qualified as emergency services intervention (ESI) and argues that, regardless, ESI does not fall within the insurance contract’s exception to coverage for professional services. We reject these arguments and affirm.

I.

A.

Seven-year-old J.T. lived at a behavioral care center in Kentucky. On July 17, 2022, J.T.

began to misbehave. Annoyed, shift supervisor Deborah Francis complained that J.T. “had ruined her church day,” and she threatened to “restrain” the child to make him “throw up.” RE 33-5, OIG Report, PageID 1210. Francis confined J.T. to his room where he soiled himself, prompting Francis to mock J.T. in front of other residents.

J.T.’s misbehavior apparently escalated later in the day. For instance, the child tried to leave his room without permission. And a post-incident report states that J.T. attempted to “assault” staff, “charg[ing]” and “yelling” at them, which caused both J.T. and a care worker to fall to the floor. RE 33-6, Incident Report, PageID 1329. Two care workers, Jillian Parks and Amanda Whitlow, then tried to secure J.T. in a physical hold called a “kneeling cradle.” Id. Parks held J.T.’s arms and torso in a “cradle position” and Whitlow held J.T.’s legs, while they attempted to calm him. Id. Francis then entered the room and took over the upper-extremity restraint from Parks, pushing J.T.’s face almost to the floor and telling J.T. to “[g]o ahead [and] throw up, throw up!” RE 33-5, OIG Report, PageID 1216, 1284. J.T. vomited and attempted to struggle out of the restraint but fell unconscious. Staff attempted CPR and called 911, but, tragically, J.T. died.

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The state Office of the Inspector General (OIG) conducted a review of the incident.

OIG’s interview with care worker Whitlow reveals that she “did not think the [kneeling cradle] hold was even necessary” because J.T. had threatened to hit Whitlow and Parks but never acted on his threat. Id. at PageID 1227. Indeed, Whitlow thought that J.T. was “de-escalating” because he was “laughing with her,” and that Parks “escalated the situation by getting involved.” Id. According to the OIG report, the care workers also failed to call the “Clinical-on-Call Therapist at the beginning of [the] hold” to determine if the restraint should be continued, as required by their training. Id. at PageID 1230. The report concluded that “the facility failed to protect [J.T.] from experiencing an unnecessary” ESI hold, because J.T. did “not place[] himself” or others “in harm[’]s way” before staff administered the hold. Id. at PageID 1233-34.

B.

Seven Counties is a non-profit corporation that provides “mental and behavioral health services” across Kentucky. RE 34-1, Post Decl., PageID 1370. The corporation maintained a primary insurance policy with Mental Health Risk Retention Group (MHRRG) and an excess policy with Scottsdale Insurance Company. The only coverage at issue here is the Commercial General Liability Coverage (CGL) part of the MHRRG policy. That part covered claims for “bodily injury,” subject to several exceptions. RE 1-3, MHRRG Policy, PageID 393. The two relevant exceptions to coverage are: (1) an exclusion for injury arising from “professional service[s]” and (2) MHRRG’s right to decline liability coverage where Seven Counties had “available” other “valid and collectible insurance” covering the same incident. Id. at PageID 398, 405.

Seven Counties partnered with a non-profit corporation called Uspiritus to operate the behavioral care center where J.T. resided. In 2018, Uspiritus and Seven Counties contracted for Seven Counties to “provide overall management services for and on behalf of Uspiritus.” RE 34-1, Post Decl., PageID 1379. As part of this agreement, Uspiritus also had to obtain insurance coverage and name Seven Counties as an additional insured under that policy. Uspiritus maintained such independent coverage with the Hanover Insurance Group. The Hanover policy permitted Uspiritus to add Seven Counties as an additional insured by “written

Nos. 25-5806/6059 Scottsdale Ins. Co., et al. v. Page 4 Seven Cntys. Servs., Inc.

contract, written agreement or permit.” RE 1-2, Hanover Policy, PageID 257. The written agreement between Uspiritus and Seven Counties expired on December 31, 2021, but the companies continued operating under the terms of the agreement without a written extension.

C.

After J.T. died, his estate sued Uspiritus, Seven Counties, and several other defendants in state court for wrongful death and negligence. Hanover agreed to defend and indemnify Uspiritus in the action but refused to defend or indemnify Seven Counties, explaining that Seven Counties was “NOT named as an additional insured” on the Hanover policy. RE 34-1, Post Decl., PageID 1433. MHRRG and Scottsdale, too, declined coverage.

As the case proceeded to mediation, the insurers affirmed their denial of coverage to Seven Counties. The insurers explained that it was Hanover’s responsibility to provide primary coverage to Seven Counties, with MHRRG providing excess coverage only. A few days prior to the mediation, the insurers further informed Seven Counties that the restraint used on J.T. was an excluded professional service but reassured Seven Counties that “Hanover [would] reach the right decision” and cover Seven Counties “as an additional insured.” RE 34-5, Insurers’ Corr., PageID 1481. Hanover, however, continued to deny coverage, and Seven Counties participated in the mediation without confirmed insurance.

Later, the insurers filed the present lawsuit against Seven Counties seeking a declaration of rights under the two insurance policies. Seven Counties countersued for breach of contract, alleging that the insurers violated their duties to defend and indemnify Seven Counties in the underlying wrongful death suit. Both sides moved for summary judgment.

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Scottsdale Ins. Co. v. Seven Cntys. Servs., Inc., (6th Cir. 2026).

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