Scripps Health v. Nautilus Insurance Company

District Court, S.D. California·Decided November 20, 2024·No. 3:21-cv-01634·Unknown

Opinion

SCRIPPS HEALTH, Case No.: 21-cv-01634-AJB-VET Plaintiff, ORDER: v. NAUTILUS INSURANCE COMPANY; (1) GRANTING DEFENDANT’S and DOES 1–20, inclusive, MOTION FOR SUMMARY JUDGMENT; and Defendant.

(2) DENYING PLAINTIFF’S MOTION JUDGMENT

(Doc. No. 132, 135) This action for breach of contract and breach of the covenant of good faith and fair dealing is brought by Plaintiff Scripps Health (Scripps). Presently pending before the Court is Defendant Nautilus Insurance Co.’s Motion for Summary Judgment, or alternatively, Partial Summary Judgment (Doc. No. 132), and Scripps’ Motion for Partial Summary Judgment (Doc. No. 135). The motions have been fully briefed. (Doc. Nos. 136, 137, 138.) Pursuant to Local Civil Rule 7.1(d)(1), the Court find the motion suitable for adjudication without oral argument, and thus VACATES the hearing set for December 12, 2024, at 2:00 p.m. Having carefully considered the Parties’ arguments and the law, the Court GRANTS Nautilus’ Motion for Summary Judgment and DENIES Scripps’ Motion for Partial Summary Judgment for the reasons set forth below. A. The Nautilus Policy This case arises out of a first-party mold claim for cleanup costs under a Site-Specific Pollution Liability Policy issued by Defendant Nautilus Insurance Company to Plaintiff Scripps Health, effective from March 2, 2018 to March 2, 2021, under Policy number SSP2025613-10 (the “Policy”). (Doc. No. 132-1 at 8, 11.)1 The Policy is comprised of a Main Form and Endorsements providing both (1) “liability” or “third-party” coverage, and (2) “first-party” coverage, including Coverage A, at issue here. (Doc. No. 135 at 13.) The Main Form includes coverage provisions, exclusions, and conditions to coverage. (Id.) The Endorsement expressly modifies various provisions of the Main Form in that it adds coverage and deletes and replaces Coverage D in the Main Form. (Id. at 13–14.) The Policy provides coverage for numerous Scripps clinics and five acute care hospitals, including Scripps Green Hospital and three buildings on the Scripps Green Campus in La Jolla, California: Geisel Pavilion (formerly known as Anderson Outpatient Clinic and referred to herein as “AOP”), Shiley Pavilion, and MD Anderson Cancer Center. (Doc. No. 132-1 at 8.) Coverage A of the Policy provides First Party Cleanup Costs, with limits of $10,000,000 per “pollution condition,” subject to a $100,000 per “pollution condition” self-insured retention. (Declaration of Christina Remolina (“Remolina Decl.”), Doc. No. 132-2, ¶ 2; see generally Policy, Doc. No. 132-8.) During all pertinent times, Nautilus utilized the services of Berkley Environmental (“Berkley”) as its agent and claims administrator. (Complaint, Doc. No. 1-2, ¶ 3.) Berkley handled some or all of Nautilus’ claims handling duties with respect to Scripps’ claims. (Id.) During the initial communications between Scripps’ broker, Alliant Insurance Services (“Alliant”), and Nautilus underwriters in February 2018, Scripps requested that it be allowed to submit a Chubb Application it had already completed. (Doc. No. 132-1 at 11.) Nautilus approved the submission of the Chubb Application in lieu of its own Site- 1 Citations to the record refer to the CM/ECF system page number at the top of each page rather than the Specific Pollution Liability Application, so long as Scripps executed a Warranty Statement. (Doc. No. 132-12, at 3; Deposition of Toby Leung (“Leung Depo.”), Doc. No. 132-56, at 3–6.) Thus, on March 2, 2018, Scripps submitted its Chubb Application for the Policy to Berkley through Alliant, which was reviewed by Toby Leung and Dave Gibbs, the underwriters of the Nautilus Policy. (Doc. No. 132-1 at 11; Leung Depo. at 16–19.) Scripps also executed Nautilus’ Warranty Statement agreeing that the Chubb Application “shall be deemed to be attached to and made part of the policy, if issued, as if physically attached to the policy” and that “the Company is relying on the information contained in the Application in lieu of my completion of the Company’s own application.” (Doc. No. 132- 14.) Scripps’ Application for insurance contained the following warranty: BY SIGNING THIS APPLICATION, THE APPLICANT WARRANTS TO THE INSURER THAT IT AND THE OTHER PARTIES TO THIS INSURANCE WILL STRICTLY FOLLOW ANY WATER INTRUSION, MOLD-RELATED, FUNGI-RELATED OR BACTERIA-RELATED INCLUDING ANY WATER INTRUSION, MOLD-RELATED, FUNGI- RELATED OR BACTERIA-RELATED DUE DILIGENCE PROCEDURES OR PROTOCOLS FOR THE ACQUISITION, LEASE OPERATION, MANAGEMENT OR MAINTENANCE OF ANY PROPERTIES, WHICH WERE PROVIDED TO THE INSURER PRIOR TO THE INCEPTION OF ANY COVERAGE APPLIED FOR HEREIN. THE APPLICANT ACKNOWLEDGES THAT THE INSURER’S AGREEMENT TO PROVIDE MOLD, FUNGI AND/OR LEGIONELLA PNEUMOPHILA COVERAGE AS PART OF THE COVERAGE APPLIED FOR PURSUANT TO THIS APPLICATION IS PREDICATED UPON THE APPLICANT’S AGREEMENT TO PROVIDE THIS WARRANTY. (Chubb Application, Doc. No. 132-13, at 8.) As part of the underwriting process, Scripps provided to the underwriter numerous documents regarding its infection control, preventative maintenance, and environmental protocols. (Policy at 56–57.) /// B. Site History of Scripps Green Campus From 2016 through 2019, there was “growth and discoloration” in the heating, ventilation, and air-conditioning (“HVAC”) systems, including but not limited to the air handling units (“AHUs”) serving the Scripps Green Campus. (Declaration of Chris Hubbard (“Hubbard Decl.”), Doc. No. 132-4, ¶ 4; Declaration of Joseph Palanca, P.E. (“Palanca Decl.”), Doc. No. 132-3, ¶ 4.) Thus, Scripps retained American Technologies Inc. (“ATI”) to assist with HVAC air handling cleaning. (Deposition of Marcell Seunarine (“Seunarine Depo.”), Doc. No. 132-58, at 3–4.) Scripps employee Justin Smiech, a licensed HVAC technician, characterized ATI’s work as “remediation” in Scripps internal e-mail communications, (Doc. No. 132-19), and explained that “[a]ny work done is remediation. . . . Remediation to me is a very broad defining word. So for me remediation is rendering of any services performed to take care of an issue[,] be it replacement to a burned up motor as simple as anything to resolve an issue[,]” (Deposition of Justin Smiech (“Smiech Depo.”), Doc. No. 132-59, at 8–9). ATI was not retained to perform preventative maintenance of the HVAC systems as that was handled internally by Scripps. (Seunarine Depo. at 7–8.) Chris Hubbard, a Scripps employee as an HVAC technician, states that during this time, mold testing was not done to confirm the presence of mold, and that it was Scripps’ practice to not test for mold. (Hubbard Decl. ¶¶ 3–4.) On May 30, 2019, Scripps received an anonymous complaint about an odor in the Interventional Radiology Department (“IR”) in the main hospital, which was investigated by the Joint Commission. (Doc. No. 132-20 at 9.) The cause of the odor was determined to be a dirty coil, which was cleaned by ATI. (Seunarine Depo. at 9.) Although there was no mold testing in the IR HVAC, there was particulate matter on the second filter in the AHU because Scripps was not using anti-microbial filters. (Doc. No. 132-20 at 9.) Thereafter, a full assessment of all AHUs at the Scripps Green Campus was conducted. (Id. at 10.) Scripps retained San Diego Tech Building Solutions, Inc. (“SD Tech”) to inspect the HVAC system. (Doc. No. 132-1 at 15.) The investigation found that all AHUs at the Scripps Green Campus needed to be “serviced and cleaned.” (Deposition of Tina E. Pickett (“Pickett Depo.”), Doc. No. 132-60, at 12–13.) Between July 22, 2019 to August 30, 2019, Scripps inspected and assessed the condition of all 40 AHUs, and from September 1, 2019 to March 24, 2020, remediated 24 AHUs. (Doc. No. 132-1 at 15.) Scripps did not perform any mold testing in those AHUs to confirm the presence of mold before remediation. (Deposition of Raydel Gomez (“Gomez Depo.”), Doc. No. 132-57, at 8.) C. Scripps’ Mold Claim On February 18, 2020, Scripps gave notice for a pollution claim to Nautilus th

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