SHH Holdings, LLC v. Allied World Specialty Insurance Company

CourtDistrict Court, N.D. Ohio
DecidedSeptember 28, 2021
Docket1:19-cv-02900
StatusUnknown

This text of SHH Holdings, LLC v. Allied World Specialty Insurance Company (SHH Holdings, LLC v. Allied World Specialty Insurance Company) is published on Counsel Stack Legal Research, covering District Court, N.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
SHH Holdings, LLC v. Allied World Specialty Insurance Company, (N.D. Ohio 2021).

Opinion

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF OHIO

: SHH HOLDINGS, LLC : CASE NO. 1:19-cv-2900 : Plaintiff, : OPINION & ORDER : [Resolving Docs. 50, 51 & 52] v. : : ALLIED WORLD INSURANCE : COMPANY, : : Defendant. :

JAMES S. GWIN, UNITED STATES DISTRICT COURT JUDGE:

Earlier, this Court granted Plaintiff SHH Holdings, LLC (SHH) partial summary judgement on its breach of contract and declaratory judgment counts against Defendant Allied World Specialty Insurance Company (Allied World). After summary judgment was given on this breach of an insurance contract claim, the Court ordered the parties to brief certain disputed damages questions. For the reasons below, the Court awards certain described damages. I. Background Plaintiff SHH purchased insurance coverage from Defendant Allied World. During the policy period, the United States brought a false claims action against SHH. Certain former SHH employees initiated the action as a qui tam case.1 The qui tam action contained claims of both improper billing practices and employee retaliation.2

1 at 4. SHH did not ask for Allied World coverage for the false claims allegations.3 Instead, SHH applied for only the retaliation claims.4 Allied World rejected the claim and said that

SHH knew, but earlier failed to disclose with its application, an earlier false claims inquiry.5 Without Allied World’s help, SHH then defended and ultimately settled the retaliation claims.6 SHH also separately settled the billing-related claims with the government.7 In this lawsuit, SHH sued Allied World and said Allied World owed both indemnity and defense cost coverage for the retaliation claim. After the parties agreed that the coverage issue was a legal question and on

summary judgement, the Court determined that the insurance policy entitled SHH to coverage on the retaliation claim.8 Accordingly, both parties agree that under this Court’s insurance contract ruling, that SHH is entitled to the cost of the SHH’s retaliation claims settlement, less the cost of the retention fee under the insurance policy.9 That uncontested amount is $2 million.10 Given this Court’s merits ruling, the parties also agree that SHH should recover attorneys’ fees incurred in defending and ultimately settling the retaliation claim.11

3 Doc. 39 at ¶ 12. 4 5 6 at 5. 7 8 Doc. 48 at 14. 9 Doc. 49. 10 However, they contest the scope and amount of fees appropriately included in that representation.12 Additionally, Plaintiff and Defendant disagree whether Plaintiff can recover attorneys’ fees for bringing this litigation to enforce the policy.13 Lastly, the parties agree that SHH is entitled to both pre-judgment and post- judgement interest.14 II. Retaliation Claim Attorneys’ Fees Under the Insurance Policy The parties dispute the scope of the fees that SHH can recover for SHH’s defense of the employee retaliation claim. Based on invoices of attorneys’ fees incurred from the time

period during which the policy was in effect, SHH contends that it is entitled to $111,918.04.15 Allied World argues that SHH is only entitled to a subset of those costs, amounting to $55,226.54.16 Allied World explains that its calculation excludes fees for work related to the False Claims Act portion of the underlying case, “mixed entries as to which SHH has failed to prove an entitlement to coverage in a discernable amount,”17 and SHH counsel’s work related to insurance coverage itself. The parties agree that “entries that strictly involve work on the false claims defense”

are not proper SHH policy damages in this case.18 However, they arrive at different totals.

12 13 14 15 Doc. 52 at 5. SHH initially claimed that it was entitled to $116,999.50. Doc. 50 at 3. But SHH subsequently acknowledged that some of its initial sum included costs SHH incurred before giving notice to Allied World, which are not covered under the policy. Doc. 52 at 5. 16 Doc. 51 at 5. 17 at 6. SHH rejects Allied World’s contention that fees can be “squarely divided” between the billing issue defense and the retaliation claims defense.19 At a higher level, SHH argues that Allied World forfeited its right to “second-guess” SHH’s execution of its defense when it declined SHH’s insurance application.20 The Court finds SHH’s argument unpersuasive. Under Ohio law, the party “who seeks to recover on an insurance policy generally has the burden of . . . proving a loss.”21 To do so, “[t]he insured must show facts sufficient to prove that its loss was within the description of the policy.”22 Here, SHH has not met that burden. SHH only briefly asserts the relatedness of the billing issue and the retaliation issue in its reply brief.23 And a review

of the entries themselves does not provide further clarity. For example, multiple entries refer to discussions with the government regarding a “settlement,” but fail to specify whether they are referring to the billing issue or retaliation claims settlement or indicate that the issues are necessarily related.24 In light of the Court’s inability to determine that all of the time entries that SHH seeks to recover come under its policy coverage, the Court finds that SHH has failed to meet its burden. Lastly, the Court finds that SHH is not entitled to attorneys’ fees related to

investigating its insurance coverage options following Allied World’s denial. These fees fall outside the insurance coverage and SHH has not met its burden.25

19 20 at 3 (citing , No. 2:11-CV-1114, 2014 WL 4915269, at *6 (S.D. Ohio Sept. 30, 2014)). 21 , 719 N.E.2d 955, 959 (Ohio 1999). 22 , 506 N.E.2d 1192, 1198 (Ohio App. Ct. 1986). 23 Doc. 52 at 4–5. 24 Doc. 44 at 413, 422, 438, 439, 444. Accordingly, the Court ORDERS Plaintiff SHH to be AWARDED $55,226.54 in attorneys’ fees. III. Attorneys’ Fees in This Litigation Under Ohio Law The parties understandably dispute whether SHH is entitled to attorneys’ fees for bringing this action as Ohio federal district courts and two Sixth Circuit decisions on this Ohio law question have reached differing results. Following this Court’s ,26 requirement, the Court applies what it believes the Ohio Supreme Court would rule. As a general matter, Ohio law makes litigants responsible for their own attorneys’

fees.27 But in the context of certain insurance contracts, the Ohio Supreme Court has created an exception to that rule. First, in 1973, the Ohio Supreme Court decided .28 In that case, an insurer brought a declaratory judgment action seeking to avoid both indemnifying and defending the insured in an underlying negligence action.29 The court ruled against the insurer, holding in the syllabus that: Where an insurer wrongfully refuses to defend an insured in a negligence action [ . . . ] the insured is entitled to recover from the insurer his expenses, including reasonable attorney fees, in defending the action.30

The Court based its ruling on the “rationale [that] the insured must be put in a position as good as that which he would have occupied if the insurer had performed its duty.”31

26 304 U.S. 64 (1938). 27 , 48 N.E. 500, 502 (Ohio 1897). 28 294 N.E.2d 874 (Ohio 1973). 29 at 878. 30 at 875, at ¶ 4. Then, in the 1982 case the Ohio Supreme Court extended . In , Refiners had an agreement to indemnify and defend Standard Oil.33 When Refiners refused to defend Standard Oil against a negligence claim, Standard Oil undertook the defense itself and filed a third-party complaint to enforce the agreement.

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SHH Holdings, LLC v. Allied World Specialty Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/shh-holdings-llc-v-allied-world-specialty-insurance-company-ohnd-2021.