United Home Care, Inc., Trinity Home Health Care, Inc. and John D. Jones v. Charlie Simpson, Charles Gardner, CCZ, L.L.C., DJ-CS Properties, Inc. and CKS Properties, L.L.C.

Louisiana Court of Appeal·Decided November 16, 2022·No. 54,797-CA·Published

Opinion

Judgment rendered November 16, 2022.

Application for rehearing may be filed within the delay allowed by Art. 2166, La. C.C.P.

No. 54,797-CA

COURT OF APPEAL

SECOND CIRCUIT

STATE OF LOUISIANA

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UNITED HOME CARE, INC., Plaintiff-Appellees TRINITY HOME HEALTH CARE, INC. AND JOHN D. JONES

versus

CHARLIE SIMPSON, CHARLES Defendant-Appellants GARDNER, CCZ, L.L.C., DJ-CS PROPERTIES, INC. AND CKS PROPERTIES, L.L.C.

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Appealed from the

Fourth Judicial District Court for the Parish of Ouachita, Louisiana Trial Court No. 2017-1296

Honorable Daniel J. Ellender, Judge

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AYRES, SHELTON, WILLIAMS, Counsel for Appellant BENSON & PAINE, LLC Charles Gardner By: J. Todd Benson

BARRASSO USDIN KUPPERMAN Counsel for Appellee FREEMAN & SARVER, LLC Federal Insurance Co. By: Steven W. Usdin John W. Joyce Laurence D. LeSueur

HYMEL DAVIS & PETERSEN, LLC Counsel for Appellees By: Michael R. Davis Charlie Simpson, CCZ, Tim P. Hartdegen DJ-CS Properties, and CKS Properties

JOHN D. “DANNY” JONES In Proper Person

*****

Before MOORE, THOMPSON, and HUNTER, JJ.

MOORE, C.J.

Charles Gardner appeals a summary judgment that rejected his claims against Federal Insurance Company on two business liability policies. The district court found that Federal’s insureds (and Gardner’s former employers), United Home Care and Trinity Home Health Care, breached their obligations to Federal under the policies and thus negated coverage. For the reasons expressed, we affirm.

FACTUAL BACKGROUND

United and Trinity were home healthcare providers in West Monroe, Louisiana. In 2011, they hired Gardner as their controller; in 2012, they hired the other defendant, Charlie Simpson, as their chief operating officer. In March 2017, United and Trinity terminated them, citing “employee theft” (in a notice to the Louisiana Workforce Commission) and “theft and embezzlement” (in a letter to employees). In April 2017, United and Trinity (and their principal, John D. Jones) filed this suit to recover “embezzled money, misallocated and misappropriated company funds” and for “misuse of unauthorized funds.” By an amended petition, they alleged that Gardner overpaid himself by more than $200,000.1 Gardner denied all allegations and reconvened against United, Trinity, and Jones. He raised three claims: unpaid wages and statutory penalties; defamation (contending that the accusations of embezzlement and theft were “false and lack any good faith basis”); and violations of the Louisiana Unfair Trade Practices Act, La. R.S. 51:1401, et seq.

1 In brief, Federal asserts that the amount was $3.5 million.

Apparently, United and Trinity did not participate well in discovery.

Gardner and Simpson filed motions to compel, and in January 2018, the district court issued a long, detailed order compelling United and Trinity to hand over 31 sets of documents pertaining to the claims (and to pay attorney fees of $2,500 to each defendant). Once this discovery was partly satisfied, Gardner found that United and Trinity had bought business liability policies from Federal in force at the time of his firing. Gardner felt that these policies would cover his wage, defamation, and LUTPA claims.2 In February 2018, Gardner amended his claim to add Federal as a defendant in reconvention via the Direct Action Statute, La. R.S. 22:1269. United, Trinity, and Jones all filed for Chapter 7 bankruptcy in May 2020; Gardner then amended his reconvention again, this time to frame his defamation claim solely against Federal.3 Federal answered denying all allegations and asserting 23 affirmative defenses. It showed that its policies, two identical ForeFront Portfolio 3.0 policies, required the insureds to notify Federal “as soon as practicable” about Gardner’s claims. It contended that because the insureds failed to do so, this breach negated Federal’s liability.

THE MOTION FOR SUMMARY JUDGMENT Federal followed up with a motion for summary judgment as to coverage and defamation. In support, it attached copies of the policies, with coverage from November 1, 2016, to November 1, 2017, and one extension

2 Discovery was only partly satisfied. At a later hearing on the motions to compel, the court ordered further compliance and assessed the plaintiffs with attorney fees of $35,407 for Gardner and $69,271 for Simpson.

3 The remaining assets of United and Trinity were acquired by an entity called FUDJ LLC, which is not a party to the appeal.

through February 10, 2018. These included provisions setting “full compliance with all the terms of this Policy” and “written notice of any Claim as soon as practicable” as conditions precedent to coverage, and a requirement that the insured must “provide [Federal] with all information, assistance and cooperation” as it may reasonably request and “do nothing that may prejudice” Federal’s position or rights of recovery. Federal showed that its insureds were served with Gardner’s reconventional demand, and filed an answer on June 7, 2017; however, the affidavit of Federal’s vice- president and executive claims director, Mr. Allison-Couto, showed that they never notified Federal of the claim, and Federal was unaware of it until being served with Gardner’s amended reconventional demand, on March 6, 2018; even after that, the insureds never responded to Federal’s repeated requests for information or cooperation. It argued that these breaches of policy negated coverage, even as to third parties, citing Lee v. United Fire & Cas. Co., 607 So. 2d 685 (La. App. 4 Cir. 1992); Ortiz v. MeadWestvaco Corp., 18-869 (La. App. 3 Cir. 6/5/19), 274 So. 3d 158; and Gorman v. City of Opelousas, 13-1734 (La. 7/1/14), 148 So. 3d 888. It also argued that United and Trinity’s persistent refusal to comply with discovery had prejudiced Federal’s rights in the underlying action.

Gardner opposed the MSJ. After arguing that Lee, Ortiz, and Gorman were not really apposite, he cited earlier cases holding that the right of a third party under the Direct Action Statute is fixed “at the time of the accident or injuries, and the insured’s later breach of the policy requirements for cooperation will not vitiate coverage in the absence of proof or fraud or conspiracy.” King v. King, 253 La. 270, 217 So. 2d 395 (1968); Futch v. Fidelity & Cas. Co. of New York, 246 La. 688, 166 So. 2d 274 (1964).

Further, the insured’s “dilatory conduct” could not negate the protection of “tort victims from insolvent tortfeasors.” West v. Monroe Bakery, 217 La. 189, 46 So. 2d 122 (1950). In essence, United and Trinity’s shoddy compliance with their policies should not negate the coverage afforded to Gardner. He also argued that Federal received actual notice of the claim, by service of the amended reconventional demand, within 90 days of the end of the policy period, making it timely and refuting any claim of prejudice. Finally, he argued that Federal waived any policy defenses because it failed to provide its insureds a defense by hiring separate counsel for them. Breazeale v. T.T., 12-1703 (La. App. 1 Cir. 4/26/13), 117 So. 3d 192, writ denied, 13-1852 (La. 11/1/13), 125 So. 3d 437; Emery v. Progressive Cas. Ins. Co., 10-0327 (La. App. 1 Cir. 9/10/10), 49 So. 3d 17.

Federal responded that the Supreme Court’s latest statement, Gorman, applied the policy requirements literally, recognized the validity of a claims- made policy, and said nothing about “fraud or conspiracy”; the insureds never gave the required notice of claim; once it was served with the amended reconvention, Federal promptly issued a reservation of rights letter offering separate counsel, but the insureds never responded; and Federal was profoundly prejudiced by this failure to cooperate. In support, it attached copies of emails from Federal to United, Trinity, and Jones in May 2018 and January 2021.

ACTION OF THE DISTRICT COURT After a hearing in October 2021, the district court denied Federal’s MSJ on the defamation claim, but granted it as to coverage, and rendered judgment dismissing all claims against Federal “because no coverage exists.”

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United Home Care, Inc., Trinity Home Health Care, Inc. and John D. Jones v. Charlie Simpson, Charles Gardner, CCZ, L.L.C., DJ-CS Properties, Inc. and CKS Properties, L.L.C., (La. Ct. App. 2022).

United Home Care, Inc., Trinity Home Health Care, Inc. and John D. Jones v. Charlie Simpson, Charles Gardner, CCZ, L.L.C., DJ-CS Properties, Inc. and CKS Properties, L.L.C. (United Home Care, Inc., Trinity Home Health Care, Inc. and John D. Jones v. Charlie Simpson, Charles Gardner, CCZ, L.L.C., DJ-CS Properties, Inc. and CKS Properties, L.L.C.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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