Wausau Business Insurance v. Sentosa Care LLC

10 F. Supp. 3d 444, 2014 U.S. Dist. LEXIS 42490, 2014 WL 1282570
CourtDistrict Court, S.D. New York
DecidedMarch 28, 2014
DocketNo. 10 Civ. 7484(PAC)
StatusPublished
Cited by2 cases

This text of 10 F. Supp. 3d 444 (Wausau Business Insurance v. Sentosa Care LLC) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wausau Business Insurance v. Sentosa Care LLC, 10 F. Supp. 3d 444, 2014 U.S. Dist. LEXIS 42490, 2014 WL 1282570 (S.D.N.Y. 2014).

Opinion

OPINION & ORDER

PAUL A. CROTTY, District Judge:

Plaintiff Wausau Business Insurance Co. (“Wausau” or “Plaintiff’) brings this action in diversity against Sentosa Care LLC (“Sentosa”), and the other named defendants 1 (collectively “Defendants”) for breach of contract, alleging that Defendants failed to pay outstanding premiums under three separate Workers’ Compensation and Employers’ Liability policies for the years 2008-09, 2009-10, and 2010-11.

Wausau now moves for summary judgment. Defendants oppose the motion and cross-move for summary judgment. Defendants maintain that (1) there were no contracts between Wausau and any of the Defendants other than Sentosa, because Sentosa is the only one named on the policies; and (2) the contracts are illegal because Defendants were not commonly owned and therefore could not be properly combined under the same policies with Sentosa. Defendants also argue that, even if there were a contract — and the Court determines that there certainly was an [446]*446insurance contract between the parties— Wausau has failed to establish a prima facie case for the unpaid premiums because Wausau (i) did not submit a full copy of the policies; (ii) did not sufficiently explain how the premiums were calculated; and (in) failed to authenticate the audits it relied upon for damages, which were created in the course of litigation. Defendants also move the Court to reconsider its prior order of November 21, 2011 determining that it has diversity jurisdiction over this action.

Wausau argues there is an enforceable contract with Defendants: (1) each Defendant was a party to a policy endorsement; (2) the Defendants were properly combined under the same policy; (3) even if they were not, Defendants never submitted information indicating they could not be combined, as required by the New York Experience Rating Plan Manual, so the contracts cannot be invalidated; and (4) having received the benefits of coverage under the policies for years, Defendants cannot now argue a contract never existed. Wausau also submits it provided all necessary documentation, authentication, and explanation to support its damages claims. Wausau urges the Court to reaffirm its prior position regarding diversity jurisdiction.2

For the reasons that follow, the Court denies Defendants’ motion for reconsideration of the November 21, 2011 Order and motion for summary judgment, and grants Wausau’s motion for summary judgment in its entirety.

BACKGROUND

I. The Parties and Policies

Wausau is a stock insurance company organized under the laws of Wisconsin, with its primary place of business in Boston, Massachusetts. (Second Am. Compl. ¶ 1; Def.’s Answer ¶ 1.) It is undisputed that Wausau issued three Workers’ Compensation and Employers’ Liability policies to Sentosa.3 The first policy, No. WCKY91-448515-018 (the “018 Policy”), had a policy period of February 1, 2008 to March 1, 2009. (Gauthier May Decl. Ex. 1.) The second policy, No. WCK-Z01-448515-019 (the “019 Policy”) had a policy period of March 1, 2009 to March 1, 2010. (Id. Ex. 3.) The third policy, No. WCK-Z91448515-010 (the “010 Policy”), had a policy period of March 1, 2010, to March 1, 2011. (Id. Ex. 5.)

In each of the three policies, Item 1 lists Sentosa Care LLC as the name of the primary insured. (Gauthier May Decl. Ex. 1 WAU 010000, Ex. 3 WAU 010533, Ex. 5 WAU 011096.) The section below Item 1 entitled “Coverage” states “This policy includes these endorsements and schedules: See Item 3. Coverage D-Extension of Information Page.” (Id.) Item 3 modifies Item 1, stating “Change in Item 1 of the Information Page Endorsement (Add Insureds).” (Id. Ex. 1 WAU 010002; Ex. 3 WAU 010535; Ex. 5 WAU 011098.) The form referenced in that section is entitled “Change in Item 1 of the Information Page Endorsement (Add Insureds),” and it lists the names of additional insured entities for each policy. (Id. Ex. 1 WAU 010028-29; Ex. 3 WAU 010598-99; Ex. 5 WAU [447]*447011140-41.) Additional insureds’ names are also listed on separate endorsements and schedules incorporated by reference. (See, e.g., id. Ex. 1 WAU 010094 (“Policy Information Page Endorsement” adding “Insured’s Name”); Ex. B WAU 010595 (“Named Insured Link Schedule”).)

Specifically, the 018 Policy endorsements list the following additional entities — Defendants in this action — as insureds: Brookhaven Rehabilitation & Health Center, LLC; Avalon Gardens Rehabilitation & Health Care Center, LLC; B & B Management LLC; Bay Park Center for Nursing & Rehabilitation, LLC; Bayview Manor LLC4; Eastchester Rehabilitation & Health Care Center, LLC; Garden Care Center, Inc.; Golden Gate Rehabilitation & Health Care Center LLC; Nassau Operating Co. LLC; New Surfside Nursing Home, LLC; NMC Acquisition, LLC; North Sea Associates, LLC; Park Avenue Operating Company LLC; Pine Grove Manor II, LLC; Throgs Neck Operating Co. LLC; Townhouse Operating Co. LLC; West Lawrence Care Center, LLC; White Plains Center for Nursing Care LLC; Willoughby Rehabilitation & Health Care Center LLC; Wood-mere Rehabilitation & Health Care Center Inc.; Allstate ASO Inc.; Greater New York Home Care, LLC; Stat Portable X-Ray, Inc.; Little Neck Nursing Home LLC; Franklin Center for Rehabilitation & Nursing, LLC; Split Rock Rehabilitation & Health Care Center, LLC; and Fort Tryon Center for Rehabilitation & Nursing, LLC (collectively, with Sentosa, the “018 Policy Defendants”). (Gauthier May Deck Ex. 1 WAU 010028-29, WAU 010094, WAU 010177, WAU 010268, WAU 010332.)

The 019 Policy endorsements and schedules list as insureds all of the 018 Policy Defendants, plus the following entities, also Defendants in this action: Prompt Nursing Employment Agency, LLC; Greater New York Home Care Systems, Inc.; Greater New York Sendees, Inc.; Congregation.Chareidim Corp.; and Economy Exterminating USA LLC (the insureds covered by the 019 Policy are hereinafter the “019 Policy Defendants”). (Id. Ex. 3 WAU 010595-99, WAU 010702, WAU 010898, WAU 010963.)

The 010 Policy endorsements and schedules list as insureds all of the 019 Policy Defendants, except for Franklin Center for Rehabilitation & Nursing, LLC; Split Rock Rehabilitation & Health Care Center, LLC; and Fort Tryon Center for Rehabilitation & Nursing, LLC (the insureds covered by the 010 Policy are hereinafter the “010 Policy Defendants”). (Id. Ex. 5 WAU 011140-42.)

In addition to adding insureds to each policy, Item 3 refers to policy schedules under “Item 4. Premium — Extension of Information Page.”- (Gauthier May Deck at Ex. 1 WAU 010002; Ex. 3 WAU 010535; Ex. 5 WAU 011098.) Item 4 lists information about the additional insureds covered under each policy — the same entities listed above. This information includes classification of each additional insured’s operations, the insured’s class code, the premium basis (which defaults to payroll unless otherwise indicated), applicable rate, and the estimated premium. (See, e.g., id. Ex. 1 WAU 010004.) The 018 Policy contains this information about the 018 Policy Defendants (id. Ex. 1 WAU 010004-23); the 019 Policy contains this information about the 019 Policy Defendants (id. Ex. 1 WAU 010538-92); and the 010 Policy [448]*448contains this information about the 010 Policy Defendants (id. Ex.

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10 F. Supp. 3d 444, 2014 U.S. Dist. LEXIS 42490, 2014 WL 1282570, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wausau-business-insurance-v-sentosa-care-llc-nysd-2014.