KENNETH L. RYSKAMP, District Judge.
Plaintiffs Kathleen Ramey and Douglas Wayne Ramey ("Plaintiffs") filed this action for common law bad faith against Defendant Interstate Fire and Casualty Company ("Interstate") to recover for medical injuries sustained from a negligently performed operation. The operation was performed by Dr. Andrew D. Weiss, an insured under Interstate's Physician & Surgeons Professional Liability Claims Made Insurance Policy (the "policy"). Plaintiffs previously sued Dr. Weiss in state court for medical malpractice, where a judgment was entered in favor of Plaintiffs against Dr. Weiss for $36,925,869.00. Plaintiffs now seek recovery of the "full amount of the judgment" from Interstate, claiming that it is required to indemnify Dr. Weiss under the terms of the policy.
Dr. Weiss was insured under Interstate's policy from February 16, 2000 to February 16, 2002 (the "policy period"). Under the policy, coverage was provided for certain claims made against Dr. Weiss and reported to Interstate during the policy period. In pertinent part, the first page of the policy states:
The policy defines a "claim" as a "demand for money, or the filing of a
On September 21, 2000, Dr. Weiss improperly administered a cervical epidural injection to Kathleen Ramey, causing her significant injuries. Following the procedure, Mrs. Ramey notified Dr. Weiss by telephone on September 27, 2000 that her injuries had worsened "as a result of [his] improperly performed [procedure]." The next day, on September 28, 2000, Dr. Weiss sent Interstate a letter providing "notice of [Mrs. Ramey's] incident." In the letter, he stated "there is no litigation pending," but that he wanted to keep his insurance agent informed. On October 24, 2000, Interstate responded to Dr. Weiss's letter, and advised him as follows:
The letter cited the applicable policy provisions discussed above, and concluded that because "neither a
Subsequently, on October 25, 2000, Plaintiffs' counsel sent a letter to Dr. Weiss requesting copies of Mrs. Ramey's
As alleged in the complaint, there were no further communications between Plaintiffs, Dr. Weiss, and Interstate prior to the close of the policy period.
On February 25, 2002, Plaintiffs sent Dr. Weiss a pre-suit notice of intent to initiate litigation. Dr. Weiss provided the notice to Interstate, but it denied coverage, stating that a claim was not reported during the policy period, and therefore, no defense or indemnification would be provided. Plaintiffs sued Dr. Weiss on September 20, 2002 in state court for medical malpractice, and after ten years of litigation, a judgment was entered in favor of Plaintiffs against Dr. Weiss personally in the amount of $36,925,869.00. Plaintiffs subsequently filed this action alleging a single claim for common law bad faith against Interstate. Specifically, Plaintiffs allege that Interstate breached its "duties to Dr. Weiss by wrongly denying a covered claim for damages."
Pursuant to Fed.R.Civ.P. 12(c), Interstate now moves for a judgment on the pleadings. Interstate argues that (1) a finding of coverage must be made before Plaintiffs' bad faith claim can be decided and (2) Plaintiffs' claim fails as a matter of law because the complaint demonstrates that no claim was made so as to trigger coverage under the policy. In response, Plaintiffs move to amend their complaint to abate their common law bad faith claim and proceed with a declaratory judgment action. Interstate contends, however, that any such amendment would be futile, as the facts alleged in the proposed amended complaint are virtually identical to those of the original complaint, and thus Plaintiffs fail to adequately allege a "claim" sufficient to trigger policy coverage.
In support of its motion, Interstate attaches various exhibits, some of which are referenced in the complaint. These exhibits include: documents from Dr. Weiss's bankruptcy proceedings; a criminal indictment and judgment against Dr. Weiss for distributing narcotics; settlement documents between Plaintiffs and Dr. Weiss's former employer; and pre-suit correspondence between Plaintiffs, Dr. Weiss, and Interstate, as discussed above. Plaintiffs assert that in review of Interstate's motion, the Court should ignore extrinsic evidence
Pursuant to Fed.R.Civ.P. 12(c), after the pleadings are closed, a party may move for judgment on the pleadings if no material facts remain at issue and the parties' dispute can be resolved on the pleadings and those facts of which the court can take judicial notice. See Fed.R.Civ.P. 12(c); Hawthorne v. Mac Adjustment, Inc., 140 F.3d 1367, 1370 (11th Cir.1998). A motion for judgment on the pleadings "is governed by the same standard as a Rule 12(b)(6) motion to dismiss." In re Accutane Prods. Liab., 2011 WL 6224546, at *1 (M.D.Fla. Nov. 9, 2011). Thus, the Court accepts the factors in the complaint as true and views them in light most favorable to the nonmoving party. Hawthorne, 140 F.3d at 1370. However, a plaintiff's grounds for relief "requires more than labels and conclusions;" he must plead "enough facts to state a claim to relief that is plausible on its face." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 547, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007).
Generally, a court must convert a motion for judgment on the pleadings into a motion for summary judgment if it considers materials outside the pleadings. Fed.R.Civ.P. 12(d). A court may, however, consider documents attached to a motion for judgment on the pleadings without converting it into one for summary judgment if the documents are (1) central to the plaintiffs claim and (2) their authenticity is not challenged. Day v. Taylor, 400 F.3d 1272, 1276 (11th Cir.2005). In determining whether documents are "central" to a plaintiffs claim, courts conduct a fact-sensitive analysis, considering such factors as: whether the claims depend on the documents, see Botero v. South Florida Pain & Rehabilitation Center Corp., Inc., No. 12-20924, 2012 WL 3614329, at *3 (S.D.Fla. Aug. 21, 2012); whether the contents of the documents are alleged in the complaint, see In re Silicon Graphics Inc. Securities Litigation, 183 F.3d 970, 986 (9th Cir.1999); or, whether the documents form a "necessary part of [the plaintiffs] effort to make out [his] claim." Day, 400 F.3d at 1276; see e.g., Horsley v. Feldt, 304 F.3d 1125, 1134-35 (11th Cir.2002) (ruling in a defamation case that an article in which the alleged defamatory statement was made was central to the plaintiffs claim). Generally, the extrinsic materials must either form the basis for the claim or be necessary to support the claim at issue. See Orange Beach Dev. Group, L.P. v. Powers, 2007 WL 1889814, at *3 (S.D.Ala. June 28, 2007).
Under Federal Rule of Civil Procedure 15, leave to amend pleadings should be freely given when justice so requires. "In the absence of any apparent or declared reason — such as undue delay, bad faith or dilatory motive on the part of the movant, repeated failure to cure deficiencies by amendments previously allowed, undue prejudice to the opposing party by virtue of allowance of the amendment, futility of amendment, etc. — the leave sought should, as the rules require, be `freely given.'" Foman v. Davis, 371 U.S. 178, 182, 83 S.Ct. 227, 9 L.Ed.2d 222 (1962).
Interstate introduces a variety of extrinsic evidence in support of its motion. To
Here, the Court declines to convert Interstate's Rule 12(c) motion into a motion for summary judgment. The Court finds that while some of Interstate's extrinsic materials are irrelevant, most of the exhibits are central to Plaintiffs' claims, undisputed, and otherwise properly considered by the Court at this stage. The Court, therefore, declines to consider documents from Dr. Weiss's bankruptcy proceedings, the criminal indictment and judgment against Dr. Weiss, or settlement documents between Plaintiffs and Dr. Weiss's former employer. These materials are not mentioned in the complaint, do not form the basis of Plaintiffs' claim, and are not relied upon Plaintiffs in any respect. The Court does consider, however, the pre-suit correspondence letters between Plaintiffs, Dr. Weiss, and Interstate. These correspondence letters are alleged in the complaint and relied upon by Plaintiffs as a necessary part of their effort to set forth a claim for coverage under the policy. Plaintiffs' action rises and falls upon whether a "claim" was made such that Interstate owed a duty to indemnify Dr. Weiss under the terms of the policy. The complaint, or amended complaint, contains no other allegations of communications between parties other than the correspondence letters and the September 21, 2000 phone call from Mrs. Ramey to Dr. Weiss complaining of her injuries. Thus, in reviewing the legal sufficiency of the Plaintiffs' action, the content of the letters is essential.
The Court finds that the undisputed facts establish no claim was made under the policy. A review of the amended complaint demonstrates the same. Therefore, the Court finds that based on the facts alleged, Plaintiffs are not covered under the policy. Thus, the Court holds that Interstate is entitled to judgment as a matter of law and denies Plaintiffs' motion to amend the complaint as futile.
The policy at issue provides coverage for "Claims first made against the Insured [Dr. Weiss] and reported to the Company [Interstate] during the Policy Period." The policy defines a "claim" as a "demand for money, or the filing of Suit named the Named Insured." The complaint and proposed amended complaint (which, factually, is virtually identical) reference seven different communications between Plaintiffs, Dr. Weiss, and Interstate. Taken from the amended complaint, they are as follows:
A review of these allegations demonstrates that Plaintiffs fail to plausibly allege the existence of a "claim". The facts show that Plaintiffs neither made a demand for money nor initiated a lawsuit within the policy period. Moreover, even if a claim was made, there are no facts to support that Interstate was notified of such during the policy period. Plaintiffs' lawsuit against Dr. Weiss was not initiated until after the policy period. Furthermore, mere speculation that Plaintiffs' October 25, 2000 letter suggests an intention to seek reimbursement is not enough. A notice of a potential claim does not constitute a demand for money and, thus, a "claim" under the policy. See Myers v. Interstate Fire & Casualty Co., 2008 WL 276055, at *7 (M.D.Fla. Jan. 30, 2008) (finding that a letter did not constitute a "claim" under a Physicians and Surgeons Liability Policy where the lawyer's "statement that he was retained to represent [the patient] in `a claim for damages' was merely a notice of a potential claim, insufficient to trigger the insurer's duty to defend and indemnify"); Aguilar v. Royal Surplus Lines Ins. Co., 2006 WL 2038643, at *12 n. 4 (Bankr. S.D.Fla. June 5, 2006) (explaining that a letter from a patient's attorney requesting medical records "was nothing more than a preparatory act to the possibility of making a claim").
Where a policy is clear and unambiguous, the Court must give effect to its plain language. See Myers, 2008 WL 276055 at *3. Here, the Court finds the bold, capitalized print stating
Based on the foregoing, granting Plaintiffs leave to file their proposed amended complaint would be futile. The amended complaint, from which the excerpted portions of Plaintiffs' allegations were taken, provides no factual allegations to support a finding that a "claim" was made under the policy so as to trigger coverage. Plaintiffs argument that discovery is needed to determine whether verbal demands for money were made to Dr. Weiss is unavailing. The amended complaint does not allege Plaintiffs made a verbal demand for money, or what is more, it does not contain allegations that such a demand was reported to Interstate. Therefore, the Court finds that no factual allegations are in dispute and Interstate is entitled to judgment as a matter of law.
The Court has carefully considered the motions, responses, replies, applicable law, and pertinent portions of the record. For the foregoing reasons, it is hereby
The Clerk of Court is directed to