SUSAN C. BUCKLEW, District Judge.
This cause comes before the Court on a Motion to Dismiss filed by Defendant Chartis Specialty Insurance Company n/k/a AIG Specialty Insurance Company ("Chartis"), to which Plaintiff Windhaven Managers, Inc. ("Windhaven") filed a response, and Chartis filed a reply. (Docs. 6, 10, 13).
In the instant action, Windhaven alleges it was wrongfully denied coverage under its professional liability insurance policy issued by Chartis, a "claims-made" policy covering Windhaven for losses arising out of claims "first made" against it during the policy period of May 1, 2011 to May 31, 2012, and reported to Chartis within 30 days after the policy period. (Doc. 1)
Windhaven is an insurance carrier and issued Faye Austin a motor vehicle policy. Ms. Austin was subsequently injured in a car accident and, in December 2009, sued Windhaven in state court, alleging she was entitled to her policy's $10,000 limit for her injuries ("coverage action"). (Doc. 1 at ¶¶ 9-11).
Also, in December 2009, Ms. Austin filed a civil remedy notice of insurer violation (CRN) pursuant to Florida's bad-faith statute, Florida Statutes § 624.155(1)(b).
In May 2011, Windhaven's policy period began. (Doc. 1-3 at 2). Coverage under this claims-made policy was limited to claims first made against Windhaven during the policy period and reported in writing to Chartis within 30 days after the policy period:
(Id. at 4) (emphasis added).
Under the policy, a "claim" is a "written demand for monetary damages," or "judicial ... proceeding in which monetary damages are sought." (Id. at 4-5). The policy explains when a claim is considered to have been "first made" against the insured and how the insured must report such a claim to Chartis no later than 30 days after the expiration of the policy period:
(Id. at 10, 20) (second emphasis added).
On July 14, 2011, following a jury trial in Ms. Austin's coverage action, the state court entered judgment in the amount of $893,651.85, against Windhaven and in Ms. Austin's favor. (Doc. 1 at ¶ 13; Doc. 1-2). On the same day, Ms. Austin filed an amended complaint against Windhaven, alleging that its bad-faith failure-to-settle was a violation of Florida Statutes § 624.155 ("bad faith action"). (Id. ¶ 16; Doc. 1-2). Specifically, Ms. Austin alleged that she had made a claim for coverage under her policy and offered to settle her claim within the policy limits; Windhaven in bad faith rejected her claim; and she brought a coverage action against Windhaven, resulting in a judgment in her favor exceeding her policy limit. (Doc. 1 at ¶ 17; Doc. 1-2). Ms. Austin sought damages in the amount of the excess judgment.
Windhaven's claims manager mailed a letter, dated August 26, 2011, to "A.I. Management and Professional Liability Claims Adjusters" at "P.O. Box 1000, New York, NY 10268," stating:
(Doc. 1-4). Windhaven alleges that the purpose of this letter was to put Chartis on notice of Ms. Austin's bad faith action against Windhaven. (Doc. 1 at ¶ 23).
In October 2011, Windhaven appealed the judgment entered in Ms. Austin's coverage action. (Id. at ¶ 14).
The policy period expired in May 2012, with a reporting deadline of June 2012. Three months later, in October 2012, Windhaven's appeal resulted in an affirmance of the judgment entered in Ms. Austin's coverage action. (Id. at ¶ 15). Windhaven's claims manager then sent an email to Chartis, dated November 5, 2012, stating:
(Doc. 1-5). Windhaven contends this was its "second letter to Chartis providing notice of [Ms. Austin's bad faith] lawsuit." (Doc. 1 at ¶ 25).
In response to this email, Chartis sent Windhaven a letter, dated February 12, 2013, acknowledging receipt of Ms. Austin's amended complaint. (Doc. 1-6). However, Chartis asserted that no coverage existed because the claim was made and reported outside the policy period:
(Id.).
According to Windhaven, Chartis then "supplemented its denial letter and acknowledged receipt of Windhaven's August 26, 2011 letter." (Doc. 1 at ¶ 26). Specifically, Windhaven cites to a letter from Chartis to Windhaven, dated February 20, 2013, which states:
(Doc. 1-7 at 2). Chartis nonetheless concluded that no coverage existed under the policy, finding that Windhaven's August 2011 letter failed to comply with the policy's notice requirements and therefore failed to report Ms. Austin's claim during the policy period. (Id. at 3).
In July 2014, Windhaven filed a two-count Complaint for declaratory judgment and breach of contract against Chartis, alleging Chartis improperly denied Windhaven coverage for losses arising from Ms. Austin's bad faith action. (Doc. 1 at ¶¶ 30-44). Chartis moves to dismiss the Complaint with prejudice under Federal Rule of Civil Procedure 12(b)(6), arguing that Windhaven's policy provides no coverage because Ms. Austin's bad faith action was a claim that was "first made" against Windhaven outside the policy period. (Doc. 6). Alternatively, Chartis argues that, even if the claim was first made during the policy period, no coverage exists because Windhaven did not timely report the claim.
To survive a motion to dismiss under Rule 12(b)(6), a complaint must allege sufficient facts, accepted as true, to state a plausible claim for relief. Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). The Court views the complaint in the light most favorable to the plaintiff. Murphy v. Fed. Deposit Ins. Corp., 208 F.3d 959, 962 (11th Cir. 2000) (citation omitted).
The decisive issue is whether Ms. Austin's bad faith claim was "first made" against Windhaven during the policy period and therefore covered under Windhaven's claims-made policy. Chartis argues (and the Court agrees) that Ms. Austin first made her bad faith claim against Windhaven when she filed her CRN in 2009. (Doc. 6).
Windhaven counters that Ms. Austin could not have first made her bad faith claim against Windhaven when the CRN was filed, arguing that the CRN was not an "enforceable demand" (as Ms. Austin could not have proceeded with her bad-faith action where judgment in the underlying coverage action had not been entered) and therefore not a "claim" at that time. (Doc. 10). Windhaven contends Ms. Austin first made her bad faith claim against Windhaven during the policy period when she filed her amended complaint in 2011.
At the outset, neither party addresses the following policy language—expressly providing when a claim is deemed to have been "first made against the Insured"—which expressly addresses this issue:
(Doc. 1-3 at 10) (emphases added). Under these express terms, then, Ms. Austin's bad faith claim was first made against Windhaven when written notice of that claim was received by Windhaven, or by Chartis, whichever came first.
Here, Ms. Austin's CRN provides written notice of Ms. Austin's bad faith claim under the policy. Specifically, the CRN details the allegations underlying her bad-faith failure-to-settle action against Windhaven pursuant to § 624.155, and constitutes a demand for Windhaven to pay the benefits owed under her policy. See Fla. Stat. § 624.155(3); Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So.2d 1278, 1283 (Fla. 2000). The CRN is a written demand for monetary damages and therefore a claim as defined by the policy. Further, Windhaven's Complaint indicates that Windhaven received the CRN—i.e., written notice of Ms. Austin's bad faith claim—before Chartis in 2009. (Doc. 1 at ¶ 12; Doc. 1-2 at 9). Thus, under the policy language quoted above, Ms. Austin's bad faith claim is considered to have been first made against Windhaven when Windhaven received the CRN in 2009. See, e.g., Fidelity Nat'l. Property and Cas. Co. v. Boardwalk Condo. Ass'n, Inc., 2010 WL 1911159, at * 5 (N.D. Fla. May 12, 2010) (where the policy provided that a claim was "first made" when the insured receives notice of the claim, the claim was "first made" when the insured received pre-suit letters). Because this was outside the policy period, no coverage exists under the policy. See id.; see also Country Manors Ass'n, Inc. v. Master Antenna Sys., Inc., 534 So.2d 1187, 1194 (Fla. 4th DCA 1989) (no coverage under a claims-made policy where the claim was first made before the policy's effective date).
The Court rejects Windhaven's argument that the CRN is not a claim as defined by the policy because Ms. Austin could not have proceeded with her bad faith lawsuit; whether Ms. Austin could have proceeded with a bad faith lawsuit is irrelevant under the policy's definition of "claim." The Court also rejects Windhaven's argument that the policy is ambiguous because the definition of claim includes written demands or judicial actions, without any limitation as to which one would trigger coverage. The policy is clear that coverage is triggered by a claim that is first made against Windhaven during the policy period, and that a claim is first made against Windhaven when written notice of the claim is received by Windhaven, or Chartis, whichever comes first. Here, although the CRN and amended complaint both meet the definition of claim, Windhaven first received written notice of Ms. Austin's bad faith claim when it received the CRN in 2009. Thus, no coverage exists for Ms. Austin's bad faith claim against Windhaven.
Chartis' motion to dismiss Windhaven's complaint with prejudice is therefore granted.
Accordingly, it is hereby ordered and adjudged that Chartis' Motion to Dismiss (Doc. 6) is