CAMERON MCGOWAN CURRIE, Senior District Judge.
This matter is before the court on cross-motions for partial summary judgment and several related motions. The motions and resolution are as follows:
1. Defendants' Motion for Partial Summary Judgment, ECF No. 201, is granted in part and denied in part;
2. Plaintiff's Motion for Partial Summary Judgment, ECF No. 202, is granted in part and denied in part;
3. Defendants' Motion to Exclude Opinion Testimony of Charles L. McGimsey, ECF No. 199, is denied;
4. Defendants' Motion to Strike Declaration of Charles L. McGimsey, ECF No. 239, is denied;
5. Plaintiff's Motion to Strike Certain Exhibits and Arguments, ECF No. 252, is denied.
The three PEO Defendants and Aspen are owned by Defendant Charles David Wood, Jr. ("Wood"). Wood signed a Guaranty and Indemnity Agreement ("Wood Guaranty") in favor of Companion guaranteeing full performance under the 2006 Coverage and Claims Agreements.
Wood also owns Defendant Highpoint Risk Services, LLC ("Highpoint"). Highpoint is not a party to the Coverage Agreement, Claims Agreement, or Wood Guaranty but allegedly played a role in issuing policies on which certain claims are based.
Wood previously owned Dallas National Insurance Company ("Dallas National"), an additional signatory to the 2006 Coverage Agreement that acted as reinsurer for policies issued under that agreement. Wood sold Dallas National to a third-party in March 2013. After that sale, Companion, Dallas National, and Dallas National's new owner entered into agreements referred to as the 2013 Program Agreement and 2013 Guaranty.
In or around July 2013, Companion terminated Defendants' authority to write new business or renew policies under the 2006 Coverage Agreement. The relationship between the parties was not, however, ended as claims continued to be processed and paid during the run-off period ("Run-Off") that followed. Much, but not all, of the present litigation relates to Companion's handling of claims and collateral and Defendants' payment (or non-payment) of claims and collateral obligations (and related obligations under the Wood Guaranty) during Run-Off, which continues to this day.
Companion then initiated this action on September 19, 2014, seeking a declaratory judgment as to the same subject matter and asserting additional claims as to other lines of business. This court stayed claims to the extent related to the PayGo line of business, in deference to the first filed action in the Northern District of Texas.
This matter has proceeded as to all other claims and counterclaims with discovery concluding for most purposes on August 1, 2016. The court extended discovery for limited purposes through mid-October 2016. The parties filed cross-motions for partial summary judgment on October 28, 2016. Briefing on those motions and several related evidentiary motions is now complete.
Summary judgment should be granted if "the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(a). It is well established that summary judgment should be granted "only when it is clear that there is no dispute concerning either the facts of the controversy or the inferences to be drawn from those facts." Pulliam Inv. Co. v. Cameo Properties, 810 F.2d 1282, 1286 (4th Cir. 1987). The party moving for summary judgment has the burden of showing the absence of a genuine issue of material fact, and the court must view the evidence before it and the inferences to be drawn therefrom in the light most favorable to the non-moving party. United States v. Diebold, Inc., 369 U.S. 654, 655 (1962).
Rule 56(c)(1) provides as follows:
Fed. R. Civ. P. 56(c)(1).
The discussion that follows considers all arguments relating to a given subject matter together. Thus, where Companion and Defendants have moved for summary judgment on the same claims or counterclaims or filed related evidentiary motions, the related portions of the various motions are considered together.
Defendants' fifth counterclaim suggests AMS is seeking in excess of $9 million in unreimbursed Above-Deductible Payments. However, shortly before the dispositive motions deadline, AMS stipulated it is seeking no more than $1,826,145 on this counterclaim. ECF No. 196 (filed October 19, 2016). Companion argues even this amount is overstated. In support of this argument, Companion relies on a Declaration by McGimsey (ECF No. 214-6 ("McGimsey Declaration")), which challenges the accuracy of a spreadsheet prepared by Kara Childress ("Childress Spreadsheet") and corresponding opinion by Defendants' expert, Key Coleman.
Companion further argues that, regardless of the amount of unreimbursed Above-Deductible Payments, AMS is entitled to no recovery because AMS's co-Defendant and owner, Wood, is ultimately responsible under the Wood Guaranty for any failure by Dallas National to reimburse AMS for Above-Deductible Payments. Finally, Companion argues Defendants are equitably estopped from seeking relief on this counterclaim because they failed to alert Companion to any concerns about reimbursements when Companion might have corrected the problem (most critically before Dallas National went into receivership).
In their memorandum in opposition to summary judgment (ECF No. 235), as well as in a separate motion to strike (ECF No. 239), Defendants argue McGimsey's Declaration should not be considered. The latter argument is based largely on Companion's failure to offer such opinions prior to the close of discovery.
Defendants respond to the alternative argument that Wood is ultimately responsible for any failure by Dallas National to reimburse AMS for Above-Deductible Payments by noting Companion still holds collateral to fulfill Dallas National's obligations. They also argue, inter alia, any shortfall in that collateral is the fault of either Companion, or Dallas National's new owner, relieving Wood of any responsibility. Finally, as to the equitable estoppel argument, Defendants argue there is no evidence AMS lulled Companion into believing the Above-Deductible Payments would all be settled by Wood or Dallas National.
On reply, Companion argues the timing and circumstances relating to Childress's deposition justify any delay in proffering McGimsey's Declaration opinions. It challenges arguments Coleman's opinion and the Childress Spreadsheet are admissible. The latter argument is also addressed in Companion's later Motion to Strike (ECF No. 252). Companion argues it has no obligation to pursue Dallas National or deplete Dallas National's collateral (which Companion maintains is already underfunded) before pursuing Wood on his Guaranty. Finally, it argues silence may support equitable estoppel, and it was given no notice of any concern before December 2013.
These are subjects that require analysis of complex and extensive data and on which both sides have offered expert testimony. The court has, therefore, considered the parties' related evidentiary motions in resolving this aspect of Companion's motion for partial summary judgment. Those motions are denied for reasons explained below as they relate to the Above-Deductible Payments issue.
In sum, the rulings as to the evidentiary motions leave both sides with challenged expert testimony on the amount, if any, of unreimbursed Above-Deductible Payments. In making these rulings, the court has resolved any close questions (as to both sides' motions) in favor of allowing rather than excluding expert testimony at this stage and deferring any final determination of admissibility until the court may consider the proffered testimony in context at trial.
The court also finds the equitable estoppel argument unavailing as a basis for summary judgment. To the extent and for whatever period AMS was receiving timely and adequate reimbursement or credit from Dallas National, it presumably had no reason to alert Companion to any concern. While AMS concedes some amounts may have been unpaid prior to June 2013, it suggests the problem with non-payment (particularly for Florida policies) arose after that date. Thus, any claim for estoppel would presumably have to arise during this period. There is, however, no specific evidence or argument advanced to support a claim of estoppel arising during this period, and certainly no evidence or argument that supports a ruling as a matter of law.
For the reasons set forth above, the court (1) denies Companion's motion for summary judgment on its second cause of action and Defendants' fifth counterclaim; (2) denies Defendants' motion to strike McGimsey's Declaration; (3) denies Defendants' motion to exclude opinion testimony of McGimsey (to the extent his testimony relates to this subject matter); and (4) denies Companion's motion to strike to the extent it relates to the Childress Spreadsheet (or Coleman's related opinion). The rulings on evidentiary motions do not preclude the parties from testing and challenging the adequacy of expert testimony and underlying foundation at trial.
Both sides seek summary judgment on Companion's third cause of action for breach of contract. ECF No. 202 Argument § II; ECF No. 201-1§ II.C. This cause of action seeks damages for Defendants' alleged failure to reimburse Companion for payments made for Below-Deductible claims ("Below-Deductible Payments"). ECF No. 88 ¶¶ 59-65. Companion also seeks summary judgment on Defendants' related first through third counterclaims.
Based on these arguments, Companion seeks three alternative summary judgment rulings: (1) Defendants be found liable for $15 million in unreimbursed Below-Deductible Payments; (2) Defendants be found liable for the amount the collateral account was underfunded as of June 30, 2015 (over $2 million), plus additional claims (also over $2 million) paid since that date; or (3) Defendants be found liable on Companion's third cause of action and the matter proceed to trial only as to damages. Companion also asks the court to grant summary judgment that it has no liability on Defendants' first through third counterclaims because it properly took funds from the collateral account to make Below-Deductible Payments. Companion argues there is no support for any claim it improperly paid non-AMS claims with AMS funds, and it has no obligation to release any remaining collateral at this time.
In reply in support of their own motion for partial summary judgment, Defendants argue Companion has understated the collateral held and overstated what may be required to cover future claims. They note the estimate is outdated and suggest subsequent events (including closure of some claims) should reduce the required collateral.
Companion responds with a Declaration from the individual who prepared the actuarial report, Patrick L. Whatley, who explains the "draft" designation is used within the industry even for documents that are final reports. Whatley avers the document at issue reflects his final analysis. Companion also asserts it was proper for McGimsey to rely on this report because the 2006 Coverage Agreement allowed Companion to require actuarial reports based on whatever methodology it approved. Thus, the very fact Companion received the report supports McGimsey's reliance on it.
The issue of damages also cannot be determined on the present record. Whether Companion suffered any damages as a result of a breach will turn on detailed accounting data, presented, at least in part, through expert witnesses. Companion relies on McGimsey's expert report and proffered testimony in support of the relevant damages calculations, which testimony Defendants seek to exclude. See, e.g., ECF No. 199 § V.B. Having considered the arguments on Defendants' motion to exclude and related arguments in the summary judgment memoranda, the court finds the challenges to McGimsey's testimony raise issues appropriate for cross examination at trial. The court is not, for example, persuaded that it was improper for McGimsey to rely on an outside auditor's report, particularly in light of the contract language which allows Companion to select the method to be used for actuarial reports. The court, therefore, declines to exclude McGimsey's testimony as it relates to Companion's third cause of action, but also finds McGimsey's testimony does not support summary judgment. His testimony and Companion's theories of relief should, instead, be tested at trial and resolved by a jury.
The court raises these concerns now so that the parties may consider how these concerns might be addressed at trial. As appropriate, the parties may consider agreeing to an accounting and related procedures as to issues that may not be readily resolved by a jury.
Companion seeks summary judgment on Defendants' sixth counterclaim. This counterclaim seeks a refund of premium payments. While it refers, at some points, to overpayment of premiums on "Policies," the only policy specifically identified is the 2013 Florida Master Policy. ECF No. 90 ¶¶ 258-64.
Companion notes Defendants' expert, Coleman, calculated the final premium at roughly $3.5 million if the 49.7% discount rate was applied along with the experience factor Coleman opined was appropriate. Based on this calculation, Companion argues it owes no refund because documentary evidence indicates the premiums paid totaled $3.1 million.
Finally, Defendants argue they are due a refund on the 2012 Florida Master Policy. This argument rests on an email exchange in which a representative of Companion notes an audit suggested a refund of roughly $1 million might be owed, but questions the accuracy of the data on which the audit is based.
Defendants' expert, Coleman, calculated the final premium using the 49.7% rate as approximately $3,528,075. Companion accepts this calculation for purposes of summary judgment.
Given Coleman's calculation, Companion is entitled to summary judgment on the sixth counterclaim (as it relates to the 2013 Florida Master Policy) unless Defendants paid more than $3,528,075. Defendants argue they meet this burden because they paid $4 million in premiums. The proffered support for the claimed payment consists of two witness's testimony they "believe" Defendants may have paid "about" this amount. This testimony is too speculative to support Defendants' position, particularly when viewed in light of Companion's documentary evidence the amount paid was roughly $3.1 million. Therefore, without deciding the amount actually paid, the court holds Defendants have failed to proffer evidence sufficient to support a finding they are owed any premium refund for the 2013 Florida Master Policy.
Defendants' alternative argument they are owed a premium refund on the 2012 Florida Master Policy also fails. This is, first, because the sixth counterclaim fails to give fair notice it seeks a refund as to any policy other than the 2013 Florida Master Policy. Even if properly raised, this aspect of the sixth counterclaim would fail because the only proffered support is an email stating that an audit suggested a refund might be owed, but the audit itself was suspect. Despite requesting and receiving additional time to provide audit data and follow up requests from Companion for that data, Defendants never provided the requested data. This leaves no more than a possibility that a refund is due. Accordingly, the court grants Companion's motion for summary judgment on Defendants' sixth counterclaim.
Both sides seek summary judgment on Companion's thirteenth cause of action for breach of fiduciary duty. Through this cause of action, Companion seeks to hold Highpoint and Wood liable for injuries Companion has suffered or may suffer as a result of Highpoint's failure to make clear whether Companion or Dallas National was responsible for particular risks where policies were issued in the name of both Companion and Dallas National covering the same insured. ECF No. 88 ¶¶ 173-82.
Companion seeks summary judgment on this claim as to liability only, arguing it is entitled to a ruling that Highpoint and Wood are responsible for Companion's legal expenses and any claims it is required to pay. Defendants seek summary judgment rejecting the claim in full on various grounds including that there was no fiduciary relationship between the parties, most critically as to issuance of policies, because of Companion's role in preparing the policies. For reasons explained below, the court denies Companion's motion for summary judgment and grants Defendants' motion.
In its reply in support of its motion, Companion suggests Wood may also be directly responsible because he was "heavily involved in the oversight of Highpoint[] as a producing agent of Companion policies, including Highpoint's issuance of certificates of insurance." ECF No. 247 § IV. Companion characterizes its own role in "issuing" the policies as "simply print[ing] off the policies out of its electronic system" and argues this role "is of no moment [because] Highpoint and Wood issued, underwrote, and produced the policies." Id. (asserting "Defendants gathered and provided all of the insureds' information to be input into the policies" and were, therefore, "in the unique position to avoid the potentially `dual' or `overlapping' policies").
In opposing Defendants' cross-motion for summary judgment on this claim, Companion argues that, if its motion for summary judgment is denied, it is because there are genuine issues of material fact. ECF No. 236 § III.B.1. It argues the evidence demonstrates Highpoint and Wood acted as Companion's "producing agents" and were responsible for issuing policies on Companion paper. Id. (relying, inter alia, on corporate representative's testimony Highpoint was the producing agent). Companion argues "the potentially overlapping policies written on Dallas National paper were obviously in the control of Highpoint and Wood, because Companion would have known nothing about those policies and certainly had no right or reason to be involved in their issuance." Id. It does not deny that it played a role in "printing off the policies" issued on Companion paper. Id.
As to the first issue, Defendants point to three provisions of the 2006 Coverage Agreement that refer to Companion being the party that "issues" the policies. ECF No. 201-1 § II.D.1 (citing ¶¶ 2, 7, 10 of 2006 Coverage Agreement). They assert Highpoint's role was that of independent agent or broker, which they argue does not give rise to a fiduciary duty to the insurer, and Wood played no role in issuance of the policies. Id. (citing cases finding no fiduciary relationship between independent agency and insurer). Finally, Defendants assert Companion, rather than Highpoint or Wood, actually "issued" the policies through its Point system. Id.; see also ECF No. 241 § III.D (arguing in response to Companion's motion for summary judgment that Highpoint and Wood were neither general agents of Companion nor owed any duty to underwrite or issue the policies).
As to the second issue, whether Highpoint or Wood breached a duty of care, Defendants argue Companion was provided information that identified the AMS clients insured under the relevant policies (the 2012 and 2013 AMS Multi-State Master Policies). ECF No. 201-1 § II.D.2. Defendants note this information was provided before the policies were issued and was used to calculate premiums. Id. (citing, e.g., Adams dep. at 191-91); see also ECF No. 241 § III.D (summarizing related communications between Companion, Dallas National and AMS-affiliated personnel between December 2011 and April 2013).
Defendants also argue Companion's damages are speculative (third issue). This argument rests on the fact Companion is contesting and has not yet paid any sums demanded by state insurance guaranty funds or others to satisfy what would otherwise be Dallas National's insurance obligations. ECF 201-1 § II.D.3; see also ECF No. 241 § III.D.
The absence of South Carolina authority recognizing a fiduciary relationship between insurer and independent broker does not necessarily foreclose the existence of a fiduciary relationship between Highpoint and Companion. This is because the relationship at issue in this action differs from the typical relationship between independent agent and insurer in several respects. Most critically, Highpoint was responsible for production of policies under a fronting arrangement designed to ensure Companion was not, ultimately, financially responsible for paying any claims. Under these circumstances, Companion may have relied more heavily on information provided by Highpoint than it would have in the typical insurer-independent agent relationship.
The specific role played by Highpoint is, however, disputed. Most critically, there are disputed facts as to Highpoint's role in "issuing" or "underwriting" policies, the roles on which Companion relies in arguing Highpoint acted as a fiduciary. As to policy issuance, the 2006 Coverage Agreement provides Companion "shall issue the Policies as requested by the AMS Entities subject to" various requirements. 2006 Coverage Agreement ¶ 7 (emphasis added). Nothing in the agreement itself indicates Highpoint plays a role in issuance of the policies. Indeed, the only reference to Highpoint is in a list of costs and expenses, which provides Highpoint will receive a 15% commission "for production of Policies with respect to this Agreement." Id. ¶ 10(v). In a footnote to its chart summarizing the parties' responsibilities under the 2006 Coverage Agreement, Companion asserts that, while it "printed off the policies, it was Highpoint that actually issued the policies." ECF No. 202 Facts § I n.1 (relying on admissions in First Amended Answer ¶¶ 21, 174). Specific evidence as to the roles played indicates Highpoint provided the data that was input by Companion into its Point system (a computer program) and this data was used by Companion to produce the actual policies. Companion, however, retained the ability to dictate underwriting requirements and seek additional information when needed. 2006 Coverage Agreement ¶ 2; see also id. ¶ 7 (stating "companies with respect to which Policies are issued must meet the underwriting requirements established from time to time by [Companion.]."). Companion offers no evidence Highpoint drafted the policy forms or was responsible for the particular manner in which the policies defined the risks covered, most critically where Companion and Dallas National provided coverage to the same insured.
Companion also fails to establish, as a matter of law, that Highpoint acted as underwriter. The 2006 Coverage Agreement assigns responsibility for underwriting and administrative services to Dallas National, not Highpoint. Id. Companion's chart summarizing the parties' relationship acknowledges this division of responsibilities under the 2006 Coverage Agreement, but characterizes Highpoint's role as that of "general agent" based on a General Agency Agreement. ECF No. 202 Facts § I (citing General Agency Agreement ¶ 2). Companion does not attach the cited General Agency Agreement. However, Defendants have filed a General Agency Agreement, which appears to be the agreement to which Companion refers. ECF No. 242-5 (submitted for in camera review). That agreement does state Highpoint serves as general agent, and places underwriting responsibility on Highpoint, but is an agreement between Dallas National and Highpoint relating to policies written on Dallas National paper, not between Companion and Highpoint relating to policies written on Companion paper. Id. ¶¶ 2, 4(e). It was, moreover, effective April 1, 2013, and, consequently, fails to support the existence of any general agency agreement prior to that date. Thus, there is, at most, weak evidence that Highpoint played any underwriting role with respect to the Companion policies at issue.
Given the disputed facts as to the role played by Highpoint, the record fails to support a finding as a matter of law that any fiduciary relationship existed between Companion and Highpoint or Wood, much less a fiduciary relationship giving rise to a relevant duty. It follows that Companion's motion for summary judgment must be denied as to this cause of action. The court also denies Companion's motion for reasons addressed below as to Defendants' motion for summary judgment.
As noted above, Companion proffers evidence Highpoint (or other affiliated entities) provided information regarding insured risks that was input into Companion's Point system. The Point system printed out the policies based on the information provided. For purposes of Defendants' motion, the court will assume without deciding that Highpoint's role in providing the information, combined with admissions in its Answer and discovery responses, constitute "issuance" of the policies by Highpoint.
Companion's fiduciary duty claim does not rest on any assertion the information provided by Highpoint and used to issue the policies was inaccurate. Neither does Companion allege Highpoint failed to provide information necessary for the Point system to issue policies in the form that they were issued.
Companion's claim, instead, rests on an assumption the policies issued were defective for failure to better clarify the risks covered. Companion does not, however, proffer any evidence that Highpoint determined the form of the policy or other evidence that might support imposition of a specific duty on Highpoint to modify the policy form.
Both sides seek partial summary judgment on Companion's fifteenth cause of action for enforcement of the Wood Guaranty, as it relates to Dallas National's obligation to fund reinsurance collateral.
Defendants also argue Wood should not be held responsible for some or all of the alleged shortfall for three additional reasons. First, Defendants argue PayGo and Occupational Accident Policies were never covered under the 2006 Coverage Agreement, placing them beyond the reach of the Wood Guaranty.
On or about March 31, 2013, all parties to the 2006 Coverage Agreement entered "Extension Agreement #12." ECF No. 205 at 1.
ECF No. 205 at 1 (emphasis added).
This one paragraph agreement extended and modified the 2006 Coverage Agreement in two ways. First, the two signatories not owned by Wood, Dallas National and Companion, were authorized by all parties to terminate the 2006 Coverage Agreement. Second, the 2006 Coverage Agreement, as amended, remained "in full force and effect" until either Companion or Dallas National gave the other written notice of termination. Id.
There is no evidence either Companion or Dallas National, thereafter, gave the other thirty (30) days prior written notice of termination of the 2006 Coverage Agreement. Neither is there evidence any party terminated the 2006 Coverage Agreement in its entirety. It is, however, undisputed that, in July 2013, Companion terminated the rights of the PEO Defendants and other Wood-owned entities to reissue or write new policies and entered the 2013 Program Agreement with Dallas National (effective retroactively to April 1, 2013). The critical question for purposes of the present argument is the effect of the 2013 Program Agreement.
Companion argues the 2013 Program Agreement did not supersede Wood's obligation to guarantee performance under the 2006 Coverage Agreement. While this is correct, it ignores Defendants' actual argument which is that (1) the 2013 Program Agreement, to which Companion is a party, superseded Dallas National's obligations under the 2006 Coverage Agreement; and (2) because Dallas National's obligations after the 2013 Program Agreement was effective (April 1, 2013) were governed solely by the 2013 Program Agreement, no Dallas National obligation remained under the 2006 Coverage Agreement for Wood to guarantee.
The essence of Companion's responsive argument appears to be as follows: (1) the 2013 Program Agreement covered only future relations between Companion and Dallas National and, consequently, had no application to policies issued (or obligations that initially arose) under the 2006 Coverage Agreement; (2) to the extent it might be read to cover policies issued (or obligations initially arising) under the 2006 Coverage Agreement, the 2013 Program Agreement is unenforceable because the 2006 Coverage Agreement precludes modification unless signed by all parties; and (3) the Wood Guaranty remains in full force and effect as to Dallas National's obligations. These arguments are addressed, in turn, below.
The Background section of the 2013 Program Agreement refers to a then-existing "Program" through which Dallas National or other "Program Participants" produce workers compensation, commercial general liability, and other policies, collectively referred to as the "Policies." 2013 Program Agreement § 2. It states this existing relationship had "been governed by that certain Coverage Agreement between the Parties (and certain DN Affiliates or former DN Affiliates) dated as of December 1, 2006 (`the Coverage Agreement')." Id. It defines "Program Related Agreements" to include the Coverage Agreement together with Policies issued under the existing Program, and reinsurance treaties with respect to the Policies, and "any and all other agreements contemplated by the Program to which [Companion] is a party, in each case whether now existing or hereafter entered into by [Companion.]" Id. (emphasis added). It also defines "Policies" to "include all policies issued pursuant to the Program prior to the Effective Date[.]" Id. (preserving Companion's right to compensation for periods predating the Effective Date). This description of the relationship between the parties indicates the subject matter of the 2013 Program Agreement is intended to encompass the relationship covered by the 2006 Coverage Agreement, including obligations arising under both old and new policies issued as part of that relationship.
The 2013 Program Agreement `s integration clause, reads as follows:
Id. § 28. Read together with the Background section, this integration clause indicates the 2013 Program Agreement is intended to supersede all "Program Related Agreements" governing the relationship between Dallas National and Companion, including but not limited to the 2006 Coverage Agreement.
Like the 2006 Coverage Agreement, the 2013 Program Agreement requires Dallas National to fund an account "for the payment of all clams" and to replenish that account as requested by Companion. 2013 Program Agreement § 10. It also requires Dallas National to fund "one or more reserve funds for Policy liabilities (collectively, the `Claims Reserve Fund')" and provides the amount in the Claims Reserve Fund shall at all times equal or exceed the applicable `Required Reserve' determined as set forth below." Id. § 14.A. Succeeding sections address how the reserve is established, referring, inter alia, to "Policy Liabilities" and "Program loss ratio experience." Id. §§ 14.A-F.
Despite being a party to the 2013 Program Agreement, Companion argues this agreement is unenforceable to the extent it is interpreted to supersede obligations between Dallas National and Companion previously governed by the 2006 Coverage Agreement. In support of this argument, Companion relies on a provision of the 2006 Coverage Agreement that states "[n]o provision of this Agreement may be amended or waived except pursuant to a writing signed by all Parties." 2006 Coverage Agreement ¶ 27. Companion further contends the 2013 Program Agreement could not have superseded the obligations of Companion and Dallas National under the 2006 Coverage Agreement because the 2013 Program Agreement was only signed by two of the parties to the 2006 Coverage Agreement, Companion and Dallas National.
In 2013, however, all parties agreed to an extension and modification permitting Companion or Dallas National to terminate the 2006 Coverage Agreement with thirty days written notice to the other. Thus, Companion and Dallas National were authorized (by all parties) to terminate their relationship under the 2006 Coverage Agreement.
The 2013 Program Agreement expressly provides that it is intended to supersede "any provision, understandings, representations or agreements by or between the parties . . . to the extent the same are related to the subject matter hereof. 2013 Program Agreement § 28. Dallas National's obligations under the 2006 Coverage Agreement were directly related to the subject matter of the 2013 Program Agreement and, thus, were superseded. As a party to the 2013 Program Agreement, Companion cannot complain that language in that agreement is given its clear and natural effect.
The Wood Guaranty, by its plain language, requires Wood to ensure full performance by all AMS Entities under the 2006 Coverage Agreement. For purposes of this order, the court assumes Wood's obligations under the Wood Guaranty could not be and were not changed by Wood's sale of Dallas National to a third-party or by that third-party's execution of a new guaranty.
Defendants (specifically Highpoint and Woods) also seek summary judgment on Companion's fourteenth cause of action for violation of the South Carolina Unfair Trade Practices Act, S.C. Code Ann. § 39-5-20(a) et. seq. ECF No. 201-1 § II.F. This cause of action is asserted solely against Wood and Highpoint, e.g., ECF No. 88 ¶¶ 184, 185, and identifies only three allegedly deceptive and unfair acts:
ECF No. 88 ¶ 185.
The first two acts correspond with allegations in Companion's tenth through twelfth causes of action for fraud, constructive fraud and breach of contract accompanied by a fraudulent act. ECF No. 88 ¶¶ 127-172. As explained below, these allegations relate primarily if not solely to PayGo policies and have been stayed to the extent so related. Infra § VII (addressing "PayGo" claims). The third act corresponds with the allegations in Companion's thirteenth cause of action for breach of fiduciary duty. That cause of action is addressed above. Supra § IV (granting summary judgment to Defendants).
Defendants argue the SCUTPA claim fails because Companion has failed to adduce evidence of public impact. As to this element, Defendants assume Companion will rely on the potential for repetition.
Focusing on the third alleged wrongful act, Companion argues there is evidence of prior repetition. Specifically, it argues Defendants Wood and Highpoint repeatedly issued policies with potentially overlapping coverage.
The court assumes for purposes of this order that the referenced prior repetition suffices to preclude summary judgment on this element. Companion's SCUTPA claim, nonetheless, fails to the extent it relies on the third alleged wrong (issuing Companion and Dallas National policies to the same insured without making clear which insurer covers which risks) for reasons addressed above as to Companion's corresponding thirteenth cause of action. See supra § IV. As explained with respect to that cause of action, Companion fails to proffer evidence Highpoint or Woods provided inaccurate or even incomplete information leading to issuance of these policies. It, instead, alleges they should have done something more to clarify which insurer covered which risks. Id. at 29 (noting, in granting summary judgment to Defendants on thirteenth cause of action, that Companion's claim rests on assumption policies were defective for failing to better clarify the risks covered but Companion failed to proffer evidence Highpoint determined the form of the policy or other evidence that might support imposition of a specific duty on Highpoint to modify the policy form). Accordingly, the court grants summary judgment to this extent.
As noted above, the first two alleged wrongs appear to relate primarily or solely to PayGo policies (or other policies Defendants maintain fall outside the scope of the 2006 Coverage Agreement and are not properly before this court).
Defendants seek summary judgment on all claims to the extent they relate to PayGo policies. ECF No. 201-1 § II.E. Defendants base this request on this court's prior orders staying such claims in favor of the first-filed Texas Action and that court's decision not to transfer the PayGo-related claims to this court. As Defendants note, the net result is the PayGo-related claims have not advanced in this court and discovery is now closed.
Defendants identify Companion's sixth through twelfth causes of action as claims relating primarily if not solely to PayGo policies. They identify the thirteenth and fourteenth causes of action as claims relating, in part, to such policies, though they do not explain which aspects of these claims relate to PayGo policies. While characterizing this aspect of their motion as a motion for summary judgment, Defendants assert granting the motion would "enabl[e]the parties to move forward with litigating the PayGo-related claims in Texas." Thus, Defendants are, more accurately, seeking dismissal without prejudice.
Companion argues summary judgment is inappropriate because the claims have been stayed here, precluding discovery on these issues. ECF No. 236 § III.B.3. It also asserts the "Texas court has not issued a final ruling on whether these claims should be litigated in Texas or in South Carolina." Id. Companion maintains it is entitled to conduct discovery, in one venue or the other, before any dispositive motion is considered. It does not contest Plaintiff's characterization of the sixth through twelfth causes of action as relating primarily (though perhaps not solely) to PayGo policies or the thirteenth and fourteenth causes of action as relating partially to PayGo policies.
On reply, Defendants maintain they are entitled to summary judgment because they have pointed to the absence of evidence to support the claims, thus shifting the burden to Companion to go beyond the pleadings and point to specific evidence supporting the claims. ECF No. 246 § II.D. They note this court's stay applied to claims other than the sixth cause of action "to the extent they involve PayGo policies within the scope of the Texas Action" and did not preclude claims other than claim six from advancing "unless the claim relates solely to PayGo policies." Id. quoting ECF No. 109 at 3-4. Thus, they argue the court should dismiss Companion's sixth cause of action based on its prior stay, should dismiss the seventh through twelfth causes of action if they relate solely to PayGo policies, and should grant summary judgment on those claims if they also relate to other policies to which the stay did not apply. Defendants do not address the thirteenth and fourteenth causes of action in their reply.
This resolves, in full, the sixth cause of action in this proceeding. While the seventh through twelfth causes of action appear to relate primarily to PayGo policies (and were stayed to this extent), they may also relate to other categories of policy. The court dismisses these claims, in full, because Companion proffers no evidence or argument that it has prosecuted those claims to the extent they were not stayed. Dismissal is without prejudice to pursuit of any claims that have been or may be allowed to proceed in the Texas Action, whether related to PayGo claims or such other claims as that court may allow, so long as those claims do not relate to the categories of Policy covered by the first through fifth causes of action here (e.g., Master Policies or other non-PayGo policies issued to AMS Entities and their clients).
Companion's thirteenth and fourteenth causes of action (for breach of fiduciary duty and violation of the South Carolina Unfair Trade Practices Act) receive a slightly different treatment. The aspects of these claims that have not been stayed here are addressed in other sections of this order. See supra §§ IV, VI. All other aspects of these claims are dismissed without prejudice to pursuing claims that have been or may be pursued in the Texas Action to the same extent noted above as to the sixth through twelfth cause of action.
In sum, the court (1) dismisses the sixth cause of action without prejudice in its entirety;
(2) dismisses the seventh through fourteenth causes of action without prejudice to the extent they relate to PayGo policies or other claims that have been or may be pursued in the Texas Action and do not relate to policies addressed in the first through fifth causes of action here; and (3) in all other respects, dismisses the sixth through fourteenth causes of action with prejudice (including based on the summary judgment rulings in §§ IV and VI above).
To the extent not mooted by rulings above, the court denies Defendants' motion to exclude McGimsey's opinion testimony and to strike his declaration. The court, likewise, denies Companion's motion to strike. The denial of these motions is without prejudice to the parties' right to object to corresponding testimony at trial.
For reasons set forth above: (1) Companion's motion for partial summary judgment is granted as to Defendants' sixth counterclaim and denied in other respects; (2) Defendants' motion for partial summary judgment is granted as to Companion's thirteenth cause of action (in full), fourteenth cause of action (to the extent it overlaps with the allegations in the thirteenth cause of action), fifteenth cause of action (to the extent it relates to Dallas National's collateral obligations), sixth though twelfth causes of action (which claims are dismissed without prejudice as to claims that may proceed in the Texas Action), and denied in other respects; (3) Defendants' motions to exclude McGimsey's opinion testimony and to strike his declaration are denied, and (4) Companion's motion to strike is also denied.
IT IS SO ORDERED.