Companion Property and Casualty Insurance Company v. Wood et al
Filing
414
OPINION and ORDER on Non-Jury Issues. Signed by Honorable Cameron McGowan Currie on 7/20/2017. (cbru, )
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF SOUTH CAROLINA
COLUMBIA DIVISION
COMPANION PROPERTY AND CASUALTY
INSURANCE COMPANY,
C/A No. 3:14-cv-03719-CMC
Plaintiff,
v.
CHARLES DAVID WOOD, JR.; AMS STAFF
LEASING, INC., d/b/a/ AMS Staff Leasing
Corporation; BRECKENRIDGE ENTERPRISES,
INC., d/b/a/ AMS Staff Leasing II; AMS Staff
Leasing II, Inc.; HIGHPOINT RISK SERVICES,
LLC; and ASPEN ADMINISTRATORS, INC.,
OPINION AND ORDER
NON-JURY ISSUES
Defendants.
This matter is before the court for resolution of six issues that raise predominantly legal
questions. The issues are as follows:
1. Whether Companion Property and Casualty Insurance Company (“Companion”) is
obligated to provide Defendants AMS Staff Leasing, Inc., Breckenridge Enterprises, Inc.,
and AMS Staff Leasing II, Inc. (collectively “AMS” or “AMS Defendants”) with collateral
statements, claims data, and updated claims records as to open claims and consult with
AMS prior to settling workers’ compensation claims using AMS funds;
2. Whether Defendant Charles David Wood Jr. (“Wood”) is obligated to pay Companion
unreimbursed and future below-deductible claims and collateral obligations of AMS,
arising under the Coverage Agreement dated December 1, 2006 (“2006 Coverage
Agreement”), as well as other liabilities and losses relating to those obligations, based on
paragraph I (“Guaranty Provision”) of the Guaranty and Indemnity Agreement Wood
signed in favor of Companion ( “Wood Guaranty”);
3. Whether Wood must indemnify Companion, based on paragraph II (“Indemnity
Provision”) of the Wood Guaranty, for any liability imposed on Companion in favor of
AMS for unreimbursed above-deductible claims payments made on policies governed by
the 2006 Coverage Agreement;
4. Whether Companion is entitled to all earnings, including reinvested earnings, accrued on
assets deposited in the trust account at State Street Bank & Trust Company (“State Street
Account”) that is governed by a Trust Agreement between Companion, AMS, and State
Street Bank and has an effective date of January 31, 2012 (“Trust Agreement”);
5. Whether all funds held in the State Street Account are held solely for the benefit of AMS,
regardless of the entity that deposited the funds (or other assets) or on whose behalf funds
were deposited;
6. Whether Wood must indemnify Companion for all reasonable attorney’s fees and expenses
incurred in connection with this action.
The parties seek declaratory relief as to each of the issues listed above. 1
Prior to filing their memoranda, the parties agreed Defendants would bear the burden of
proof on the first issue and Companion would bear the burden of proof on the remaining five
1
The first five questions correspond with items III.A, C, D, E, and F in the parties’ Joint
Submission (ECF No. 409-1). That submission was (1) provided to the court on or about April
17, 2017, (2) discussed during an April 18, 2017 teleconference (ECF No. 364, transcript),
referenced in a May 8, 2017 docket text order (ECF No. 379), and subsequently filed (ECF Nos.
384-8, 409-1). As noted in the May 8, 2017 docket text order, other non-jury issues referenced in
the parties joint pre-trial submission (items B and G) were mooted by prior agreement (settlement
of two jury issues). ECF No. 379; see also ECF No. 376 (status report and proposed briefing
schedule). The sixth issue addresses one aspect of a matter that is otherwise reserved for later
determination (entitlement to attorney’s fees and costs). See ECF No. 376 n.1.
2
issues. See ECF No. 409-1 Joint Submission; ECF No. 379 (docket text order noting agreement
and setting briefing schedule).
STANDARD
The parties have stipulated the court may resolve the non-jury issues on the written
submissions even if it becomes necessary to determine a dispute of fact or draw inferences from
the facts. ECF No. 409.
FACTS 2
1.
The AMS Defendants are professional employer organizations (“PEOs”), entities
that provide leased employees to other businesses, primarily in the construction industry. The
AMS Defendants provide workers’ compensation coverage for the leased employees.
2.
Wood owns the AMS Defendants.
Wood also owns Defendants Aspen
Administrators, Inc. (“Aspen”), and Highpoint Risk Services, LLC (“Highpoint”). 3
Wood
previously owned an entity that was named Dallas National Insurance Company (“Dallas
National”). Dallas National provided reinsurance for certain policies at issue in this action. It is,
however, in receivership and no claims are asserted against it in this action. 4
3.
Companion is a business that provides, inter alia, workers’ compensation insurance
in a number of states including but not limited to Texas and Florida.
2
This section provides an overview of facts common to multiple issues discussed in this order.
More detailed information, including quotation of relevant documents, is provided in the relevant
sections of the Discussion.
3
This order does not address claims by or against either Aspen or Highpoint.
4
Wood sold Dallas National to a third-party in March 2013. Dallas National was renamed after
the sale and was placed into receivership during or after April 2014.
3
4.
Companion and AMS (as well as other entities) are parties to the 2006 Coverage
Agreement (ECF No. 340-1 at 3-9). That agreement established a relationship through which
Companion provided certain forms of insurance to AMS, including workers’ compensation
insurance for AMS employees. The insurance provided pursuant to the 2006 Coverage Agreement
is governed by separate policies (“Policies”). The relationship established was not, however, a
traditional insurance relationship. It was, instead, what the parties have described as a “fronting”
arrangement, meaning Policies were issued in Companion’s name but all risk was to be borne by
the other contracting parties through a combination of high-deductibles, reinsurance, and other
protections. 5 Wood signed the 2006 Coverage Agreement on behalf of all AMS Defendants (and
some other “AMS Entities”) 6 but is not, himself, a party to that agreement. Id. at 9.
5.
Companion and Wood are parties to the Wood Guaranty. Id. at 28-46. The Wood
Guaranty included both a Guaranty Provision and an Indemnity Provision.
The Guaranty
Provision (Wood Guaranty ¶ I) guaranteed performance under “Subject Agreements” that include
the 2006 Coverage Agreement, Policies, and a related third-party claims administration agreement
(“TPA Agreement”). 7 Id. at 28. The Indemnity Provision (Wood Guaranty ¶ II) indemnified
5
Certain aspects of the fronting arrangement were later modified as to Policies covering Florida
workers. See infra Facts ¶ 7.
6
“AMS Entities” is a defined term in the 2006 Coverage Agreement. It includes the AMS
Defendants, at least one other PEO, and Dallas National. 2006 Coverage Agreement ¶ 1.
7
The TPA Agreement is between Companion and Aspen and required Aspen to provide thirdparty claims administration services for Policies issued pursuant to the 2006 Coverage Agreement.
ECF No. 340-1 at 10-26. Aspen’s role as third-party claims administrator was eliminated in 2011,
at least as to Policies covering Florida workers. See infra Facts ¶ 7.
4
Companion for claims, losses, and liabilities related directly or indirectly to the Subject
Agreements, including attorney’s fees and costs. Id. at 29. Wood signed the Wood Guaranty on
his own behalf. Id. at 45.
6.
In general terms, the 2006 Coverage Agreement provided for establishment of two
distinct accounts, a “Claims Operating Account” and a “Claims Reserve Fund.” 8 2006 Coverage
Agreement ¶¶ 12, 13. The Claims Operating Account was to be controlled by Aspen as third-party
claims administrator and funded by the AMS Entities who were to be invoiced on a periodic basis.
Id. ¶ 12. All claims were to be paid from the Claims Operating Account. Id. The Claims Reserve
Fund was to be established by Companion in its own name but funded by the AMS Entities. Id. ¶
13. The 2006 Coverage Agreement called for quarterly audits to “determine the appropriate
amount of the Required Reserve for the next quarter[.]” Id. The AMS Entities were to deposit
additional amounts on a monthly basis to ensure “the Required Reserve is maintained in the Claims
Reserve Fund at all times.” Id. 9
7.
In mid-2011, Companion entered a consent order with the Florida Office of
Insurance Regulation (respectively, “Florida Consent Order” and “Florida OIR”). ECF No. 310;
see also ECF No. 384 at 3, 4 (Defendants’ memorandum addressing changes resulting from Florida
Consent Order). Certain aspects of the relationship established by the 2006 Coverage Agreement
and TPA Agreement were modified as a result of the Florida Consent Order. Most critically, at
8
The summary judgment order refers to the “Claims Reserve Fund” as the “AMS collateral
account.” See, e.g., Summary Judgment Order at 11, 14 n.10 (ECF No. 258).
9
More specific terms of the 2006 Coverage Agreement are addressed in the sections of the
Discussion corresponding to related disputes.
5
least as to Florida Policies, (1) Companion took over claims processing and payment duties for
Aspen and (2) AMS’s Claims Reserve Fund was moved from the Bank of America account where
funds deposited by AMS were held in common with other collateral to a separate trust account at
State Street Bank. See, e.g., Id. ¶¶ 6.(c), (d), (g); ECF No. 398-15 (Nov. 29, 2011 letter from
Companion’s president to Florida OIR); ECF No. 411-2 (Dec. 1, 2011 email from Florida OIR to
Companion’s vice-president and CEO advising a trust account was required).
8.
In or around July 2013, Companion terminated AMS’s 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 that followed (“Run-Off”). See generally ECF No. 258 at 3, 13-17 (Order on cross motions
for partial summary judgment (“Summary Judgment Order”) discussing handling of claims during
Run-Off and resulting disputes); ECF No. 384 at 4-5 (Defendants’ memorandum addressing RunOff period).
9.
In October 2013, AMS refused to continue making payments to Companion to
cover claims as they were incurred. See generally ECF No. 258 at 11. AMS, instead, directed
Companion to pay future claims from the Claims Reserve Fund. Companion, thereafter, paid (and
continues paying) claims from the Claims Reserve Fund held in the State Street Account.
10.
The present litigation ensued. 10 Allegations relevant to the issues addressed here
include Companion’s allegation AMS breached the 2006 Coverage Agreement by refusing to pay
10
Before this litigation was initiated, Highpoint filed suit against Companion in the Northern
District of Texas (“Texas Court”) seeking return of collateral held as to certain policies. See ECF
No. 23-1 at 1 (motion to dismiss identifying Highpoint Risk Services, LLC v. Companion Property
& Casualty Insurance Company, No. 3:14-cv-3398-L (N.D. Tex. filed Aug. 20, 2014) as first filed
6
claims as incurred, forcing Companion to pay claims from the Claims Reserve Fund. Companion
contends this course of action resulted in significant underfunding of the Claims Reserve Fund.
Companion seeks to recover for the underfunding from (1) AMS based on the 2006 Coverage
Agreement and (2) Wood based on the Guaranty Provision of the Wood Guaranty. Defendants
maintain the Claims Reserve Fund is overfunded and they are due a refund.
11.
By agreement, whether the Claims Reserve Fund is over or underfunded, as well as
certain related issues, will be resolved through independent accounting and actuarial review
(collectively “Initial Review”). ECF No. 409-1. The Initial Review will cover the period ending
April 30, 2017, and the initial report is due on or about July 31, 2017. See ECF Nos. 386, 387
(orders appointing experts). Thereafter, the independent experts are to conduct quarterly reviews
(“Quarterly Reviews”). The parties have agreed to “abide by the Required Reserve determinations
made by the independent actuarial firm” and that “the independent accounting firm shall calculate
the amount of AMS collateral needed” based on the actuary’s Required Reserve determinations.
ECF No. 409-1 § IV.A & B. They further agree additional funds will be contributed if these
determinations demonstrate underfunding or excess funds will be refunded if the Required Reserve
is found to be overfunded based on the Initial Review and subsequent Quarterly Reviews. Id.
action). That action (the “Texas Action”) sought return of certain funds relating to what the court
and parties have referred to as a “PayGo” line of business. Companion responded, in part, by filing
the present action, on September 19, 2014, seeking a declaratory judgment as to the claims asserted
in the Texas Action and asserting additional claims as to other lines of business. Companion also
moved in the Texas Court to transfer venue of the Texas Action to this court, relying, in part, on
an argument the PayGo line of business was governed by the 2006 Coverage Agreement and its
forum selection clause. The Texas Court rejected Companion’s initial and renewed motions to
transfer venue based, in part, on its rejection of Companion’s argument as to the scope of the 2006
Coverage Agreement. In deference to the first-filed status of the Texas Action, this court initially
stayed and has now dismissed claims relating to the PayGo line of business.
7
DISCUSSION
The six non-jury issues raised by the parties are addressed seriatim below.
I.
Companion’s obligation to provide information and notification or consultation.
Defendants’ arguments. Relying on an insurer’s duty of good faith and fair dealing,
Defendants seek a judicial declaration that Companion owes AMS a duty “to timely provide claims
data, information regarding AMS collateral, and information regarding the administration of
workers’ compensation claims.” ECF No. 384 at 1; see also id. at 10 (arguing Companion must
“timely provide claims data, collateral statements, and updated claims records to AMS for open
claims under the AMS policies”). Defendants, nonetheless, concede “Companion has already been
ordered to produce, or has voluntarily agreed to provide, claims data, claims files, reserve
information, and information regarding its use of AMS collateral.” Id. at 8; see also id. at 9 (noting
Companion’s agreement, as part of a joint proposal for resolution of non-jury issues, to provide
data simultaneously to Defendants and an independent actuarial firm). Defendants do not identify
any document or category of information sought that Companion has not already agreed to provide
or the court has not previously ordered be produced.
In their opening memorandum, Defendants also argue “Companion should be required [to]
consult with AMS prior to settling any remaining claims using AMS funds.” Id. at 10; see also id.
at 9 (asserting “Companion must consult with AMS regarding the settlement of any AMS claims
using AMS funds” (emphasis added)). Defendants modified their position on reply, explaining
“AMS does not seek to insert itself into the resolution of open claims[.]” ECF No. 402 at 3.
Defendants, instead, argue they are entitled to notification “prior to [Companion] entering into a
lump-sum (i.e., non-routine) settlement using AMS funds[.]”
8
Id. at 8 (emphasis added).
Defendants argue this notification as to non-routine settlements is appropriate because lump-sum
settlements are outside the normal course and may pose a conflict of interest between Companion
and AMS. Id. The potential conflict identified is the risk Companion may favor immediate
payment of a higher amount within AMS’s deductible over the risk of future payments that may
become Companion’s sole responsibility because they exceed the deductible. Id. AMS also argues
immediate payment of an amount that might otherwise be paid over a period of years may harm
AMS because of the effect on cash flow and a risk Companion may fail to reduce anticipated future
payments to present value.
Companion’s response. Companion responds to Defendants’ opening arguments, first,
by asserting AMS failed to plead any claim for declaratory relief, most critically any claim
“seek[ing] prospective relief that would allow Defendants to stand alongside Companion as a
forced ‘consultant’ in the settlement of workers’ compensation claims[.]” Id. at 1, 2. While this
argument at first blush appears to seek a ruling that no declaratory relief is proper because none
was sought, in context it appears limited to the absence of any claim that Companion is obligated
to consult AMS prior to settling claims. Thus, it focuses on an argument Defendants largely if not
entirely abandoned through their reply. Companion’s remaining arguments, likewise, are directed
primarily to AMS’s now-abandoned argument that Companion must consult with AMS before
settling any claim.
Companion addresses Defendants’ argument for entitlement to information (as opposed to
a right of consultation), only in its concluding paragraph. As to this issue, Companion states it
“remains willing to work with Defendants regarding providing closed claims data for auditing
purposes, as has been done in the past.” Id. at 9. It does not otherwise address what information
might be covered by the requested declaration.
9
Discussion. As noted above, Defendants’ reply abandons any argument Companion owes
AMS a duty of consultation before settling claims in the ordinary course. Even were this argument
not abandoned, the court would find imposition of such a duty inappropriate because no
counterclaim predicted Defendants would seek such relief and because it is not supported by any
language in the governing contracts or case law from a relevant jurisdiction.
Defendants’ modified request for declaratory relief, seeking a declaration Companion owes
a prior duty of notification before settling certain categories of claim, is denied for much the same
reasons. No counterclaim predicts a request for such relief and it is not supported by any language
in the governing contracts, certainly none that has been drawn to the court’s attention. The
argument for prior notification has, moreover, not been properly raised or adequately briefed
because Defendants first raised this request on reply. For all of these reasons, the court denies
Defendants’ request for a declaration Companion must either consult or notify AMS prior to
settlement of any claim, whether in the ordinary course or the lump-sum settlements addressed in
Defendants’ reply.
This leaves Defendants’ request for a declaration Companion must “timely provide claims
data, collateral statements, and updated claims records to AMS for open claims under the AMS
policies.” ECF No. 384 at 10. Defendants concede the requested relief has largely been resolved
by agreement or prior order. Id. at 8 (“Companion has already been ordered to produce, or has
voluntarily agreed to provide, claims data, claims files, reserve information, and information
regarding its use of AMS collateral.”). They fail to identify any specific information or document
sought through their request for declaratory relief that is not covered by prior agreement or order
and also fail to direct the court to the source of any duty of disclosure. This leaves the court with
10
a request for a declaration that lacks necessary specificity and support. The court, therefore, denies
this aspect of Defendants’ request for declaratory relief.
While the court denies the requested relief, it does not modify other orders or agreements
that are in place. Most critically, as previously ordered and agreed by the parties, the court
appointed both an independent accounting expert (“Independent Accountant”) and an independent
actuarial expert (“Independent Actuary”) who will prepare reports covering a multiyear period
ending April 30, 2017.
ECF Nos. 386, 387.
These reports will be based on extensive
documentation compiled by the parties relating to claims and dealings between the parties through
April 30, 2017. See generally ECF No. 396-1 (letters and attachments sent to experts explaining
how to access documents and data, delineating tasks to be performed, and providing instructions
for preparation of initial and final reports).
The data and documentation provided to the experts is and will be equally available to both
sides. The experts’ reports shall, likewise, be equally available. Indeed, the plan for preparation
of final reports, developed jointly by the parties, anticipates each side will have an opportunity to
provide feedback to the experts between preparation of the experts’ initial and final reports. Id.
Both experts will, moreover, prepare subsequent quarterly reports on an ongoing basis after the
first report is final. 11 Information necessary to conduct the Initial Review and subsequent
11
The requirement for ongoing Quarterly Reviews by the Independent Actuary addresses the 2006
Coverage Agreement’s requirement for a quarterly “audit [of] claims experience in connection
with the Policies [to] determine the appropriate amount of the Required Reserve for the next
quarter.” 2006 Coverage Agreement ¶ 13. While the 2006 Coverage Agreement does not
expressly address whether the audit report is shared, the agreed procedures going forward require
the Independent Actuary to prepare “quarterly actuarial audit reports using the same methodology
and [to] advise the parties and Court of the results of the same, including the updated Required
Reserve.” See Joint Submission § IV.A. (emphasis added). The Independent Accountant,
11
Quarterly Reviews will, pursuant to prior order and agreement, be made available to Defendants
prior to or at the same time it is made available to the Independent Actuary and Independent
Accountant. Presumably at least some other information will be provided to Defendants by
Companion in the ordinary course of business (e.g., invoices for claims paid or to be paid). 12
In sum, Defendants’ request for declaratory relief is denied because Defendants have failed
to (1) specifically identify any documentation or information that Companion has not previously
produced (including through discovery or pursuant to court order) or agreed to provide in the future
(including in connection with the Initial Reviews and future Quarterly Reviews), or (2) identified
the source of any duty to provide information or documentation beyond that already ordered or
agreed to be produced. To the extent Defendants seek to impose any duty of consultation before
claims are settled, the relief sought is also denied because it is not predicted by any counterclaim.
II.
Wood’s guarantee of AMS’s below-deductible payment and collateral obligations.
Companion’s opening argument. Companion seeks a judicial declaration Wood is
obligated, under the Wood Guaranty, to fulfill various obligations AMS has failed to fulfill under
the 2006 Coverage Agreement and related Policies. ECF No. 382 at 5-11. More specifically,
Companion asks the court to declare Wood must “(i) promptly indemnify Companion for
unreimbursed below-deductible claims paid by Companion to date under the AMS Policies, (ii)
likewise, remains involved, calculating the amount of collateral needed “after each subsequent,
updated actuarial report.” Id. § IV.B. (further providing Independent Accountant “shall advise the
parties and court of the same”).
12
For example, the 2006 Coverage Agreement indicates the claims administrator (now
Companion) will send periodic invoices for claims incurred. Companion will, presumably,
provide such invoices in the future, at least so long as Defendants are providing payments in a
timely manner following receipt. See 2006 Coverage Agreement ¶ 12.
12
pay all such claims in the future as they come due, and (iii) fund any below-deductible collateral
owed to Companion now and in the future.” Id. at 11.
As a factual threshold, Companion asserts AMS has refused to pay or reimburse any belowdeductible claims since October 28, 2013, forcing Companion to use collateral to pay claims, and
“leaving the collateral account underfunded under the actuarial methodologies contractually
approved by Companion.” ECF No. 328 at 5, 6. As to the status of the collateral, Companion
notes Defendants have taken the position since December 10, 2013, that the collateral is
overfunded. Id. at 6. Companion further asserts it has demanded but Wood has refused to pay
claims and make up the alleged collateral shortfall for a period of over two-and-a-half years. Id.
at 10. 13
Companion argues Wood should be directed to pay the claims as they come due and make
up any collateral shortfall under the Wood Guaranty, which (1) defines “Subject Agreements” to
include the 2006 Coverage Agreement and Policies issued pursuant to that agreement; (2) provides
Wood “absolutely and unconditionally guarantees . . . full and prompt performance and payment
when due, of all obligations of each OBLIGOR under the Subject Agreements[,]” (3) provides the
guaranty “is direct and unconditional and may be enforced by [Companion] without first resorting
to any right or remedy against any OBLIGOR or any other person[.]” and (4) also provides Wood
13
Except for whether the collateral is under or overfunded, the factual assertions are essentially
undisputed. That is, it is undisputed Defendants insisted Companion use collateral to pay claims,
Companion has done so resulting in a substantial reduction in collateral, and Wood has declined
to pay claims or fund collateral despite one or more demands. Whether the reduction in collateral
has resulted in underfunding is a disputed issue that will be resolved, by agreement, through the
independent actuarial review and accounting currently in process. See infra this section (§ II) at
“Discussion.”
13
will “indemnify and hold harmless [Companion] . . . from and against any and all claims, suits,
hearings, proceedings, actions, damages, liabilities, fines, penalties, losses, costs or expenses . . .
arising out of or otherwise related to, directly or indirectly, the Subject Agreements.” Id. at 9
(quoting 2006 Coverage Agreement ¶ 15 and Wood Guaranty, Background, ¶¶ 1.A. & B, II.A.).
Companion notes the express purpose of the Wood Guaranty is to “ensure [Companion] incurs no
pecuniary liability whatsoever in entering into the Subject Agreements.” Id. at 10 (quoting Wood
Guaranty, Background and noting 2006 Coverage Agreement characterizes the Wood Guaranty as
an essential inducement).
Defendants’ response. Defendants oppose Companion’s requested declaratory relief,
characterizing it as a “request for an across-the-board declaration” that violates rules against
“issuing an advisory opinion on matters that are not yet ripe[.]” ECF No. 398 at 5. 14 Defendants
also assert the declaration “would violate Wood’s rights under the Guaranty Agreement because
they would vitiate his express rights to notice and presentment.” Id. Expanding on these
arguments and characterizing Wood’s obligations as “potential secondary obligations,”
Defendants argue no amount will be due from AMS (or Wood) until the “independent experts
resolve the outstanding accounting disputes.” Id. at 7, 8.
Companion’s reply. On Reply, Companion notes Defendants “do not dispute that Wood
must guaranty AMS’s below-deductible claims payment and collateral funding obligations under
the 2006 Coverage Agreement and the related AMS Policies.” ECF No. 400 at 1. Rather, they
rely on what are essentially arguments as to timing. Id.
14
Page numbers in citations to this document refer to the page number on the electronic case filing
header, rather than the document’s internal page numbering system.
14
Companion argues the relief sought is neither premature nor advisory. It relies in particular
on the age and stage of the litigation. Id. (noting litigation has been pending for nearly three years).
Companion notes the parties’ agreed to submit this issue, among others, to the court for non-jury
resolution. Id. at 2 (quoting Joint Submission). Finally, Companion notes the very purpose of
declaratory relief is to clarify respective obligations going forward. Id. at 3.
Companion contends Defendants’ argument that Wood is entitled to notice and
presentment prior to incurring any obligation under the Wood Guaranty is inconsistent with the
agreement as expressed in the Joint Submission (setting out agreement for resolution of jury and
non-jury issues). Id. Relying on the Guaranty Provision’s statement Wood’s liability “is direct
and unconditional and may be enforced . . . without first resorting to any right or remedy against
any [AMS Entity] or any other person,” Companion argues Wood’s obligations are not secondary
to those of AMS and, consequently, do not require prior demand. Id. at 4 (quoting Wood Guaranty
¶ I.B.). Finally, Companion points to evidence of prior demands, including one sent by counsel
on September 29, 2014, addressing claims in this and related litigation. Id. 15
Discussion—Ripeness. The dispute as to Defendants’ liability for claims payments and
collateral arose no later than October 28, 2013, when representatives of Defendants advised
15
The referenced letter (attached to Companion’s opening memorandum) cites the Guaranty and
Indemnity Provisions as well as other paragraphs of the Wood Guaranty. ECF No. 382-2 at 2
(citing ¶¶ I, II, III, and IX.B., and IX.D. of the Wood Guaranty). It quotes the Indemnity Provision
in support of a demand Wood “indemnify and hold harmless Companion from any and all claims,
suits, losses[,] hearings, proceedings, actions, damages, liabilities, fines, penalties, costs, or
expenses, including without limitation reasonable attorney’s fees, associated with the Claims,
Deposits, TX Action and SC Action.” Id. While this language may suggest only a demand for
indemnification, subsequent subparagraphs refer to Wood’s obligation to perform various
contractual duties including rendering payments for premiums and funding collateral.
15
Companion they would no longer make payment for claims as incurred and, instead, directed
Companion to pay claims from collateral. The dispute as to Woods’ responsibility for claims
payments and collateral arose no later than September 19, 2014, when this action was filed seeking,
inter alia, relief from Wood based on the Wood Guaranty. ECF No. 1 at ¶¶ 65-69 (indemnification
claim); see also ECF No. 382-2 (September 29, 2014 demand letter to Wood covering, inter alia,
claims in this action). The matter has, since that time, proceeded through discovery, dispositive
motions, jury selection, negotiation and agreement as to resolution of all remaining issues through
a combination of jury trial, independent expert reviews, and non-jury ruling, settlement of jury
issues on the eve of trial, appointment of experts, and full briefing on non-jury issues. This
procedural history demonstrates any dispute as to interpretation of the Wood Guaranty is ripe for
review as it applies to claims in this action.16
This is particularly true in light of the April 17, 2017 Joint Submission through which the
parties agreed the court would resolve, non-jury, “whether, as a matter of law, under the Guaranty
and Indemnity Agreement . . . Wood must pay deductibles and/or below deducible collateral, if
any, owed by AMS to Companion in connection with the AMS Policies in the amount determined
by the independent actuary and accountant.” Joint Submission ¶ III.A. (ECF No. 409-1) (emphasis
added).
The same document addresses how the relative financial responsibilities will be
determined. See Joint Submission § IV.A. (agreeing parties will “abide by the Required Reserve
Determinations made by the independent actuarial firm”); id. § IV.B. (agreeing, “[b]ased on the
independent accounting firm’s examination, and the Required Reserve determined by the
16
There are, in fact, no further proceedings contemplated that might address scope and intent of
the Wood Guaranty.
16
independent actuarial firm . . . , the independent accounting firm shall calculate the amount of
AMS collateral needed as of April 30, 2017, and shall advise the parties and court of the same.”).
It also addresses how the resulting financial responsibility will be resolved: “If additional
collateral is needed for AMS, AMS and Wood will promptly assure that the collateral account is
funded. On the other hand, if Companion is holding excess collateral on behalf of AMS,
Companion will promptly assure that the excess collateral is refunded to AMS.” Id. § IV.B.
Finally, it provides the process will be repeated after future Quarterly Reviews, after which “the
parties shall continue to fund (or refund) as described above.” Id.
Merits.
Defendants’ only argument on the merits is that Wood’s responsibility is
secondary to that of AMS, arising only if AMS does not timely perform. ECF No. 398 at 10
(arguing declaration sought would violate Wood’s right to presentment and demand). Companion
counters the Wood Guaranty provides “Wood’s liability ‘is direct and unconditional and may be
enforced by [Companion] without first resorting to any right or remedy against [AMS] or any other
person.’” ECF No. 400 at 4 (quoting Wood Guaranty ¶ I.B.).
Both are, in some respects, correct. As Companion notes, Section I of the Wood Guaranty
provides Wood “absolutely and unconditionally guarantees . . . the full and prompt performance
and payment when due of all obligations of all OBLIGORS [e.g., AMS] under the Subject
Agreements [e.g., 2006 Coverage Agreement].” Wood Guaranty ¶ I.A. It further provides the
guaranty is “a guaranty of performance and of payment and not of collection, and the liability of
[Wood] is direct and unconditional and may be enforced . . . without first resorting to any right or
remedy against any OBLIGOR or any other person.” id. ¶ I.B.; see also 2006 Coverage Agreement
¶ 15 (characterizing Wood Guaranty as an “essential inducement”). This, at the least, means
Companion is not required to pursue collection or legal proceedings against AMS before invoking
17
its rights under the Wood Guaranty. Read in isolation, it might also suggest Companion may seek
payment from Wood without first seeking payment from AMS.
However, that reading is
precluded by Section III of the Wood Guaranty (“Demand”), which reads as follows:
A.
[Wood], within thirty (30) days of receipt of [Companion’s] written demand
from time to time, shall (as applicable):
***
2.
Pay to [Companion] in full in cash or immediately available funds
any amount due and owing to [Companion] from any OBLIGOR under any
Subject Agreement that has not been timely paid.
3.
Pay to [Companion] in cash or immediately available funds any and
all amounts owing in respect of [Wood’s] indemnity under Section I.B.
hereunder.
Wood Guaranty ¶ III (emphasis added); see also Wood Guaranty ¶ I.A. (stating Wood guarantees
“full and prompt performance and payment when due and defining “prompt” as “unconditionally,
without request for extension, and within thirty (30) days of [Companion’s] written demand for
payment.”).
The second subparagraph’s reference to amounts owing “that ha[ve] not been timely paid,”
presumes a prior request to an Obligor for payment and failure of that Obligor (e.g. AMS) to make
payment in a timely manner under the relevant contract. AMS’s obligation to pay claims and fund
collateral arises under the 2006 Coverage Agreement (and related Policies). The court, therefore,
looks to the 2006 Coverage Agreement to determine what constitutes a failure of timely
performance of either obligation. 17
17
The parties have not directed the court to any provision of a Policy that addresses timeliness of
payments.
18
As to claims payments, the 2006 Coverage Agreement provides the claims administrator
“shall invoice the appropriate AMS Entity for all incurred claims on a periodic basis and terms
acceptable to [Companion.]
All invoice payments shall be deposited into the [claims
administrator’s] Claims Operating Account . . . and all claims shall be paid from such account.”
2006 Coverage Agreement ¶ 12 (emphasis added). While this paragraph does not expressly state
how quickly the invoices must be paid, it envisions claims payments will be made using AMS
funds, thus, it envisions payments deposited before claims are paid. It follows that payment is due
at some point prior to the earlier of when claims should be or actually are paid.
The collateral provision requires an initial deposit of $1,000,000 and provides for quarterly
reviews to determine future reserve needs. Rather than indicating payments (or refunds) will be
made based on those quarterly reviews, it provides for monthly contributions based on the value
of incurred claims and calls for payment by the tenth of the month. Id. ¶ 13 (“As actual claims are
incurred the AMS Entities shall deposit into the Claims Reserve Fund the amount of such claims
on a monthly basis by the 10th day of the month.”). While not explicit, this appears to envision a
deposit within ten days of notification of claims incurred. Lacking any other guide, the court finds
collateral deposits are timely if made within ten days of notification or invoicing of claims or
collateral obligations (such as through quarterly reports).
Claims and collateral obligations through April 30, 2017. Since October 2013, AMS
has refused to pay claims as incurred or make additional collateral contributions. It maintains this
refusal is justified because existing collateral is more than sufficient to cover all current and
reasonably anticipated future claims. Faced with AMS’s refusal, Companion demanded Wood
perform AMS’s payment and funding obligations under the Wood Guaranty. This demand was
clear no later than September 2014. Wood, like AMS, refused to perform. Both the demand and
19
refusals to perform are ongoing and have remained so throughout this litigation. Thus, any
prerequisites of a failure of timely performance by AMS and demand to Wood are satisfied as to
any obligations predating April 30, 2017. 18 The only issue is whether AMS’s (and Wood’s) refusal
to make payment is excused because collateral was (and remains) overfunded or at least sufficient
to cover current and future claims.
Sufficiency of collateral as of April 30, 2017, is being determined by the Initial Review by
an the Independent Actuary and Independent Accountant. The Initial Review is being conducted
by agreement and will take into account certain adjustments agreed to based on settlement of jury
issues, claims that have been paid since October 2013, rulings in this order and certain other agreed
adjustments. The parties have agreed to abide by the results of the Initial Review. If the Initial
Review establishes the collateral account is underfunded, Wood will be responsible for the
underfunded amount (jointly with AMS) because AMS’s sole basis for refusing to pay claims will
be resolved against it. For reasons explained above, there is no need for further demand of AMS
and failure of timely payment before a demand may be made under the Wood Guaranty. The
Initial Review itself, when final, will suffice as the demand and Wood will be jointly responsible
with AMS for funding any deficiency that must be paid within thirty days of entry of judgment as
contemplated by the Demand language quoted above. 19 Wood Guaranty ¶ III.A.
18
The court uses this date because it is the date through which claims and collateral funding needs
will be determined by ongoing actuarial review and accounting.
19
The Initial Review will be final upon the Independent Accountant’s calculation of amounts due
after receiving the final report of the Independent Actuary. See April 17, 2017, Joint Submission
¶ IV.B. As noted above, the parties will have an opportunity for comment before the Initial Review
and related reports become final.
20
Collateral going forward. The parties have agreed to Quarterly Reviews of collateral
going forward and to abide by the results of those reviews. Joint Submission ¶ IV.B. (“The
independent accounting firm shall repeat this process after each subsequent, updated actuarial
report, and the parties shall continue to fund (or refund) as described above.”). As to these
Quarterly Reviews, the court agrees the Wood Guaranty is triggered only if AMS fails to make
timely payment. Nonetheless, in light of the parties’ agreement to abide by the results of the
Quarterly Reviews, those reviews will, themselves, be deemed the invoice or notice to AMS. If
AMS does not satisfy the obligation within ten calendar days of receipt of a Quarterly Review,
that failure shall automatically be deemed a demand on Wood following a failure of timely
payment, triggering his duty to perform within thirty days of the expiration of AMS’s ten-day
period for performance. See supra pp. 18, 19 (addressing Wood Guaranty ¶ I.A. and 2006
Coverage Agreement ¶ 13). 20
Claims going forward. The claims payment and collateral obligations are distinct, though
related, obligations. See 2006 Coverage Agreement ¶¶ 12, 13. Therefore, in addition to the
collateral funding procedures addressed above, Companion shall invoice AMS as claims are
incurred and before they are paid. 2006 Coverage Agreement ¶ 12. If it does so, AMS shall fund
the claims in sufficient time to allow for timely payment. Id. As noted above, the 2006 Coverage
Agreement does not provide a specific timeframe for funding. However, drawing on the timeframe
suggested for deposit of collateral (¶ 13), the court finds ten days is an appropriate period for
“timely” payment to Companion. If AMS fails to fund claims payments within ten days of
20
Companion’s obligation to refund any overage is subject to the same period. Thus, if a Quarterly
Review determines AMS’s Claims Reserve Fund is overfunded, Companion must refund the
excess within ten days of receipt of the Quarterly Review.
21
notification, Companion may make a demand for payment under the Wood Guaranty that must be
satisfied within thirty days after demand.
III.
Wood’s obligation to indemnify Companion for liability on above-deductible claims.
Companion’s opening argument. Companion seeks a declaration Wood must indemnify
Companion for any liability Companion incurs for unreimbursed above-deductible claims
payments made from AMS funds. 21 This relief is within the scope of Companion’s fifteenth cause
of action for recovery based on the Wood Guaranty. 22
Companion relies on the first subparagraph of the Indemnity Provision of the Wood
Guaranty (¶ II.A.). ECF No. 382 at 12-13. Companion notes this provision is broadly worded,
promising to indemnify and hold Companion harmless “from and against any and all claims, suits
hearings, proceedings, actions, damages, liabilities, fines, penalties, losses, costs or expenses,
including without limitation reasonable attorney’s fees, at any time arising out of or otherwise
related to, directly or indirectly, the Subject Agreements[.]” Id. at 13 (quoting Wood Guaranty ¶
21
Companion will incur such liability only if AMS has not previously been reimbursed for all
above-deductible claims payments. By agreement, whether there are any unreimbursed payments
will be resolved by the Independent Accountant as part of the Initial Review. See ECF No. 409-1
(Joint Submission); ECF No. 387 (order appointing accounting expert); ECF No. 396-1 at 7
(“Instructions for Preparation of Court-Appointed Accountant Expert Report”).
22
The underlying issue of Companion’s liability for unreimbursed above-deductible payments
was raised both by a claim for declaratory relief and a counterclaim for damages. See ECF No. 88
¶¶ 50-58 (Companion’s second cause of action); ECF No. 90 ¶¶ 249-57 (Defendant’s fifth
counterclaim). The pleadings suggest the amount at issue exceeds $9 million. Id. However,
shortly prior to the deadline for filing dispositive motions, Defendants stipulated the amount did
not exceed $1,826,145. ECF No. 196.
22
II.A.). 23 Companion points to distinctions between the Guaranty and Indemnity Provisions, most
critically that the Guaranty Provision (Wood Guaranty ¶ I) guarantees performance and payment
of obligations of defined “OBLIGORS” (i.e. AMS Entities) 24 arising under the “Subject
Agreements” (e.g., 2006 Coverage Agreement), while the cited portion of the Indemnity Provision
(¶ II.A.) is not limited as to the source of the claims or duties, instead, applying to “any and all
claims . . . arising out of or otherwise related to, directly or indirectly” the Subject Agreements.
ECF No. 382 at 14.
Companion relies on the legally recognized distinctions between a guaranty and an
indemnity agreement, with the latter creating a “primary liability” protecting “the promisee against
loss or liability to a third person.” Id. (quoting 38 Am. Jur. 2d Guaranty § 11). It notes indemnity
agreements, like other contracts, should be enforced based on the language chosen by the parties.
Id.
Anticipating Defendants’ argument that prior rulings on the parties’ cross-motions for
partial summary judgment foreclose the relief sought, Companion asserts the court has not
previously addressed the Indemnity Provision of the Wood Guaranty. Thus, the court’s prior
ruling that Wood is not required to fulfill Dallas National’s collateral-funding obligation and
23
The Wood Guaranty defines “Subject Agreements” to include “The [2006] Coverage
Agreement, the Policies and the TCPA [Third Party Claims Administration Agreement between
Companion and Aspen].” The 2006 Coverage Agreement defines “Policies” to include “high and
low deductible workers’ compensation and commercial general liability policies of insurance” as
well as “Master Policies.”
24
“AMS Entities” is defined to include Dallas National. While that definition remains unchanged,
subsequent events have changed the effective reach of certain aspects of the Wood Guaranty, most
critically as they relate to Dallas National’s obligations under the “Subject Agreements.” See infra
pp. 26, 27 (“Discussion—Issues not earlier resolved”).
23
related ruling on Companion’s motion for clarification are not dispositive. ECF No. 382 at 15
(citing ECF No. 258 at 39, ECF No. 286).
Defendants’ response. Defendants respond the court has already, twice, “ruled that Wood
is not liable under the Guaranty Agreement for Dallas National’s above-deductible obligations
with respect to the AMS Policies at issue.” ECF No. 398 at 14. Defendants rely on the court’s
summary judgment ruling that Wood is “not obligated to cover any shortfall in Dallas National’s
collateral” and subsequent clarification that language in the summary judgment order did not allow
Companion “to pursue recovery for any shortfall in Dallas National collateral from Wood as
Guarantor of other AMS Entities’ obligations under the 2006 Coverage Agreement.” Id. at 15.
Defendants characterize Companion’s argument as an end-run around prior rulings, stating “[i]f
Companion could just transform any guaranty obligation into an indemnity obligation . . . the
guaranty provision . . . and the legal distinction between guaranty and indemnity, would be
meaningless.” Id. at 16.
On the merits, Defendants argue Companion’s interpretation of the Indemnity Provision is
“contrary to South Carolina law” because indemnity provisions “are presumed to only apply to
third-party liability claims, not first- or second-party breach of contract claims.” Id. (quoting
Laurens Emerg. Med. Specialists, PA v. M.S. Bailey & Sons Bankers, 584 S.E.2d 375, 378 (S.C.
2003) (“Laurens”) for proposition “the default rule of interpretation for indemnity clauses is that
third party claims are a prerequisite to indemnification.”). Defendants assert “Companion cannot
credibly contend that AMS – which Companion named as a co-defendant in this case with Wood
– is a ‘third-party’ to this dispute or the applicable agreements.” Id. at 17.
Defendants also argue the court should reject Companion’s argument because it would lead
to an absurd result. Id. at 18. Defendants note the parties’ intent “must be gathered from the
24
contents of the entire agreement” and the agreement should be interpreted “to give effect to all of
[its] provisions, if practical.” Id. at 18. They argue the intent drawn from the documents would
be defeated and the benefit of the insurance arrangement would be illusory, if the Indemnity
Provision was given the effect sought by Companion. More specifically, Defendants argue:
There would be no reason to purchase an insurance policy – and pay premiums to
Companion – if Wood were responsible for paying all amounts below and above
the deductible. Likewise, there would be no reason for Companion to reinsure the
policies with Dallas National if Wood was supposedly on the hook for all abovedeductible payments by virtue of the indemnity provision in the Guaranty
Agreement.
ECF No. 398 at 19, 20.
Finally, Defendants argue the court should reject Companion’s argument because
Companion has received more than enough collateral from Dallas National to cover all abovedeductible obligations.
Defendants assert Dallas National collateral was overfunded by
approximately $8.6 million as of September 30, 2013, and Companion still held $17,897,436 in
collateral as of June 30, 2015.
Companion’s reply. On reply, Companion emphasizes the distinction between the
Indemnity and Guaranty Provisions, arguing the court’s prior rulings only addressed the latter.
ECF No. 400 at 5, 7. It challenges Defendants’ characterization of the Indemnity Provision, noting
the various related agreements evidence an “undisputed, overarching purpose” of protecting
Companion through “multiple layers of financial protection.” Id. at 7, 8. Companion further
asserts AMS is a third party to the Wood Guaranty because it is a legal entity distinct from Wood
and Wood is the only party to the Wood Guaranty other than Companion. Id. at 9. It argues the
language at issue is particularly broad, thus the type language that allows the court to reach beyond
any general limitation to third-party claims.
25
Id. (noting cases relied on by Defendants
acknowledge indemnity clauses are not limited to third-party claims if there is “language to the
contrary”).
As to existing collateral, Companion argues the collateral it holds is “irrelevant to the legal
issue before the court.” Id. at 10. It asserts Wood either is or is not “contractually obligated as a
matter of law to indemnify Companion for allegedly unreimbursed above-deductible claims
payments[.]” Id. (“This is a purely legal determination based on the parties’ contracts and
applicable law. The Wood indemnity does not turn on, and has nothing to do with, the amount of
collateral Defendants say Companion holds, or for that matter, any other funding source[.]”).
Companion asserts Dallas National collateral is, in any event, underfunded.
Discussion–Issue not earlier resolved.
As Companion argues, the court has not
previously construed or resolved any claim based on the Indemnity Provision (¶ II) of the Wood
Guaranty. The court, instead, considered the Guaranty Provision (¶ I), concluding that provision
did not require Wood to fulfill Dallas National’s obligation to fund collateral. The court reached
this result based on its conclusion the relationship between Dallas National and Companion was
no longer governed by the 2006 Coverage Agreement (one of the agreements covered by the Wood
Guaranty) at the relevant time. As a result, Dallas National’s obligation to fund collateral was no
longer an obligation under a “Subject Agreement” and, consequently, no longer an obligation to
which the Wood Guaranty applied.
The court did not construe any other provision of the Wood Guaranty in ruling on
Companion’s subsequent motion for clarification. It did not, in fact, focus on the Wood Guaranty
itself. Rather, the court considered whether the 2006 Coverage Agreement imposed all obligations
of any AMS Entity on all AMS Entities, such that the AMS Entities still subject to the 2006
Coverage Agreement would remain responsible for Dallas National’s collateral obligation. The
26
court rejected this interpretation and, consequently, held Wood was not obligated to fund Dallas
National’s collateral obligation as the collective obligation of all AMS Entities.
Companion did rely on the Indemnity Provision in one of its summary judgment
arguments. Much as it does here, Companion argued the Indemnity Provision requires Wood to
indemnify Companion if Companion is held liable to AMS for unreimbursed above-deductible
claims. That argument was, however, raised as a defense to AMS’s claim for reimbursement. The
court declined to reach the merits of the argument because the AMS Entities are distinct legal
entities from Wood. Thus, even if Wood is required to indemnify Companion for damages paid
to AMS, the court held it would not provide a defense to AMS’s claim. ECF No. 258 at 9
(concluding Companion’s position “fails to recognize that, despite common ownership, Wood and
AMS are separate entities. Thus, even if Wood must ultimately reimburse Companion for any
amount Companion owes to AMS, it would not defeat this counterclaim.”).
In sum, while the court has previously construed the Guaranty Provision of the Wood
Guaranty, it has not construed the Indemnity Provision. The court, therefore, addresses the effect
of the Indemnity Provision on a clean slate.
Merits. The Indemnity Provision reads as follows:
A.
GUARANTOR hereby agrees to indemnify and hold harmless COMPANY
[Companion] and all shareholders, officers, directors, employees and other agents
of COMPANY, from and against any and all claims, suits, hearings, proceedings,
actions, damages, liabilities, fines, penalties, losses, costs or expenses, including
without limitation reasonable attorney’s fees, at any time arising out of or otherwise
related to, directly or indirectly, the Subject Agreements.
B.
GUARANTOR shall further pay all reasonable expenses, including without
limitation, attorney’s fees and other legal expenses, paid or incurred by COMPANY
in collecting amounts owed hereunder or otherwise enforcing this Agreement.
ECF No. 340-1 at 29 (Wood Guaranty ¶ II).
27
Language in the preceding “Background” section explains the intent of the Wood Guaranty
as follows:
COMPANY and GUARANTOR wish to ensure that COMPANY incurs no
pecuniary liability whatsoever by entering into the Subject Agreements. As a
condition precedent to COMPANY’s willingness to enter into the Subject
Agreements, COMPANY has insisted upon GUARANTOR providing, and
GUARANTOR is willing to provide, this Guaranty and Indemnity Agreement for
the benefit of COMPANY.
Id. at 28 (“Background”) (emphasis added).
“Third-party” argument. As noted above, Defendants argue the Indemnity Provision
does not apply to claims by AMS against Companion because, under South Carolina law,
indemnity provisions generally cover only third-party claims. ECF No. 398 at 16 (citing Laurens,
584 S.E.2d at 378). The difficulty with this argument is AMS, though a party to the “Subject
Agreements” addressed by the Wood Guaranty, is not a party to the Wood Guaranty itself. Thus,
AMS’s claim against Companion for unreimbursed above-deductible claims payments is a thirdparty claim with respect to the Wood Guaranty. 25
Given AMS’s status as a third party to the Wood Guaranty, the court need not decide
whether the broad indemnification language used in the Wood Guaranty would reach first-party
claims. The court notes, nonetheless, that the indemnification language used in the Wood
25
As noted above, the court relied on the separate legal existence of Wood and AMS, thus AMS’s
third-party status relative to the Wood Guaranty, in declining to address a similar argument raised
by Companion in briefing on cross-motions for partial summary judgment. AMS has not
challenged that ruling.
28
Guaranty is broader than that applied in Laurens (a case on which Defendants rely), particularly
when read in the context of the Background’s statement of intent (quoted supra at 28). 26
Not an “absurd” result. The court is not persuaded that applying the Indemnity Provision
to claims against Companion by Wood’s Co-Defendants would either be “absurd” or render the
insurance policies issued under the 2006 Coverage Agreement “completely illusory.” 27 See ECF
No. 398 at 19. Defendants’ argument on this point presumes the underlying agreements created a
typical insurer-insured relationship. Id. (“There would be no reason to purchase an insurance
policy–and pay premiums to Companion–if Wood were responsible for paying all amounts below
and above the deductible.”).
The relationship created by the Subject Agreements was not a typical insurer-insured
relationship. It was, instead, a “fronting” arrangement that allowed issuance of insurance policies
on Companion’s paper but contemplated claims would be processed and paid in full by the various
Wood-owned entities. 28 The many layers of protection built into the arrangement and the Wood
26
In Laurens, the court construed an indemnity provision between a hospital (“Hospital”) and an
emergency medical services company (“EMS”). The key language provided “Hospital will
indemnify and hold [EMS and its physicians] harmless from and against any and all claims[,]
causes of action, or expenses . . . caused by or resulting from allegations of wrongful acts or
omissions of Hospital employees [or agents].” Laurens Emerg. Med. Specialists, 584 S.E.2d at
378. The court found this language was a “typical indemnity agreement” and, consequently, did
not apply to a claim by EMS against Hospital for a Hospital employee’s theft from EMS. Id.
(holding “the intended purpose of this indemnification clause was protection against third party
claims, not reimbursement for claims between the parties themselves.”).
27
“Policies” written under the 2006 Coverage Agreement are within the definition of “Subject
Agreements.” Thus, the Indemnity Provision applies to claims arising out of or relating directly
or indirectly to such Policies.
28
Certain aspects of the relationship changed in and after 2011, in part due to the Florida OIR’s
objections to the fronting arrangement. However, at the time Wood signed the Guaranty, he owned
29
Guaranty’s statement the parties intended Companion should “incur[] no pecuniary liability
whatsoever by entering the Subject Agreements” further support this intent. ECF No. 340-1 at 28
(Wood Guaranty, Background). In light of the nature of the relationship, particularly when viewed
in context of the various AMS Entities’ responsibilities at the time the Wood Guaranty was signed,
there is nothing absurd in Companion’s interpretation. It, instead, gives effect to the plain meaning
of the language.
This is particularly true because Defendants’ counterclaim for unreimbursed abovedeductible payments made from AMS funds and Companion’s corresponding claim for declaratory
relief do not require a determination that Companion was at fault for causing any improper
payments or failure of reimbursement. For this reason, it does not raise a concern that the
indemnification provision is being used to immunize a party from its own conduct. 29
the entities responsible for below-deductible amounts (including AMS), the party responsible for
above-deductible payments (Dallas National), and the third-party claims administrator (Aspen).
The above-deductible payments for which AMS seeks reimbursement in this action include
payments dating back to 2005, thus they include payments made during the period when AMS,
Dallas National and Aspen were all owned by Wood and Aspen handled the claims processing. In
other words, the payments at issue were made, at least in part, during a period when the “fronting
arrangement” operated as originally envisioned by the 2006 Coverage Agreement.
29
Defendants rely on Ashley II of Charleston LLC v. PCS Nitrogen, 763 S.E.2d 19 (S.C. 2014) in
arguing South Carolina follows a general rule an “indemnification provision does not immunize a
party from its own conduct.” ECF No. 398 at 18. As Defendants acknowledge in a footnote,
however, the general rule addressed in Ashley II is specific to negligence claims and intended to
deter negligent conduct. Ashley II, 763 S.E.2d at 20 (stating indemnity provisions are “not
construed to indemnify the indemnitee against losses resulting from its own negligent acts unless
such intention is expressed in clear and unequivocal terms”). The court held this underlying policy
would not be served in the context of a federal environmental liability claim because such a claim
was “fundamentally not a fault-based determination.”
30
To the contrary, the Independent Accountant has been instructed to review claims for the
duration of the parties’ relationship, from 2005 through 2013, to determine the amount of any
unreimbursed above-deductible payments made from AMS funds. For the majority of this period
(through mid-2011), Defendants’ affiliate Aspen handled claims processing for all Policies at
issue. See ECF No. 241 at 7 (Defendants’ response to Companion’s motion for partial summary
judgment, asserting Companion took over claims processing from Aspen for Florida policies in
mid-2011). Also for the majority of the period (until June 2013), Defendants’ affiliate Dallas
National reimbursed AMS for the above-deductible payments. See ECF No, 241 at 14 (conceding
Dallas National provided credits to reimburse AMS for above-deductible payments until June
2013, though suggesting not all payments were fully reimbursed during this period). This leaves
only a portion of the period (from mid-2011 to October 2013), during which Companion might be
“responsible” for paying above-deductible amounts from AMS funds and an even shorter period
(June to October 2013), when no entity affiliated with Defendants was providing (or expected to
provide) AMS with corresponding credits. See id. (asserting Companion continued the practice of
making above-deductible payments from AMS funds from June to October 2013 and Dallas
National did not provide credits during this period). As the period under review by the Independent
Accountant is not limited to this shorter period, resolution of this issue is “fundamentally not a
fault-based determination.” See Ashley II, 763 S.E.2d at 20. 30
30
It is also of some significance that the issue will be resolved without determining Companion’s
estoppel defense. See ECF No. 273 at 19, 25 (unredacted version of Companion memorandum in
support of partial summary judgment arguing, inter alia, Defendants are estopped from seeking
reimbursement due to their long acquiescence in the practice and failure to raise a concern during
a time Companion might have cured any error).
31
Availability of Dallas National collateral. Defendants argue Companion should not be
allowed to rely on the Indemnity Provision because it has received and retains collateral from
Dallas National intended to cover above-deductible claims.
Companion, in reply, argues the availability of collateral is irrelevant because the
Indemnity Provision must be interpreted without regard to whether Companion might seek relief
from a different source. It further argues the collateral is not sufficient to cover all of Dallas
National’s obligations intended to be secured by that collateral.
Because nothing in the Indemnity Provision requires Companion to resort to other means
of satisfying a claim or liability before seeking indemnity from Wood, the court finds the possible
existence of sufficient collateral does not avoid coverage under the Indemnity Provision. This is
the natural result of the broad language the parties chose for the Indemnity Provision. It is also
consistent with the obvious intent of the Indemnity Provision at the time the Wood Guaranty was
signed, given Wood’s control over all AMS Entities (including Dallas National). 31
31
It is unlikely the present dispute would have arisen while Wood owned all “AMS Entities” as
defined in the Wood Guaranty. This is because it would have been, in essence, a claim by one
Wood-owned entity (AMS) for breach of duty by another Wood-owned entity (Dallas National)
relating largely if not entirely to a claims-payment practice of a third Wood-owned entity (Aspen).
Nonetheless, had this dispute arisen at that time, and had AMS sought recovery from Companion,
Wood could not have argued it was absurd to construe the Indemnity Provision to cover the claim.
The wrinkle of possible excess Dallas National collateral could, in that instance, have been
resolved through a separate claim by Dallas National against Companion for return of excess
collateral. Whatever settling up might occur later between Wood and Dallas National would not
have involved Companion. Thus, the language of the Indemnity Provision, viewed in light of the
facts as they existed at the time it was entered and stated intent of the Wood Guaranty, favors
Companion’s interpretation.
.
32
While ownership of Dallas National and some responsibilities have changed, the Wood
Guaranty has remained the same. Nothing in the subsequent changes persuades the court that it
would be improper to construe the Indemnity Provision to cover Companion’s liability for AMS’s
claim for unreimbursed above-deductible payments. 32
Accordingly, the court grants Companion’s request for a declaration that Wood must
indemnify Companion for liability Companion incurs for unreimbursed above-deductible claims
payments made from AMS funds.
IV.
Companion’s entitlement to earnings on State Street Account.
Companion’s opening argument. Companion seeks a declaration it is entitled to all
earnings, including reinvested earnings, accrued on the Claims Reserve Fund in the State Street
Account. ECF No. 382 at 15-17. Companion relies on the following language from the 2006
Coverage Agreement in seeking this relief:
During the Coverage Term of the Master Policies, [Companion] shall establish and
maintain in its name with the Bank of America an account to serve as a claims
reserve fund (the “Claims Reserve Fund”). . . . All earnings on the Claims Reserve
Fund shall belong to [Companion] and no AMS Entity shall have any interest
therein. . . . All earnings on funds held within the Claims Reserve Fund will inure
to the benefit of [Companion].
2006 Coverage Agreement ¶ 13. Companion argues this language is unambiguous and, given its
plain, ordinary and popular meaning, “makes clear that Companion is contractually entitled to all
32
The two most significant subsequent changes are Companion’s assumption of claim-processing
duties with respect to Florida policies and Wood’s sale of Dallas National. Defendants have not
demonstrated either change warrants disregarding the plain language of the Indemnity Provision.
33
earnings—which necessarily include reinvested earnings” on funds held in the State Street
Account. ECF No. 382 at 16 (citing, e.g., Blakely v. Rabon, 221 S.E.2d 767, 769 (S.C. 1976)). 33
In the alternative, Companion argues if AMS “successfully claims an interest in these
earnings or otherwise demands that Companion must credit those earnings to AMS,” Wood must
indemnify Companion for “any such claim, liability or loss.” ECF No. 382 at 17. This argument
rests on the Indemnity Provision of Wood’s Guaranty.
Defendants’ response. Defendants argue the language on which Companion relies (2006
Coverage Agreement ¶ 13) “has no application to the AMS funds maintained in the State Street
trust account” because the paragraph at issue refers to an account maintained at Bank of America.
ECF No. 398 at 21, 22. They further argue Companion’s position is “contrary to its own sworn
financial statements and its representations regarding the amount of AMS funds held in the State
Street trust account” because such statements and reports refer to the full balance of the State Street
account “as collateral held in trust, not as ‘earnings’ that belonged to Companion.” Id.
In support of the first argument, Defendants cite deposition testimony relating to
Companion’s ownership and control over the Bank of America collateral account (“Bank of
America 4866 Account”) and distinctions between that account and the State Street Account. Id.
at 22, 23 n.65. Defendants note the State Street Account is “a separate account, at a separate
institution, in which Companion holds funds in trust solely for AMS.” Id. at 23 (citing Letter from
33
The portion of the account attributable to earnings will be determined by the Independent
Accountant. Companion maintains the portion of the account attributable to earnings should be
“subtracted from the current AMS collateral balance” as part of the determination whether the
account is under or overfunded. ECF No. 382 at 17, n.45.
34
G. Reeth to A. Gillie dated Nov. 29, 2011). 34 Based on these distinctions, Defendants argue the
State Street Account is not subject to the earnings provisions of paragraph 13 of the 2006 Coverage
Agreement. 35
In support of their second argument, Defendants rely on Companion’s sworn financial
statements. Those statements describe the State Street Account as “a segregated, off-balance sheet
collateral account held in trust” and state “the trust account is used to settle paid losses associated
with Florida large deductible workers’ compensation policies.” ECF No. 398 at 24 (quoting
Companion’s 2012 Annual Statement, ECF No. 398-1). Noting the same value is reported as the
“balance of the trust account” in this Annual Statement and on the bank statement, Defendants
assert “Companion reported all AMS funds in the State Street [A]ccount as collateral held in trust
not as ‘earnings’ that belonged to Companion.” ECF No. 398 at 24. Defendants note Companion
used the same or similar language and followed the same reporting practice in its 2013 and 2014
34
The cited letter is signed by an officer of Companion and addressed to a representative of the
“Office of Insurance Regulation” (presumably Florida, as the letter refers to the consent order). It
states “Companion maintains a separate, segregated account for AMS Staff Leasing collateral,”
explaining as follows in a footnote:
Companion created the account as a segregated custodial account as the most
expedient method of maintaining the funds in a separate manner. Additionally, by
acknowledging that it holds the funds in trust, Companion believes that this
accomplishes the same purpose as a designated trust account.”
ECF No. 398-15 (Companion letter dated Nov. 29, 2011). Other documents submitted with
supplemental briefing (discussed below) indicate the State Street Account was established after
the Florida OIR advised Companion a segregated custodial account did not satisfy the
requirements of the consent order.
35
In a footnote, Defendants refer to the absence of any “claim for ‘earnings’” and argue
“Companion’s attempt to take AMS funds as ‘earnings’ should be seen for what it is – an argument
manufactured by litigation counsel in an effort to reduce the amount of AMS funds held in the
State Street trust account.” ECF No. 398 at 22 n.62.
35
Annual Reports and has never withdrawn earnings from the account. Id. (citing ECF Nos. 398-2,
398-11). Defendants argue these and similar reports to Dallas National (reporting the full account
value as “collateral” held) support their interpretation. ECF No. 398 at 25 (quoting Farr v. Duke
Power Co., 218 S.E.2d, 431, 433 (S.C. 1975) for proposition “[t]he practical interpretation of the
contract by the parties to it for any considerable period of time before it becomes the subject of
controversy is entitled to great, if not controlling, influence.”).
Defendants oppose Companion’s alternative indemnification argument, incorporating
earlier arguments as to non-availability of indemnification (for unreimbursed above-deductible
payments). In addition, Defendants argue there is nothing to indemnify because there is “nothing
to change [in the account value] if the Court rejects Companion’s request for declaratory relief.”
Companion’s reply. On reply, Companion characterizes the State Street Account as a
“replacement” for the Bank of America account referenced in paragraph 13 of the 2006 Coverage
Agreement. ECF No. 400 at 11. Based on this characterization, it argues the provisions of that
paragraph are equally applicable to the State Street Account. Id. (acknowledging the State Street
Account is governed by a Trust Agreement (ECF No. 383-9) but arguing this does not modify
Companion’s right to earnings under the 2006 Coverage Agreement ¶ 13).
Companion challenges Defendants’ characterization of Companion’s financial statements
as contradicting its position on earnings. ECF No. 400 at 12. It asserts the only point made in
those statements is “the collateral held in the State Street account is in fact collateral,” but does
“not disavow Companion’s right to earnings[.]”
Finally, Companion argues its prior failure to withdraw funds is not probative. It relies on
the 2006 Coverage Agreement’s statement Companion has “the right to exercise its remedies in
any order and forbearance in the exercise of any remedy shall not constitute a waiver of the right
36
to exercise such remedy at a future time or a waiver of the right to exercise any other remedy.” Id.
(quoting 2006 Coverage Agreement ¶ 16).
Supplemental Briefs. The court requested additional briefing on the import of Section 5
of the Trust Agreement and related topics including whether the parties followed the provisions of
Section 5 and how income, dividends, and other earnings were reported for tax purposes. Section
5 reads as follows:
SECTION 5. The Income Account
All payments of interest and dividends actually received in respect of Assets
in the Trust Account shall be deposited by the Trustee, subject to deduction of the
Trustee’s compensation and expenses as provided in Section 8 of this Agreement,
in a separate account (the “Income Account”) established and maintained by the
Beneficiary at an office of the Trustee. The Trustee shall treat the Beneficiary as
tax owner of all Trust Account Income.
Trust Agreement § 5 (ECF No. 383-9 at 4). The parties’ supplemental briefs on these issues are
summarized below. ECF Nos. 410, 411.
Companion’s Supplemental Brief. Companion responded that its understanding is State
Street Bank did not deposit interest and dividends into a separate account, but retained those and
other earnings in the State Street Account. ECF No. 410 at 5. It maintains the bank statements
support this premise as they reflect transfers to principal. Relying on paragraphs 13 and 16 of the
2006 Coverage Agreement, Companion maintains it has the right to all earnings and its decision
to defer withdrawing those earnings was not a waiver. Id. at 5, 6. It relies in particular on
paragraph 16 which states Companion may “exercise [all] remedies” under the 2006 Coverage
Agreement in any order and forbearance to exercise a remedy is not a waiver of the remedy. Id.
at 6. Companion argues the Trust Agreement language treating Companion “as tax owner of all
37
Trust Account Income” is also consistent with application of the 2006 Coverage Agreement’s
earnings provisions to the State Street Account. Id. at 5. 36
Responding to a related inquiry from the court, Companion states the Florida OIR has
neither formally approved nor disapproved the Trust Agreement and was not required to do so by
the Consent Order. ECF No. 410 at 5. It notes that office has been provided a fully executed copy
of the Trust Agreement and did not lodge any subsequent objection. Id. 37
Defendants’ Supplemental Brief. Defendants first argue the court should not consider
Section 5 of the Trust Agreement because Companion has not sought damages or relief based on
that agreement and failed to address Section 5 in its earlier memoranda. ECF No. 411 at 2-3.
Defendants expand their earlier reference to the belatedness of the claim for earnings, asserting the
court should reject the “claim” for earnings as not timely raised. Id.
Turning to the merits, Defendants argue the requirement Companion establish a separate
income account was a condition precedent to receiving interest and dividend payments. Id. at 4.
Based on this premise, they argue if such an account was not established, and there is no evidence
36
Companion concedes it has not paid taxes on the earnings but agrees it bears the tax liability
for any earnings on the State Street Account. Id. at 6,7; ECF No. 412 (Second Supplemental
Memorandum indicating bank did not issue 1099s for earnings and “although Companion has not
yet paid taxes on earnings . . . , Companion intends to appropriately account for and resolve any
tax liability associated with such earnings . . . , including any tax liability for earnings on prior
years”).
37
Companion also argues certain of Defendants’ supplemental arguments (discussed below) are
not properly raised because they go beyond the scope of the court’s request, amounting to improper
sur-reply. Specifically, Companion challenges Defendant’s arguments (1) Companion has not
pleaded a claim for relief under the Trust Agreement, and (2) Companion is seeking to avoid the
plain language of paragraph 13 of the 2006 Coverage Agreement (because that paragraph refers to
a Bank of America Account). ECF No. 410 at 2-4.
38
it was, the failure bars receipt of interest and dividends. Id. Alternatively, if an account was
established but funds were not deposited, Companion’s remedy is to seek recovery from State
Street Bank directly, not through a reduction of assets in the State Street Account. Id. Rather than
offering an interpretation of the account statements, Defendants suggest they are unclear as to
whether funds were disbursed. Id. at 4-8.
As to the Florida OIR’s approval or non-approval, Defendants cite communications
demonstrating the Florida OIR responded to Companion’ November 11, 2011 letter (ECF No. 39815), advising that a trust account (rather than a segregated custodial account as proposed in
Companion’s letter) was required and requesting a copy of the trust agreement once the account
was set up. ECF No. 411-2 (Dec. 1, 2011 email from Florida OIR to Companion). The Trust
Agreement was entered into thereafter and was fully executed on March 5, 2012, on which date
Companion sent a copy to the Florida OIR. ECF No. 411-3 (Mar. 5, 2012 email from Companion
to Florida OIR). There is no indication the Florida OIR objected to the Trust Agreement despite
acknowledging receipt in subsequent communications. ECF No. 411-4 (Oct. 10, 2012 email from
Florida OIR referring to receipt of Trust Agreement in March 2012). Thus, the Florida OIR
appears to have accepted the Trust Agreement as written.
Discussion—Issue properly raised. Companion’s request for a judicial declaration as to
its right to earnings on the State Street Account falls within Companion’s first cause of action,
which seeks a “judicial declaration regarding the rights of Defendants with respect to the Collateral
and the obligations of Companion, if any, with respect to the return of that Collateral, if
overfunded.” ECF No. 88 ¶ 49. In order to determine AMS’s rights to funds in the State Street
Account (the only “Collateral” account now at issue) and whether that account is under or
overfunded, the court must determine whether any portion of the funds belong to some other entity.
39
This requires a determination of whether “earnings” in the account belong to AMS or
Companion. 38
Companion is not asserting a “damages” claim or any claim “based on” the Trust
Agreement. The Trust Agreement (like the Florida Consent Order) is, nonetheless, a document
that must be considered in determining the effect of the transfer, at the insistence of the Florida
OIR, of a portion of the Claims Reserve Fund previously held in the Bank of America 4866
Account to a separate trust account at State Street Bank.
Paragraph 13 of 2006 Coverage Agreement. It is undisputed paragraph 13 of the 2006
Coverage Agreement governed AMS’s Claims Reserve Fund prior to entry of the Florida Consent
Order. This paragraph provides “[a]ll earnings on the Claims Reserve Fund shall belong to
[Companion] and no AMS Entity shall have any interest therein. . . . All earnings on funds held
within the Claims Reserve Fund will inure to the benefit of [Companion].” 2006 Coverage
Agreement ¶ 13. Thus, Companion clearly was entitled to earnings on the AMS Claims Reserve
Fund before the Florida Consent Order was entered and AMS’s funds were transferred from Bank
of America 4866 Account to a separate trust account in compliance with that order. The question,
then, is what effect the transfer had on paragraph 13 of the 2006 Coverage Agreement.
It is clear from the sequence of events (and no party disputes) the State Street Account was
established to comply with the Florida Consent Order and the AMS Claims Reserve Fund
38
Companion argues the portion of the account available to secure AMS’s obligations excludes
both earnings (addressed in this section of the order) and funds or other assets contributed by or
for the benefit of a different entity, PPS (addressed in § V below).
40
previously held in the Bank of America 4866 Account was transferred to the State Street Account
as a result of that order. The Florida Consent Order includes the following relevant provision:
The collateral funding received by COMPANION for large deductible
policies shall not be reported on the company’s balance sheet. The funds should be
maintained in a trust account to be funded by the policyholder of the large
deductible workers’ compensation policy and only be used by Companion to settle
paid losses. The notes to COMPANION’s financial statements should disclose the
existence of the trust and period-end balance.
Florida OIR Consent Order ¶ 6(c) (ECF No. 310 (signed and filed March 18, 2011). The State
Street Account was opened and related Trust Agreement executed to comply with this paragraph.
See ECF No. 398-15 (Nov. 29, 2011 letter from Companion to Florida OIR stating Companion
was using a “segregated custodial account” rather than a “designated trust account” as the “most
expedient method of maintaining the funds in a separate manner.”);. ECF No. 411-2 (Dec. 1, 2011
email from Florida OIR to Companion responding that trust account was required and requesting
a copy of the trust agreement once the account was established); ECF No. 411-3 (Mar. 5, 2012
email from Companion to Florida OIR enclosing copy of Trust Agreement); ECF No. 383-9 (Trust
Agreement effective January 31, 2012, but fully executed on March 5, 2012).
Thus, as Companion argues, the State Street Account is, at least in part, a “replacement”
for the Bank of America account referenced in paragraph 13 of the 2006 Coverage Agreement.
See ECF No. 398-8 at 10, 11 (Simpson dep. at 73, 74 stating “I believe prior to the State Street
account [Bank of America 4866 Account] held some of the below deductible Florida collateral”
as well as collateral for other states and some Dallas National collateral). Given its status as a
(partial) replacement account, the terms in paragraph 13 of the 2006 Coverage Agreement remain
in effect as to the State Street Account unless modified by the Florida Consent Order, Trust
Agreement, or some other controlling document.
41
The Florida Consent Order does not address how earnings will be treated. Its language as
to funding and use of funds is ambiguous on whether earnings belong to Companion or the
policyholder(s). For example, while the Consent Order states funds “shall only [be] used by
COMPANION to settle paid losses,” the preceding language states the account will “be funded by
the policyholder,” which may suggest the only “funds” restricted in use are those the policyholder
contributes. Id. at 4. Because the language is ambiguous, it is not sufficient to overcome the clear
language of the 2006 Coverage Agreement, at least absent some other indication of intent.
The only record evidence of the Consent Order’s intent as to earnings is the Florida OIR’s
failure to object to any provision of the Trust Agreement. 39 As discussed below, Sections 4 and 5
of the Trust Agreement refer to AMS’s rights to principal and Companion’s rights to “Trust
Account Income.” Had the Florida OIR intended the Consent Order to preclude Companion from
receiving earnings (thus modifying the earnings provision of the 2006 Coverage Agreement ¶ 13),
it would have objected to these sections of the Trust Agreement.
Section 4(a) states “[t]he Trustee shall surrender for payment all maturing Assets and all
Assets called for redemption and deposit the principal amount of the proceeds of any such payment
to the Trust Account.” Trust Agreement § 4(a). This supports the premise the Grantor (AMS) is
entitled only to principal. Section 5 provides “[a]ll payments of interest and dividends actually
received in respect of Assets in the Trust Account shall be deposited by the Trustee [subject to
certain deductions] in a separate account (the “Income Account”) established and maintained by
39
In an October 2012 email, the Florida OIR acknowledged it received the Trust Agreement in
March 2012. ECF No. 411-4. Nothing in this email or any other record evidence indicates the
Florida OIR either disapproved or indicated a concern with any aspect of that agreement.
42
the Beneficiary at an office of the Trustee.” Trust Agreement § 5. It also provides “[t]he Trustee
shall treat the Beneficiary [Companion] as tax owner of all Trust Account Income.” Id.
Defendants do not challenge Companion’s right to interest and dividends under Section 5
if the funds are transferred immediately to a separate account. They, instead, argue Companion’s
failure to establish an Income Account and enforce this provision by immediate transfer constitutes
a waiver of the right to earnings. The court disagrees. Defendants’ position would work a
forfeiture of Companion’s rights and windfall to Defendants. Defendants point to no authority
that would support such a result.
The court is, likewise, not persuaded by Defendants’ argument Companion waived its
present claim, or at least indicated a contrary intent, by listing the full account value of the State
Street Account (which included earnings) on its annual reports as the value of the collateral
account. The reports are accurate as to the value of the account, which is a collateral account,
though arguably misleading or at least incomplete because they fail to disclose that some portion
of the account is earnings Companion claims a right to withdraw. This may require a future
correction of earlier reports or explanation of reduction in value when the funds are withdrawn,
but does not warrant a finding of forfeiture.
In sum, (1) the 2016 Coverage Agreement provides Companion is entitled to all earnings
on the Claims Reserve Fund; (2) the Florida Consent Order and subsequent directions from the
Florida OIR required a portion of the Claims Reserve Fund be transferred to a trust account but
did not address earnings; (3) the Trust Agreement subsequently entered establishing the required
account gave Companion the right to “interest and dividends” as well as “trust account income,”
specified Companion was the owner for purposes of taxes on income, and indicated only principal
would be returned to the account upon the sale of assets; and (4) the Florida OIR did not object to
43
any term in the Trust Agreement. Thus, the only documents addressing earnings support the
conclusion Companion is entitled to earnings on funds deposited by or on behalf of AMS in the
Claims Reserve Fund. While the Trust Agreement is most express as to interest and dividends, it
may be read as entitling Companion to all earnings. At the least, it does not preclude that
interpretation. Thus, it does not override the broad earnings provision in the 2006 Coverage
Agreement. Accordingly, the court finds Companion is entitled to all earnings on AMS funds held
in the State Street Account. 40
V.
AMS’s entitlement to funds held in the State Street Account.
Companion’s opening argument. In addition to seeking a declaration as to its own
entitlement to earnings on the State Street Account, Companion seeks a declaration funds do not
automatically become the property of AMS simply because they are deposited into this account.
ECF 382 at 4, 18-22. It asserts some of the funds in the account belong to Professional Payroll
Solutions (“PPS”), a separate entity from, though related to, AMS. 41 Companion seeks this ruling
based on evidence some funds belonging to PPS were contributed to the State Street Account to
40
The court does not address whether Companion is entitled to earnings on any PPS funds that
may be in the State Street Account. Such a determination must be made in litigation to which PPS
is a party. The present determination is, however, sufficient for purposes of the remaining issues
in this action as it establishes AMS is not entitled to any earnings on the account. Thus, in
determining whether the AMS Claims Reserve Fund is under or overfunded, earnings should be
excluded from the value of the account.
41
PPS is not listed as a party to the 2006 Coverage Agreement. See 2006 Coverage Agreement ¶
1. Companion describes PPS as a “separate entity with its own high-deductible policies written
on Companion policy forms. ECF No. 382 at 4.
44
cover PPS’s collateral obligations. 42 Companion asserts that, since their deposit, these funds have
“been paid, tracked and accounted for separately.” ECF No. 382 at 19.
Companion characterizes AMS’s position, that all funds in the account belong to AMS, as
based on a legal fiction the Trust Agreement between Companion, AMS, and State Street Bank
converts PPS funds into AMS funds. Id. As Companion notes, the Trust Agreement defines
“Assets” in Section I as follows:
The Grantor shall transfer to the Trustee, for deposit in the Trust Account [specified
categories of assets], and may transfer to the Trustee, for deposit to the Trust
Account such other assets as it may from time to time desire (all such assets
actually received in the Trust Account are herein referred to individually as an
“Asset” and collectively as the “Assets”).
42
Companion relies on testimony of its employee, Laura Simpson, that some PPS funds were
deposited to the State Street Account. Asked why the collateral funds of AMS and PPS were comingled, Simpson responded “I believe at the time it was unclear whether or not PPS was an AMS
Entity.” Simpson dep. at 128 (ECF No. 382-4 at 2). Simpson explained that, when “the funds
were transferred into the AMS State Street account it was broken out between AMS and PPS[.]”
Id. at 183 (ECF No. 382 at 4). Thus, this testimony suggests some PPS collateral funds were
transferred, apparently by Companion, to the State Street Account based on a mistaken belief PPS
was an AMS Entity as defined in the 2006 Coverage Agreement. Companion does not point to
evidence of any later transfers.
Emails between employees of Wood-owned entities support Companion’s position the
parties treated PPS and AMS obligations relating to the underlying policies separately, at least in
and after June 2013, although those emails refer to premium payments rather than collateral. See
ECF No. 383 (June 21, 2013 email string between Kara Childress and Kristin Wynn distinguishing
between premiums for AMS Florida and PPS Florida policies); ECF No. 383-1 (Kristin Wynn
email from later the same day referring to spreadsheet prepared by Companion employee as the
“better sheet to use” because it “breaks it down nicely into AMS and PPS.”). On the other hand,
communications between employees of Wood-owned entities may acknowledge the collective
holding of AMS and PPS collateral. See ECF No. 383-4 (Wood-owned entity employee referring,
in January 30, 2013 email, to various collateral accounts as falling into three buckets, one of which
was “AMS/PPS”). These emails support both the separateness of AMS and PPS and the view they
are at least affiliated entities if not co-owned as of January 30, 2013.
45
Trust Agreement § I (b) (emphasis added). Companion relies on this language to argue the Trust
Agreement defines the “Assets” covered by the Trust Agreement as only those Assets Grantor
(AMS) transferred to the Trustee. Id. at 21.
Defendants’ response.
Defendants oppose Companion’s interpretation of the Trust
Agreement, arguing that interpretation is contrary to its purpose and plain language. They also
argue “Companion has failed to offer credible evidence . . . [PPS] actually deposited any collateral
funds into the State Street trust account.” ECF No. 398 at 26.
On the first point, Defendants point to events leading to establishment of the Trust Account,
including Companion’s concession in the Florida Consent Order that it had improperly co-mingled
large deductible collateral funds from AMS with “other company funds.” See Id. at 26, 27
(discussing Companion’s November 29, 2011 letter to the Florida OIR stating Companion had
established a separate segregated account for the AMS Staff Leasing collateral and indicating a
belief this was sufficient to satisfy the trust account requirements of the Consent Order, and
subsequent execution of the Trust Agreement governing the State Street Account). 43 Relying on
the limited purposes for which the “Assets” may be used, Defendants argue all assets in the account
must be used solely by or for the benefit of AMS. Defendants characterize Companion’s requested
relief as seeking a “declaration [Companion] may commingle PPS collateral in the AMS trust
account” and asserting such relief would “contravene the purpose and plain terms of the Trust
Agreement.” Id.
43
As discussed above (Discussion § IV), the Florida OIR insisted in a December 1, 2011 email
that Companion establish a trust account to hold collateral for Florida policies rather than relying
on a segregated custodial account.
46
On their second point, Defendants argue Companion has failed to produce “any bank
records, wire transfer receipts, or other original documentation to substantiate” its claim that the
Trust Account includes PPS funds. Defendants assert the records on which Companion relies
consist primarily of an actuary’s report on collateral requirements and communications relating to
premiums rather than collateral. Id. at 28. Defendants also point to evidence PPS collateral was
deposited in the Bank of America 4866 Account and absence of evidence PPS has asserted any
rights to the funds in the State Street Trust Account. Finally, Defendants point to documents in
which Companion has referred to the State Street Account as holding AMS funds or as the “AMS
State Street Account.” Id.
Companion reply. In reply, Companion notes Defendants’ failure to affirmatively state
that AMS provided all collateral in the State Street Account and argues the court should allow the
Independent Accountant to determine what portion of the collateral, if any, was contributed by or
for the benefit of PPS. ECF No. 400 at 12. Companion argues Defendant’s position, that funds
deposited in the State Street Account automatically become AMS’s collateral even if deposited by
or on behalf of a third party (“either by design or by accident”), is “illogical, unfair, and not
supported by the Trust Agreement on which they singularly rely.” ECF No. 400 at 13. Companion
points to both the absence of any express provision supporting this conversion argument and
language indicating AMS has rights only to assets it transfers into the account. Finally, Companion
asserts the result sought by AMS would be to the detriment of PPS, which is not a party to this
action.
Discussion. The events leading to creation of the State Street Account and execution of
the related Trust Agreement suggest this account was intended to hold only AMS collateral, not
collateral for any non-AMS entity. That said, nothing in the Trust Agreement supports AMS’s
47
position any funds deposited into the account automatically convert to AMS funds, regardless of
the source of the funds or intended purpose at the time of the deposit.
To the extent any language addresses the source of funds, it is in defining “Assets” in a
paragraph that refers to securities and other assets the “Grantor shall transfer to the Trustee, for
deposit in the Trust Account[.]” This and other language relating to use of funds supports the
conclusions (1) the account should have been used solely for AMS collateral and (2) PPS funds
should not have been placed into the account. It does not address the proper remedy if non-AMS
funds are deposited.
Thus, it does not support the extraordinary remedy AMS proposes,
conversion of funds, as opposed to the more routine remedy of return of the improperly deposited
funds so that they might be deposited into the proper claims reserve account. AMS’s preferred
approach would, in any event, be improper without first joining the entity whose funds would be
taken (PPS).
Though minimal, the evidence to which Companion points suggests PPS funds were or
may have been deposited into the State Street Account due to Companion’s mistaken belief PPS
was an AMS entity. See Simpson dep. at 128 (ECF No. 382-4 at 2). While the source of this
apparent confusion is unclear, emails between employees of Wood-owned entities indicate a level
of common treatment at least in January 2013. See ECF No. 383-4 (stating “at the end of the day
we should have 3 Entity Buckets” and listing “AMS/PPS” as one of three entities, the other two
being Dallas National and Redwood, but noting there were “line of business buckets” within the
entities). In contrast, emails in May and June 2013 address these entities’ relative responsibilities
referring to what may have been a recent division of clients between the entities See, e.g., ECF
Nos. 400-1 (email from Lisa Lott to Kristin Wynn stating “[t]his is the shortfall in collateral
required related to the staff leasing AMS/PPS policies and we discussed that it was truly PPS
48
costs” and Wynn’s response stating “[a]ll things for [PPS] should be in the related party account[.]
. . . There is no money to be had at all. It simply will go into the what [R]ich owes [D]ave
bucket[,]” explaining future “transactions” should be split based on who kept the clients, and
indicating the relative responsibilities would be resolved by a future accounting between PPS and
AMS); ECF No. 383-1 (June 2013 email from Wynn stating an attachment from Companion
“breaks [premium obligations] down nicely into AMS and PPS”).
Accordingly, the court grants Companion’s request for declaratory relief that funds held in
the State Street Account are not automatically the property of AMS simply by virtue of their
deposit into that account. Funds in the account may, instead, be found to be improperly deposited
funds belonging to a different entity. Whether funds were deposited on behalf of another entity
and, if so, the amount of such funds will be resolved by the Independent Accountant.
VI.
Wood’s obligation to indemnify Companion for attorney’s fees and expenses.
Companion’s opening argument. Companion seeks a declaration Wood is obligated to
indemnify Companion for all reasonable attorney’s fees and expenses (“Fees and Expenses”)
incurred in connection with this case. 44 Companion argues an award of all Fees and Expenses is
supported by both subparts of the Indemnity Provisions in the Wood Guaranty. See Wood
Guaranty ¶ II.A. (listing “reasonable attorney’s fees” as recoverable “costs and expenses” under
subpart providing indemnification for claims, losses, etc. arising out of or relating directly or
indirectly to the Subject Agreements); Id. ¶ II.B. (agreeing to “pay all reasonable expenses,
44
Companion does not seek an award of Fees and Expenses at this juncture. It, instead, seeks a
preliminary ruling as to the scope of Fees and Expenses covered by the Wood Guaranty.
49
including without limitation, attorney’s fees and other legal expenses, paid or incurred by
[Companion] in collecting amounts owed hereunder or otherwise enforcing” the Wood Guaranty).
Companion argues these provisions provide for broader relief than under a fee-shifting
statute because they do not impose a requirement Companion be the prevailing party or incorporate
any requirement Companion not be at fault for events giving rise to a claim for indemnification.
Companion relies on the “expansive” language used, which covers claims, damages, and losses
(etc.) “arising out of or otherwise relating to, directly or indirectly, the Subject Agreements.” ECF
No. 382 at 23, 24 (citing, e.g., Am Recovery Corp. v. Computerized Thermal Imaging, 96 F.3d 88,
93 (4th Cir. 1996)). It argues the clause “directly or indirectly” supports a particularly broad
reading. Id. at 24, 25 (citing Chevron USA, Inc. v. Aker Maritime Inc., 689 F.3d 497, 506 (5th Cir.
2012) for proposition the word “indirectly” may reach the entire litigation if the Subject
Agreements are “indirectly related to . . . actions that resulted in the obligation to indemnify”).
Companion also points to the nature of the relationship (a fronting program) and the parties’ stated
intent in both the 2006 Coverage Agreement and the Wood Guaranty to protect Companion from
all liabilities and expenses as a basis for construing the Fees and Expenses provisions broadly. Id.
at 25, 26.
Companion maintains “all of its attorney’s fees and expenses ‘aris[e] out of or otherwise
relate[] to, directly or indirectly,’ the 2006 Coverage Agreement and/or the Policies, and/or have
been ‘paid or incurred by [Companion] in collecting amounts owed [under the Wood Guaranty] or
otherwise enforcing’” the 2006 Coverage Agreement and Policies. Id. at 26-28. It also aserts each
of the non-jury issues now before the court relates directly or indirectly to the 2006 Coverage
Agreement or Policies and maintains the same is true for “any other claims made, liabilities
incurred and losses suffered [that] have been substantially litigated in this case.” Id.
50
Companion argues Fees and Expenses should be awarded, even for its claim for breach of
fiduciary duty (seeking recovery from Highpoint and Wood for damages flowing from dualcoverage policies), which failed to survive summary judgment, because that claim arose out of or
relates, directly or indirectly, to the Subject Agreements. Id. at 29. In furtherance of this argument,
Companion asserts the below-deductible portions of these claims must be funded by AMS pursuant
to ¶ 12 of the 2006 Coverage Agreement, collateral must be funded under ¶ 13, premiums must be
remitted pursuant to ¶ 11, and fronting policy issuance fees must be paid pursuant to ¶¶ 9 and 10. 45
Finally, Companion argues claims associated with PayGo Policies are covered, despite
being stayed and ultimately dismissed. It asserts the Fees and Expenses relating to these claims
“are relatively insignificant” as a result of the stay, but argues they are recoverable because they,
also, arise from or relate to the 2006 Coverage Agreement. ECF No. 382 at 29, 30 n.63.
Defendants’ Response. Defendants raise two arguments in opposition. First, they argue
the indemnification provision in the Wood Guaranty cannot support fees because, under South
Carolina law, indemnification (including for attorney’s fees) applies only to third-party claims
absent express language to the contrary. Defendants argue what Companion seeks here amounts
to an automatic fee-shifting provision, which, they maintain, is not supported by any provision in
the 2006 Coverage Agreement or indemnification language in the Wood Guaranty.
45
These arguments appear to correspond with a theory of recovery for certain losses resulting
from the same dual-coverage policies Companion advanced, for the first time, shortly prior to the
scheduled trial. The court addressed this theory at a conference held following jury selection,
holding it would not be presented to the jury because it was not a part of this litigation. See
Transcript of April 12, 2017, post-jury selection conference at 22-24, 31, 32.
51
Second, Defendants argue attorney’s fees and expenses should not be awarded to the extent
Companion was unsuccessful on its claims and defenses. Defendants assert “Companion exerted
substantial time and energy . . . pursuing meritless claims against Wood and AMS” that were
ultimately rejected including by adverse summary judgment rulings on Companion’s attempt to
recover for Dallas National collateral shortfall under the Wood Guaranty and breach of fiduciary
duty action (for dual coverage) against Highpoint and Wood. They argue, in effect, that allowing
recovery for failed claims would encourage pursuit of frivolous claims.
Companion’s reply.
In reply, Companion argues Defendants’ position as to the
availability of indemnification generally ignores the specific language of the Wood Guaranty,
which includes a broad indemnification clause as to claims, losses, or liability arising from or
relating directly or indirectly to the Subject Agreements as well as a fee-shifting provision for
enforcement of the Wood Guaranty.
Discussion. The Wood Guaranty includes two distinct fee-shifting provisions that provide
Companion with overlapping, though distinct protections.
The first provision indemnifies
Companion “from and against any and all claims, suits, hearings, proceedings, actions, damages,
liabilities, fines, penalties, losses, costs or expenses, including without limitation reasonable
attorney’s fees, at any time arising out of or otherwise related to, directly or indirectly, the Subject
Agreements.” Wood Guaranty ¶ II.A. For reasons explained in Section III of this order, even if
limited to third-party claims, this provision reaches claims between Companion and Defendants
other than Wood, because no other Defendant is a party to the Wood Guaranty. While this
subparagraph does not impose any requirement Companion be successful on the merits or faultless,
the wording (protecting Companion “from and against” suits, damages, liabilities, etc.) presumes
Companion is defending a claim. Thus, Companion may rely on this provision to the extent it
52
incurred Fees and Expenses in defending a counterclaim, regardless of whether it was successful
in that defense (presuming reasonableness is otherwise satisfied), but may not rely on it to recover
Fees and Expenses in claims it pursued. 46
The second fee-shifting provision, found in paragraph II.B., requires Wood to “pay all
reasonable expenses, including without limitation, attorney’s fees and other legal expenses, paid
or incurred by Company in collecting amounts owed hereunder or otherwise enforcing this
Agreement.” Unlike the first sub-paragraph, this paragraph presumes Companion is the party
seeking relief rather than defending a claim and requires an element of success as it refers to
expenses incurred “in collecting amounts owed” or “otherwise enforcing this Agreement.” As
“this Agreement” covers both the Guaranty Provision and Indemnity Provision, Companion may
obtain Fees and Expenses from Wood under paragraph II.B. in two circumstances: (1) Companion
successfully pursued a claim against Wood under the Guaranty Provision (with incorporated Fees
and Expenses necessary to prove the underlying failure of an AMS Entity to perform its contractual
obligations under the Subject Agreements); or (2) Companion successfully pursued enforcement
of paragraph II.A. (thus, successfully pursued a claim for Fees and Expenses for defending a
counterclaim in this action). 47
46
While success on the merits is not necessarily a prerequisite to relief under paragraph II.A., the
degree of success may be a factor in determining the reasonableness of the fees. See generally
Robinson v. Equifax Information Svcs, LLC, 560 F.3d 235, 245 (4th Cir. 2009) (reaffirming use of
twelve factors set out in Barber v. Kimbrell’s Inc., 577 F.2d 216, 226 n. 28 (4th Cir. 1978)).
47
The second of these (recovery under ¶ II.B. for Fees and Expenses allowed under II.A.) may be
largely redundant of the relief available under paragraph II.A. itself, though it covers the Fees and
Expenses incurred in enforcing, through paragraph II.B., the rights to Fees and Expenses otherwise
available under II.A.
53
Neither subparagraph indemnifies Companion for Fees and Expenses it incurred pursuing
claims that did not result in any recovery for Companion (at least absent a corresponding
counterclaim). Thus, neither supports an award of Fees and Expenses in pursuing claims (without
corresponding counterclaims) that were resolved against Companion on summary judgment.48
The same is true for Companion’s claims that were dismissed from this action. 49
Beyond the limited rulings provided above, the court makes no ruling as to entitlement to
Fees and Expenses here. That determination must await resolution of claims following receipt of
the reports of the Independent Actuary and Independent Accountant.
CONCLUSION
For the reasons set forth above, the court:
1.
Denies Defendants’ request for declaratory relief as to Companion’s obligation to provide
information and notification or consultation;
2.
Grants Companion’s request for a declaration Wood is obligated to guarantee AMS’s
below-deductible payment and collateral obligations and to do so within the timeframes addressed
in Section II of this order;
48
The court granted Defendants’ motion for summary judgment on Companion’s thirteenth cause
of action for breach of fiduciary duty (dual coverage issues) in full, fourteenth cause of action for
violation of the South Carolina Unfair Trade Practices Act to the extent it overlapped with the
thirteenth cause of action, and fifteenth cause of action on the Wood Guaranty to the extent it
related to Dallas National’s collateral obligations. ECF No. 258 at 24-29, 32-42, 45, 46.
49
This court first stayed and later dismissed multiple claims relating to Pay-Go policies, largely
but not entirely in deference to the first-filed Texas Action. ECF No. 258 at 44, 45. The Texas
Court denied at least two motions to transfer venue to this district based, in part, on a finding the
Pay-Go policies were not governed by the 2006 Coverage Agreement (and its forum selection
clause). This court deferred to the Texas Court as to that issue, which would also lead to the
conclusion the claims are not subject to the Wood Guaranty.
54
3.
Grants Companion’s request for a declaration Wood is obligated under the Wood Guaranty
to indemnify Companion for liability Companion incurs for unreimbursed above-deductible claims
payments made from AMS funds;
4.
Grants Companion’s request for a declaration Companion is entitled to all earnings,
including reinvested earnings, accrued on the Claims Reserve Fund in the State Street Account.
5.
Grants Companion’s request for a declaration funds in the State Street Account do not
automatically become the property of AMS simply by virtue of their deposit into that account; 50
6.
Grants in part and denies in part Companion’s request for a declaration Companion is
entitled to attorney’s fees and expenses incurred in this action, with the determination of the
propriety and amount of any award being reserved until after completion of the Initial Reviews by
the Independent Actuary and Independent Accountant.
IT IS SO ORDERED.
s/ Cameron McGowan Currie
CAMERON MCGOWAN CURRIE
Senior United States District Judge
Columbia, South Carolina
July 20, 2017
50
Whether funds were deposited on behalf of another entity and, if so, the amount of such funds
is an issue reserved for determination by the Independent Accountant.
55
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