Mohnkern v. Professional Insurance

ALICE M. BATCHELDER, Circuit Judge,

dissenting.

I respectfully dissent from the majority’s decision to deny Janet Mohnkern attorney’s fees under Fla. Stat. § 627.428. As the majority recognizes, (Maj. Op. at 162-63), Mohnkern satisfies the only requirements for such recovery as set forth by the plain text of § 627.428(1): She was the assignee — beneficiary of a life insurance policy, she was compelled to sue to enforce her rights, and the litigation resulted in a determination that she was entitled to the policy proceeds. Because § 627.428 is applicable to this case, and because the district court that ordered PIC to pay NES instead of Mohnkern was without authority to resolve the issue, Mohnkern is entitled to attorney’s fees.

As the Supreme Court of Florida has recognized, “[i]f the dispute is within the scope of [§ ] 627.428 and the insurer loses, *164the insurer is always obligated for attorney’s fees.” Ins. Co. of N. Am. v. Lexow, 602 So.2d 528, 531 (Fla.1992) (emphasis added). In determining whether a dispute comes within the scope of § 627.428, Florida courts look to the purpose of the statute, which is “to discourage the contesting of valid claims against insurance companies and to reimburse successful insureds for their attorney’s fees when they are compelled to defend or sue to enforce their insurance contracts.” Id. at 531. Thus, the statute serves two general purposes: to deter insurers from taking actions that compel insureds into litigation (by punishing those that do), and to compensate the insureds when they are so compelled.

Examining the current case under this rubric, it is clear that the compensatory purpose of § 627.428 is applicable. As the majority acknowledges, “Mohnkern was compelled to sue to enforce her rights under the Blacknell policy.” Maj. Op. at 162. As a result, at the time of settlement Mohnkern had paid $56,147 in attorney’s fees and litigation costs to recover the $100,000 on the policy for which she had initially paid $49,995.

As to the deterrent or punitive purpose, a brief review of PIC’s actions is helpful. PIC informed Mohnkern on January 3, 2002, that it was ready to pay her the Blacknell Policy proceeds, and that such payment would take place upon resolution of an unrelated collateral matter.1 The following day, Lynn Day from NES emailed Scott Holman at PIC; Day was trying to “wrap [Mohnkern’s] file up,” and wanted to know if PIC had decided to pay Mohnkern the policy proceeds. Within ten minutes, Holman replied that based on the collateral assignment, PIC had authorized payment to Mohnkern. Holman went on to say, “[i]f you believe this decision is incorrect please let me know as soon as possible.” This solicitation of advice was entirely unprompted, as Day had made clear that she was asking for an update only for the purpose of wrapping up Mohn-kern’s file, not to weigh in on the issue. Nonetheless, a few hours later, Day replied that it was the federal court-appointed Receiver’s position that “the court must okay the payment of this benefit,” and that the Receiver was “putting a motion before the court today for direction.” PIC agreed to await action by the Receiver and the district court. This led to the court order, which then led to PIC’s paying the policy proceeds to NES, not Mohnkern.

I think it is clear that the punitive or deterrent purpose of § 627.428 is well served on these facts. Despite having determined that Mohnkern was entitled to the proceeds, PIC chose to involve NES and the Receiver in the process instead of paying Mohnkern the proceeds as required under the insurance contract, with the result that Mohnkern was forced to initiate this litigation. Accordingly, this case is within the scope of § 627.428, and, because Mohnkern prevailed, PIC is obligated for attorney’s fees. See Lexow, 602 So.2d at 531 (“If the dispute is within the scope of [§ ] 627.428 and the insurer loses, the insurer is always obligated for attorney’s fees.”).

The cases relied on by the majority do not undermine this conclusion. They merely prove that § 627.428 does not award attorney’s fees to every insured-beneficiary who ultimately prevails in litigation, a point that I am willing to concede. But that is not determinative of whether Mohnkern is entitled to attorney’s fees under § 627.428 based on the facts and circumstances of this case. My read*165ing of the Florida case law, including all of the cases cited in the majority opinion, indicates that § 627.428 does not award attorney’s fees to a victorious insured-beneficiary only where the insurer did not wrongfully deny benefits, and that the Florida courts have applied this exception to § 627.428’s awarding of fees only in two distinct factual settings, neither one of which applies to this case.

First, the Florida courts have found that the insurer did not wrongfully deny benefits where, at the time the insurer was alleged to have denied benefits, it was under no obligation to pay. For example, in Liberty National Life Ins. Co. v. Bailey, 944 So.2d 1028 (Fla.Dist.Ct.App.2006), which the majority cites at Maj. Op. at 161-62 n. 2, the insured submitted a claim form and treating physician’s statement that erroneously reflected her illness as predating her policy, which caused the insurer to deny her claim. When the insured brought suit before attempting to correct or explain the errors in her submissions, she was not entitled to attorney’s fees under § 627.428, because “upon receipt of [the insuredj’s initial claim, [the insurer] had no obligation to pay.” 944 So.2d at 1030; see also Time Ins. Co. v. Arnold, 319 So.2d 638 (Fla.Dist.Ct.App.1975) (same general fact pattern as Bailey and cited by the majority at Maj. Op. at 161-62 n. 2). Additionally, in Tristar Lodging, Inc. v. Arch Speciality Ins. Co., 434 F.Supp.2d 1286 (M.D.Fla.2006), cited by the majority at Maj. Op. at 161-62 n. 2, at the time the insured filed suit, the insurer had already paid a number of claims and was in the process of adjusting the remaining claims. The court declined to award attorney’s fees because there was no indication of when the remaining claims were due and payable, and therefore, it was impossible to say that the insurer had failed to pay timely. With no breach of a duty to pay, benefits were not wrongfully denied or withheld, and attorney’s fees were not appropriate. 434 F.Supp.2d at 1294-1301.

Clearly, PIC is not helped by this line of cases, and the majority is mistaken to conclude otherwise. There is no dispute that, at the time PIC paid NES the Black-nell Policy proceeds, PIC was under a contractual obligation to pay Mohnkern those proceeds. Mohnkern submitted all of the necessary paperwork to claim her benefits, and PIC informed Mohnkern that it had approved her receipt of the benefits. Furthermore, as I will explain below, PIC was not relieved of this obligation by the district court’s order instructing it to pay NES.

The majority similarly errs in its reliance on Government Employees Ins. Co. (GEICO) v. Battaglia, 503 So.2d 358 (Fla.Dist.Ct.App.1987), which falls squarely within the no-duty-to-pay line of cases. In Battaglia, the insured, who had uninsured motorist coverage through GEICO, was injured in a collision with the tortfeasor, who had liability coverage through Florida Farm Bureau (“FFB”). The insured filed an action against the tortfeasor and FFB. After one year of litigation, the tortfeasor disappeared and refused to cooperate, causing FFB to deny coverage on the basis that its defense had been prejudiced by the tortfeasor’s actions. After this denial, the insured sought arbitration on its uninsured motorist policy. With no opposition from GEICO, arbitration was granted. But prior to the final hearing date, GEICO located the tortfeasor, who was then deposed by counsel for all interested parties — GEICO, FFB, and the insured. FFB reinstated coverage for the accident, and, as a result, GEICO moved for a stay of arbitration and initiated a declaratory judgment action seeking a determination that it was not liable for the uninsured motorist coverage due to the availability of *166FFB’s coverage. The court granted a stay of arbitration but dismissed both sides’ motions for summary judgment in the declaratory judgment action. Thereafter, the tortfeasor again disappeared, once again causing FFB to deny coverage based on the tortfeasor’s lack of cooperation. After this denial of coverage by FFB, the insured filed a motion for summary judgment in the declaratory judgment action seeking a determination that he was entitled to the uninsured motorist coverage from GEICO. The court entered summary judgment to that effect, and also granted insured attorney’s fees under § 627.428.

The Florida district court of appeals reversed the attorney’s fees determination, finding that GEICO never wrongfully denied coverage. The court reasoned:

At the times FFB was affording coverage, GEICO was not obligated to do so. From [the time the trial court stayed the arbitration after FFB’s reinstatement of coverage], until FFB again denied coverage [after tortfeasor disappeared for the final time], there was no coverage obligation on the part of GEI-CO. It was eminently reasonable for GEICO to seek resolution of that fact by declaratory judgment and to obtain a stay of arbitration during that period. Given the last coverage denial by FFB ... GEICO did not deny coverage or reject arbitration. It did resist the imposition of attorney fees against it, which it had every right to do.

503 So.2d at 360-361. In other words, because the insured had only uninsured motorist coverage through GEICO, GEI-CO was obligated to pay on that policy only if FFB denied coverage. After FFB reinstated coverage, GEICO was not obligated to the insured for any coverage and it was therefore not a wrongful denial of coverage to seek a declaratory judgment to that effect and a stay of arbitration on that basis. Clearly, as with Bailey and Tristar, the rationale of Battaglia in denying attorney’s fees was that the insurer did not wrongfully deny benefits to the insured because, during the time in question, the insurer was under no duty to pay the insured. Thus, for the same reasons Bailey and Tristar are inapplicable to the current case, so is Battaglia.

The second factual setting in which the Florida courts have found no wrongful denial of coverage is where the insurer does “not deny liability but simply bec[o]me[s] involved in a dispute over which of two claimants [i]s entitled to the benefits of the policy,” and a court conclusively decides the issue. Lexow, 602 So.2d at 531 (citing Manufacturers Life Insurance Co. v. Cave, 295 So.2d 103 (Fla.1974); Equitable Life Assurance Society v. Nichols, 84 So.2d 500 (Fla.1956)); see also Manufacturers Life Insurance Co. v. Cave, 295 So.2d 103 (Fla.1974); Crotts v. Bankers & Shippers Ins. Co., 476 So.2d 1357 (Fla.Dist.Ct.App.1985). Among these cases, the majority relies on Nichols and Crotts. Maj. Op. at 5-6 n. 2. In Nichols, the insured, prior to his death, changed the beneficiary of his life insurance policy from his surviving spouse, Walsh, to Nichols. After the insured’s death, Walsh contested the change of beneficiary arguing that the decedent had been unduly influenced by Nichols. The insurer attempted to reach a settlement between the parties, but when this failed, both Walsh and Nichols filed suits at law to recover the policy proceeds. The insurance company filed a cross-bill of inter-pleader, which was dismissed because the court determined that consolidating the cases brought by Walsh and Nichols would suffice. The Supreme Court of Florida upheld the lower court’s determination that Nichols was entitled to the benefits, but reversed its determination that Nichols was entitled to attorney’s fees under a *167prior (and nearly identical) version of § 627.428.2 The Court reasoned:

The insurance company admitted liability under the policy but declined to pay either claimant until the dispute between them had been settled, either by negotiation or judicial fiat. The facts would have supported a bill for inter-pleader, had one been timely filed, and thus there was no “wrongful” refusal to pay the proceeds of the policy to the appellee Nichols.

84 So.2d at 502 (emphasis added).

Likewise, in Crotts v. Bankers & Shippers Ins. Co., the insured was injured in a motorcycle accident and transported to a hospital, where, upon his arrival, he signed an assignment to the hospital of “the insurance hospital benefits due me.... ” He signed a second, identical form when he was readmitted. Two months later, the insured, through counsel, requested that his entire no-fault insurance benefits be paid to him as disability benefits, rather than medical benefits, and the insurer commenced biweekly disability payments to him. Approximately eight months later, the insured requested that he be paid the entire remaining $5,920 balance of the policy because he was then considered permanently disabled. Before this lump sum payment was made, the hospital informed insurer of its claim to the proceeds based on the assignments signed by the insured. The insured eventually sued the insurer to receive the proceeds, at which time the insurer filed a third-party complaint against the hospital for interpleader and declaratory relief. The hospital then filed a counterclaim against insured for unpaid hospital bills. The trial court granted summary judgment to the insured on his claim for the policy proceeds and to the hospital on its claim for unpaid bills. The court denied the insured attorney’s fees. The Florida district court of appeals affirmed the denial of fees, reasoning that because the insurer was faced with competing claims to the policy proceeds that involved “factual and legal issues which the insurance company could not reasonably be expected to resolve on its own, the insurance company was not wrongful in withholding payment and forcing the conflict into court.” 476 So.2d at 1359.

To determine whether Nichols and its progeny apply to the instant case, the nature of the district court’s involvement in this case must be examined. The record reflects that Mohnkern’s right to the proceeds of the insurance policy had entirely vested in her by virtue of an absolute assignment before there was any receivership estate, and neither PIC nor Mohn-kern was a party to the action in which the district court issued its order instructing PIC to pay NES. As a result, the district court was without authority to adjudicate entitlement to the policy proceeds, or to order PIC to make such payment to NES. Indeed, an examination of receivership law confirms this point. It is “well settled” that a court “cannot by its order take property from the actual possession of a stranger to the action in which a receiver is appointed who claims title to it or right to its possession.” 2 Clark on Receivers *168§ 636 (3d ed.1959).3 Such an order violates due process, Liberte Capital Group, LLC v. Capwill, 421 F.3d 377 (6th Cir.2005) (holding Mohnkern’s due process rights violated), and is therefore void, 2 Clark on Receivers § 636. Indeed, for a receiver to obtain possession of property from a non-party, such as the policy proceeds from PIC, the receiver:

must either proceed by suit in the ordinary way to try his right to it, or the complainant or petitioner in the main suit should make such third person a party to the main suit and apply to have the receivership extended to the property in his hands so that an order for the delivery of the property may be made which will be binding, and which may be enforced by process of contempt if not obeyed.

2 Clark on Receivers § 628 (3d ed.1959). Quite clearly, the single motion filed by the Receiver and the resulting court order were wholly insufficient to divest Mohn-kern of her property interest in the proceeds and to compel a nonparty, PIC, to pay the proceeds to NES.

Because the district court was without authority to resolve the issue, PIC’s payment to NES — and denial of payment to Mohnkern — occurred prior to any conclusive resolution of the issue of which party was entitled to the policy proceeds. This stands in stark contrast to Nichols and Crotts, where attorney’s fees were denied because the insurer acknowledged its duty under the policy but withheld payment from the competing parties until their claims were conclusively resolved by the court. In Nichols and Crotts, the insurer forced the claims into court, allowing all parties the opportunity to present their claim to the proceeds and enabling the court’s judgment on the matter to bind all parties. Here, PIC did not force the dispute into court, but instead simply paid NES and washed its hands of the matter. Because neither Mohnkern nor PIC was a party to the receivership case, neither had the opportunity to present any arguments to the district court, and the court’s order on the issue did not bind either party.

The majority is also incorrect to rely on the language from decisions by intermediate Florida appellate courts that find the punitive purpose of § 627.428 inapplicable when “the claim is one that the [insurer] reasonably can expect to be resolved by a court, rather than by itself.” Maj. Op. at 162 (citing Battaglia, 503 So.2d at 360). The Supreme Court of Florida has rejected this argument, stating:

We reject the argument that attorney’s fees should not be assessed against [the insurer] because this dispute involved a type of claim which reasonably could be expected to be resolved by a court. *169[The insurerj’s good faith in bringing this suit is irrelevant. If the dispute is within the scope of section 627.428 and the insurer loses, the insurer is always obligated for attorney’s fees.

Lexow, 602 So.2d at 531. PIC, therefore, cannot escape liability for attorney’s fees by arguing that it was reasonable to allow a court to determine whether the policy was affected by the Receivership estate. And in any event, PIC could not rely on that ground here because, as I detailed above, PIC did not — nor did it attempt to — have the issue properly resolved by a court.

Accordingly, there is no basis for denial of Mohnkern attorney’s fees under § 627.428. She meets all of the statutory requirements for recovery of those fees. The compensatory purpose of the statute is well served in this case because Mohn-kern was forced to spend $56,147 in attorney’s fees and litigation costs to recover the $100,000 on the policy for which she had initially paid $49,995. The punitive purpose of the statute is well served because PIC, despite having determined that Mohnkern was entitled to the proceeds, voluntarily and with virtually no advance notice to Mohnkern, breached its obligation under the policy by remitting the proceeds to a third-party that had no legal right to them. Furthermore, PIC should not be permitted to escape this liability based on the involvement of the district court, because the matter was never properly before the court. Finally, because there is no other basis under Florida law by which PIC can escape liability, I would reverse the district court and award Mohn-kern attorney’s fees under § 627.428.

. The collateral matter was the question of whether PIC should refund to NES or Mohn-kern premium payments that had been made after Blacknell’s death.

. Section 625.08, Fla.Stat.1953, F.S.A. provided that:

Upon the rendition of a judgment or decree by any of the courts of this state against any insurer in favor of the beneficiary under any policy or contract of insurance executed by such insurer, there shall be adjudged or decreed against such insurer, and in favor of the beneficiary named in said policy or contract of insurance, a reasonable sum as fees or compensation for his attorneys or solicitors prosecuting the suit in which the recovery is had.

. For example, in Wheaton v. Daily Tel. Co., 124 Fed. 61 (2d Cir.1903), an insolvent corporation involved in receivership was indebted to a bank. Where the bank was not a party to the receivership action, it was error to order the bank to pay the receiver the amount of corporate deposits with the bank, pending a determination of the bank's right to set off such deposits against the corporate debt. As the Wheaton court described, the bank was “entitled to their day in court, and the receiver must proceed by suit in the ordinary way to try his right to the property, or the plaintiff must bring them in as parties to the action, and apply to have the receivership extended to the property in their hands.” 124 Fed. at 62. Some might mistakenly read this as inconsistent with Horn v. Pere Marquette R. Co. et al., 151 Fed. 626 (Circ.Ct.E.D.Mich.1907), where a receivership court's order to hand over all assets of a railroad company was found to apply to a bank that was not a party at the time of the order. However, the key in Horn was that the defendant bank “came in[to the action] and answered to the merits.” 151 Fed. at 629. Thus, there is nothing inconsistent about Horn and the rule that a nonparty cannot be forced by summary proceeding to hand over property to the receivership estate.