Appalachian Reg'l Healthcare v. Cunningham, 806 S.E.2d 380, 294 Va. 363 (2017)

Nov. 22, 2017 · Supreme Court of Appeals of Virginia · Record No. 161767
806 S.E.2d 380, 294 Va. 363

APPALACHIAN REGIONAL HEALTHCARE, et al.
v.
Jacqueline K. CUNNINGHAM, Commissioner of Insurance, et al.

Record No. 161767

Supreme Court of Virginia.

NOVEMBER 22, 2017

Greg E. Mitchell (Eric M. Page ; William C. Gullett ; Eckert Seamans Cherin & Mellott, Richmond; Frost Brown Todd, on briefs), for appellants.

Joseph N. West (Robert D. Perrow ; Patrick H. Cantilo ; Williams Mullen, Richmond; Cantilo & Bennett, on brief), for appellee Jacqueline K. Cunningham.

*381No brief filed by appellee State Corporation Commission.

PRESENT: All the Justices

OPINION BY JUSTICE D. ARTHUR KELSEY

**365The State Corporation Commission ("SCC") denied claims filed by a group of Kentucky hospitals (the "Hospitals") requesting reimbursement for $439,375.20 in legal fees and costs from Reciprocal of America ("ROA"), an insolvent insurer. The Hospitals appeal, arguing that certain agreements constituting an assumption reinsurance transaction provided a contractual basis for the claims and that the SCC erred in concluding otherwise. We disagree and affirm.

**366I.

In the late 1970s and early 1980s, a group of Kentucky hospitals created two self-insured Trusts-the Compensation Hospital Association Trust ("CHAT") and the Kentucky Hospital Association Trust ("KHAT") (collectively, the "Trusts").1 See 1 J.A. at 422. CHAT provided workers' compensation and employers' liability coverage to the Hospitals and other healthcare providers. KHAT provided professional liability and general liability coverage to the Hospitals and other healthcare providers. The Hospitals were member insureds of CHAT and KHAT.

A. THE MERGER

In 1997, CHAT and KHAT each entered into "Master Agreements" with ROA that merged both Trusts into ROA as the surviving entity. See id. at 66-105, 112-50. The parties2 executed the Master Agreements and related agreements as part of a holistic transaction and, thus, accepted that the agreements should be construed together. See id. at 101, 146 (incorporating exhibits into the Master Agreements).3 The Master Agreements also stipulated that the "provisions of this Agreement were negotiated by the parties hereto and such Agreement shall be deemed to have been **367drafted by all of the parties hereto," id., thereby seeking to avoid the application of the contra proferentem canon of construction.4

Accompanying each of the Master Agreements was an "Indemnification Agreement" in which ROA agreed to indemnify the Trusts for certain kinds of liabilities and expenses. See id. at 334-40, 342-48. In the Indemnification Agreements, ROA agreed

to indemnify and hold harmless [each Trust] and its member-insureds from any and all Damages arising out of or in connection with the Business, the Assumed Liabilities, the conveyance and delivery of the Transferred Assets, or any related transactions, provided no such indemnification shall be provided for any and all Damages of such member-insureds relating to *382their obligations under their respective policies of insurance issued by [ROA]. The indemnification by [ROA] ... shall include reasonable costs and expenses (including fees and expenses of [each Trust's] or any of its member-insured's counsel) in defending itself against any claim Damages arising from or in connection with the Damages.

Id. at 336, 344 (quoted verbatim in pertinent part). Several of the terms in these Indemnification Agreements had contractually defined meanings:

• "Damages" meant "any liability, expense, cost or obligation, however incurred or characterized, assumed by[ROA] as provided for in this Agreement." Id.(emphasis added).
• "Assumed Liabilities" included "all obligations" of the Trusts "in connection with [their] Business except for the Excluded Liabilities." Id. The Master Agreements clarified that ROA agreed "to assume and become responsible for all of the Assumed **368Liabilities at the Closing Date." Id. at 72, 118; see also id. at 176-81 ("Agreement of Assumption").
• "Business" was defined according to "the meaning set forth in the Recitals," which described the Trusts' pre-merger self-insurance business. Id. at 335-36, 343-44.

Because both Trusts were wholly merged into ROA, they had no separate legal existence after the merger. Neither Trust continued to conduct its pre-merger self-insurance business. The liabilities that ROA assumed included the business liabilities of the Trusts prior to the merger. In that context, the Indemnification Agreements expressly addressed legal fees. ROA agreed to indemnify the Trusts for fees and associated costs that the Trusts or any of their member insureds incurred "in defending [themselves] against any claim Damages arising from or in connection with the Damages." Id. at 336, 344.

B. ROA IN RECEIVERSHIP

In 2003, the Circuit Court of the City of Richmond placed the financially troubled ROA into receivership and appointed the SCC as the Receiver, the Commissioner of Insurance as the Deputy Receiver, and a Special Deputy Receiver. The SCC later found ROA to be insolvent and ordered its liquidation. During the liquidation process, the Hospitals became involved in two separate judicial proceedings.

The Deputy Receiver initiated the first case ("the Virginia litigation") by filing an application with the SCC requesting authorization for ROA to continue paying workers' compensation claims that ROA had assumed from various self-insured trusts and group self-insurance associations, including CHAT and KHAT. See id. at 579. He filed the application because various state guaranty associations, including the Kentucky Insurance Guaranty Association ("KIGA"), had denied or were likely to deny guaranty fund coverage for these claims. See id.

The Hospitals joined the Virginia litigation in support of the Deputy Receiver, appearing as the "Kentucky Claimants" or the "Claimants" throughout this litigation and the receivership proceeding. See **369id. at 2-22, 380 & n.25, 382, 384, 586 & n.25, 588, 590; 2 id. at 667-68, 700-20, 768-69 nn.30-31, 938 n.25. After the Hearing Examiner issued his report in the Virginia litigation, the SCC adopted most of his findings, including his conclusion that "[t]he Assumed Claims constitute 'claims of other policyholders arising out of insurance contracts' pursuant to [ Code § 38.2-1509(B)(1)(ii) ]" and that the claims were therefore entitled to second priority in the asset distribution scheme for insolvent insurers under Code § 38.2-1509(B)(1)(ii). See 1 J.A. at 527-45.

While the Virginia litigation was pending, the Hospitals initiated the second case by filing a suit for declaratory and injunctive relief in a Kentucky trial court (the "Kentucky litigation"). See id. at 549-58. They claimed that because of ROA's insolvency, KIGA was responsible for the claims that ROA had assumed. The court ultimately held in favor of the Hospitals. See id. at 610-31. The court reasoned that, under Kentucky law, the agreements operated as a novation that extinguished all coverage liabilities of the Trusts and their member insureds and placed ROA in the Trusts' shoes as the sole *383source of coverage for these claims. See id. at 620-21.

After their victories in the Virginia and Kentucky proceedings, the Hospitals filed claims with the Special Deputy Receiver requesting payment of $439,375.20 for legal fees and costs that they had incurred in those cases. They claimed that the 1997 agreements obligated ROA to pay their fees and costs. The Special Deputy Receiver, in his initial claim determination, denied the claims, and the Deputy Receiver affirmed. The Hospitals thereafter appealed to the SCC. The SCC appointed a Hearing Examiner, who granted summary judgment to the Deputy Receiver, finding that the Indemnification Agreements did not require ROA to indemnify the Hospitals. In its final order, the SCC agreed with the Hearing Examiner and held that the Hospitals had no contractual right to reimbursement for their legal fees and costs.

**370II.

On appeal, the Hospitals contend that the SCC misconstrued the applicable contract provisions and that, properly construed, the provisions required ROA to indemnify them for all legal fees and costs incurred in the Virginia and Kentucky cases.5 We disagree.

A.

The Indemnification Agreements specifically addressed the question of indemnity for legal fees and costs:

The indemnification by [ROA] ... shall include reasonable costs and expenses (including fees and expenses of [each Trust's] or any of its member-insured's counsel) in defending itself against any claim Damages arising from or in connection with the Damages.

Id. at 336, 344 (quoted verbatim in pertinent part). Thus, to trigger this indemnity, the Hospitals must have incurred their legal fees and costs while "defending" themselves "against any claim" for contractually defined "Damages." Id.6

We begin by asking whether this contractual text has a "usual, ordinary, and popular meaning."

**371Babcock & Wilcox Co. v. Areva NP, Inc., 292 Va. 165, 179, 788 S.E.2d 237, 244 (2016) (citation omitted). If so, the interpretative task is over. "When courts *384search for the parties' intent in an unambiguous contract provision, the search ends where it begins-with the plain, usual, and ordinary meaning of the words themselves." Id. at 188, 788 S.E.2d at 249. "Each party to a contract," Justice Holmes reminds us, "has notice that the other will understand his words according to the usage of the normal speaker of English under the circumstances, and therefore cannot complain if his words are taken in that sense." Id. (alteration omitted) (quoting Oliver Wendell Holmes, The Theory of Legal Interpretation, 12 Harv. L. Rev. 417, 419 (1899) ).7

In our opinion, the plain meaning of the phrase "defending ... against any claim," 1 J.A. at 336, 344, is that the Hospitals can seek legal fees and costs for defending a claim filed by someone else-not for asserting a claim against someone else. Neither the Virginia litigation nor the Kentucky litigation fits within this contractual paradigm. The Hospitals voluntarily intervened in the Virginia litigation as "Claimants." See supra at 382. Their goal was to support the Deputy Receiver's attempt to place the liabilities that ROA had assumed from the Trusts in line for priority status upon ROA's liquidation. In this respect, the Hospitals were not defending themselves; they were trying to moot the need to ever do so.

**372The same can be said of the Kentucky litigation. The Hospitals filed a declaratory judgment action against KIGA, seeking to ensure that the state guaranty association would pay the underlying workers' compensation and liability claims so that the Hospitals would not have to do so themselves. In neither case were the Hospitals defending themselves against claims asserted against them. See Oral Argument Audio at 6:31 to 6:43 (conceding the point in the context of workers' compensation claims).

The contractual definition of "Damages" reinforces our conclusion. The Indemnification Agreements defined "Damages" as "any liability, expense, cost or obligation, however incurred or characterized, assumed by[ROA] as provided for in this Agreement." 1 J.A. at 336, 344 (emphasis added). "Assumed Liabilities" included "all obligations" of the Trusts "in connection with [their] Business except for the Excluded Liabilities." Id. The Master Agreements clarified that ROA agreed "to assume and become responsible for all of the Assumed Liabilities at the Closing Date." Id. at 72, 118; see also id. at 176-81 ("Agreement of Assumption"). The Indemnification Agreements also defined "Business" according to "the meaning set forth in the Recitals," which described the Trusts' pre-merger self-insurance business. Id. at 335-36, 343-44.

The plain meaning of "defending ... against any claim," id. at 336, 344, and the specific contractual definition of "Damages," among other terms, together support the SCC's characterization of the agreements as an assumption reinsurance transaction that effected a complete novation substituting ROA for the Trusts. In an assumption reinsurance contract, the assuming reinsurer "steps into the shoes of the ceding company with respect to the reinsured policy, assuming all its liabilities and its responsibility to maintain required reserves against potential claims. The assumption reinsurer thereafter receives all premiums directly and becomes directly liable to the holders of the policies...." Colonial Am. Life Ins. v. Commissioner, 491 U.S. 244, 247, 109 S.Ct. 2408, 105 L.Ed.2d 199 (1989), superseded on other grounds by statute, Omnibus Budget Reconciliation Act of 1990, *385Pub. L. No. 101-508, § 11301(a), 104 Stat. 1388, 1388-448 (codified as amended at I.R.C. § 848(g) (2011) ); see also Hartford Fire Ins. v. California, 509 U.S. 764, 806-07, 113 S.Ct. 2891, 125 L.Ed.2d 612 (1993) ; **373Jurupa Valley Spectrum, LLC v. National Indem. Co., 555 F.3d 87, 90 (2d Cir. 2009) ; Merit Life Ins. v. Commissioner, 853 F.2d 1435, 1436 (7th Cir. 1988), vacated on other grounds, 492 U.S. 902, 109 S.Ct. 3208, 106 L.Ed.2d 559 (1989).8

Both textually and contextually, the indemnity provision applies only to liabilities that CHAT and KHAT had to their insureds prior to the ROA merger. ROA's duty to indemnify could rise no higher than the pre-merger obligations of the two Trusts-for those were the only liabilities that ROA assumed, and thus the only "Damages" for which it was responsible to indemnify the Trusts, see 1 J.A. at 336, 344. This contractual definition of "Damages" necessarily excludes any obligation for ROA to indemnify the Trusts and their member insureds for the legal fees and costs incurred in the Virginia and Kentucky cases.9

**374With respect to the Virginia litigation, neither Trust had any pre-merger obligation to pay legal fees and costs incurred by its member insureds in the event that the member insureds joined a receivership proceeding involving either Trust. Consequently, if there had been no merger and the Trusts had themselves become insolvent, the Hospitals would have had no contractual right to recover the legal fees and costs incurred in filing claims in the receivership proceeding and in seeking to establish the proper priority of their claims in the distribution plan. ROA, therefore, did not assume these liabilities from the Trusts because they never existed.

The same logic applies to the Kentucky litigation. Neither Trust had any pre-merger obligation to pay legal fees and costs incurred by its member insureds in the event that the member insureds, upon the liquidation of either trust, filed suit against the state insurance guaranty association seeking coverage for unpaid claims. Without the merger, the Hospitals never could have initiated such litigation against KIGA because CHAT and KHAT were never members of *386KIGA. ROA, therefore, did not assume such liabilities because they never existed.

B.

We acknowledge but find unpersuasive the thematic counterarguments of the Hospitals. They contend that in the Virginia and Kentucky proceedings they were "defending [their] status as policyholders of ROA and their legal rights in the receivership." Appellants' Br. at 1. From this premise, they argue that the indemnity provision required ROA to pay their legal fees and costs associated with the Virginia and Kentucky cases. By "limit[ing] the definition of 'Damages' a priori and in isolation," the Hospitals assert, the SCC and the Deputy Receiver "simply divorce a few words from the entirety of the Agreements to support their own flawed position." Reply Br. at 4.

The thrust of the Hospitals' argument is that their participation in the Virginia and Kentucky cases was simply an effort to defend themselves against liability for unpaid claims and to protect their rights to payments from the receivership estate and to guaranty fund coverage. We see the point, which, colloquially speaking, is merely an application of the useful axiom that the best defense is a good offense. And we have no doubt that this stratagem, popular in war and game theory, may have a favored place in litigation as well.

**375But acknowledging the utility of the concept does not mean that we must interpret the phrase "defending ... against any claim" by someone, 1 J.A. at 336, 344, to mean "asserting a claim" against anyone. Nor can we overlook the contractual definition of "Damages," which is limited to liabilities, costs, expenses, or obligations "assumed by [ROA]" from the Trusts at the time of the merger. Id. We thus do not believe that the SCC or the Deputy Receiver "simply divorce[d] a few words" from the larger context of the merger transaction. Reply Br. at 4. They instead took the ordinary and plain meaning of the phrase "defending itself against any claim," 1 J.A. at 336, 344, and applied that plain meaning in light of the specific contractual definition of the word "Damages."

With their broader interpretation, the Hospitals seek to establish a contractual framework for a contingency unaddressed by any of the voluminous provisions of the various integrated agreements-indemnification for litigation in the event that ROA became insolvent. We offer no criticism of the Hospitals' proactive approach in either the Virginia or the Kentucky proceedings. Nor do we suggest that a properly drafted indemnity provision could not have shifted the responsibility for legal fees and costs in engaging in such litigation to ROA in the event of its insolvency.

That said, "[w]e have neither the duty nor the inclination to creatively construe an unambiguous contractual phrase 'so as to conform it to the court's notion of the contract the parties should have made' under the circumstances." Babcock & Wilcox Co., 292 Va. at 189, 788 S.E.2d at 249 (alteration and citation omitted). Instead, our duty is "to declare what the instrument itself says it says. What the parties claim they might have said, or should have said, cannot alter what they actually said." Id. at 189, 788 S.E.2d at 249-50 (alteration and citations omitted).10

**376*387III.

The SCC correctly held that the governing contractual provisions did not obligate ROA to reimburse the Hospitals for legal fees and costs that they incurred in the Virginia and Kentucky proceedings. We thus affirm.

Affirmed.