CONTINENTAL CASUALTY COMPANY, VALLEY FORGE INSURANCE COMPANY, Plaintiffs-Appellants-Cross Appellees, versus WINDER LABORATORIES, LLC, STEVEN PRESSMAN, Defendants-Appellees-Cross Appellants, CONCORDIA PHARMACEUTICALS, S.A.R.L., Defendant-Appellee.
No. 21-11758
United States Court of Appeals For the Eleventh Circuit
July 13, 2023
[PUBLISH]
D.C. Docket No. 2:19-cv-00016-RWS
Before WILSON, BRANCH, and LAGOA, Circuit Judges.
BRANCH, CIRCUIT JUDGE:
Continental Casualty Company and Valley Forge Insurance Company (collectively, “the insurers“) and Winder Laboratories, LLC and Steven Pressman (collectively, “the insureds“) appeal and cross-appeal from the district court‘s judgment in this insurance coverage dispute. In short, the parties’ insurance agreements required the insurers to defend the insureds against certain third-party lawsuits. After being sued by non-party Concordia Pharmaceuticals Inc., S.A.R.L. (“Concordia“), the insureds sought coverage under the policies. The insurers agreed to defend the insureds against Concordia, subject to a reservation of rights, including the right to seek reimbursement of defense costs incurred for claims not covered by the policies. The insurance agreements themselves, however, did not provide for reimbursement.
This appeal presents two questions. The more straightforward question is whether the insurers had a duty to
I. Background
A. Facts
In 2015, Winder Laboratories, LLC (“Winder“)—a generic pharmaceutical manufacturer managed by Steven Pressman—purchased two insurance policies: a Primary General Liability Policy from Valley Forge Insurance Company (“VFI“) and an Umbrella Policy from Continental Casualty Company (“Continental“). The materially identical policies required the insurers to “defend the insured[s] against any ‘suit‘” seeking damages for “personal and advertising injury.” In pertinent part, “personal and advertising injury” was defined to include an injury “arising out of” either “[o]ral or written publication, in any manner, of material that slanders or libels a person or organization or disparages a person‘s or organization‘s goods, products or
On January 6, 2016, Concordia sued Winder and Pressman in the United States District Court for the Northern District of Georgia, asserting various claims under the Lanham Act and Georgia law.3 In the Concordia action, the Fourth Amended Complaint became the operative complaint after a series of claim dismissals and amendments.4 The crux of Concordia‘s Fourth
In light of the Concordia action, on February 19, 2016, the insurers jointly sent the insureds a letter agreeing to provide their defense—subject to a fairly standard reservation of rights to disclaim coverage. Importantly, however, the letter also included a not-so-standard reimbursement provision: “VFI specifically reserves its right to seek reimbursement of defense costs incurred on [the insureds‘] behalf for all claims which are not potentially covered by the VFI Policy.”5 Pressman—on behalf of the insureds—signed and returned an “Acknowledgement of Defense under a Reservation of Rights,” that noted “[the insureds] elect to retain independent counsel6 to represent them in the Underlying
B. Procedural History
During the pendency of the Concordia action, on January 17, 2019, the insurers filed suit in the Northern District of Georgia seeking a declaratory judgment that they had no duty to defend or to indemnify the insureds under the policies and were entitled to “reimbursement of legal costs and fees spent in providing [the insureds] a defense” in the Concordia suit under the reservation of rights. Following the insureds’ answer denying that both the insurers had no duty to defend and that the insurers were entitled to reimbursement, the insurers moved for judgment on the pleadings. Focusing on the duty to defend, they argued that they had no duty to defend the insureds against Concordia‘s operative complaint because Concordia did not allege a “personal or advertising injury,” and—even if there were such an injury—the “failure to conform” provision excluded coverage. The district court granted the insurers’ motion, holding that Concordia‘s allegations were “squarely” excluded by the “failure to conform” provision because the “operative complaint [was] based entirely upon allegations that [Winder] misrepresented the quality” of
In November 2020, having not reached an agreement, the parties cross-moved for summary judgment on the insurers’ reimbursement claim. The district court denied the insurers’ motion and granted the insureds‘. The district court noted that the question presented—whether an insurer had a right to reimbursement when that right was included only in a reservation of rights letter but not the parties’ insurance contract—was an open question under Georgia law. The district court found in favor of the insureds, reasoning that an effective reservation of rights necessarily required a preexisting contract right: “[A]bsent a provision in the insurance policy—or some other express agreement—an insurer who issued an otherwise valid, unilateral reservation of rights cannot recoup its defense fees or costs.”
The insurers appeal the district court‘s reimbursement decision and the insureds cross-appeal the duty to defend determination.
II. Standard of Review
We review a “district court‘s grant of judgment on the pleadings de novo.” Bankers Ins. Co. v. Fla. Residential Prop. & Cas. Joint Underwriting Ass‘n, 137 F.3d 1293, 1295 (11th Cir. 1998) (per curiam). Judgment on the pleadings is appropriate when “there are no material facts in dispute and the moving party is entitled to judgment as a matter of law.” Cannon v. City of W. Palm Beach, 250 F.3d 1299, 1301 (11th Cir. 2001). “We must accept the facts alleged in the complaint as true and view them in the light most favorable to the nonmoving party.” Id.
We review a district court‘s summary judgment determinations de novo. Great Am. All. Ins. Co. v. Anderson, 847 F.3d 1327, 1331 (11th Cir. 2017). In this posture, “[w]e view the evidence and draw all reasonable inferences in favor of . . . the party opposing summary judgment.” Munoz v. Selig Enters., Inc., 981 F.3d 1265, 1272 (11th Cir. 2020). The moving party must “show[] that there is no genuine dispute as to any material fact” so that it is “entitled to judgment as a matter of law.”
Because this federal action is premised on diversity jurisdiction, “Georgia‘s substantive law governs.” AEGIS Elec. & Gas Int‘l Servs. Ltd. v. ECI Mgmt. LLC, 967 F.3d 1216, 1223 (11th Cir. 2020).
III. Discussion
We start with the insureds’ cross-appeal on the duty to defend before considering the insurers’ appeal of the
A. Duty to Defend
The insureds argue that because Concordia alleged a “personal and advertising injury,” which is a covered claim, the insurers were obligated to defend the insureds against the Concordia action. Specifically, the insureds argue that Concordia‘s complaint alleged a “personal and advertising injury” because it included allegations that Winder copied Concordia‘s DONNATAL label inserts.8 The insurers argue that no “personal and advertising injury” was alleged; rather, they contend that Concordia‘s allegations of false and misleading advertising triggered the “failure to conform” exclusion such that there was no coverage under the policies. The district court held that the allegations fell under the “failure to conform” exclusion, and the insurers had no duty to defend. We agree with the insurers and the district court.
Georgia law treats insurance as “a matter of contract” so that “the parties to the contract of insurance are bound by its plain and unambiguous terms.” Lima Delta Co. v. Glob. RI-022 Aerospace, Inc., 789 S.E.2d 230, 233 (Ga. Ct. App. 2016) (quotation omitted). “The construction of an unambiguous contract is a question of law for the court.” Id. (quotation omitted).
An insurer‘s duty to defend is determined by “comparing the allegations of the complaint with the provisions of the policy.” Pilz v. Monticello Ins. Co., 599 S.E.2d 220, 221 (Ga. Ct. App. 2004) (quotation omitted). Under Georgia law, when the policy uses the broad term “suit,” the insurer has a duty “to defend the entire suit if any of the individual claims could be covered under the [p]olicy.” S. Tr. Ins. Co. v. Mountain Express Oil Co., 828 S.E.2d 455, 458 (Ga. Ct. App. 2019); City of Atlanta v. St. Paul Fire & Marine Ins. Co., 498 S.E.2d 782, 784 (Ga. Ct. App. 1998) (“If the facts as alleged in the complaint even arguably bring the occurrence within the policy‘s coverage, the insurer has a duty to defend the action.” (emphasis added)). If, however, the complaint “does not assert any claims upon which there would be insurance coverage, the insurer is
With Georgia law in mind, we now look to the operative complaint to see if Concordia‘s allegations relating to its contributory false advertising claim (a) triggered coverage under the “personal and advertising injury” provision or (b) triggered the “failure to conform” exclusion.10 We hold that the “failure to conform” exclusion applied.
In the contributory false advertising count, Concordia focused on Winder‘s allegedly false and misleading representations about its products:
[Winder] actively and materially furthered such false or misleading, or false and misleading, advertising and promotion of [its] B-Donna or Phenohytro products by making false or misleading, or false and misleading, representations about the products on their labels and product inserts, making false or misleading, or false and misleading representations to the Drug Databases to list [its] B-Donna or Phenohytro products with the Drug Databases, listing the products with the Drug Databases, and/or marketing the products as “generics” that are
comparable to and/or substitutable for [Concordia‘s] DONNATAL.
Thus, Concordia‘s contributory false advertising claim clearly rested on Winder‘s false and misleading representations—not its label copying. Accordingly, we conclude that the allegations in the complaint do not arise out of a “personal and advertising injury” stemming from “[t]he use of another‘s advertising idea“—i.e., Concordia‘s labels—that would have required the insurers to defend the insureds against Concordia‘s Fourth Amended Complaint. See Pilz, 599 S.E.2d at 221; St. Paul Fire, 498 S.E.2d at 784 (“[W]here the complaint filed against the insured does not assert any claims upon which there would be insurance coverage, the insurer is justified in refusing to defend the insured‘s lawsuit.“).
In fact, Concordia‘s count-specific allegation that Winder made “false or misleading” representations and statements about its products by “marketing the products as ‘generics’ that are comparable to and/or substitutable for [Concordia‘s] DONNATAL,” is a textbook example of an injury “[a]rising out of the failure of goods, products or services to conform with any statement of quality or performance made in [Winder‘s] ‘advertisement.‘”11 Thus, contrary to the insureds’ argument, Concordia‘s allegation that
The insureds resist our conclusion with the following counter-arguments.
For one, the insureds maintain that Concordia‘s complaint involved a “personal and advertising injury” because it included allegations of label copying. This statement is true. In the section of the complaint containing factual allegations, Concordia did reference label copying:
- “Upon information and belief, the labels and package inserts for [Winder‘s] B-Donna products have been copied from the labels and package inserts for [Concordia‘s] DONNATAL, including the ‘Indications and Usage’ section, which claims that the product has been reviewed and classified by FDA.”
- “Upon information and belief, the labels and package inserts for [Winder‘s] Phenohytro products have also been copied from the labels and package inserts for [Concordia‘s] DONNATAL.”
- “Upon information and belief, [Winder‘s] copying of [Concordia‘s] drug labels and product inserts was not done as part of a submission to the FDA or other
government agency, nor was it permitted or contemplated under any legislative provision authored by Congress.”
But these factual allegations provided the foundation for some of Concordia‘s previously dismissed claims. The only thing tying the label-copying allegations to Concordia‘s false advertising count is that count‘s language incorporating by reference “each and every allegation contained in the [preceding] paragraphs.” We conclude that this tangential connection—fastened through boilerplate language—is inconsequential because, as analyzed above, the actual count-specific allegations for the contributory false advertising claim centered on Winder‘s allegedly false and misleading representations about its products.12
Moving forward, the insureds also argue that the “failure to conform” exclusion does not apply because Concordia‘s false advertising claim stems from (1) false advertisements made by non-party drug databases (such that Winder is not responsible), and (2) true statements about Winder‘s products which cannot “fail . . . to conform with any statement of quality or performance . . . .”
Second, we also reject the insureds’ argument that the “failure to conform” provision does not apply because the representations Winder made to the drug databases were true. At this juncture, our analysis looks only to the allegations in the complaint and the terms of the insurance agreement. See Pilz, 599 S.E.2d at 221 (“An insurer‘s duty to defend is determined by comparing the allegations of the complaint with the provisions of the policy.” (emphasis added and quotation omitted)). And Concordia‘s complaint was littered with allegations that Winder misrepresented its drugs which in turn caused the drug databases to make misrepresentations. Accordingly, Concordia‘s allegations
In the end, after our close comparison of the complaint and insurance policies, we conclude that the “failure to conform” exclusion applied such that the district court properly determined that the insurers did not have an ongoing duty to defend the Fourth Amended Complaint.
B. Right to Reimbursement
The duty to defend determination answers only the first of the two questions presented in this appeal. In other words, we have concluded that the insurers no longer have a duty to defend the Fourth Amended Complaint, but that does not mean that the insurers never had a duty to defend at earlier stages of the case. Rather, because insurers under Georgia law have a broad duty to defend when there is “even arguably” a covered claim, see St. Paul Fire, 498 S.E.2d at 784, the insurers had an active duty to defend up
Following the insurers’ line of argument, we break our analysis into two questions. First, did the insurers’ reservation of rights letters create a new contract? We conclude that a new contract was not created and proceed to the second question that is novel under Georgia law: Would the Supreme Court of Georgia recognize a right to reimbursement absent a contractual right to such reimbursement? See Ga. Interlocal Risk Mgmt. Agency v. City of Sandy Springs, 788 S.E.2d 74, 79 (Ga. Ct. App. 2016) (“The issue of whether insurers are entitled to recoup defense costs where there is no contractual provision creating such a right is an issue of first impression in Georgia courts, but we need not reach that issue here.“). We conclude that it would not and, therefore, affirm the district court.
i. Did the insurers’ reservation of rights letters including a reimbursement provision create a new contract?
The insurers argue that the insureds implicitly and explicitly agreed to the terms of the reservation of rights letters which included the reimbursement provision. This argument centers on a day-one principle of contract law: consideration. We must decide whether the insurers’ reservation of rights letters created a new contract—either explicitly (because one of the letters was signed by the insureds) or implicitly (because the insureds accepted the defense while aware of the letters’ terms).15
Express contracts and implied-in-fact contracts are exceedingly similar. See Turfgrass Grp., Inc. v. Ga. Cold Storage Co., 816 S.E.2d 716, 721 (Ga. Ct. App. 2018). The only difference is how the parties’ will to be bound is shown—either “expressly in some form recognized by law” or “by circumstances from which assent may be inferred as a conclusion of fact.” Id. (emphasis added). Both must meet the standard contract requirements.
The original insurance contracts between the parties provided that insurers had the “duty to defend the insured[s] against any ‘suit’ seeking [] damages” for “personal and advertising injury.” The policies did not expound on the details of the defense. For example, the policies did not mention which party would choose defense counsel if the insureds were sued.
In a series of reservation of rights letters that the insurers sent to the insureds after Concordia brought the underlying litigation, the insurers included terms that were not part of the original insurance contract. Critically, the first letter specified that: “VFI specifically reserves its right to seek reimbursement of defense costs incurred on [the insureds‘] behalf for all claims which
For the insurers’ implicit and explicit contract arguments, the issue of consideration is dispositive. The insurers argue that there was adequate consideration stemming from the reservation of rights letters in two ways: (1) the insureds were provided a defense and (2) the insureds were able to choose their defense counsel. We hold that because the parties’ contracts already required the insurers to defend the insureds against certain third-party lawsuits, there is no new consideration for the reimbursement provision in the reservations of rights letters and thus no new contract under Georgia law.
The insurers’ first argument is easy to reject. The underlying contract required the insurers to defend the insureds against certain third-party lawsuits. The reservation of rights letters also provided for such defense. That is, the letters were the quintessential “promise to perform a preexisting contractual
The insurers’ second argument is colorable—but still inadequate. The underlying contract did not contemplate which party would select legal counsel for the promised defense, but the reservation of rights letters gave the insureds the ability to either (a) choose their legal representation or (b) have it chosen for them by the insurers. Boiled down, the insurers went from having to provide a defense (under the underlying contract) to having to provide a defense through counsel of their own choosing or counsel chosen by the insureds (under the reservation of rights). Either way, however, the insurers were obligated to provide a defense. In other words, because the insurers did not have the explicit right to choose counsel for the insureds under the original contract, the insurers did not give anything up to reach the new arrangement wherein the insureds have the option of selecting their own counsel. As such, there is no consideration under Georgia law. See
ii. Unjust Enrichment
Alternatively, the insurers contend that the insureds were unjustly enriched because they retained the benefit of an expensive defense to which they knew they were not entitled. See Campbell v. Ailion, 790 S.E.2d 68, 73 (Ga. Ct. App. 2016) (“[A] claim for unjust enrichment exists where a plaintiff asserts that the defendant induced or encouraged the plaintiff to provide something of value
iii. Predicting Georgia Law on Reimbursement
The final question we face is whether, under Georgia law, an insurer can recoup defense costs when such a right is provided for in a reservation of rights letter but not the parties’ operative insurance contract. Georgia courts have not addressed this question.18 See Ga. Interlocal, 788 S.E.2d at 79.
Without any state court guidance, we attempt to “predict state law” without “creat[ing] or modify[ing] it.” Salinero v. Johnson & Johnson, 995 F.3d 959, 969 (11th Cir. 2021) (internal citations omitted); see Bravo v. United States, 577 F.3d 1324, 1325 (11th Cir. 2009) (per curiam) (citing Erie R.R. Co. v. Tompkins, 304 U.S. 64 (1938)). As part of this inquiry, we “consider whatever might lend [us] insight, including relevant state precedents, analogous decisions, considered dicta, scholarly works, and any other reliable
The duty to defend is extremely broad under Georgia law.19 See, e.g., Landmark Am. Ins. Co. v. Khan, 705 S.E.2d 707, 710 (Ga. Ct. App. 2011) (“[I]f the facts as alleged in the complaint even arguably bring the occurrence within the policy‘s coverage, the insurer has a duty to defend the action. Indeed, to excuse the duty to defend the petition must unambiguously exclude coverage under the policy . . . .” (quotation omitted)); St. Paul Fire, 498 S.E.2d at 784. An insurer “may be obligated to defend, even though it [may not be] ultimately liable for any judgment . . . .” Penn-Am. Ins. Co. v. Disabled Am. Veterans, Inc., 490 S.E.2d 374, 376–77 (Ga. 1997); see also Elan Pharm. Rsch. Corp. v. Emps. Ins. of Wausau, 144 F.3d 1372, 1375 (11th Cir. 1998) (“[U]nder Georgia law . . . [a]lthough an insurer need not indemnify an insured for a liability the insured incurs
As an initial matter, we disagree with the insurers’ argument that there is a clear “majority” rule favoring recoupment across the nation. See SA Palm Beach, 32 F.4th at 1357 (“We therefore consider whatever might lend [us] insight, including . . . analogous decisions . . . scholarly works, and any other reliable data tending convincingly to show how the [Supreme Court of Georgia] would decide the issue at hand.” (quotations omitted)). This description of a “majority rule” may have been correct in the past, but it is not an accurate depiction of the current case law, which appears to be more-or-less in equipoise with the recent trend favoring the “no recoupment” rule. See Gen. Star Indem. Co. v. Driven Sports, Inc., 80 F. Supp. 3d 442, 461 n.14 (E.D.N.Y. 2015) (“Although the parties dispute which is the majority rule in other jurisdictions, both parties referred to an article published by the American Bar Association in 2011, noting that ‘[t]here is a fairly even split among state and federal courts’ concerning recoupment. However, . . . there has been a recent trend toward courts rejecting claims for recoupment.” (internal citation omitted)); Westchester Fire Ins. Co. v. Wallerich, 563 F.3d 707, 715 (8th Cir. 2009) (“[T]he most recent decisions reflect the [no recoupment] position.” (quotations omitted)). The Restatement of the Law of Liability Insurance confirms this switch in trend:
Over the past few decades, the pro-recoupment cases have been viewed as stating the majority position, while anti-recoupment cases have been labeled the minority. But in recent years, several state courts, including several state high courts, have faced recoupment of defense costs as an issue of first impression and have rejected a right of recoupment for the insurer, unless that right is established expressly by contract.
Restatement of the Law of Liability Insurance § 21, cmt. a (Am. L. Inst. 2019). Jurisdictions not allowing recoupment tend to focus on the deleterious effect that such a rule would have on the distinction between the duty to defend and the duty to indemnify. See, e.g., Am. & Foreign Ins. Co. v. Jerry‘s Sport Ctr., Inc., 2 A.3d 526, 544 (Pa. 2010) (“[P]ermitting reimbursement . . . would amount to a retroactive erosion of the broad duty to defend in Pennsylvania by making the right and duty to defend contingent upon a court‘s determination that a complaint alleged covered claims, and would therefore narrow Pennsylvania‘s long-standing view that the duty to defend is broader than the duty to indemnify.“). We are persuaded by the recent trend of state high courts holding that there is no right to reimbursement in similar cases.
The most important consideration in our predictive analysis, however, is the structure of Georgia‘s insurance law. See SA Palm Beach, 32 F.4th at 1357 (“We therefore consider whatever might lend [us] insight, including relevant state precedents . . . and any
We think it clear based on Georgia‘s substantive law as well as its general insurance framework that the Supreme Court of Georgia would not allow an insurer to recoup its expenses based on a reservation of rights letter without any contractual provision allowing for reimbursement. This position comports with the national trend that disfavors recoupment in similar circumstances.
IV. Conclusion
We affirm both of the district court‘s holdings. First, we agree that the insurers did not have a duty to defend the insureds in the underlying action. To supplement this analysis, we hold that the duty to defend was extinguished when the district court‘s ruling was issued. Second, we agree that the insurers do not have a right to reimbursement because the reservation of rights letters did not create a new contract, the insurers’ unjust enrichment argument is untenable, and we do not believe the Supreme Court of Georgia would upend the State‘s insurance law framework by establishing a right to reimbursement for an insurer who has no contractual right to recoupment.
AFFIRMED.
BRANCH
CIRCUIT JUDGE
