Tracie PELOQUIN, as Administratrix of the Estate of Pearl E. Archambault v. HAVEN HEALTH CENTER OF GREENVILLE, LLC, et al.
No. 2011-130-Appeal.
Supreme Court of Rhode Island.
Jan. 14, 2013.
58 A.3d 419
Chief Justice SUTTELL
After reviewing the limited evidence contained in the record, we conclude that plaintiffs were wrongfully deprived of their opportunity to satisfy the elements necessary to recover under a theory of quasi-contract or unjust enrichment. Indeed, even DWS does not argue that there is no scenario under which plaintiffs would be able to satisfy these elements. Instead, DWS contends that plaintiffs’ equitable claims were properly dismissed because
Although it is generally true that there must be no adequate remedy at law for a plaintiff to proceed in equity, here, the express language of
IV
Conclusion
For the reasons set forth in this opinion, we vacate the judgment of the Superior Court and remand the record to it.
Stephen P. Sheehan, Esq., Providence, for Plaintiff.
Douglas K. Eisenstien, Esq., Pro Hac Vice, for Defendant.
Present: SUTTELL, C.J., GOLDBERG, FLAHERTY, ROBINSON, and INDEGLIA, JJ.
OPINION
Chief Justice SUTTELL, for the Court.
In June 2006, Pearl E. Archambault tragically died while in the care of Haven Health Center of Greenville, LLC (Haven Health) after a nurse mistakenly administered a lethal overdose of morphine. The administratrix of her estate, Tracie Peloquin (plaintiff),2 filed a medical malpractice action and now appeals from the Superior Court‘s denial of her partial summary-judgment motion and grant of summary judgment in favor of the defendant Columbia Casualty Company (Columbia),1 the professional liability insurer of the now-defunct nursing facility. The plaintiff avers that the Superior Court erred in interpreting Rhode Island law, argues that this Court should construe the insurance contract between Columbia and its insured in her favor, and urges this Court to reverse the Superior Court‘s decision and order that summary judgment be entered in her favor. For the reasons set forth in this opinion, we vacate the judgment of the Superior Court and remand with instructions that the Superior Court enter judgment in favor of the plaintiff for $100,000, plus prejudgment and post-judgment interest that has accrued on that amount.
I
Facts and Procedural History3
In June 2006, Archambault was a resident at Haven Health. On June 24 of
In December 2006, plaintiff filed the present action against Haven Health and Hardesty on behalf of Archambault‘s estate. During discovery, Hardesty gave deposition testimony acknowledging that she was negligent when she mistakenly administered the incorrect dosage of morphine solution to Archambault. She also testified at her deposition that she was a registered nurse in Rhode Island and a full-time employee of Haven Health at the time of Archambault‘s death.
When plaintiff filed her complaint, the Greenville Haven Health facility was insured under a claims-made professional liability insurance policy issued by Columbia (Columbia policy). The Columbia policy insured both Haven Health as an entity, as well as “any individual who is or becomes [a Haven Health] ‘employee’ * * * during the ‘policy period’ but only for ‘professional services’ performed on [Haven Health‘s] behalf.”5 This policy limited coverage for professional liability to $1 million per claim and $3 million in the aggregate. However, the policy also contained a self-insured retention endorsement (SIR Endorsement) requiring Haven Health to pay the first $2 million of “all ‘damages’ and all ‘claim expenses’ resulting from * * * each ‘claim’ under the Professional Liability Coverage Form.” The policy described the parties’ obligations under the SIR Endorsement as follows:
“[Columbia‘s] obligation to pay ‘damages’ and ‘claim expenses’ as a result of a ‘claim’ is in excess of the Self-Insured Retention. [Haven Health] [is] required to pay all ‘damages’ and ‘claim expenses’ up to the amount of the Self-Insured Retention listed herein. The Limits of Liability set forth on the Declarations Page are in excess of the Self-Insured Retention regardless of [Haven Health‘s] financial ability or inability to pay the Self-Insured Retention and in no event are we required to make any payments within [Haven Health‘s] Self-Insured Retention.”
Thus, under the terms of the policy, Columbia‘s obligation to pay on a professional liability claim would arise only to the extent that the damages and expenses exceeded $2 million, and Haven Health would be directly responsible for paying any amounts less than that.
In late 2007 or early 2008, Haven Health and two related entities—Haven Eldercare of New England, LLC (HENE) and Ha
In 2009, plaintiff amended her complaint to add Columbia as a defendant and to assert two counts against Columbia directly, based on
The plaintiff moved for partial summary judgment against Columbia on May 10, 2010,10 urging the Superior Court to declare the SIR Endorsement “void and unenforceable as against public policy” and to enter judgment against Columbia for $238,007.96.11 Columbia objected to plaintiff‘s motion for summary judgment, and it filed its own cross-motion for summary judgment. The Superior Court granted summary judgment in favor of Columbia, denied plaintiff‘s summary judgment motion, and entered final judgment against plaintiff. The plaintiff filed a timely notice of appeal.
II
Standard of Review
“In reviewing the parties’ cross-motions for summary judgment, we examine the matter de novo.” Derderian v. Essex Insurance Co., 44 A.3d 122, 126 (R.I.2012) (quoting Travelers Property and Casualty Corp. v. Old Republic Insurance Co., 847 A.2d 303, 307 (R.I.2004)). “In reviewing the Superior Court‘s judgment on the parties’ motions for summary judgment, we * * * apply the same standards as those used by the trial court.” Delta Airlines, Inc. v. Neary, 785 A.2d 1123, 1126 (R.I.2001). Thus, “[s]ummary judgment is appropriate when, viewing the facts and all reasonable inferences therefrom in the light most favorable to the
“[Q]uestions of statutory construction are reviewed de novo by this Court.” Mendes v. Factor, 41 A.3d 994, 1002 (R.I.2012) (quoting Generation Realty, LLC v. Catanzaro, 21 A.3d 253, 258 (R.I.2011)). “When the language of the statute is clear and unambiguous, it is our responsibility to give the words of the enactment their plain and ordinary meaning.” Id. (quoting Generation Realty, LLC, 21 A.3d at 258). “Moreover, when we examine an unambiguous statute, there is no room for statutory construction and we must apply the statute as written.” Tanner v. Town Council of East Greenwich, 880 A.2d 784, 796 (R.I.2005) (quoting State v. DiCicco, 707 A.2d 251, 253 (R.I. 1998)).
“The plain meaning approach, however, is not the equivalent of myopic literalism, and it is entirely proper for us to look to the sense and meaning fairly deducible from the context.” Mendes, 41 A.3d at 1002 (quoting Generation Realty, LLC, 21 A.3d at 259). “Therefore we must consider the entire statute as a whole; individual sections must be considered in the context of the entire statutory scheme, not as if each section were independent of all other sections.” Id. (quoting Generation Realty, LLC, 21 A.3d at 259). “It is generally presumed that the General Assembly ‘intended every word of a statute to have a useful purpose and to have some force and effect,‘” Curtis v. State, 996 A.2d 601, 604 (R.I.2010) (quoting LaPlante v. Honda North America, Inc., 697 A.2d 625, 629 (R.I.1997)), and this Court‘s “ultimate goal is to give effect to the purpose of the act as intended by the Legislature.” Hanley v. State, 837 A.2d 707, 711 (R.I. 2003) (quoting Oliveira v. Lombardi, 794 A.2d 453, 457 (R.I.2002)). “Finally, under no circumstances will this Court construe a statute to reach an absurd result.” Mendes, 41 A.3d at 1002 (quoting Generation Realty, LLC, 21 A.3d at 259).
III
Discussion
The plaintiff raises numerous issues on appeal. She maintains that the SIR Endorsement in Columbia‘s policy is invalid under Rhode Island law, and she further urges that it is void as against public policy. Additionally, plaintiff asserts that the trial justice erred in concluding that
A
Validity of the SIR Endorsement
The parties disagree about whether the SIR Endorsement in the Columbia Policy, which required Haven Health to cover the first $2 million of any damages awarded and expenses incurred in connection with a claim, is valid under Rhode Island law. Under
The plaintiff contends that self-insurance does not constitute insurance coverage and, thus the SIR Endorsement in Haven Health‘s policy did not satisfy the minimum coverage levels purportedly required by
To support her argument, plaintiff cites Ryan v. Knoller, 695 A.2d 990, 992 (R.I.1997), in which this Court held that an intoxication exclusion in an automobile rental and insurance agreement was void because it limited statutorily required liability coverage. The plaintiff also asserts that cases from other jurisdictions have declared self-insurance void as against public policy. See Commercial Union Insurance Co. v. Insurance Co. of North America, 155 Ga.App. 786, 273 S.E.2d 24, 27, 28 (1980); Thomas v. Petrolane Gas Service Limited Partnership, 588 So.2d 711, 720 (La.Ct.App.1991).
Columbia responds that
Although plaintiff emphasizes public policy in urging that this Court declare the present SIR Endorsement void, we need not undertake a public policy analysis here because we read
This reading of the statute also comports with the treatment of Rhode Island self-insurers in other contexts. For example,
We also note that some authorities have characterized self-insurance as “the antithesis of insurance” because it fails to shift the risk of loss away from the insured, and we agree with the general proposition that “[t]o meet the conceptual definition of self-insurance, an entity would have to engage in the same sorts of underwriting procedures that insurance companies employ.” 1A Steven Plitt et al., Couch on Insurance 3d § 10:1 & n. 1 (rev. ed.2010). Here, the record is devoid of any indication that any effort was undertaken to ascertain Haven Health‘s risk of loss and financial ability to meet that potential loss. Moreover, we believe that the fact that Haven Health filed for bankruptcy protection less than a year and a half after the Columbia policy was issued would bring into question whether at the time the Columbia policy became effective, Haven Health was in a financial position to adequately self-insure against the first $2 million of loss pursuant to the SIR Endorsement.
Because the DBR has not yet promulgated “rules and regulations allowing persons or entities with sufficient financial resources to be self-insurers,” we hold that the Columbia policy‘s SIR Endorsement is invalid under
B
Mandatory Minimum Policy Limits Under § 42-14.1-2 and Insurance Regulation 21
The plaintiff argues that
We note that at no point during this proceeding has plaintiff asserted that she is entitled to recover any damages in excess of the per-claim minimum coverage limit of $100,000 that she contends
C
Separate Treatment of Insureds Under the Policy
On appeal, plaintiff argues that because
Columbia responds that plaintiff waived her right to make this argument to this Court when she failed to raise it in the first instance in the summary-judgment proceedings before the Superior Court. We agree. “It is axiomatic that this [C]ourt will not consider an issue raised for the first time on appeal that was not properly presented before the trial court.” State v. Breen, 767 A.2d 50, 57 (R.I.2001) (quoting State v. Saluter, 715 A.2d 1250, 1258 (R.I.1998)). The plaintiff acknowledges that she did not make this argument below, but urges that we apply an exception to the raise-or-waive rule apparently recognized by some federal courts under which an appellate court will consider questions of law not posed to the trial court. See, e.g., United States v. Kin-Hong, 110 F.3d 103, 116 (1st Cir.1997) (“While it is true that, as a general matter, federal courts of appeals do not rule on issues not decided in the district court, * * * we do have discretion to address issues not reached by the district court when the question is essentially legal and the record is complete.“). However, although “[s]ome courts seem to be slightly less exigent about the raise or waive rule * * *, this Court has remained quite exigent with respect to the raise or waive rule * * * and we continue to believe that the rule is jurisprudentially sound.” Pollard v. Acer Group, 870 A.2d 429, 433 n. 11 (R.I.2005). Here, plaintiff had the opportunity to make this argument when she moved for summary judgment against defendant, but she failed to do so.16 Thus,
D
Prejudgment and Postjudgment Interest
Finally, the parties disagree as to the amount of prejudgment and postjudgment interest that Columbia is required to pay pursuant to the policy language. The “Supplemental Payments” section of the Columbia policy provides that “[Columbia] will pay with respect to any ‘claim’ * * * prejudgment interest and postjudgment interest that is awarded in connection with a judgment made against the Insured, or that portion of the judgment that is within the applicable limits of insurance.” The parties disagree on the meaning of this provision. The plaintiff argues that because a comma and the disjunctive term “or” separate the initial clause establishing Columbia‘s obligation to pay prejudgment and postjudgment interest from the final clause limiting interest to the amount of the judgment that falls within the policy limits, the policy provision actually sets out two alternative methods for determining interest (one that permits interest based on the full amount of the judgment, and a second that limits the interest calculation to only that portion of the award that is within the policy limits). The plaintiff asserts that she should be able to benefit from the method for interest calculation that is most advantageous to her. Alternatively, plaintiff argues that the two clauses, taken together, create an ambiguity that should be construed in her favor. Thus, plaintiff asserts, Columbia is obligated to pay $100,000 toward plaintiff‘s damages award as well as prejudgment and postjudgment interest calculated on the basis of the total damages award, i.e., $256, 881.
Columbia, on the other hand, maintains that the final clause of this policy provision modifies the preceding clause, thereby limiting prejudgment and postjudgment interest to only that portion of the judgment actually covered by the policy. Thus, Columbia argues, any prejudgment and postjudgment interest that it is obligated to pay must be determined with reference only to $100,000 of plaintiff‘s damages, not the entire judgment amount.
“It is well established that this [C]ourt applies the rules for construction of contracts when interpreting an insurance policy * * *.” Lynch v. Spirit Rent-A-Car, Inc., 965 A.2d 417, 425 (R.I.2009) (quoting Mallane v. Holyoke Mutual Insurance Co. in Salem, 658 A.2d 18, 20 (R.I.1995)). “The necessary prerequisite to this Court‘s departure from the literal language of a policy is a finding that the policy is ambiguous. In order to make such a determination of ambiguity, we read a policy in its entirety, giving words their plain, ordinary, and usual meaning.”
To support her argument, the plaintiff cites to Fratus v. Republic Western Insurance Co., 147 F.3d 25, 27 (1st Cir.1998). There, the First Circuit held that policy language requiring the insurer to pay “[a]ll interest accruing after the entry of judgment” unambiguously obligated the insurer to pay interest on the full amount of the judgment (over $3 million), rather than on only that portion of the judgment that was within the policy‘s coverage limit ($25,000). Id. at 27, 28-29. By contrast, here, the Columbia policy language is not as sweeping or general, and we disagree with the plaintiff‘s argument that the policy provides for two alternate methods for determining how much interest is owed. Instead, we are of the opinion that a fair reading of the policy provision limits Columbia‘s obligation to pay interest only on that portion of the award that falls within the policy limits. Thus, because we hold that the plaintiff is entitled to receive $100,000 under the policy, see Section III, B, supra, prejudgment and postjudgment interest in this case must be calculated on the basis of that limited amount rather than on the full amount of the plaintiff‘s judgment against Haven Health and its affiliated entities.
IV
Conclusion
For the reasons set forth in this opinion, we vacate the judgment of the Superior Court, and we remand the record to the Superior Court with instructions to enter judgment in favor of the plaintiff for $100,000, plus prejudgment and postjudgment interest calculated on the basis of that amount.
