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Category: Fees Paid by Insurers

Miami Law Firm Fights for Coverage of Fee Dispute

September 21, 2023

A recent Law 360 story by Ganesh Setty, “Miami Law Firm Fights For Coverage Of Overbilling Claims”, reports that a Miami law firm's insurer cannot rely on an "ambiguous" fee dispute exclusion to totally avoid defending overbilling claims, the law firm told a Florida federal court, arguing that even if the exclusion applies, the underlying lawsuit it faces involves broader legal malpractice claims.  In a brief opposing James River Insurance Co.'s motion for summary judgment, Sheehe & Associates PA and three of its attorneys said that, despite the insurer's effort to construe the underlying action as an "overbilling scheme," at least two counts — breach of fiduciary duty and breach of oral contract — are still covered.

And the potential for coverage triggers an insurer's duty to defend an entire lawsuit, the firm noted.  According to court filings, James River issued a professional liability policy to Sheehe running from March 2020 to March 2021 that broadly provided coverage for wrongful acts in the performance or failure to perform "professional services."  The policy defined that term in part as services performed by an insured as a lawyer, arbitrator or trustee, along with other fiduciary roles performed in one's capacity as a lawyer.

In the underlying action, Frontline Insurance Co. accused Sheehe and the attorneys in state court of overbilling hours worked while handling first-party property claims, alleging that in some cases multiple attorneys for the firm individually billed Frontline more than 24 hours for a single day.  Frontline specifically lodged breach of fiduciary duty, negligent supervision, unfair trade practices, unjust enrichment, breach of oral contract, fraud and legal malpractice claims.

In denying coverage, James River argued that overbilling does not constitute professional services, pointing in part to a fee dispute exclusion that barred coverage for claims arising from the "rights or duties under any agreement including disputes over fees for services."

Highlighting an underlying allegation that Sheehe and the other attorneys failed to ensure their legal services were "reasonable and necessary and advanced the best interest of Frontline," the law firm said such a claim shows that Frontline is not just suing Sheehe for a billing dispute but its "strategic decisions," too.  "A claim for breach of fiduciary duty grounded in an attorney-client relationship is considered a malpractice action and subject to the same standards as a legal malpractice claim," Sheehe continued, adding that the same goes for the breach of oral contract claim.

As for the fee dispute exclusion itself, its use of "any agreement" renders its scope overly broad since all professional services in the policy stem from an attorney-client relationship in which an attorney agrees to appropriately represent their client's interests, the firm further argued.  "This exclusion precludes coverage for all agreements, including ones between attorneys and clients, rendering the coverage illusory if read as expansively as James River urges," it said.

For its part, James River further cited in its August motion for summary judgment a prior knowledge exclusion, which barred coverage for a professional services claim if "any insured" could have reasonably foreseen their conduct would give rise to a claim.  It also invoked a "gain of profit or advantage" exclusion barring coverage for any gain or profit an insured is not legally entitled to.

But the policy still covers claims following its retroactive date of March 2004, which was prior to Sheehe's representation of Frontline, the firm responded, adding that the audit Frontline commissioned was still ongoing at the time Sheehe's policy started coverage.  "As the audit included dates cited in the complaint late as March of 2020, there is no allegation in the underlying complaint that supports that Sheehe would or should know that a claim would arise," the firm said.  The gain of profit or advantage exclusion, meanwhile, does not extend to the breach of fiduciary duty and oral contract claims either, Sheehe said, noting both counts seek damages rather than repayment of fees.

Texas Court Rules in Insurer’s Right to Control Defense Fees

September 7, 2023

A recent Law.com story by Adolfo Pesquera, “3 Lawyers? One’s Enough, Court Rules in Insurer’s Fight Over Attorney Fees”, reports that a Texas state district court was found to have erred in denying an insurer’s summary judgment motion in an attorney fees dispute, where plaintiffs alleged more than one attorney was needed to avoid a “potential” conflict of interest.

The Ninth District Court of Appeals reversed a ruling of the Montgomery County 457th District Court in a case where a government entity and two elected officials depended on a Directors and Officers policy from Mid-Continent Casualty Co. to provide for their defense when a losing candidate filed suit alleging election irregularities.

Insurer Right to Control Defense

The reversal hinged on Mid-Continent’s right under the policy to control the defense, and whether there was an actual conflict of interest that the insurer formally recognized.  In the underlying suit, third-place candidate Edgar Clayton sued Harris County Municipal Utility District No. 400 and the two candidates who placed ahead of him, Ann Marie Wright and Cheryl Smith.

The court ultimately dismissed the lawsuit with prejudice, but the parties disagreed about how many lawyers the insurer should provide the district.  James Stilwell of Stilwell, Earl & Apostolakis, based in The Woodlands, Texas, and acting for the district responded to Mid-Continent’s letter agreeing to defend but preserving its reservation of rights.  Stilwell told Mid-Continent that was a “possibility of a conflict of interest in representation regarding Mid-Continent’s desire to have a single attorney represent all three defendants.”

Stilwell and the district were informed by a claims adjuster for Mid-Continent that it was the opinion of coverage attorney Brent Cooper of Cooper & Scully that Mid-Continent had the right to select defense counsel “because the facts to be adjudicated are not necessarily the same facts that control coverage,” and the Houston attorney Britt Harris had been retained by Mid-Continent as their counsel.

Instead, Stilwell’s subsequent correspondence informed Mid-Continent that the elected officials would be represented by Houston-area attorneys and Bruce Tough and Kenna Seiler, and the district by its general counsel, Chris Skinner of Schwartz, Page & Harding.

Conflict of Interest?

Stilwell asserted the potential conflict had to do with Wright and Clayton having run on the same slate against Smith, as well as the district’s desire to defend the election through trial, whereas the individual directors possibly wanting a do-over or settlement.

Mid-Continent attorney Mark Lewis cut a check made out to the district for $4,290 in attorney fees, which covered the period up to Mid-Continent’s offer to assume the defense.  Stilwell, in a pre-suit demand letter asked for attorney fees of $151,750 for the Clayton suit defense, plus $5,600 attorney fees for defending the wrongful denial.

Referring to the Texas Disciplinary Rules of Professional Conduct, the Ninth District court noted a lawyer may only represent multiple clients if he reasonably believes each client will not be materially affected, and each client consents after full disclosure of possible adverse consequences of common representation.

The deposition testimony and affidavit generally averred that the defendants discussed material conflicts at a board meeting and would not waive those conflicts, and they requested separate counsel, the opinion stated.  Nevertheless, the Ninth District held that the district’s “arguments are without merit.”

“We note that the information on which appellees rely falls outside the eight-corners of the pleadings and the insurance policy,” the court said.  In addition, the court said Stilwell’s responses to Mid-Continent referred only to “potential” conflicts, but never stipulating actual conflicts.

“We conclude that Clayton’s petition did not allege facts that would necessitate separate counsel. Clayton does not allege anything in his petition that would make the interests of Wright, Smith, or MUD 400 adverse to the interests of each other,” the court said.

Insurer Must Pay Full Defense Fees, Can Impose Future Rate Reductions

August 16, 2023

A recent Law 360 story by Hailey Konnath, “’SoCal Edison’s Insurer Ordered To Pay Wildfire Attorney Fees”, reports that the insurer for Southern California Edison Co. must pay in full the counsel fees stemming from a number of negligence suits over the September 2020 Bobcat Fire that the carrier initially refused to defend, a move that was a breach of its insurance contract, a California federal judge ruled.

U.S. District Judge John F. Walter granted in part and denied in part SoCal Edison's motion for summary judgment, agreeing with the utility that Greenwich Insurance Co. forfeited the right to limit counsel fees associated with those cases when Greenwich refused to defend them.  However, the insurer can indeed rely on California law to impose lower billable rates on future defense fees incurred in three cases that Greenwich agreed to defend earlier this year, the judge held.

"There is no evidence that Greenwich has breached its duty to defend as to the three lawsuits tendered on Jan. 13, 2023, and May 11, 2023," Judge Walter said.  "As such, it has not forfeited its rights and may take advantage of the rate limitations set forth in California Civil Code [Section] 2860."

The dispute centers on a slew of suits against SoCal Edison and its parent company, Edison International, following the devastating Bobcat Fire in the Angeles National Forest in September 2020.  The plaintiffs in those suits claimed that the fire was likely caused by tree branches and other vegetation that came into contact with SoCal Edison's conductors.

The utility sought coverage from Greenwich under a commercial general liability policy that the insurer issued to Utility Tree Service LLC, which SoCal Edison hired to provide vegetation services where the fire started.  But the insurer repeatedly denied its duty to defend.

Last year, SoCal Edison filed suit against Greenwich, asking the court to declare that the insurer owes coverage under the CGL policy and asserting breach of contract and bad faith claims.  Greenwich argued that it has no defense obligations to the utility company because the underlying suits don't accuse UTS of negligence.  However, in January, the court held that SoCal Edison clearly established that Greenwich has a duty to defend.

The utility lodged its motion for partial summary judgment in June, arguing that Greenwich has failed to reimburse its fees in full following that order.  Instead, it told the utility it planned to pay only a fraction of the fees by significantly reducing the hourly rate of SoCal Edison's defense counsel, it said at the time.

Insurer Owes Attorney Fees After Reduction in Fees

August 3, 2023

A recent Law 360 story by Elizabeth Daley, “Insurer Owes Sugar Co. $3.5M After Fee Cut in Emissions Suit”, reports that United States Sugar Corp. cannot recoup from its insurer all it spent in a nearly $10 million battle against a proposed class action alleging toxic emissions from pre-harvest sugarcane burns, a Florida federal judge ruled, finding costs excessive.  In his order, U.S. District Judge Robert N. Scola Jr. wrote that Commerce and Industry Insurance Co. would only be responsible for paying just over $6.5 million in connection with the underlying case, resulting "in roughly a 24% overall reduction of US Sugar's requested attorneys' fees and costs."  Because the insurer had already paid about $2.1 million and the sugar company was subject to a $1 million self-insured retention, the insurer ended up owing U.S. Sugar nearly $3.5 million, the judge said.

The dispute between U.S. Sugar and Commerce and Industry stemmed from an underlying lawsuit that was voluntarily dismissed in 2022.  The complaint, filed in 2019, accused U.S. Sugar and other leading sugar producers of harming nearby Florida properties through the practice of pre-harvest sugarcane burns, which the lawsuits alleged emitted toxic "black snow" in the Glades region.  The plaintiffs alleged the black snow, which sent plumes of smoke into the air and deposited ash on cars, homes and yards, harmed public health and local property values.

U.S. Sugar told the court that the underlying complaint was amended three times and the company spent millions of dollars defending itself.  The plaintiffs eventually dropped the litigation.  The insurer refused to defend U.S. Sugar, but was ultimately found responsible, according to court documents.  In his order, Judge Scola found that the costs of defending the lawsuit were so steep that he agreed with the insurer that they were beyond the reasonable costs that Florida law dictates must be reimbursed under the circumstances.

While opposing the insurer's request for a 50% reduction of the costs and fees, Judge Scola did agree that the work by some of the six law firms U.S. Sugar employed — Gunster, Mayer Brown, Holland & Knight, Litchfield Cavo, Haliczer Pettis & Schwamm and Clare Locke — was at times duplicative.  He specifically cited Gunster and Mayer Brown, writing "both firms [took] overlapping roles on the review and investigation of the pleadings and on legal briefing relating to the pleadings."

As a result, the judge cut Gunster's fees by 20% and Mayer Brown's by 30%. He also challenged some costs related to expert witnesses, leading him to employ the overall 24% reduction to U.S. Sugar's costs.  However, the judge declined to challenge the pay rates for three Mayer Brown attorneys despite the insurer calling their hourly rates of $1,058, $995 and $932 excessive.

Judge Scola explained that though the underlying case did not proceed to discovery, it lasted for over two and a half years.  While it did not involve novel questions, there were many legal filings and the case was more challenging than many because it involved both personal injury and environmental harm, he said.  The case required specialty environmental attorneys with "an above-average level of skill," Judge Scola wrote.  As such, he wrote that the attorney fees were high as might be expected for a complex case.

Additionally, the Miami-based judge added that "the South Florida legal market has changed drastically in the last several years.  Miami in particular has developed into a national legal market.  That top-end firms will be able to charge national hourly rates in South Florida, now, is an inevitable consequence of that development."

Client Didn’t Notice Billing Rate Hikes, Jury Hears

July 14, 2023

A recent Law 360 story by Brian Steele, “McCarter & English Client Didn’t Notice Rate Hikes, Jury Hears”, reports that a dietary supplement company founder battling McCarter & English LLP over a $2 million legal bill admitted to a Connecticut federal jury that he didn't thoroughly read the firm's invoices, but also refuted the firm's claim that he was verbally informed about the rate hikes at the heart of his counterclaim. 

On the third day of testimony in a Hartford trial, Jarrow Formulas Inc. owner Jarrow Rogovin said that he was responsible for reviewing and approving payment on the company's legal bills, including those that were generated after Caudill Seed & Warehouse Co. filed a lawsuit in Kentucky in 2013 for misappropriation of trade secrets.  But he said that he did not read those monthly bills past the first page, with one exception, because the thought of the legal action and its potentially devastating consequences made him "sick."

"I didn't do a good job" reviewing the bills before paying them, Rogovin said. He added that he did not notice when rates for two partners rose months after the start of the case, or that prior bills were reissued with higher rates.

McCarter & English, which has offices in Hartford and Stamford, is seeking more than $2 million in unpaid legal bills, mostly from the final five invoices related to the lawsuit filed in Kentucky federal court.  Jarrow countersued for allegedly improper billing practices and claimed that its attorneys botched the case, which ended in 2019 with an adverse verdict for Jarrow and $2.4 million in damages.

Rogovin, a Los Angeles resident, testified that several of the legal team's decisions caused his namesake company to lose the lawsuit and he "repeatedly" conveyed his concerns to McCarter & English attorneys, including partner Mark D. Giarratana.  He said the attorneys declined to pursue certain third-party subpoenas and depose the owner of the plaintiff, Caudill, about a disputed claim that it had spent $5 million and 23 years on research and development related to a broccoli-based product at issue in the case.

"They didn't do their job. They committed malpractice," Rogovin said, prompting U.S. District Judge Michael Shea to instruct the jury that only an expert witness can draw that conclusion.  Judge Shea said the testimony could be used to illustrate Rogovin's state of mind when deciding not to pay outstanding bills after the trial.

On direct examination, defense attorney James E. Heavey asked if Rogovin conducted a line-by-line review of legal bills before authorizing payment.  Rogovin said no, and that he was the only one at Jarrow responsible for reviewing the relevant bills when they came in.  "I looked at the front, the amount of money, and I was sick to my stomach about what was going on," he said when asked about his review process during cross-examination.  "I read the front, I saw what it was and I signed off."

Giarratana previously testified that the firm accidentally billed for his and fellow partner Eric Grondahl's services at the start of the case at an outdated rate, and when he discovered the mistake, the firm reissued three out of five monthly invoices.  But the firm also submitted all five invoices, showing the higher rate, to Jarrow's insurer as part of a failed effort to secure coverage.  Rogovin said that the attempt to obtain payment from the insurer at the higher rate was "unethical" and Jarrow did not know about it.  If he had been aware, Rogovin said, he would have been "very disapproving."

McCarter & English chief financial officer Jacqueline Bosma testified Monday that when the firm reissued the bills to Jarrow, it applied a credit for payment that had been received on one invoice already, according to a review of accounting records.  She said the reissued bills were paid at discounts near the end of the fiscal year.  She was hired as a controller at the firm in 2016.

When the rates rose, they were then frozen for the length of the lawsuit in accordance with Giarratana's policy, even when, Bosma said, the standard rate for each attorney continued to climb.  The freeze allowed Jarrow to save more than $500,000 on fees for Giarratana and Grondahl, she said, and even though attorney Thomas J. Rechen's rate rose in 2016 when the firm noticed it was charging an outdated figure, it also froze, amounting to a total savings to Jarrow of more than $200,000.  Heavey said there was no evidence that Jarrow agreed to the rate increases, but Bosma reiterated Giarratana's prior testimony that paying 70 of the bills without complaint signified an agreement.

Rogovin testified that he was not aware of a credit and the company never received a refund.  He said that he "probably had some kind of vague idea" of what the attorneys were charging per hour, but he did not know that the rates rose several months into the trial, or that McCarter reissued the previous months' bills at higher rates for Giarratana and Grondahl.  Rogovin denied Giarratana's testimony that he had told Rogovin of the rate changes in three phone calls.

"What would be the point of telling me three times?" Rogovin said. "If it were three times, I'd certainly remember it."  He said that if he had known the rates were going up, he would not have agreed to pay them and would have sought advice from the company's CFO.

Rogovin said that since he first retained Giarratana in 1996, when Giarratana worked for a different firm, he had only caught two errors on his legal bills, and one of them appeared on the first page.  Defense attorneys showed that on at least one bill related to the Kentucky litigation, the attorneys' hourly rates were shown on page 32.

Under questioning from plaintiffs' attorney Louis R. Pepe, Rogovin said he found an error on one bill related to the Kentucky case when he noticed that a particular line item described work on a separate legal matter McCarter & English was handling.  Pepe said the only way he could have noticed the error on page 5 was by conducting a line-by-line review, allegedly contradicting his prior testimony.  Rogovin disagreed that he had contradicted himself on the stand or in his deposition, but Judge Shea stopped him from reading the transcript of his deposition out loud and Pepe moved on.

Pepe asserted that there was a decades-long "pattern and practice" whereby Giarratana and ultimately other McCarter partners' rates would rise without prior written notice, Rogovin and Giarratana would not discuss it, and Rogovin would simply settle up, sometimes with a discount if the bills were still outstanding as the end of the fiscal year approached.

Rogovin said he founded Jarrow in 1977 and the company started manufacturing its own product lines in 2002.  He and Giarratana signed an engagement letter in 1996 that notified Rogovin that hourly rates could rise "from time to time," and Rogovin said that he read and understood that letter.  Even though Giarratana's standard rate climbed over the years and he moved firms, landing at McCarter & English through a merger in 2003, Rogovin said they did not sign a new written agreement that contemplated fees.