TMH Medical Services, LLC v. National Union Fire Insurance Company of Pittsburgh, PA ( 2019 )


Menu:
  •            Case: 18-14991   Date Filed: 12/04/2019   Page: 1 of 9
    [DO NOT PUBLISH]
    IN THE UNITED STATES COURT OF APPEALS
    FOR THE ELEVENTH CIRCUIT
    ________________________
    No. 18-14991
    Non-Argument Calendar
    ________________________
    D.C. Docket No. 6:17-cv-00920-RBD-DCI
    TMH MEDICAL SERVICES, LLC,
    Plaintiff-Appellant,
    versus
    NATIONAL UNION FIRE INSURANCE
    COMPANY OF PITTSBURGH, PA.,
    Defendant-Appellee.
    ________________________
    Appeal from the United States District Court
    for the Middle District of Florida
    ________________________
    (December 4, 2019)
    Before NEWSOM, BRANCH, and GRANT, Circuit Judges.
    PER CURIAM:
    Case: 18-14991    Date Filed: 12/04/2019   Page: 2 of 9
    TMH Medical Services, LLC appeals from the judgment in favor of
    defendant National Union Fire Insurance Company of Pittsburgh, Pa. in this
    insurance coverage case. We affirm.
    I.
    In January 2017, TMH began doing business with a group of entities
    operating under the name Synuity. Synuity described itself as a Professional
    Employer Organization (PEO) offering a range of staffing and human resources
    outsourcing services, including payroll processing, tax remission and reporting,
    Workers Compensation and health insurance administration, and employment
    practice liability insurance (EPLI). One of the Synuity companies, Platinum-HR,
    LLC, provided payroll processing and tax remission and reporting services for
    TMH beginning in late January 2017.
    In February 2017, TMH received written notice of workplace tort claims by
    two of its employees against TMH “and related persons and entities.” TMH
    tendered the claims to Synuity, seeking defense costs and indemnity under
    Synuity’s EPLI policy with National Union—the policy at issue here. The policy
    provided EPLI coverage for specified claims against Synuity and its PEO clients,
    under specified conditions.
    Apparently recognizing that the policy required, among other things, a
    written agreement between Synuity and its PEO client, TMH and Synuity prepared
    2
    Case: 18-14991       Date Filed: 12/04/2019     Page: 3 of 9
    a “Service Agreement” using parts of two form contracts provided by Synuity.
    The Service Agreement bore an “entered into” date of January 1, 2017, though it
    was completed and executed by the parties on March 13, 2017.
    National Union agreed to provide a defense for the claims against TMH,
    subject to a reservation of rights, but ultimately determined that the claims were
    not covered under the policy and declined to provide indemnity for TMH or
    participate in the settlement of the claims. TMH filed suit against National Union
    in federal court, alleging that the insurer had wrongfully failed to indemnify and
    defend TMH for the claims. The parties filed competing motions for summary
    judgment, and the district court granted National Union’s motion, denied TMH’s,
    and entered judgment for National Union on all of TMH’s claims. This appeal
    followed.1
    II.
    “We review de novo a district court’s rulings on cross-motions for summary
    judgment.” Chavez v. Mercantil Commercebank, N.A., 
    701 F.3d 896
    , 899 (11th
    Cir. 2012). On each motion, we view the facts in the light most favorable to the
    nonmoving party. 
    Id. Summary judgment
    is appropriate “if the movant shows that
    1
    On appeal, TMH presents argument related to its claim for indemnity only. TMH has therefore
    abandoned its claim that National Union failed to provide a defense. See Sapuppo v. Allstate
    Floridian Ins. Co., 
    739 F.3d 678
    , 681–82 (11th Cir. 2014).
    3
    Case: 18-14991     Date Filed: 12/04/2019   Page: 4 of 9
    there is no genuine dispute as to any material fact and the movant is entitled to
    judgment as a matter of law.” Fed. R. Civ. P. 56(a).
    The parties agree that Florida law applies in this diversity-jurisdiction case
    involving insurance coverage under a policy that was delivered and executed in
    Florida. See Trailer Bridge, Inc. v. Illinois Nat. Ins. Co., 
    657 F.3d 1135
    , 1141
    (11th Cir. 2011) (per curiam); State Farm Mut. Auto. Ins. Co. v. Roach, 
    945 So. 2d 1160
    , 1163 (Fla. 2006). Questions regarding the interpretation of a contract,
    including a contract for insurance, are matters of law that we review de novo. See
    Hegel v. First Liberty Ins. Corp., 
    778 F.3d 1214
    , 1219 (11th Cir. 2015); Penzer v.
    Transp. Ins. Co., 
    29 So. 3d 1000
    , 1005 (Fla. 2010).
    III.
    Under Florida law, an insurance contract is interpreted according to the plain
    language of the policy. Siegle v. Progressive Consumers Ins. Co., 
    819 So. 2d 732
    ,
    735 (Fla. 2002). Ambiguous terms are construed in favor of coverage, but “if a
    policy provision is clear and unambiguous, it should be enforced according to its
    terms whether it is a basic policy provision or an exclusionary provision.” Taurus
    Holdings, Inc. v. U.S. Fid. & Guar. Co., 
    913 So. 2d 528
    , 532 (Fla. 2005) (citation
    omitted). “In construing insurance contracts, ‘courts should read each policy as a
    whole, endeavoring to give every provision its full meaning and operative effect.’”
    4
    Case: 18-14991      Date Filed: 12/04/2019      Page: 5 of 9
    Washington Nat. Ins. Corp. v. Ruderman, 
    117 So. 3d 943
    , 948 (Fla. 2013) (citation
    omitted).
    Synuity’s policy with National Union provided EPLI coverage for Synuity’s
    PEO clients, “but only with respect to PEO Client Company Claim(s).” Based on
    the various definitions and conditions in the policy, this meant that TMH was
    entitled to indemnity for its employees’ claims only if—among other conditions—
    it leased the claimant-employees from Synuity through a written employee leasing
    agreement that was in effect at the time the claims were made. Because TMH did
    not have such an agreement with Synuity when it received notice of the claims (or
    at any other time), the district court correctly determined that TMH was not
    entitled to coverage under the policy.2
    The practice of employee leasing is regulated by statute in Florida. It is a
    crime for any entity not licensed by the state to operate as an employee leasing
    company, and licensed entities may lease employees only through written
    agreements that satisfy certain statutory conditions. Fla. Stat. Ann. §§ 468.531;
    468.525(3)(a), (4). Among other things, the leasing contract must contain
    provisions by which the leasing company (1) reserves “a right of direction and
    2
    Because we conclude that TMH and Synuity never had a valid employee leasing agreement, we
    need not resolve the parties’ dispute about whether TMH’s written agreement with Synuity was
    in effect when the claims were made.
    5
    Case: 18-14991     Date Filed: 12/04/2019   Page: 6 of 9
    control over leased employees assigned to the client’s location”; (2) assumes
    “responsibility for the payment of wages to the leased employees without regard to
    payments by the client to the leasing company”; (3) retains “authority to hire,
    terminate, discipline, and reassign the leased employees,” subject to the client’s
    approval; and (4) confirms that it has “given written notice of the relationship
    between the employee leasing company and the client company to each leased
    employee it assigns to perform services at the client’s worksite.” 
    Id. § 468.525(4)(a)–(b),
    (d), (f). TMH had no written agreement with Synuity that
    satisfied those terms.
    TMH argues that a Synuity brochure that it received on an unspecified date,
    along with email correspondence and a letter from TMH to a third-party insurance
    company naming Synuity as its insurance agent, constituted a written agreement
    for PEO services. The brochure described Synuity as a PEO and outlined some of
    the services that Synuity offered, including payroll and benefits administration and
    employer risk mitigation services such as EPLI and unemployment insurance. The
    email correspondence contained a discussion of TMH’s Workers’ Compensation
    and health insurance needs. But none of those writings referenced an employee
    leasing arrangement between Synuity and TMH or fulfilled the statutory
    requirements for an employee leasing agreement. And in any event, even if read
    together, the brochure and correspondence did not evince mutual agreement to any
    6
    Case: 18-14991       Date Filed: 12/04/2019      Page: 7 of 9
    specific terms—ultimately, Synuity did not provide either health insurance or
    Workers’ Compensation insurance for TMH’s employees. Writings in which the
    parties discuss available services but do not specify essential terms do not amount
    to a binding agreement under Florida law. See Vega v. T-Mobile USA, Inc., 
    564 F.3d 1256
    , 1272 (11th Cir. 2009); Irby v. Memorial Healthcare Grp., 
    901 So. 2d 305
    , 306 (Fla. Dist. Ct. App. 2005).
    Next, TMH contends that the Service Agreement executed by the parties in
    March 2017 met the policy’s requirement for a written PEO service agreement.
    But regardless of what other PEO services may have been contemplated in the
    Service Agreement, it did not meet Florida’s statutory requirements for an
    employee leasing agreement—and therefore could not meet the policy’s
    requirement for a written agreement to lease the claimants to TMH.3 See Korman
    v. HBC Fla., Inc., 
    182 F.3d 1291
    , 1297 (11th Cir. 1999) (“state law is read into and
    becomes part of a contract”). The Agreement did not describe a coemployer
    relationship between Synuity and TMH, reserve to Synuity any right of direction
    and control over leased employees, require Synuity to assume responsibility for
    payment of wages regardless of payments to Synuity by TMH, give Synuity
    authority to hire, fire, discipline, or reassign leased employees, or require Synuity
    3
    The Service Agreement contained an express choice-of-law provision stating that it was to be
    “governed by and construed in accordance with the laws of the State of Florida.”
    7
    Case: 18-14991         Date Filed: 12/04/2019   Page: 8 of 9
    to provide written notice of the relationship between Synuity and TMH to the
    leased employees. See Fla. Stat. Ann. § 468.525(4)(a)–(b), (d), (f). To the
    contrary, the Agreement reserved exclusive direction and supervision of the
    “Contract Personnel” to TMH, gave TMH exclusive authority to make hiring and
    retention decisions, provided that Synuity would have no obligation to pay wages
    if TMH did not wire payroll funds to Synuity in advance, and said nothing about
    providing notice to employees of the contractual relationship between TMH and
    Synuity.
    TMH points out that the relevant statute permits the client company to retain
    “such sufficient direction and control over the leased employees as is necessary to
    conduct the client’s business,” and implementing regulations provide that the PEO
    need not actually exercise its hiring and firing authority on the jobsite; the “client
    shall be allowed to exercise such authority as may be allocated to the client, in
    writing, and in conformity with Florida law.” Fla. Stat. Ann. § 468.525(4)(a); Fla.
    Admin. Code Ann. r. 61G7-6.001(9). But the contract that TMH and Synuity
    entered into did not merely allocate worksite authority between them; it gave TMH
    exclusive control of its employees and exclusive authority to hire, fire, and
    discipline them. Florida law plainly prohibits an employee leasing arrangement in
    which the leasing company surrenders all authority over the employees to the
    client and retains none for itself.
    8
    Case: 18-14991    Date Filed: 12/04/2019   Page: 9 of 9
    IV.
    Because the Service Agreement failed to comply with multiple statutory
    requirements for employee leasing contracts, it was not a valid employee leasing
    agreement. And because TMH did not have a valid written agreement to lease the
    employee-claimants from Synuity, the employees’ claims against TMH were not
    covered under Synuity’s EPLI policy with National Union. The district court
    therefore correctly denied TMH’s motion for summary judgment and granted
    summary judgment in favor of National Union.
    AFFIRMED.
    9