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Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 1 of 23



Carey E. Matovich
Jesse Myers
MATOVICH, KELLER & MURPHY, P.C.
2812 First Avenue North, Suite 225
P.O. Box 1098
Billings, MT 59103-1098
Telephone: (406) 252-5500
Facsimile: (406) 252-4613
Email: cmatovich@mkfinn.com
Email: ;myers@mkfinn.com

John M. Kauffman
Lilia Tyrrell
KASTING, KAUFFMAN & MERSEN, P.C.
716 S. 20th Avenue, Suite 101
Bozeman, MT 59718
Telephone: (406) 586-4383
Facsimile: (406) 587-7871
Email: jkauffman@kkmlaw.net
Email: Ityrrell@kkmlaw.net

A ttorneys for Central Asia Institute


                  IN TIlE UNITED STATES DISTRICT COURT

                       FOR THE DISTRICT OF MONTANA

                                  BUTTE DIVISION

                                            )
 CENTRAL ASIA INSTITUTE,                    )
                                            )         Cause No. CV-I;J.=75-t3u-   DLL
              Plaintiff,                    )
                                            )
       vs.                                  )       COMPLAINT AND DEMAND
                                            )          FOR JURY TRIAL
 PHILADELPHIA INDEMNITY                     )
 INSURANCE COMPANY,                         )
- - - - - - - - - - - ---~) 

                           Complaint and Demand for Jury Trial- 1
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               Defendant.                    )


      Plaintiff Central Asia Institute ("CAl"), by and through its attorneys, files

this Complaint against Defendant Philadelphia Indemnity Insurance Company

("Philadelphia"), and alleges as follows.

                            NATURE OF THE ACTION

      1.      CAl files suit for declaratory relief and for recovery of compensatory

and punitive damages from Philadelphia arising out of Philadelphia's failure to

honor its obligations under its insurance contract with CAl and for its unfair,

erroneous, and bad faith refusal to pay Defense Costs incurred by CAl for covered

claims.

                                        PARTIES

      2.      CAl is a Delaware 501(c)(3) non-profit corporation, with its principle

place of business in Montana. CAl's charitable mission is to empower

communities of Central Asia through literacy and education, especially for girls, to

promote peace through education and convey the importance of these activities

globally.

      3.      Philadelphia is a foreign insurance company authorized to do business

in Montana. Philadelphia is a Pennsylvania corporation, with its principle place of

business in Pennsylvania.




                            Complaint and Demand tor Jury Trial- 2
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                          JURISDICTION AND VENUE

      4.      CAl and Philadelphia are citizens of different states and the amount in

controversy in this matter exceeds $75,000, exclusive of interest and costs. This

Court has diversity jurisdiction pursuant to 28 U.S.C. § 1332.

       5.     Venue is proper in this Court pursuant to 28 U.S.C. § 1391 (b)(2) and

Local Rule 3.2(b).

                 ALLEGATIONS COMMON TO ALL CLAIMS

       6.     CAl purchased Philadelphia Commercial Lines Policy No.

PHSD577929 with a Policy Period of December 1,2010, through December 1,

2011 (the "Policy"). A true and correct copy ofthe Policy is attached as Exhibit 1.

       7.     CAl is the Named Insured Organization under the Policy. The Policy

provides liability insurance for the Organization (CAl), in addition for Individual

Insureds. The Individual Insureds under the Policy include, inter alia, CAl's past,

present, and future officers and directors, including but not limited to its executive

director.

       8.     During the Policy Period and at all relevant times herein, Greg

Mortenson ("Mortenson") served as CAl's executive director, and is an Individual

Insured under the Policy. CAl has a duty to indemnify Mortenson, as the



                           Complaint and Demand for Jury Trial - 3
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executive director of CAl under Delaware law and under an indemnification

resolution passed by its Board of Directors.

      9.       Under the terms of the Policy, CAl and Mortenson had (and have)

responsibility to defend any Claim made against them. They are obligated to elect

counsel oftheir choice, subject to approval of Philadelphia. Philadelphia's

approval may not be unreasonably withheld.

       10.     Under the terms of the Policy, Philadelphia has a duty to advance

Defense Cost for investigation, adjustment, defense and appeal of claims, in

addition to the Limit of Liability as follows:

               If the Insured has assumed the defense of a Claim pursuant to
               A. above, the Underwriter shall advance Defense Cost prior
               to the final disposition of a Claim ...

       11.     The Policy defines the term "Defense Cost" as "any reasonable and

necessary legal fees and expenses incurred in the defense of a Claim, whether by

the insured with the Underwriter's consent or directly by Underwriter, in the

investigation, adjustment, defense and appeal of a Claim ... " Hereinafter the term

is referred to as "Defense Cost" or "Defense Costs."

       12.     Payment of Defense Costs by Philadelphia under the Policy is an

obligation which is in addition to, and not part of, the Limit of Liability unless the

applicable Limit of Liability has been exhausted by payment of damage claims.




                           Complaint and Demand for Jury Trial. 4
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      13.      CAr incurred Defense Costs for itself and for Mortenson in

connection with the lawsuit initiated against them on or about May 5, 20 II, in the

United States District Court of Montana known as Case No. CV-II-72-M-DWM

("Pfau Litigation").

      14.      The plaintiffs in the Pfau Litigation claimed to have purchased books

authored by Mortenson entitled Three Cups ofTea and Stones Into Schools. The

complaints filed against Mortenson and CAl in the Pfau Litigation contained a

variety of legal and equitable claims (fraud, deceit, RICO violations breach of

contract, unjust enrichment and constructive trust) all of which were predicated on

the same core set of factual allegations.

       IS.     The plaintiffs in the Pfau Litigation amended their complaint four

times. CAl timely provided Philadelphia with copies of the First, Second, Third,

and Fourth Amended Complaints filed in the Pfau Litigation. A copy of the Fourth

Amended Complaint is attached as Exhibit 2.

      16.      The Pfau Litigation at all times involved an attempt to establish a

nationwide class of book purchasers and included motions and briefs on class

certification, discovery, and whether the matter should be dismissed for failing to

state claims upon which relief could be granted.

      17.      On April 30, 2012, the United States District Court for the District of

Montana dismissed the Fourth Amended Complaint filed in the Pfau Litigation



                            Complaint and Demand for Jury Trial - 5
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with prejudice, holding, in part, that the plaintiffs had failed to state claims upon

which relief could be granted. Plaintiffs appealed the decision to the Ninth Circuit

Court of Appeals and that appeal is pending

       18.     CAl wrote to Philadelphia on May 27, 2011, and again on May 31,

2011, to notify Philadelphia of the Piau Litigation and to request full coverage

under the Policy, including approval of retained counsel (the "May 2011 Notices").

Philadelphia acknowledged receipt ofthe May 2011 Notices on June 2, 2011.

       19.     Separately from the May 2011 Notices, Mortenson notified

Philadelphia of the Piau Litigation on or about June 9, 2011, and requested full

coverage under the Policy including approval of counsel. Philadelphia

acknowledged receipt of Mortenson's notice of loss on June 17,2011.

      20.      Given the complex and nation-wide issues presented in the Piau

Litigation and the fact that it was filed in the United States District Court in the

State of Montana, it was reasonable and necessary for CAl and Mortenson to

engage both Montana counsel and national counsel with experience in RICO, class

action, and the other claims in this litigation, which they had done, and of which

they timely notified Philadelphia.

       21.     Following receipt ofthe complaint in the Piau Litigation, CAl

incurred reasonable and necessary Defense Costs investigating, preparing to




                           Complaint and Demand for Jury Trial- 6
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defend, and defending itself and Mortenson against the allegations therein, and

continues to do so with respect to the appeal.

      22.     CAl also incurred Defense Costs for itself and for Mortenson in

connection with investigations initiated against them beginning in May of2011, by

the Office of the Attorney General ofMontana

      23.     On or about September 16,2011, CAl (i) notified Philadelphia of its

defense in the AG Matter, (ii) provided Philadelphia with applicable

correspondence from the Office of the Montana Attorney General; and (iii)

requested full coverage under the Policy including but not limited to approval of

retained counsel. Philadelphia received the September 16, 2011, notice from CAL

      24.     On or about May 27 and 31, June 21, and August 1, 2011, Mortenson

(i) notified Philadelphia of his defense in the AG Matter; (ii) provided Philadelphia

with applicable correspondence from the Office ofthe Montana Attorney General;

and (iii) requested full coverage under the Policy including approval of retained

counsel. Philadelphia received the May 27 and 31, June 21, and August 1, 201 I,

notices from Mortenson.

      25.     CAl and Mortenson had each retained legal counsel to assist them

with the AG Matter. Given the complex issues presented in the AG Matter, it was

reasonable for CAl and Mortenson to engage both Montana counsel and counsel




                          Complaint and Demand for Jury Trial - 7
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with experience working with administrative attorneys general investigations

involving non-profit corporations and their directors.

      26.     On AprilS, 2012, CAl, Mortenson and the Office of the Montana

Attorney General entered into a Settlement Agreement and Assurance of Voluntary

Compliance regarding the AG Matter. CAl incurred Defense Costs for both itself

and Mortenson, as that term is defined in the Policy, to achieve this result.

      27.     The Piau Litigation and the AG Matter (collectively, the "Claims")

are covered matters within the Policy. Philadelphia must pay the Defense Costs

incurred by CAl for itself and Mortenson in connection with the Claims.

      28.     CAl has complied with ail applicable conditions precedent to entitle it

to the benefits afforded by the Policy with respect to payment of Defense Costs for

the Claims.

      29.     CAl regularly provided Philadelphia with copies of legal bills it

received (and which it had paid) from its defense counsel and requested that

Philadelphia recognize its duty to pay and advance to CAl the Defense Cost it was

incurring. CAl did not receive a reservation of rights letter from Philadelphia in

which Philadelphia set forth any facts or law that might relieve Philadelphia of its

obligation to provide full coverage under the Policy, until after significant Defense

Costs for the Claims had been incurred.




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      30.     On or about December 6, 2011, Philadelphia first acknowledged that

the Piau Litigation and AG Matter constituted Claims during the Policy Period.

      31.     In the December 6, 20 II letter, Philadelphia claimed it issued CAl a

"reservation of rights on June 17,2011." CAl never received such a "reservation

of rights" on or about June 17,2011.

      32.     Mortenson received a letter from Philadelphia on or about June 17,

2011, in which Philadelphia only discussed why it might reserve its rights.

      33.     Before December 6, 2011, Philadelphia never informed CAl of Policy

defenses it intended to raise or provided CAl a reasonable explanation based upon

the applicable facts and law of why CAl may not receive advances or

reimbursements for all Defense Costs.

      34.     Before December 6, 2011, Philadelphia never stated or suggested that

CAlor Mortenson should not retain counselor should not proceed with the defense

of all ofthe Claims, as required by the Policy. Philadelphia did not state or suggest

that any portion of the Defense Cost might be apportioned in a manner designated

by Philadelphia.

      35.     On or about December 6,20 II, Philadelphia wrote to CAl and

repudiated its duty to advance Defense Cost in full. For the first time, Philadelphia

claimed it was only obligated to reimburse CAl for 35% of the Defense Cost

incurred by CAl in defending the Piau Litigation; 25% of the Defense Cost



                           Complaint and Demand for Jury Trial - 9
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incurred by Mortenson in defending the Piau Litigation; 20% of the Defense Cost

incurred by Mortenson in defending the AG Matter; and 100% of the Defense Cost

incurred by CAl in defending the AG Matter. By presenting the foregoing

allocation percentages, Philadelphia misrepresented its obligations under the

Policy.

      36.     Philadelphia contended that it could allocate in the manner discussed

in its December 6,2011, letter based upon the following provision in Part 6,

Section XIX ofthe Policy (the "Allocation Provision"):

      If both Loss covered by this Policy and Loss not covered by this Policy are
      incurred either because a Claim includes both covered and uncovered
      matters, or because a Claim is made against both the Individual Insured
      and/or the Organization, and others, the Insured and the Underwriter shall
      use their best efforts to agree upon a fair and proper allocation of such
      amount between covered Loss and uncovered loss. Any such allocation
      shall be based upon the relative legal exposures of the parties to covered and
      uncovered matters.

      37.     Philadelphia may not use the "Allocation Clause" to limit the scope of

its obligation to advance or reimburse 100% of the Defense Costs incurred by CAl

in connection with the Claims because:

              a.    The Allocation Clause, as interpreted by Philadelphia, is

      contrary to Montana law. Moreover, the claims in both the Piau Litigation

      as well as the claims in the AG matter were so inextricably intertwined so as

      to make them inseparable when it came to incurring the attorneys' fees and

      costs defending the same. As a result, it is unreasonable to attempt to

                          Complaint and Demand for Jury Trial - 10
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      allocate Defense Costs amongst the claims and Philadelphia is responsible

      for 100% of the Defense Costs.

              b.    Philadelphia has acquiesced to the choices of counsel made by

      CAl and Mortenson and to the amounts incurred by CAl in defending CAl

      and Mortenson on the Claims. Philadelphia has not properly reserved its

      rights and is estopped from (i) challenging the reasonableness and necessity

      of hiring the counsel chosen by CAl and Mortenson; (ii) challenging the

      amounts incurred by CAl and Mortenson in defending against the Claims

      and; (iii) reimbursing CAl, in full, for the entire Defense Costs it has

      incurred for itself and Mortenson in connection with the Claims.

      38.     In addition to imposing an arbitrary allocation percentage to reduce its

obligation to CAl, Philadelphia also attempted in its December 6, 20 11, letter to

lower the rate it would compensate the attorneys hired by CAl and Mortenson,

though Philadelphia had knowledge these attorneys had been engaged at contracted

rates since May, 20 11, and they had already undertaken significant efforts in

defending the Claims.

      39.     By email datedJanuaryI8.2012.Philadelphia belatedly requested

that retained defense counsel provide litigation plans and budgets for the Claims.




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      40.      By email dated January 19, 2012, Philadelphia belatedly attempted to

unilaterally impose reporting and billing "guidelines" on the previously retained

defense counsel.

      41.      Despite Philadelphia receiving notice of one or more of the Claims

beginning in May of 20 II, Philadelphia made no payment to CAl for Defense

Costs for over a year, including the "allocations" suggested in its December 6,

2011, letter. In the interim, CAl had incurred and paid hundreds of thousands of

dollars in Defenses Costs for itself and Mortenson, for which Philadelphia was

responsible.

      42.      CAl made numerous pleas to Philadelphia to pay Defense Costs, but

the pleas were ignored or received substantially and unreasonably delayed

responses.

      43.      As of August 13,2012, more than fourteen (14) months after litigation

in the Piau Litigation and the AG matter had been commenced and after the

majority of anticipated Defense Costs had been incurred, Philadelphia had only

reimbursed CAl for less than 6% of the Defense Cost CAl had incurred for itself

and Mortenson in defending the Claims.

      44.      On August 27,2012, Philadelphia issued a second letter with new

proposed percentages for covering Defense Costs. In the August 17, 20 II, letter,

Philadelphia proposed to reimburse CAl 33% of the defense fees and costs



                           Complaint and Demand for Jury Trial - 12
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incurred by Mortenson in the Piau litigation prior to the Fourth Amended

Complaint; 15% of Mortenson's defense fees and costs in the Piau litigation after

the Fourth Amended Complaint; 35% "allocation" of defense fees and costs

incurred by CAl in the Piau Litigation; 50% of Mortenson's defense fees and costs

for the AG matter; and 100% of CAl's costs for the AG matter, with CAT's fees

to be "adjusted" to "Philadelphia's agreed upon rates and less certain deductions."

By presenting the foregoing allocation percentages and arbitrary rate

modifications, Philadelphia misrepresented its obligations under the Policy.

      45.     Philadelphia is estopped from attempting to impose the allocations

and fee reductions reflected in its December 6,2011, and August 27, 2012, letters.

The Policy directs the insureds (CAl and Mortenson) to initially assume full

control of their defense, which they did with the full knowledge and acquiescence

of Philadelphia, with Philadelphia's full knowledge of and acquiescence in the

rates charged by the defense attorneys, and with Philadelphia's full knowledge and

acquiescence that a full defense was necessary.

      46.       Despite numerous communications by CAl to Philadelphia regarding

payments, Philadelphia refuses to pay all of CAl's and Mortenson's Defense Costs

arising from the investigation, adjustment, defense and appeal of the Claims.

Philadelphia has not even paid CAl the amounts Philadelphia had agreed to pay in

its December 6, 2011, and August 27, 2012, letters.



                          Complaint and Demand for Jury Trial- 13
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       47.     Philadelphia has acted in bad faith by refusing to acknowledge the

applicable scope of coverage of the Claims, refusing to engage in timely and

meaningful communications with CAl, refusing to pay and advance the reasonable

and necessary Defense Cost associated with the Claims; and attempting to

arbitrarily reduce fees incurred by CAl and Mortenson.

                                        COUNT I
               DECLARATORY JUDGMENTRE: DEFENSE COST

       48.     CAl incorporates by reference the enumerated paragraphs above, as if

fully set forth herein.

       49.     Under the Policy, Philadelphia has both a duty to defend (by paying

Defense Costs) and a duty to indemnify (pay damages). The duty to defend is

broader than the duty to indemnify. Philadelphia must pay Defense Costs if any

facts or allegations bring the Claims even potentially within the protection

purchased by CAl, even if the claims are groundless, false or fraudulent.

       50.     CAl has complied with the terms of the Policy in order to receive the

benefits ofthe Policy. It timely paid its premiums for the Policy. It timely

provided Philadelphia with notice of the Claims. CAl has complied with all

material terms of the Policy. CAl and Mortenson have incurred and paid hundreds

of thousands of dollars in Defense Costs, which are Philadelphia's responsibility.




                           Complaint and Demand for Jury Trial - 14
------ - - - - - - - - - - -


            Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 15 of 23



      51.      Under the Policy, Philadelphia has an obligation to pay, advance

and/or reimburse CAl and Mortenson all reasonable and necessary Defense Costs

CAl has incurred for itself and Mortenson in connection with the Claims.

      52.     CAl has repeatedly demanded payment ofthe reasonable and

necessary Defense Costs incurred in defending the Claims.

      53.     Philadelphia has improperly refused to pay, advance or reimburse all

ofthe reasonable and necessary Defense Costs incurred by CAl on behalf of itself

and Mortenson.

      54.      An actual controversy exists between the parties regarding their

respective rights and remedies under the Policy. CAl contends Philadelphia has no

legal right under the Policy or under Montana law (i) to allocate percentages of

Defense Costs it will pay under the Policy; (ii) to impose below market rates it

arbitrarily determines approporiate and to pay less than the actual fees incurred by

CAl and Mortenson for Defense Costs for the Claims; (iii) to withhold payment to

CAl of the Defense Costs it has already incurred in connection with the Claims or

(iv) to refuse to advance on-going Defense Cost for the Claims.

      55.      A declaration of rights pursuant to 28 U.S.C. §§ 2201 and 2202 and

Rule 57 of the Federal Rules of Civil Procedure would alleviate the uncertainty

facing CAl with regard to Philadelphia's obligations under the Policy to pay and

advance Defense Cost arising from the Claims.



                           Complaint and Demand for Jury Trial - 15
- - - - - - - - - - - - " " ,..     _-,_ ..,-,,--­

                     Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 16 of 23



               56.     CAl is entitled to a declaration that under the terms of the Policy,

        Philadelphia (i) may not allocate a percentage of Defense Costs it will pay under

        the Policy for fees and costs incurred in connection with the Claims; (ii) may not

        impose below market rates it arbitrarily determines approporiate and pay less than

        the actual fees incurred by CAl and Mortenson for Defense Costs for the Claims;

        (iii) must reimburse CAl all of the Defense Costs CAl incurred for itself and

        Mortenson in connection with the Claims and (iv) must advance on-going Defense

        Cost for the Claims in the appeal of the Piau Litigation.


                                            COUNT II
                                       BREACH OF CONTRACT

               57.     CAl incorporates by reference the enumerated paragraphs above, as if

        fully set forth herein.

               58.      Under the applicable standards of Montana law and the Policy,

         Philadelphia is obligated to pay and advance all of the reasonable Defense Costs

        CAl incurred for itself and Mortenson with respect to the Claims. Philadelphia

         must pay and advance the same, according to the Policy, "prior to the final

         disposition of a claim."

               59.      An insurer's defense-payment obligation is broader than its obligation

         to indemnify.




                                    Complaint and Demand for Jury Trial- 16
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      60.     CAl has complied with all conditions and obligations under the Policy

regarding its rights to receive Defense Costs from Philadelphia with respect to the

Claims.

      61.      Philadelphia breached the Policy by denying it has the obligation to

pay, advance or reimburse the reasonable and necessary Defense Costs CAl has

incurred for itself and Mortenson and will continue to incur in defense and appeal

of the Claims.

      62.      Because Philadelphia has not paid according to the Policy terms, CAl

been damaged. CAl has paid for Defense Costs without being reimbursed the

same. CAl has had to advance Defense Costs that it would not have had to

advance but for Philadelphia's intransigence. CAl has had to engage legal counsel

to enforce its rights under the Policy.

      63.      CAl has suffered the foregoing damages despite having paid

substantial premiums to Philadelphia for the Policy.

      64.      CAl is entitled to a judgment in its favor and against Philadelphia in

an amount proven at trial that will compensate CAl for the damages incurred by

Philadelphia's breach of the Policy, together with CAl's reasonable attorney's fees

and costs.

      65.      Once CAl provided notice to Philadelphia of the Claims, it should

have paid, advanced or reimbursed the Defense Costs. The Defense Costs are an



                           Complaint and Demand for Jury Trial - 17
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amount certain due on a date certain and, as a result, CAl is entitled to recover pre­

judgment interest on the amount owed at the rate of 10% per annum.

                                  COUNT III 

                           UNFAIR TRADE PRACITCES 


      66.      CAl incorporates by reference the enumerated paragraphs above, as if

fully set forth herein.

      67.      CAl properly gave Philadelphia notice of the Claims and the Claims

included "Wrongful Acts" and "Claims," as those terms are defined in the Policy.

       68.      Philadelphia knew it had an obligation to advance timely and

complete Defense Costs for the Claims.

      69.       Philadelphia wrongfully refused (and continues to refuse) to pay and

advance the reasonable and necessary Defense Costs incurred by CAl for itself and

Mortenson.

       70.      Philadelphia unreasonably withheld (and continues to withhold)

payment of reasonable and necessary Defense Costs despite CAl's full compliance

with all Policy requirements. Such withholding is with the wrongful intent of

depriving CAl of its rights.

       71.      Philadelphia failed to use reasonable care in the exercise ofits

relationship with CAL Philadelphia has not acted as a reasonable insurer would

have acted under the same or similar facts and circumstances.




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      72.     Philadelphia's actions in regard to CAl's claims for Defense Costs

were without justification or excuse. At worse, they were taken in bad faith and

without regard to the adverse effect it would have on CAL At best, Philadelphia's

conduct is grossly negligent and oppressive. In any event, its actions were taken to

further Philadelphia's own improper objectives and with disregard for the interests

of CAI, to the prejudice and detriment of CAl in violation of Montana law.

      73.      Philadelphia has violated subparagraphs (1), (4), and (5) of Montana's

Unfair Trade Practices Act, Section 33-18-20 I, MCA, by misrepresenting pertinent

facts or insurance policy provisions relating to coverage at issue, by refusing to pay

claims for Defense Cost without conducting a reasonable investigation based upon

all available information, and/or by failing to affirm or deny coverage of claims

within a reasonable time, causing CAl to suffer injury, damage and loss, giving

rise to a general tort action in favor of CAl pursuant to Section 33-18-242, MCA.

      74.      Philadelphia knew at all times that it was unlawful to misrepresent

pertinent facts or Policy provisions relating to coverage at issue in handling claims.

      75.      Philadelphia knew at all times that it was unlawful to disregard

pertinent policy provisions and/or refuse to pay claims without conducting a

reasonable investigation based upon all available information, and giving due

consideration to the plain language of its insurance contract, both as to the

particular facts and the applicable law governing the claim.



                           Complaint and Demand for Jury Trial- 19
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      76.      Philadelphia knew at all times that in return for the premiums paid by

CAl, it was obligated to adjust, pay and advance Defense Costs in accordance with

the terms, provisions and requirements of the Policy and Montana law.

      77.      Philadelphia knowingly applied its own internal procedures and rules

in intentional and conscious disregard of the applicable provisions of the Policy

and Montana law, all for the purpose of enhancing its profit at CAl's expense and

gaining unfair advantage over its competitors, and in conscious disregard of the

certainty that CAl, which had the right to rely and did rely upon Philadelphia's

false promises and misrepresentations, would suffer injury as a result.

      78.      At all relevant times, Philadelphia acted in conscious disregard of, or

indifference to, the knowledge that its arbitrary and unjustifiable conduct injured

CAl, and did so pursuant to policies, procedures and programs designed and

calculated to justify wrongdoing in the process of adjusting legitimate claims and

evade the responsibility imposed upon all legitimate insurers to reimburse insureds

in strict accordance with the promises set forth in the Policy.

      79.      Philadelphia's acts, decisions, and conduct clearly and convincingly

demonstrate actual malice, actual fraud, or both. CAl is entitled to a judgment in

its favor and against Philadelphia for punitive damages in an amount to be proven

at trial. CAl should be awarded such damages against CAl for the purpose of

disgorging from Philadelphia all ill-gotten gains obtained through such wrongful



                           Complaint and Demand for Jury Trial" 20
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behavior, taking the profit out of unlawful claim handling practices, punishing and

making an example of Philadelphia sufficient to deter similar fraudulent and

malicious behavior by it and all other insurers doing business in Montana now and

forever in the future, all in accordance with the strict procedural and substantive

protections afforded by Montana law.

      80.      As a result of Philadelphia's wrongful conduct, CAl has been required

to obtain counsel to represent its interests in pursuing this claim. As a result, CAl

has incurred, and will continue to incur, attorney's fees and litigation expenses in

order to establish its right to compensation for Defense Costs under the Policy.

      WHEREFORE, CAl respectfully prays for the Court grant CAl the

following relief;

      1.       Issue a judgment in favor of CAl and against Philadelphia declaring

that Philadelphia, as a matter of fact and law, is obligated to pay and advance all

sums for all of the Defense Costs CAl incurred for itself and Mortenson for the

Claims, and that Philadelphia's duty to pay and advance all of the Defense Costs

will continue until the Claims are finally resolved;

      2.       Issue a judgment in favor of CAl and against Philadelphia for

Philadelphia's breach of the terms of the Policy and awarding CAl compensatory

damages and pre-judgment interest as proven at trial;




                           Complaint and Demand for Jury Trial - 2 J
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       3.      Issue a judgment in favor of CAl and against Philadelphia for

Philadelphia's violation of Montana's Unfair Trade Practices Act, awarding CAl

compensatory and punitive damages as proven at trial;

       4.      Issue a judgment in favor of CAl and against Philadelphia awarding

CAl its reasonable attorney's fees incurred in this matter, together with costs and

disbursements as allowed by law or in equity; and

       5.      Issue an Order granting CAl such other and further relief as the Court

deems just and proper under the circumstances.

      DATED this 31 st day of October, 2012.

                                    MATOVICH, KELLER & MURPHY, P.C.


                                    By:   lsi Carey E. Matovich
                                           Carey E. Matovich
                                           Jesse Myers

                                    KASTING, KAUFFMAN & MERSEN,            p.e.
                                    By:   lsi John M Kaufftnan
                                           John M. Kauffinan
                                           Lilia Tyrrell

                           DEMAND FOR JURY TRIAL

       Plaintiff Central Asia Institute hereby demands a jury for all issues properly

triable by a jury in this matter.

       DATED this 31 st day of October, 2012.




                           Complaint and Demand for Jury Trial - 22
Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 23 of 23



                     MATOVICH, KELLER & MURPHY, P.e.


                      By: 	 /s/ Carey E. Matovich
                            Carey E. Matovich
                            Jesse Myers

                      KASTING, KAUFFMAN & MERSEN, P.e.

                      By: 	 /s/ John M Kaufftnan
                            John M. Kauffman
                            Lilia Tyrrell




              Complaint and Demand for Jury Trial- 23

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1 main

  • 1. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 1 of 23 Carey E. Matovich Jesse Myers MATOVICH, KELLER & MURPHY, P.C. 2812 First Avenue North, Suite 225 P.O. Box 1098 Billings, MT 59103-1098 Telephone: (406) 252-5500 Facsimile: (406) 252-4613 Email: cmatovich@mkfinn.com Email: ;myers@mkfinn.com John M. Kauffman Lilia Tyrrell KASTING, KAUFFMAN & MERSEN, P.C. 716 S. 20th Avenue, Suite 101 Bozeman, MT 59718 Telephone: (406) 586-4383 Facsimile: (406) 587-7871 Email: jkauffman@kkmlaw.net Email: Ityrrell@kkmlaw.net A ttorneys for Central Asia Institute IN TIlE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MONTANA BUTTE DIVISION ) CENTRAL ASIA INSTITUTE, ) ) Cause No. CV-I;J.=75-t3u- DLL Plaintiff, ) ) vs. ) COMPLAINT AND DEMAND ) FOR JURY TRIAL PHILADELPHIA INDEMNITY ) INSURANCE COMPANY, ) - - - - - - - - - - - ---~) Complaint and Demand for Jury Trial- 1
  • 2. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 2 of 23 Defendant. ) Plaintiff Central Asia Institute ("CAl"), by and through its attorneys, files this Complaint against Defendant Philadelphia Indemnity Insurance Company ("Philadelphia"), and alleges as follows. NATURE OF THE ACTION 1. CAl files suit for declaratory relief and for recovery of compensatory and punitive damages from Philadelphia arising out of Philadelphia's failure to honor its obligations under its insurance contract with CAl and for its unfair, erroneous, and bad faith refusal to pay Defense Costs incurred by CAl for covered claims. PARTIES 2. CAl is a Delaware 501(c)(3) non-profit corporation, with its principle place of business in Montana. CAl's charitable mission is to empower communities of Central Asia through literacy and education, especially for girls, to promote peace through education and convey the importance of these activities globally. 3. Philadelphia is a foreign insurance company authorized to do business in Montana. Philadelphia is a Pennsylvania corporation, with its principle place of business in Pennsylvania. Complaint and Demand tor Jury Trial- 2
  • 3. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 3 of 23 JURISDICTION AND VENUE 4. CAl and Philadelphia are citizens of different states and the amount in controversy in this matter exceeds $75,000, exclusive of interest and costs. This Court has diversity jurisdiction pursuant to 28 U.S.C. § 1332. 5. Venue is proper in this Court pursuant to 28 U.S.C. § 1391 (b)(2) and Local Rule 3.2(b). ALLEGATIONS COMMON TO ALL CLAIMS 6. CAl purchased Philadelphia Commercial Lines Policy No. PHSD577929 with a Policy Period of December 1,2010, through December 1, 2011 (the "Policy"). A true and correct copy ofthe Policy is attached as Exhibit 1. 7. CAl is the Named Insured Organization under the Policy. The Policy provides liability insurance for the Organization (CAl), in addition for Individual Insureds. The Individual Insureds under the Policy include, inter alia, CAl's past, present, and future officers and directors, including but not limited to its executive director. 8. During the Policy Period and at all relevant times herein, Greg Mortenson ("Mortenson") served as CAl's executive director, and is an Individual Insured under the Policy. CAl has a duty to indemnify Mortenson, as the Complaint and Demand for Jury Trial - 3
  • 4. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 4 of 23 executive director of CAl under Delaware law and under an indemnification resolution passed by its Board of Directors. 9. Under the terms of the Policy, CAl and Mortenson had (and have) responsibility to defend any Claim made against them. They are obligated to elect counsel oftheir choice, subject to approval of Philadelphia. Philadelphia's approval may not be unreasonably withheld. 10. Under the terms of the Policy, Philadelphia has a duty to advance Defense Cost for investigation, adjustment, defense and appeal of claims, in addition to the Limit of Liability as follows: If the Insured has assumed the defense of a Claim pursuant to A. above, the Underwriter shall advance Defense Cost prior to the final disposition of a Claim ... 11. The Policy defines the term "Defense Cost" as "any reasonable and necessary legal fees and expenses incurred in the defense of a Claim, whether by the insured with the Underwriter's consent or directly by Underwriter, in the investigation, adjustment, defense and appeal of a Claim ... " Hereinafter the term is referred to as "Defense Cost" or "Defense Costs." 12. Payment of Defense Costs by Philadelphia under the Policy is an obligation which is in addition to, and not part of, the Limit of Liability unless the applicable Limit of Liability has been exhausted by payment of damage claims. Complaint and Demand for Jury Trial. 4
  • 5. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 5 of 23 13. CAr incurred Defense Costs for itself and for Mortenson in connection with the lawsuit initiated against them on or about May 5, 20 II, in the United States District Court of Montana known as Case No. CV-II-72-M-DWM ("Pfau Litigation"). 14. The plaintiffs in the Pfau Litigation claimed to have purchased books authored by Mortenson entitled Three Cups ofTea and Stones Into Schools. The complaints filed against Mortenson and CAl in the Pfau Litigation contained a variety of legal and equitable claims (fraud, deceit, RICO violations breach of contract, unjust enrichment and constructive trust) all of which were predicated on the same core set of factual allegations. IS. The plaintiffs in the Pfau Litigation amended their complaint four times. CAl timely provided Philadelphia with copies of the First, Second, Third, and Fourth Amended Complaints filed in the Pfau Litigation. A copy of the Fourth Amended Complaint is attached as Exhibit 2. 16. The Pfau Litigation at all times involved an attempt to establish a nationwide class of book purchasers and included motions and briefs on class certification, discovery, and whether the matter should be dismissed for failing to state claims upon which relief could be granted. 17. On April 30, 2012, the United States District Court for the District of Montana dismissed the Fourth Amended Complaint filed in the Pfau Litigation Complaint and Demand for Jury Trial - 5
  • 6. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 6 of 23 with prejudice, holding, in part, that the plaintiffs had failed to state claims upon which relief could be granted. Plaintiffs appealed the decision to the Ninth Circuit Court of Appeals and that appeal is pending 18. CAl wrote to Philadelphia on May 27, 2011, and again on May 31, 2011, to notify Philadelphia of the Piau Litigation and to request full coverage under the Policy, including approval of retained counsel (the "May 2011 Notices"). Philadelphia acknowledged receipt ofthe May 2011 Notices on June 2, 2011. 19. Separately from the May 2011 Notices, Mortenson notified Philadelphia of the Piau Litigation on or about June 9, 2011, and requested full coverage under the Policy including approval of counsel. Philadelphia acknowledged receipt of Mortenson's notice of loss on June 17,2011. 20. Given the complex and nation-wide issues presented in the Piau Litigation and the fact that it was filed in the United States District Court in the State of Montana, it was reasonable and necessary for CAl and Mortenson to engage both Montana counsel and national counsel with experience in RICO, class action, and the other claims in this litigation, which they had done, and of which they timely notified Philadelphia. 21. Following receipt ofthe complaint in the Piau Litigation, CAl incurred reasonable and necessary Defense Costs investigating, preparing to Complaint and Demand for Jury Trial- 6
  • 7. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 7 of 23 defend, and defending itself and Mortenson against the allegations therein, and continues to do so with respect to the appeal. 22. CAl also incurred Defense Costs for itself and for Mortenson in connection with investigations initiated against them beginning in May of2011, by the Office of the Attorney General ofMontana 23. On or about September 16,2011, CAl (i) notified Philadelphia of its defense in the AG Matter, (ii) provided Philadelphia with applicable correspondence from the Office of the Montana Attorney General; and (iii) requested full coverage under the Policy including but not limited to approval of retained counsel. Philadelphia received the September 16, 2011, notice from CAL 24. On or about May 27 and 31, June 21, and August 1, 2011, Mortenson (i) notified Philadelphia of his defense in the AG Matter; (ii) provided Philadelphia with applicable correspondence from the Office ofthe Montana Attorney General; and (iii) requested full coverage under the Policy including approval of retained counsel. Philadelphia received the May 27 and 31, June 21, and August 1, 201 I, notices from Mortenson. 25. CAl and Mortenson had each retained legal counsel to assist them with the AG Matter. Given the complex issues presented in the AG Matter, it was reasonable for CAl and Mortenson to engage both Montana counsel and counsel Complaint and Demand for Jury Trial - 7
  • 8. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 8 of 23 with experience working with administrative attorneys general investigations involving non-profit corporations and their directors. 26. On AprilS, 2012, CAl, Mortenson and the Office of the Montana Attorney General entered into a Settlement Agreement and Assurance of Voluntary Compliance regarding the AG Matter. CAl incurred Defense Costs for both itself and Mortenson, as that term is defined in the Policy, to achieve this result. 27. The Piau Litigation and the AG Matter (collectively, the "Claims") are covered matters within the Policy. Philadelphia must pay the Defense Costs incurred by CAl for itself and Mortenson in connection with the Claims. 28. CAl has complied with ail applicable conditions precedent to entitle it to the benefits afforded by the Policy with respect to payment of Defense Costs for the Claims. 29. CAl regularly provided Philadelphia with copies of legal bills it received (and which it had paid) from its defense counsel and requested that Philadelphia recognize its duty to pay and advance to CAl the Defense Cost it was incurring. CAl did not receive a reservation of rights letter from Philadelphia in which Philadelphia set forth any facts or law that might relieve Philadelphia of its obligation to provide full coverage under the Policy, until after significant Defense Costs for the Claims had been incurred. Complaint and Demand for Jury Trial - 8
  • 9. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 9 of 23 30. On or about December 6, 2011, Philadelphia first acknowledged that the Piau Litigation and AG Matter constituted Claims during the Policy Period. 31. In the December 6, 20 II letter, Philadelphia claimed it issued CAl a "reservation of rights on June 17,2011." CAl never received such a "reservation of rights" on or about June 17,2011. 32. Mortenson received a letter from Philadelphia on or about June 17, 2011, in which Philadelphia only discussed why it might reserve its rights. 33. Before December 6, 2011, Philadelphia never informed CAl of Policy defenses it intended to raise or provided CAl a reasonable explanation based upon the applicable facts and law of why CAl may not receive advances or reimbursements for all Defense Costs. 34. Before December 6, 2011, Philadelphia never stated or suggested that CAlor Mortenson should not retain counselor should not proceed with the defense of all ofthe Claims, as required by the Policy. Philadelphia did not state or suggest that any portion of the Defense Cost might be apportioned in a manner designated by Philadelphia. 35. On or about December 6,20 II, Philadelphia wrote to CAl and repudiated its duty to advance Defense Cost in full. For the first time, Philadelphia claimed it was only obligated to reimburse CAl for 35% of the Defense Cost incurred by CAl in defending the Piau Litigation; 25% of the Defense Cost Complaint and Demand for Jury Trial - 9
  • 10. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 10 of 23 incurred by Mortenson in defending the Piau Litigation; 20% of the Defense Cost incurred by Mortenson in defending the AG Matter; and 100% of the Defense Cost incurred by CAl in defending the AG Matter. By presenting the foregoing allocation percentages, Philadelphia misrepresented its obligations under the Policy. 36. Philadelphia contended that it could allocate in the manner discussed in its December 6,2011, letter based upon the following provision in Part 6, Section XIX ofthe Policy (the "Allocation Provision"): If both Loss covered by this Policy and Loss not covered by this Policy are incurred either because a Claim includes both covered and uncovered matters, or because a Claim is made against both the Individual Insured and/or the Organization, and others, the Insured and the Underwriter shall use their best efforts to agree upon a fair and proper allocation of such amount between covered Loss and uncovered loss. Any such allocation shall be based upon the relative legal exposures of the parties to covered and uncovered matters. 37. Philadelphia may not use the "Allocation Clause" to limit the scope of its obligation to advance or reimburse 100% of the Defense Costs incurred by CAl in connection with the Claims because: a. The Allocation Clause, as interpreted by Philadelphia, is contrary to Montana law. Moreover, the claims in both the Piau Litigation as well as the claims in the AG matter were so inextricably intertwined so as to make them inseparable when it came to incurring the attorneys' fees and costs defending the same. As a result, it is unreasonable to attempt to Complaint and Demand for Jury Trial - 10
  • 11. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 11 of 23 allocate Defense Costs amongst the claims and Philadelphia is responsible for 100% of the Defense Costs. b. Philadelphia has acquiesced to the choices of counsel made by CAl and Mortenson and to the amounts incurred by CAl in defending CAl and Mortenson on the Claims. Philadelphia has not properly reserved its rights and is estopped from (i) challenging the reasonableness and necessity of hiring the counsel chosen by CAl and Mortenson; (ii) challenging the amounts incurred by CAl and Mortenson in defending against the Claims and; (iii) reimbursing CAl, in full, for the entire Defense Costs it has incurred for itself and Mortenson in connection with the Claims. 38. In addition to imposing an arbitrary allocation percentage to reduce its obligation to CAl, Philadelphia also attempted in its December 6, 20 11, letter to lower the rate it would compensate the attorneys hired by CAl and Mortenson, though Philadelphia had knowledge these attorneys had been engaged at contracted rates since May, 20 11, and they had already undertaken significant efforts in defending the Claims. 39. By email datedJanuaryI8.2012.Philadelphia belatedly requested that retained defense counsel provide litigation plans and budgets for the Claims. Complaint and Demand for Jury Trial - 11
  • 12. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 12 of 23 40. By email dated January 19, 2012, Philadelphia belatedly attempted to unilaterally impose reporting and billing "guidelines" on the previously retained defense counsel. 41. Despite Philadelphia receiving notice of one or more of the Claims beginning in May of 20 II, Philadelphia made no payment to CAl for Defense Costs for over a year, including the "allocations" suggested in its December 6, 2011, letter. In the interim, CAl had incurred and paid hundreds of thousands of dollars in Defenses Costs for itself and Mortenson, for which Philadelphia was responsible. 42. CAl made numerous pleas to Philadelphia to pay Defense Costs, but the pleas were ignored or received substantially and unreasonably delayed responses. 43. As of August 13,2012, more than fourteen (14) months after litigation in the Piau Litigation and the AG matter had been commenced and after the majority of anticipated Defense Costs had been incurred, Philadelphia had only reimbursed CAl for less than 6% of the Defense Cost CAl had incurred for itself and Mortenson in defending the Claims. 44. On August 27,2012, Philadelphia issued a second letter with new proposed percentages for covering Defense Costs. In the August 17, 20 II, letter, Philadelphia proposed to reimburse CAl 33% of the defense fees and costs Complaint and Demand for Jury Trial - 12
  • 13. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 13 of 23 incurred by Mortenson in the Piau litigation prior to the Fourth Amended Complaint; 15% of Mortenson's defense fees and costs in the Piau litigation after the Fourth Amended Complaint; 35% "allocation" of defense fees and costs incurred by CAl in the Piau Litigation; 50% of Mortenson's defense fees and costs for the AG matter; and 100% of CAl's costs for the AG matter, with CAT's fees to be "adjusted" to "Philadelphia's agreed upon rates and less certain deductions." By presenting the foregoing allocation percentages and arbitrary rate modifications, Philadelphia misrepresented its obligations under the Policy. 45. Philadelphia is estopped from attempting to impose the allocations and fee reductions reflected in its December 6,2011, and August 27, 2012, letters. The Policy directs the insureds (CAl and Mortenson) to initially assume full control of their defense, which they did with the full knowledge and acquiescence of Philadelphia, with Philadelphia's full knowledge of and acquiescence in the rates charged by the defense attorneys, and with Philadelphia's full knowledge and acquiescence that a full defense was necessary. 46. Despite numerous communications by CAl to Philadelphia regarding payments, Philadelphia refuses to pay all of CAl's and Mortenson's Defense Costs arising from the investigation, adjustment, defense and appeal of the Claims. Philadelphia has not even paid CAl the amounts Philadelphia had agreed to pay in its December 6, 2011, and August 27, 2012, letters. Complaint and Demand for Jury Trial- 13
  • 14. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 14 of 23 47. Philadelphia has acted in bad faith by refusing to acknowledge the applicable scope of coverage of the Claims, refusing to engage in timely and meaningful communications with CAl, refusing to pay and advance the reasonable and necessary Defense Cost associated with the Claims; and attempting to arbitrarily reduce fees incurred by CAl and Mortenson. COUNT I DECLARATORY JUDGMENTRE: DEFENSE COST 48. CAl incorporates by reference the enumerated paragraphs above, as if fully set forth herein. 49. Under the Policy, Philadelphia has both a duty to defend (by paying Defense Costs) and a duty to indemnify (pay damages). The duty to defend is broader than the duty to indemnify. Philadelphia must pay Defense Costs if any facts or allegations bring the Claims even potentially within the protection purchased by CAl, even if the claims are groundless, false or fraudulent. 50. CAl has complied with the terms of the Policy in order to receive the benefits ofthe Policy. It timely paid its premiums for the Policy. It timely provided Philadelphia with notice of the Claims. CAl has complied with all material terms of the Policy. CAl and Mortenson have incurred and paid hundreds of thousands of dollars in Defense Costs, which are Philadelphia's responsibility. Complaint and Demand for Jury Trial - 14
  • 15. ------ - - - - - - - - - - - Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 15 of 23 51. Under the Policy, Philadelphia has an obligation to pay, advance and/or reimburse CAl and Mortenson all reasonable and necessary Defense Costs CAl has incurred for itself and Mortenson in connection with the Claims. 52. CAl has repeatedly demanded payment ofthe reasonable and necessary Defense Costs incurred in defending the Claims. 53. Philadelphia has improperly refused to pay, advance or reimburse all ofthe reasonable and necessary Defense Costs incurred by CAl on behalf of itself and Mortenson. 54. An actual controversy exists between the parties regarding their respective rights and remedies under the Policy. CAl contends Philadelphia has no legal right under the Policy or under Montana law (i) to allocate percentages of Defense Costs it will pay under the Policy; (ii) to impose below market rates it arbitrarily determines approporiate and to pay less than the actual fees incurred by CAl and Mortenson for Defense Costs for the Claims; (iii) to withhold payment to CAl of the Defense Costs it has already incurred in connection with the Claims or (iv) to refuse to advance on-going Defense Cost for the Claims. 55. A declaration of rights pursuant to 28 U.S.C. §§ 2201 and 2202 and Rule 57 of the Federal Rules of Civil Procedure would alleviate the uncertainty facing CAl with regard to Philadelphia's obligations under the Policy to pay and advance Defense Cost arising from the Claims. Complaint and Demand for Jury Trial - 15
  • 16. - - - - - - - - - - - - " " ,.. _-,_ ..,-,,--­ Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 16 of 23 56. CAl is entitled to a declaration that under the terms of the Policy, Philadelphia (i) may not allocate a percentage of Defense Costs it will pay under the Policy for fees and costs incurred in connection with the Claims; (ii) may not impose below market rates it arbitrarily determines approporiate and pay less than the actual fees incurred by CAl and Mortenson for Defense Costs for the Claims; (iii) must reimburse CAl all of the Defense Costs CAl incurred for itself and Mortenson in connection with the Claims and (iv) must advance on-going Defense Cost for the Claims in the appeal of the Piau Litigation. COUNT II BREACH OF CONTRACT 57. CAl incorporates by reference the enumerated paragraphs above, as if fully set forth herein. 58. Under the applicable standards of Montana law and the Policy, Philadelphia is obligated to pay and advance all of the reasonable Defense Costs CAl incurred for itself and Mortenson with respect to the Claims. Philadelphia must pay and advance the same, according to the Policy, "prior to the final disposition of a claim." 59. An insurer's defense-payment obligation is broader than its obligation to indemnify. Complaint and Demand for Jury Trial- 16
  • 17. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 17 of 23 60. CAl has complied with all conditions and obligations under the Policy regarding its rights to receive Defense Costs from Philadelphia with respect to the Claims. 61. Philadelphia breached the Policy by denying it has the obligation to pay, advance or reimburse the reasonable and necessary Defense Costs CAl has incurred for itself and Mortenson and will continue to incur in defense and appeal of the Claims. 62. Because Philadelphia has not paid according to the Policy terms, CAl been damaged. CAl has paid for Defense Costs without being reimbursed the same. CAl has had to advance Defense Costs that it would not have had to advance but for Philadelphia's intransigence. CAl has had to engage legal counsel to enforce its rights under the Policy. 63. CAl has suffered the foregoing damages despite having paid substantial premiums to Philadelphia for the Policy. 64. CAl is entitled to a judgment in its favor and against Philadelphia in an amount proven at trial that will compensate CAl for the damages incurred by Philadelphia's breach of the Policy, together with CAl's reasonable attorney's fees and costs. 65. Once CAl provided notice to Philadelphia of the Claims, it should have paid, advanced or reimbursed the Defense Costs. The Defense Costs are an Complaint and Demand for Jury Trial - 17
  • 18. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 18 of 23 amount certain due on a date certain and, as a result, CAl is entitled to recover pre­ judgment interest on the amount owed at the rate of 10% per annum. COUNT III UNFAIR TRADE PRACITCES 66. CAl incorporates by reference the enumerated paragraphs above, as if fully set forth herein. 67. CAl properly gave Philadelphia notice of the Claims and the Claims included "Wrongful Acts" and "Claims," as those terms are defined in the Policy. 68. Philadelphia knew it had an obligation to advance timely and complete Defense Costs for the Claims. 69. Philadelphia wrongfully refused (and continues to refuse) to pay and advance the reasonable and necessary Defense Costs incurred by CAl for itself and Mortenson. 70. Philadelphia unreasonably withheld (and continues to withhold) payment of reasonable and necessary Defense Costs despite CAl's full compliance with all Policy requirements. Such withholding is with the wrongful intent of depriving CAl of its rights. 71. Philadelphia failed to use reasonable care in the exercise ofits relationship with CAL Philadelphia has not acted as a reasonable insurer would have acted under the same or similar facts and circumstances. Complaint and Demand for Jury Trial - 18
  • 19. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 19 of 23 72. Philadelphia's actions in regard to CAl's claims for Defense Costs were without justification or excuse. At worse, they were taken in bad faith and without regard to the adverse effect it would have on CAL At best, Philadelphia's conduct is grossly negligent and oppressive. In any event, its actions were taken to further Philadelphia's own improper objectives and with disregard for the interests of CAI, to the prejudice and detriment of CAl in violation of Montana law. 73. Philadelphia has violated subparagraphs (1), (4), and (5) of Montana's Unfair Trade Practices Act, Section 33-18-20 I, MCA, by misrepresenting pertinent facts or insurance policy provisions relating to coverage at issue, by refusing to pay claims for Defense Cost without conducting a reasonable investigation based upon all available information, and/or by failing to affirm or deny coverage of claims within a reasonable time, causing CAl to suffer injury, damage and loss, giving rise to a general tort action in favor of CAl pursuant to Section 33-18-242, MCA. 74. Philadelphia knew at all times that it was unlawful to misrepresent pertinent facts or Policy provisions relating to coverage at issue in handling claims. 75. Philadelphia knew at all times that it was unlawful to disregard pertinent policy provisions and/or refuse to pay claims without conducting a reasonable investigation based upon all available information, and giving due consideration to the plain language of its insurance contract, both as to the particular facts and the applicable law governing the claim. Complaint and Demand for Jury Trial- 19
  • 20. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 20 of 23 76. Philadelphia knew at all times that in return for the premiums paid by CAl, it was obligated to adjust, pay and advance Defense Costs in accordance with the terms, provisions and requirements of the Policy and Montana law. 77. Philadelphia knowingly applied its own internal procedures and rules in intentional and conscious disregard of the applicable provisions of the Policy and Montana law, all for the purpose of enhancing its profit at CAl's expense and gaining unfair advantage over its competitors, and in conscious disregard of the certainty that CAl, which had the right to rely and did rely upon Philadelphia's false promises and misrepresentations, would suffer injury as a result. 78. At all relevant times, Philadelphia acted in conscious disregard of, or indifference to, the knowledge that its arbitrary and unjustifiable conduct injured CAl, and did so pursuant to policies, procedures and programs designed and calculated to justify wrongdoing in the process of adjusting legitimate claims and evade the responsibility imposed upon all legitimate insurers to reimburse insureds in strict accordance with the promises set forth in the Policy. 79. Philadelphia's acts, decisions, and conduct clearly and convincingly demonstrate actual malice, actual fraud, or both. CAl is entitled to a judgment in its favor and against Philadelphia for punitive damages in an amount to be proven at trial. CAl should be awarded such damages against CAl for the purpose of disgorging from Philadelphia all ill-gotten gains obtained through such wrongful Complaint and Demand for Jury Trial" 20
  • 21. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 21 of 23 behavior, taking the profit out of unlawful claim handling practices, punishing and making an example of Philadelphia sufficient to deter similar fraudulent and malicious behavior by it and all other insurers doing business in Montana now and forever in the future, all in accordance with the strict procedural and substantive protections afforded by Montana law. 80. As a result of Philadelphia's wrongful conduct, CAl has been required to obtain counsel to represent its interests in pursuing this claim. As a result, CAl has incurred, and will continue to incur, attorney's fees and litigation expenses in order to establish its right to compensation for Defense Costs under the Policy. WHEREFORE, CAl respectfully prays for the Court grant CAl the following relief; 1. Issue a judgment in favor of CAl and against Philadelphia declaring that Philadelphia, as a matter of fact and law, is obligated to pay and advance all sums for all of the Defense Costs CAl incurred for itself and Mortenson for the Claims, and that Philadelphia's duty to pay and advance all of the Defense Costs will continue until the Claims are finally resolved; 2. Issue a judgment in favor of CAl and against Philadelphia for Philadelphia's breach of the terms of the Policy and awarding CAl compensatory damages and pre-judgment interest as proven at trial; Complaint and Demand for Jury Trial - 2 J
  • 22. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 22 of 23 3. Issue a judgment in favor of CAl and against Philadelphia for Philadelphia's violation of Montana's Unfair Trade Practices Act, awarding CAl compensatory and punitive damages as proven at trial; 4. Issue a judgment in favor of CAl and against Philadelphia awarding CAl its reasonable attorney's fees incurred in this matter, together with costs and disbursements as allowed by law or in equity; and 5. Issue an Order granting CAl such other and further relief as the Court deems just and proper under the circumstances. DATED this 31 st day of October, 2012. MATOVICH, KELLER & MURPHY, P.C. By: lsi Carey E. Matovich Carey E. Matovich Jesse Myers KASTING, KAUFFMAN & MERSEN, p.e. By: lsi John M Kaufftnan John M. Kauffinan Lilia Tyrrell DEMAND FOR JURY TRIAL Plaintiff Central Asia Institute hereby demands a jury for all issues properly triable by a jury in this matter. DATED this 31 st day of October, 2012. Complaint and Demand for Jury Trial - 22
  • 23. Case 2:12-cv-00075-DLC Document 1 Filed 10/31/12 Page 23 of 23 MATOVICH, KELLER & MURPHY, P.e. By: /s/ Carey E. Matovich Carey E. Matovich Jesse Myers KASTING, KAUFFMAN & MERSEN, P.e. By: /s/ John M Kaufftnan John M. Kauffman Lilia Tyrrell Complaint and Demand for Jury Trial- 23