An insurer says it was not told about an elder abuse lawsuit against its insured until a default had already been entered.
Ironshore Specialty Insurance Company filed suit in federal court in Atlanta on August 24, 2026, asking a judge to declare it owes nothing on an elder abuse and wrongful death claim against a Georgia nursing home operator.
The complaint, filed in the Northern District of Georgia, names Atlanta Association for Convalescent Aged Persons, Inc. and the same entity doing business as Sadie G Mays Health & Rehabilitation Center. Ironshore describes the matter as "an insurance coverage dispute stemming from an underlying elder abuse and nursing home neglect lawsuit."
The carrier's case rests on dates.
According to the filing, the underlying suit was filed on November 21, 2025. The insured was served on December 7, 2025, and told its retail agent, Propel Insurance, two days later. Ironshore says it did not hear about the case until April 8, 2026, which its complaint describes as "four months after Atlanta Association learned of the Smith Lawsuit."
By then, the filing states, a default had been entered against the facility on March 23, 2026, more than two weeks before the carrier was notified. Ironshore also alleges that when notice finally came through, the retail agent did not mention that the suit had been served four months earlier or that a default had already been entered.
The complaint says Ironshore sent a reservation of rights letter on April 22, 2026, then a second one on June 24, 2026 once it learned the fuller sequence. The insured asked the court to reopen the default on July 8, 2026. That request was denied on August 11, 2026, according to the filing, and a hearing on damages was set for August 20, 2026.
Two policies are in play, both running October 4, 2024 to October 4, 2025. The primary is a long-term care professional liability, general liability, employee benefits liability and regulatory proceeding defense policy with limits of $1 million each claim and $3 million aggregate. Sitting above it is an excess follow form policy with $5 million per claim and aggregate limits.
The notice wording is what the complaint calls a condition precedent, meaning the insured has to meet it before any right to payment kicks in. Once a claim is first made, the primary requires that "the Insured shall give the Insurer written notice of such Claim as soon as practicable thereafter but in no event later than" 60 days after the policy expires. The excess policy runs on the primary's terms and separately requires notice of a professional liability claim "as soon as practicable, but in no event later than ninety (90) days after the expiration of the Policy Period."
Ironshore also points to a clause requiring the insured to help the carrier once a claim comes in. The filing quotes it as saying that "[i]n the event of a Claim, the Insured shall provide the Insurer with all information, assistance and cooperation that the Insurer reasonably requests."
The carrier is not arguing the claim fell outside the policy period. Its filing says the underlying suit "is deemed a Claim first made within the October 4, 2024 to October 4, 2025 policy period due to defendants' prior notice of circumstance of the Smith records demand and separate bordereau notice provided during the policy period." A "notice only" report of a medical record request had come through the retail agent on June 10, 2025, according to the complaint.
The second count turns on an exclusion. The primary policy, as quoted in the filing, cuts off coverage for "any Claim, based upon, arising out of, directly or indirectly resulting from, in consequent of, or in any way involving any actual or alleged... dishonest, fraudulent, criminal or intentionally malicious act, error or omission by an Insured; any willful violation of law, statute, rule or regulation by an Insured."
Ironshore's argument is that a fraud count in the underlying suit triggers that exclusion. Per the complaint, the underlying suit alleges the facility made "fraudulent misrepresentations" about its ability to provide around-the-clock nursing care and supervision, and that it concealed or failed to disclose material facts including "Inadequate RN Coverage," "Insufficient staff training," "Multiple regulatory violations," "Lack of proper equipment and supplies for wound care" and "Insufficient staffing levels to implement required turning and repositioning protocols." The filing says the underlying suit also brings claims tied to federal long-term care requirements at 42 CFR § 483.1 et seq., the Georgia Bill of Rights for Residents of Long-Term Care Facilities at O.C.G.A. § 31-8-100 et seq, and Department of Community Health Rules for Nursing Homes.
As Ironshore recounts that suit, the resident was admitted on October 23, 2024 with a complex medical history and an existing Stage 4 sacral pressure ulcer, and was moved to a hospital on March 24, 2025 after his condition allegedly worsened, including new wounds, a loss of almost 20 pounds, and unrecognized signs of infection and sepsis. The filing says the underlying suit alleges he suffered asystole on April 19, 2025 and was pronounced dead a few minutes later, and that his death certificate recorded "sepsis" and "skin soft tissue infection."
Ironshore is asking the court to declare it has no obligation to defend or indemnify under either policy.
The allegations in Ironshore's complaint have not been tested in court. The defendants have not filed a response, and no court has ruled on any of the claims. The elder abuse and wrongful death allegations described in the filing are allegations made in a separate lawsuit and have not been proven.
