Monica Frois Obtains Summary Judgment that Dismissed a One Million Dollar Claim Against a Professional Liability Insurance Carrier

The insurer was served with a Writ of Garnishment regarding its former policy owners that operated an ambulance company. The underlying suit was brought by the estate of an individual who died at the scene of a traffic accident. The estate claimed that their decedent died due to the actions and inactions of the policy holders’ EMTs that responded to scene of the crash. The estate successfully obtained a $1 million judgment against the two ambulance companies in 2009 for personal injuries and wrongful death. The estate served a Writ of Garnishment on Baker Donelson’s client, the insurance carrier, in an effort to collect on the judgment based on the policy issued to the ambulance companies.

The policy included two separate declaration pages for two insurance contracts. One insurance contract provided claims-made professional liability coverage and the other provided occurrence-based general liability coverage. 

In addition to filing a response to the Writ of Garnishment, Ms. Frois and Ms. Pickering filed a Motion for Summary Judgment on behalf of the insurance carrier, arguing that that insurance carrier did not receive notice of any professional liability claim within the “claims-made” coverage period. In addition, the unambiguous exclusions for injuries arising from “healthcare professional services” in the general liability policy also effectively foreclosed coverage under the policy. 

The estate made efforts to end-run the applicable exclusion by asserting alternate theories for relief, such as the wrongful selection, training, and supervision of the EMTs that responded to the crash.  The estate also argued that these “board room decisions” to hire, train, and supervise EMT’s did not involve the rendering of healthcare professional services, and therefore were not excluded under the general liability policy.

The estate sought to isolate and focus only on the board room decisions that were made by the ambulance company’s executives months or even years in advance of the car crash. The court framed the issue as whether prior board room decisions about staffing, training and supervision that may have influenced the ability of the EMTs to render proper medical care at the scene of the crash should be considered a separate “occurrence” from the actual rendering or failure to render adequate medical care. The issue was a matter of first impression for Mississippi courts.

After extensive briefing and oral arguments, the trial court adopted the arguments advanced by Ms. Frois and Ms. Pickering. The trial court granted summary judgment in favor of the insurance carrier because (1) insurance carrier did not receive notice of any professional liability claim within the “claims-made” coverage period and (2) the plain language of the “healthcare professional services” exclusion states that coverage does not apply for bodily injuries that “result from acts or omissions in the providing or failure to provide ‘health care professional services.’” Accordingly, regardless of purported influence that board room decision had in causing the bodily injury in question, if bodily injury is the ultimate “result” and that result can be linked to healthcare professional services, coverage for the bodily injury is prohibited by the healthcare professional services exclusion of the general liability policy.