Argonaut Insurance Companies v. Medical Liability Mutual Insurance

760 F. Supp. 1078, 1991 U.S. Dist. LEXIS 3368, 1991 WL 46868
CourtDistrict Court, S.D. New York
DecidedMarch 13, 1991
Docket88 Civ. 2750 (CSH)
StatusPublished
Cited by3 cases

This text of 760 F. Supp. 1078 (Argonaut Insurance Companies v. Medical Liability Mutual Insurance) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Argonaut Insurance Companies v. Medical Liability Mutual Insurance, 760 F. Supp. 1078, 1991 U.S. Dist. LEXIS 3368, 1991 WL 46868 (S.D.N.Y. 1991).

Opinion

MEMORANDUM OPINION AND ORDER

HAIGHT, District Judge:

In this diversity action presently pitting one medical malpractice insurer against another, the issue relates to the proper allocation of costs incurred in defending malpractice actions. Following extensive discovery, the parties cross-move for summary judgment under Rule 56, Fed.R.Civ.P.

BACKGROUND

Since the mid-1960’s, physicians who are members of the Medical Society of the State of New York (“MSSNY”) have received medical malpractice liability insur-anee coverage from three insurance companies. The initial coverage was furnished by defendant Wausau Insurance Company (“Wausau”). Wausau covered MSSNY members from the inception of the coverage to June 30, 1974. When Wausau stopped writing that coverage, it was succeeded by plaintiff Argonaut Insurance Companies (“Argonaut”), which wrote medical liability insurance for MSSNY members from July 1, 1974, to June 30, 1975. Argonaut then ceased the coverage and was succeeded by defendant Medical Liability Mutual Insurance Company (“MLMIC”). MLMIC commenced its coverage on July 1, 1975. It continues to the present day.

This type of non-overlapping coverage is known in the insurance industry as “end-to-end” coverage. The policies MLMIC issues to covered physicians are annual policies, so that MLMIC maintains the coverage for a particular physician by writing a new policy for that physician at the end of each policy year. For all that appears from the record, this is the industry practice in such insurance policies.

A claim for medical malpractice may arise out of a single diagnosis or treatment, or out of a physician’s allegedly negligent treatment of a patient over a number of years (for example, negligent failure to diagnose cancer). This is known as a “continuous treatment” medical malpractice claim. Within the parlance of medical malpractice insurance, a “continuous treatment case” involves allegations of malpractice spanning more than one policy period where there is a single insurer involved. An “end-to-end case” involves allegations of malpractice spanning more than one policy period where there are two or more insurers involved.

By virtue of Argonaut’s relatively brief appearance on the stage of medical malpractice coverage for MSSNY physicians, it found itself involved in continuous treatment cases where the plaintiff alleged malpractice beginning during the period of Wausau’s coverage, extending through Argonaut’s period of coverage, and continu *1080 ing into MLMIC’s coverage. This put Argonaut into relationship with the other two insurance companies in respect of, inter alia, the costs of defending against the action (attorney’s fees, investigation expense, and the like). As to a continuing treatment case alleging malpractice beginning during the policy year July 1, 1974 through June 30, 1975 but extending thereafter, Wausau had dropped out of the picture, and Argonaut was in relation only with MLMIC.

A question of obvious mutual concern was how defense costs should be allocated among insurers in end-to-end cases. Until February 1987, Argonaut shared end-to-end defense costs equally with Wausau and MLMIC (or with MLMIC only, if the malpractice claimed did not arise until after Wausau’s coverage had ceased). However, in February 1987 Argonaut rethought that allocation, and during that month “put the defendants [Wausau and MLMIC] on notice that it would no longer allocate end-to-end defense costs equally when the policy periods of the respective insurers were unequal.” Complaint at H 16. Notwithstanding that notice, the two defendants maintain that Argonaut was bound by prior agreement to allocate defense costs equally, and instructed defense attorneys handling the cases to bill their fees and expenses on an equal basis among the insurance companies concerned. Since February 1987 Argonaut continued to pay on that basis, under protest and with all rights reserved, to avoid the prejudice to itself and its insureds which would result if Argonaut placed defense counsel in the center of a conflict among the insurance companies. Id. at 17. Argonaut commenced this action for declaratory and injunctive relief, and for restitution for defense costs “paid by Argonaut under protest in excess of its pro rata share in end-to-end coverage cases.” . Complaint, prayer for relief at ¶(4).

Subsequently Wausau was dismissed from the action by a stipulation of settlement endorsed by the Court on May 1, 1989. Argonaut and MLMIC continued to litigate the issue, culminating in their cross-motions for summary judgment. Given plaintiff’s theory as pleaded in the complaint, the malpractice cases forming the basis for this action involve only those cases where the malpractice plaintiff alleges negligence during Argonaut’s one-year policy, and also alleges continued treatment and negligence during the period of two or more of the successive annual policies issued by MLMIC. That is because malpractice during the year of Argonaut’s coverage and only during the first succeeding year of MLMIC’s coverage would, even on Argonaut’s theory, result in an even allocation of the costs of defense.

Argonaut’s claim is based primarily upon its perception of fairness. MLMIC resists anything other than equal division of the costs of defense on two grounds. First, MLMIC contends that in an exchange of correspondence beginning in 1977, Argonaut agreed to the equal division of defense costs among the insurance companies concerned. Second, MLMIC contends that the provisions in the insurance policies with respect to “other insurance” mandate an equal division of defense costs.

MLMIC’s conception of how these defenses relate to each other is not entirely clear. In its main brief, MLMIC argued that “the parties’ overall agreement in 1977 and their subsequent case by case agreements supersede the policy provisions ...” 18 at n. 6. The reply brief states at 2 that if the Court determines that the “other insurance” clause obligates the two insurers to share defense costs equally, then I need not address the question of whether they entered into and are bound by a letter agreement to share defense costs equally.

It seems to me that MLMIC had the issues right the first time. Accordingly I will consider, first, the pertinent exchange of correspondence between the parties; and second, the terms of the policies.

The Correspondence

Under date of October 24, 1977, Marvin Kipnes, the claims supervisor for Argonaut, addressed a letter to John Andreotta, his opposite number at MLMIC. Kipnes began his letter by confirming his recent discussions with Andreotta “with regard to *1081 the handling of claims involving overlapping coverage.” Kipnes expressed the desire “to take this opportunity to ratify the methods which have served us well in the past; offer some proposals for a more efficient means of accomplishing this function; and clarify certain issues which may require same.” Kipnes expressed his objective “to promulgate procedures” enabling the two insurance companies to discharge their responsibilities in manners consistent with their best interests and of their mutual insureds.

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Bluebook (online)
760 F. Supp. 1078, 1991 U.S. Dist. LEXIS 3368, 1991 WL 46868, Counsel Stack Legal Research, https://law.counselstack.com/opinion/argonaut-insurance-companies-v-medical-liability-mutual-insurance-nysd-1991.