Gil v. Clara Maass Medical Center

162 A.3d 1093, 450 N.J. Super. 368, 2017 WL 2625964, 2017 N.J. Super. LEXIS 78
CourtNew Jersey Superior Court Appellate Division
DecidedJune 19, 2017
StatusPublished
Cited by9 cases

This text of 162 A.3d 1093 (Gil v. Clara Maass Medical Center) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gil v. Clara Maass Medical Center, 162 A.3d 1093, 450 N.J. Super. 368, 2017 WL 2625964, 2017 N.J. Super. LEXIS 78 (N.J. Ct. App. 2017).

Opinions

The opinion of the court was delivered by

FISHER, P.J.A.D.

In this appeal, we examine clauses contained in insurance policies covering a hospital to determine, among other things, whether the trial judge erred in rejecting plaintiffs’ arguments that an allegedly negligent physician was also covered because he was the hospital’s “employee” or a “leased worker,” or because his limited liability company was “affiliated or associated” with the [374]*374hospital. We conclude the policy language could not be plausibly interpreted to provide coverage to the physician or his limited liability company, and affirm.

I

In 2011, plaintiff Keyko Gil, on her own behalf and for her infant child, Kenneth, commenced this medical malpractice action against Huseyin Copur, M.D., FirstChoiee OB/GYN LLC, and Clara Maass Medical Center, alleging that Kenneth’s birth defects were caused by an emergency Caesarian section performed by Dr. Copur at Clara Maass in 2004. At the time of the procedure, Dr. Copur was purportedly acting in accordance with a services agreement between Clara Maass and FirstChoiee; the latter was an entity formed by Dr. Copur and another physician.

By motion, the trial judge capped Clara Maass’s exposure at $250,000, pursuant to the Charitable Immunities Act, N.J.S.A. 2A:53A-1 to -11, and denied without prejudice plaintiffs’ motion to declare Dr. Copur an employee of Clara Maass. The judge, however, granted plaintiffs leave to file an amended complaint and later permitted another amendment by which plaintiffs sought relief on their own behalf, and as assignees of Dr. Copur and FirstChoiee,2 against defendant Executive Risk Specialty Insurance Company, which issued a policy to Saint Barnabas Health Care System3 covering its “employees,” and against defendants Lexington Insurance Company, Endurance Specialty Insurance, Ltd., First Specialty Insurance Company, and Steadfast Insurance Company, which provided excess insurance.4 The trial judge later [375]*375severed the coverage claims from the medical negligence claim, pending disposition of the former.5

Following the entry of summary judgment on the coverage issues in the insurers’ favor, plaintiffs filed this appeal, posing issues about the interpretation of the relevant policies. Because summary judgment was entered, we employ the familiar Brill6 standard which the trial judge was also required to apply. See Townsend, v. Pierre, 221 N.J. 36, 59, 110 A.3d 52 (2015).

II

In ascertaining whether the policies provided coverage for either Dr. Copur or FirstChoice or both, we first consider that the policies expressly covered “named insuredfe].” FirstChoice and Dr. Copur, however, were not specifically listed in any of the policies as “named insureds.”7

[376]*376The Executive Risk policy, however, also defined “insured” as including not only those expressly “named” but also “any [e]m-ployee or [v]olunteer.” Since it has not been argued that Dr. Copur was a volunteer, we turn to that part of the policy that defined an “employee” as

any person who has an assigned work schedule for and is on the regular- payroll of the Named Insured, with federal and state taxes withheld. Independent contractors are not Employees. An Employee’s status as an Insured shall be determined as of the date of the Occurrence or Wrongful Act upon which a Claim involving the Employee is based.

The Lexington policy — which was followed, as to its form, by the other excess insurers — also included coverage for Clara Maass’s “employees” “but only for acts within the scope of their employment ... or while performing duties related to the conduct of [Clara Maass’s] business.” The word “employee” is defined in that policy as “a person paid by [Clara Maass] in connection with [its] business.” The word “employee” does not include “a temporary worker[8] or independent contractor[9]” but does include “a leased worker,” which was described as “a person leased to [the named insured] by a labor leasing firm, under an agreement between [the named insured] and the labor leasing firm, to perform duties related to the operations as described in the Declarations and which are at [the named insured’s] direction.”

Ill

In granting summary judgment in favor of the insurers through his reading of the policy provisions quoted above, the trial judge rejected plaintiffs’ arguments: (a) that Dr. Copur was an “employee,” (b) that either Dr. Copur or FirstChoice fell within the terms of the “catch-all” provisions, or (c) that Dr. Copur was a “leased worker.” We separately consider these arguments. But, [377]*377before that, we observe that although, as summary-judgment movants, the insurers were required to demonstrate the absence of a genuine dispute of all material facts, Brill, supra, 142 N.J. at 540, 666 A.2d 146, the ultimate burden of persuasion rested with plaintiffs, who stood in the shoes of Dr. Copur and FirstChoice on these issues,10 to show the policies provided coverage. See Wakefern Food Corp. v. Liberty Mut. Fire Ins. Co., 406 N.J.Super. 524, 538, 968 A.2d 724 (App. Div.), certif. denied, 200 N.J. 209, 976 A.2d 385 (2009); Polarome Int’l, Inc. v. Greenwich Ins. Co., 404 N.J.Super. 241, 258, 961 A.2d 29 (App. Div. 2008), certif. denied, 199 N.J. 133, 970 A.2d 1050 (2009).

A

The parties’ debate goes so far as to question how we should determine whether Dr. Copur was an employee for purposes of the insurance policies in question. Plaintiffs invite us to look to common-law principles regarding what it means to be an employee or independent contractor. The insurers urge that we stick to the plain meaning of the words and phrases employed without straying into other areas where societal policies require an alternate view. In this circumstance, we agree with the insurers but will nevertheless discuss both approaches.

(1)

The policies expressly defined an “employee” as a person who is paid by the named insured, here Clara Maass. The Executive Risk policy is very explicit in this regard, defining an employee within the meaning of that policy as “any person who has an assigned work schedule for and is on the regular payroll of the Named Insured, with federal and state taxes withheld.” Dr. Copur testified at his deposition that he was not an employee, and it is undisputed that he was not on Clara Maass’s “regular payroll.”

[378]*378The other policies do not define the term “employee” by insisting upon that person being on the named insured’s “regular payroll” but nevertheless require that the purported “employee” be “a person paid by [Clara Maass] in connection with [its] business.” Again, there is no dispute that Dr. Copur was not paid by Clara Maass; FirstChoice was compensated by Clara Maass,11 and Dr. Copur was paid by FirstChoice.

Undaunted, plaintiffs argue that even in the absence of evidence that Dr. Copur was paid by Clara Maass, other indicia of the relationship suggested that Dr.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
162 A.3d 1093, 450 N.J. Super. 368, 2017 WL 2625964, 2017 N.J. Super. LEXIS 78, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gil-v-clara-maass-medical-center-njsuperctappdiv-2017.