Hirst v. St. Paul Fire & Marine Insurance

683 P.2d 440, 106 Idaho 792, 1984 Ida. App. LEXIS 463
CourtIdaho Court of Appeals
DecidedMay 15, 1984
Docket14343
StatusPublished
Cited by86 cases

This text of 683 P.2d 440 (Hirst v. St. Paul Fire & Marine Insurance) is published on Counsel Stack Legal Research, covering Idaho Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hirst v. St. Paul Fire & Marine Insurance, 683 P.2d 440, 106 Idaho 792, 1984 Ida. App. LEXIS 463 (Idaho Ct. App. 1984).

Opinions

WALTERS, Chief Judge.

Bartley and Peggy Hirst, as guardians ad litem of Mark Hirst, appeal from a partial summary judgment granted in favor of St. Paul Fire and Marine Insurance Company in an action upon an insurance policy. The district court ruled that certain conduct by Mark Hirst’s doctor, William Done-hue, and the harm which resulted from that conduct, was not covered under the terms of Donehue’s professional liability insurance policy. Accordingly, the court held that the Hirsts were not entitled to recover from St. Paul the amount of damages specified in a settlement agreement between the Hirsts and Donehue.

On appeal, the Hirsts argue thai the trial court erred in deciding that the insurance policy did not cover Donehue’s actions. They also assert as error the district court’s judgment limiting St. Paul’s liability to damages arising from breach of its duty to defend the underlying claim against Donehue. As part of a settlement between Donehue and the Hirsts, Donehue’s entitlement to recover such damages was assigned to the Hirsts. These damages were deemed by the court to consist only of the costs, expenses and attorney fees incurred by Donehue in defending and settling the Hirsts’ causes of action. The damages did not include compensation for the underlying harm claimed by the Hirsts. Finally, the Hirsts request attorney fees on this appeal, pursuant to I.C. § 41-1839.

St. Paul also cross-appeals from the partial summary judgment entered in favor of the Hirsts. As noted, the court found that St. Paul had breached its contractual duty to defend Donehue. St. Paul raises the question whether there is a duty to defend an insured if the complaint filed against the insured does not state a ground for damages covered by the terms of the insurance policy.

We affirm the district court’s ruling that the injuries suffered were not covered by the policy. We also affirm the court’s ruling that St. Paul breached its duty to defend Dr. Donehue. Finally, we affirm the damages awarded by the district court. We award no attorney fees on appeal.

[794]*794I. The Facts

Dr. Donehue gave Mark Hirst a physical examination so that Hirst could participate in high school wrestling. Hirst later suffered a wrestling injury to a finger and thumb of one hand. After an initial consultation concerning the injury, Donehue asked Hirst to return a few days later. When Hirst returned, Donehue drugged him with valium and librax — two mild tranquilizers — and performed sexual acts, including oral sex and masturbation, on Hirst against Hirst’s will. Donehue told Hirst that Hirst might also have mononucleosis. Donehue scheduled several more appointments at his office and at the Hirst home, for treatment of the injury and testing for mononucleosis. His sexual activities with Hirst recurred during each visit.

Mark Hirst and his parents presented a claim of medical malpractice to the Idaho State Board of Medicine, pursuant to I.C. § 6-1001, as a compulsory condition precedent to litigation of the claim. This process is informal and nonbinding. I.C. § 6-1001. A hearing panel, appointed pursuant to I.C. § 6-1002, determined that “there [was] no evidence of [Donehue] prescribing improper contra-indicated medication for [Hirst’s] physical injuries or negligence in failing to follow proper standards of care in treating [Hirst’s wrestling] injuries.”

The panel did find evidence of Donehue’s sexual advances. The panel determined that substantial questions were raised concerning whether the panel had jurisdiction over “this type of medical malpractice”— which it described as “unethical medical conduct.” The panel noted that Donehue’s actions were for his own personal satisfaction and that there is no general rule as to whether such conduct amounts to malpractice. The panel concluded that “if malpractice includes the immoral conduct and criminal acts complained of then ... the claim may have merit.”

The panel unanimously stated that “prescribing excess dosages of improper and contra-indicated medication of Valium and Librax ... had no relation to treatment” for Hirst’s wrestling injuries. The panel determined that use of these drugs was to render Hirst susceptible to Donehue’s actions or to cover up the sexual assaults. The panel found that this use of drugs was “clearly without justification and [was] not consistent with any applicable standard of health care.” The panel unanimously concluded that this portion of the Hirsts’ claim was meritorious.

The Hirsts brought suit against Done-hue, alleging he had “committed various acts of negligence and professional malpractice.” Donehue asked St. Paul to defend the suit, but St. Paul refused. Subsequently, the Hirsts and Donehue executed a written agreement to settle the Hirsts’ claims. Donehue admitted that he had failed to meet the applicable community standard of care, see I.C. § 6-1012, and that he had committed various acts of medical or professional malpractice. The Hirsts agreed to settle all claims for $90,-000, in return for execution by Donehue of a consent to judgment and for an assignment by Donehue of any and all of his causes of action arising out of the failure of St. Paul Fire and Marine Insurance Company, Donehue’s insurer, to appear and defend the action. The Hirsts also agreed not to execute against Donehue, leaving the option of prosecuting an action against St. Paul to collect the amount of the judgment. The district court entered judgment for the Hirsts against Donehue in the sum of $90,000.

The Hirsts then brought the instant suit against St. Paul to collect on the insurance policy which was in force during Donehue’s treatment of Mark Hirst. The policy covered damages resulting from the “providing or withholding of professional services.” It also stated that St. Paul would defend any suit brought against Donehue for damages covered under this agreement.

After St. Paul answered, the Hirsts moved for partial summary judgment. They alleged St. Paul’s breach of its duty to defend, Donehue’s assignment to the Hirsts of his cause of action against St. Paul for the breach, and St. Paul’s result[795]*795ing liability for any reasonable settlement, costs and attorney fees incurred by Done-hue. St. Paul also moved for summary judgment.

The district court granted partial summary judgment to both parties. The court decided that the Hirsts were entitled to summary judgment on the issue of St. Paul’s duty to defend. For the purpose of resolving that issue, the court found that the original complaint against Donehue contained allegations which, if proved, could have brought the case within the coverage of the policy. On that basis, the judge awarded to the Hirsts the amount of attorney fees, costs and expenses which Donehue had incurred in defending and settling the initial action.

However, the court ultimately granted summary judgment in favor of St. Paul on the issue of coverage of the policy. The court held that Donehue’s actions did not constitute the “providing or withholding of professional services.” The court determined that the actions and injuries alleged in the complaint against Donehue were not covered by the terms of the policy, as a matter of law. Therefore St. Paul was held not liable for the substantive amount of the settlement agreed to by Donehue and the Hirsts. Although the court’s rulings on the duty to defend issue and on the ultimate question of coverage under the policy may appear to be facially inconsistent, there is a distinction between those concepts. We will discuss that distinction later in this opinion.

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Bluebook (online)
683 P.2d 440, 106 Idaho 792, 1984 Ida. App. LEXIS 463, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hirst-v-st-paul-fire-marine-insurance-idahoctapp-1984.