Hospital Underwriting Group, Inc. v. Summit Health Ltd.

719 F. Supp. 627, 1989 U.S. Dist. LEXIS 9342, 1989 WL 89698
CourtDistrict Court, M.D. Tennessee
DecidedJuly 5, 1989
DocketCiv. A. 3:88-0297
StatusPublished
Cited by3 cases

This text of 719 F. Supp. 627 (Hospital Underwriting Group, Inc. v. Summit Health Ltd.) is published on Counsel Stack Legal Research, covering District Court, M.D. Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hospital Underwriting Group, Inc. v. Summit Health Ltd., 719 F. Supp. 627, 1989 U.S. Dist. LEXIS 9342, 1989 WL 89698 (M.D. Tenn. 1989).

Opinion

MEMORANDUM

WISEMAN, Chief Judge.

This action for declaratory judgment is currently before the Court on five motions. The parties have fully briefed each motion and defended their positions in oral argument. Defendants Mesa General Hospital, Inc. (Mesa), and Dr. James Baumann have moved to be dismissed for lack of personal jurisdiction. The Court grants their motion. Defendant Sarahmarge Crigler has adopted the motion for summary judgment which Mesa and Baumann have filed in the alternative. This motion is effectively a cross motion for summary judgment, responding to the motion of plaintiff, Hospital Underwriting Group, Inc. (HUG), on the issue of whether HUG is liable under an insurance policy it issued to defendant Summit Health, Ltd. (Summit). For the reasons stated below, the Court rules in favor of Mrs. Crigler on the liability issue. HUG and Summit have also filed cross motions for summary judgment on the issue of whether Summit is required to indemnify HUG for any liability which HUG might incur under the policy. The Court denies both of the motions on the indemnity issue. Finally, Summit has moved to substitute Mrs. Crigler as a party, but the Court finds it unnecessary to rule upon this motion.

I. FACTS

A. GENERAL BACKGROUND

Summit, a California entity, indirectly owns a large number of hospitals. Its wholly-owned subsidiary, Summit Hospital Corp., owns defendant Mesa, an Arizona corporation whose sole business is the operation of Mesa General Hospital in Mesa, Arizona. In other words, defendant Mesa is a wholly-owned subsidiary of a wholly-owned subsidiary of defendant Summit.

Defendant Baumann is a Doctor of Osteopathy who, as an independent contractor, works as an emergency room physician at Mesa General Hospital on a part-time, *629 hourly basis. While in the emergency room on December 24, 1985, Dr. Baumann treated a patient, Oscar Crigler, who died shortly thereafter. The patient’s widow, Sarahmarge Crigler, subsequently sued Mesa and Dr. Baumann, received a verdict of $4,000,000 and settled for $2,000,000 plus an assignment of rights under the excess liability policy written by HUG, which is at issue in this suit. By virtue of that assignment, Mrs. Crigler has been joined as a defendant.

Plaintiff is a Tennessee corporation with its principal place of business in Tennessee. It insures groups of hospitals and certain physicians for, among other things, their professional and general liability risks. HUG issued Policy No. 85-100 to Summit, effective October 1, 1985, to June 1, 1986, with a liability limit of $25,000,000 less a $2,000,000 deductible per occurrence. Defendants Mesa and Baumann played no role in procuring the policy or negotiating its terms. Only HUG and Summit were parties to the transaction.

Defendant Summit is the sole “Member Insured” under the policy. 1 As the Member Insured, Summit became a shareholder in HUG. 2 Although neither was named specifically in the policy, Mesa and Baumann were among the “Insured” under the policy. The policy defines “Insured” as “any person or organization qualifying as an Insured in the Persons Insured provision of the applicable insurance coverage.” 3 As an “organization in which the Member Insured or its subsidiaries has or acquires a financial interest of 50% or more,” defendant Mesa qualifies for coverage as a “Naméd Insured.” 4 Baumann qualifies by virtue of an “Emergency Room Endorsement” to the policy. 5 The policy specifies that “[t]he insurance afforded applies separately to each Insured against whom claim is made or suit is brought.” 6

The policy’s notice requirements lie at the heart of this dispute. They provide:

3. Insured’s Duties in the Event of Occurrence, Claim or Suit:
(A) In the event of an occurrence (even within the applicable deductible) written notice containing particulars sufficient to identify the Insured and also reasonably obtainable information with respect to the time, place and circumstances thereof, and the names and addresses of the injured and of available witnesses, shall be given by or for the Insured to the Company or any of its authorized agents as soon as practicable after any of the following have knowledge of the occurrence: (1) the Member Insured, if an individual, (2) any partner of the Member Insured, if the Member Insured is a partnership, (3) any officer located at the Member Insured’s principal offices, if the Member Insured is a corporation, or (4) any person designated by the Member Insured to give such notice. The Member Insured shall designate a reasonable number of persons to give such notice. This written notice shall be made in such a report form as the Company shall from time to time determine.
(B) If claim is made or suit is brought against the Insured, the Insured shall immediately forward to the Company every demand, notice, summons or other process received by him or his representative.
(C) The Insured shall cooperate with the Company and upon the Company’s request, assist in making settlements, in the conduct of suits and in enforcing any right of contribution or indemnity *630 against any person or organization who may be liable to the Insured because of injury or damage with respect to which insurance is afforded under this Policy, and the Insured shall attend hearings and trials and assist in securing and giving evidence and obtaining the attendance of witnesses. The Insured shall not, except at his own cost, voluntarily make any payment, assume any obligation or incur any expense other than for first aid to others at the time of the accident.
4. Action Against Company: No action shall lie against the Company unless as a condition precedent thereto, there shall have been full compliance with all the terms of this Policy, including, but not limited to, the payment of Premium and Retrospective Premium Adjustment, nor until the amount of the Insured’s obligation to pay shall have been finally determined either by judgment against the Insured after actual trial or by written agreement of the Insured, the claimant and the Company. 7

HUG has no department for handling or investigating claims. HUG relies upon its member hospital groups, i.e. the Member Insureds, to handle claims and to provide HUG with information concerning the claims. 8 Samuel Dillard, Vice President of HUG, has testified,

the way we operate, we don’t have the outside claims staff. We look directly to the member hospital group for the claims handling function.... We rely on the member hospital group claims staff or risk management staff to provide us with information. We don’t go direct to the hospital or the doctor, if there’s a doctor involved — or even to the attorney, unless we get permission from the member hospital group.

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Cite This Page — Counsel Stack

Bluebook (online)
719 F. Supp. 627, 1989 U.S. Dist. LEXIS 9342, 1989 WL 89698, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hospital-underwriting-group-inc-v-summit-health-ltd-tnmd-1989.