Johnson v. ProSelect Insurance

33 Mass. L. Rptr. 637
CourtMassachusetts Superior Court
DecidedOctober 12, 2016
DocketNo. 2013CV3981
StatusPublished

This text of 33 Mass. L. Rptr. 637 (Johnson v. ProSelect Insurance) is published on Counsel Stack Legal Research, covering Massachusetts Superior Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Johnson v. ProSelect Insurance, 33 Mass. L. Rptr. 637 (Mass. Ct. App. 2016).

Opinion

Pierce, Laurence D., J.

In this action the plaintiff, Ellen Johnson, M.D. (“Dr. Johnson”), alleges that the defendant, ProSelect Insurance Company (“ProS-elect”), acted negligently and breached its duty of good faith in the defense of a medical malpractice action against Dr. Johnson by failing to investigate the case, properly evaluate the liability risks, and undertake pre-trial settlement negotiations. Dr. Johnson also contends that ProSelect failed to pursue post-trial motions and an appeal, and instead settled the case against her wishes after an adverse jury verdict. Her Complaint and Jury Demand (the “Complaint”) in this matter contains three counts: negligent defense (Count I); negligent refusal to pursue post-trial motions and an appeal (Count A); and breach of the insurance contract (Count in). ProSelect now moves for summary judgment.

For the reasons discussed below, ProSelect’s motion for summary judgment is ALLOWED.

FACTUAL BACKGROUND

The following facts, viewed in the light most favorable to the plaintiff, are taken from the Consolidated [638]*638Statement of Undisputed Material Facts (“SUMF”). Some facts are reserved for discussion below.

Dr. Johnson is a medical doctor specializing in radiology. SUMF, ¶1. ProSelect is an insurer providing professional liability coverage to healthcare professionals. Id. at 12. At all times relevant to this dispute, ProSelect was the medical malpractice insurer for Dr. Johnson and Advanced Diagnostic Imaging, PLLC (“ADI”), Dr. Johnson’s employer. Id. at 17. The total available coverage under the applicable malpractice policy issued to Dr. Johnson and .ADI was $4 million dollars.1 Id. at! 13.

I. The ProSelect Policy and Applicable Case Management Guidelines

Dr. Johnson’s ProSelect policy provides, in pertinent part: “[ProSelect] shall have the right and duly to defend with defense counsel selected by US . . . and WE may make any investigation and settlement of any CLAIM or SUIT as WE deem expedient.” Id. at 120. The policy also includes a “Consent to Settle Endorsement” that provides: “[ProSelect] shall not settle any CLAIM or SUIT against any practitioner scheduled on the Group Schedule attached to the DECLARATIONS . . . without that SCHEDULED PRACTITIONER’S written consent . . . If the SCHEDULED PRACTITIONER consents to settlement or is deemed to have consented, then WE may settle the CLAIM or SUIT for such amount up to the applicable Limit of Liability of the POLICY and on such terms as WE in OUR sole judgment determine. WE shall not be obligated to obtain consent to settle any CLAIM or SUIT against any SCHEDULED PRACTITIONER: (1) After a jury verdict, judgment, or any other ruling by a court establishing that SCHEDULED PRACTITIONER’S liability regardless of whether such verdict, judgment or ruling is subject to appeal or further judicial review.” Id. at ¶22.

ProSelect is affiliated with Coveiys, a larger group of professional malpractice insurers. As such, ProS-elect employs various Coveiys business practices and procedures. The applicable “Coverys Case Management Guidelines,” which among other things, “provide] ] an outline of the roles and responsibilities of the [ProSelect] Claim Representative and defense counsel,” include the following provision: “Coverys expects to be kept advised of case developments, and further expects to be generally involved in developing defense strategies. However, by accepting assignments from Coverys, counsel acknowledge and agree that they are independent contractors, that they are solely responsible for directing and controlling the details of the insured’s defense, and that they owe an ethical obligation to the insured to exercise their independent professional judgment in matters concerning the defense of the insured." Case Management Guidelines, attached to SUMF as Exhibit 23, p. 1.

The Case Management Guidelines also include the following claim department responsibilities: “Investigations will be coordinated and conducted by the assigned Claim Representative. On occasion, defense counsel will be requested to assume certain limited claim investigation responsibilities.” Id. at p. 3. The Guidelines further state that it is the claim representative’s responsibility to “develop and refine the investigation plan for the case” and “coordinate the selection of all experts, investigators and consultants.” Id. Meanwhile, the Guidelines explain that defense counsel is responsible for ”conduct[ing] general investigation activities when requested, which minimally include: interviewing involved insureds and/or their staffs; obtaining relevant documents; identifying other potentially culpable parties; reporting findings to the Claim Representative; and providing a concise sum-maiy of case facts to the Claim Representative.” Id.

II. The Underlying New Hampshire Litigation

In July 2010, Noel Jodoin and her husband filed a complaint in Rockingham County Superior Court in New Hampshire, alleging that on August 9, 2007, Mrs. Jodoin received negligent care from Dr. Johnson, ADI and other medical professionals at Exeter Hospital in Exeter, New Hampshire, and that as a result she suffered a stroke (the “Jodoin case”). SUMF at ¶5. The other named defendants included physician assistant Heidi Hatch (“PA Hatch”), Exeter Hospital Emergency Department (“ED”) physician Dr. Raymond. Kelly (“Dr. Kelly”), Exeter Emergency Physicians, VA., and neurologist Dr. Ken Logan (“Dr. Logan”). Id. at 116, 96.. Attorney J. Peter Kelley (“Attorney Kelley”) was retained by ProSelect to represent Dr. Johnson and ADI in the Jodoin case. Id. at 18. Attorney Kelley has been a practicing attorney since 1991 and is licensed to practice in Massachusetts and New Hampshire. Id. at ¶70. He has been litigating and trying medical malpractice cases since 1998. Id. at 171.

The Jodoin case was litigated for approximately two years. Before the case went to trial, the Jodoins’ claims against all of the defendants, other than Dr. Johnson, were either dismissed or settled. Id. at 119-10. In August 2011, the Jodoins filed notice of a voluntary non-suit as to defendants Dr. Kelly, PA Hatch, and Exeter Emergency Physicians, P.A. Id. at ¶96. Attorney Kelley sought to learn the reasons for the dismissal, but was unable to learn anything beyond that the plaintiffs, “in their consideration of the case [had] determined to drop PA Hatch and Dr. Kelly as defendants.” Id. at 197. Dr. Logan settled with the plaintiffs shortly before trial for $950,000. Id. at 1110.

A jury trial of the remaining claims against Dr. Johnson took place November 5 through November 12, 2012. Id. at 111. At the conclusion of the trial, the juiy returned a verdict against Dr. Johnson, awarding $4 million to Mrs. Jodoin and $1 million to her husband for loss of consortium. Id. at 112. On or about November 29, 2012, ProSelect settled the case on behalf of Dr. Johnson and ADI for $3.75 million. Id. at 113.

[639]*639III. The Care at Issue in the Jodoin Case

The facts of the Jodoin case focused on Mrs. Jodoin’s presentation to Exeter Hospital on the morning of August 9, 2007, complaining of a persistent headache, and Dr. Johnson’s subsequent communications with ED providers following a head CT scan. Id. at 1124-25, 42-48. Mrs.

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Cite This Page — Counsel Stack

Bluebook (online)
33 Mass. L. Rptr. 637, Counsel Stack Legal Research, https://law.counselstack.com/opinion/johnson-v-proselect-insurance-masssuperct-2016.