Kenneth H. Archibald and Archibald & Associates, Inc. v. El Paso Orthopedic Surgery Group, P.A., Brett Henderson, M.D. and the Medical Protective Company

Court of Appeals of Texas·Decided February 24, 2023·No. 08-22-00091-CV·Published

Opinion

COURT OF APPEALS

EIGHTH DISTRICT OF TEXAS

EL PASO, TEXAS

KENNETH H. ARCHIBALD AND § ARCHIBALD & ASSOCIATES, INC., § No. 08-22-00091-CV Appellants,

§ Appeal from the v.

§ 327th Judicial District Court EL PASO ORTHOPEDIC SURGERY GROUP, P.A., BRETT HENDERSON, M.D., § of El Paso County, Texas AND THE MEDICAL PROTECTIVE COMPANY, § (TC# 2015-DCV2669)

Appellees. §

MEMORANDUM OPINION

In this permissive interlocutory appeal involving an insurance dispute, we are asked to decide whether certain claims are barred by the statute of limitations. Appellants, Kenneth Archibald and Archibald & Associates, Inc., appeal a partial summary judgment in favor of Appellees, El Paso Orthopedic Surgery Group, P.A. (EPOSG), Dr. Brett Henderson, and The Medical Protective Company (MedPro). Specifically, Appellants appeal the trial court’s order dismissing their affirmative defense of limitations as to all causes of action asserted by Appellees.

The trial court’s order granted Appellants permission to pursue an interlocutory appeal as to nine controlling questions of law. After a thorough review of the record, we dismiss the appeal for want of jurisdiction.

Factual Background

Mr. Archibald is the sole owner of Archibald & Associates Inc., an insurance agency that writes medical malpractice insurance for physicians and physician groups. Mr. Archibald has been a licensed agent with the Texas Department of Insurance since 1990. He began working with EPOSG in 1998, and since 2003, Mr. Archibald has obtained policies for EPOSG and its physicians as its sole medical malpractice insurance agent with policies underwritten by MedPro, a healthcare liability insurance provider. EPOSG’s standard practice was to carry a group policy, while each physician within the group also maintained his or her own policy, which allowed EPOSG to add or cancel an individual physician’s coverage without changing its group coverage whenever a physician joined or left EPOSG.

When a physician joined EPOSG, Mr. Archibald would recommend to EPOSG what type of coverage to obtain for that physician. Both occurrence-based and claims-made policies are available for medical malpractice coverage. An occurrence-based policy is one in which coverage is triggered based upon when the alleged offense occurred, regardless of when a claim is made. It differs from a claims-made policy, under which coverage is triggered based upon the date the claim is made, regardless of when the alleged underlying event occurred. If a claims-made policy terminates, the physician may choose to secure tail coverage, or extended reporting coverage, to cover liability for any later-asserted claims based on events that occurred during the term of the claims-made policy in exchange for a one-time payment to the insurance carrier. Mr. Archibald testified claims-made policies are industry standard for medical-malpractice coverage.

When Dr. Henderson joined EPOSG, his situation differed from the norm at EPOSG because he was joining on a part-time, possibly short-term, basis, while continuing his own practice in New Mexico, and practicing only orthopedic spinal surgery, not neurosurgery. Based on his conversation with Dr. Henderson, Mr. Archibald recommended an occurrence-based policy. EPOSG and Dr. Henderson agreed, and Dr. Henderson submitted his application for an occurrence-based policy to Archibald & Associates with an effective date of April 13, 2010.

Though Dr. Henderson’s written application requested an occurrence-based policy, it is undisputed once Mr. Archibald or an Archibald & Associates employee input his application into the electronic underwriting system for submission to MedPro, it erroneously reflected a request for a claims-made policy. In other words, though Dr. Henderson and EPOSG agreed to obtain an occurrence-based policy per Mr. Archibald’s recommendation, Mr. Archibald or one of his company’s employees mistakenly requested a claims-made policy.

After MedPro accepted the application, Archibald & Associates issued a certificate to EPOSG for credentialing purposes reflecting Dr. Henderson’s coverage and stating the limits of liability applicable to his policy; however, the certificate did not state whether the policy was claims-made or occurrence-based. Thus, at the time, Dr. Henderson, EPOSG, and Mr. Archibald all believed that Dr. Henderson had an occurrence-based policy. Mr. Archibald testified MedPro sent the policy—which would have reflected the coverage discrepancy—to EPOSG and Dr. Henderson directly in 2010.

Dr. Henderson left EPOSG on November 30, 2011. A representative from EPOSG contacted Mr. Archibald in July 2012 to ask whether EPOSG needed to secure tail coverage for Dr. Henderson. However, still believing Dr. Henderson had an occurrence-based policy, Mr. Archibald said there was no need for tail coverage since under an occurrence-based policy, Dr.

Henderson would remain insured for all events during his coverage period, regardless of when a claim may be asserted.

In June 2013, one of Dr. Henderson’s EPOSG patients lodged a medical-malpractice claim against EPOSG and Dr. Henderson. Shortly after, attorney Larry Hicks accepted assignment from MedPro of EPOSG’s defense in the case. Mr. Hicks contacted Mr. Archibald regarding Dr. Henderson’s coverage for the claim, at which point Mr. Archibald still believed Dr. Henderson had an occurrence-based policy. However, on August 8, 2013, Mr. Archibald emailed Mr. Hicks and acknowledged Dr. Henderson in fact had a claims-made policy. Specifically, he stated:

[W]hen Dr. Henderson was added to the policy, it was our intent to do so on a Part-

Time Occurrence Basis. It appears that he was added on a Part-Time Claims Made Basis. We are continuing to look into the details on how this slipped through the cracks. With that said, I have notified the E&O carrier for Archibald & Associates of the incident. They are setting up a preliminary file. I realize time is of the essence on this. With this email, I authorize you to answer the claim on behalf of Dr.

Henderson. Please send billing correspondence at this time to our office. I will need it for my E&O carrier. I will keep you totally apprised of the coverage situation.

Please keep me apprised of the defense of the claim.

Mr. Hicks responded, stating he spoke to Dr. Henderson, “told him about [Mr. Archibald’s] decision to handle his portion of the case” through Mr. Archibald’s E&O carrier, and Dr. Henderson “seems satisfied with that plan.”

Mr. Archibald also emailed Mr. Hicks’s assistant on August 22, 2013, stating, “[a]s per my conversation with Larry, he is going to work on the case for Dr. Henderson as we will cover the claim.” On September 6, 2013, Mr. Hicks emailed Mr. Archibald, writing:

I am meeting with Dr. Henderson today to talk to him about the case. I have told him that you and/or your E&O carrier will cover his defense and indemnity up to whatever limits he would have had under the EPOSG policy. I suggest you communicate with him about whatever arrangements you have made.

I spoke to Paul Rinaldi, [the MedPro Claims Manager] yesterday. As you know, I put [MedPro] on notice of Dr. Henderson’s claim. Paul informed me yesterday that Med[]Pro does not have coverage for Dr. Henderson on this matter. However,

Med[]Pro is considering providing a courtesy defense for him because EPOSG may be vicariously liable for his negligence, if any. Nevertheless, this does not get Dr.

Henderson out of the woods from an indemnity or settlement standpoint.

As you know, I cannot get involved in coverage issues for Dr. Henderson. I am happy for you and Med[]Pro to work out any arrangement you may choose concerning Dr. Henderson’s coverage and, frankly, I do not need to know the details. I just need to know that a.) his legal fees will be paid, and b.) he will have indemnity money available to him if he chooses to settle or has an adverse verdict.

Let me know if this is an acceptable approach, or if you have any questions.

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Kenneth H. Archibald and Archibald & Associates, Inc. v. El Paso Orthopedic Surgery Group, P.A., Brett Henderson, M.D. and the Medical Protective Company, (Tex. Ct. App. 2023).

Kenneth H. Archibald and Archibald & Associates, Inc. v. El Paso Orthopedic Surgery Group, P.A., Brett Henderson, M.D. and the Medical Protective Company (Kenneth H. Archibald and Archibald & Associates, Inc. v. El Paso Orthopedic Surgery Group, P.A., Brett Henderson, M.D. and the Medical Protective Company) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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