McCarthy v. Berman

668 So. 2d 721, 1996 WL 83872
CourtSupreme Court of Louisiana
DecidedFebruary 28, 1996
Docket95-CC-1456
StatusPublished
Cited by30 cases

This text of 668 So. 2d 721 (McCarthy v. Berman) is published on Counsel Stack Legal Research, covering Supreme Court of Louisiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
McCarthy v. Berman, 668 So. 2d 721, 1996 WL 83872 (La. 1996).

Opinion

668 So.2d 721 (1996)

Julia McCARTHY, wife of James McCarthy
v.
William BERMAN, D.C., National Chiropractic Mutual Insurance Company, and Allstate Insurance Company.

No. 95-CC-1456.

Supreme Court of Louisiana.

February 28, 1996.
Rehearing Denied March 29, 1996.

*722 Jefferson Randolph Tillery, Suzanne Michele Ray, Jones, Walker, Waechter, Poitevent, Carrere & Denegre, New Orleans, for Applicant.

Hugh M. Glenn, Jr., Gregory John McDonald, Bienvenu, Foster Ryan & O'Bannon, New Orleans, Scott Alan Cannon, New Orleans, Bobby Ray T. Malbrough, Metairie, for Respondent.

LEMMON, Justice.[*]

The issue presently before the court in this chiropractic malpractice action is whether the "Incidental Medical Malpractice Liability" coverage in the comprehensive business insurance policy issued to a chiropractor provides coverage for the injuries the chiropractor allegedly caused in treating plaintiff.

I

Alleging that she had sustained an injury to her cervical spine during chiropractic treatment by Dr. William Berman,[1] plaintiff *723 filed this action against (1) Dr. Berman, (2) National Chiropractic Mutual Insurance Company, Dr. Berman's medical malpractice insurer, and (3) Allstate Insurance Company, Dr. Berman's comprehensive business insurer.[2] Allstate filed an answer denying coverage of Dr. Berman under its policy.

Allstate then filed a motion for summary judgment. In support of its motion, Allstate argued that its policy was not a professional malpractice policy, but rather was a limited business liability policy that expressly excluded injuries arising out of the rendering of professional services, and that its policy's incidental medical malpractice liability coverage expressly excluded persons engaged in the occupation of furnishing medical services. Allstate further argued that its policy was not an excess policy or an umbrella policy.

The trial court denied Allstate's motion, stating that there were genuine issues of material fact for trial. The judge further noted that the incidental medical malpractice provision was ambiguous and subject to more than one interpretation.

Allstate then filed an application for supervisory writs, which was denied by the court of appeal. On application for certiorari, this court remanded the case to the court of appeal for briefing, argument and an opinion. 94-2856 (La. 2/3/95); 649 So.2d 396.

On remand, the court of appeal again denied Allstate's application for supervisory writs in a full written opinion. 94-778 (La. App. 5th Cir. 5/10/95); 656 So.2d 717. Noting (contrary to the ruling of the trial court) that there was no genuine issue of material fact, the intermediate court held that Allstate was not entitled to judgment as a matter of law because the policy exclusions, characterized by the court as "exclusion[s] by implication," were ambiguous and must be construed in favor of coverage.

Allstate applied to this court for certiorari. This court seldom grants certiorari applications involving interlocutory judgments in which both lower courts have simply refused to grant motions for summary judgment and allowed the case to go to trial. However, the court of appeal in the present case on remand decided the coverage issue as a matter of law. Because this court previously remanded the case to the court of appeal for an opinion deciding the merits and because a majority of this court tentatively believed the decision by the intermediate court on the merits was in error, this court granted certiorari. 95-1456 (La. 6/30/95); 657 So.2d 1005.

II

The comprehensive business liability policy,[3] issued by Allstate to Dr. William S. Berman d/b/a Berman Chiropractic, provided two types of coverage, Coverage A—Business Property and Coverage B—Business Liability. Under Coverage B was Part One— Comprehensive Liability, which covered the business liability of insured persons in pertinent part as follows:

Part One—Comprehensive Liability
Liabilities Covered
We will pay on behalf of persons insured all sums which they become legally obligated to pay as damages arising out of an accidental event, personal injury or advertising injury that occurs while this policy is in effect.... (emphasis added).
The exclusions to Coverage B-Business Liability coverage included:

We will not pay for:

. . . . .
21. Any accidental event, personal injury, or advertising injury, arising out of the rendering of or the failure to render scientific or professional services, or consulting business or technical services. This exclusion does not apply to Incidental Medical Malpractice Liability. (emphasis added).

Thus, Coverage B-Business Liability generally covered Dr. Berman's liability for damages arising out of personal injury, except when the personal injury arose out of the *724 rendering of or the failure to render professional services, as in the present case. This exclusion is typical of the professional services exclusion generally found in comprehensive business liability policies, because coverage for such exposure is provided by special policies. William Shelby McKenzie & H. Alston Johnson, III, Insurance Law and Practice, 15 Louisiana Civil Law Treatise § 201 (1986). Special policies covering professional liability do not replace comprehensive general liability insurance, but provide protection for professional errors and omissions that are usually excluded by comprehensive general liability policies.[4]Id.

Coverage B also provided the following coverage, in addition to the general coverage:

Incidental Medical Malpractice Liability:

We will also pay of behalf on persons insured all sums which they become legally obligated to pay for bodily injury arising out of the rendering of or failure to render the following services while this policy is in effect:
1. Medical, surgical, dental, x-ray or nursing service or treatment, or the furnishing of food or beverages in connection with these services, or
2. The furnishing or dispensing of drugs or medical, dental or surgical supplies or appliances.
However, this coverage does not apply to persons insured if they are engaged in the business or occupation of providing any of the services described in (1) and (2) above. (emphasis added).

As noted earlier, Exclusion No. 21, which excluded coverage for personal injury arising out of the rendering of professional service, applied to the broad general coverage under "Liabilities Covered," but was expressly inapplicable to the "Incidental Medical Malpractice Liability" coverage. The case on summary judgment therefore turns on the interpretation of the coverage and exclusion in the incidental medical malpractice coverage provision.

III

The court of appeal, instead of using the acts expressly described in the incidental medical malpractice liability coverage provision to determine the extent of that coverage, erroneously referred to the definitions of "health care provider" and "malpractice" in La.Rev.Stat. 40:1299.41 A(1) and (8).[5]

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Cite This Page — Counsel Stack

Bluebook (online)
668 So. 2d 721, 1996 WL 83872, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mccarthy-v-berman-la-1996.