Medical Malpractice Joint Underwriting Ass'n of Massachusetts v. Witherspoon

4 Mass. L. Rptr. 204
CourtMassachusetts Superior Court
DecidedAugust 17, 1995
DocketNo. 904319
StatusPublished

This text of 4 Mass. L. Rptr. 204 (Medical Malpractice Joint Underwriting Ass'n of Massachusetts v. Witherspoon) 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
Medical Malpractice Joint Underwriting Ass'n of Massachusetts v. Witherspoon, 4 Mass. L. Rptr. 204 (Mass. Ct. App. 1995).

Opinion

Roseman, J.

The Medical Malpractice Joint Underwriting Association of Massachusetts (“JUA”) seeks a declaration that the professional liability insurance policies it issued to the defendants, Harold L. Goldberg and Harold L. Goldberg, M.D., Inc. (sometimes “Goldberg”) do not cover the judgment against Goldberg, a psychiatrist, obtained in the Superior Court by one Witherspoon, his former patient, and reimbursement of the settlement amount JUA paid to Witherspoon on eve of argument before the Supreme Judicial Court on appeal by Goldberg seeking reversal of the judgment against him and by Witherspoon seeking to vacate the dismissal of her c. 93A claim. JUA also asks this Court, should it determine there is coverage in an amount greater than $1,000,000, to order reimbursement of $300,000, the statutory maximum, of the settlement amount of $1,875,000 from the Massachusetts In[205]*205surers Insolvency Fund, successors in obligations to American Universal Insurance Company.

Goldberg defends on a number of grounds, inter alia, no right of JUA to reimbursement, waiver, and failure of JUA to settle after demand had been made within policy limits. American Universal and the Insolvency Fund raise other defenses. In view of its ruling that JUA, in the circumstances here, is not entitled to reimbursement, the Court does not reach the claims against them.

JUA’s theory of recovery against Goldberg seems to rest on an agreement between it and Goldberg, if not expressed, then implied, that Goldberg would reimburse the settlement award should the coverage issues in this action be adjudicated in JUA’s favor. Accordingly, we examine JUA’s claims against Goldberg in that light, that is to say, we turn immediately to the question whether JUA, in these circumstances, is entitled to reimbursement assuming, arguendo, coverage did not exist.

The parties stipulated to certain facts in a document entitled “Stipulated Facts,” copy appended, which, in addition to matters found at the trial and set forth below, constitute the Court’s Findings of Fact. Because of the view of. the case taken by the Court, it recites those matters it deems critical to decision.

This matter originates in 1971 when Witherspoon, then 19, began therapy sessions with Goldberg. Witherspoon, depressed, was diagnosed by Goldberg as a “borderline personality,” a disorder characterized “by a poorly defined self-image.” Plaintiffs Trial Brief at 4.

In 1976, while in therapy, Goldberg and Witherspoon “discussed having a sexual relationship.” Id. On December 27, 1976, they first had sexual intercourse. That relationship continued for ten years. After the death of his wife in October 1986, Goldberg discontinued therapy with Witherspoon but continued to see and have sexual relations with her. When Goldberg refused to commit himself to Witherspoon, and refused to see her, Witherspoon suffered a mental breakdown, twice attempting suicide.

In early 1988, Witherspoon filed suit in Norfolk Superior Court charging Goldberg with negligence, intentional or negligent infliction of emotional distress, assault, battery, and breach of contract.

We now turn to the critical events.

Goldberg turned to his insurer, JUA, for defense and indemnity under a series of claims made and “occurrence” policies. The claims made policies, in part, provided:

that the JUA will pay on behalf of the insured all sums which the insured shall become legally obligated to pay as damages because of any claim or claims made against the insured during the policy period arising out of the performance of professional services rendered, or which should have been rendered . . .

The “occurrence” policies had a similar provision. They provided that JUA

will pay on behalf of the insured all sums which the insured shall become legally obligated to pay as damages because of. . . injuries arising out of the rendering of or failure to render, during the policy period, professional services by the individual insured . . .

The limits of coverage were $1,000,000 per claim and $3,000,000 in the aggregate. Each policy gave JUA the discretion to settle “any claim or suit as it deems expedient.” None of the policies expressed a right in JUA, on settling a claim, to seek reimbursement from its insured of the amount paid. By letter of March 9, 1988, JUA notified Goldberg that it would provide him with a defense, retaining counsel subject to the following reservations:

1. The denial of coverage of any injury arising from conduct occurring during the period from spring 1971 through May 1, 1976 “and for any period when Ms. Witherspoon was not [Goldberg’s] patient.”

2. Disclaiming coverage of any act “which [Dr. Goldberg] did not intend to constitute professional medical services or [were] objectively outside the scope of professional services.”

3. Asserting the right “to disclaim coverage for all acts that involved an intent to injure or cause emotional harm” to Witherspoon.

Counsel took up their task of defense. By June 1989, counsel referred to the case as a “blazing forest fire.” In August 1989 Witherspoon amended her complaint founding her claim on theories of negligence, breach of contract, and violation of c. 93A. On December 13, 1989, in the midst of discovery with Goldberg’s liability to the charges reasonably apparent, Witherspoon’s lawyer made a written demand on JUA to settle for $ 1,000,000 or the policy limit, whichever was greater, reciting that it would remain open for thirty days. JUA did not respond. On February 20, 1990, Goldberg’s personal lawyer, Edward J. Barshak, Esq., who had filed an appearance the previous summer, wrote JUA and demanded that it settle the case within policy limits. On February 22, 1990, with the depositions of Goldberg and Witherspoon taken, counsel reported to JUA that the settlement demand still was $1,000,000, that the likelihood of a defendant’s verdict was “approaching zero,” that the value of the case was between $500,000 to $2,000,000 and that efforts should be made to settle within the $1,000,000 policy limit. On March 5, 1990 JUA responded to Mr. Barshak. It again denied coverage and stated that it intended to file a declaratory judgment action to resolve the coverage issue. JUA went on:

[206]*206Because of Dr. Goldberg’s admissions we agree that it is in his interest to settle the matter. However, in light of our view that there is no coverage, any settlement contribution we might make would be subject to an express reservation on the part of JUA to seek recovery of any settlement in the context of the to be filed declaratory judgment action.

On March 20, the case scheduled for trial in April, Mr. Barshak replied. Claiming JUA bore the obligation to settle within policy limits, and noting that Witherspoon’s demands were within such limits, Mr. Barshak wrote: “You made it clear you are not entertaining the demand on the merits because [you] claim there is no coverage ... Dr. Goldberg agrees that if you settle the case, the settlement will not be considered a waiver of your reservation of rights (for whatever value the reservation may have).” On that day, having reserved on or about March 15, 1990 $500,000 and, faced with a demand of $ 1,000,000, setting settlement authority at $350,000 on estimating Goldberg’s chance of a defense verdict as between 0 to 5% and judging the verdict range to be between $300,000 to $2,000,000, JUA offered $150,000 in settlement.

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Bluebook (online)
4 Mass. L. Rptr. 204, Counsel Stack Legal Research, https://law.counselstack.com/opinion/medical-malpractice-joint-underwriting-assn-of-massachusetts-v-masssuperct-1995.