Medical Professional Mutual Life Insurance v. Steinberg

20 Mass. L. Rptr. 672
CourtMassachusetts Superior Court
DecidedFebruary 23, 2006
DocketNo. 035746BLS2
StatusPublished

This text of 20 Mass. L. Rptr. 672 (Medical Professional Mutual Life Insurance v. Steinberg) 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 Professional Mutual Life Insurance v. Steinberg, 20 Mass. L. Rptr. 672 (Mass. Ct. App. 2006).

Opinion

Garsh, E. Susan, J.

INTRODUCTION

Plaintiff, Medical Professional Mutual Life Insurance Company (“ProMutual”), filed this suit seeking, in Count I, a declaration: (i) that ProMutual has no duty to defend or indemnify the defendant, Lester A. Steinberg, M.D. (“Steinberg”), against a medical malpractice suit brought by defendants David and Eleanor Margolis against Steinberg (the “Margolis Suit”); and (ii) that ProMutual may discontinue its participation in and funding of the defense of the Margolis Suit and seeking, in Count II, reimbursement for attorneys fees and expenses that already have been incurred by ProMutual in the defense of the Margolis Suit. The matter is now before the court on ProMutual’s motion for summary judgment on Count I. For the reasons set forth below, the plaintiffs motion for summary judgment is allowed.

BACKGROUND

The summary judgment record reveals the following facts, which either were not disputed in accordance with Superior Court Rule 9A(b)(5) or, if disputed in accordance with that rule, reflect the facts in the light most favorable to Steinberg.

In 1975, Steinberg purchased an individual claims-made professional liability policy from the Medical Malpractice Joint Underwriting Association (“MMJUA”), effective October 1, 1975 to October 1, 1976. The MMJUA and the Massachusetts Medical Professional Insurance Association are predecessors to ProMutual. Between October 1, 1975 and October 1, 2002, Steinberg was insured under a series of individual claims-made professional liability policies issued by ProMutual or its predecessors, renewed annually on October 1 of each year. Steinberg’s ProMutual claims-made medical malpractice coverage remained in effect until October 1, 2002. At all relevant times, Nixon Insurance Agency (“Nixon Insurance”) was Steinberg’s insurance broker.

From 1975 through January 2001, ProMutual’s medical malpractice policies consisted of four parts: (1) the policy jacket, (2) the coverage form, (3) a declaration page or renewal certificate, and (4) any endorsement to the policy. At all relevant times, it was ProMutual’s custom and practice to send two copies of the applicable policy jacket and coverage form to an insured’s broker when the insured first purchases a policy and to do the same whenever those documents are updated or revised. One copy is intended for the broker’s file, and the other is for the broker to send to the insured. The coverage form sent to Nixon Insurance in 1975, when Steinberg first purchased liability insurance from ProMutual, included the following provisions:

TO OUR POLICYHOLDER
This is a claims made policy. It covers claims arising from the performance of professional services subsequent to the retroactive date indicated and first brought against you while the policy is in force. Please review the policy carefully and discuss the coverage with your insurance agent.
A claim shall be considered to be first made when the company first receives written notice of the claim or occurrence.
3. REPORTING ENDORSEMENT
In the event of termination either by non-renewal or cancellation of this policy, or termination of a reporting period the insured shall have the right upon payment of an additional premium (to be [673]*673computed in accordance with the company’s rules, rates, rating plans and premiums applicable on the effective date of the endorsement) to have issued an endorsement(s) providing additional reporting periodos) in which claims otherwise covered by this policy may be reported. Such right hereunder must, however, be exercised by the insured by written notice not later than thirty (30) days after such termination date.
“[Reporting period" means the period of time stated in the reporting endorsement for reporting claims or suits arising out of professional services.

ProMutual revised or updated the coverage form for its claims-based individual professional liability policies in January 1990, April 1993 and May 1995. ProMutual sent two copies of the revised coverage forms to Steinberg’s broker, Nixon Insurance, in January 1990, April 1993 and May 1995. Steinberg himself did not personally receive copies of any of these revised coverage forms. The revised coverage forms issued in January 1990, April 1993 and May 1995 each include the following provisions:

TO OUR POLICYHOLDER
This is a claims made policy. It covers claims arising from the performance of professional services on or after the retroactive date indicated and first brought against you while the policy is in force, but only if the company first receives formal written notice of the claim from you or your agent during the policy period. This policy does not cover claims reported to the company after the expiration of the policy period. Therefore, when you terminate or fail to renew your claims made policy with the [company], it will be necessary to purchase a reporting endorsement to extend the period of coverage beyond the expiration date of the policy. Please review the policy carefully and discuss the coverage with your insurance agent.
3. REPORTING ENDORSEMENT
In the event of termination of insurance either by non-renewal or cancellation of this policy, or termination of a reporting period the named insured shall have the right upon payment of an additional premium (to be computed in accordance with the company’s rules, rates, rating plans and premiums applicable on the effective date of the endorsement) to have issued a reporting endorsement(s) providing additional reporting periodos) in which claims otherwise covered by this policy may be reported. Such right hereunder must, however, be exercised by the named insured by written notice no later than thirty (30) days after such termination date.

In January 2001, ProMutual again revised its claims-made individual professional liability policy, effective October 1,2001. Neither Nixon Insurance nor Steinberg received a copy of the revised policy. Drawing all inferences adverse to ProMutual, a fact finder could find- that the revised policy form was not forwarded to the broker or to Steinberg by Pro Mutual.

On or about August 26, 2002, Promutual sent to Nixon Insurance two copies of a Renewal Declaration for the 2002-2003 period. Steinberg received a copy of that Renewal Declaration. On or about September 3, 2002, ProMutual sent Steinberg, with a copy to Nixon Insurance, an invoice for the premium for the 2002-2003 policy period. Steinberg received this invoice. The invoice stated that payment of the premium for the 2002-2003 policy was due by October 3, 2002. At about the time Steinberg received the Renewal Declaration and invoice, he was unhappy with the premiums charged by ProMutual and with ProMutual’s settlement of a previous claim against him. Steinberg chose not to renew his ProMutual policy for the 2002-2003 period and deliberately did not pay any of the premium due for the 2002-2003 period. Steinberg informed Nixon Insurance that he was cancelling his coverage with ProMutual effective October 1, 2002. Steinberg purchased professional liability insurance for the 2002-2003 period from another insurance company, Controlled Risk Insurance Company (“CRICO”).

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Cite This Page — Counsel Stack

Bluebook (online)
20 Mass. L. Rptr. 672, Counsel Stack Legal Research, https://law.counselstack.com/opinion/medical-professional-mutual-life-insurance-v-steinberg-masssuperct-2006.