Princeton Insurance Company v. curi/medical Mutual Insurance Company of North Carolina

New Jersey Superior Court Appellate Division·Decided May 1, 2026·No. A-2847-24·Unpublished

Opinion

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the internet, this opinion is binding only on the parties in the case and its use in other cases is limited . R. 1:36-3.

SUPERIOR COURT OF NEW JERSEY APPELLATE DIVISION

DOCKET NO. A-2847-24

PRINCETON INSURANCE COMPANY,

Plaintiff-Appellant/

Cross-Respondent,

v.

CURI/MEDICAL MUTUAL INSURANCE COMPANY OF NORTH CAROLINA,

Defendant-Respondent/

Cross-Appellant,

and KENNEDY HEALTH ALLIANCE,

Defendant.

Submitted March 24, 2026 – Decided May 1, 2026 Before Judges Firko and Vinci.

On appeal from the Superior Court of New Jersey, Law Division, Camden County, Docket No. L-3356-23.

Saiber LLC, attorneys for appellant/cross-respondent (Jennine DiSomma, of counsel and on the briefs;

Vincent C. Cirilli, on the briefs).

Thomas Thomas & Hafer, LLP and Mark D. Malloy (Meissner, Tierney, Fisher & Nichols SC) of the Wisconsin, Illinois and Minnesota bars, admitted pro hac vice, attorneys for respondent/cross-appellant (Gregory C. Kunkle and Mark D. Malloy, on the briefs).

PER CURIAM In this insurance coverage declaratory judgment action, defendant CURI/Medical Mutual Insurance Company of North Carolina (MMIC) and plaintiff Princeton Insurance Company (PIC) cross-appeal from a January 31, 2025 order granting in part and denying in part their cross-motions for summary judgment. PIC also appeals from an April 25, 2025 order denying its motion for reconsideration. We reverse the January 31 order to the extent it denied MMIC's motion for summary judgment and granted PIC's cross-motion.

I.

The relevant facts are uncontroverted. The dispute in this case is over the parties' respective obligations to pay the $1.5 million settlement of an underlying medical malpractice lawsuit against Kennedy Health Alliance (KHA) and its employee, Dr. Adeshola Fakulujo (malpractice action). In the malpractice action, the plaintiffs alleged Dr. Fakulujo committed malpractice, and KHA was

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jointly and severally vicariously liable for his malpractice. MMIC and PIC agreed to settle the malpractice action by each paying $750,000 toward the settlement, subject to their rights to litigate their respective obligations to pay the settlement and defense costs incurred in connection with the malpractice action.

KHA obtained a professional liability insurance policy from PIC with applicable limits of liability of $1 million for each claim (PIC policy). The insuring agreement of the PIC policy provides, in relevant part, that PIC "will pay on behalf of [KHA] . . . 'damages' and 'defense expenses' for 'claims' for 'injury' to which this insurance applies caused by the rendering or failure to render 'professional services.'" There is no dispute that the PIC policy affords coverage for KHA's alleged liability in the malpractice action. There is also no dispute that Dr. Fakulujo is not an insured under the PIC policy, and the PIC policy does not afford coverage to him personally for his medical malpractice.

KHA, as the named insured, obtained a second professional liability insurance policy from MMIC (MMIC policy). The "insuring agreements" section of the professional liability coverage part of the MMIC policy contains three different and independent types of insurance: (1) entity liability (EL); (2)

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physician's and surgeon's professional liability (PL); and (3) designated employee liability (DE).

The MMIC policy provides that "[i]n consideration of the payment of premium, in reliance upon the statements in the [d]eclarations made a part hereof, and subject to all of the terms of this policy, we agree with the . . . named insured in the [d]eclarations to provide insurance as follows." The "[d]eclarations" page of the MMIC policy lists only the PL and DE coverages and sets forth limits of liability applicable only to those coverages. The declarations page does not list EL coverage or set forth limits of liability applicable to EL coverage. Specifically, the declarations page provides:

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"Section V[-]persons insured" of the MMIC policy provides that "[e]ach of the following is an insured under this policy":

(a) the named insured;

(b) under EL, the insured entity, and any officer, partner, member, or stockholder thereof with respect to the acts or omissions of others, provided no officer, partner, member, or stockholder of an insured entity shall be an insured under this subparagraph with respect to liability for his or her personal acts;

(c) under PL, any physician for whom such coverage is afforded under this policy as indicated in the [d]eclarations page;

(d) under DE, any employee . . . for whom such coverage is afforded under this policy as indicated in the [d]eclarations page while working within the scope of [their] duties at the direction of the named insured or insured entity.

The definitions section of the MMIC policy provides, "[n]amed insured means the person(s) or organization(s) designated as the named insured in the [d]eclarations of this policy." The term "[i]nsured means any person or organization qualifying as an insured under [s]ection V-[p]ersons insured provisions of this policy." "Insured entity means any corporation, partnership, association, limited liability company, or joint venture designated and scheduled as an insured on this policy."

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The PL insuring agreement provides, in relevant part, "[w]e will pay on behalf of an insured scheduled on this policy all sums that the insured shall become legally obligated to pay as damages because of . . . bodily injury . . . caused by a medical incident to which this insurance applies." The MMIC policy contains a "schedule of physicians" that provides "[c]overage for the individuals named below is limited to medical professional services performed for the named insured only." The endorsement lists Dr. Fakulujo and others as insureds under the PL insuring agreement.

The DE insuring agreement similarly provides, in relevant part, "[w]e will pay on behalf of an insured scheduled on this policy all sums that the insured shall become legally obligated to pay as damages because of . . . bodily injury . . . caused by a medical incident to which this insurance applies." The MMIC policy contains a "schedule of designated employees" that provides "[c]overage for the individuals named below is limited to medical professional services performed for the named insured only." The endorsement lists a registered nurse and two nutritionists as insureds under the DE insuring agreement.

The EL insuring agreement of the MMIC Policy provides, in relevant part, "[w]e will pay on behalf of an insured all sums that an insured shall become

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legally obligated to pay as damages because of . . . bodily injury . . . caused by a medical incident to which this insurance applies." The limits of liability section of the MMIC policy applicable to EL coverage provides, "[o]ur total liability for all damages because of all bodily injury . . . shall not exceed the limit of liability stated in the [d]eclarations as the aggregate as respects EL" and "[o]ur total liability for all damages because of all bodily injury . . . arising from any one medical incident shall not exceed the limit of liability stated in the [d]eclarations as applicable to each medical incident as respects EL."

The MMIC policy also contains an endorsement titled "NO ENTITY COVERAGE–CLAIMS MADE," which amends the claims made coverage provisions of all the insuring agreements as well as an exclusion unrelated to the issues raised on this appeal.

II.

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Princeton Insurance Company v. curi/medical Mutual Insurance Company of North Carolina, (N.J. Ct. App. 2026).

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