St. Paul Fire & Marine Insurance v. Mitchell

296 S.E.2d 126, 164 Ga. App. 215
Court of Appeals of Georgia·Decided October 13, 1982·No. 64403, 64404·Published·Cited by 61 cases

Opinions

Sognier, Judge.

St. Paul Fire and Marine Insurance Company (St. Paul), Dr. Ronald Kleber’s malpractice insurance carrier, filed the instant declaratory judgment action after Mary Sue Mitchell and her husband filed suits against Dr. Kleber, for medical malpractice. After [216] answers were filed, St. Paul moved for partial summary judgment on the ground that the Mitchells’ suit was a tort action not covered under Dr. Kleber’s malpractice policy.* The Mitchells and Dr. Kleber moved for summary judgment on all issues. The trial court granted partial summary judgment to the Mitchells and Dr. Kleber requiring St. Paul to defend the malpractice suit against Dr. Kleber. The court denied all motions on the coverage question. St. Paul appeals and the Mitchells cross appeal.

1. Appellant St. Paul contends that the trial court erred in granting summary judgment to appellees because the insurance company had no duty to defend Dr. Kleber under the insurance policy. The trial court’s ruling was based on a clause in the insurance policy which provided, in pertinent part: “COVERAGE A-PROFESSIONAL LIABILITY ... the Company shall have the right and duty to defend in his name and behalf any suit against the Insured alleging damages, even if such suit is groundless, false or fraudulent . . .”

The trial court followed the rule enunciated in Loftin v. U. S. Fire Ins. Co., 106 Ga. App. 287 (127 SE2d 53) (1962), quoted and cited with approval in Great American Ins. Co. v. McKemie, 244 Ga. 84,85 (259 SE2d 39) (1979), as follows: “ ‘The true rule is that the duty to defend is determined by the contract; and since the contract obligates the insurer to defend claims asserting liability under the policy; even if groundless, the allegations of the complaint are looked to to determine whether a liability covered by the policy is asserted. ’ ” Thus, the issue in the instant case is not whether Dr. Kleber is actually liable to the Mitchells or whether he actually committed the acts alleged to be malpractice; the issue is whether a claim has been asserted which falls within the policy coverage and which St. Paul has a duty to defend.

The Mitchells’ complaints alleged, inter alia: “. . . Defendant so aroused Mrs. Mitchell’s emotions by manipulation of the transference phenomemon that she fell in love with him. Defendant brought about this result by wrongfully manipulating the doctor-patient relationship to the point where Plaintiff’s feelings were no longer transferred feelings of love for Defendant as a psychiatrist but direct feelings of love for him as a person, beyond the phenomenon of transference . . . Defendant was negligent in his treatment and counseling of Plaintiff in that he failed to exercise the degree of care and skill, or to possess the degree of knowledge [217] ordinarily exercised and possessed by other psychiatrists with regard to the existing state of knowledge in psychiatry. Defendant was. negligent in that he mishandled the transference phenomenon.” The complaints further alleged that this mishandling of the transference phenomenon resulted in the doctor having sexual relations with his patient, Mrs. Mitchell.

We recognize that if a claim is asserted which does not fall within the contract coverage then the insurer is relieved of his contractual duty to defend. Great American Ins. Co., supra. However, in our opinion, the allegations set forth above assert a claim which falls within the policy coverage.

The policy in question provides that the insurer will “pay on behalf of the Insured all sums which the Insured shall become legally obligated to pay as damages arising out of the performance of professional services rendered or which should have been rendered, during the policy period, by the Insured or by any person for whose acts or omissions the Insured is legally responsible . . .” St. Paul argues that Dr. Kleber’s alleged acts are outside the category of professional services for purposes of coverage.

Courts in other states have held that conduct such as that alleged to have been committed by Dr. Kleber may be considered malpractice by a psychiatrist. In Cotton v. Kambly, 101 Mich. App. 537, 541 (300 NW2d 627) (1980), the court stated: “Plaintiff alleges that defendant induced her to engage in sexual relations with him as part of her prescribed therapy. We see no reason for distinguishing between this type of malpractice and others, such as improper administration of a drug or a defective operation. In each situation, the essence of the claim is the doctor’s departure from proper standards of medical practice. Therefore, while the facts alleged by plaintiff might also state a cause of action for common law seduction, we do not find that seduction was the gist of her malpractice claim.” See also Anclote Manor Foundation v. Wilkinson, (Fla.) 263 S2d 256 (1972), and Zipkin v. Freeman, (Mo.,) 436 SW 2d 753, 761 (1968). In Zipkin the court said: “However, it is an oversimplification to focus on the more spectacular and extreme acts of the doctor as determinative of the issue. Under the extremely broad terms of the policy before us, defendant agreed to pay damages ‘based on’ — which would also mean resulting from, or caused by, or due to — professional services rendered or which should have been rendered. The word ‘damages’ is not limited to any particular kind of damage or injury and applies to any claim or suit, with certain specific exceptions not here material. Defendant would limit the damages to the very act itself of professional services, but the policy clearly covers the results and liability flowing from professional services rendered [218] or which should have been rendered.

“The gravamen of the petition is that defendant did not treat Mrs. Zipkin properly and as a result she was injured. He [allegedly] mishandled the transference phenomenon, which is a reaction the psychiatrists anticipate and which must be handled properly. He [allegedly] mishandled it over a long period of time. As [experts] explained, to take the relationship outside the office into social relationships, ‘would allow the patient to develop all sorts of unusual ideas just around the feelings that she has about the doctor’...” Thus, we find ample authority for holding that acts such as those alleged in the Mitchells’ complaints come within St. Paul’s contractual obligation to defend for matters arising out of Dr. Kleber’s performance of his professional duties.

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St. Paul Fire & Marine Insurance v. Mitchell, 296 S.E.2d 126, 164 Ga. App. 215 (Ga. Ct. App. 1982).

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