Wake County Hospital System, Inc. v. National Casualty Co.

804 F. Supp. 768, 1992 U.S. Dist. LEXIS 19943, 1992 WL 314737
CourtDistrict Court, E.D. North Carolina
DecidedOctober 22, 1992
Docket91-728-CIV-5-BR
StatusPublished
Cited by16 cases

This text of 804 F. Supp. 768 (Wake County Hospital System, Inc. v. National Casualty Co.) is published on Counsel Stack Legal Research, covering District Court, E.D. North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wake County Hospital System, Inc. v. National Casualty Co., 804 F. Supp. 768, 1992 U.S. Dist. LEXIS 19943, 1992 WL 314737 (E.D.N.C. 1992).

Opinion

ORDER

BRITT, District Judge.

This matter is before the court on plaintiff’s motions for summary judgment and for protective order pursuant to Rules 56 and 26(c) of the Federal Rules of Civil Procedure respectively. The motions have been fully briefed, and oral argument was heard by the court on 15 October 1992. The court is now ready to rule.

FACTS

Plaintiff Wake County Hospital System, Inc. (“Wake”) commenced this action for declaratory judgment by filing its complaint on 31 October 1991 seeking to have this court declare that an insurance policy *770 issued by defendant is the primary and exclusive coverage for a previous settlement entered into by the parties concerning a medical malpractice claim. Specifically, this action arises out of a wrongful death medical malpractice claim involving the neonatal care rendered to Paul Lampe, Jr., a minor, by nurse Sharon Sarvey (“Sar-vey”), an employee of Wake. Two resident physicians from the University of North Carolina Hospitals of Chapel Hill (“UNC”) also administered care to Paul Lampe, Jr.; however, the claims against them are not the subject of, nor are relevant to, this lawsuit.

At the time of the events giving rise to the Lampe claim, Wake had professional liability insurance with St. Paul Fire and Marine Insurance Company (“St. Paul”), under which Sarvey as an employee of plaintiff was a protected person. The terms of the policy were such that Wake had a self-insured retention (in essence, a deductible) of $750,000 per person/per event and a $1,000,000 annual total. In addition, Sarvey had a separate professional liability insurance policy of her own with National Casualty Company (“National”), which had no deductible. Crucial to this lawsuit, the National policy had an “Other Insurance” clause which basically provided that the National policy was deemed to be excess over “other valid and collectible insurance.”

After the Lampe incident, the parents of the baby brought a claim and an intent to file suit against Sarvey, the two UNC residents, and Wake. When notified of the claim, Wake, St. Paul, UNC, and National all agreed by way of a written, signed document that the Lampe claim should be settled. The claim was in fact settled before a suit was initiated for an amount less than Wake’s deductible, or retention, of $750,000 under its policy with St. Paul. According to the written agreement dated 3 July 1991, UNC was to pay 25% of the settlement amount, and in fact paid that amount and it is not at issue in this suit. The 75% remainder was funded between Wake and National with the understanding that the coverage dispute would be litigated after the settlement. It was also agreed that the amount, if any, contributed by each party to fund the settlement would remain confidential. The parties failed to agree, however, as to which entity, Wake or National, was responsible for payment of the 75% portion of the settlement. From these events, Wake filed the instant suit and now makes this motion for summary judgment.

DISCUSSION

I. Wake’s Motion for Summary Judgment

Rule 56 of the Federal Rules of Civil Procedure provides that summary judgment is appropriate “if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(c). In this case, the sole issue before the court is whether Wake’s self-insured retention constitutes “other valid and collectible insurance” within the meaning of the National policy issued to Sarvey. Since the term “other valid and collectible insurance” is not defined in either the Wake or National policies, the determination as to the meaning of that term is one for the court to make as a matter of law. Reliance Insurance Co. v. Lexington Insurance Co., 87 N.C.App. 428, 361 S.E.2d 403, 406 (1987).

In support of its motion, Wake asserts that its self-insured retention of $750,000 under the St. Paul policy does not constitute “other valid and collectible insurance” as that term is used in National’s policy protecting Sarvey. The gist of Wake’s argument is that National’s policy provides the sole coverage for the claims arising out of the Lampe incident because the “other insurance” clause in National’s policy should be interpreted to mean that it is applicable only as excess over another insurance policy, not a self-insured retention. Specifically, Wake contends that self-insurance is not insurance at all because: 1) there is no payment of a premium or other consideration to Wake; 2) there is no shifting of a risk of loss; 3) Wake is not in the *771 business of insurance; and, 4) Wake is not subject to the requirements of ordinary insurers under North Carolina General Statutes, namely Chapter 58. Thus, a self-insured retention, as the argument goes, does not fall within the plain and ordinary meaning of the term “insurance” — an insurance policy issued by a licensed insurer in exchange for a premium charged.

National first argues that there is an additional issue before the court on this motion for summary judgment as to whether National’s maximum potential exposure is one-half of or all of the amount paid to settle the Lampe claim against Wake and Sarvey. In other words, National contends that the relative liabilities of Wake and Sarvey arising out of the Lampe claim need to be determined and litigated so that a proper payment obligation may be apportioned to each. Because the relative liabilities of Wake and Sarvey regarding the Lampe claim are in dispute here, as National alleges, summary judgment is not warranted.

National next argues, as to the self-insured retention/“other insurance” issue, that Wake had a contractual obligation to defend and indemnify Sarvey, as a third-party beneficiary under the Wake/St. Paul insurance policy, for claims up to $750,000, and thus this contractual obligation constitutes “other insurance” as the term is used in National’s policy. Essentially, National suggests that since it is undisputed that St. Paul had an obligation to provide coverage for Sarvey for any claim in excess of $750,-000, it should likewise be determined that Wake had a similar obligation, under the St. Paul policy, to Sarvey, as an employee of Wake, for any claim less than $750,000 which arose out of the performance of her employment duties.

Further, National asserts that Wake should not be allowed to shift to National a risk that Wake accepted and for which it received a benefit. To explain, National maintains that it would be inequitable to allow a company to shift the risk of loss to another once it has accepted a benefit — i.e., the advantage of a lower premium for a higher deductible — in return for a promise to provide coverage.

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Bluebook (online)
804 F. Supp. 768, 1992 U.S. Dist. LEXIS 19943, 1992 WL 314737, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wake-county-hospital-system-inc-v-national-casualty-co-nced-1992.