EMAIL TO A FRIEND COMMENT

 

Expired Claims-Made Insurer Dismissed from Third-Party Medical Malpractice Case


The son of a deceased patient filed a medical malpractice suit against the hospital where she died. The complaint alleged that the hospital failed to provide adequate medical care and treatment to his mother. The hospital filed a third-party complaint against the woman’s treating physician and his insurer. The third-party complaint alleged that the physician's negligent acts and/or omissions and alleged departures from medical standards caused the patient's death.

 

The physician had previously had two claims-made policies with the insurer. Both had expired prior to the filing of the hospital’s third-party complaint and neither policy had been renewed. Pursuant to the policies' language, these did not apply to any claim that occurred subsequent to the termination date of the policy or to any claim first made against the insured after the termination of the policy. Generally, an “occurrence policy” protects the policyholder from liability for any act done while the policy is in effect, whereas a “claims-made policy” protects the holder only against claims made during the life of the policy.

 

The insurer filed a motion requesting that all claims against it be dismissed inasmuch as, at the time it received the complaint, there was no insurance policy in force on behalf of the physician.

 

The United States District Court for the District of Puerto Rico granted the insurer’s motion to dismiss. The court held that the claims-made policies did not provide coverage to the physician for the third-party medical malpractice claims.

 

The claims-made policies did not provide coverage to the physician for the third-party medical malpractice claims. The claims-made policies that protected the insured physician only against claims made during the life of the policies did not provide coverage to the physician for the hospital's third-party medical malpractice claim, where the policies had expired and were not renewed before the claim was filed. In addition, the physician stated that he has an insurance policy that provides coverage for the malpractice claim in this case with the Puerto Rico Medical Defense Insurance Company, and he did not oppose the dismissal motion.

 

The United States District Court for the District of Puerto Rico granted the insurer’s motion to dismiss because the claims-made policies did not provide coverage to the physician for third-party medical malpractice claims.

 

See: Bauz-Gonzalez v. Presbyterian Community Hosp., Inc., 2014 WL 5493185 (D.Puerto Rico, October 30, 2014) (not designated for publication).

 

 

REPRINTS & PERMISSIONS COMMENT