Johnson v. CONNECTICUT INS. GUAR. ASS'N
302 Conn. 639
| Conn. | 2011Background
- Johnson sued Middlesex Obstetrics and Gynecology Associates and Sally Irons for medical malpractice; Hoffman, a paramedical employee, allegedly negligent.
- Exchange insured Middlesex; Exchange later became insolvent and the Connecticut Insurance Guaranty Association assumed Exchange's obligations under the guaranty act.
- The association sought declaratory judgment that Hoffman's acts were not covered due to a paramedical exclusion in the policy.
- Trial court held the exclusion did not apply, noting Hoffman was not named as a defendant but coverage would exist absent the exclusion.
- Association appealed, arguing the exclusion unambiguously applies to paramedical employees as a class based on the declarations page.
- Court affirmed the trial court, concluding the exclusion is ambiguous and must be construed in favor of coverage.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does the paramedical exclusion unambiguously apply to Hoffman? | Johnson contends the exclusion should apply only if Hoffman's acts are the sole basis of liability and the class is clearly defined by the declarations. | Association argues paramedical exclusion applies to the class with a premium shown for that class on declarations. | Exclusion not unambiguously applying; ambiguity favors coverage. |
| Is the phrase 'premium charge shown on the declarations page' clear or ambiguous regarding coverage for paramedicals? | Johnson asserts 'included' for paramedical coverage is ambiguous and does not prove a premium for paramedicals. | Association asserts that 'included' indicates a premium for paramedicals is shown on declarations. | Policy language is ambiguous; construed in favor of coverage. |
Key Cases Cited
- Connecticut Medical Ins. Co. v. Kulikowski, 286 Conn. 1 (2008) (discusses named insured requirement and declarations page relevance)
- Liberty Mut. Ins. Co. v. Lone Star Indus., Inc., 290 Conn. 767 (2009) (construction of insurance contract language in favor of insured when ambiguity exists)
- Holy Trinity Church of God in Christ v. Aetna Casualty & Surety Co., 214 Conn. 216 (1990) (lay interpretation principle for policy language)
- Allstate Ins. Co. v. Barron, 269 Conn. 394 (2004) (ambiguities in exclusion clauses resolved in favor of insured)
- Pacific Indem. Co. v. Aetna Cas. & Surety Co., 240 Conn. 26 (1997) (policy language interpreted from layperson's perspective)
- Connecticut Ins. Guar. Assn. v. Fontaine, 278 Conn. 779 (2006) (interpretation of ambiguous policy language in guaranty context)
- State v. Jones, 51 Conn. App. 126 (1998) (statutory interpretation principles used in ambiguous contexts)