Maryland Casualty Company v. FLORIDA ATLANTIC ORTHOPEDICS, PL
771 F. Supp. 2d 1328
S.D. Fla.2011Background
- Maryland Casualty issued a commercial/general liability policy to Florida Atlantic Orthopedics for May 1, 2008 to cancellation; policy covers bodily injury to third parties and includes a defense duty but only for covered claims.
- Policy contains two exclusions: professional services exclusion and health care services exclusion, excluding bodily injuries arising from medical/professional services.
- Ms. Dixon was injured March 13, 2008, consulted May 29, underwent June 28, 2008 surgery at Florida Atlantic, and died July 9, 2008 after complications; elevator/transport issues were involved in post-surgical transfer.
- Mahbears sued in Broward County for premises liability (Count X), failure to have emergency procedures (Count XI), and negligent retention/hiring (Count XII); all conditions precedent were satisfied.
- Issue is whether the health/professional exclusions bar Maryland Casualty’s duty to defend the Mahbears’ claims; Florida law governs duty to defend, and the court must construe policy terms.
- Court’s determination hinges on whether the underlying injury arose from covered medical services or from excluded professional health care activities; if excluded, no defense duty arises.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Do policy exclusions bar the duty to defend Counts XI and XII? | Maryland Casualty argues all three counts stem from medical care. | Florida Atlantic/Mahbears contend defense duty remains for premises liability independent of medical care. | Yes; the exclusions apply, so no defense duty for XI and XII. |
| Does the premises liability claim (Count X) fall within the exclusions due to origin in medical malpractice? | X claims arise from dangerous conditions related to medical procedures. | Premises liability independent of medical treatment should be defendable. | Yes; the injury’s factual origin was medical malpractice, so no duty to defend Count X. |
Key Cases Cited
- Colony Ins. Co. v. Suncoast Medical Clinic, LLC, 726 F. Supp. 2d 1369 (M.D. Fla. 2010) (Florida law; insurer only defends where policy covers and excludes otherwise)
- Alpha Therapeutic Corp. v. St. Paul Fire & Marine Ins. Co., 890 F.2d 368 (11th Cir. 1989) (ambiguity and coverage intent in policy exclusions)
- WPC Indus. Contractors, Ltd. v. Amerisure Mut. Ins. Co., 720 F. Supp. 2d 1377 (S.D. Fla. 2009) (duty to defend determined by underlying complaint and policy terms)
- Lime Tree Vill. Cmty. Club Ass’n v. State Farm Gen. Ins. Co., 980 F.2d 1402 (11th Cir. 1993) (duty to defend based on allegations; resolve doubt in insured’s favor)
- Miranda Constr. Dev., Inc. v. Mid-Continent Cas. Co., 2010 WL 5677913 (S.D. Fla. 2010) (duty to defend assessed from underlying complaint)
- Northland Cas. Co. v. HBE Corp., 160 F. Supp. 2d 1348 (M.D. Fla. 2001) (policy interpretation as matter of law in declaratory actions)
- National Union Fire Ins. Co. v. Brown, 787 F. Supp. 1424 (S.D. Fla. 1991) (policy terms interpreted to determine coverage)