Ohio Security Insurance Company v. Premier Pain Specialists, LLC, 1:17-cv-05937

Ohio Security Insurance Company (OSIC) sued for a declaratory judgment that it owes no duty to defend or indemnify Premier Pain Specialists, LLC (PPS) or Dr. Omar Said in a negligence suit by Mary Ann Elam arising from a fall in a PPS recovery room after an epidural procedure.
PPS holds a business-owners liability policy from OSIC that covers "bodily injury," including "incidental medical malpractice injury," but excludes coverage for injuries "caused by the rendering or failure to render any professional service."
Elam's underlying complaint alleges two counts of medical negligence and one count of general negligence, with facts describing PPS staff not monitoring or restraining her, and possible unsafe recovery-room conditions; she claims multiple fractures from the fall.
OSIC moved for judgment on the pleadings seeking a ruling that the professional services exclusion bars coverage; PPS countered that some allegations concern ordinary premises/equipment negligence distinct from professional medical services.
The court applied Illinois "eight corners" analysis and construed ambiguities in favor of the insured but focused on whether the alleged failures involved specialized medical knowledge and professional judgment.

Issue	Plaintiff's Argument (OSIC)	Defendant's Argument (PPS)	Held
Whether OSIC has a duty to defend/indemnify PPS for Elam's negligence suit	No duty: Elam's claims fall within the professional services exclusion because they arise from failures to render medical services	Duty exists: underlying complaint alleges ordinary negligence (unsafe room, faulty equipment) covered by policy	Held for OSIC: no duty to defend or indemnify because claims arise from failure to render professional services
Whether Elam's allegations are "incidental medical malpractice" or ordinary "bodily injury"	They fit incidental medical malpractice and thus fall within exclusions for providers	Even if incidental malpractice applies, some claims are garden-variety bodily injury and should be covered	Court assumed coverage could exist but resolved dispute via exclusion: professional services exclusion applies to alleged conduct
Whether PPS is entitled to statutory attorney's fees under 215 ILCS 5/155	PPS sought fees claiming insurer acted unreasonably	OSIC argued exclusion made refusal reasonable	Denied: insurer's position was not vexatious or unreasonable given applicability of exclusion

Forrest v. Universal Sav. Bank, 507 F.3d 540 (7th Cir.) (procedural standard for Rule 12(c))
Amerisure Mut. Ins. Co. v. Microplastics, Inc., 622 F.3d 806 (7th Cir.) (ambiguities in insurance coverage construed against insurer)
Addison Ins. Co. v. Fay, 232 Ill.2d 446 (Ill.) (insured bears burden to show coverage; insurer must prove exclusions)
State St. Bank & Trust Co. v. INA Ins. Co., 207 Ill. App. 3d 961 (Ill. App.) (broad construction of "professional services" in insurance exclusions)
Nat. Fire Ins. Co. v. Kilfoy, 375 Ill. App. 3d 530 (Ill. App.) (claims involving assessment of medical qualifications fall within professional-services exclusion)
Md. Cas. Co. v. Fla. Atl. Orthopedics, P.L., 771 F. Supp. 2d 1328 (S.D. Fla.) (facility-design decisions tied to patient transport and care fall within professional-services exclusion)
Guaranty Nat. Ins. Co. v. North River Ins. Co., 909 F.2d 133 (5th Cir.) (distinguishing administrative/implementation acts from professional-judgment decisions)
D'Antoni v. Sara Mayo Hosp., 144 So.2d 643 (La.) (implementation of a medical decision can be "purely mechanical" and outside professional-services exclusion)