Westchester General Hospital, Inc. v. Evanston Insurance Company, 48 F.4th 1298

On December 31, 2018, Jane Doe—a patient at Westchester General Hospital’s mental‑health facility—was allegedly sexually assaulted by Westchester employee Fernando Ramos‑Garcia. Doe and a John Doe sued Westchester for negligence in hiring, training, supervising, and enforcing policies.
Westchester held a Specified Medical Professions Insurance Policy from Evanston with two relevant parts: a Professional Liability (PL) Coverage Part and a General Liability (GL) Coverage Part (plus an Umbrella policy that follows the GL).
Evanston issued a reservation of rights: it offered a PL defense but refused to defend under the GL Coverage Part, citing two GL exclusions—the Professional Services Exclusion and the Bodily Injury Exclusion.
Westchester sued for a declaratory judgment that Evanston must defend under the GL; the district court granted partial summary judgment for Westchester; the Eleventh Circuit affirmed.
The appeal turned on whether either GL exclusion (Professional Services or Bodily Injury) barred coverage for the Does’ claims; the court held neither exclusion applied and therefore Evanston owes a defense under the GL (and the Umbrella applies).

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the Professional Services Exclusion bars coverage	Westchester: the assault and negligence in hiring/supervision are not acts "in the performance of services of a professional nature."	Evanston: the exclusion is broad and applies to any claim "in any way involving" services of a professional nature; term need not match defined "Professional Services."	Held: Exclusion does not apply—sexual assault lacks causal connection to professional medical services; alleged negligent hiring/supervision are administrative, not professional‑services acts.
Whether the Bodily Injury Exclusion bars coverage	Westchester: exclusion is ambiguous and reads to cover injuries occurring contemporaneously while a patient is receiving professional services; Doe was not receiving treatment when assaulted.	Evanston: clause modifies which patients are excluded (those "receiving services of a professional nature"), so injuries to such patients are excluded regardless of timing.	Held: Exclusion ambiguous and construed for insured; present‑participle grammar implies contemporaneous receipt of services—exclusion does not apply to this assault.
Whether the Umbrella policy applies	Westchester: Umbrella follows GL, so it applies if GL duty to defend exists.	Evanston: disputes GL coverage, so contends Umbrella shouldn't apply.	Held: Because GL duty to defend exists, the Umbrella also applies.

Lindheimer v. St. Paul Fire & Marine Ins. Co., 643 So. 2d 636 (Fla. 3d DCA 1994) (an act occurring in a professional’s office does not automatically qualify as a "professional service"; a causal connection is required).
Taurus Holdings, Inc. v. U.S. Fid. & Guar. Co., 913 So. 2d 528 (Fla. 2005) (insurance contracts construed according to plain meaning; ambiguities against insurer).
Jones v. Fla. Ins. Guar. Ass’n, 908 So. 2d 435 (Fla. 2005) (duty to defend arises when the complaint alleges facts that fairly or potentially bring the suit within coverage).
Auto‑Owners Ins. Co. v. Anderson, 756 So. 2d 29 (Fla. 2000) (court must give each policy provision its full meaning and operative effect).
HR Acquisition I Corp. v. Twin City Fire Ins. Co., 547 F.3d 1309 (11th Cir. 2008) (phrases like "in any way related" are very broad).
Hudson v. Prudential Prop. & Cas. Ins. Co., 450 So. 2d 565 (Fla. 2d DCA 1984) (coverage construed broadly and exclusions narrowly; ambiguity resolved for insured).