Lead Opinion
delivered the opinion of the Court, in which
On motion for rehearing we withdraw our opinion of June 26, 2003, and substitute the following.
In this case, we must interpret the scope of a professional services exclusion in a general liability insurance policy. The insurer argues that the court of appeals erred in affirming the trial court’s judgment that it had a duty to defend and to indemnify its insured, a doctors’ association, against a claim filed by patients who were injured by the administration of contaminated anesthetics. The insurer relies on a provision in its policy excluding coverage for any “[bjodily injury ... due to rendering or failure to render any professional service.” This exclusion, the insurer asserts, precludes coverage any time a patient’s medical treatment is a but-for cause
We do not share such a narrow view of the language. We conclude that the policy excludes coverage only when the insured has breached the standard of care in rendering those professional services. In this case, the allegations in the pleadings raised both the possibility that the treating doctors were negligent in their administration of the drug and the possibility that the doctors’ association was negligent in the storage of that drug. Because the plaintiffs alleged both professional and nonprofessional negligence, the general liability insurer had a duty to defend the underlying suit in this case under the eight-corners doctrine. But because a fact issue exists about whether the patients’ injuries were caused at least in part by the doctors’ rendition of professional services, in which event the insurer’s policy would not cover the doctors’ association, we remand the indemnity claims to the trial court for further proceedings.
I
In late 1991 and early 1992, Mid-Cities Surgi-Center (the surgical center) employed a scrub technician, David Wayne Thomas, who stole fentanyl, an anesthetic, from the surgical center. Apparently using the same syringe, Thomas removed fentanyl from the glass ampoules in which it was stored, injected himself with the drug, then injected saline solution back into the ampoules to hide his theft. Thomas then re-sealed the ampoules with super glue and re-wrapped them with cellophane to further hide his crime. Because Thomas was infected with Hepatitis C, his use of a dirty syringe allegedly contaminated the ampoules.
After Thomas’s crime was discovered, he pleaded guilty to stealing the drugs and went to prison. A number of patients who received fentanyl injections before Thomas’s crime was discovered subsequently tested positive for Hepatitis C. This lawsuit deals with the claims of four patients against Mid-Cities Anesthesiology, P.A., a professional association of ten doctors who practiced anesthesia at the surgical center, and the association’s member anesthesiologists (hereinafter collectively called the doctors’ association).
TPCIGA first tendered the suit for a defense and coverage to American Indemnity Co., the association’s general liability insurer at the time of litigation. American Indemnity originally denied coverage, ar
American Indemnity then filed this suit against Utica and TPCIGA, seeking reimbursement from Utica for the settlement costs and a judgment declaring the respective rights and obligations of all three insurance companies for defense of the underlying suit. TPCIGA filed a cross-claim against Utica for its defense and settlement costs and a counter-claim against American Indemnity for defense costs. American Indemnity and TPCIGA settled their claims against each other, and both companies proceeded against Utica.
All three parties moved for summary judgment. The trial court denied Utica’s motion and granted TPCIGA’s and American Indemnity’s motions, holding that Uti-ca breached its obligation to defend and was therefore hable for defense costs. The trial court also held that Utica’s professional services exclusion did not preclude coverage of the claims, and further granted summary judgment to American Indemnity and TPCIGA for the full cost of their settlement, together with attorneys’ fees and pre- and post-judgment interest. The court of appeals affirmed the judgment.
II
A liability insurer is obligated to defend a suit if the facts alleged in the pleadings would give rise to any claim within the coverage of the policy. Nat’l Union Fire Ins. Co. v. Merchs. Fast Motor Lines, Inc.,
In this appeal, Utica does not dispute that its general liability policy could cover a claim for the negligent failure to store or
In determining the scope of coverage, we examine the policy as a whole to ascertain the true intent of the parties. Mid-Century Ins. Co. v. Lindsey,
Furthermore, this is an exclusionary clause. “The court must adopt the construction of an exclusionary clause urged by the insured as long as that construction is not unreasonable, even if the construction urged by the insurer appears to be more reasonable or a more accurate reflection of the parties’ intent.” Nat’l Union Fire Ins. Co. v. Hudson Energy Co.,
The policy language supports the conclusion that the exclusion can be reasonably read to preclude coverage only when the plaintiffs injury is caused by the breach of a professional standard of care. The policy excludes injury “due to” the rendition of professional services. TPCI-GA and American Indemnity’s argument that bodily injury “due to” professional
This Court has held that “arise out of’ means that there is simply a “causal connection or relation,” Mid-Century Insurance Co.,
We thus conclude that TPCIGA and American Indemnity have more than met their burden to show that their interpretation of the exclusionary provision was reasonable. We agree with the court of appeals’ holding that the trial court properly held Utica liable for its share of the defense costs.
Ill
Merely because Utica had a duty to defend the underlying suit, however, does not mean that it was obligated to indemnify its insured for the settlement. The duty to defend and the duty to indemnify “are distinct and separate duties.” King v. Dallas Fire Ins. Co.,
At trial, both parties argued that the indemnity question could be decided as a matter of law. But we believe that the
It may sometimes be necessary to defer resolution of indemnity issues until the liability litigation is resolved. In some cases, coverage may turn on facts actually proven in the underlying lawsuit. For example, the plaintiff may allege both negligent conduct and intentional conduct; a judgment based upon the former type of conduct often triggers the duty to indemnify, while a judgment based on the latter usually establishes the lack of a duty.
Farmers Tex. County Mut. Ins. Co. v. Griffin,
The injured patients alleged both professional and general liability. TPCIGA argues that the plaintiffs alleged covered and excluded causes which separately caused their injuries, regardless of whether the doctors breached a professional standard of care. Texas courts and the Fifth Circuit applying Texas law have recognized a distinction between cases involving “separate and independent” causation and “concurrent” causation when both covered and covered and excluded events cause a plaintiffs injuries. In cases involving separate and independent causation, the covered event and the excluded event each independently cause the plaintiffs injury, and the insurer must provide coverage despite the exclusion. See Guaranty
Nat’l Ins. Co. v. North River Ins. Co.,
We recognize the distinction that TPCI-GA urges. However, without a finding that the doctors did or did not breach a professional standard of care, we cannot determine whether this case involves concurrent causes. A determination by the finder of fact that the infection was caused by the breach of a professional standard of care — for example, a finding that the infec
IV
We conclude that Utica’s general liability policy excluded coverage for any injury caused by the breach of a professional standard of care. Because the plaintiffs’ pleadings in the underlying dispute alleged a cause of action that could establish liability for the doctors’ association even in the absence of such a breach, we affirm that part of the court of appeals’ judgment holding that Utica had a duty to defend the case. Because we disagree with the court of appeals that this record established Utica’s indemnity obligation as a matter of law, we reverse that part of the court of appeals’ judgment and remand this case to the trial court to determine Utica’s indemnity obligation.
Notes
. In addition to the doctors' association, forty-four infected patients also sued the surgical center, the corporate owners of the surgical center, the medical director of the surgical center's corporate owner, the surgical center's head pharmacist, the corporation that managed the surgical center’s pharmacy, and David Wayne Thomas. The case in this Court deals with a settlement made between four of the original forty-four plaintiffs and the doctor's association and. its members. The record in this case does not tell us exactly what became of the other forty patient’s claims, though it does show that TPCIGA paid some additional settlement money to other patients. The record also does not reflect whether the four patients who settled with the doctor’s association either settled with, or proceeded against, the other defendants.
. As the dissent notes, securing pharmaceuticals may implicate a professional duty. In fact, Utica complained to the court of appeals that failure to secure medications also fell within the scope of the professional services exclusion. However, Utica does not present that argument in this Court. Rather, Utica concedes for purposes of this appeal that such a claim would not be per se excluded by the professional services exclusion. We therefore express no opinion whether the failure to secure medication would implicate a general or a professional standard of care, but instead we accept the parties' contention that such failure would implicate a general duty.
Dissenting Opinion
dissenting.
Four patients alleged that they contracted Hepatitis C from injections of fentanyl, an anesthetic, that was contaminated by a surgical technician, David Wayne Thomas, while stealing the drug for his own use. The patients asserted that their respective treating physicians, and the other anesthesiologists with whom they associated in Mid-Cities Anesthesiology, P.A.-ten of them altogether-were negligent in not securing the drug and supervising Thomas so as to prevent the contamination. The association and its members carried commercial general liability (CGL) insurance and professional liability insurance. The patients have settled, and the only remaining dispute is between the insurers over which of them was obligated to defend and indemnify the claims. One of the CGL carriers, Utica National Insurance Co., contends that the claims were not covered by its policy. The other CGL carrier, American Indemnity Co., and the receiver for the professional liability carrier, Texas Property and Casualty Insurance Guaranty Association, disagree.
In my view, if the association and its member physicians were negligent in failing to prevent the contamination of a drug they used in medical treatment, it was because they breached a professional standard of care, whether the injured patients were theirs or their associates’, and not because they breached some ordinary duty of care that they may have owed irrespective of their medical training and practice.
Thus, I Would hold that the patients’ claims were for professional liability, against which Utica had no obligation under its CGL policy to defend or indemnify. The Court does not foreclose this result but remands for fact findings. If I am correct-if the association and its members could not have been negligent without violating a professional standard of care-the outcome will eventually be the same. I remain troubled by the way the Court goes about reading insurance policies, which we constantly reiterate must be interpreted and construed like other contracts,
The standard form Texas Business owners Policy of commercial general liability insurance that is available to businesses of all types and that Utica National Insurance Co. issued to Mid-Cities Anesthesiology, P.A. and its ten member anesthesiologists excluded from coverage “ ‘[bjodily injury’ ... due to rendering or failure to render any professional service”. According to the Court, what the exclusion really means is that the policy does not cover “[bjodily injury ... due to rendering or failure to render any professional service in breach of the professional standard of care”. This is by no means a simple clarification; the Court’s added phrase changes the meaning significantly. As written, the exclusion applies to any professional service; as rewritten by the Court, it applies only to any negligent professional service. Why? Because, the Court explains, “due
(1) due to rendering or failing to render any professional service; or
(2) arising out of rendering or failing to render any professional service; or
(3) due to rendering or failing to render any professional service in breach of the standard of professional care.
The Court concludes that because (1) does not mean (2), (1) must mean (3). It is not clear why, assuming (1) does not mean (2), (1) should not mean (1).
Nor is it clear why either of the two generalities support its construction of the policy language. The Court says it “ ‘must adopt the construction of an exclusionary clause urged by the insured as long as that construction is not unreasonable’ ”.
Where an ambiguity involves an exclusionary provision of an insurance policy, we “must adopt the construction ... urged by the insured as long as that construction is not unreasonable, even if the construction urged by the insurer appears to be more reasonable or a more accurate reflection of the parties’ intent.”6
If an exclusionary clause is clear, we cannot ignore its plain meaning just because someone can imagine some other construction that is not unreasonable. No one argues in this case that the exclusionary clause is ambiguous. Importantly, it is not the resulting coverage that must not be unreasonable, otherwise policy language would not mean much. Earlier this Term, in American Manufacturers Mutual Insurance Co. v. Schaefer, the insureds argued that an insurer’s obligation under a standard automobile policy to “repair” a damaged vehicle should include compensation for loss in value.
The Court adds: “Reasonable expectations are often affected by the conditions surrounding the formation of the policy language, and by the type of clause at issue.”
In Schaefer, a unanimous Court wrote: “we may neither rewrite the parties’ contract nor add to its language.”
I respectfully dissent.
Justice Enoch, who participated in the original decision in this case, resigned his office on October 1, 2003, and did not participate in the motion for rehearing.
. Cf. Harris Methodist Health Sys. v. Employers Reinsurance Corp., No. 3:96-CV-0054-R,
. Ante at 200.
. Ante at 202 n. 2.
. Ante at 202 (citing National Union Fire Ins. Co. v. CBI Indus., Inc.,
. Ante at 202 (citing National Union Fire Ins. Co.,
. Balandrán,
.
. Ante at 202.
. Murphy,
.Schaefer,
