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FL: ambiguities in professional liability policy: ambiguities construed against insurance cos.

CASE FACTS: Sara Campbell was a patient at the podiatric practice of Drs. Beth Pearce and Brett Cutler. On March 27, 2002, Campbell complained of heel pain and Dr. Pearce ordered an x-ray of her foot. While a certified x-ray technician was positioning Campbell's foot to take the x-ray, Campbell lost her balance and fell backward. Campbell filed suit against Drs. Pearce and Cutler. Each of the doctors notified their professional liability insurance carriers. State Farm Liability Insurance Company (State Farm) sought a declaratory judgment that it was not required to cover or defend against Campbell's claim. The trial court entered summary judgment in favor of Campbell The defendants appealed..

COURT'S OPINION: The District Court of Appeals of Florida reversed the trial court and entered summary judgment for State Farm. The court held, inter alia, that when interpreting an insurance contract, it" must be read in light of the skill and experience of ordinary people, and given everyday meaning." If an insurance policy is ambiguous, any ambiguities are to be interpreted in favor of the insured and strictly against the insurer. An insurance policy is ambiguous when the language is susceptible of two reasonable interpretation: one providing coverage, the other limiting coverage. However, a provision that is clear and unambiguous "should be enforced according to its terms whether it is a basic policy provision or an exclusionary provision." The court observed that the provision in question in the case at bar is commonly known as a "professional services exclusion" and stated; Business Liability Exclusions. Under Coverage L, this insurance does not apply: 10. To bodily injury, property damage or personal injury due to rendering or failure to render any professional services or treatments. This includes but is not limited to: d. Medical expense, surgery, dental, x-ray, anesthetics or nursing services or treatments, but this exclusion only applies to an insured who is engaged in the business or occupation of providing any of those services or treatments.. The trial court interpreted "duty to" means "caused by" The appellate court concluded that the trial court erred in granting summary judgment to State Farm. The inclusion of the word "services" within the contract clearly encompassed more than just taking an x-ray. The court noted that the other side admitted as' much when they conceded that Campbell's claim would be excluded from coverage if her claim involved injuries stemming from a misdiagnosis because her foot was not positioned properly. State Farm Florida Insurance Company v. Campbell, 2008-FL-110.045 (11/7/2008)--FL

Meet the Editor & Publisher: A. David Tammelleo, JD, is a nationally recognized authority on health care law. Practicing law for over 40 years, he concentrates in health care law with the Rhode Island firm of A. David Tammelleo & Associates. He has presented seminars on medical, nursing and hospital law throughout the United States. In addition to his writings as Editor of Medical Law's, Nursing Law's & Hospital Law's Regan Reports, his legal articles have been published in the most prestigious health law journals. A prolific writer, his thousands of articles, as well as his achievements as an attorney and lecturer, have won him recognition in Martindale-Hubbell's Bar Register of Preeminent Lawyers, Marquis Who's Who in American Law, Who's Who in America and Who's Who in the World.
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Title Annotation:Medical Law Cases of Note
Author:Tammelleo, A. David
Publication:Medical Law's Regan Report
Date:Nov 1, 2008
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