Connecticut Ins. Guaranty Assn. v. Fontaine
| Citation | 278 Conn. 779 |
| Decision Date | 04 July 2006 |
| Court | United States State Supreme Court of Ohio |
Page 779
v.
CAROL FONTAINE ET AL.(SC 17457).
Sullivan, C. J., and Borden, Norcott, Katz, Palmer, Vertefeuille and Zarella, Js.*
The named defendant, C, had asserted a claim for loss of consortium in a medical malpractice action that was brought in 1999 by her husband
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against the defendant physician, J. At that time, J was insured under a professional liability insurance policy issued by P Co., which obligated P Co. to pay on behalf of J all sums that he was obligated to pay as "damages because of bodily injury . . . caused by a medical incident." In 2002, P Co. became insolvent and pursuant to the Connecticut Insurance Guaranty Act (§ 38a-836 et seq.), the plaintiff insurance guaranty association became liable for covered claims arising out of P Co.'s liability policies. The plaintiff sought a declaratory judgment to determine the extent of its obligation to provide coverage for C's claim, alleging that loss of consortium was not a "bodily injury" sustained by C's husband, as that term was defined in the insurance policy. C alleged that, because her loss of consortium arose from her husband's bodily injury, the claim was covered under the policy's plain language. Both the plaintiff and the defendants filed cross motions for summary judgment. Thereafter, the trial court determined that the loss of consortium claim was covered under the insurance policy's plain and unambiguous language. That court granted the defendants' motion for summary judgment and rendered judgment in their favor, from which the plaintiff appealed. Held that the trial court properly concluded that C's loss of consortium claim was covered under the terms of the liability policy issue to J by P Co., the policy language, which covered claims that arise "because of bodily injury," having been ambiguous, it was properly construed against the plaintiff in place of P Co., the insolvent insurer, which had drafted the policy, and C would not have had a claim for damages for loss of consortium but for the bodily injury sustained by her husband.
Action for a declaratory judgment to determine the extent of the plaintiff's statutory obligation to provide coverage for a claim of loss of consortium by the named defendant pursuant to a professional liability policy issued to the defendant Michael Jimenez by an insolvent insurance company, brought to the Superior Court in the judicial district of Stamford-Norwalk, where the court, Tyma, J., denied the plaintiff's motion for summary judgment and granted the defendants' cross
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motions for summary judgment; thereafter, the court granted the plaintiff's motion to reargue and vacated its decision on the motions; following reargument, the court again denied the plaintiff's motion and granted the defendants' cross motions for summary judgment, and rendered judgment thereon in their favor, from which the plaintiff appealed. Affirmed.
Gregg A. Rubenstein, pro hac vice, with whom were Charles W. Pieterse and, on the brief, Gerard N. Saggese III and Joseph C. Tanski, pro hac vice, for the appellant (plaintiff).
Antonio Ponvert III, for the appellee (named defendant).
NORCOTT, J.
In this appeal, we consider whether the trial court properly concluded that a loss of consortium claim is covered under the terms of a professional liability insurance policy covering claims that arise "because of bodily injury." The plaintiff, the Connecticut Insurance Guaranty Association (association), brought this declaratory judgment action to determine its obligation to pay a loss of consortium claim brought in connection with a medical malpractice action that had been commenced by the named defendant, Carol Fontaine, and her husband, Thomas Fontaine. The association appeals1 from the judgment of the trial court granting the named defendant's cross motion for summary judgment on the basis of the insurance policy's plain and unambiguous language. We affirm the judgment of the trial court, but on the alternate ground that the language at issue is ambiguous and, therefore, properly construed against the association in place of the insolvent insurer that drafted the policy.
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The record reveals the following undisputed facts and procedural history. In 1999, the named defendant and her husband brought an action against the defendant physician, Michael Jimenez,2 alleging that his medical malpractice had caused Thomas Fontaine bodily injury, and the defendant a resulting loss of consortium. At the time of the alleged malpractice, Jimenez was insured by the PHICO Insurance Company (PHICO) under a policy that covered "[p]hysician and [s]urgeon [p]rofessional [l]iability" and "[i]nstitutional [p]rofessional [l]iability." The relevant portion of the policy stated that PHICO "agree[d] with the named insured to pay on behalf of the insured all sums which the insured shall be legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies caused by a medical incident . . . ." The policy further defined " `[b]odily [i]njury' " as " `injury to the human body, illness or disease sustained by [a] person, including death at any time resulting therefrom.' " Thereafter, PHICO was declared insolvent by a Pennsylvania court of competent jurisdiction, and the association became responsible for the payment of all "covered claims" pursuant to the Connecticut Insurance Guaranty Act (guaranty act), General Statutes § 38a-836 et seq.
The association then brought this declaratory judgment action seeking determinations, inter alia, that it has: (1) "no obligation to pay [the defendant's] claim for loss of consortium"; and (2) "no obligation to defend or indemnify . . . Jimenez with respect to [the defendant's] loss of consortium claim." The plaintiff moved, and the defendant cross moved, for summary judgment, with each party claiming that the relevant policy language
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clearly and unambiguously supported its position. The trial court denied the plaintiff's motion and granted the defendant's cross motion for summary judgment, concluding that, "it is clear under the policy that [the defendant's] loss of consortium claim comes within the coverage for damages because of . . . bodily injury. . . caused by a medical incident . . . . In this action, the coverage is not limited by the policy terms to damages paid for the direct bodily injury suffered by [Thomas] Fontaine. The language at issue does not require that recovery be limited to one who sustained a bodily injury. . . . [T]here is no question of material fact that [the defendant's] claim for loss of consortium is covered under the terms and conditions of the policy."3 (Citations omitted; emphasis in original; internal quotation marks omitted.) This appeal followed.
On appeal, the association, relying primarily on this court's decision in Izzo v. Colonial Penn Ins. Co., 203 Conn. 305, 524 A.2d 641 (1987), and the decision of the United States Court of Appeals for the First Circuit in Diamond International Corp. v. Allstate Ins. Co., 712 F.2d 1498 (1st Cir. 1983), claims that the unambiguous language of the policy is limited to claims for bodily injuries, which precludes coverage for the defendant because she has not suffered a bodily injury, and claims only loss of consortium. In response, the defendant
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contends that the association's reliance on Izzo is misplaced and that its reading of the policy's plain...
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