Lindheimer v. St. Paul Fire and Marine Ins. Co.

Citation643 So.2d 636
Decision Date14 September 1994
Docket NumberNo. 92-2254,92-2254
Parties19 Fla. L. Weekly D1934 Bambi LINDHEIMER and Richard Lindheimer, Appellants, v. The ST. PAUL FIRE AND MARINE INSURANCE COMPANY, Appellee.
CourtCourt of Appeal of Florida (US)

Proenza, White & Roberts, and H. Mark Vieth, Miami, for appellants.

Michaud, Buschmann, Fox, Ferrara & Mittelmark, and James T. Ferrara, and Scott H. Michaud, Boca Raton, Parker, Johnson, Goodwin, McGuire & Burke, and Pamela Mark Burke, and E. Clay Parker, Orlando, for appellee.

Sharon Lee Stedman, Orlando, for Florida Defense Lawyers Ass'n, as amicus curiae.

Before SCHWARTZ, C.J., and BARKDULL, HUBBART, NESBITT, BASKIN, JORGENSON, COPE, LEVY, GERSTEN and GODERICH, JJ.

ON REHEARING EN BANC

GERSTEN, Judge.

Appellants, Bambi and Richard Lindheimer (the Lindheimers), appeal a declaratory judgment in favor of the appellee, St. Paul Fire and Marine Insurance Company (St. Paul), the provider of professional liability insurance to Edward Joseph, D.D.S., an oral surgeon. We affirm because the professional liability policy does not cover acts of sexual misconduct.

Ms. Lindheimer was receiving periodontal treatment from Dr. Joseph when he sexually molested her after administering anesthesia. For the purpose of determining the existence of insurance coverage, the parties stipulated: "Dr. Joseph unnecessarily administered valium to her intravenously in order to place her in a 'twilight sleep,' " and "[a]s she awoke from the effects of this anesthesia, she found Dr. Joseph touching and examining the private parts of her body and rubbing the private parts of his body against her."

The Lindheimers sued Dr. Joseph for dental malpractice, battery, and intentional infliction of emotional distress, all stemming from the alleged acts of sexual misconduct. St. Paul then filed a separate action for declaratory judgment asserting that the acts of sexual misconduct were not professional services, and thus were not covered under Dr. Joseph's insurance policy. The parties filed cross-motions for summary judgment, and the trial court granted summary judgment in favor of St. Paul.

No Florida court has addressed whether a professional liability insurance policy covers a dentist's sexual abuse. In determining whether coverage exists, we first turn to the relevant provisions of the policy which provide:

What This Agreement Covers

Liability. We'll pay amounts you or others protected under this agreement are legally required to pay as damages for covered professional liability claims. To be covered, claims must be based on events that arise out of the profession named in the Coverage Summary.

....

Individual. If you are an individual shown in the Coverage Summary, you're protected against claims that result from:

Professional services that you provided or should have provided.

To analyze the scope of these provisions, the terms of the contract must be given their everyday meaning and read in light of the skill and experience of ordinary people. See Morrison Assurance Co. v. School Bd. of Suwannee County, 414 So.2d 581 (Fla. 1st DCA 1982); Fontainebleau Hotel Corp. v. United Filigree Corp., 298 So.2d 455 (Fla. 3d DCA), cert. denied, 303 So.2d 334 (Fla.1974); Sanz v. Reserve Ins. Co. of Chicago, Ill., 172 So.2d 912 (Fla. 3d DCA 1965). A reasonable and practical construction should apply in accord with the intention of the parties. Excelsior Ins. Co. v. Pomona Park Bar & Package Store, 369 So.2d 938 (Fla.1979); Weldon v. All American Life Ins. Co., 605 So.2d 911 (Fla. 2d DCA 1992); Senco of Florida, Inc. v. Continental Casualty Co., 440 So.2d 625 (Fla. 2d DCA 1983).

Here, the plain language of the insurance contract between St. Paul and Dr. Joseph provides coverage for claims that "arise out of the profession," or "result from professional services." Thus the insurance policy's coverage for a sexual assault depends upon whether such an act can reasonably be said to arise out of, or result from, the nature of the professional services rendered.

Whether an act results from the nature of a professional service is determined by focusing upon the particular act itself, as opposed to the character of the individual engaging in the act. See Hirst v. St. Paul Fire & Marine Ins. Co., 106 Idaho 792, 683 P.2d 440 (Idaho Ct.App.1984); Marx v. Hartford Acc. & Indem. Co., 183 Neb. 12, 157 N.W.2d 870 (1968); Niedzielski v. St. Paul Fire & Marine Ins. Co., 134 N.H. 141, 589 A.2d 130 (1991). An insurer's liability under a professional liability policy attaches only when the professional act or service causes the alleged harm. The act or service causing the harm must be a medical or dental act, not an act or service that requires no professional skill. Roe v. Federal Ins. Co., 412 Mass. 43, 587 N.E.2d 214 (1992).

Accordingly, the fact that an act occurred in a professional's office does not automatically transmute the act into a professional service. The location of an act's occurrence is not determinative of liability. There must be some causal connection between an act and the nature of the doctor-patient relationship:

[T]he injuries allegedly suffered by [the patient] arose from a battery and not from any medical diagnosis, treatment or care by Dr. Lieberman. The battery only remotely arose from a doctor-patient relationship, that is, the only connection between the battery and the doctor-patient relationship is the fact that the battery occurred in the doctor's office. Had Dr. Lieberman assaulted Mrs. Buchanan at a bar, that act would not be considered "medical malpractice". The result should not be any different simply because of the locality of the act. (e.s.)

Buchanan v. Lieberman, 526 So.2d 969, 972 (Fla. 5th DCA), review denied, 536 So.2d 244 (Fla.1988). See also Buckner v. Physicians Protective Trust Fund, 376 So.2d 461 (Fla. 3d DCA 1979) (insured's act of conducting a press conference not a "professional service" under policy because act was not embraced in his duty as an investigator).

Applying these concepts to the present case, we find that the dentist's sexual assault was not causally connected to the provision of professional services, regardless of the "pretense of medical care used by the insured to catch his victim unaware." New Mexico Physicians Mut. Liability Co. v. LaMure, 116 N.M. 92, 860 P.2d 734, 738 (1993). When Dr. Joseph stopped providing dental treatment to Ms. Lindheimer and began sexually assaulting her, his professional services ended.

Accordingly, Dr. Joseph's sexual assault was not covered under the terms of St. Paul's professional liability policy. See St. Paul Ins. Co. of Illinois v. Cromeans, 771 F.Supp. 349 (N.D.Ala.1991) (coverage for physician's sexual abuse of young patients was not within the contemplation of the parties and is void as against public policy); Standlee v. St. Paul Fire & Marine Ins. Co., 107 Idaho 899, 693 P.2d 1101 (Idaho Ct.App.1984) (physician's professional liability policy did not cover liability for sexually molesting young patient in hospital); Hirst v. St. Paul Fire & Marine Ins. Co., 683 P.2d at 440 (sexual assault of minor by doctor did not constitute professional services under policy even though doctor administered drugs to render patient more susceptible to his sexual advances); Roe v. Federal Ins. Co., 587 N.E.2d at 214 (dentist's sexual assault of patient did not occur in rendering "professional services" within coverage of professional liability policy); St. Paul Fire & Marine Ins. Co. v. Quintana, 165 Mich.App. 719, 419 N.W.2d 60 (1988) (EEG technician's sexual assault of patient not covered under professional liability policy); Smith v. St. Paul Fire & Marine Ins. Co., 353 N.W.2d 130 (Minn.1984) (physician's sexual assault of several young patients was not part of medical treatment); Niedzielski v. St. Paul Fire & Marine Ins. Co., 589 A.2d at 130 (dentist's sexual assault of patients did not result from dental services rendered); New Mexico Physicians Mut. Liability Co. v. LaMure, 860 P.2d at 734 (physician's sexual assault of patient committed during medical examination did not result from the rendering of professional services); South Carolina Medical Malpractice Liability Ins. Joint Underwriting Ass'n v. Ferry, 291 S.C. 460, 354 S.E.2d 378 (1987) (policy provided no coverage for oral surgeon who sexually assaulted patient); Standard Fire Ins. Co. v. Blakeslee, 54 Wash.App. 1, 771 P.2d 1172 (no coverage where dentist sexually assaulted patient while she was rendered semi-conscious by nitrous oxide), review denied, 113 Wash.2d 1017, 781 P.2d 1320 (1989); Steven G. by Robert G. v. Herget, 178 Wis.2d 674, 505 N.W.2d 422 (Wis.Ct.App.) (dentist's sexual assault of patients did not result from dental services rendered), review denied, 510 N.W.2d 136 (Wis.1993).

We further find that the dentist's use of valium does not bring the sexual assault within the course of the medical treatment provided because the act causing the injury was the assault, not the use of the drugs. Where a medical professional has used anesthesia or tranquilizers to aid his sexual assault of a patient, courts have held that the professional liability policy does not provide coverage when the patient's injury was caused by the sexual assault, not by the administration of drugs. See Standard Fire Ins. Co. v. Blakeslee, 771 P.2d at 1172; Hirst v. St. Paul Fire & Marine Ins. Co., 683 P.2d at 440. Cf. St. Paul Fire & Marine Ins. Co. v. Shernow, 222 Conn. 823, 610 A.2d 1281 (1992) (professional liability policy covered dentist's medically negligent procedure in case also involving sexual assault, because medical procedure caused the injury and established the professional negligence).

In conclusion, we hold that the everyday, common meaning of "professional services" in a professional liability policy does not include sexual assaults by dentists on their patients. Moreover, denying coverage to Dr. Joseph supports the public policy that one should not be able...

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