Psychiatric Associates v. St. Paul Fire & Marine Ins. Co.
| Decision Date | 18 April 1994 |
| Docket Number | No. 92-3279,92-3279 |
| Citation | 647 So.2d 134 |
| Parties | 9 IER Cases 706, 19 Fla. L. Weekly D875 PSYCHIATRIC ASSOCIATES, a professional association, Alvin Neumeyer, M.D., Eugene Valentine, M.D., and Frank Gill, M.D., Appellants, v. ST. PAUL FIRE & MARINE INSURANCE COMPANY, Appellee. |
| Court | Florida District Court of Appeals |
H. Edward Moore, Jr., Moore, Hill, Westmoreland, Hook & Bolton, P.A., Pensacola, for appellants.
Dale J. Paleschic, Parker, Johnson, Anderson, Goodwin, McGuire & Michaud, Orlando, for appellee.
Appellants (the insureds) seek review of a summary final judgment entered in favor of appellee (the insurer) in a declaratory judgment action. They argue that the trial court erroneously concluded that the insurer had no obligation to provide a defense for them because the policy issued by the insurer afforded no coverage as to claims made against them by a third party in a civil action. We agree with the insureds and, accordingly, reverse.
In its second amended complaint, the insurer alleged that it had issued to the insureds two policies--a "Professional Office Package" and an "Umbrella Excess Liability Policy"--attaching a copy of each. It also alleged that a civil action had been filed against the insureds by Edward A. Siegel, M.D.; attaching a copy of the amended complaint filed by Siegel. According to the insurer's complaint, the insurer was unsure of its legal rights and responsibilities under the two policies because (1) Siegel's complaint alleged "intentional acts of wrongdoing" by the insureds, and both policies provided coverage only for "an accidental event which results in damage which the insured did not expect or intend to happen"; (2) Siegel's complaint alleged that he had been harmed as a result of acts of the insureds performed in their professional capacities, and both policies "excluded coverage for acts done in the course of performing professional services"; and (3) certain of the claims made by Siegel involved allegations of violations by the insureds of federal and state criminal laws, and both policies excluded coverage for injuries resulting from intentional violations of any criminal law. The insureds answered, admitting that they believed that both policies afforded coverage for the claims made by Siegel; and denying all of the remaining material allegations.
Siegel's complaint against the insureds consists of five relatively unartfully drafted counts. It contains the following material allegations: The insured professional association had a contract with Gulf Coast Treatment Center, Inc. (the Treatment Center) to provide psychiatric medical care and administrative services to HSA Gulf Coast Hospital (the Hospital). The individual insureds were all agents or employees of the professional association. Siegel entered into a contract with the Treatment Center to engage full time in the practice of psychiatry at the Hospital. The insureds "intentionally and unjustifiably sought, at medical staff meetings and otherwise, to interfere with the contractual relationship between" Siegel and the Treatment Center by attempting to block Siegel from assuming his position on the staff of the Hospital; attempting to restrict Siegel's privileges; making false accusations in an attempt to have Siegel's privileges suspended; forcing Siegel to leave treatment team meetings at which his patients were being discussed; and having the furniture and "therapeutic tools" removed from Siegel's office. Counts I and II allege, further, that, as a result of the insureds' actions, Siegel "suffered mental and emotional anguish, loss of capacity for the enjoyment of life, expense of medical care and treatment, loss of earnings, and loss of the ability to earn money." Relying upon the foregoing allegations, Count I seeks damages for "intentional interference with an advantageous business relationship"; Count II seeks damages for "intentional infliction of emotional distress"; Count III seeks damages for violations of section 1 of the Sherman Anti-trust Act (15 U.S.C. Sec. 1); Count IV seeks damages for violations of section 2 of the Sherman Anti-trust Act (15 U.S.C. Sec. 2); and Count V seeks damages for violations of the Florida Antitrust Act (ch. 542, Fla.Stat.).
Both policies are comprehensive general liability policies, covering a number of different risks. The following provisions of the "Professional Office Package" are relevant to this appeal:
What This Agreement Covers
Liability coverage. We'll pay amounts you and others protected under this agreement are legally required to pay as damages for covered bodily injury, property damage, personal injury or advertising injury claims caused by an event.
Event means an accidental event that results in bodily injury or property damage the protected person didn't expect or intend to happen. An event also means an act or a series of similar or related acts that results in personal injury or advertising injury.
....
Personal injury means any of the following acts of interference with rights that happen in the course of your business while this agreement is in effect:
. false arrest, wrongful detention, malicious prosecution, humiliation or false imprisonment;
. libel, slander, defamation of character, or invasion of an individual's right of privacy. But not such acts that arise from advertising activities; or
. wrongful entry, wrongful eviction or other invasion of the right of private occupancy.
....
Exclusions-Claims We Won't Cover
....
Professional services. We won't cover injury or damage resulting from the performance of or the failure to perform any professional service.
This exclusion applies whether or not the claim is based on liability assumed under any contract or agreement.
....
Personal injury. We won't cover personal injury claims in these situations:
....
Deliberately breaking the law. We won't cover personal injury claims that result if you or other protected persons knowingly break any criminal law. Or if someone else breaks such law with the consent or knowledge of any protected person.
The coverage provisions of the "Umbrella Excess Liability Policy" are substantively identical to those of the "Professional Office Package." However, the exclusions contained in the former are somewhat different from those contained in the latter. The "Umbrella Excess Liability Policy" does not have a "deliberately breaking the law" exclusion; and the exclusion comparable to the "professional services" exclusion reads:
Professional Medical Services. We won't cover injury or damage due to providing or failure to provide:
. medical, surgical, dental, x-ray, nursing service or treatment, or the serving of food or beverage within these services;
. any service or treatment related to health or of a professional nature;
. any cosmetic or tonsorial service or treatment;
. drugs, medical or dental supplies or appliances; or
. the handling of corpses or the performance of autopsies.
This exclusion won't apply to coverage provided by the Umbrella Excess Hospital Professional Liability Protection--Claims Made.
It is somewhat difficult to ascertain upon which precise portions of the policies the insurer is relying. In its complaint, it took the position that there was no coverage because Siegel's complaint alleged (1) "intentional acts of wrongdoing" by the insureds; (2) that the acts were "done in the course of performing professional services"; and (3) that the insureds had "intentionally violated ... criminal laws." However, in its motion for summary judgment, it asserted that it was entitled to a summary judgment because Siegel's complaint alleged that the insureds had "committed various intentional acts as well as violations of ... criminal laws." There is no mention of the "professional services" exclusion. Then, at the hearing on the motion for summary judgment, the insurer conceded that the wrongs alleged in Siegel's complaint might be within the policies' coverage but for certain exclusions:
The policy does provide some additional coverage for personal injury which arises and the policy defines as false arrest, libel, slander, wrongful injury, wrongful eviction. Admittedly there may be some chance that this provision applies to the complaint. However, there are exclusions which do not allow the policy coverage to kick in. There's an exclusion for deliberately breaking the law ... as well as there's an exclusion for failing to render professional services.
(Emphasis added.)
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