Client Wins

Young Avoids $40 Million Demand for Coverage on Behalf of Client Insurer

Jane Young (Partner-Denver, CO) defended an insurer client that issued two excess policies to a health care provider, which provided up to $40 million in hospital professional liability coverage in excess of $2 million per medical incident underlying coverage. The insured was sued by hundreds of patients in Denver, Colorado, claiming a breach in the sterilization protocol of surgical instruments. The coverage issue was whether the hundreds of different claims by different patients constituted one medical incident or more than one medical incident under the excess policies. The insured argued all the claims should be grouped as one medical incident. Our client disagreed and, pursuant to the policy language, argued that each patient's claim constituted a separate medical incident. The insurer filed a declaratory judgment action, seeking a declaration that each claim constituted a separate medical incident. The Colorado Federal Court agreed with our client and granted summary judgment. The insured appealed to the Tenth Circuit. After oral argument, the Tenth Circuit affirmed and held that each patient's claim constituted a separate medical incident. Thus, our client does not have an obligation to pay any monies until any one claim exceeds $2 million, and only one claim did.

Jane E. Young

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