Stefan R. Underhill, United States District Judge.
This case comes before me in a very unusual procedural posture. It is a declaratory-judgment action concerning the scope of several insurance policies purchased by a hospital, brought against the hospital and its primary insurance coverage providers
Then the parties awaited a ruling, though what kind of ruling was not exactly clear. There was no pending motion — only Judge Kravitz's order to brief an issue, the resulting briefs, the supplemental briefs that arose from oral argument, and uncertainty about what Judge Kravitz intended following the briefing. I requested that the parties file some sort of motion if they wanted a ruling, and pursuant to that request they made a filing styled as a "Joint Motion by All Parties" (doc. # 317), in which they summarize this procedural history — attaching Judge Kravitz's two decisions and the transcript of oral argument — and "jointly request that the Court decide the issue posed by" Judge Kravitz in his second ruling (id. at 4). That joint request is curious, because the previous sentence says that the parties submit the Joint Motion "without prejudice to [their] respective positions as to whether and, if so, how" I should answer the question (id. at 3). The implication of the "whether and, if so" is that at least some of the parties do not think I should answer it at all; and indeed, the plaintiff's initial briefing on the question states plainly that "it is not an issue on which [the] complaint seeks a declaration." PEIC's Supplemental Mem. Allocating Defense Costs 3 (doc. # 307 at 7).
I have examined the four requests in the complaint's Demand for Relief (doc. # 8 at 25-26) and Judge Kravitz's two rulings, and, as described more fully below, I conclude
This case arises out of the many claims brought in Connecticut state courts against St. Francis Hospital (the "Hospital") by victims of the late George Reardon. Reardon was an endocrinologist at the Hospital and is said to have sexually abused many children who were his patients over a period of several decades. The Hospital's insurers disagree about the scope of their respective policies and which of them are implicated by that litigation, and this declaratory-judgment action was filed to resolve the issue.
In the relevant period of January 1981 to October 1985, the Hospital carried excess blanket catastrophe liability coverage from Pacific Employers Insurance Co. ("PEIC"), which supplemented General Liability ("GL") and Hospital Professional Liability ("HPL") coverage from Travelers (January 1981 to October 1984) and Evanston (October 1984 to October 1985). The respective scope of each policy, and the associated duties to indemnify and to defend, are disputed in this litigation.
Travelers' GL coverage part provides indemnity to St. Francis for "damages because of bodily injury or property damage to which this insurance applies, caused by an occurrence and [Travelers] shall have the right and duty to defend any suit against the insured seeking damages on account of such bodily injury or property damage...." Aff. of Maria T. Erkfitz (doc. # 130) Exs. A, C, and D. "Occurrence" is defined as "an accident, including continuous or repeated exposure to conditions, which results in bodily injury or property damage neither expected nor intended from the standpoint of the insured." Id.
Travelers' HPL coverage part provides that
Id. In addition to that duty to indemnify, Travelers' HPL coverage also creates a duty to defend:
Id.
Another paragraph of the HPL policy part contains what Travelers calls (and what, in earlier rulings in this case, Judge Kravitz called) a "non-concurrency provision":
Id. at ¶ V.C.
In sum, the Travelers policies provide HPL coverage and GL coverage, and duties both to defend and to indemnify under each; any "mixed" HPL/GL claim ultimately falls under the HPL coverage. Because of the latter provision, the parties disputed whether such "mixed" claims could trigger the GL duty to defend, and in his ruling on cross-motions for summary judgment (doc. # 226), Judge Kravitz held that they can. The duty to defend, under Connecticut law, "is considerably broader than the duty to indemnify." DaCruz v. State Farm Fire and Cas. Co., 268 Conn. 675, 687, 846 A.2d 849 (2004). If a complaint raises mixed claims but results in a judgment that only implicates GL coverage, then the fact that the (narrower) GL duty to indemnify has been triggered necessarily means that the (broader) GL duty to defend has also been triggered. Thus, Judge Kravitz ruled, if there are claims ex ante that "even possibly" implicate GL coverage but not HPL coverage, then there arises a GL duty to defend — and only if the judgment ex post includes liability for a claim (or claims) that implicates both GL and HPL coverage does the non-concurrency provision dictate that indemnification for any such mixed claim falls exclusively under the HPL coverage. Judge Kravitz ruled, moreover, that in this case, the underlying litigation does raise claims that "even possibly" implicate GL coverage alone, and that Travelers therefore has a duty under its GL coverage to defend the Hospital against those claims in the underlying litigation.
Travelers moved for reconsideration of Judge Kravitz's ruling, directing his attention to Special Endorsement #1, which it
In seeking reconsideration, Travelers also raised the question whether the underlying suits triggered a duty to defend under the HPL coverage (which was not answered in the earlier ruling, because that ruling concerned only the GL coverage). In response, Judge Kravitz ruled that they did (id. at 5). He had not previously ruled that Travelers had dual duties to defend, and in light of that ruling, he ordered the parties to submit simultaneous briefs on the proper allocation of defense costs arising from mixed cases in which Travelers has both HPL and GL duties to defend (id.). The parties submitted their briefs on the question, and I heard their oral arguments, at which time they raised two additional disputed issues: the practical effect of the "exhaustion" requirement under PEIC's excess coverage; and whether the nature of the sexual misconduct alleged in the underlying litigation puts that litigation beyond the scope of HPL coverage. PEIC requested the opportunity to submit short supplemental briefs on those questions, and I granted the parties leave to do so if they wished.
PEIC's complaint makes four specific requests for declaratory judgment, denominated a through d, and requests no other form of relief. Those requests are as follows:
Am. Compl. (doc. # 8).
Request d has clearly been resolved — it was an express holding of Judge Kravitz's first ruling and re-emphasized in his second ruling that the underlying litigation does trigger a duty to defend under the GL coverage part. It is of course significant that Judge Kravitz ruled that there is a GL duty to defend with respect to all claims (not all suits) that "even possibly" implicate GL coverage alone, and the language of request d is ambiguous on that point. Resolving that ambiguity consistently with Judge Kravitz's rulings, however, resolves request d.
Request c was not addressed in either of Judge Kravitz's rulings, but it was raised and argued in the briefing and oral argument that followed his second ruling, and I will therefore take it up below.
The effect of Judge Kravitz's rulings on requests a and b is less obvious. Judge Kravitz denied the defendants' motions for summary judgment and in effect declined to rule expressly and with finality on requests a and b, because he did not know "what facts the remaining plaintiffs will seek to prove at trial, which theories of liability they will pursue, and which the eventual juries might find convincing" (doc. # 226 at 17). He did, however, look to the underlying Uniform Complaint and concluded that "[o]n several of the theories of liability that the underlying plaintiffs might assert and a jury may or may not credit, the plaintiffs would be alleging injuries that arise out of professional services" (id. at 16). That conclusion at least implies a rejection of the requested declaration in request a, which would be that the underlying litigation as a matter of law "does not implicate" HPL coverage because of the nature of the alleged sexual misconduct. On the contrary, Judge Kravitz ruled that the underlying litigation could implicate HPL coverage. I will take up below the question whether sexual misconduct allegations are beyond the scope of HPL coverage, which Judge Kravitz declined to address and which the parties again raised and argued after his second ruling. Request a proposes an answer to that question, so addressing it will shed greater light on the disposition of that request.
Request b is the complement to request a: what the former would declare does not implicate HPL, the latter would declare implicates GL instead. Judge Kravitz did conclude that GL coverage could be implicated, because
(Id. at 15). That reasoning might be enough to resolve a request for a declaration that GL coverage is implicated by the underlying litigation, but not for a declaration that it is implicated — as request b would have it — specifically by claims of the Hospital's failure to supervise Reardon and its failure to prevent his alleged sexual misconduct. As a result of the non-concurrency provision, whether GL coverage is implicated by those claims depends at least in part on whether HPL coverage is implicated
The issue of allocation of defense costs — or of piecemeal, claim-by-claim, dollar-by-dollar allocation between HPL and GL more generally — is not raised by the complaint and none of the requests for declaratory judgment requires resolving it. Request a, for instance, seeks a declaration that HPL coverage is not implicated "because the litigation seeks to recover for injuries resulting from sexual misconduct" (emphasis added). If such litigation cannot, as a matter of law, implicate the HPL coverage, then the request must be granted; and if it can, then the request must be denied. The other requests are similarly categorical. No fact-laden inquiry into all of the particular claims that were pleaded or pursued in state court is called for by the requests for relief, and none is necessary. Such inquiry is simply beyond the scope of the complaint, and could only result in what would effectively be an advisory opinion. I will therefore take up the issues actually raised by the complaint, as described above, but will not entertain the allocation question.
By the terms of PEIC's excess blanket catastrophe liability policy, PEIC has a right and duty to defend the Hospital "[i]f limits of liability of the underlying insurance are exhausted." Mot. for Partial Summ. J. Ex. J (doc. # 105-13). PEIC argues that "the underlying insurance" refers to all of the policies listed in the attached Schedule of Underlying Insurance, id., and that because that list separately includes both GL and HPL, the excess policy is not triggered by merely one or the other being exhausted. The Hospital objects to that interpretation, worrying that it will be left with uncovered defense costs if costs are allocated to HPL after its HPL coverage limits have been reached, yet there remains unexhausted (but inapplicable) GL coverage.
PEIC is surely correct that all of the policies listed in the Schedule of Underlying Insurance are included in the phrase "underlying insurance," but that fact is not sufficient to establish the outcome PEIC advocates. The issue is not whether "underlying insurance" refers only to a subset of the listed policies, but whether "exhaustion" refers to exhaustion with respect to particular claims. If an HPL claim creates costs for the insured after the underlying HPL coverage is exhausted, then all underlying insurance is exhausted with respect to that claim — notwithstanding that some inapplicable underlying policy may remain unexhausted. PEIC's interpretation would effectively read the clause "if limits of liability of the underlying insurance are exhausted" to mean "if all limits of liability of all the underlying insurance are exhausted for all claims." That reading, which may seem reasonable enough in isolation, leads to the absurd outcome that the insured party who intends to purchase more protection by including more different kinds of underlying policies under the excess coverage actually renders the excess policy less valuable — potentially to the point of worthlessness — by profoundly decreasing the probability that all included policies will be exhausted. For instance, the Schedule of Underlying Insurance in this case includes — in addition to the HPL and GL coverage — Worker's Compensation, Automobile Liability, and Garage Keepers policies. It is difficult to imagine the circumstances that would exhaust everything from HPL to Garage Keepers, so, if accepted, PEIC's contention that it incurs
The more reasonable interpretation reads the clause "if limits of liability of the underlying insurance are exhausted" to mean "if limits of liability of the applicable underlying insurance are exhausted." PEIC's arguments to the contrary are not persuasive. It cites the "horizontal exhaustion rule," which it defines with a quotation from an insurance treatise as meaning that "all primary policies triggered by the loss must pay to their limits — that is, be exhausted — before any excess insurer will become liable." Paul E.B. Glad, et al., 3-16 APPLEMAN ON INSURANCE § 16.09[2][c][v]. But all policies "triggered by the loss" is another way of saying all applicable policies, and the decisions PEIC cites to show the application of the rule are consistent with such a reading.
The decision that, in PEIC's telling, seems most strongly to support its position, and which gets the most prominent treatment in its supplemental briefing, is Cohn v. Pacific Employers Insurance Co., 213 Conn. 540, 569 A.2d 544 (1990), but PEIC misconstrues its holding. In that case, the plaintiff was severely injured in an automobile crash
PEIC's excess policies "follow form" to the primary policies, because the basic purpose of excess insurance coverage is to protect the insured against the risk of costs exceeding the limits of primary coverage. That purpose is expressed in the language of the excess policy, which "continue[s] such coverage as is afforded by such listed underlying insurance." Mot. for Partial Summ. J. Ex. J (doc. # 105-13). In order to effect that coverage, and in order to fulfill the basic purpose of the policy, PEIC's excess coverage is triggered with respect to a particular claim when all underlying coverage is exhausted with respect to that claim. Thus, if the underlying HPL coverage limits are reached, then with respect to a claim that otherwise would have been covered by that HPL coverage, the excess policy begins paying.
PEIC's request c, to the extent it seeks
Lastly, the parties dispute whether the underlying lawsuits properly implicate HPL coverage, or if allegations of sexual abuse are necessarily outside the scope of professional liability insurance. There is certainly not, as PEIC would have it, a bright-line exclusion, because the Connecticut Supreme Court has held that a dentist's professional liability insurance covered claims that he sexually assaulted a patient after (or while) negligently administering excessive nitrous oxide. See St. Paul Fire & Marine Ins. Co. v. Shernow, 222 Conn. 823, 610 A.2d 1281 (1992). In that case, the Court held that "[w]hen [a] medically negligent procedure is so inextricably intertwined and inseparable from the intentional conduct that serves as the basis for the separate claim of a sexual assault, we join with those jurisdictions that conclude that professional liability policies must, in such instances, extend coverage." Id. at 830, 610 A.2d 1281. The underlying claims in this case allege that Dr. Reardon for several decades purported to conduct a child growth study under the auspices of the Hospital, and that the study was at least in large part a ruse to sexually exploit children. They do not allege that a person who happened to be a medical professional abused children on his days off, or even that he opportunistically abused his patients at the Hospital, but rather that he devised a long-term medical study to be carried out under the Hospital's imprimatur and ostensibly under its professional supervision and that a principal purpose of that study was to find and abuse his victims. The medical study and the sexual abuse could hardly be any more "inextricably intertwined."
Moreover, it is a significant distinction that the underlying disputes are not principally about direct liability for sexual abuse; they are about liability for failure to supervise a doctor who allegedly committed that abuse under the guise of a medical study. The HPL policy provides coverage for injury caused by the rendering of or failure to render professional services, expressly including "service by any person as a member of a formal accreditation or similar professional board or committee of the named insured, or as a person charged with the duty of executing directives of any such board or committee." Aff. of Maria T. Erkfitz (doc. # 130) Exs. A, C, and D. The plaintiffs in the underlying litigation alleged that the Hospital's Research Committee — comprised of physicians and charged by the Hospital's bylaws with the oversight of all medical research performed at the Hospital — negligently failed to supervise or oversee Dr. Reardon's putative study. The Research Committee's supervision or auditing of medical research performed by a physician at the Hospital is a professional service provided by persons who are "member[s] of a formal accreditation or similar professional board or committee," and I thus cannot hold, as PEIC argues, that as a matter of law failure-to-supervise claims brought against
Judge Kravitz's rulings, taken together with this decision as a supplement, resolve all four of the requested declarations PEIC seeks in its complaint. On request a, seeking declaratory judgment that the Reardon litigation does not implicate HPL coverage because of the nature of the underlying claims, the requested relief is denied and no such declaratory judgment will enter. On request b, seeking declaratory judgment that allegations of the Hospital's alleged failure to supervise Reardon or failure to prevent his alleged sexual abuse do implicate GL coverage, the requested relief is denied and no such declaratory judgment will enter. On request c, seeking — as construed above — declaratory judgment that PEIC has no duty to indemnify or defend until all underlying coverage is exhausted with respect to all claims rather than with respect to a particular claim, the requested relief is denied and no such declaratory judgment will enter. On request d, seeking declaratory judgment that the underlying litigation triggers a duty to defend under GL coverage, the requested relief is granted consistently with Judge Kravitz's ruling with respect to all claims (not all suits) that "even possibly" implicate GL coverage alone.
There being no demand for relief in the complaint that remains unresolved, the Clerk shall enter judgment and close this case.
So ordered.