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Exclusion for medical services in a medical malpractice claim (US)

By Sandra Sithole (ZA) on April 24, 2017

Over a 150 patients claimed damages against a hospital because of an outbreak of fungal meningitis and related infections which resulted from the patients receiving injections with contaminated substances.

The court held that there was no claim under the insurer’s commercial package policy based on personal injury claims because the policies excluded bodily injury ‘due to rendering any professional service’ which included ‘medical or nursing service or treatment’ or ‘any health or therapeutic service or treatment’.

The court said that the word ‘treatment’ was not ambiguous as the insured hospital alleged.

The professional services exclusion eliminated coverage for the hospital’s negligence in selecting the particular pharmaceutical supplier as their supplier of the medication and any negligence in managing that supplier relationship. The negligence contended for was negligence relating to services of a professional nature and the bodily injury was due to medical, nursing, health or therapeutic service or treatment. Without the injections there would have been no injuries and the injections clearly constituted medical treatment.

[The case is Westfield Insurance Company v Orthopedic and Sports Medicine Center of Northern Indiana, Inc. US District Court for the Northern District of Indiana]

  • Posted in:
    Financial
  • Blog:
    Financial Institutions Legal Snapshot
  • Organization:
    Norton Rose Fulbright

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