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Vol. 3, Iss. 13
September 10, 2014

Mississippi Supreme Court Provides A Clinic In Plain Meaning To Preclude Coverage [Yes, Mississippi]

 

It is routine for a court, setting out to resolve an insurance coverage dispute, to begin its opinion by laying out the rules that will determine its decision. And it is likely that, somewhere in the court’s recitation, will be a statement that its most important consideration is to be the language of the policy. If the policy language is clear we apply it as written and case closed. It is likely that one party will believe that the court was true to its word, and made its decision by applying solely the plain language of the policy, and the other party is likely to see it otherwise.

The Mississippi Supreme Court just decided Hayne v. The Doctors Company, No. 2013-252 (Miss. August 28, 2014). Plain meaning of a policy is what was on trial. Borrowing liberally the court’s factual summary… Dr. Steven Hayne had worked as a forensic pathologist in death investigations for the State of Mississippi. In 1992 he conducted an autopsy on the body of Christine Jackson, a three-year-old girl who was raped and murdered. During the autopsy, he observed what he described as bite marks. Hayne identified Kennedy Brewer, the boyfriend of the victim's mother, as the person who had made those marks, based upon a comparison with an upper-palate imprint obtained from Brewer. At Brewer's trial, Hayne testified that he had no doubt that nineteen of the marks on the victim's body had been made by Kennedy Brewer. This so-called bite-mark evidence was the “centerpiece of the prosecution.” Brewer was convicted of capital murder and sentenced to death. However, semen had been found on the victim, and years after his conviction, Brewer was able to gain access to the semen for DNA testing. The testing excluded Brewer as the source of the semen that had been found on the deceased victim, and his capital murder conviction was vacated in 2002. Brewer had spent fifteen years behind bars, with seven of those on death row. In 2008, Brewer filed suit against Hayne for malicious prosecution, fraud, and negligent misrepresentation.

Dr. Hayne sought coverage under a medical malpractice policy issued by The Doctors. Coverage litigation ensued. The policy provided coverage to Hayne for claims brought against him for incidents occurring during the coverage period, with “claim” defined as a suit alleging “injury, disability, sickness, disease, or death to a patient arising from [Hayne’s] rendering or failing to render professional services....”.

The Doctors argued that, because Brewer was never a patient of Hayne’s, and Brewer alleged injuries only to himself, the plain language of the policy precluded coverage for Hayne.

More specifically, The Doctors argued that “the language of the policy does not provide coverage for Hayne in the context of a suit brought by a wrongfully convicted criminal defendant against whom Hayne had testified. According to The Doctors, the policy provides coverage only for suits alleging injury to a patient. Brewer, however, is alleging injuries to himself. Brewer was never a patient of Hayne’s and makes no claim or contention to that effect. Neither does Hayne. Therefore, according to The Doctors, the policy does not cover Brewer’s claim against Hayne. The Doctors argues that if anyone was a patient of Hayne’s in the context of the Brewer complaint, it was Christine Jackson, the crime victim upon whom Hayne performed the autopsy which formed the basis for his testimony against Brewer. However, Brewer is not alleging that Hayne injured Christine Jackson, and he is not contending that she was Hayne’s patient.”

The court agreed with The Doctors and held that no coverage was owed to Hayne. The court’s decision—reached even in the face of allegations the policy was internally inconsistent and that The Doctors made representations that the policy provided coverage for the incident--was completely tied to the policy language: “We are constrained to agree with The Doctors’ position that Brewer simply cannot, by any stretch of the imagination, be considered Hayne’s patient. The language of the policy is unambiguous in this regard. Further, an insured is charged with the knowledge of the terms of the policy upon which he or she relies for protection. Although Hayne claims that The Doctors negligently misrepresented to him in the policy booklet that the policy would cover him for suits such as the one he now faces, the plain language of the policy itself unambiguously informs him that it does not. When the language of the policy is unambiguous, knowledge of the policy is imputed to the insured.”

Hayne is a very interesting and unusual case. There are plenty of cases involving coverage for convictions, determined by later-DNA testing, to have been wrongful. I’ve never seen one with facts like this. But the real take-away from Hayne is that, while the court seemed to have opportunities to find the policy ambiguous, it rejected them. The court held that no coverage was owed based on its obligation to uphold the plain meaning of the policy.

 

 
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