IS A TORT CLAIM THAT OCCURS OVER A LONG, CONTINUOUS PERIOD OF TIME CONSIDERED A SINGLE OCCURRENCE FOR PURPOSES OF AN INSURANCE CONTRACT?
Sometimes the black letter law passed by the legislature is unclear. The legislature can’t anticipate every possible fact scenario when they pass a law, so it lay to the courts to interpret the law and give guidance to what it means. This interpretation is called case law. When the court decides a certain meeting to the law it essentially answers a legal question. Lawyers and other courts then can rely on that ruling when they have a similar issue in their case. The following case answers the question above.
Zipkin v. Freeman, 436 S.W.2d 753 (Mo. 1968).
This case addresses the following issue:
Is a tort claim that occurs over a long, continuous period of time considered a single occurrence for purposes of an insurance contract?
This case dealt with a three-year-long series of professional malpractice by a psychiatrist. Id. at 755. The court ultimately found that these occurrences were all part of one single claim of malpractice by the underlying plaintiff, making the actions a single “occurrence” under the applicable insurance policy. Id. at 764. Thus, the maximum exposure the insurance company had was the limitations for a single year, not a three-year period. Id.
In this case, Defendant was a psychiatrist treating Plaintiff. Id. at 755. The treatment offered by Defendant, was, to say the least, unorthodox. Id. Defendant would often have Plaintiff and other patients over to his home for parties and social events, which he proposed as treatments that encouraged socialization. Id. Eventually, Defendant began singling out Plaintiff and manipulating her using his position as her psychiatrist. Id. at 756. Defendant ultimately led Plaintiff to leave her husband and purchase land for Defendant own personal use. Id. at 757-58. Plaintiff ultimately was removed from Defendant’s treatment and filed suit for malpractice against Defendant. Id.
The court easily found the actions of Defendant to fall within the coverage of the professional liability insurance. Id. at 763. In fact, only because of Defendant’s professional relationship with Plaintiff was he able to commit the acts that he did: quintessential malpractice. Id. Finding that the claim fell within the policy, the next question—and harder question—was how much coverage the policy offered. Id.
Insurance is solely a matter of contract, so an insurer cannot be made to pay more than the policy limits of the particular plan. Id. at 763. Further, the language of the contract will determine to what this limitation applies. Id. In the contract here, the policy limited coverage of $5,000 for “any one claim” per year and $15,000 maximum each year. Id. The actions of Defendant had spanned a period of three years and were made up of several incidents. Id. However, the court found that Defendant’s “acts and omissions continuously occurred” and was found to be “a continuing tort for which [Plaintiff] would have one claim arising out of [Defendant]’s wrongful act.” Id. at 764. Thus, the case offered a single “claim” to which the policy limit of $5,000 applied. Id.