patty, a patient of dr. smith was injured by dr. smith's malpractice in 2010, she filed suit in may 2011. under a claim-made policy, an insurance company will be responsible for defending dr. smith if it's the company who insuring dr. smith in
In order to determine whether the insurance company will be responsible for defending Dr. Smith in this situation, we need to understand the key concepts related to claim-made policies and insurance coverage.
A claim-made policy is a type of professional liability insurance that covers claims made against the insured during the policy period, regardless of when the incident giving rise to the claim actually occurred. Unlike occurrence-based policies, which cover claims based on when the incident took place, claim-made policies focus on when the claim is made.
In this case, Patty's injury occurred in 2010, but she filed a lawsuit against Dr. Smith in May 2011. To determine if the insurance company will provide coverage, we need to know whether Dr. Smith had an active claim-made policy at the time Patty filed her lawsuit.
Here are the steps to determine if the insurance company will be responsible for defending Dr. Smith:
1. Review the insurance policy: Look for the specific terms and conditions of Dr. Smith's policy to find out if it's a claim-made policy or an occurrence-based policy. The policy details should state which type of policy is in effect.
2. Check the policy period: Verify the dates of coverage for the policy in question. Claim-made policies typically cover claims made during the policy period, regardless of when the incident occurred. Make sure that Patty's lawsuit falls within the policy period.
3. Evaluate retroactive date: Claim-made policies often have a retroactive date, which is the date before which incidents are not covered. If Dr. Smith's policy includes a retroactive date, make sure that Patty's injury occurred after that date. If the injury predates the retroactive date, it may not be covered by the insurance policy.
4. Assess the timely claim reporting requirement: Claim-made policies generally require the insured to report the claim or potential claim to the insurance company within a certain timeframe (known as the reporting period) during the policy period. Ensure that Dr. Smith reported Patty's lawsuit to the insurance company within the required reporting period.
Based on the findings after going through these steps, you can determine whether the insurance company will be responsible for defending Dr. Smith. It is advisable to consult the specific policy language and a legal professional to get accurate information regarding insurance coverage.