An insurance company that provides liability coverage for about 2,700 physicians in the state asked the Ohio Supreme Court on Tuesday to declare that an anti-claims stacking provision legislators enacted in 1994 applies to medical malpractice cases as well automobile policies. Depending on how the court rules, an injured patient and his family could wind up with $1 million on a claim instead of the $3 million they are seeking.
Legislators enacted a bill in 1994 (SB20, 120th General Assembly) that specifically allows companies to limit the total coverage in a liability policy-for all claims arising from accident injuries or death to one person-to a single, aggregated dollar amount. Justices heard oral arguments in a case arising from that change of insurance laws.
Patient John Watkins and members of his family sued Dr. James Thomson for alleged medical malpractice for failing to recognize and treat symptoms of an impending stroke. Dr. Thomson had purchased malpractice coverage in 1997 from OHIC, the Ohio Hospital Insurance Company. OHIC maintained terms of the policy restricted its maximum aggregate liability to all three Watkins’ family claimants to the $1 million per person coverage limit. The family filed suit against the insurer.
The Butler County Common Pleas Court ruled the policy’s single person limit was not enforceable because it violated a previous Supreme Court decision that claims by family members for loss of consortium must be treated as legally separate. The 12th Ohio District Court of Appeals overturned the trial court, agreeing with OHIC that the General Assembly through SB20 had overruled the Supreme Court by authorizing insurers to issue policies with anti-stacking language.
Attorney Scott Frederick of Hamilton, representing the Watkins family, told justices his clients are entitled to coverage up to the total policy limit of $3 million.
Mr. Frederick said that while the anti-stacking law refers to injuries "sustained by any one person in any one accident," the word "accident" is never mentioned in the OHIC malpractice policy. Justice Maureen O’Connor told him that in order to prevail, he would have to convince the court that an act of malpractice is not an accident. "I have trouble with that concept," Ms. O’Connor said. Mr. Frederick said there is a difference between the terms "accident," describing an event, and "accidental," which may describe the results of the event. He pointed out that automobile policies specify that claim limits apply per accident.
Attorney Gary Hammond of Columbus, representing OHIC, said the anti-stacking law applies its provisions to any liability policy of insurance including, but not limited to motor vehicle coverage.
Mr. Hammond: "The legislature didn’t limit its consideration to the automobile liability uninsured motorist context."
Justice Alice Resnick: "It could have specifically included professional services liability but it didn’t do it."