Paynter v. ProAssurance Wisconsin Insurance Co. (Medical Malpractice Coverage)

In Paynter v. ProAssurance Wisconsin Insurance Co. (2017AP739), the Court of Appeals District III held that a medical malpractice insurance policy did not provide coverage for a doctor’s alleged liability connected with services performed in another state.

The underlying claim in the case arose when Dr. James Hamp, who operates offices in both Wisconsin and Michigan, misdiagnosed a growth on patient David Paynter, a Michigan resident. Paynter first saw Dr. Hamp in his Michigan office, but Dr. Hamp called Paynter with the misdiagnosis from his Wisconsin office. Paynter was residing in Michigan at the time of the call and for the next four years before he found out his growth was cancerous.

Paynter sued Dr. Hamp and his Wisconsin malpractice insurer ProAssurance, claiming both negligence and violation of the patient’s right to informed consent. The Wisconsin Supreme Court dismissed Paynter’s informed consent claim based on Wisconsin’s borrowing statute, remanding the negligence claim to the court of appeals. The issue remaining on appeal was whether the ProAssurance policy provided coverage for the negligence claim.

The ProAssurance policy included a location endorsement, which stated ProAssurance would not cover “liability arising from, relating to, or in any way connected with the rendering of or failure to render professional services…in the State of Michigan and/or outside the State of Wisconsin.” The appeals court agreed with ProAssurance that, because Dr. Hamp first tested Paynter in Michigan, the alleged negligent misdiagnosis was “connected with” services provided in Michigan. Therefore, the ProAssurance policy’s location endorsement unambiguously excluded coverage for Paynter’s negligence claim.