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Truck Insurance Exchange v. Pacificare Health Systems3/30/2005
cifiCare into a narrower policy that would have expressly excluded claims that PacifiCare failed to perform under its contracts, and Truck's underwriter warned PacifiCare that the insurer's pricing would rise if PacifiCare wanted to continue the "broad coverage" of the CHPL policy. PacifiCare elected to keep the broader coverage. Presumably, PacifiCare would have changed insurers or changed policies had Truck's agents and underwriters not dissuaded it through their assurances that this CHPL policy covered the type of risk at issue here.
b. The Personal Injury Liability Clause
Respondents' personal injury liability coverage obligates them " o pay on behalf of the insured all sums which the insured shall become legally obligated to pay as damages because of injury, sickness or disease, including death at any time resulting therefrom, sustained by any person." As with the professional liability coverage, respondents contend that the term "injury" refers exclusively to bodily or mental injury.
In light of our conclusion that the claims in the underlying lawsuits are at least potentially covered by the professional liability clause, we need not reach the question of whether coverage is also afforded by the personal injury clause.
3. Requests for Judicial Notice
The parties and amicus curiae California Healthcare Association produced a two-foot-high mountain of new evidence, offered for the first time on appeal, to prove the circumstances surrounding the creation of the CHPL policies in 1953 and the intentions of the original drafters. We decline to rely on this evidence because opinion evidence is generally inadmissible to interpret an insurance contract. (Chatton v. National Union Fire Ins. Co. (1992) 10 Cal.App.4th 846, 865.) Accordingly, the multiple requests for judicial notice and to take new evidence on appeal are denied.
CONCLUSION
The narrow and rather strained interpretation of the policies offered by respondents is not the only reasonable interpretation that can be made. (MacKinnon v. Truck Ins. Exchange (2003) 31 Cal.4th 635, 655.) The policies are ambiguous. It is not clear from the policies what, exactly, constitutes an "injury." However, an injury may include, but is "not limited to," bodily injury. Respondents seek to have us ignore the "not limited to" language in the definition of what constitutes an "injury" because that best serves their desire to avoid paying for a defense in the underlying lawsuits.
Given that respondents provided PacifiCare with professional liability coverage, and PacifiCare's profession is health care management, it should come as no surprise to respondents that PacifiCare is demanding a defense, now that it is being sued for failing to render the type of professional services it promised to its subscribers and providers. To limit the insurers' duty under the policies to instances where there is a bodily or mental injury makes little sense in light of PacifiCare's profession, where the type of health care service rendered by PacifiCare did not involve direct patient treatment.
Because policy coverage is interpreted broadly to afford the greatest possible protection to the insured (MacKinnon v. Truck Ins. Exchange, supra, 31 Cal.4th at p. 648), we shall not give this policy the narrow and self-serving interpretation offered by respondents. Accordingly, we conclude that respondents are obliged to provide PacifiCare with a defense in the underlying lawsuits.
DISPOSITION
The judgment is reversed. Respondents to bear all costs on appeal.
NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS.
We concur:
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