AAPL Landmark - Clinical Practice Liability Flashcards
Does sexual intercourse between psychiatrist and patient constitute malpractice?
Yes.
Roy v. Hartogs (1976).
Is the insurance carrier responsible for covering alleged malpractice involving sexual relationships between a physician and a patient?
Yes.
Aetna v. McCabe (1983).
Judge Shapiro held that an insurance company that had defended its insured in the underlying suit was not estopped from later raising an issue (intentionality) that it did not have the opportunity to raise in the first suit because raising that issue would have been adverse to the interests of the insured.
The Aetna opinion draws a clear distinction between issues that the insurer had an opportunity to raise earlier and those that it did not have an opportunity to raise, for Judge Shapiro held that the insurer was precluded from relitigating another issue (whether the tort “arose out of” the professional services of the insured physician) that it had an interest in raising in the underlying suit—Id. at 1351.
Does public policy prohibit insurance coverage of punitive damages based on medical malpractice?
No.
Mazza v. Medical Mutual of NC (1984). The NC SC said that Medical Mutual insurance contracts were interpreted to be broad enough to cover the punitive damages based on Dr. Huffaker’s medical negligence.
Did California’s third-party payer owe damages for harm caused by applying a cost-containment program that affected a treating doctor’s medical judgment?
No.
Wickline v. State (1986) held that the insurance company was not liable for Wickline’s injury following the denial because the physicians did not contest the denial of extra hospital days.
As a matter of law, are there triable issues of fact against an insurance company medical review if the attending physician did not appeal?
Yes.
Wilson v. Blue Cross of Southern California (1990). The California Court of Appeals said that Wickline did not apply because it did not involve an insurance contract but a state cost-containment program established by state law.
