Allstate Insurance Company v. Lerer, No. X03 Cv95 0502559s (Jan. 16, 2001)
Opinion of the Court
Factual and Procedural Background
By Complaint dated September 19, 1995 (the "Complaint"), Allstate alleged that it insured Joseph Claffey under an automobile policy which tied in with an excess policy, that on June 29, 1993, Claffey was admitted to New Britain General Hospital in a disoriented state following an automobile accident and became a patient of the defendant, Andre CT Page 1004 Lerer, M.D. Complaint ¶¶ 2-4. The Complaint further alleged that:
At all times herein mentioned, the defendant Lerer was required in the treatment of patients to exercise and use that degree of skill, leaning, and care ordinarily used and prevailing under the same or similar circumstances by members of his profession. Complaint ¶ 5.
The Complaint further alleged that Lerer's negligent care of Claffey caused Claffey to injure Adam Wozniak. On December 7, 1993 Adam Wozniak, through his mother, Zophia Wozniak brought suit against Claffey, and thereafter Allstate paid $1,100,000 to the Wozniaks in settlement of that action "the sum equal to the available amount of coverage under the plaintiff's insurance policy to Claffey," Complaint ¶¶ 14, 16, and 20. Paragraph 21 of the Complaint alleges:
Pursuant to the Allstate automobile insurance policy with policy number issued to Claffey and an assignment from Claffey, the plaintiff is the assignee and equitable and bona fide owner of Claffey's action for all monies disbursed to Zofia Wozniak on behalf of Adam Wozniak.
Allstate made the $1,100,000 settlement payment in response to an Offer of Judgment in that amount which was filed on behalf of the plaintiff, Adam Wozniak, in the case against Claffey. Neither Claffey, nor Allstate had ever moved to make Dr. Lerer or Neurological Associates P.C. a party to that action. However, prior to making the settlement payment Allstate sent Dr. Lerer a letter which advised that Dr. Lerer might have violated the applicable standard of care with respect to his medical treatment of Claffey and that that violation might have caused "the incident." The letter further stated:
[Y]ou are hereby further put on notice that if you believe that the figure to resolve this case, at this time, is not reasonable, you should immediately provide us with reasonable reasons as to why not.
The automobile insurance policy covering Claffey provided that coverage did not apply to liability for "bodily injury or property damage caused intentionally by . . . an insured person." Automobile Policy at p. 6. The Umbrella Policy provided:
Exclusions — Losses We Do Not Cover CT Page 1005
This policy will not apply:
8. to bodily injury or property damage resulting from: a) an act or omission intended or expected to cause bodily injury or property damage. This exclusion applies even if the bodily injury or property damage is of a different kind or degree, or is sustained by a different person or property than that intended or expected, or b) an act or omission committed by an insured while insane, or while lacking the mental capacity or control of his or her conduct, or while unable to form any intent to cause bodily injury or property damage. This applies only if a reasonable person would expect some bodily injury or property damage to result from the act or omission.
9. to bodily injury or property damage resulting from: a) a criminal act or omission, or b) an act or omission which is criminal in nature and committed by an insured who lacked the mental capacity to appreciate the criminal nature or wrongfulness of the act or omission, or to conform his or her conduct to the requirements of the law, or to form the necessary intent under the law.
This exclusion applies regardless of whether the insured is actually charged with or convicted or a crime. Umbrella Policy at p. 6.
The Police Report concerning the incident involving Claffey's driving his vehicle into the Wozniak family indicates the following: While in custody following the accident Claffey admitted to police officers that he was looking for an individual to intentionally injure. Claffey stated that "the people on Kenyon Circle were the wrong ones, I drove past them and turned around and deliberately ran them over." During the Criminal trial against Claffey Judge Corrigan found that Claffey "intended to drive his automobile into the respective people, Mrs. Wozniak and her three children." Judge Corrigan also found that "the defendant, at the time he committed the offenses indicated, lacked substantial capacity as a result of the mental disease or defect to appreciate the wrongfulness of his conduct in order to control his conduct within the requirements of the law." The court found Claffey not guilty by reason of mental disease or defect and ordered Claffey committed to the custody of the Commissioner of Mental Health. Transcript of trial from State ofConnecticut v. Joseph Claffey, CR-93-0142598, CR-93-0142499, Superior CT Page 1006 Court, Judicial District of Hartford/New Britain at Hartford, October 19, 1994, pp. 39, 40.
Discussion of Law and Ruling
Practice Book §
Summary judgment should only be granted if the pleadings, affidavits and other proof submitted demonstrate that there is no genuine issue as to any material fact. Scinto v. Stain,
Contribution Among Joint Tortfeasors
Joint tortfeasors are "two or more persons who are liable to the same person for the same harm. It is not necessary that they act in concert or in pursuance of a common design, nor is it necessary that they be joined as defendants." Gionfriddo v. Gartenhaus Cafe,
Connecticut General Statutes §
(a) A defendant in any civil action to which section
52-572h applies may serve a writ, summons and complaint upon a person not a party to the action who is or may be liable pursuant to said section for a proportionate share of the plaintiff's damages in which case the demand for relief shall seek an apportionment of liability. Any such writ, summons and complaint, hereinafter called the apportionment complaint, shall be served within one hundred twenty days of the return date specified in the plaintiff's original complaint.
Joinder of parties for apportionment purposes pursuant to §
It is Allstate's position that the defendants in this case are liable for some or all of the damages sustained by Adam Wozniak. Allstate claims that this subrogation action has been brought in part pursuant to a provision of Claffey's Automobile Policy which provided that "if we ask, the insured person must also help us to obtain payment from anyone who may be jointly responsible." See Plaintiff's Objection to Summary Judgment at p. 18. In addition, in attempting to refute the defendants' argument that this action is a personal injury action, Allstate has admitted that its action on behalf of Claffey in this case is for a portion of the economic damage sustained by Adam Wozniak. See Plaintiff's Objection to Summary Judgment at p. 13. CT Page 1008
Allstate's implies that it was not required to comply with §
An insurer can take nothing by subrogation but the rights of its insured, and is subrogated to only such rights as the insured possesses.Orselet v. DeMatteo,
Courts in other jurisdictions have held that the common law prohibition against contribution among joint tortfeasors bars a subrogation action by an insurer against one who is a joint tortfeasor with its insured.Florida Patient's Compensation Fund v. St. Paul Fire and Marine InsuranceCompany,
In Employers Mutual Liability, a wrongful death action was brought against two defendants. After settlement of the wrongful death action by one defendant, the insurer of the settled defendant was substituted as third party plaintiff against the second defendant. The Appellate Court affirmed the trial court's grant of summary judgment in favor of the second defendant on the basis that no right of contribution exists between joint tortfeasors.
In a medical malpractice action against two doctors, after the insurer for one of the doctors settled, it brought a subrogation action against the second doctor. Like Connecticut, Florida does not allow contribution among joint tortfeasors, except under the terms of Section
Relying on Skuzinski v. Bouchard Fuels, Inc.,
Ordinarily there is no right of indemnity or contribution between joint tort-feasors. . . . Where, however, one of the defendants is in control of the situation and his negligence alone is the direct immediate cause of the injury and the other defendant does not know of the fault, has no reason to anticipate it and may reasonably rely upon the former not to commit a wrong, it is only justice that the former should bear the burden of damages due to the injury. . . . Under the circumstances described, we have distinguished between `active or primary negligence,' and `passive or secondary negligence.' . . . Indemnity shifts the impact of liability from passive joint tortfeasors to active ones." (Citations omitted; internal quotation marks omitted.) Kyrtatas v. Stop Shop, Inc.,
205 Conn. 694 ,697-98 ,535 A.2d 357 (1988); Burkert v. Petrol Plus of Naugatuck, Inc.,216 Conn. 65 ,74 ,579 A.2d 26 (1990); Kaplan v. Merberg Wrecking Corp.,152 Conn. 405 ,412-16 ,207 A.2d 732 (1965).
The Court in Kyrtatas v. Stop Shop, Inc., supra, at 700, explained that the indemnification "doctrine arose in response to the common law prohibition against contribution, and applies only in situations in which a passive joint tortfeasor has no actual responsibility for a tort." Emphasis added. Claffey was clearly not a passive joint tortfeasor to which the passive-active indemnification rule applies. But regardless of whether Claffey's conduct is characterized as active or passive, no tortfeasor should be permitted to circumvent the apportionment and joinder provisions of §§
In the cases where the claim of indemnification versus contribution has been raised it has been raised in the context of an action in which parties have been joined pursuant to
Contractual Subrogation
Allstate has brought this claim "pursuant to the Allstate Automobile policy with policy number issued to Claffey . . . for all monies disbursed to Zofia Wozniak on behalf of Adam Wozniak." Complaint ¶ 21. However that policy contains no provision which permits Allstate to bring a subrogation action under the circumstances involved in this case.
Part I of the policy entitled "Automobile Liability Insurance" provides that: "Allstate will pay for all damages an insured person is legally obligated to pay because of bodily injury or property damages . . ." However, Part I contains no subrogation provision. Other parts of the Insurance Policy contain subrogation provisions, but those provision do not apply to payments made by Allstate to third parties such as Adam Wozniak.
Equitable Subrogation
Even though the policy between Claffey and Allstate does not provide for subrogation of the claim against the defendants, Allstate might still have a right to equitable subrogation if its actions fit within the requirements of equitable subrogation set forth in Westchester Fire Ins.Co. v. Allstate Ins. Co.,
[The] Oklahoma Supreme Court, in Aetna Casualty CT Page 1011 Surety Co. v. Associates Transports, Inc.,
Allstate's subrogation claim in this case is distinguishable from that allowed under Westchester for a number of reasons. First, in Westchester the insurer was standing in the shoes of its insured asserting the insured's claim against the uninsured tortfeasor. In this case Allstate has made payment to Zophia and Adam Wozniak and is really attempting to stand in their shoes and recover for injuries they sustained as a result of the defendants' alleged negligence. However, the Wozniaks are standing in their own shoes. They have brought an action against the defendants,Adam Wozniak v. New Britain General Hospital, et al, No. X03 CV95 0502560S, presently pending in this court before the undersigned.
The next distinction is that Allstate has paid the amounts it now seeks to recover as a volunteer. The prohibition against equitable subrogation by an insurer who is a volunteer has been widely recognized. See Couch on Insurance § 61:52. "[T]he payment must have been made under compulsion, or for the protection of interest of the person making it in discharge of an existing liability which must be fully satisfied. Hence, an insurer which pays a loss for which it is not liable thereby becomes a mere volunteer, and is not entitled to subrogation . . ." Id. The insurance company will be regarded as a volunteer when it pays a claim CT Page 1012 not covered under the terms of the policy. Commercial Union InsuranceCo. v. Postin,
In this case it is undisputed that the acts of Claffey for which Allstate paid under the policy were intentional or criminal. The policies at issue explicitly exclude coverage for intentional acts or criminal acts or acts criminal in nature by an insured who lacked the mental capacity to appreciate the criminal nature of those acts.
"It is axiomatic, in the tort lexicon, that intentional conduct and negligent conduct, although differing only by a matter of degree,Mingachos v. CBS, Inc.,
It is not disputed that at Claffey's criminal trial the court found that Claffey "intended to drive his automobile into the respective people, Mrs. Wozniak and her three children." Transcript of trial fromState of Connecticut v. Joseph Claffey, CR-93-0142598, CR-93-0142499, Superior Court, Judicial District of Hartford/New Britain at Hartford, October 19, 1994, p. 38. The court found that Claffey "did intend to cause death, which under the circumstances as he believed them to be was a substantial step in a course of conduct planned to culminate in the causing of their deaths, as he admitted to Officer Joseph Rizzo." Id. at p. 39.
There is abundant evidence that the conduct in this case was not accidental, but was intentional and that the acts of Claffey were CT Page 1013 criminal acts or acts of a criminal nature where the insured lacked the mental capacity to appreciate the criminal nature or wrongfulness of the acts. The foregoing type of conduct was not covered by the insurance policies between Claffey and Allstate.
Allstate relies on Home Insurance Co. v. Aetna Life Casualty,
In Nationwide Mutual Insurance Co. v. Weeks-Allen Motor Co.,
The legal posture of the insurer in Westchester is different from that of Allstate here because the insurer in Westchester was clearly not a volunteer. There was no dispute in Westchester that the insurer was obligated to pay its insured for losses the insured sustained as a result of the undisputed primary negligence of the uninsured tortfeasor. Therefore, the insurer did not make payment as a volunteer. In this case there is a significant dispute as to whether the Allstate was obligated to make payment to third parties for their injuries. Therefore, for the purpose of determining its entitlement to make a claim for equitable subrogation, Allstate made payments under the policies here as a CT Page 1014 volunteer.
A third distinction between the present case and Westchester is that in this case there is a significant question as to where the primary fault lies for the injuries sustained in the incident. Equitable subrogation is founded in part upon the need to prevent injustice by allowing an insurer who has paid for injuries suffered by its insured to recover that payment from the person who caused those injuries. The Court in Westchester stated:
Upon such payment, the insurer became subrogated to any rights that its insured might have had against the party who had caused the loss. The tortfeasor, who was the party primarily liable for the losses sustained by the insured, benefited by the insurer's payment of a debt truly owed by the tortfeasor. We see no logical reason to permit a tortfeasor to be unjustly enriched by virtue of having its debt paid by the insurance company of a party who had the foresight to obtain insurance coverage, and thus to escape all liability for its wrongdoing, simply because the insurance company was not permitted to participate in a suit against the tortfeasor in order to recover the money that it had paid to its insured but which was properly payable by the tortfeasor.
236 Conn. At 372-373.
Have the defendants in this case enjoyed the "insurer's payment of a debt [that they] truly owed?" Based on the finding of the criminal court as to Claffey's intentional conduct, it appears more accurate to say that Allstate has paid for a debt that Claffey clearly owed. Allstate's position in this suit is that the defendants' negligence is the primary cause of Claffey's intentional conduct. For the purposes of deciding whether Allstate has the same rights to equitable subrogation as those recognized in Westchester, it is not necessary to determine where the ultimate fault lies. The crucial distinction between the present case andWestchester is that in Westchester there was no dispute as to the party responsible for the injuries involved. Here there is a significant dispute. Therefore, there is certainly no undisputed unjust enrichment of the defendants here as there was in Westchester.
The Westchester court also talked about the tortfeasor's escaping liability "simply because the insurance company was not permitted to participate in a suit against the tortfeasor." But in this case the insurance company could easily have participated in a suit against the CT Page 1015 defendants by acting through their insured to join the defendants as parties pursuant to §
Assignment of Medical Malpractice Action Against Public Policy
An additional basis for granting the defendants' Motion for Summary Judgment here is that the assignment by Claffey to Allstate violated the longstanding public policy against assigning personal injury actions.Dodd v. Middlesex Mutual Assurance Company,
The "Assignment of Claim" under which Allstate proceeds provides:
I, Joseph Claffey, was an insured on an Allstate Insurance Company Policy No. 019166353 on September 25, 1993. I was involved in an automobile collision where several individuals were injured including Adam Wozniak. I was sued by the family of Adam Wozniak and Allstate Insurance Company defended and paid said claim pursuant to the contract of insurance. In recognition of these monies paid on my behalf, I assign, subrogate and transfer unto Allstate Insurance Company, its successors and assigns, a claim I have or may have against Andre Leher[sic], M.D. as a result of his medical treatment of me for any and all sums paid on my behalf in resolution of the Wozniak claim.
IN WITNESS WHEREOF, the undersigned has caused his instrument to be executed this 19 day of September, 1995
Under common law a cause of action for personal injuries cannot be assigned, and in the absence of a statutory provision to the contrary a right of action for personal injuries resulting from negligence is not assignable before judgment. 6 Am.Jur.2d 220, Assignments, § 37. The rule is succinctly stated in the Restatement, 2 Contracts § 547(1)(d): "An assignment of a claim against a third person or a bargain to assign such a claim is illegal and ineffective if the claim is for . . . (d) damages for an injury the gist of which is to the person rather than to property, unless the claim has been reduced to judgment.' The annotation, `Assignability of claim for personal injury or death,' 40 A.L.R.2d 500, 502 § 3, has noted: `It seems that few CT Page 1016 legal principles are as well settled, and as universally agreed upon, as the rule that the common law does not permit assignments of causes of action to recover for personal injuries.' See cases therein cited. The rule was early recognized in Connecticut. See Whitaker v. Gavit,
As set forth above, the reality of Allstate's position here is that it is attempting to recover damages it paid to a third party, Adam Wozniak, from alleged joint tortfeasors, the defendants. However, Allstate itself has chosen to characterize this case as one in which it seeks to recover damages suffered by Claffey. Allstate does not deny that this is a medical malpractice action. Clearly it cannot. It filed a good faith certificate required under §
A claim for medical malpractice is a claim to recover damages resulting from personal injury as the result of the alleged negligence of a health care provider. See, e.g. Connecticut General Statutes §
A number of other jurisdictions also adhere to the rule against assignment of personal injury actions. See e.g. White v. Auto ClubInter-Insurance,
No case law in any jurisdiction supports the plaintiff's position that an assignment of a medical malpractice action is valid. In PatientsCompensation Fund v. St. Paul Fire and Marine Insurance Co.,
In conclusion, Allstate cannot maintain this action because this action is really an attempt to seek contribution from joint tortfeasors without complying with the laws governing joinder of parties and apportionment. In addition, there is no right of subrogation stated in the policies under which Allstate made payment and no right of equitable subrogation. Finally Allstate has brought this suit pursuant to the assignment of a personal injury action which is prohibited under the law of this state. For the foregoing reasons, the Motion for Summary Judgment is granted.
By the court
Aurigemma, J.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.