Case Name: Deborah Descant, Wife of/and Leon J. DESCANT, Jr., Individually and as the Parents and Administrators of the Estate of Their Minor Child, Edith Marie Descant v. The ADMINISTRATORS OF the TULANE EDUCATIONAL FUND, d/b/a Tulane Medical Center Hospital and Clinic, Dr. Eduardo Herrera and Lexington Insurance Company
Court: Louisiana Supreme Court
Jurisdiction: Louisiana
Decision Date: 1994-07-05
Citations: 639 So. 2d 246
Docket Number: No. 93-C-3098
Parties: Deborah Descant, Wife of/and Leon J. DESCANT, Jr., Individually and as the Parents and Administrators of the Estate of Their Minor Child, Edith Marie Descant v. The ADMINISTRATORS OF the TULANE EDUCATIONAL FUND, d/b/a Tulane Medical Center Hospital and Clinic, Dr. Eduardo Herrera and Lexington Insurance Company.
Judges: LEMMON and ORTIQUE, JJ., dissent and assign reasons.
Reporter: Southern Reporter, Second Series
Volume: 639
Pages: 246–253

Head Matter:
Deborah Descant, Wife of/and Leon J. DESCANT, Jr., Individually and as the Parents and Administrators of the Estate of Their Minor Child, Edith Marie Descant v. The ADMINISTRATORS OF the TULANE EDUCATIONAL FUND, d/b/a Tulane Medical Center Hospital and Clinic, Dr. Eduardo Herrera and Lexington Insurance Company.
No. 93-C-3098.
Supreme Court of Louisiana.
July 5, 1994.
Rehearing Denied Sept. 15, 1994.
Lawrence S. Kullman, Victoria Vinturella Olson, Lewis & Kullman, New Orleans, for applicants.
Stewart Earl Niles, Jr., Michelle A. Bo-urque, Jones, Walker, Waechter, Poitevent, Carrere & Denegre, Michael D. Carbo, Denise Angele Bostick, Didriksen & Carbo, James D. Carriere, Habans, Bologna & Car-riere, New Orleans, for respondents.
Robert Gahagan Pugh, Jr., Shreveport, for LA Medical Mut. Ins. Co., amicus curiae.
William S. Pennick, Deborah Inchaustegu Schroeder, David Mark Whitaker,. New Orleans, for Ins. Corp. of America and American Continental Ins., amicus curiae.
Robert John Conrad, New Orleans, for Louisiana State Medical Soc., amicus curiae.
Charles Fenner Gay, Jr., Cristina Romig Wheat, New Orleans, for Alton Oehsner Clinic, amicus curiae.

Opinion:
I t MARCUS, Justice.
Deborah and Leon J. Descant, Jr. filed suit against Dr. Eduardo Herrera, The Administrators of the Tulane Educational Fund, d/b/a Tulane Medical Center Hospital and Clinic (Tulane), and Lexington Insurance Company (Lexington), Tulane's liability insurer, to recover damages for injuries sustained by their daughter during her birth on November 3, 1989. Tulane is a self-insured qualified health care provider under the Medical Malpractice Act, thus its liability is limited to $100,000 per claim. The Lexington policy insured Tulane against hospital professional liability incurred in excess of $1,000,000. Lexington filed exceptions of no cause of action and no right of action, 12which the trial court granted. The court of appeal affirmed. Upon plaintiffs' application, we granted certiorari to determine the correctness of that decision.
The narrow issue presented for our review is whether plaintiffs have a cause and/or right of action against a qualified health care provider's insurer for damages above the statutory limit, despite the fact that the health care provider is not liable for damages in excess of $100,000.
In 1975, the Louisiana Legislature enacted the Medical Malpractice Act in an effort to combat the rising costs of health care in this state. In part, the Act was designed to increase the likelihood that health care providers would carry malpractice insurance by regulating the total damage recovery of malpractice victims, thereby reducing insurance premiums. Butler v. Flint Goodrich Hospital, 607 So.2d 517 (La.1992), cert. denied sub nom., Butler v. Medley, — U.S.-, 113 S.Ct. 2338, 124 L.Ed.2d 249 (1993); Williams v. Kushner, 549 So.2d 294, 307-308 (La.1989) (Dixon, C.J., dissenting); Everett v. Goldman, 359 So.2d 1256, 1263 (La.1978). With this purpose in mind, we must determine if the regulatory scheme provided in the Act applies to the excess insurer of a qualified health care provider.
The Medical Malpractice Act limits the liability of each individual health care provider to $100,000. Further, the Act provides that as long as the health care provider remains qualified, the provider "and his insurer" are liable for malpractice only to the extent provided by the Act. La.R.S. 40:1299.45 A(1); Sewell v. Doctors Hospital, 600 So.2d 577, 578 (La.1992). In addition, La.R.S. 40:1299.42 B(l) limits the plaintiffs total recovery:
The total amount recoverable for all malpractice claims for injuries to or death of a patient, exclusive of future medical care and related benefits as provided in R.S. 40:1299.43, shall not exceed five hundred thousand dollars plus interest and cost.
The Act further provides that all amounts due plaintiff from a judgment or settlement which exceed the limitation of liability of the health care providers shall be paid by the Patient's Compensation Fund, however the "total amounts paid" shall not exceed $500,-000. La.R.S. 40:1299.42 B(3)(a) and (b). We find that the language limiting the plaintiffs recovery, and not just the health care provider's liability, supports a conclusion that the Act's liability limitation is available to the insurer.
Lexington was- joined as a party in this lawsuit pursuant to the Louisiana Direct Action statute, which provides:
The injured person . shall have a right of direct action against the insurer within the terms and limits of the policy; and, such action may be brought against the insurer alone, or against both the insured and insurer jointly and in solido....
La.R.S. 22:655 B(l). The statute further provides that it benefits "all injured persons . to whom the insured is liable" and declares that "it is the purpose of all liability policies to give protection and coverage to all insureds . for any legal liability said insured may have.... " La.R.S. 22:655 D (emphasis added). The direct action statute does not create an independent cause of action against the insurer, it merely grants a procedural right of action against the insurer where the plaintiff has a substantive cause of action against the insured. Dumas v. United States Fidelity & Guaranty Co., 241 La. 1096, 1117, 134 So.2d 45, 52 (1961); Ruiz v. Clancy, 182 La. 935, 950, 162 So. 738 (1935). Thus, there must be legal liability on the part of Tulane in order for Lexington to be liable. See Ruiz, 162 So. at 738.
We reject plaintiffs' contention that a health care provider remains legally liable for claims beyond the statutory limit of $100,-000. The Medical Malpractice Act declares that a qualified health care provider "is not liable" for amounts in excess of $100,000. La.R.S. 40:1299.42 B(2). This language is explicit and does more than merely limit the plaintiffs procedural right to sue the provider. There is a clear distinction between an immunity from liability and an immunity from suit. See Duree v. Maryland Casualty Co., 238 La. 166, 114 So.2d 594 (1959) (distinguishing between the state's immunity from liability and immunity from suit). An immunity from liability destroys the plaintiffs substantive cause of action against the immune party, whereas an immunity from suit merely restricts the plaintiffs right to sue the defendant. Therefore, because the Medical Malpractice Act restricts the health care provider's liability, there is no cause of action against Tulane beyond the statutory limit. Consequently, there is no cause of action against Lexington and the exceptions must be sustained.
However, even assuming that a cause of action does exist for a claim in excess of $100,000, we find that the statutory limitation of liability is a defense available to Lexington. The direct action statute provides that the insurer is solidarily liable with its insured. La.R.S. 22:655 B(l). Thus, Louisiana Civil Code article 1801 determines which defenses are available to the insurer:
IgA solidary obligor may raise against the obligee defenses that arise from the nature of the obligation, or that are per sonal to him, or that are common to all the solidary obligors. He may not raise a defense that is personal to another solidary obligor.
In determining which defenses are personal and thus cannot be raised by the insurer, Louisiana courts distinguish a cause of action from a right of action. Personal defenses bar "a right of action where a cause of action would otherwise have existed." Liberty Mutual Ins. Co. v. State Farm Mutual Automobile Ins. Co., 579 So.2d 1090, 1093 (La.App. 4th Cir.) (emphasis in original), writ denied, 586 So.2d 563 (La.1991). Personal defenses are granted to all members of a specific class and do not depend upon the nature of the accident. Edwards v. Royal Indemnity Co., 182 La. 171, 181, 161 So. 191, 195 (1935). For example, interspousal immunity applies to all married persons and prohibits all tort litigation between spouses during marriage. See La.R.S. 9:291.
The limitation of liability found in the Medical Malpractice Act differs from the traditional immunities which have been deemed personal defenses. First, the limitation does not automatically apply to all health care providers. A provider must first "qualify" for the benefit by showing proof of financial responsibility and by paying a surcharge. La.R.S. 40:1299.42 A. Second, the Act does not protect the provider from all acts of misconduct between the provider and his patients. It is only triggered by the negligent care and treatment of the patient. Were the provider to commit an intentional tort against his patient or negligently injure his patient in a manner unrelated to medical treatment, the limitation of liability would not be available. See Sewell, 600 So.2d at 577 (defects in hospital bed which resulted in injury to patient were not included in "malpractice" under the Medical Malpractice Act). Finally, as stated above, one of the | ¡purposes behind the liability limitation was the reduction in malpractice insurance rates. Thus, unlike many other immunities , the legislature contemplated that this Act would affect insurers. Consequently, we find that the limitation provided in the Medical Malpractice Act is not a personal defense, but rather one that arises from the nature of the obligation and can be raised by the insurer.
In sum, we find that the legislature intended the Medical Malpractice Act to benefit the insurers of qualified health care providers in light of its general purpose to reduce insurance rates. Further, we hold that since the Act eliminates the cause of action against Tulane for amounts in excess of $100,000, there is no remaining cause of action against Lexington and thus the direct action statute is unavailable to plaintiffs. Finally, even assuming that there is a cause of action against Tulane for claims above $100,000, and therefore against its insurer, Lexington can assert the limitation of liability of the Medical Malpractice Act as a defense to defeat plaintiffs right of action against it.
DECREE
For the reasons assigned, the judgment of the court of appeal is affirmed. All costs are assessed against the plaintiffs.
Pursuant to Rule IV, Part 2, § 3, Shortess, J., Court of Appeal, First Circuit, sitting in place of Justice James L. Dennis, was not on the panel which heard and decided this case.
.The Medical Malpractice Act provides a limitation of liability for health care providers who qualify under the Act. In order to qualify, La. R.S. 40:1299.42 A requires that a health care provider:
(1) Cause to be filed with the board proof of financial responsibility as provided by Subsection E of this Section.
(2) Pay the surcharge assessed by this Part on all health care providers according to R.S. 40:1299.44.
(3) For self-insureds, qualification shall be effective upon acceptance of proof of financial responsibility by and payment of the surcharge to the board....
. 627 So.2d 214 (La.App. 4th Cir.1993).
. 93-3098 (La. 3/18/94); 634 So.2d 843.
. La.R.S. 40:1299.41 et seq.
. La.R.S. 40:1299.42 B(2) provides:
A health care provider qualified under this Part is not liable for an amount in excess of one hundred thousand dollars plus interest thereon accruing after April 1, 1991, for all malpractice claims because of injuries to or death of any one patient.
.In addition, we note that La.R.S. 9:2793, which was passed the same year as the Medical Malpractice Act and provides immunity for "good Samaritans," specifically excludes insurers from its liability limitation. Thus, if the Legislature had intended to restrict the applicability of this statute to health care providers alone, it could have explicitly stated so.
. Louisiana courts have declared similarly worded statutes immunities from liability. See e.g., Castille v. Chaisson, 544 So.2d 670, 674 (La.App. 3d Cir.1989) (recreational use statutes). Cf. La. R.S. 9:291 (statute restricting spouses' ability "to sue" each other).
. The Louisiana Constitution of 1974 abrogated the state's immunity from liability and suit. See La. Const-, art. XII, § 10.
. Louisiana courts have held the following immunities to be personal to the insured and therefore unavailable to the insurer: interspousal immunity, parental immunity, governmental immunity, charitable immunity, minority, bankruptcy and insanity. See Danzy v. United States Fidelity & Guaranty Co., 380 So.2d 1356, 1359 n. 5 (La.1980).
. For example, interspousal and parental immunities were designed to prevent discord among family members. Therefore, the concerns at issue in these immunities are not implicated when an insurance company is involved, and thus the courts have refused to find these defenses available to the insurer. See Edwards, 161 So. at 193-94.
.In addition, plaintiffs argue that Tulane purchased this excess insurance policy for the benefit of its patients; therefore, public policy dictates that we find Lexington liable. However, Tulane sufficiently counters this assertion by advancing alternative reasons for obtaining the insurance policy in question, including: to shield itself from unlimited liability in the event the limitation was declared unconstitutional; to cover tort liabilities not included under the Act; and to guard against malpractice which may result in the injury of multiple persons.