Title: Mobile Infirmary Association v. Quest Diagnostics Clinical Laboratories, Inc.
Citation: N/A
Docket Number: 2022-0641
State: Alabama
Issuer: Alabama Supreme Court
Date: February 24, 2023

Rel: February 24, 2023 
 
 
 
 
 
 
 
Notice: This opinion is subject to formal revision before publication in the advance sheets of Southern 
Reporter.  Readers are requested to notify the Reporter of Decisions, Alabama Appellate Courts, 
300 Dexter Avenue, Montgomery, Alabama 36104-3741 ((334) 229-0650), of any typographical or other 
errors, in order that corrections may be made before the opinion is printed in Southern Reporter. 
 
 
SUPREME COURT OF ALABAMA 
 
OCTOBER TERM, 2022-2023 
 
_________________________ 
 
SC-2022-0641 
_________________________ 
 
Mobile Infirmary Association d/b/a Mobile Infirmary Medical 
Center  
 
v.  
 
Quest Diagnostics Clinical Laboratories, Inc. 
 
 
 
Appeal from Mobile Circuit Court 
(CV-17-900403) 
 
SHAW, Justice. 
 
Mobile Infirmary Association d/b/a Mobile Infirmary Medical 
SC-2022-0641 
2 
 
Center ("Mobile Infirmary"), the plaintiff seeking contractual indemnity 
in the action below, appeals the Mobile Circuit Court's summary 
judgment in favor of the defendant below, Quest Diagnostics Clinical 
Laboratories, Inc. ("Quest"). We affirm. 
Facts and Procedural History 
On March 17, 2014, Quest and Mobile Infirmary entered into a 
Laboratory Management Agreement ("the LMA"), in which Quest agreed 
to manage Mobile Infirmary's onsite clinical laboratory facilities and to 
provide clinical testing services used by Mobile Infirmary's medical staff 
to diagnose and treat patients. The LMA also contained indemnity 
provisions.  Specifically, Section 8.1 of the LMA stated, in pertinent part: 
"Quest Diagnostics hereby agrees to indemnify, defend and 
hold [Mobile Infirmary], and [Mobile Infirmary's] officers, 
directors, employees and agents (collectively, the 'Lab 
Indemnitees'), harmless from and against any and all 
liability, losses, damages, claims or causes of action ('Claims'), 
and expenses connected therewith, including reasonable 
attorneys' fees, that are caused by or a result of (i) any 
negligent or intentional act, error or omission by Quest 
Diagnostics, 
its 
employees, 
agents, 
servants 
or 
representatives with respect to its responsibilities and/or the 
performance of Services hereunder, to the extent such Claim 
does not arise from an act or omission or cause for which 
[Mobile Infirmary] is required to provide indemnity pursuant 
to Section 8.2 below … [or] (v) any personal injury (including 
death) or property damage caused by or arising from the 
negligence, acts or omissions of Quest Diagnostics or any 
SC-2022-0641 
3 
 
employee or agent of Quest Diagnostics …." 
 
Section 8.2 of the LMA addressed Mobile Infirmary's indemnity 
obligations:  
"[Mobile Infirmary] hereby agrees to indemnify, defend and 
hold Quest Diagnostics and Quest Diagnostics Affiliates, 
officers, directors, employees and agents (collectively, the 
'Quest Indemnitees') harmless from and against any and all 
Claims, and expenses connected therewith, including 
reasonable attorneys' fees, (i) directly caused by or as a result 
of any negligent or intentional act, error or omission by 
[Mobile 
Infirmary], 
its 
employees, 
agents, 
servants, 
contractors 
or 
representatives 
with 
respect 
to 
its 
responsibilities hereunder, to the extent such Claim does not 
arise from an act or omission or cause for which Quest 
Diagnostics is required to provide indemnity pursuant to 
Section 8.1 above … [or] (v) any personal injury (including 
death) or property damage caused by or arising from the 
negligence, acts or omissions of [Mobile Infirmary] or any 
employee or agent of [Mobile Infirmary] …." 
 
On March 13, 2015, James A. Ward went to Mobile Infirmary's 
emergency room after suffering weakness, dizziness, loss of fluids, a mild 
cough, and severe body aches. While there, he was diagnosed with the 
flu, and he was later discharged with a prescription for medication. Two 
days later, Ward's symptoms worsened, and he returned to the 
emergency room.  Ward was eventually diagnosed with diabetic 
ketoacidosis.  
When his condition did not improve, Ward was moved into the 
SC-2022-0641 
4 
 
intensive-care unit, at which point his doctor ordered him to undergo 
glucose finger-sticks and a basic metabolic panel every four hours to help 
monitor his serum glucose, kidney function, acid/base status, and 
electrolytes. According to Mobile Infirmary, those basic metabolic panels 
were supposed to be performed by Quest, but they were allegedly 
canceled by one of Quest's employees. 
Over the next several hours, Ward developed cardiac dysfunction 
and lost consciousness. At some point, he suffered an "anoxic brain 
injury" and later died "as a result of multisystem organ failure secondary 
to severe sepsis and septic shock."  
In 2017, Ingrid Mia Ward ("Mia"), Ward's wife and the personal 
representative of his estate, commenced a wrongful-death action against 
Mobile Infirmary and other defendants, including Mobile Infirmary's 
doctors and nurses who were responsible for Ward's treatment and care. 
Mia alleged that the defendant medical-care providers had breached the 
standard of care in several ways, including by "failing to obtain serial 
basic metabolic panels every four hours" and by "failing to properly 
monitor and report Mr. Ward's blood glucose levels on an hourly basis." 
She also alleged that Mobile Infirmary was vicariously liable for those 
SC-2022-0641 
5 
 
who "undertook to and did provide medical, diagnostic, nursing, 
technical, and/or other health care services and treatment to [Ward]." 
According to Mia, her husband died as a proximate result of the acts or 
omissions of Mobile Infirmary and its staff in failing to properly diagnose 
and treat his condition. 
Quest was not named as a party to Mia's action. Mobile Infirmary 
informed Quest of the action and, as the case progressed, apprised Quest 
of the status of the proceedings, including its negotiations with Mia for 
potential settlement of the lawsuit.  Mia and Mobile Infirmary ultimately 
settled the wrongful-death action.  Before Mia's claims against Mobile 
Infirmary were dismissed pursuant to a joint motion of those parties, 
Mobile Infirmary filed a third-party complaint against Quest in which it 
sought contractual and equitable indemnity related to its defense and 
settlement of Mia's action.  Quest filed a motion to dismiss, which the 
trial court granted in part by dismissing Mobile Infirmary's equitable-
indemnity claim. 
Mobile Infirmary later amended its complaint to more specifically 
state its remaining claim of contractual indemnity against Quest. Mobile 
Infirmary alleged:  
SC-2022-0641 
6 
 
"4. The claims of [Mia] against Mobile Infirmary in this 
action were caused by and/or resulted from negligent acts, 
errors or omissions of Quest in its responsibilities under the 
[LMA] and/or the performance of services under [the LMA], 
and said claims did not arise from an act or omission or cause 
for which Mobile Infirmary is required to provide indemnity 
to Quest pursuant to Section 8.2 of the [LMA]. Such negligent 
acts, errors or omissions included the following: 
 
"a. Quest's failure to timely collect, test, 
diagnose and/or report the results of blood work 
ordered by doctors and other healthcare providers 
in connection with the care and treatment of the 
… Decedent, James Ward, on a timely basis, in 
breach of its duties under the [LMA] …. 
 
"b. Quest's unwarranted delay in collecting, 
testing, diagnosing and/or reporting the results of 
blood work ordered by physicians and other 
healthcare providers in connection with the care 
and treatment of … James Ward, in breach of its 
duties under the [LMA] …. 
 
"c. Quest's cancellation of physicians' and 
other healthcare providers' orders for blood work 
needed in the care and treatment of [Mia's] 
Decedent, James Ward, in breach of its duties 
under the [LMA] …. 
 
"5. As a proximate result of the aforesaid negligence, the 
physicians and other healthcare providers attending Mr. 
Ward lacked the information necessary to appropriately 
monitor and assess his condition on a timely basis and to 
administer the appropriate amounts of insulin and IV fluids, 
and take other action, in accordance with his on-going 
condition and, as a proximate result thereof, Mr. Ward died." 
 
 
Quest later served Mobile Infirmary with a set of requests for 
SC-2022-0641 
7 
 
admissions, to which Mobile Infirmary provided the following responses: 
"1. Admit that there were allegations of negligence in 
the Third Amended Complaint filed by Mia Ward, as personal 
representative of the Estate of James Ward, against Mobile 
Infirmary Medical Center that did not relate to the laboratory 
services provided by Quest Diagnostics pursuant to the [LMA] 
(hereinafter the 'non-lab allegations.'). 
 
"RESPONSE: Admitted. 
 
"2. Admit that the death of James A. Ward was caused, 
in part, by the negligence of Mobile Infirmary Medical Center. 
 
"RESPONSE: Admitted. 
 
"3. Admit that the death of James A. Ward was caused, 
in part, by the negligence of Mobile Infirmary Medical for non-
lab allegations. 
 
"RESPONSE: Denied. 
 
"4. Admit that the death of James A. Ward was caused, 
in part, by the negligence of Mobile Infirmary Medical Center 
within the meaning of Section 8.2 of the [LMA] between Quest 
Diagnostics and Mobile Infirmary Medical Center dated 
March 17, 2014. 
 
"RESPONSE: Admitted. 
 
"5. Admit that Mobile Infirmary Medical Center is solely 
seeking indemnification in this matter from Quest for monies 
it spent in defending itself and for the confidential settlement 
with the Estate of James A. Ward. 
 
"RESPONSE: Admitted. 
 
"6. Admit that Mobile Infirmary Medical Center 
SC-2022-0641 
8 
 
incurred legal defenses expenses in defending its conduct for 
those non-lab allegations referenced in Requests for 
Admission Nos. 1 and 3. 
 
"RESPONSE: Admitted. 
 
"7. Admit that Mobile Infirmary Medical Center settled 
the lawsuit filed by Mia Ward, as personal representative of 
the Estate of James A. Ward, based in part on allegations of 
Mobile Infirmary Medical Center's own negligent conduct in 
the care of James A. Ward. 
 
"RESPONSE: Admitted. 
 
"8. Admit that Mobile Infirmary Medical Center settled 
the lawsuit filed by Mia Ward, as personal representative of 
the Estate of James Ward, while claims based on allegations 
of Mobile Infirmary Medical Center's own negligent conduct 
were still pending. 
 
"RESPONSE: Admitted." 
 
   
Quest filed a motion for a summary judgment in which it argued in 
its supporting brief that Mobile Infirmary's contractual-indemnity claim 
failed as a matter of law. Relying on Mobile Infirmary's responses to its 
requests for admissions, Quest argued that because Mobile Infirmary's 
own negligence was at least a partial cause of Ward's death and because 
the parties had not agreed under either Sections 8.1 or 8.2 in the LMA to 
indemnify each other against losses caused by the indemnitee's own 
negligence, it was not required to indemnify Mobile Infirmary for the 
SC-2022-0641 
9 
 
settlement of Mia's action.  Quest further argued that, absent clear and 
unequivocal language to the contrary, any argument by Mobile Infirmary 
that the reciprocal indemnity provisions found in Sections 8.1 and 8.2 of 
the LMA allowing each party to recover indemnification for the other's 
negligence also permitted partial indemnification based on the 
proportionate fault of the indemnitor was meritless.  
In response to Quest's motion, Mobile Infirmary filed a cross-motion 
for a summary judgment in which it argued that, under the LMA and 
upon proof that Quest's negligent acts or omissions in the performance of 
its duties under the LMA caused Ward's death, it was entitled to full 
indemnification from Quest.  In the alternative, Mobile Infirmary argued 
that it was entitled to indemnification for the portion of its losses that 
were attributable to Quest's negligence under a comparative-fault 
analysis.  
 
After a hearing, the trial court entered a summary judgment in 
favor of Quest and denied Mobile Infirmary's cross-motion for a summary 
judgment. In its judgment, the trial court explained:  
"At this stage, the Parties have not conducted discovery 
on [Mobile Infirmary's] allegations of negligence against 
Quest. However, this Court does not need such evidence or 
lack thereof to rule on the pending motions. Rather, given the 
SC-2022-0641 
10 
 
foregoing indemnity provisions and [Mobile Infirmary's] 
admission of negligence, there are two threshold legal 
questions for this Court to decide at this juncture: 
 
"(1) Is [Mobile Infirmary] precluded from 
seeking contractual indemnity from Quest when 
its own independent negligence contributed to the 
death of Mr. Ward?; and 
 
"(2) Whether the indemnity provisions in 
Sections 8.1 and 8.2 are ambiguous, and if so, 
whether an agreement was reached as to 
comparative fault analysis despite the ambiguity? 
 
"As discussed below, the Court concludes the answer to 
the first question to be 'Yes', and thus [Mobile Infirmary] 
cannot recover here. The Court further concludes that the 
provisions are by [Mobile Infirmary's] own admission 
ambiguous and as such, the parties did not 'knowingly, 
clearly, and unequivocally' enter into a comparative fault 
indemnification contract. For either of these reasons, 
summary judgment on behalf of Quest is due to be granted." 
 
In support of its conclusions, the trial court explained: 
"Section 8.2 of the LMA provides the various scenarios 
in which [Mobile Infirmary] must indemnify, defend, and hold 
Quest harmless from and against any and all liability, losses, 
damages, claims or causes of action. Specifically, Section 
8.2(v) requires [Mobile Infirmary] to defend, indemnify, and 
hold Quest harmless against a death 'caused by or arising 
from the negligence, acts or omissions of [Mobile Infirmary] 
or any employee or agent of [Mobile Infirmary].' Based on 
[Mobile Infirmary's] admission that the death of Mr. Ward 
was indeed caused, in part, by the negligence of Mobile 
Infirmary, the Court concludes that Section 8.2(v) is 
triggered. 
 
SC-2022-0641 
11 
 
"The triggering of [Section] 8.2(v) is sufficient to end the 
Court's inquiry and dictates that Quest is entitled to 
summary judgment on [Mobile Infirmary's] third-party claim. 
Because Section 8.2(v) requires [Mobile Infirmary] to hold 
Quest harmless when [Mobile Infirmary] is negligent, [Mobile 
Infirmary] cannot advance a third-party claim against Quest 
while simultaneously conceding it [(Mobile Infirmary)] was 
negligent. Put another way, Section 8.2(v) imposes a duty on 
[Mobile Infirmary] to hold Quest harmless when [Mobile 
Infirmary] or its employees are negligent -- and there is no 
question they were negligent in this case. [Mobile Infirmary's] 
attempt here to recover damages from Quest while also 
admitting negligence defies the hold harmless nature of 
Section 8.2(v). [Mobile-Infirmary's] Third-Party Complaint is 
doing the opposite of holding Quest harmless. Accordingly, 
the Court need not look any further to determine that Quest 
does not owe [Mobile Infirmary] contractual indemnity in this 
case, and the Court's inquiry can end here. 
 
"[Mobile Infirmary] is essentially seeking indemnity 
from Quest for [Mobile Infirmary's] own negligence -- or at 
least in part for [Mobile Infirmary's] own negligence. See 
[Mobile Infirmary's] responses to Quest's Requests for 
Admission …. The Alabama Supreme Court has addressed 
the standard of review of agreements by one party to 
indemnify 
for 
another's 
wrongful 
conduct, 
stating: 
'Agreements by which one party agrees to indemnify [the 
other] for the consequences of the other's acts or omissions are 
carefully scrutinized .… An agreement by one person to 
indemnify the [other] for the other's negligence is enforceable 
only if the indemnity provisions are unambiguous and 
unequivocal.' Royal Ins. Co. v. Whitaker Contr. Corp., 824 So. 
2d 747, 752 (Ala. 2002), quoting Industrial Tile, Inc. v. 
Stewart, 388 So. 2d 171 (Ala. 1980).  
 
"Quest further contends that the competing indemnity 
provisions of [Sections] 8.1(i) and 8.2(i) cancel each other out 
when there is mutual negligence. Quest argues that [Section] 
SC-2022-0641 
12 
 
8.1(i) cannot be analyzed in a vacuum: if [Mobile Infirmary] is 
negligent -- as conceded in this case -- [Section] 8.2(i) must be 
read in conjunction with [Section] 8.1(i). The Court finds that 
when read together, [Sections] 8.1(i) and 8.2(i) establish that 
Quest and [Mobile Infirmary] agreed to indemnify the other 
for their own sole fault when the other is not also at fault. 
Under these circumstances, [Section] 8.2(i) is triggered 
because [Mobile Infirmary] has already admitted its own 
independent negligence. Thus, Quest cannot owe indemnity 
to [Mobile Infirmary] under [Section] 8.1(i), and the Court's 
inquiry could also end here. 
 
"In contrast, [Mobile Infirmary] wants the Court to 
interpret [Section] 8.1(i) independent of [Sections] 8.2(i) and 
8.2(v), and find that three (3) words, 'to the extent,' provides 
the framework for a comparative fault trial where [Mobile 
Infirmary] can ultimately recover partial indemnity from 
Quest in proportion to the Parties' respective comparative 
fault to the Estate of Mr. Ward. The Supreme Court of 
Alabama requires this Trial Court to find that any such 
purported agreement between [Mobile Infirmary] and Quest 
is clear and unequivocal with an agreed-upon formula for it to 
order a comparative fault trial. Holcim (US), Inc. v. Ohio Cas. 
Inc. Co., 38 So. 3d 722, 728 (Ala. 2009) (determining that 'if 
two parties knowingly, clearly, and unequivocally enter into 
an agreement whereby they agree that the respective liability 
of the parties will be determined by some type of agreed-upon 
formula, then Alabama law will permit the enforcement of 
that agreement as written'). Here, [Mobile Infirmary] and 
Quest did not 'knowingly, clearly, and unequivocally' craft 
Section 8.1(i) to create a comparative fault indemnification 
contract. This is further supported by the fact that Section 
8.1(i) lacks 'an agreed-upon formula' for a comparative fault 
trial. 
 
"Finally, the Court notes that under no circumstances 
should it grant [Mobile Infirmary's] Cross-Motion for Partial 
Summary Judgment against Quest because neither Party 
SC-2022-0641 
13 
 
suggest the record establishes negligence by Quest or 
proximate cause against Quest. The plain language of the 
agreement does not allow for [Mobile Infirmary] to recover 
against Quest for [Mobile Infirmary's] own negligence. Thus, 
the Cross-Motion for Partial Summary Judgment is due to be 
denied. As discussed above, the Court concludes [Section] 
8.1(i) is insufficient to compel a comparative fault trial." 
 
(Emphasis in original.)  Mobile Infirmary appeals. 
Standard of Review 
The material issue at this stage of the case does not involve a 
question of fact. "We review a summary judgment and all questions of 
law de novo."  Pinkerton Sec. & Investigation Servs., Inc. v. Chamblee, 
961 So. 2d 97, 101 (Ala. 2006). 
Discussion 
 
On appeal, Mobile Infirmary maintains that Quest was required to 
indemnify it for the settlement of Mia's wrongful-death action. 
Specifically, Mobile Infirmary argues that Quest's failure to perform the 
basic metabolic panels ordered by Ward's doctor caused or contributed to 
his death and, thus, triggered the indemnity provision found in Section 
8.1 of the LMA, thereby entitling it to full indemnification from Quest 
under that provision. To the extent, however, that its own admitted 
negligence contributed, at least in part, to Ward's death, Mobile 
SC-2022-0641 
14 
 
Infirmary argues in the alternative that, under Section 8.1(v) of the LMA, 
Quest was still required to indemnify it for Quest's proportionate share 
of the fault in causing or contributing to Ward's death.  For these reasons, 
Mobile Infirmary argues that the trial court erred in entering a summary 
judgment in Quest's favor. 
 
We address the alternative argument first.  The decision in Holcim 
(US), Inc. v. Ohio Casualty Insurance Co., 38 So. 3d 722, 727 (Ala. 2009), 
considered the following certified question, as rephrased by the Court: 
"Whether, under Alabama law, an indemnitee may enforce an 
indemnification provision calling for the allocation of an obligation or 
damages based on the respective fault of the indemnitee and 
indemnitor?"  The answer was "in the affirmative": "[I]f two parties 
knowingly, clearly, and unequivocally enter into an agreement whereby 
they agree that the respective liability of the parties will be determined 
by some type of agreed-upon formula, then Alabama law will permit the 
enforcement of that agreement as written."  Holcim, 38 So. 3d at 729. 
In arriving at this answer, the Court first noted that, generally, 
"joint tortfeasors are not entitled to common-law indemnity or 
contribution."  Id. at 727.  
SC-2022-0641 
15 
 
"In Vandiver v. Pollak, 107 Ala. 547, 553, 19 So. 180, 182 
(1895), this Court explained that the basis of this prohibition 
is found in the maxim ex turpi causa non oritur actio: 
 
"'As a general principle of the common law it 
is often stated that indemnity or contribution will 
not be enforced as between joint wrong-doers. The 
reason underlying the principle is, that courts will 
not lend assistance to him who founds his cause of 
action on an immoral or illegal act -- "Ex turpi 
causa, oritur non actio." A trespasser confessing 
that he has injured or taken the property of 
another, is not entitled to the assistance of courts, 
instituted as well for the protection of property as 
for the protection of persons, to recover indemnity 
or contribution from his associates in the 
trespass.'" 
 
38 So. 3d at 727.  See also Sherman Concrete Pipe Mach., Inc. v. Gadsden 
Concrete & Metal Pipe Co., 335 So. 2d 125, 127 (Ala. 1976) ("The general 
rule in Alabama, subject to exceptions, prohibits one of several joint 
tortfeasors from enforcing contribution from the others who participated 
in the wrong. This is because of the maxim that no man can make his 
own misconduct the ground for an action in his own favor."). 
 
Despite the maxim ex turpi causa non oritur actio, indemnity 
agreements in which the indemnitor agrees to indemnify the indemnitee 
for the indemnitee's own negligence can be enforced: 
"'The Court has, for many years, held that as 
SC-2022-0641 
16 
 
between private parties, indemnity contracts are 
enforceable if the contract clearly indicates an 
intention to indemnify against the consequences of 
the indemnitee's negligence, and such provision 
was clearly understood by the indemnitor, and 
there is not shown to be evidence of a 
disproportionate bargaining position in favor of 
the indemnitee.' 
 
"Industrial Tile, Inc. v. Stewart, 388 So. 2d 171, 175 (Ala. 
1980). This rule includes the enforcement of a valid indemnity 
agreement that requires an indemnitor to indemnify an 
indemnitee for the indemnitee's own wrongdoing: '[I]f the 
parties knowingly, evenhandedly, and for valid consideration, 
intelligently enter into an agreement whereby one party 
agrees to indemnify the other, including indemnity against 
the indemnitee's own wrongs, if expressed in clear and 
unequivocal language, then such agreements will be upheld.' 
388 So. 2d at 176. See also Apel Mach. & Supply Co. v. J.E. 
O'Toole Eng'g Co., 548 So. 2d 445, 448 (Ala. 1989) ('Although 
the general rule in Alabama is that joint tort-feasors are not 
entitled to indemnity, when one joint tort-feasor agrees in 
writing to indemnify the other, even for claims based on the 
other's own negligence, the agreement, if it is a valid 
indemnity agreement, can be upheld, and the joint tort-feasor 
can receive indemnification.')." 
 
38 So. 3d at 727-28.  That said, those agreements must be clear: 
"However, 'the intention to indemnify the negligence of the indemnitee 
must clearly appear from the wording of the instrument, but when that 
intention is clear, the indemnity provisions will be read and construed so 
as to give them the meaning the parties have expressed.'"  Holcim, 38 So. 
SC-2022-0641 
17 
 
3d at 728 (quoting Eley v. Brunner-Lay S. Corp., 289 Ala. 120, 124, 266 
So. 2d 276, 280 (1972), overruled on other grounds by Goodyear Tire & 
Rubber Co. v. J.M. Tull Metals Co., 629 So. 2d 633 (Ala. 1993)). 
Because parties may enter into agreements that allow an 
indemnitee to recover from the indemnitor even for claims resulting 
solely from the negligence of the indemnitee, this Court saw no legal 
obstacle to an indemnification agreement calling for the allocation of an 
obligation or damages based on the respective fault of the indemnitee and 
the indemnitor, that is, a contractual agreement providing a form of 
otherwise barred joint-tortfeasor contribution: 
"If, under Alabama law, the maxim ex turpi causa non 
oritur actio provides no barrier to a contractual agreement in 
which an indemnitor may obligate himself or herself to pay an 
indemnitee's obligation resulting from the indemnitee's own 
wrongs, then, a fortiori, we see no barrier to an agreement 
between parties for an indemnitor to provide indemnity where 
the indemnitor's own wrongs also contribute to the creation of 
the obligation. Similarly, we see no barrier to the freedom of 
parties to negotiate an agreement providing for the allocation 
of a proportionate part of the obligation or damages based on 
the parties' respective fault. As we have previously stated, 
when '"dealing with an Alabama contract entered into by two 
competent contracting parties in this State, ... we are mindful 
of our duty to avoid, if at all possible, infringing upon the 
rights of either or both."' Shoney's [LLC v. MAC East, LLC], 
27 So. 3d [1216,] 1223 [(Ala. 2009)] (quoting Summers v. 
Adams Motor Co., 34 Ala. App. 319, 324, 39 So. 2d 300, 304 
(1949))." 
SC-2022-0641 
18 
 
 
38 So. 3d at 728-29 (footnote omitted). 
 
This Court held that such agreements,1 which, again, are contrary 
to the general prohibition on indemnity or contribution between joint 
wrongdoers, must themselves be clear: "[I]f two parties knowingly, 
clearly, and unequivocally enter into an agreement whereby they agree 
that the respective liability of the parties will be determined by some type 
of agreed-upon formula, then Alabama law will permit the enforcement 
of that agreement as written."  Id. at 729 (emphasis added).2     
 
As noted previously, in Section 8.1 of the LMA, Quest agreed to 
indemnify and hold Mobile Infirmary harmless against  
"any and all liability, losses, damages, claims or causes of 
action … that are caused by or a result of (i) any negligent or 
intentional act, error or omission by Quest Diagnostics, its 
employees, agents, servants or representatives with respect 
to its responsibilities and/or the performance of Services 
hereunder, to the extent such Claim does not arise from an 
 
1In Holcim, this Court specifically disclaimed "expressing an 
opinion as to the proper interpretation" of the agreement in that case.  38 
So. 3d at 727.   
   
2Given the above, we reject the conclusion of the Eleventh Circuit 
Court of Appeals in Ohio Casualty Insurance Co. v. Holcim (US), Inc., 
589 F.3d 1361, 1363 n.1 (11th Cir. 2009), in which that court interpreted 
our decision in Holcim as not requiring such agreements to have "clear 
and unequivocal language." 
SC-2022-0641 
19 
 
act or omission or cause for which [Mobile Infirmary] is 
required to provide indemnity pursuant to Section 8.2 below 
… [or] (v) any personal injury (including death) or property 
damage caused by or arising from the negligence, acts or 
omissions of Quest Diagnostics or any employee or agent of 
Quest Diagnostics .…" 
 
(Emphasis added.)  Under Section 8.2, Mobile Infirmary in turn agreed 
to indemnify Quest from and against  
"any and all Claims … (i) directly caused by or as a result of 
any negligent or intentional act, error or omission by [Mobile 
Infirmary] … with respect to its responsibilities [under the 
LMA], to the extent such Claim does not arise from an act or 
omission or cause for which Quest Diagnostics is required to 
provide indemnity pursuant to Section 8.1 above … [or] (v) 
any personal injury (including death) … caused by or arising 
from the negligence, acts or omissions of [Mobile Infirmary] 
or any employee or agent of [Mobile Infirmary] …." 
 
(Emphasis added.)  
 
Under Section 8.1(v), Quest has agreed to indemnify and hold 
Mobile Infirmary harmless for "any and all liability" caused by or that 
was the result of "any personal injury (including death)" that arose out of 
Quest's negligence, acts, or omissions. Likewise, under Section 8.2(v), 
Mobile Infirmary has agreed to indemnify and hold Quest harmless for 
"any and all" claims related to "any personal injury (including death)" 
that arose from Mobile Infirmary's negligence, acts, or omissions. 
SC-2022-0641 
20 
 
Together, these provisions may be read to mean that the parties have 
agreed to indemnify each other for all liability that may arise from their 
respective negligence, acts, or omissions.    
 
Mobile Infirmary admitted that Ward's death was caused in part 
by its negligence within the meaning of Section 8.2; its acts formed a 
basis for Mia's action (that is, Mia's action arose from Mobile Infirmary's 
acts).  Under Section 8.2(v), it would be required to hold Quest harmless 
for all claims arising from such acts.  If Quest's acts also contributed to 
Ward's death (that is, if Mia's action also arose from Quest's acts), then, 
under Section 8.1(v), Quest would hold Mobile Infirmary harmless from 
all claims arising from such acts.  If both of these provisions apply, they 
could be read to require each party to hold the other harmless from all 
claims asserted in Mia's wrongful-death action.  
Mobile Infirmary argues, however, that Sections 8.1(v) and 8.2(v) 
instead require each party to indemnify the other for its own 
proportionate share of fault. As stated previously, Holcim makes clear 
that parties must "knowingly, clearly, and unequivocally enter into an 
[indemnity] agreement whereby they agree that the respective liability 
of the parties will be determined by some type of agreed-upon formula."  
SC-2022-0641 
21 
 
38 So. 3d at 729.  In the present case, although Sections 8.1(v) and 8.2(v) 
can be read to address when a claim arises from either party's acts, they 
do not clearly and unequivocally address what happens when a claim 
arises out of acts of both parties.  The provisions require indemnification 
for all liability; but, if both are at fault, it is unclear how both can be liable 
in full.  Nowhere in these provisions do the parties expressly agree or 
clearly provide a formula that, in the event there is a claim that arises 
out of partial liability or concurrent acts by both parties, indemnification 
will be required for a proportionate share.  Without a "clear" and 
"unequivocal" agreement addressing indemnification in such a 
concurrent-fault situation, Mobile Infirmary's proposed reading of these 
sections does not comply with Holcim.  
 
The same analysis applies to Section 8.1(i).  Mobile Infirmary 
argues that this provision provides a proportionate-fault formula 
pursuant to which Quest must indemnify it for the portion of the damages 
resulting from its negligence that caused or contributed to Ward's death.  
Under Section 8.1(i), Quest has agreed to indemnify Mobile Infirmary 
against "any and all" claims that are caused by or are the result of "any 
negligent or intentional act, error or omission by Quest … to the extent 
SC-2022-0641 
22 
 
such Claim does not arise from an act or omission or cause for which 
[Mobile Infirmary] is required to provide indemnity pursuant to Section 
8.2." (Emphasis added.)  As noted above, Section 8.2(v) can be read to 
require Mobile Infirmary to hold Quest harmless for all claims asserted 
in Mia's wrongful-death action.  Further, the phrase "to the extent" can 
be read to mean that indemnity is required "if" the claim does not "arise" 
from Mobile Infirmary's own conduct, which would be consistent with a 
reading of Sections 8.1(v) and 8.2(v) requiring indemnity for "sole" fault. 
However, Mobile Infirmary suggests that the phrase can also be read as 
providing a quantity or proportion, meaning, "to the degree."  If this 
alternate reading is also viable, it only amplifies the ambiguity of these 
indemnity provisions, demonstrating that they are not "clear" and 
"unequivocal" as required by Holcim. 
 
 In summary, the LMA could have specified that each party was 
required to indemnify the other for any proportional share of fault in the 
case of potential joint liability.  The cited provisions do not clearly and 
unequivocally do so.  It might be implied, but so might other reasonable 
and contrary implications.  Thus, Mobile Infirmary's alternate argument 
does not demonstrate reversible error. 
SC-2022-0641 
23 
 
 
As to Mobile Infirmary's initial argument, it contends that, because 
Sections 8.1(v) and 8.2(v) "cancel each other out," it would not be required 
to provide any indemnity to Quest under Section 8.2.  Thus, it asserts, 
under Section 8.1(i), Quest would be required to indemnify it "in full" for 
all damages in Mia's wrongful-death action because the limitation in that 
part -- "to the extent such Claim does not arise from an act or omission 
or cause for which [Mobile Infirmary] is required to provide indemnity 
pursuant to Section 8.2" -- would not apply.  (Emphasis added.)  We 
disagree.  As the trial court held, "[b]ased on [Mobile Infirmary's] 
admission that the death of Mr. Ward was indeed caused, in part, by the 
negligence of [Mobile Infirmary], the Court concludes that Section 8.2(v) 
is triggered."  In such a circumstance, the terms of Section 8.1(i) do not 
require indemnification by Quest.  That Quest could be required to 
indemnify Mobile Infirmary under Section 8.1(v) does not nullify the fact 
that Section 8.2(v) was, as the trial court held, "triggered" under the facts 
of this case. 
Conclusion 
 
For the reasons stated above, the trial court's judgment is affirmed.   
 
AFFIRMED. 
SC-2022-0641 
24 
 
 
Wise, Bryan, Sellers, Mendheim, and Stewart, JJ., concur.  
Cook, J., concurs specially, with opinion, which Mitchell, J., joins. 
Parker, C.J., dissents, with opinion. 
 
 
 
SC-2022-0641 
25 
 
COOK, Justice (concurring specially). 
I concur with the main opinion.  I write specially to clarify my 
understanding of our holding in this case.  
In Holcim (US), Inc. v. Ohio Casualty Insurance Co., 38 So. 3d 722, 
729 (Ala. 2009), this Court explained: "[I]f two parties knowingly, clearly, 
and unequivocally enter into an agreement whereby they agree that the 
respective liability of the parties will be determined by some type of 
agreed-upon formula, then Alabama law will permit the enforcement of 
that agreement as written." (Emphasis added.) Requiring that indemnity 
agreements be "clear and unequivocal" is not confined solely to the fact 
of indemnity but logically extends to the scope of that indemnity (that is, 
it applies even if the parties are joint tortfeasors).  After all, indemnity, 
contribution among joint tortfeasors, and comparative negligence are all 
departures from our normal liability rules.   
In this case, Mobile Infirmary contends that simply by including 
the language "to the extent" in the Laboratory Management Agreement's 
indemnity provisions, the allocation of fault among the parties to those 
provisions was "clear and unequivocal." It was not. Although the parties 
string-cited cases from other jurisdictions interpreting similar "to the 
SC-2022-0641 
26 
 
extent" language in contracts, both sides admit that courts have reached 
conflicting results on whether this language is ambiguous.  In fact, the 
Eleventh Circuit Court of Appeals held that this language was 
ambiguous. See Ohio Cas. Ins. Co. v. Holcim (US), Inc., 548 F.3d 1352, 
1356-58 (11th Cir. 2008); Ohio Cas. Ins. Co. v. Holcim (US), Inc., 589 F.3d 
1361, 1363 (11th Cir. 2009).  If a number of courts have found this 
language to be "ambiguous," such language generally fails the 
heightened requirement of being "clear and unequivocal."    
Although the main opinion alludes to the need for an "agreed-upon 
formula" in such provisions, I do not understand our holding to require 
specific, talismanic language or a mathematical formula expressed in 
numbers or any heightened test of certainty in how a formula will work.  
For instance, I do not understand our holding to decide whether the 
words "to the degree" would have been sufficient.  The problem here is 
that the contract was not "clear and unequivocal" regarding whether 
there would be any allocation if there was concurrent liability. What I 
understand our holding to say is that such provisions should make clear 
that some allocation of fault among the parties will occur.  If necessary, 
the court can then apply traditional contract-construction principles to 
SC-2022-0641 
27 
 
provisions regarding how to actually make that allocation. Clarity is 
almost always a good thing, and the parties almost always understand 
-- far better than a court after the fact -- what they truly intend. 
Mitchell, J., concurs. 
 
 
SC-2022-0641 
28 
 
PARKER, Chief Justice (dissenting).  
In my view, the issue presented in this case was not decided by 
Holcim (US), Inc. v. Ohio Casualty Insurance Co., 38 So. 3d 722 (Ala. 
2009). And I believe that Sections 8.1(v) and 8.2(v) of the Laboratory 
Management Agreement are best understood as requiring fault-based 
apportionment of indemnity between the parties.  
First, Holcim did not hold that apportioned-indemnity provisions 
must be unambiguous to be enforceable. In reading Holcim as so holding, 
the main opinion overlooks the analytical frame within which that case 
was decided. 
Holcim came to us on a certified question from the United States 
Court of Appeals for the Eleventh Circuit. The indemnity provision there 
required indemnification of losses suffered by the indemnitee "'"'to the 
extent such losses are attributable to the negligence or willful misconduct 
of [the indemnitor].'"'" Id. at 725 (emphasis added; citations omitted). 
Before the Eleventh Circuit, the indemnitee argued that the phrase "to 
the extent" required indemnification based on apportionment of fault 
between the parties. Id. at 726. The indemnitor argued that the 
indemnity provision's language was not specific enough to require 
SC-2022-0641 
29 
 
apportionment, partly because it did not provide a method for 
apportionment. Id. The Eleventh Circuit thought both arguments were 
reasonable. Id. But that court recognized that, if the indemnitee's 
argument were right and the provision required apportionment, a 
question would arise whether such a provision is enforceable under 
Alabama law. That question is the essence of what the Eleventh Circuit 
certified to us. See id. We rephrased the certified question, distilling it to 
that essence. Id. at 727.  
Crucially for the present case, we then made clear that we would 
answer the question "[w]ithout expressing an opinion as to the proper 
interpretation of the actual agreement between [the indemnitee] and [the 
indemnitor]." Id. In other words, we did not decide the issue disputed by 
the parties in the Eleventh Circuit -- whether the indemnity provision's 
language was specific enough to require apportionment. Rather, we did 
the same thing the Eleventh Circuit had done in certifying the question: 
We assumed for purposes of our analysis that the indemnitee's view was 
correct -- that the provision's language was specific enough to require 
apportionment. That assumption was necessary to the whole analysis 
that followed, because if the provision did not require apportionment 
SC-2022-0641 
30 
 
because it was not specific enough, then the certified question -- 
essentially, 
whether 
apportioned-indemnity 
provisions 
are 
unenforceable based on Alabama public policy -- was moot. 
In answering the (rephrased) certified question, we reviewed our 
precedent on contractual indemnity for an indemnitee's own wrongdoing, 
as discussed in today's main opinion. In summary, under common law, 
joint tortfeasors were not entitled to indemnity because courts generally 
will not assist a person whose claim is founded on his own wrongdoing. 
Id. at 727. Despite that equity-based rationale, courts will enforce 
contracts in which a party agrees to indemnify for the indemnitee's own 
negligence. Id. However, to be enforceable, such provisions must be 
written in clear and unequivocal language and must be entered into by 
the indemnitor knowingly, evenhandedly, and without disproportionate 
bargaining position of the indemnitee, id. at 727-28, presumably because 
of those provisions' tension with equity. Next, we reviewed our precedent 
on freedom of contract and its general applicability to indemnity. Id. at 
728. Finally, we applied these principles by reasoning from the greater 
to the lesser: If Alabama public policy did not prohibit an indemnitor from 
contracting to indemnify an indemnitee for the indemnitee's own 
SC-2022-0641 
31 
 
wrongdoing, then Alabama public policy also did not prohibit an 
indemnitor from contracting to indemnify an indemnitee for the 
indemnitor's apportioned wrongdoing as to a jointly caused harm. Id. at 
728. We then concluded: "Accordingly, if two parties knowingly, clearly, 
and unequivocally enter into an agreement whereby they agree that the 
respective liability of the parties will be determined by some type of 
agreed-upon formula, then Alabama law will permit the enforcement of 
that agreement as written." Id. at 729. 
Within that last sentence, the words "knowingly, clearly, and 
unequivocally" and "by some type of agreed-upon formula" were 
necessarily dicta. As explained above, the only question before this Court 
was whether an indemnity provision whose language did require 
apportionment would be unenforceable under Alabama public policy. 
Clearly not before us was the question what language was necessary to 
require apportionment. Both the Eleventh Circuit and this Court had 
expressly declined to answer that question at that juncture, because both 
courts were focused on the public-policy question that required assuming 
that the subject provision required apportionment.  
SC-2022-0641 
32 
 
Put another way, today's main opinion views Holcim as requiring 
that apportioned-indemnity provisions be "clear and unequivocal" and 
provide a "formula" for apportionment. If that view were correct, in 
Holcim we would have held at the outset that the provision was 
unenforceable (and declined to answer the certified question as moot) 
because the Eleventh Circuit had already determined that the provision 
was ambiguous. But we did not approach the provision that way, because 
we were assuming that the provision was enforceable as a matter of 
language and were examining only whether it was unenforceable as a 
matter of policy. 
There is another reason why that surplus language in Holcim's 
conclusion sentence should be understood as dicta: It does not flow from 
the equitable, public-policy concerns that underlie our cases' "clear and 
unequivocal" requirement for provisions that agree to indemnification for 
an indemnitee's own wrongdoing. Such a provision does more than depart 
from the common-law rule against indemnity among joint tortfeasors. It 
goes further, requiring an indemnitor to indemnify against the 
indemnitee's own fault, separate from the indemnitor's fault, thus 
essentially requiring the indemnitor to act as an insurer. Cf. Industrial 
SC-2022-0641 
33 
 
Tile, Inc. v. Stewart, 388 So. 2d 171, 175-76 (Ala. 1980) ("'[S]uch 
provisions must be construed in favor of the indemnitor in instances 
where the indemnity is not contracted for from an insurance company 
engaged in the business of writing, for consideration, such coverage ….'" 
(citation omitted)). Such an arrangement cuts so deeply against the grain 
of ordinary principles of equity that, to be enforceable, it must have been 
entered into with the clearest of notice to the indemnitor. See id. at 176 
("The Court's insistence that such provisions be unambiguous and 
unequivocal arises from its concern that, generally speaking, one should 
not be able to contract against the consequences of his own wrong.").  
In contrast, a provision that calls for partial indemnity based on 
apportionment of fault does not trigger that equitable concern. The 
indemnitor is not indemnifying against the indemnitee's own fault, but 
only against the indemnitor's fault. Even absent a contractual indemnity 
provision, the common law itself would likely require that kind of 
indemnification (via contribution), at least outside the context of joint 
active tortfeasors. See American S. Ins. Co. v. Dime Taxi Serv., Inc., 275 
Ala. 51, 55, 151 So. 2d 783, 785 (1963). An apportioned-indemnity 
provision merely extends the common law's fault-based scheme of 
SC-2022-0641 
34 
 
indemnity/contribution to the joint-tortfeasor scenario. Hence, the 
equitable justification for a "clear and unequivocal" requirement, so 
necessary as to an indemnitee's-own-wrongdoing provision, is simply not 
present when dealing with an apportioned-indemnity provision.  
In accord with this view was the Eleventh Circuit's follow-up 
Holcim decision after we answered the certified question: 
"The Supreme Court of Alabama explicitly declined to express 
an opinion about the proper interpretation of the language at 
issue here. Moreover, our conclusion that the contract 
language is ambiguous does not require the ultimate finding 
that no valid agreement on this issue existed between the 
parties. Alabama's requirement for 'clear and unequivocal' 
language seems to us to apply to those agreements in which 
an indemnitor agrees to assume the burden of losses 
attributable to the fault of the indemnitee. Here, however, 
[the indemnitee] only seeks indemnification from [the 
indemnitor] to the extent of [the indemnitee's] losses that 
were caused by [the indemnitor], pursuant to an analysis of 
comparative fault." 
 
Ohio Cas. Ins. Co. v. Holcim (US), Inc., 589 F.3d 1361, 1363 n.1 (11th Cir. 
2009) (citations omitted). In my view, that part of the Eleventh Circuit's 
decision correctly interpreted our Holcim opinion. That opinion did not 
hold that apportioned-indemnity provisions must be clear and 
unequivocal or that they must provide a formula for apportionment. 
SC-2022-0641 
35 
 
Second, the indemnity provisions here are best interpreted as 
requiring fault-based apportionment of indemnity between the parties. 
Outside the context of provisions requiring indemnification for an 
indemnitee's own wrongdoing, "[w]hen construing an indemnity 
agreement, this Court has applied the general rules of contract 
interpretation," Once Upon a Time, LLC v. Chappelle Props., LLC, 209 
So. 3d 1094, 1096 (Ala. 2016). Specifically, when confronted with 
ambiguous indemnity provisions, we have looked to principles of contract 
interpretation that might resolve the ambiguity. See, e.g., FabArc Steel 
Supply, Inc. v. Composite Constr. Sys., Inc., 914 So. 2d 344, 357-61 (Ala. 
2005); Alfa Mut. Ins. Co. v. Nationwide Mut. Ins. Co., 684 So. 2d 1295, 
1298-1301 (Ala. 1996).  
 
Thus, I would resolve the present provisions' ambiguity as we would 
resolve any other, by applying principles of contract interpretation. There 
are three possible interpretations of Sections 8.1(v) and 8.2(v) in a 
situation when both parties are at fault: (1) The two parties can obtain 
indemnification back and forth ad infinitum, (2) the provisions cancel 
each other out and have no effect, or (3) the provisions require 
apportionment of fault. "'[W]here there is a choice between a valid 
SC-2022-0641 
36 
 
construction and an invalid construction [of an indemnity provision,] the 
court has a duty to accept the construction that will uphold, rather than 
destroy, the contract and that will give effect and meaning to all of its 
terms.'" Once Upon a Time, 209 So. 3d at 1097 (citation omitted). Only 
option (3), apportionment, avoids both the absurdity of option (1) and the 
destruction that would result from option (2). Other courts have 
interpreted 
similarly 
dueling 
indemnity 
provisions 
to 
require 
apportionment. See Joseph Francese, Inc. v. DOS Concrete Servs., Inc., 
47 Mass. App. Ct. 367, 713 N.E.2d 984 (1999); Bank One, N.A. v. Echo 
Acceptance Corp., 522 F. Supp. 2d 959, 971-73 (S.D. Ohio 2007); Gap, Inc. 
v. Apex Xpress, Inc., No. A146176, June 14, 2017 (Cal. Ct. App. 2017) 
(unpublished opinion). 
In addition to allowing Sections 8.1(v) and 8.2(v) to be enforceable, 
this interpretation allows them to be read harmoniously with Sections 
8.1(i) and 8.2(i). The (i) subsections require indemnification for "any 
negligent or intentional act, error or omission by [the indemnitor] ... with 
respect to its responsibilities ... hereunder, to the extent such Claim does 
not arise from an act or omission or cause for which [the indemnitee] is 
required to provide indemnity pursuant to [the corresponding indemnity 
SC-2022-0641 
37 
 
section] ...." (Emphasis added.) The (v) subsections are more specific, 
requiring indemnification for "any personal injury (including death) or 
property damage caused by or arising from the negligence, acts or 
omissions of [the indemnitor]" (emphasis added) and do not contain the 
"to the extent" caveat. Under the general/specific canon of construction, 
specific provisions override general provisions in the specific situations 
to which they apply. See ERA Commander Realty, Inc. v. Harrigan, 514 
So. 2d 1329, 1335 (Ala. 1987); Antonin Scalia & Bryan A. Garner, 
Reading Law 183-88 (Thomson/West 2012). Thus, under the (i) 
subsections, generally indemnity is not provided when both parties cause 
an indivisible harm ("to the extent such Claim does not arise from an act 
or omission or cause for which [the indemnitee] is required to provide 
indemnity" (emphasis added)). However, under the (v) subsections, when 
the harm is specifically personal injury, death, or property damage, there 
is no prohibition of reciprocal indemnity, and the parties are liable to 
indemnify each other based on their respective apportioned fault. 
Today's main opinion imposes new requirements that apportioned-
indemnity provisions be clear and unequivocal and provide a formula for 
apportionment. Those requirements infringe on the parties' freedom of 
SC-2022-0641 
38 
 
contract (which we emphasized in Holcim, see 38 So. 3d at 727-28) 
without any justification in either Holcim's holding or the equitable 
principles underlying its analysis. Without such a justification, I would 
not impose those new requirements.