Opinion ID: 39658
Heading Depth: 4
Heading Rank: 3

Heading: Supervising, teaching, proctoring others at

Text: your request. On appeal, Educare argues that the negligent training and supervision of its employee qualifies as falling within the “supervising, teaching, and proctoring” prong of the professional services definition, resulting in coverage under the MPL. This assertion, however, wholly removes the phrase from the list in which it is enumerated and from the context which that list provides–-namely, professional healthcare. The very title of the coverage, “Medical Professional Liability,” suggests that coverage depends on providing professional medical care. All of the examples of services enumerated in part 1 of the definition require 13 Additionally, the MPL provisions excluded coverage “for any actual, alleged, attempted, or proposed erotic physical contact, or any sexual abuse or harassment” and contained a “separation of insureds” clause. The primary policy limited insurance to $1,000,000 per “each medical incident.” 5 some specialized education or experience. Furthermore, part 2 requires some special accreditation. Though urging a broad interpretation of the language “other health care services” found in part 1, Educare does not argue that the relevant employees are covered by parts 1 or 2 of the definition. If we were to accept Educare’s view of coverage under part 3, all of Educare’s employees, simply by virtue of being trained or supervised in a group home environment, would qualify for coverage under the MPL part of the policy, irrespective of the employee’s level of participation in providing healthcare. This cannot be true. Interpreting the policy as a whole, it is clear that the MPL excludes the training and supervision of an employee not possessing the type of skills set forth in parts 1 or 2 of the definition. After all, this is the purpose of MPL coverage, to supplement non-professional CGL coverage.14 Therefore, when read in context, the supervision and teaching must be for healthcare services-- professional in nature–-demanding either specialized knowledge, such as that required to perform the enumerated tasks in part 1, or recognized training, such as that 14 Cochran v. B.J. Services Co. USA, 302 F.3d 499, 502 (5th Cir. 2002) (stating “[i]nsured professionals, such as engineers...ordinarily carry special insurance separate from the CGL policy to cover obligations arising from the rendering of professional services”). 6 required by part 2. In affirmation, this court previously has interpreted a coverage exclusion for supervisory activities contained within a detailed definition for professional services to require specialized training.15 Moreover, when not expressly defined in such a way that purports to vary the customary usage of the term, the accepted meaning of professional services, according to both Fifth Circuit and Texas state law, conforms to this interpretation of the professional services definition in the present case. This Court has defined professional healthcare services as not “a purely physical action in response to a business determination, but rather the exercise of a trained judgment in obedience to an established medical policy.”16 Likewise, Texas courts define “professional services” as requiring specialized education and knowledge.17 These customary definitions do 15 Id. In an appeal from the Western District of Louisiana, a supervisory exclusion within the definition of professional services was deemed not to preclude coverage where an insured was injured merely by removing a cement head from an oil rig because the nature of the work did not constitute a professional service, which would require “special insurance.” The policy defined professional services as: “1. The preparing, approving, or failure to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. Supervisory, inspection, architectural, or engineering activities.” Id. 16 Big Town Nursing Homes v. Reserve Ins. Co., 492 F.2d 523, 525 (5th Cir. 1974); Guaranty Nat’l Ins. Co. v. North River Ins. Co., 909 F.2d 133, 137 (5th Cir. 1990) (applying same definition). 17 Duncanville Diagnostic Ctr. v. Atlantic Lloyd’s Ins. Co., 875 S.W.2d 788, 790-91 (Tex.App.-Eastland 1994), reh’g denied (Though holding that a professional services exclusion from coverage in a CGL policy was inapplicable to a radiological technician who administered a lethal dose of a chemical to a 7 not singularly inform but, rather, stand to buttress the conclusion that the parties contracted for coverage related to professional medical treatment.