Opinion ID: 1727608
Heading Depth: 1
Heading Rank: 2

Heading: St Paul's Policy

Text: St. Paul, who had insured Dr. Ichinose for his professional liability since 1975, issued the pertinent policy, entitled a Physicians' Professional Liability Protection-Claims Made policy, for a policy period of October 1, 1986 to October 1, 1987. The policy set forth the following coverage provisions: When you are covered To be covered the professional service must have been performed (or should have been performed) after your retroactive date that applies. [3] The claim must also first be made while this agreement is in effect. When is a claim made? A claim is made on the date you first report an incident or injury to us or our agent. You must include the following information:  Date, time and place of the incident.  What happened and what professional services you performed.  Type of claim you anticipate.  Name and address of injured party.  Name and address of any witness. (emphasis added). The policy also provided Dr. Ichinose with an option, in the event the policy was not renewed, to buy an extension of coverage beyond the policy period, [4] as follows: Optional reporting endorsement Your professional coverage may end because one of us chooses to cancel or not to renew it. If this happens, you have the right to buy an optional extension of coverage. It's called a reporting endorsement. This endorsement will cover:  Injuries or deaths that occur after the retroactive date and before the date this agreement ends. And  Claims that are first made or reported to us after the ending date of this agreement and before the reporting endorsement ends. You must request the reporting endorsement in writing within 30 days after this agreement ends. We'll then send it to you for a premium based on the rules and rating plans we're using on the day the reporting endorsement begins. When the St. Paul policy period expired on October 1, 1987, Dr. Ichinose did not renew the policy, and he subsequently purchased a new professional liability policy with another insurer. On December 2, 1987, after Dr. Ichinose had purchased other professional liability insurance, St. Paul wrote to Dr. Ichonose, offering him an extension until January 2, 1988 of is option to purchase the reporting endorsement. The letter expressly referred to the reporting endorsement and cautioned, This is a claims-made form of coverage. This means that you will not have coverage for claims arising out of acts performed prior to the termination date for which a claim may be made after the termination date, unless you purchase Reporting Endorsement coverage. (emphasis in original). Dr. Ichinose did not purchase the reporting endorsement coverage. Moreover, the policy he procured through another company had a retroactive date of November 11, 1987, a date that precluded coverage under the new policy of the act or omission that had occurred in October 1986. The circumstances of Dr. Ichinose's changing of insurers, his failure to buy extended coverage from St. Paul, and the setting of the retroactive date of the new policy resulted in a lack of coverage under the express terms of both claims-made policies. As to the St. Paul policy, the only one at issue in the proceedings, the misdiagnosis occurred at a time covered by the policy, but no claim was made and no claim was reported during that policy term.