Court Opinion

ID: 9468879
Source: CourtListenerOpinion
Date Created: 2023-08-05 02:25:48.016063+00
Date Added: 2024-06-11T17:41:05.677028
License: Public Domain

TAMM, Circuit Judge,
concurring in part and dissenting in part:
I concur in the majority’s holding that Ambassador Insurance Company (Ambassador) owed no duty to defend or to indemnify Dr. Sherman for his professional acts qua physician because by the terms of the policy such acts were specifically excluded from coverage. I cannot agree, however, with the majority’s conclusion that there existed a duty to defend if allegations in the McDowell complaint, McDowell v. Sherman, Civil Action No. 5783-75 (D.C.Super.Ct.) [hereinafter McDowell]; Appendix (A.) at 318, presented claims of administrative negligence. Because of my resolution of the duty to defend issue, I would also hold that no duty to indemnify existed in this case.
*261The majority states that “the critical issues here concern whether the Complaint in McDowell raises any claims of administrative negligence and, if so, whether any portion of the award in that suit was attributable to Dr. Sherman’s acts as an administrator.” Majority Op. at 257. I must disagree. The issue presented in this case is whether Dr. Sherman as a defendant in the McDowell case was an “insured” within the provisions of the Ambassador policy which covered the Columbia Family Planning Clinic (Clinic).1 This was the issue presented to the district court and, accordingly, is the one that this court should resolve. I begin my analysis with a summary of the relevant law:2
[Ujntil anaction has been brought against the insured there is by definition no claim against which the insurer is required to defend.... The obligation ... is to be determined by the allegations of the complaint or petition in such action, and it is generally held that an insurer is under a duty to defend a suit against the insured where the petition or complaint in such suit alleges facts within the coverage of the policy.
14 Couch on Insurance §§ 51:39, 51:40 at 532-33 (2d ed. R. Anderson 1965) (emphasis added) (footnotes omitted).
At the risk of unnecessary repetition, I feel that I must stress what the majority addresses only in passing: a duty to defend will not arise regardless of whether claims within the scope of the policy coverage are alleged, if those claims are alleged against a person who is not an “insured” under the policy terms. The majority arrives at its determination that a duty to defend existed by assuming away the real issue presented in this case — whether an “insured” was a party in the original McDowell suit.
Resolution of this issue requires a brief discussion of the legal status of the Clinic. At the time the insurance policy in question was issued, Dr. Sherman represented, and Ambassador believed, that the named insured was a corporation: Columbia Family Planning Clinic, P. C. See Plaintiff’s Statement of Material Facts As To Which No Genuine Controversy Exists, Sherman v. Ambassador Insurance Co., Civil Action No. 79-1039 (D.D.C.) [hereinafter Sherman]; A. at 289. The McDowell plaintiff named as a defendant “Columbia Family Planning Clinic and Counselling Service, P.C.” McDowell ; A. at 318. Because the Clinic had been misnamed and an investigation revealed no such corporation, counsel for Ambassador moved to quash service. Deposition of Arthur V. Butler,3 Sherman ; A. at 34-35.
*262As the majority correctly points out, “[t]he insurance policy in force at the time of Ms. McDowell’s death covered ‘Columbia Family Planning Clinic, P.C.,’ including ‘any partner, executive officer, director or stockholder thereof while acting within the scope of his duties as such.’ ” Majority Op. at 253. Ambassador agreed to insure an entity — the Clinic. Although it is by no means clear, it appears that if the Clinic, whatever its legal status and regardless of any misnomer, had been a party to the suit Ambassador would have had a duty to defend. That, however, was not the case. Following the successful Motion to Quash Service in McDowell, the Clinic was no longer a party to the case. Only a defendant who was an “insured” under the policy could trigger Ambassador’s duty to defend. I turn now to the dispositive question in this case — whether Dr. Sherman was such an “insured.”
Dr. Sherman was, concededly, the “administrator” of the Clinic. See Affidavit of Elliot Doliner,4 Sherman ; A. at 278-79. It does not automatically follow as night does the day, however, as the majority suggests, that because he was the administrator he was also an “executive officer and director” of the Clinic. In his affidavit in support of the Motion to Quash Service on the Clinic filed in the McDowell case, Dr. Sherman stated: “I am not an officer or agent or employee of the Columbia Family Planning Clinic and Counselling Service, P.C.” A. at 331. Although the appellant derides Ambassador for its reliance on the confusion generated by the misnomer involving the Clinic, Brief for Appellant at 6-8, he apparently does not feel that his statements concerning the misnamed entity ■ should weigh against him. The doctor, it seems, would like to have his cake and eat it, too. The only executive office that the doctor ever claimed to have held was president of Robert J. Sherman, M.D., P.C., which, it is undisputed, was not the named insured. Indeed, in the Motion for Summary Judgment filed on behalf of Dr. Sherman, it was not claimed that the Clinic was a corporation or that Dr. Sherman was an “executive officer,” “director,” or employee of it. Rather, appellant stated:
The Columbia Family Planning Clinic was the operational arm of Robert J. Sherman, M.D., P.C., and the trade name of Robert J. Sherman.... Dr. Sherman was the president of Robert J. Sherman, M.D., P.C..... He was the administrator of the Columbia Family Planning Clinic.
Plaintiff’s Statement of Material Facts As To Which No Genuine Controversy Exists, Sherman ; A. at 289.
Dr. Sherman, the primary actor in this case, had unique access to all such information and still failed to allege the facts necessary for a ruling in his favor. The majority bypasses this stumbling block by simply stating that it is “undisputed” that Dr. Sherman was an executive officer and director of the Clinic. Majority Op. at 253. In interrogatories submitted to Dr. Sherman by Ambassador, however, the following exchange occurred:
19. State whether on July 16, 1975, you bore any of the following relationships to “Columbia Family Planning Clinic”.
a. Officer
b. Agent
c. Employee
19. [answer] Plaintiff [Dr. Sherman] was the President of Robert J. Sherman, M.D., P.C. of which Columbia Family Planning Clinic was the operational arm.
Plaintiff’s Answers to Interrogatories, Sherman ; A. at 16. Dr. Sherman has consistently and repeatedly denied the existence of the Clinic as a corporation; moreover, he has denied any relationship with *263the Clinic as an officer, director, or employee.5
Appellant apparently recognized the fundamental weakness in this argument; when the crucial phrase “executive officer and director” appears in his brief, appellant has tacked on the words “and administrator.” Brief for Appellant at 16. These are not the words of the policy; nor did Ambassador ever admit or fail to deny that Dr. Sherman was an “executive officer or director” of the Clinic as appellant and the majority repeatedly insist. See Brief for Appellant at 11, 14; Majority Op. at 253, 258, 259 n.13. Ambassador was never presented with an allegation that Dr. Sherman held either or both of these positions. If there was no existing corporation called Columbia Family Planning Clinic or any variation of that name, and it is clear that there was not, it is beyond my understanding how the majority can conclude that Dr. Sherman was undisputedly an “executive officer and director” of the Clinic.
I do not find at all material Ambassador’s various statements concerning what it would have done had the facts of the case been different. For example, counsel for Ambassador states that “name and corporate status problems aside defendant would have defended if the McDowell complaint contained allegations indicating negligence by insured individuals of the clinic, — e.g. nurses, technicians, psychologists, etc.” Affidavit of Howard S. Davis,6 Sherman; A. at 354. This case does not concern what Ambassador would have done, might have done, could have done, or should have done — it concerns only what Ambassador was under a duty to do, for the breach of which duty an action for damages would lie. On this score, the majority notes that “[although officials at Ambassador apparently understood that the insurance policy covered the Clinic, including the administrative acts of Dr. Sherman, Ambassador’s counsel nevertheless was instructed to withdraw from the McDowell suit after the Motion to Quash had been granted.” Majority Op. at 254-255. This statement, I surmise, is intended to imply that Ambassador, knowing of its duty to defend, abandoned Dr. Sherman. Stating that the policy covered the administrative acts of Dr. Sherman, however, is not the same as acknowledging a duty to defend against allegations directed at Dr. Sherman individually. The majority fails to note that the referenced statement by Ambassador was made at the time the Clinic was still a party to the McDowell suit.
*264Although appellant repeatedly cites Zavo-ta v. Ocean Accident & Guarantee Corp., 408 F.2d 940 (1st Cir. 1969), in support of his interpretation of the definition-of-insured clause, Brief for Appellant at 11-14, a careful reading of that opinion reveals that it is not only factually at variance with the instant case, but actually supports a position adverse to appellant’s. In this case, as in Zavota, there is “no question that this policy covers the named insured.. . . ” 408 F.2d at 942. The only issue is whether it also covers Dr. Sherman. The definition-of-insured clause at issue in Zavota was practically identical to the Ambassador clause at issue here.7 In Zavota the person in question was the vice-president, a director and a one-third stockholder of the corporation that was the named insured. In startling contrast, the case before us does not involve an existing corporation let alone an executive officer or director.
In light of the fact that the Clinic was not a corporation and that Dr. Sherman could not be an “executive officer or director,” Zavota, in fact, supports the conclusion that Dr. Sherman was sued individually and that no duty to defend existed. In explanation of why a definition-of-insured clause covers an executive officer of a corporation, the Zavota court said:
Any employee of a corporation whose negligent act imposes ordinary tort liability on his employer is himself personally liable to the third party, if the third party chooses to sue. Normally employees are not sued- — the corporation is richer, as well as a better target. However, a corporate officer might be a useful defendant, and consequently may be in need of insurance. The purpose of a clause like the present, in our opinion, is to protect the officer against suits wherever his conduct is such, in relation to the corporation, that the corporation would be liable.
Zavota, 408 F.2d at 942 (emphasis added).
The conclusion I reach does not deny that it is plausible that the complaint in McDowell alleged acts of administrative negligence that may have been considered by the Superior Court as determinative of a portion of the damages for which Dr. Sherman was ultimately held liable. There should be no surprise that allegations that can arguably be considered “administrative negligence” appeared in the complaint. After all, the McDowell plaintiff did file suit against the Clinic as well as Dr. Sherman. It is, however, immaterial that allegations that could be considered administrative negligence on the part of the Clinic remained in the complaint. The Clinic was no longer a party and there could be no “executive officer or director” of a non-existent corporation. Simply put, there can be no further duty to defend where an insurance company’s insured is no longer a party. Dr. Sherman was sued and defended as an individual, and as Robert J. Sherman, M.D., P.C.
In the Superior Court proceedings and in answer to interrogatories taken in the instant case, the doctor stated that the Clinic as a corporate entity did not exist and that he was not an officer or director of it. The definition-of-insured provisions are quite specific; it is only for an entity “designated in the declaration as other than an individual, partnership or joint venture,” A. at 301, that an executive officer or director is also considered an insured.8 It seems to me an inescapable conclusion that when an entity is designated as a corporation, the terms “executive officer” and “director” can take their meaning only in that context — if there was in fact no corporation there cannot have been an “executive officer” or “di*265rector.” There was no corporation. Dr. Sherman’s status, whatever it may have been in relation to the Clinic, was not as an “executive officer” or “director” as those terms are used in the applicable provisions of the policy.
I am not without sympathy for Dr. Sherman’s plight. He did purchase insurance and pay premiums to Ambassador. Whatever Dr. Sherman’s other remedies may be, one thing is clear to me, Ambassador did not breach a duty to defend in this case. It is simply wrong for this court to treat the case as if a corporation existed and to treat Dr. Sherman as if he were an executive officer or director. These are not the facts, and this decision should not rest on a hypothetical version of what the facts would have been had Dr. Sherman incorporated his Clinic as he represented to Ambassador he had. Accordingly, although Ambassador stood ready, willing and able to defend, once the Motion to Quash was granted in McDowell, it being clear from Dr. Sherman’s own admissions and denials that he was not an “executive officer or director” of the Clinic, Ambassador had no one left to defend. Regardless of whether allegations of administrative negligence remained in the complaint, there was no duty to defend a non-insured party. These facts, which Dr. Sherman did not deny in the papers filed in connection with the Motion and Cross-Motion for Summary Judgment, were squarely presented to the district court.
After careful consideration of this case, I can only conclude that the district court was correct in granting summary judgment for Ambassador. Dr. Sherman, individually and as Robert J. Sherman, M.D., P.C., was not an insured of Ambassador. Once the Motion to Quash was granted, Ambassador had fulfilled its duty to its insured. This is precisely what the district court held; accordingly, that judgment should be affirmed in its entirety. I respectfully dissent from the majority opinion insofar as it holds otherwise.

. The definition-of-insured provision at issue here is contained in two places in the Ambassador Insurance Company (Ambassador) policy. Under the “Comprehensive General Liability Insurance” provision, the pertinent portion reads:
II. Persons Insured
Each of the following is an insured under this insurance to the extent set forth below:
(c) if the named insured is designated in the declarations as other than an individual, partnership or joint venture, the organization so designated and any executive officer, director or stockholder thereof while acting within the scope of his duties as such.
Appendix (A.) at 301. In the “Malpractice Liability” provision is contained the following clause:
DEFINITION OF INSURED: The unqualified word “insured” includes the named insured and also includes any partner, executive officer, director or stockholder thereof while acting within the scope of his duties as such.
A. at 308.

. Although neither party to this case has raised the issue, I note that there is no reference by appellant to any provision in the policy that requires Ambassador to defend; nor is there reference to any provision which gives Ambassador the right to control the litigation in suits against its insured that would imply a corresponding right of the insured to require Ambassador to defend. For purposes of this case, I assume, arguendo, that if a suit had been filed against the insured that raised claims within the coverage of the policy, Ambassador would be required to defend. See generally, 14 Couch on Insurance § 51:32 at 528 (2d ed. R. Anderson 1965).

. Arthur V. Butler was the attorney retained by Ambassador to represent the interests of Ambassador’s insured in McDowell v. Sherman, Civil Action No. 5783-75 (D.C.Super.Ct.) [hereinafter McDowell]. Deposition of Arthur V. Butler, Sherman v. Ambassador Ins. Co., Civil *262Action No. 79-1039 (D.D.C.) [hereinafter Sherman]; A. at 27.

. Elliot Doliner was Claims Manager for Ambassador at the time the McDowell case arose. *263Deposition of Elliot Doliner, Sherman; A. at 204.

. In another interrogatory Dr. Sherman continued his evasive answers concerning the status of the Clinic and his relationship with it:
17. With regard to an entity known as “Columbia Family Planning Clinic” state:
a. Whether that entity was or is a lawful corporation under the laws of any jurisdiction.
b. If so, the names of that jurisdiction and date of incorporation.
c. If not a corporation, the type of business association which “Columbia Family Planning Clinic” constituted.
d. The date the entity came into being and, if it no longer exists, the date it ceased to be.
e. The names of all officers, shareholders, partners, employees, and other individuals having a financial or other business interest in “Columbia Family Planning Clinic”.
f. The names of all physicians who served at any time as independent contractors of said entity, or who were permitted to use the facilities of said entity whether or not as independent contractors.
17. [answer]
a. Columbia Family Planning Clinic was the operational arm of Robert J. Sherman, M.D., P.C., P.A., which was legally incorporated under the laws of the District of Columbia and Maryland.
b. D.C. and Maryland, 1973
c. CFPC was part of the P.C./P.A. organized by plaintiff
d. 1973; 2/76 (approx.)
e. Robert J. Sherman, Pres.
Elizabeth L. Sherman, Sec.
f. Louis Fettig, M.D.
Bardeo Balkisoon, M.D.
Plaintiffs Answers to Interrogatories, Sherman; A. at 15-16.

. Howard S. Davis was counsel for Ambassador during the proceedings before the district court in the instant case. Affidavit of Howard S. Davis, Sherman; A. at 353.

. The only material difference between the two clauses is not relevant to the disposition of this case. The Ambassador clause included the position of “partner”; the Zavota clause did not. See note 1, supra.

. See note 1, supra. Although the definition-of-insured clause in the “Malpractice Liability” portion of the policy does not contain the language relating to the designation of the named insured, it is clear from the context of the provision that the terms “executive officer, director or stockholder” relate to corporate positions. It is also clear that these terms must take their meaning from the type of entity insured, in this case a purported corporation.