Law firm fumbles away malpractice coverage
January 27th, 2012A Colorado law firm’s sad tale reemphasizes why it’s important to strictly observe the notice requirements of a professional liability insurance policy.
The hard lesson was handed down Tuesday by a federal judge in Davis & Associates v. Westchester Fire Insurance.
Davis & Associates (now Davis Schilken, PC) was retained in February 2004 by Ella Mae Bates. The client wanted the Golden, Colorado, firm to create a trust that would enable her to qualify for Medicaid benefits.
The Davis Firm duly created the Bates Trust, but a state agency subsequently denied Bates’ application for Medicaid benefits. According to the state, the assets of the Bates Trust were not exempt from consideration because of the terms of a loan provision in the trust.
Bates’ application for Medicaid benefits was denied on March 15, 2007. The Davis Firm prosecuted the administrative appeal of the denial of benefits, but it was ultimately upheld by the state in a final agency decision entered Sept. 4, 2007.
Pertinent to Bates’ later malpractice lawsuit, the Davis Firm allegedly failed to file an action for judicial review before the 30-day statute of limitations expired. Thus, the client lost her right to have a state court review the administrative decision.
Naturally, Bates was miffed at the result. She had funded the trust and depleted her remaining assets, all without accomplishing her goal of attaining Medicaid eligibility.
In March 2009, the Davis Firm became aware that Bates was considering a suit for legal malpractice. The firm accordingly turned its attention to its insurance coverage.
The Davis Firm was insured continually under successive professional liability policies for the period in question. Specifically, Westchester Fire Insurance issued three successive “claims made and reported” policies from April 1, 2007, through April 1, 2010.
On March 29, 2009, a few days before coverage under the 2008-2009 policy ended, the Davis Firm notified Westchester of a potential claim resulting from its representation of Ella Mae Bates.
The law firm probably assumed it was safely covered under the 2008-2009 policy. But its assumption was wrong.
Westchester denied the claim, asserting that, on the inception date of the 2008-2009 policy, April 1, 2008, the Davis Firm had a reasonable basis to believe that it had breached a professional duty owed to Bates and that a legal malpractice lawsuit was a distinct possibility.
The Davis Firm filed a suit to establish its right to coverage in the U.S. District Court for the District of Colorado.
Judge Robert E. Blackburn duly considered the parties’ arguments and on Jan. 24 handed a victory to the insurance company in the form of a summary judgment.
The problem for the Davis firm was an insurance clause that should be pretty familiar to attorneys. The 2008-2009 policy issued by Westchester to the Davis Firm provides coverage for a claim only if “at the inception of this policy the Insured had no reasonable basis to believe that any Insured had breached a professional duty and no reasonable basis to believe an act, error, omission or Personal Injury might be expected to result in such Claim or Suit.”
Applying this clause to the Davis firm’s dealings with Bates, it became clear to the judge that Westchester had no coverage obligation:
By the time the 2008-2009 Policy became effective on April 1, 2008, more than 200 days had passed since the Davis Firm had learned of the thirty day deadline to file an action for judicial review [in the Bates Medicaid case]. The Davis Firm’s knowledge of this breach of duty, and the resulting reasonable belief that a claim might be expected to result from the breach, prior to April 1, 2008, demonstrates that the 2008-2009 Policy does not provide coverage for this claim.
(Davis & Associates v. Westchester Fire Insurance)
The basic problem for the Davis firm was that it should have been alert to the potential legal malpractice claim in 2007 and taken the steps necessary to trigger coverage under Westchester’s 2007-2008 policy. The firm didn’t, so now it will have to bear the full brunt of its former client’s lawsuit.
– Pat Murphy







