Ordinary Negligence is What Medical Professi0nal Liability Insures
Post number 5319
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Sexual Conduct Exclusion Doesn’t Apply When Doctor Negligently Uses His Own Sperm
In Integris Insurance Company v. Narendra B. Tohan, No. AC 47222, Court of Appeals of Connecticut (April 7, 2026) Integris Insurance Company, a medical professional liability insurer, initiated a declaratory action to determine its duty to defend and indemnify Narendra B. Tohan, a physician licensed in Connecticut, in a separate negligence action alleging medical misconduct.
FACTUAL BACKGROUND
In 2019, Kayla Suprynowicz and Reilly Flaherty (civil action plaintiffs), who were strangers for most of their lives, discovered through a genetic testing company that they are half siblings.
INSURANCE POLICY
The policy defines “Professional Services” in relevant part as “any professional medical services within the customary scope of the insured’s practice specialty or classification ….” The policy further obligates the plaintiff, among other things, to “defend the insured against any claim or suit which includes . . . allegations of professional negligence for which coverage is provided under this policy.” It excluded sexual conduct.
The plaintiff claimed that the sexual conduct exclusion applies because “procreation is quintessentially sexual.” That contention overlooked the fact that procreation was the purpose of the professional services rendered in this case. As the underlying complaint makes clear, the civil action concerns the defendant’s provision of fertility services to the civil action plaintiffs’ parents through IVF procedures, which undoubtedly are medical procedures.
The professional service at issue is not the defendant’s production of sperm. It is, instead, the fraudulent use of his sperm to inseminate his patients. Although that suit alleged that the defendant negligently mixed his own sperm with that of Gary Suprynowicz to impregnate Kayla’s mother, it also alleges that he negligently failed to offer her parents “the choice of sperm donor” and negligently utilized sperm that contained a genetic disease. The Court of Appeal was unable to see how either of the latter two negligence allegations implicate the sexual conduct exclusion in any way.
The trial court granted summary judgment in favor of Integris Insurance Company, finding that the policy exclusions applied and that there was no coverage for the alleged misconduct. Tohan appealed this decision to the Connecticut Court of Appeals.
LEGAL ISSUES
The dispute centers on the interpretation of the medical professional liability insurance policy and whether the underlying complaint alleged facts potentially within the scope of coverage.
The trial court examined two principal issues: (1) whether the underlying complaint contained allegations that could trigger coverage, and (2) whether exclusions in the policy clearly and unambiguously barred coverage for all allegations and concluded there was no coverage for defense or indemnity.
DISCUSSION AND ANALYSIS
Providing IVF services to Kayla’s parents plainly is within the customary scope of the defendant’s practice specialty and thus constitutes “professional services” as that term is defined in the policy. The fact that the defendant may have negligently used his own sperm while providing those professional services, as the civil action plaintiffs allege in their complaint, does not alter that conclusion.
CONCLUSION
The Court of Appeals found that the trial court erred by concluding that the policy exclusions applied to every allegation without ambiguity.
The Court of Appeals concluded that the defendant’s fraudulent artificial insemination of his patients with his own sperm involved the provision of professional, medical services requiring special skill and knowledge. In this case, it is the operation itself, i.e., the insemination (and, ironically, its success), that is the proximate cause of the harms alleged in the underlying civil actions. As a result, the plaintiff’s policy extends coverage to claims arising from the defendant’s misconduct.
The civil action plaintiffs did not allege in count one that the defendant was aware that his sperm contained a genetic disease or that he knowingly used sperm that contained a genetic disease when providing IVF services to Kayla’s parents and that specific allegation constitutes an ordinary claim of negligence on the part of the defendant, and one that is not sexual in nature.
ZALMA OPINION
Since the good doctor never had any contact with the plaintiff’s mother but merely performed his specialty, inseminating her eggs with sperm from the father mixed with the doctor’s sperm. There was no excluded sexual conduct, just professional in vitro fertilization of the mother’s egg – a medical procedure not excluded.
(c) 2026 Barry Zalma & ClaimSchool, Inc.
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Arsonist Tried To Represent Himself, Failed, and Sought Habeas Relief
Post number 5357
Read the full article at https://www.linkedin.com/pulse/he-who-acts-his-own-lawyer-has-idiot-client-barry-zalma-esq-cfe-d4bwc, See the full video at and at and at https://zalma.com/blog.
Karacson’s Arson for Profit Attempt Required Skill & Experience to Succeed
In Steve Ellis Karacson v. David Shaver, Warden, No. 25-1089, United States Court of Appeals, Sixth Circuit (May 20, 2026) Steve Karacson was convicted in Michigan state court of arson and insurance fraud after evidence showed he burned his own insured home. Investigators found multiple points of origin, gasoline odor, and evidence tying him to the scene, including cell-phone location data and a receipt showing he had purchased a gas can and gloves shortly before the fire.
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Karacson initially had appointed counsel, but his relationships with both appointed attorneys ...
Foolish to Repeatedly Disobey Court Orders
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Post number 5348
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In Linh Wang v. Esurance Insurance Company, No. C24-0447-JCC, United States District Court, W.D. Washington, Seattle (May 1, 2026) John C. Coughenour, United States District Judge, found that throughout this case, culminating with its briefing on Plaintiff’s renewed motion and that Defendant has subjected Plaintiff to unnecessary motion practice for clearly discoverable information and made dubious representations (including to the Court).
FACTUAL BACKGROUND
This case involves an underinsured/uninsured motorist insurance bad faith claim arising from a 2017 motor vehicle collision. The plaintiff, Linh Wang, alleges that Esurance Insurance ...
The Right to Negotiate with Insurer is Not an Assignment of Claims
Post number 5347
Read the full article at https://www.linkedin.com/pulse/ambiguous-contract-repair-assignment-barry-zalma-esq-cfe-2xppc, see the full video at https://rumble.com/v79is1s-ambiguous-contract-to-repair-not-an-assignment.html and at and at https://zalma.com/blog plus more than 5300 posts.
Nebraska Requires an Actual Assignment to Allow Contractor to Sue Insurer
In Millard Gutter Company, a corporation doing business as Millard Roofing and Gutter v. Farmers Mutual Insurance Company of Nebraska, also known as Farmers Mutual Insurance, also known as Farmers Mutual, No. A-24-818, Court of Appeals of Nebraska (May 5, 2026) Millard sued Farmers as an assignee of Jane Anzalone who had hired Millard Gutter to repair the roof of her home and agreed to allow Millard Gutter to coordinate with her insurer, Farmers Mutual, concerning reimbursement for repairs authorized under her insurance policy.
FACTUAL BACKGROUND
In ...
Qui Tam Case Without Evidence to Prove Fraud Fails
Post number 5369
Read the full article at https://www.linkedin.com/pulse/qui-tam-insurer-contended-defrauded-barry-zalma-esq-cfe-pgfgc and at https://zalma.com/blog plus more than 5550 posts.
In People Of The State Of California Ex Rel. Heath & Yuen, APC v. Silver Bird Auto Leasing, LLC et al., B342847, California Court of Appeals, Second District, Eighth Division (June 5, 2026) Heath & Yuen, APC defended parties in an automobile collision case involving a McLaren and a tour van. After that case settled for $25,000, the firm filed a qui tam action under California’s Insurance Frauds Prevention Act (IFPA) against Silver Bird Auto Leasing, LLC, X-Law Group, PC, and Filippo Marchino. The firm alleged three fraudulent acts in the underlying litigation:
1. the complaint falsely stated the McLaren was making a “legal turn,”
2. respondents produced a fraudulent repair bill/estimate, and
3. respondents failed to disclose Marchino’s GEICO insurance and its payment for repairs....
Full Faith and Credit Act Controlled
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Posted on June 9, 2026 by Barry Zalma
Post number 5368
Posted on June 9, 2026 by Barry Zalma
In Prime Insurance Company, Inc. v. Medicab Transportation, LLC, Jason Rhodes, and Dale Johnson v. Prime Insurance Company, Inc and Prime Property & Casualty Insurance, Inc. No. 2:24-cv-421-SPC-KRH, United States District Court, M.D. Florida, Fort Myers Division (June 3, 2026) Medicab, a paratransit company, bought two policies in 2021: a Business Auto Policy from PPCI and a Commercial Liability Policy from Prime. Both policies, as originally written, appeared to cover injuries arising from loading and unloading patients from Medicab vans.
After a patient, Margaret St. Aubin, fell while being unloaded from a van and suffered injuries, her Estate made a $1 million demand. Prime and its claims administrator concluded that the Commercial Policy’s loading/unloading language had been included by mutual mistake, because...
Full Faith and Credit Act Controlled
Read the full article at https://lnkd.in/evHXiiFE and at https://zalma.com/blog.
Posted on June 9, 2026 by Barry Zalma
Post number 5368
Posted on June 9, 2026 by Barry Zalma
In Prime Insurance Company, Inc. v. Medicab Transportation, LLC, Jason Rhodes, and Dale Johnson v. Prime Insurance Company, Inc and Prime Property & Casualty Insurance, Inc. No. 2:24-cv-421-SPC-KRH, United States District Court, M.D. Florida, Fort Myers Division (June 3, 2026) Medicab, a paratransit company, bought two policies in 2021: a Business Auto Policy from PPCI and a Commercial Liability Policy from Prime. Both policies, as originally written, appeared to cover injuries arising from loading and unloading patients from Medicab vans.
After a patient, Margaret St. Aubin, fell while being unloaded from a van and suffered injuries, her Estate made a $1 million demand. Prime and its claims administrator concluded that the Commercial Policy’s loading/unloading language had been included by mutual mistake, because...
