Our client had a trip and fall claim so we reported to CNA for general liability coverage. They are denying it, saying it falls under professional liability. I was always told bodily injury doesn't fall under professional. While we have a malpractice policy, I feel it's bodily injury and should be paid under the GL.
CNA says the loss occurred inside the exam room. It is their position that the facts support that the exam/professional medical services had begun at the time the claimant was escorted into the exam room and claimant fell next to the exam table when about to get on the table. Further, the cause of the loss was a medical gel inadvertently left on the floor by insured sonographer which had been used during the rendering of a prior medical exam and unfortunately was not cleaned up. The sonographer confirmed there was medical gel on the floor and she helped claimant clean the gel off her shoe.
CNA admits that once escorted to the inner hallways of the examination area, the issue gets a little gray, but feels the facts of this loss warrant settlement under the Professional Liability policy. We disagree.
New York Subscriber
We are in agreement with you that this fall should be adjusted under the CGL policy as opposed to the professional liability policy. The act of applying the sonogram gel to the person would be a professional liability act; however the spill of the gel was a premises liability exposure and the claim is thus a bodily injury claim.
To help explain our position, suppose the sonogram technician or anyone else spilled water from the sink washing her hands as opposed to dropping some of the gel on the floor. Both are substances that increase the slip and fall hazard in the exam room, but neither require a professional certification to carry. Whether the gel was spilled in the exam room or in the hallway has no bearing on the claim; the medical office is the entire premises, including exam rooms, lab rooms, waiting rooms, etc.