In March 2025 a Georgia USA court held that a professional indemnity insurer had no duty to defend nor indemnify an orthopaedic surgery centre and one of its surgeons against a medical malpractice claim for failed spinal surgery because the policy excluded incidents previously reported to another insurer, which had been the case.

The policy exclusion provided that the policy did not apply to incidents which had been the subject of any notice given to any insurer prior to the effective date of the policy.

Notice of the incident had been given to a previous insurer prior to the effective date of the policy 1 September 2019. The insured alleged however that the effective date was the retroactive date.

The court found that the policy unambiguously excluded coverage for all claims and allegations reported prior to the stated effective date, 1 September 2019. The incident had been reported to the previous insurer on 10 May 2019. The language of the policy was clear as to the effective date which was clearly distinguished from the retroactive dates. To interpret the effective date as the retroactive date would require the court to contravene the plain language of the policy and inject ambiguity when there was none.

The claim failed. The same result would follow on this policy wording and these facts under South African law.

[Professional Solutions Insurance Co. v Chappuis case no 1:23-cv-05037-VMC in the US District Court for the Northern District of Georgia]