Malpractice Insurance Denial Risks OB-GYN Defense Costs
A Washington OB-GYN faces potential out-of-pocket legal costs after an insurer denied coverage for a misdiagnosis lawsuit.
Updated on Oct. 20, 2026 in Insurance
An insurer has moved to deny malpractice coverage to a Washington state OB-GYN facing a lawsuit over a pregnancy misdiagnosis. The insurer argues that a patient record request made prior to the start of the physician's policy triggers an exclusion clause.
Why it matters
This dispute highlights how strict adherence to policy effective dates can create significant financial risks for medical professionals. Coverage gaps can leave practitioners personally liable for legal defense costs if an incident is interpreted to have occurred before a policy was in force.
The federal court filing concerns a single medical malpractice claim involving an alleged misdiagnosis. It remains unknown how the court will interpret the timing of the patient record request against the specific terms of the insurance policy.
The details
The insurer seeks to enforce an exclusion by claiming that the patient's request for medical records serves as the trigger point for the incident. Because this request occurred before the OB-GYN's policy effective date, the insurer contends it holds no obligation to provide coverage or legal defense for the current lawsuit. This places the physician at risk of funding a defense independently if the court upholds the insurer's interpretation of the policy language.
Timeline
October 20, 2026: The insurer notified the federal court of its coverage denial.
Money Landscape
This case sits within the broader context of professional liability insurance where coverage often hinges on the specific timing of incident reporting. It illustrates the ongoing tension between insurers and providers regarding the definition of a reportable event in claims-made policies.
For medical professionals, this underscores the importance of verifying how your policy defines incident reporting and the start of coverage. You should review your malpractice policy declarations page with a qualified professional to ensure you understand specific exclusion triggers.
The takeaway
Insurance coverage disputes can arise from seemingly minor procedural steps like early records requests. Practitioners should maintain clear documentation and confirm with a qualified insurance professional that their policy effectively covers prior incidents or specific reportable events.
Further reading
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