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Am. Econ. Ins. Co. v. Jackson, 2007 U.S. App. LEXIS 3232 (8th Cir. 2007)

This case involves an insurance coverage dispute after Freddie Mae Burns died at Leland Health Care Center, a 128 bed skilled nursing facility, due to excessive heat. Teresa Johnson, administrator and former director of nursing, was responsible for controlling the HVAC settings and failed to set them properly during a heat wave. Leland Health Care, LLC owned and operated the facility. Morris Esformes was the sole owner of Leland. Esformes also owned EMI Enterprises which had management agreements with other nursing homes, but not Leland. American Economy Insurance Company issued a special business owners policy to EMI where EMI was described as an “office – accounting bookkeeping.” EMI also listed the insured address in Illinois, although Leland was in Missouri. American Economy had never issued insurance to a nursing home and its policy included a policy exclusion for claims relating to professional services, including any health or therapeutic treatment. It moved for summary judgment, which was granted by the district court. On appeal the decision was affirmed because Johnson’s decision to refrain from switching the HVAC system to air condition rested on her training and experience as a nurse, director of nursing and administrator. Thus, the professional services exclusion applied. District court decision at Am. Econ. Ins. Co. v. EMI Enter., 2006 U.S. Dist. LEXIS 34871 (D. Mo. 2006).


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