Patient Injury at Day Spa Brings Definition of a ‘Claim’ to Court

Versailles Medical Spa prides itself on helping its clientele look and feel their best. One such patron, Lillian Voigt, entered the Connecticut facilities in August 2016, in the hopes the staff could help her remove brown spots from her legs. 

Voigt was administered intense pulse light therapy to burn the darkened areas and break up the pigmentation.  

However, something was amiss, and Voigt, as well as Marie Saade, the nurse attending her, agreed the treatment had indeed burned Voigt’s legs. In dispute was whether or not the burns were a normal side effect of the treatment. 

Around one month later, Voigt allegedly e-mailed Saade and Robin Nye, founder and CEO of Versailles.  

In that e-mail, she claimed that she wrote about wanting to discuss her leg burns with the CEO. She noted she would like to be reimbursed for the treatment. Nye denied ever receiving this e-mail. 

Voigt did return to Versailles in late Sept. 2016 to be evaluated, and Saade “agreed to waive certain costs of therapy from there on.” A “second” e-mail was sent in Nov. 2016 as a follow-up to Saade, in which Voigt claimed, “I am not seeing much improvement.”  

Voigt continued to receive treatments into early 2017. 

Meanwhile, Versailles applied to renew its professional liability insurance with Admiral Insurance Company in May 2017. Admiral asked if the medical spa had any known claims filed against its employees, and Versailles responded with a resounding “no.” 

On Dec. 21, 2017, Voigt’s attorney informed Saade and Nye that she obtained counsel to represent her in relation to “injuries she sustained” on her legs and forehead during her Aug. 2016 appointment. Versailles informed Admiral by Jan. 2018. 

Voigt’s suit was officially filed in Jan. 2019. By Dec. 2019, Admiral informed Versailles it would not provide coverage or pay for the defense. It turned to policy language that stated a “claim” is defined as “a written demand for money or services by any insured resulting from a professional incident,” which is “a negligent act, error, or omission in the rendering of or failure to render professional services by the insured.” 

By this definition, Voigt’s Nov. 2016 e-mail constituted a claim, and Admiral claimed Versailles had provided misinformation on its application in 2017 regarding knowledge of any claims. Further, its policy excluded coverage for claims that an insured had “prior knowledge” of. 

But Versailles held that this e-mail was not a claim by any definition. Notice of a pending claim, per Versailles, came in Jan. 2018 and was officially filed in Jan. 2019.  

Both sought summary judgment in court. 

Scorecard: After back and forth in court, a judge granted Saade, Nye and Versailles summary judgment, after determining that Voigt’s 2016 e-mail did not fall under the definition of a “claim first made.” 

Takeaway: It goes without saying that due diligence is necessary when providing medical-based services to clients. Procuring adequate coverage and notifying insurers of all potential mishaps or complaints is a better way forward than omitting what could be valuable information. &