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The insurer must defend supported housing against the residents’ mood



An insurer must defend a nursing home in North Carolina in a lawsuit prosecuting the nursing home for failing to provide adequate meals and activities, a federal appeals court said Tuesday and confirmed a lower court.

In November 2018, residents of Lake Pointe Assisted Living Inc., an adult nursing home in Lake Waccamaw, North Carolina, filed a class action lawsuit against the facility and two of its officials, claiming they did not provide them with nutritious meals, help with daily activities. and adequate programming, as required by North Carolina law, in accordance with the judgment of the 4th U.S. Circuit Court of Appeals in Richmond, Virginia, in Church Mutual Insurance Co. v. Lake Pointe Assisted Living Inc. et al.

Merrill, Wisconsin-based Church Mutual, which had issued primary and umbrella policies to the facility, sued Lake Pointe, officials and residents of the U.S. District Court in Greenville, North Carolina, to seek a declaratory judgment that it did not have to defend or indemnify Lake Pointe. or its officials in the dispute.

The district court ruled against the insurer and was determined by an appellate body with three judges.

The policies require that “a professional healthcare incident”

; caused the damage in order for there to be coverage, it said. This includes failure to “comply with a resident’s rights under any state or federal law” that governs a resident’s health care facility.

“North Carolina regulates the quality of the food that nursing homes serve and the amount of activities they provide,” the panel said in concluding that residents “have alleged a health care incident” and Church Mutual has an obligation to provide a defense.

Lawyers in the case did not respond to a request for comment.


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