Aufrichtig v. Lowell, 85 N.Y.2d 540 (1995)
A treating physician owes a duty to their patient to provide truthful information regarding the patient’s medical condition, especially when providing sworn testimony or affidavits that the patient’s insurance company will rely on.
Summary
This case addresses whether a physician can be held liable for providing false information about a patient’s condition to the patient’s insurance company. The Aufrichtigs sued Dr. Lowell, alleging he provided a false affidavit to their insurance company, leading to a reduced settlement in their insurance coverage dispute. The New York Court of Appeals held that factual issues existed regarding whether Dr. Lowell breached his duty to provide truthful information, precluding summary judgment. The court emphasized the physician’s duty of trust and honesty to the patient, particularly when providing sworn statements.
Facts
Janette Aufrichtig, suffering from severe multiple sclerosis, required 24-hour skilled nursing care according to her primary care physician, Dr. Lowell. Hartford Insurance Company, initially providing reimbursement for this care, later reduced coverage based on a different neurologist’s assessment. The Aufrichtigs sued Hartford in federal court, alleging Mrs. Aufrichtig needed round-the-clock care. Dr. Lowell initially provided deposition testimony and an affidavit favorable to Hartford, stating Mrs. Aufrichtig only needed skilled nursing care at meal times. He later recanted, providing a new affidavit stating she needed constant care. Due to the conflicting statements, the federal judge encouraged settlement, resulting in a reduced benefits agreement.
Procedural History
The Aufrichtigs sued Dr. Lowell in state court for damages caused by his allegedly false affidavit. The Supreme Court granted Dr. Lowell’s motion to dismiss, and the Appellate Division affirmed. The Court of Appeals granted leave to appeal.
Issue(s)
Whether a treating physician can be held liable for breach of duty to a patient for providing false information to the patient’s insurance company regarding the patient’s medical condition when the information is used to reduce insurance benefits.
Holding
Yes, because a treating physician owes a duty of care to the patient to not impart false information in formal sworn submissions, especially when the litigation involves the patient’s medical condition and insurance benefits.
Court’s Reasoning
The Court of Appeals emphasized the fiduciary-like relationship between a physician and patient, stating that a physician has a duty to provide truthful information about a patient’s condition, especially when providing sworn testimony. The court distinguished this from a medical malpractice claim, focusing on the distinct duty of a physician to be truthful when providing information. The court noted that Dr. Lowell’s conflicting statements created a factual issue regarding whether he breached this duty. The court pointed out that doctors who provide false information may face professional misconduct charges under Section 6509 of the Education Law, highlighting the importance of truthful reporting. The court reasoned that Dr. Lowell was the key source of information about Mrs. Aufrichtig’s condition, and his false statements directly impacted the federal court case. The court stated, “[P]art of a physician’s duty to the patient, when authorized to supply otherwise confidential information to others…includes truthful utterances, particularly…when delivered under oath and with awareness that a false statement will be relied upon to the detriment of the patient.” Because Dr. Lowell admitted his initial statements were false and his testimony was crucial to the insurance coverage decision, summary judgment was inappropriate. The settlement, allegedly spurred by the trial judge’s assessment of the case based on Dr. Lowell’s contradictory statements, further supported the need for a trial on the merits.