A missed reporting deadline just cost a family the chance to collect a $3 million judgment - and handed insurers a lesson on claims-made coverage.
An Ohio appeals court ruled on July 23, 2026, that Great American Risk Solutions Surplus Lines Insurance Company, formerly American Empire Surplus Lines Insurance Company, owed nothing on a $3 million default judgment against its insured, a rehabilitation facility operator. The Eighth District Court of Appeals affirmed summary judgment for the insurer.
The case began with the death of a resident admitted to a short-term rehabilitation facility after hip surgery. According to an affidavit, she choked on a hot dog provided by a staff member who had left her unattended, and she died ten days later, on June 29, 2020.
Her daughter, acting for the estate, spent months trying to identify the facility's liability carrier. She filed a lawsuit in 2020 just to obtain medical records, then a malpractice action in December 2021 alleging that staff negligently provided food to and failed to supervise a resident. The facility never answered. It and its parent company filed for bankruptcy, and the daughter got permission to pursue the claim, with any recovery capped at insurance proceeds.
Then coverage unraveled. A default judgment of $3 million landed against the facility in April 2024 - $500,000 on the survivorship claim and $2,500,000 for surviving family members. The insurer knew none of it was happening.
The policy's professional liability part, Coverage D, was "claims made and reported." A claim had to be first made and reported to the insurer during the policy period or within a 60-day extended window. The policy ran December 21, 2019 through December 21, 2020. The malpractice suit was not filed until December 2021, and was never reported to the insurer.
The court explained that reporting is not a technicality in this kind of policy. It "defines the scope of the coverage purchased." Miss the window, and there is no coverage to argue about, so the usual question of whether the insurer was prejudiced never arises.
The daughter also argued the general liability part, Coverage A, should fill the gap. The court disagreed. Coverage A carried the same reporting requirement and excluded professional healthcare services - exactly what the choking claim involved.
The daughter had pinned down the right insurer only "largely through happenstance." By then, it was too late.
