Hickin v. American Guarantee Liab., Unpublished Decision (12-10-2003)
Hickin v. American Guarantee Liab., Unpublished Decision (12-10-2003)
Opinion of the Court
{¶ 3} In January 1997, State Farm waived its right to subrogation against the tortfeasor and gave Appellant permission to settle with the tortfeasor. In March 1997, Appellant executed a full and final release of the tortfeasor in exchange for $62,500; Appellant recovered $50,000 from the tortfeasor's insurance carrier and $12,500 from the rental company. In the same year, Appellant executed a partial release of her own insurer, State Farm, for $37,500 in underinsured motorist coverage.
{¶ 4} At the time of the accident, Appellant lived with her parents and worked at Arby's Restaurant. She was also employed as a part-time substitute teacher with the Akron Public Schools. Akron Public Schools carried several insurance policies with Nationwide Mutual Fire Insurance Company ("Nationwide") with policy limits of $1,000,000. Appellant's father was employed by A. Schulman Inc., in Tallmadge, Ohio, which carried a policy with American Guarantee and Liability Insurance Company ("American Guarantee") with policy limits of $1,000,000. On December 19, 2001, Appellant brought a declaratory judgment action against Nationwide, American Guarantee, and the unknown insurer of Arby's Restaurant. Appellant sought uninsured ("UM") and underinsured ("UIM") motorist benefits pursuant to Scott-Pontzer v. Liberty Mut. Fire Ins.Co. (1999),
{¶ 5} Appellant filed an amended complaint on May 20, 2002. In the complaint, she added several defendants: Traveler's Indemnity Company of Illinois ("Traveler's") and State Farm.2
{¶ 6} On September 30, 2002, State Farm filed a motion for summary judgment, wherein it argued that the homeowner's insurance policy issued to Appellant's father was not a motor vehicle liability policy and, as such, was not subject to the mandates of R.C.
{¶ 7} On October 4, 2002, American Guarantee filed a motion for summary judgment, wherein it argued that Appellant was precluded from coverage on the ground that 1) Appellant was not an "insured" because its policy contained a "Drive Other Car Coverage Form[,]" which effectively eliminated any ambiguity in the term "you" and that therefore Scott-Pontzer did not apply; and 2) assuming Appellant was an "insured," she failed to comply with the notice and subrogation provisions, thereby materially breaching the insurance contract. On the same day, Appellant filed motions for partial summary judgment against both American Guarantee and Nationwide. In her motions, Appellant argued that the language contained in the insurance policies was ambiguous, and that therefore Scott-Pontzer applied to extend coverage to her.
{¶ 8} On December 4, 2002, Nationwide filed a motion for summary judgment, wherein it argued that Appellant was not entitled to UM/UIM benefits because 1) Appellant did not qualify as an "insured" under the policies because Akron Public Schools did not have the legal authority to purchase UM/UIM coverage for off-duty employees; 2) the language in the policy was unambiguous, and therefore Scott-Pontzer did not apply and Appellant did not quality as an "insured"; and 3) assuming Appellant was an "insured," she materially breached the notice and subrogation provisions, thereby destroying Nationwide's subrogation rights.
{¶ 9} On December 16, 2002, Appellant voluntarily dismissed State Farm from the action. Nationwide and American Guarantee voluntarily dismissed their cross-claims against State Farm only.
{¶ 10} On February 11, 2003, the trial court ruled on the pending motions. It granted American Guarantee's and Nationwide's motions for summary judgment and it denied Appellant's partial motions for summary judgment. With regard to American Guarantee's motion, the trial court held that the term "you" as defined in "WHO IS AN INSURED" was ambiguous and that Scott-Pontzer applied to extend coverage from A. Schulman, Appellant's father's employer, to Appellant's father. Because UM/UIM coverage that arises pursuant to Scott-Pontzer also extends to family members of employees, the court found that Appellant was also an "insured" for purposes of UM/UIM coverage. Although the trial court concluded that Appellant was an "insured," it denied coverage on the ground that Appellant materially breached the notice and consent provisions contained in the insurance policy, thereby destroying American Guarantee's subrogation rights.
{¶ 11} As to Nationwide's motion for summary judgment, the trial court found that the primary issue "[was] whether [Appellant was] entitled to UM/UIM coverage under Nationwide's [p]olicies issued to the Akron Public Schools even though the school board did not have authority to purchase UM/UIM coverage for off-duty employees and their families." The trial court held that pursuant to Nationwide Agribusiness Ins. Co.v. Wagner (Nov. 13, 2002), 9th Dist. No. 21013, 2002-Ohio-6119, discretionary appeal allowed (2003),
{¶ 12} Appellant has timely appealed, asserting two assignments of error. Nationwide has cross-appealed, asserting one assignment of error.
{¶ 13} In Appellant's first assignment of error, she has argued that the trial court erred when it held that she was not entitled to UM/UIM benefits because she materially breached the notice and consent provisions contained in American Guarantee's insurance contract.
{¶ 14} As an initial matter, we note that the appropriate appellate standard of review for an award of summary judgment is de novo. Doe v.Shaffer (2000),
{¶ 15} According to Civ.R. 56(C), summary judgment is proper if: (1) no genuine issue as to any material fact remains to be litigated; (2) the moving party is entitled to judgment as a matter of law; and (3) it appears from the evidence, viewed most strongly in favor of the nonmoving party, that reasonable minds can come to but one conclusion, which is adverse to the non-moving party. See State ex rel. Howard v. Ferreri
(1994),
{¶ 16} To prevail on a motion for summary judgment, the moving party must be able to point to evidentiary materials that show that there is no genuine issue as to any material fact, and that the moving party is entitled to judgment as a matter of law. Dresher v. Burt (1996),
{¶ 17} Civ.R. 56(C) provides an exclusive list of materials which the trial court may consider on a motion for summary judgment. Spier v.American Univ. of the Caribbean (1981),
{¶ 18} We first note that, in construing the terms of the insurance policy at issue, the Ohio Supreme court has stated that: "[I]nsurance policies should be enforced in accordance with their terms as are other written contracts. Where the provisions of the policy are clear and unambiguous, courts cannot enlarge the contract by implication so as to embrace an object distinct from that originally contemplated by the parties." Goodyear Tire Rubber Co. v. AetnaCas. Sur. Co.,
{¶ 19} The insurance policy at issue provided:
"A. Coverage
"1. We will pay all sums the `insured' is legally entitled to recover as compensatory damages from the owner or driver of an `uninsured motor vehicle' because of `bodily injury' sustained by the `insured' caused by an `accident.'"
{¶ 20} Pursuant to the terms of the policy, in order to recover UM/UIM benefits Appellant must be an "insured." If Appellant is an "insured," then this Court must next determine if she is precluded from coverage because of her failure to timely notify American Guarantee of the accident and her subsequent settlement with the tortfeasor. Therefore, in reviewing the trial court's decision, this Court must first determine if Appellant is an "insured."
{¶ 21} Appellant has contended that she is an "insured" based on the Ohio Supreme Court's holding in Scott-Pontzer. She has argued thatScott-Pontzer applies because the contractual language is ambiguous, and that therefore she is an "insured" for the purposes of UM/UIM coverage. In Scott-Pontzer, the court addressed whether a corporation's employees were entitled to UIM coverage under the corporation's insurance policies. More specifically, the court had to determine if the definition of "insured" included a corporation's employees. A provision in the policy defined "insured" as:
"B. Who Is An Insured
"1. You.
"2. If you are individual, any family member.
"3. Anyone else occupying a covered auto or a temporary substitute for a covered auto. The covered auto must be out of service because of its breakdown, repair, servicing, loss or destruction.
"4. Anyone for damages he or she is entitled to recover because of bodily injury sustained by another insured." Scott-Pontzer,
{¶ 22} The coverage form further provided that "[t]hroughout this policy the words you and your refer to the [n]amed [i]nsured shown in the [d]eclarations.'" Scott-Pontzer,
"[I]t would be reasonable to conclude that `you,' * * * also includes * * * employees, since a corporation can act only by and through real live persons. It would be nonsensical to limit protection solely to the corporate entity, since a corporation, itself, cannot occupy an automobile, suffer bodily injury or death, or operate a motor vehicle. Here, naming the corporation as the insured is meaningless unless the coverage extends to some person or persons — including to the corporation's employees." Scott-Pontzer,
{¶ 23} In the instant matter, A. Schulman, Appellant's father's employer, maintained an insurance policy with American Guarantee. The policy contained a provision similar to the "WHO IS AN INSURED" provision discussed in Scott-Pontzer. The provision, which defined "insured" in the section of the policy entitled "OHIO UNINSURED MOTORISTS COVERAGE — BODILY INJURY[,]" stated, in pertinent part:
"B. Who is an Insured
"1. You
"2. If you are an individual, any `family member.'
"3. Anyone else `occupying' a covered `auto' or a temporary substitute for a covered `auto.' The covered `auto' must be out of service because of its breakdown, repair, servicing, loss or destruction.
"4. Anyone for damages he or she is entitled to recover because of `bodily injury' sustained by another `insured.'"
{¶ 24} As the definition of "insured" contained in the present policy is identical to the definition of "insured" contained in theScott-Pontzer policy, we conclude "that `you,' while referring to [A. Schulman], also includes [A. Schulman's] employees, since a corporation can act only by and through real live persons." Scott-Pontzer,
{¶ 25} In Galatis, the Ohio Supreme Court addressed "Ohio's law regarding whether uninsured and underinsured motorist insurance issued to a corporation may compensate an individual for a loss that was unrelated to the insured corporation." Galatis,
{¶ 26} The court explained that "[w]hen confronted with an issue of contractual interpretation, the role of a court is to give effect to the intent of the parties to the agreement." Galatis,
{¶ 27} In a situation where the ambiguous "contract is standardized and between parties of unequal bargaining power, an ambiguity in the writing will be interpreted strictly against the drafter and in favor of the nondrafting party." Galatis,
{¶ 28} With these contract principles in mind, the Ohio Supreme Court explained that, in the insurance context, the court must construe ambiguities in favor of the insured. "A claimant, however, is not necessarily an insured. An insured can be the policyholder or another who is entitled to insurance coverage under the terms of the policy. When a court decides whether a claimant is insured under a policy, ambiguities are construed in favor of the policyholder, not the claimant." (Emphasis sic.) Galatis,
{¶ 29} Extending coverage to an "unintended third party," distorts the purpose of any contract, especially a motor vehicle policy of insurance issued to a corporation. "The general intent of a motor vehicle insurance policy issued to a corporation is to insure the corporation as a legal entity against liability arising from the use of motor vehicles."Galatis,
"[A]n employee's activities outside the scope of employment are not of any direct consequence to the employer as a legal entity. An employer does not risk legal or financial liability from an employee's operation of a non-business-owned motor vehicle outside the scope of employment. Consequently, uninsured motorist coverage for an employee outside the scope of employment is extraneous to the general intent of a commercial auto policy." Galatis,
{¶ 30} In concluding that an "unintended third party," or in this case an employee working outside the scope of employment, was entitled to UM/UIM coverage, the Scott-Pontzer court relied on King. In King, an employee, Dale Gordon, was driving a vehicle owned by a co-worker when he suffered fatal injuries as a result of an automobile accident. Gordon was working within the course and scope of employment when the accident occurred. Gordon sought UIM coverage under his employer's insurance policy, but his claim was denied. He then brought a declaratory judgment action against his employer, but the trial court and appellate court found that Gordon was not entitled to UIM benefits. On appeal, the Ohio Supreme Court had to determine "whether underinsured motorist coverage provided in an employer's insurance policy extends to a deceased employee whose fatal injuries were sustained in the course of employment as the result of an automobile accident with an underinsured motorist, where the employee was not listed as a designated driver nor was he in an auto named under the policy issued to his employer." Id. at 209.
{¶ 31} The King court found that Gordon, although not specifically listed in the employer's insurance policy, was entitled to UIM coverage.King,
{¶ 32} The Galatis Court explained that its analysis inScott-Pontzer, and later in Ezawa v. Yasuda Fire Marine Ins. Co. ofAm. (1999),
{¶ 33} Despite the Scott-Pontzer court's illogical decision to extend an employer's UM/UIM coverage to an employee not working within the scope of employment, the Galatis court held that the decision inScott-Pontzer was correct "to the extent that it held that an employee in the scope of employment qualifies as `you' as used in [the employer's insurance policy], and thus, is entitled to uninsured motorist coverage."Galatis,
{¶ 34} This Court notes that "[t]he general rule is that a decision of a court of supreme jurisdiction overruling a former decision is retrospective in its operation, and the effect is not that the former was bad law, but that it never was the law." Peerless Elec. Co. v. Bowers
(1955),
{¶ 35} Although the trial court erred in concluding that Appellant was an "insured," and granted summary judgment in favor of American Guarantee on the ground that Appellant breached the notice and subrogation provisions contained in the policy, this Court is empowered to affirm the judgment of the trial court on grounds other than those relied upon by the trial court. Ramco Specialties v. Pansegrau (1998),
{¶ 36} In Appellant's second assignment of error, she has argued that the trial court erred in granting summary judgment in favor of Nationwide. We disagree.
{¶ 37} As discussed in Appellant's first assignment of error, the appropriate appellate standard of review for an award of summary judgment is de novo. Doe,
{¶ 38} Appellant has argued that Scott-Pontzer applies because the term "you" refers only to the corporation, and is thus ambiguous. Appellant maintained in her response to Nationwide's motion for summary judgment, and on appeal, that "[t]he definition of insured contained in the Nationwide policy maintained by [Appellant's] employer, the Akron Public Schools, defines insured in an identical manner to that which was contained in the policy before the Ohio Supreme Court in [Scott-Pontzer]." Appellant is correct in her assertion that the policy provision contained in Scott-Pontzer is virtually identical to the instant provision. Akron Public Schools maintained three insurance policies with Nationwide. Each policy contained a provision which defined the term "insured" in the section entitled "OHIO UNINSURED MOTORISTS COVERAGE." The pertinent provisions stated:
"B. Who is an Insured
"1. You
"2. If you are an individual, any `family member'
"3. Anyone else `occupying' a covered `auto' or a temporary substitute for a covered `auto.' The covered `auto' must be out of service because of its breakdown, repair, servicing, loss or destruction.
"4. Anyone for damages he or she is entitled to recover because of `bodily injury' sustained by another `insured.'"
{¶ 39} Because the definition of "insured" contained in the present policy is identical to the definition of "insured" contained in theScott-Pontzer policy, we conclude that the term "you" is ambiguous and, pursuant to Scott-Pontzer, the term refers to Akron Public Schools and its employees. We find, however, that although Appellant is an employee of Akron Public Schools she does not qualify as an "insured" based onGalatis. As discussed in Appellant's first assignment of error, whenScott-Pontzer applies to an insurance contract the term "you" means the corporation and its employees working within the scope of employment. Here, it is undisputed that Appellant was not working within the scope of employment at the time of the accident. Therefore, pursuant to Galatis, Appellant is not an "insured" and she is therefore not entitled to UM/UIM benefits.
{¶ 40} Because we find that Appellant is not an "insured" for purposes of UM/UIM coverage, we do not need to determine whether she breached the notice and subrogation provisions contained in Nationwide's insurance policies when she failed to notify the company of her settlement with the tortfeasor.
{¶ 41} Although we find that Appellant was not entitled to UM/UIM benefits for reasons different than those relied upon by the trial court, we conclude that the trial court did not err in granting summary judgment to Nationwide. Consequently, Appellant's assignment of error is not well taken.
{¶ 42} In Nationwide's cross-assignment of error, it has argued that the trial court erred in determining that Appellant qualified as an "insured." In light of our disposition of Appellant's assignments of error, we need not address Nationwide's cross-assignment of error. See App.R. 12(A)(1)(c).
Judgment affirmed.
Baird, P.J., Batchelder, J. concur.
Reference
- Full Case Name
- Julie Hickin, appellant/cross-appellee v. American Guarantee and Liability Insurance Company, and Nationwide Mutual Fire Insurance Company appellee/cross-appellant.
- Cited By
- 2 cases
- Status
- Unpublished