Landers v. Lucent Technologies, Inc., Unpublished Decision (6-26-2003)
Landers v. Lucent Technologies, Inc., Unpublished Decision (6-26-2003)
Opinion of the Court
{¶ 3} We decided this precise issue in Straubhaar v. Cigna Prop. Casualty Co., Cuyahoga App. No. 81115, 2002-Ohio-4791, and could summarily affirm on that basis alone. We are aware, however, thatStraubhaar was assigned to the accelerated docket of this court and our decision was issued in conclusory form as permitted by App.R. 11.1(E). We therefore take this opportunity to make a fuller statement of the reasons supporting our decision.
{¶ 4} At the time Lucent entered into the contract of insurance with Reliance National, former R.C.
{¶ 5} A very significant exception to this law exists in cases involving self-insurers. In Grange Mut. Cas. Co. v. Refiners Transp. Term. Corp. (1986),
{¶ 6} R.C.
{¶ 7} But the absence of proof of financial responsibility as allowed by statute is not dispositive. In Grange, the supreme court recognized that entities could be self-insured in the "practical sense," even if they did not comply with the statutory (or "legal") means for proving financial responsibility. The syllabus to Grange states, "[t]he uninsured motorist provisions of R.C.
{¶ 8} We acknowledge that Grange did not involve insurance of the kind involved in this case, but that is a distinction without meaning. The undisputed facts show that Lucent carried what is known as a "fronting" policy with Reliance National Indemnity Company. A fronting policy is a form of self-insurance in which the deductible is identical to the limits of liability, and the insurance company acts only as surety that the holder of the fronting policy will be able to pay any judgment covered by the policy. See Air Liquide America Corp. v. Continental Cas.Co. (C.A. 10, 2000),
{¶ 9} It makes no difference to our conclusion that Lucent holds a policy of insurance with Reliance National. Some might argue that this would suggest they are not self-insured, but the practicalities of transacting business dictate the opposite conclusion. A corporation like Lucent would want to hold a policy of insurance, even though its deductible matches the limits of liability, so as to have a clear set of terms that define the limits of its liability. In other words, Reliance National provides Lucent with a policy that sets forth all the terms under which Lucent can be held liable. Reliance National also can deal with the complexities of individual state law and ensure that Lucent carries the type of coverage mandated in a particular state. Moreover, an insurance company has expertise in processing and handling claims, and Lucent clearly paid a premium for that service.
{¶ 10} We acknowledge, but disagree with, Tucker v. Wilson, Clermont App. No. CA2002-01-002, 2002-Ohio-5142, in which the Twelfth District considered a very similar fronting agreement and held that the insurer retained some risk of loss based on the existence of a bankruptcy clause which "clearly provides that were [the insured] to file bankruptcy or otherwise become insolvent, [the insurer] would not be relieved of its obligation to pay a valid loss during the term of the policy to a third party." Id. at ¶ 14. The court concluded that the operation of the bankruptcy clause would mean that the self-insured would not retain one hundred percent of the loss, "however minuscule the risk" of loss might be. Id.
{¶ 11} We do not believe that the presence of a bankruptcy clause in an insurance policy is as telling as Tucker believed. That kind of clause simply memorializes R.C.
{¶ 12} But our primary disagreement with Tucker centers on its failure to perceive that a fronting agreement in which an insurance company acts as a surety is, for all practical purposes, no different than the R.C.
{¶ 13} Lucent's policy with Reliance National bore all the markings of a surety relationship. Lucent agreed to bear all of the loss, with Reliance National agreeing to be responsible for the loss in the event Lucent went into bankruptcy. Perhaps Tucker read too literally an often-cited definition of self-insurance: "Self-insurance is not insurance; it is the antithesis of insurance." See Physicians Ins. Co. ofOhio v. Grandview Hosp. Med. Ctr. (1988),
{¶ 14} Finally, even if we are wrong about our conclusion that a fronting policy is similar in application to a surety bond, we respectfully submit that Tucker gave too much credit to the idea that we must apply the law based on the "minuscule" risk that a self-insured would become insolvent. Admittedly, a corporation the size of Lucent Technologies could be subject to insolvency — the Enron and MCI/WorldCom bankruptcies have shown us that much. Nevertheless, Lucent is not currently in bankruptcy and we must assume in the absence of argument or fact to the contrary that it is able to satisfy the full amount of its deductible under the Reliance National policy. At this point in time, Lucent bears the entire risk under the policy. We do not believe that the law should be read so rigidly that it elevates a minuscule chance of risk to the status of fait accompli. As long as there is no proof that the self-insured is not presently capable of satisfying the full amount of the deductible in a fronting agreement, we will not be in any hurry to declare that a party to a fronting agreement is not self-insured.
{¶ 15} For these reasons, we find that Lucent is self-insured and thus no UM/UIM coverage can arise by operation of law. The court did not err by granting summary judgment to Lucent.
{¶ 17} On October 31, 2001, the General Assembly amended R.C.
{¶ 18} The first question presented is whether the Linko elements for rejection of UM/UIM coverage continue to apply after the amendment to R.C.
{¶ 19} The supreme court recently held that they did, in Kemperv. Michigan Millers Mut. Ins. Co.,
{¶ 20} American States acknowledges Linko, but argues on authority of Manalo v. Lumbermans Mut. Ins. Co., Montgomery App. No. 19391, 2003-Ohio-613, that the absence of the Linko requirements are not necessarily determinative of a knowing rejection of UM/UIM coverage where other evidence exists to show that the insured understood the effect of rejecting UM/UIM coverage, particularly when the insured is a "sophisticated large corporation" that was involved in Manalo.
{¶ 21} Although Manalo reached an interesting result, the facts of that case are significantly different than those presented in this case. Most notably, the insured in Manalo did choose UM/UIM coverage, albeit at a level lower than the liability coverage. The evidence in Manalo also included an affidavit from the risk manager of Avon Products, Inc., which stated that the risk manager was well aware of the requirements for an offer of UM/UIM coverage, that premiums would be increased if he were to select. There is no evidence of that kind in the record before us, so the specific facts would not permit the conclusion that the commissioners made the same kind of knowing rejection of coverage as made in Manalo.
{¶ 23} In its motion for summary judgment, the commissioners raised the issue whether a political subdivision was bound byScott-Pontzer in light of R.C.
{¶ 24} The General Assembly is charged with providing by general law for the organization and government of counties. See Article
{¶ 25} "These authorities render it clear that county organizations are mere agencies of the state for certain specified purposes; that such powers as they possess and such liabilities as they may create are given by statute; that these statutes are to be strictly construed in favor of the state, which reserves to itself all power not thus delegated * * *." See, also, Geauga Cty. Bd. of Commrs. v. Munn RoadSand Gravel (1993),
{¶ 26} Although Scott-Pontzer would normally operate to give rise to coverage for employees of an employer, the commissioner's ability to purchase liability insurance coverage stems from an express grant of authority by the General Assembly. There are two statutes which give the commissioners the authority to purchase motor vehicle insurance: the aforementioned R.C.
{¶ 27} R.C.
{¶ 28} This leaves R.C.
{¶ 29} "The state and any political subdivision may procure a policy or policies of insurance insuring its officers and employees against liability for injury, death, or loss to person or property that arises out of the operation of an automobile, truck, motor vehicle with auxiliary equipment, self-propelling equipment or trailer, aircraft, or water craft by the officers or employees while * * *."
{¶ 30} A county is a political subdivision. See R.C.
{¶ 31} We are aware that this court, as well as other courts of appeals, have decided this issue differently in the context of boards of education. In Mizen v. Utica Nat. Ins. Group,
{¶ 32} "We do not agree with the trial court that R.C.
{¶ 33} Likewise, in Roberts v. Wausa Business Ins. Co.,
{¶ 34} The obvious distinction between the board of education cases and this case filed against the commissioners is that the enabling legislation granting the commisioners permission to purchase liability insurance specifically states that it is limited to occurences which occur in the course and scope of employment. Were we to applyScott-Pontzer to the facts of this case in the manner urged by Landers, it would mean that Landers' father would be entitled to coverage that the commissioners could not, by law, provide to him. Since we are obligated to construe R.C.
{¶ 35} Our ruling necessarily renders moot any consideration of the alternative grounds listed for summary judgment. See App.R. 12(A)(2).
Judgment affirmed.
PATRICIA A. BLACKMON, J., concurs.
DIANE KARPINSKI, J., concurs in judgment only with separate concurring opinion.
Concurring Opinion
{¶ 36} I agree with the outcome, but for reasons different from what the majority gives. I do not believe Lucent was self-insured. I would affirm, however, because plaintiff is not included as a family member in the policy.
{¶ 37} It is agreed that the mandate of R.C.
{¶ 38} Landers, on the other hand, says Lucent cannot be self-insured because it does not have a certificate of insurance on file with the state nor does it assume 100% of the financial risk under the policy.
{¶ 39} Risk
{¶ 40} "In determining whether an entity is self-insured, courts look at who bears the risk of loss." Dalton v. Wilson, Franklin App. No. 01 AP-1014, 2002-Ohio-4015, at ¶ 35. "While insurance shifts the risk of loss from the insured to the insurer, self-insurance involves no risk-shifting." Jennings v. Dayton (1996),
{¶ 41} The Supreme Court of Ohio has explained in order for a company to be a self-insurer, it must always retain the risk of loss. Thus the Supreme Court held that "a financial responsibility bond is not liability insurance." The court explained that the company was "a `self-insurer' in the practical sense in that [the employer] was ultimately responsible under the term of its bond either to a claimant or the bonding company in the event the bond company paid any judgment claim." Grange Mut. Cas. Co. v. Refiners Transport and Terminal Corp. (1986), 21 Oh. St.3d 47. The Fifth Appellate District has similarly found a letter of credit is not liabilitty insurance. Dijon DeLong v. BrandonMyers, 2003-Ohio-2702.
{¶ 42} Other courts have subsequently expanded this exemption for self-insurers. Dolly v. Old Republic Ins. Co., (N.D.Ohio. 2002),
{¶ 43} The Fifth District has acknowledged a self-insured exemption for a company lacking the normal certificate but only under certain conditions. In Dalton v. Travelers Ins. Co., (December 23, 2002), Stark App. Nos. 2001CA00380, 2001CA00393, 2001CA00407, 2001CA00409, 2002-Ohio-7369, the court held that even though the company had not complied with filing a certificate of insurance or a bond, it had nonetheless proven that it bore the financial responsibility at all times.
{¶ 44} Attached to its motion for summary judgment, the company included "a Payment Agreement * * *. The payment agreement makes Collins responsible upon billing for each payment made under the policy, up to $500,000 for the commercial automobile policy and $1,000,000 for the general liability policy. * * * In order to secure the amounts that may be paid, Collins is required to provide a promissory note and a securityacceptable as collateral." Based upon these documents, the court's opinion found "Collins is responsible for payments made to claimants under the policy up to the retained amounts. By agreeing to reimburse and provide a promissory note and security, Collins is self-insured up to the retained amounts because the risk of loss has not shifted away from Collins." (Emphasis added.) In other words, a company claiming to be self-insured and therefore exempt from R.C.
{¶ 45} No such proof was provided in the case at bar. It is agreed Lucent did not file a certificate of insurance with the state, nor does it have a bond. Lucent's motion, moreover, did not attach any proof of its financial ability to pay claims as was produced in Dalton v.Travelers, supra. Nor did Lucent take any "definitive and legally certain steps" such as providing a "promissory note and security acceptable as collateral."
{¶ 47} The Tenth District, in Dalton v. Wilson (Aug. 8, 2002), Franklin App. No. 01AP-1014, 2002-Ohio-4015, rejected expanding self-insurance in the "practical sense" to a policy containing "matching deductible" language. The court explained: "Because [the insured] neither obtained a certificate of self-insurance certifying that it is of sufficient financial ability to pay judgments against it (as contemplated in Snyder), nor posted a financial responsibility bond (as contemplated in Grange), [the insured] may not be considered a self-insurer. As the Montgomery County Court of Common Pleas stated in Roberts v. State FarmMutual Auto. Ins. Co. (2001), Montgomery C.P. No. 00-CV-0886: `It may be well and good and entirely lawful for a "fronting agreement" * * * to spare [an entity] the expense and potential administrative quagmires of formal registration in every state, territory and country where it does business and for these "devices" to provide [an entity] the use of [an insurer's] filings and claims service, but they do not paralyze or mute the walking and quacking duck of insurance coverage.'" The Tenth District found this argument persuasive and concluded that Parker was not self-insured and therefore its policy was subject to the requirements of R.C.
{¶ 49} The majority admits that "the insurance company has absolute liability under the policy in the event that the self-insured is unable to satisfy judgment * * *." Although such a provision may satisfy the need for a guarantee, it also raises the threshold question of whether the employer is self-insured if, in the event of bankruptcy, the risk shifts to an insurance company. I disagree with the majority's sweeping conclusion that "the insured's discharge in bankruptcy would not affect the insurance company's absolute liability under the policy." For the majority, proof of financial responsibility is irrelevant so long as the self-insured "continues to bear the present risk of loss." The majority has impermissibly narrowed the proof of financial responsibility to the "present risk of loss."
{¶ 50} The majority is following the Fourth District, which begins its analysis with risk as the defining characteristic of a self-insured: "While insurance shifts the risk of loss from the insured to the insurer, self-insurance involves no risk shifting. Rather, in the self-insurance context, the risk is borne by the one on whom the law imposes it. The defining characteristic of insurance, the assumption of specific risks from customers in consideration for payment, is entirely absent where an entity self insures." Musser v. Musser, 2003-Ohio-1440 ¶ 17, citing Jennings v. Dayton (1996),
{¶ 51} The Twelfth Appellate District, however, distinguished between a fronting policy with matching liability limits and deductible, on the one hand, and, on the other hand, a policy with a clause specifying that during bankruptcy the insurer is obliged to pay a valid loss. Tucker v. Wilson, 2002-Ohio-5142 ¶ 14. Although both focus on risk, the Fourth and Twelfth Districts disagree in their analysis of the effect of the bankruptcy clause found in the insurance policy.
{¶ 52} In the case at bar, the provision in the "Business Auto Coverage Form" reads: "Bankruptcy or insolvency of the `insured' or the `insured's estate will not relieve us of any obligations under this Coverage Form."1 "Us" refers to drafter of the policy, that is, the insurance company. In Tucker the Business Automobile policy contained an identical "bankruptcy clause that provided that `bankruptcy or insolvency of the insured or the insured's estate will not relieve us [the insurer] of any obligations under this Coverage Form.'" (Emphasis added.) Id. ¶ 2. The Tucker court held that in the event of bankruptcy, the risk falls upon the insurer. The court emphasized, "* * * however minuscule the risk to [the insurer] may be, [the insured] does not retain 100 percent of the risk of loss. Rather, some risk has shifted to [the insurer]." Id. ¶ 4.
{¶ 53} In a cryptic paragraph, the Musser court disagreed that the presence of the bankruptcy clause changed the result. The Musser court claimed the employer retained "the risk of loss at all times." The court explained: "The employer's bankruptcy or insolvency simply relieves the employer of a present obligation to pay the deductible. The insurerpresumably could later attempt to recover the funds from the employer." (Emphasis added.) ¶ 20. This latter explanation glosses over the contradiction of the prior statement. If the insurer cannot recover the funds from the employer, then the employer did not retain the risk of loss at all times. Moreover, any future relief of a "present obligation to pay" is shifts the risk. Whatever distinctions one makes between present relief and future attempts, the risk shifts. Where there is a dependency upon an insurance policy to provide the necessary guarantees, the statutory requirements governing an insurance policy applies.
{¶ 54} I agree with Judge Harsha's dissent in Musser: "* * * the legislature has created specific requirements for `self-insurance.' An entity that wishes to avail itself of that status ought to comply with the statutory scheme created by the legislature." ¶ 24.
{¶ 55} I, therefore, believe Landers' first assignment of error has merit.
{¶ 56} However, I would affirm the trial court's ruling that both the Lucent and American States policies did not extend to family members.2
{¶ 57} Unlike the policy in Scott-Pontzer, neither Lucent's nor American States' policy has "family member" language. In Edmondson v.Premier Indus. Corp. Cuyahoga App. No. 81132, 2002-Ohio-5573, this court noted the importance of language referencing "family members." "Absent such language, the coverage in the policy does not extend to family members of employees. Allen v. Johnson, 9th Dist. No. 01 CA0047, 2002-Ohio-3404; see also, Devore v. Richmond, 6th Dist. No. WD-01-044, 2002-Ohio-3965 (coverage did not extend to wife when policy specified employees covered when action within the scope of employment). Accordingly, Rodney Edmondson is not an `insured' under CNA's policy and summary judgment in favor of CNA and Premier was appropriate."
{¶ 58} Similarly, in Personal Serv. Ins. Co. V. Werstler, Stark App. Nos. 2002CA00232 and 2002CA00250, 2003-Ohio-932, the court stated: "[B]ecause the definition of "insured" does not contain the `if you are an individual, any family member' language found in the Scott-Pontzer policy, * * * [plaintiff] * * * is not an `insured' under the liability portion of [the] policy."
{¶ 59} In the case at bar, neither policy contains the crucial "family member" language present in Scott-Pontzer. I would thus overrule the second and sixth assignments of error. Because this issue is dispositive of the entire appeal, the trial court did not err in granting summary judgment to Lucent and American States.
{¶ 60} I thus concur in judgment only with the majority opinion.
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