Ballard v. Nationwide Ins. Co.

2015 Ohio 4474
CourtOhio Court of Appeals
DecidedOctober 22, 2015
Docket14-MA-85
StatusPublished
Cited by2 cases

This text of 2015 Ohio 4474 (Ballard v. Nationwide Ins. Co.) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ballard v. Nationwide Ins. Co., 2015 Ohio 4474 (Ohio Ct. App. 2015).

Opinion

[Cite as Ballard v. Nationwide Ins. Co., 2015-Ohio-4474.]

STATE OF OHIO, MAHONING COUNTY IN THE COURT OF APPEALS SEVENTH DISTRICT

LATIA N. BALLARD, et al., ) ) PLAINTIFFS-APPELLANTS, ) ) CASE NO. 14 MA 85 V. ) ) OPINION NATIONWIDE INSURANCE COMPANY, ) ) DEFENDANT-APPELLEE. )

CHARACTER OF PROCEEDINGS: Civil Appeal from Court of Common Pleas of Mahoning County, Ohio Case No. 10CV1132

JUDGMENT: Reversed and Remanded

APPEARANCES: For Plaintiffs-Appellants Attorney Angela J. Mikulka Attorney Thomas L. Mikulka 134 Westchester Drive Youngstown, Ohio 44515

For Defendant-Appellee Attorney John C. Pfau P.O. Box 9070 Youngstown, Ohio 44513

JUDGES:

Hon. Gene Donofrio Hon. Cheryl L. Waite Hon. Carol Ann Robb

Dated: October 22, 2015 [Cite as Ballard v. Nationwide Ins. Co., 2015-Ohio-4474.] DONOFRIO, P.J.

{¶1} Plaintiffs-appellants, Latia Ballard and James Glenn, appeal from a Mahoning County Common Pleas Court judgment granting summary judgment in favor of defendant-appellee, Nationwide Insurance Company, on appellants’ claim for bad faith. {¶2} Appellants were involved in an automobile accident on February 6, 2001. Glenn was driving and Ballard was a passenger in his car. Glenn was insured by Nationwide. Pursuant to the terms of the policy, Ballard was also an insured. {¶3} The insurance policy contains a “medical benefit” provision, which provides that Nationwide will pay “usual, customary and reasonable charges—not to exceed $5,000—for medically necessary services.” Appellants both submitted medical claims pursuant to this provision. {¶4} Nationwide initially allowed Glenn’s claim and issued him a check. But Glenn’s counsel returned the check and asked that Nationwide reissue it in the name of the medical provider. Nationwide then denied Glenn’s claim as well as Ballard’s claim. {¶5} Appellants filed a complaint against Nationwide raising claims for breach of contract and bad faith denial of coverage. {¶6} Nationwide filed a motion for summary judgment on the breach of contract claims, where it argued that in light of appellants' full settlement with the tortfeasor, they could not establish damages. The trial court granted summary judgment in Nationwide’s favor. Appellants filed an appeal with this court. Ballard v. Nationwide, 7th Dist. No. 11 MA 122, 2013-Ohio-2316. {¶7} On appeal, this court found that appellants completely settled their personal injury claims with the tortfeasor, including their claims for medical expenses. Id. at ¶18. Because of this settlement, we found appellants agreed they had been reimbursed for their medical expenses. Id. We went on to conclude that if there were no medical expenses to reimburse, there were no damages in the breach of contract claims. Id. In affirming the trial court’s grant of summary judgment on the breach of contract claims, we noted that the bad faith denial of coverage claims remained pending in the trial court. Id. at ¶30. -2-

{¶8} Back in the trial court, Nationwide filed a motion for summary judgment on appellants’ bad faith claims. It relied on a finding in the trial court’s previous summary judgment ruling:

Defendant Nationwide investigated the claims under the medical payments benefits of the Nationwide policy in effect, which included a chiropractic records review. Defendant Nationwide did not pay the medical expenses under the coverage since their investigation supported that the medical expenses were not related to the accident.

(July 18, 2011, Judgment Entry). Nationwide argued there was no genuine issue of material fact on the bad faith claims because the denial of the claims was fairly debatable and it was reasonably justified in denying appellants’ claims. It also argued that appellants’ bad faith claims were dependent on their success on their breach of contract claims. And because appellants failed on their breach of contract claims, Nationwide argues, appellants’ bad faith claims necessarily failed. {¶9} Appellants filed a memorandum in opposition to the summary judgment motion arguing reasonable minds could differ on the issue of whether Nationwide failed to handle their claims in good faith. {¶10} The trial court granted Nationwide’s motion for summary judgment. It found the evidence did not reach a threshold level to support a bad faith claim. The court noted that this court upheld its grant of summary judgment on the breach of contract claim. It found that even when there is a factual dispute that takes a breach of contract claim to a jury, this operates to preclude a bad faith claim. It further found the claims here were “fairly debatable” and therefore, based upon reasonable justification. The court pointed out that a factual finding was already made that Nationwide’s investigation supported that the medical expenses were not related to the accident, which was further supported by a chiropractic peer review report establishing that the issue was fairly debatable and Nationwide was justified in its denial. Because the issue was fairly debatable, the trial court found this demonstrated that Nationwide’s decision was not arbitrary or capricious but was -3-

instead based on reasonable justification. Moreover, the court found the bad faith claims were contingent on the breach of contract claims. Therefore, the court granted summary judgment on the bad faith claims. {¶11} Appellants filed a timely notice of appeal on July 8, 2014. {¶12} Appellants now raise two assignments of error. The first assignment of error deals with Ballard’s claim while the second assignment of error deals with Glenn’s claim. Both assignments of error assert the trial court should not have granted Nationwide’s summary judgment motion on the bad faith claims. {¶13} In reviewing a trial court's decision on a summary judgment motion, appellate courts apply a de novo standard of review. Cole v. Am. Industries & Resources Corp., 128 Ohio App.3d 546, 552, 715 N.E.2d 1179 (7th Dist.1998). Thus, we shall apply the same test as the trial court in determining whether summary judgment was proper. Civ.R. 56(C) provides that the trial court shall render summary judgment if no genuine issue of material fact exists and when construing the evidence most strongly in favor of the nonmoving party, reasonable minds can only conclude that the moving party is entitled to judgment as a matter of law. State ex rel. Parsons v. Flemming, 68 Ohio St.3d 509, 511, 628 N.E.2d 1377 (1994). A “material fact” depends on the substantive law of the claim being litigated. Hoyt, Inc. v. Gordon & Assoc., Inc., 104 Ohio App.3d 598, 603, 662 N.E.2d 1088 (8th Dist.1995), citing Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). {¶14} The first assignment of error states:

THE TRIAL COURT ERRED IN FINDING AS A MATTER OF LAW THAT NATIONWIDE DID NOT UNREASONABLY DELAY EITHER THE PROCESSING AND PAYMENT OR THE FORMAL DENIAL OF PLAINTIFF-APPELLANT BALLARD’S MEDICAL PAYMENTS CLAIM FOR A PERIOD OF ESSENTIALLY ELEVEN MONTHS.

{¶15} Ballard argues the facts here raise a bad faith claim for failure to -4-

process and either pay or deny her medical payments claim within a reasonable time. She asserts the issue can only be resolved by a trier of fact. She points out that her counsel submitted her medical payments claim to Nationwide on September 20, 2001, and, after receiving no response, sent reminder letters on October 29, 2001, February 6, 2002, and April 2, 2002.

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