Caliman v. American General Fire & Casualty Co.

641 N.E.2d 261, 94 Ohio App. 3d 572, 1994 Ohio App. LEXIS 1974
CourtOhio Court of Appeals
DecidedMay 11, 1994
DocketNos. C-920602, C-930236 and C-930260.
StatusPublished
Cited by3 cases

This text of 641 N.E.2d 261 (Caliman v. American General Fire & Casualty 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
Caliman v. American General Fire & Casualty Co., 641 N.E.2d 261, 94 Ohio App. 3d 572, 1994 Ohio App. LEXIS 1974 (Ohio Ct. App. 1994).

Opinion

Per Curiam.

On April 18, 1984, John D. Mize (“Mize”) was employed by National Life & Accident Insurance Company (“NLAI”). As an employee of NLAI, Mize was eligible to participate in his employer’s group health and accident insurance plan under policy GE6500, which was underwritten by defendant American General Fire & Casualty Company (“AGFC”). Mize submitted an enrollment application for coverage under policy GE6500. Mize selected the “family plan,” which included a $50,000 benefit payable upon the accidental death of his wife Amma *574 Anim Mize. The enrollment application stated that Mize, the employee-applicant, was his spouse’s beneficiary. No one else was designated as a beneficiary of the insurance on his wife’s life. The premium for Amma Anim Mize’s coverage was paid by Mize through payroll deductions.

On August 25, 1984, Mize murdered his wife. He was tried, convicted and sentenced for her murder. The appeal of his conviction was dismissed as moot in September 1986 after Mize died in prison.

On December 5, 1985, while Mize’s appeal was still pending, A. Noel Caliman, administrator of the estate of Amma Anim Mize, contacted John B. Allyn, legal counsel and vice-president of AGFC, regarding the payment of the $50,000 death benefit upon Mize’s disqualification pursuant to R.C. 2105.19. R.C. 2105.19 provides in pertinent part:

“(A) * * * [N]o person who is convicted of, pleads guilty to, or is found not guilty by reason of insanity of a violation of or complicity in the violation of section 2903.01, 2903.02, or 2903.03 of the Revised Code * * * shall in any way benefit by the death. All property of the decedent, and all money, insurance proceeds, or other property or benefits payable or distributable in respect of the decedent’s death, shall pass or be paid or distributed as if the person who caused the death of the decedent had predeceased the decedent.”

Various options were discussed as a means of resolving the potentially conflicting claims for the $50,000 death benefit.

On January 29, 1986, Caliman and the parents of Amma Anim Mize filed a complaint for declaratory judgment requesting that the trial court declare that they were entitled to the $50,000 death benefit.

On August 24, 1987, Caliman and Amma Anim Mize’s parents filed a separate complaint alleging bad faith on the part of AGFC in failing to pay to them the $50,000 death benefit. The case was not consolidated with the declaratory judgment action, and was assigned to a different trial judge. Motions for summary judgment by the parties were overruled. A jury trial commenced July 6, 1992, on the claim of bad faith. At the close of the plaintiffs’ case-in-chief, AGFC moved for a directed verdict, which the trial court granted.

The trial court held that under policy GE6500 and R.C. 2105.19, the plaintiffs had no standing to assert a claim for the insurance proceeds payable upon the death of Amma Anim Mize because the evidence showed that Mize was the only person to whom the benefit was payable pursuant to the contract of insurance. Further, the court held that while R.C. 2105.19 disqualified Mize from obtaining the $50,000 death benefit, the statute did not invest plaintiffs with the right to receive the proceeds. The trial court also held that plaintiffs had failed to present a prima facie case of bad-faith failure to pay insurance proceeds. *575 Cabman and Amma Anim Mize’s parents appealed the trial court’s ruling in case No. C-920602.

On August 31, 1992, AGFC filed a motion in the declaratory judgment action, which was pending before another judge, requesting judgment as a matter of law based upon the doctrine of collateral estoppel. AGFC argued that plaintiffs were collaterally estopped from rebtigating their right to the $50,000 death benefit because that issue had been btigated in the bad-faith action and had been decided against plaintiffs. The trial court ordered the declaratory judgment action to proceed to a bench trial on November 9, 1992. The trial court held that Amma Anim Mize’s parents were entitled to the $50,000 death benefit under policy GE6500. Plaintiffs filed a motion for prejudgment interest, which the trial court overruled. AGFC appealed the trial court’s judgment in the case numbered C-930286. Plaintiffs filed a cross-appeal from the denial of their motion for prejudgment interest in case No. C-930260. The appeal and cross-appeal in the declaratory judgment action were consolidated with the appeal in the bad-faith case.

We will first address the three assignments of error raised by Cabman and Amma Anim Mize’s parents in their appeal from the trial court’s judgment in the bad-faith action. The assignments of error, as set forth by plaintiffs, allege:

“Whether the trial court erred as a matter of law where it failed to find that the parents of Amma Anim Mize have standing to sue, pursuant to plaintiffs-appellants’ motion for summary judgment;

“The trial court erred in determining the defendant-appellee’s motion for summary judgment where it failed to find that the defendant-appellee engaged in bad faith;

“The trial court erred as a matter of law where it granted a directed verdict at the close of plaintiffs-appellants’ case.”

Insurance coverage is a matter of contract. See Karabin v. State Auto. Mut. Ins. Co. (1984), 10 Ohio St.3d 163, 10 OBR 497, 462 N.E.2d 403. An insurance company is liable for payment of insurance proceeds only according to the terms and provisions contained in the policy of insurance. White v. Ogle (1979), 67 Ohio App.2d 35, 21 O.O.3d 347, 425 N.E.2d 926.

Pobcy GE6500 provides for the payment of the accidental loss-of-bfe benefit as follows:

“Payment of Claims: Indemnity for accidental loss of life will be payable in a lump sum to the beneficiary of record.”

The enrollment application submitted by Mize stated that Mize, as the employee-applicant, was the beneficiary of the insurance coverage on his spouse, *576 Amma Anim Mize. No other beneficiary was designated for the insurance on his wife’s life. Under the payment-of-claims provision of policy GE6500, the $50,000 was payable only to Mize as the beneficiary of record.

The distribution provision of policy GE6500 provides:

“If, at the death of the Insured, there is no surviving beneficiary, the accidental loss of life indemnity shall be payable in one sum to the first surviving class of beneficiaries, otherwise to the estate of the Insured: wife, husband, child or children, father, mother, brothers or sisters.”

Plaintiffs argue that the distribution provision, in concert with R.C. 2105.19, which disqualifies Mize as a beneficiary and provides that he shall be treated as though he predeceased his wife, requires that the $50,000 death benefit be paid to the first class of surviving beneficiaries, the parents of Amma Anim Mize. We disagree.

The term “Insured” is defined in the policy of insurance as one whose name appears on a schedule maintained by the insurer.

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Bluebook (online)
641 N.E.2d 261, 94 Ohio App. 3d 572, 1994 Ohio App. LEXIS 1974, Counsel Stack Legal Research, https://law.counselstack.com/opinion/caliman-v-american-general-fire-casualty-co-ohioctapp-1994.