Cunningham Lindsey Claims Management, Inc. v. Oklahoma State Insurance Fund

2002 OK CIV APP 7, 38 P.3d 248, 73 O.B.A.J. 409, 2001 Okla. Civ. App. LEXIS 135, 2001 WL 1717230
CourtCourt of Civil Appeals of Oklahoma
DecidedAugust 28, 2001
Docket95,435
StatusPublished
Cited by3 cases

This text of 2002 OK CIV APP 7 (Cunningham Lindsey Claims Management, Inc. v. Oklahoma State Insurance Fund) is published on Counsel Stack Legal Research, covering Court of Civil Appeals of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cunningham Lindsey Claims Management, Inc. v. Oklahoma State Insurance Fund, 2002 OK CIV APP 7, 38 P.3d 248, 73 O.B.A.J. 409, 2001 Okla. Civ. App. LEXIS 135, 2001 WL 1717230 (Okla. Ct. App. 2001).

Opinion

OPINION

GARRETT, Judge.

{1 - Appellant, - Cunningham - Lindsey Claims Management, Inc., (Cunningham), 1 had a contract with Appellee, Oklahoma State Insurance Fund (Fund), to serve as a third party administrator for workers' compensation "lost time" claims on a "per claim" basis. These claims were designated as "Tier II claims". Cunningham alleged the contract price per claim was $780.00, as agreed by the parties and approved by the State Purchasing Director (SPD) of the Department of Central Services (DCS), pursuant to the Oklahoma Central Purchasing Act, (OCPA), 74 O.S.1991 §§ 85.1, et seq., as amended. Cunningham sued Fund for the unpaid portion of $730.00 per claim which it alleged was due on each of 3792 files. Cunningham also sued for $178,120.00, for payment for its work on the claims relating to the Murrah Building bombing, and for reimbursement of $18,261.82 expense for legal experts and $3,600.00 expense for medical experts who assisted it in processing the claims. Cunningham claimed it is due a total of $1,258,366.80. Fund alleged in its answer that the contract price was modified from $730.00 per claim to $475.00 per claim. It also alleged that it never gave Cunningham its approval to process the bombing claims or to incur expenses for the experts.

12 Cunningham filed a motion for summary judgment. The trial court's order provides as follows:

IT IS HEREBY ORDERED, ADJUDGED AND DECREED that the contract between the parties was modified from a price of $730.00 for each Tier II "lost time claim" file under the contract to a price of $475.00 per file, and that therefore, Plaintiff is not entitled to the balance of $1,053,385.00 for work on the Tier II files. The Court FINDS that Defendant is entitled to summary judgment on that issue.
THE COURT FURTHER FINDS that the Plaintiff is entitled to the modified contract rate of $425.00 per file for reviewing 244 workers compensation files involving individuals who were killed or injured in the bombing of the Murrah Building in Oklahoma City on April 19, 1995. Summary judgment is therefore awarded on this claim in favor of Plaintiff in the amount of $103,700.
THE COURT FURTHER FINDS that Plaintiff is entitled to summary judgment for fees incurred for legal and medical professionals who reviewed the 244 Mur-rah Building bombing files in the amount of $18,261.82 for the work of Attorney Charles S. Frigerio, and $3,600.00 for the work of Dr. Rick Mustain, D.C.

1 3 Cunningham filed this appeal pursuant to Rule 1.36, Supreme Court Rules, 12 O.S. 1991 Ch. 15, App. 1, Accelerated Procedure for Summary Judgments and Certain Dismissals. Fund filed a cross petition in error, alleging error as to the trial court's approval of the payment for the bombing files and for payment of the legal and medical fees incurred as expenses on the bombing files.

{4 In its response to Cunningham's motion for summary judgment, Fund claimed the price for each "Tier II" claim had been modified to $425.00 for non-litigated claims and $475.00 for litigated claims, and that this change had been by agreement with Cunningham. Fund contended its Commissioner at the time, Terry Tyree, had statutory authority to modify the contract without approval of the SPD because his actions related to the administration of the "insurance business", similar to actions which might be taken by the governing body of a private insurance carrier. See 85 O.S.1991 §§ 132, 133. 2 *250 Fund contends these statutes carve out an exception to the OCPA for its Commissioner. See also 85 O.S.Supp.1996 § 134, 3 which defines the powers and authority of Fund's Commissioner in conducting Fund's business and affairs.

T5 Fund contends the contract was modified by a letter dated April 9, 1996, from Paul R. Maggi, of Lindsey Morden, now, Cunningham, to John Yoder of "Alexander & Alexander", as follows:

Dear John:
Below is Lindsey Morden's quote for adjusting the Strike Force claims effective April 22, 1996.
$425.00 Non-Litigated Files
$475.00 Litigated Files
John, again thank you for your support on this project. If I can be of service, please do not hesitate to call me.

{6 Cunningham contended the contract could not be modified as between the parties to the contract after it was approved by the SPD, following the competitive bidding process. It also contends that the contract was unambiguous on its face and that the court should not have considered extraneous writings which varied its terms.

T7 Fund relies on a paragraph from Indiana National Bank v. State Department of Human Services, 1998 OK 101, ¶ 18 857 P.2d 53, 62-63, wherein the Supreme Court stated as follows:

[WJe now squarely hold it is only OPA 4 that has authority to approve material modifications of 'agreements onee it has accepted a bid in response to an invitation to bid, in the absence of some other Legislative authority to the contrary or specific approval from OPA sanctioning another agencies' authority to agree to such a modification. To rule otherwise would completely obliterate the Central Purchasing Act. [Emphasis supplied.]

*251 T8 Fund contends the highlighted portion of the quotation from Indiana National Bank v. State Department of Human Services, supra, indicates the Court's recognition that statutory authority could exist to which the OCPA must defer, although none applied to exempt DHS therein. Fund argues 85 O.S.1991 §§ 132, 133, supra, which are specific statutes, show Legislative intent to exempt it from the requirements of the OCPA, which is general in nature. However, we interpret §§ 132-134 to be merely Legislative intent to designate Fund's Commissioner as the PaTtY who negotiates on Fund's behalf. 5

19 We do not agree that Fund's Commissioner has authority to modify contracts without the OCPA director's approval. We have not been cited to a statute which specifically exempts the Fund from the requirements of the OCPA, or which provides the . . . Fund is authorized to modify contracts be- - . tween the SPD and private vendors following the OCPA bidding process. The OCPA ex. empts some agencies from its purview, but the Fund is not included. 6

1 10 The Supreme Court states in Indiana National Bank v. State Department of Human Services, at 857 P.2d 53, 61-63: 7

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2002 OK CIV APP 7, 38 P.3d 248, 73 O.B.A.J. 409, 2001 Okla. Civ. App. LEXIS 135, 2001 WL 1717230, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cunningham-lindsey-claims-management-inc-v-oklahoma-state-insurance-fund-oklacivapp-2001.