Dorsey v. Federal Insurance

798 N.E.2d 47, 154 Ohio App. 3d 568, 2003 Ohio 5144
CourtOhio Court of Appeals
DecidedSeptember 26, 2003
DocketNo. 02 JE 26.
StatusPublished
Cited by6 cases

This text of 798 N.E.2d 47 (Dorsey v. Federal Insurance) 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
Dorsey v. Federal Insurance, 798 N.E.2d 47, 154 Ohio App. 3d 568, 2003 Ohio 5144 (Ohio Ct. App. 2003).

Opinion

Waite, Presiding Judge.

{¶ 1} This case involves a dispute over whether or not two people injured in an automobile accident are entitled to receive underinsured motorist (“UIM”) benefits under the insurance coverage maintained by their employers. The injured plaintiffs believe that they should receive UIM benefits based on the principles set forth in Scott-Pontzer v. Liberty Mut. Fire Ins. Co. (1999), 85 Ohio St.3d 660, 710 N.E.2d 1116. The issues in the instant case are not analogous to those in the Scott-Pontzer case because neither policy is governed by the mandatory aspects of the uninsured/underinsured (“UM/UIM”) statute, R.C. 3937.18. Thus, the decision of the Jefferson County Court of Common Pleas in favor of the insurers is affirmed.

{¶ 2} On December 15, 1997, appellant Herbert Dorsey was driving his 1991 Chevy Blazer in Toronto, Ohio, with appellant Laquishia Dorsey sitting in the passenger seat. Appellants were struck by a vehicle driven by Ronald Paris. Both appellants sustained numerous injuries.

*571 {¶ 3} It is undisputed that appellants were engaged in their own personal affairs when the accident happened and were not acting in the course or scope of employment. Mr. Dorsey was employed by the Jefferson County Sheriffs Department, and Mrs. Dorsey worked for Banc One Corporation.

{¶ 4} Mr. Dorsey maintained $50,000 in UIM coverage through his personal automobile policy issued by Westfield Insurance Co. (“Westfield”).

{¶ 5} On October 29, 2001, appellants filed a declaratory judgment action in the Jefferson County Court of Common Pleas. Appellants alleged that they had additional losses not covered by Mr. Paris’s insurance policy, which had paid its limit of $100,000. Appellants claimed that they were owed UIM benefits under their personal Westfield policy and the insurance policies maintained by each of their employers.

{¶ 6} Mr. Dorsey claimed coverage as an employee of the Jefferson County Sheriffs Department, which was a member of a self-insurance program created by the Ohio County Risk Sharing Authority (“CORSA”). The CORSA policy provided $250,000 in UIM coverage.

{¶ 7} Mrs. Dorsey’s employer, Banc One, held a policy issued by Federal Insurance Co. (“Federal”). The Federal policy contained $2,000,000 in UIM coverage. Mrs. Dorsey believed that she was insured under the Federal policy.

{¶ 8} On June 4, 2002, the trial court filed its ruling on the declaratory judgment action. The trial court held that Westfield was required to pay the policy limits of Mr. Dorsey’s personal automobile policy. The court decided that the CORSA policy was not “insurance” as set forth in R.C. 3937.18. The court held that CORSA was not required to offer UIM coverage and was not subject to the requirements of R.C. 3937.18. Even though the CORSA policy was not required to offer UIM coverage, the court determined that the policy contained $250,000 in UIM coverage. The court held that UIM coverage was excluded under the CORSA policy unless the employee was acting within the scope of employment or on behalf of the business of Jefferson County. It was undisputed that Mr. Dorsey was not acting in the scope of employment, and therefore, the court concluded, there was no UIM coverage under CORSA.

{¶ 9} The court rejected Federal’s argument that it was a self-insurer and therefore exempt from the requirements of R.C. 3937.18. Federal had argued that the policy was a mere “fronting agreement” and that Banc One was actually liable for all losses. Federal pointed out that the liability limit and the deductible were the same amount and that Banc One, rather than Federal, was liable for any claims under the policy. The court acknowledged that self-insurers are not bound by the requirements of R.C. 3937.18. The court reasoned that the cases dealing with self-insurance required more than mere proof that the policy liability *572 limit and policy deductible were for the same amount. The court held that the Federal policy was not self-insurance and was subject to R.C. 3937.18. Nevertheless, the court found that appellants were excluded from coverage because they were driving an excluded automobile according to the terms of the policy. The court also found that appellants were excluded under the “drive other car” exclusion. The court rendered judgment in favor of CORSA and Federal and against Westfield. This timely appeal followed.

{¶ 10} Westfield subsequently settled with appellants and is not a party to this appeal.

ISSUES ON APPEAL

{¶ 11} Appellants did not prepare any formal assignments of error. Appellants disagree with the way the trial court interpreted both the CORSA policy and the Federal policy. Appellants believe that the policies are ambiguous and should be interpreted in the insureds’ favor in order to provide coverage.

{¶ 12} The issues raised by appellants all involve the interpretation of two insurance contracts. If the terms of an insurance policy are unambiguous, the interpretation of the policy is a matter of law to be decided by the court and is reviewed de novo on appeal. Murray v. All Am. Ins. Co. (1997), 121 Ohio App.3d 29, 31, 698 N.E.2d 1027. “Because an insurance policy is a written contract, we look to its terms to determine the intention of the parties concerning coverage. In so doing, the court must give the words in the policy their plain and ordinary meaning.” Minor v. Allstate Ins. Co., Inc. (1996), 111 Ohio App.3d 16, 20, 675 N.E.2d 550, 553. Furthermore, “[w]here provisions of a contract of insurance are reasonably susceptible of more than one interpretation, they will be construed strictly against the insurer and liberally in favor of the insured.” Lane v. Grange Mut. Cos. (1989), 45 Ohio St.3d 63, 65, 543 N.E.2d 488. The court decides whether a provision should be construed against the insurer and in favor of the insured. Id.

{¶ 13} Appellants believe that the trial court should have found ambiguities in the two polices and should have construed those ambiguities, as a matter of law, in appellants’ favor. These purely legal issues are reviewed de novo on appeal.

THE FEDERAL INSURANCE POLICY

{¶ 14} With respect to Federal, appellants assert that they are both covered by the UIM provisions of the policy based on the holdings of Scott-Pontzer, supra. The Federal policy provides insurance for a corporation and defines the corporation as “you,” just as in Scott-Pontzer. The Ohio Supreme Court in the Scott-Pontzer decision essentially held that an automobile liability policy that lists a *573 corporation as the only insured party, and that refers to the corporation as “you” in the policy, must also include the employees of the corporation as insured persons for purposes of UM/UIM coverage under R.C. 3987.18.

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Cite This Page — Counsel Stack

Bluebook (online)
798 N.E.2d 47, 154 Ohio App. 3d 568, 2003 Ohio 5144, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dorsey-v-federal-insurance-ohioctapp-2003.