Equitable General Insurance v. Johnson

303 S.E.2d 757, 166 Ga. App. 215, 1983 Ga. App. LEXIS 2105
CourtCourt of Appeals of Georgia
DecidedApril 6, 1983
Docket65619
StatusPublished
Cited by8 cases

This text of 303 S.E.2d 757 (Equitable General Insurance v. Johnson) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Equitable General Insurance v. Johnson, 303 S.E.2d 757, 166 Ga. App. 215, 1983 Ga. App. LEXIS 2105 (Ga. Ct. App. 1983).

Opinion

Birdsong, Judge.

This appeal arises from a complaint pursuant to OCGA § 33-34-6 (Code Ann. § 56-3406b) by Johnson for attorney fees and *216 penalties for Equitable’s alleged bad faith failure to pay Johnson’s insurance claims within 60 days of his demand.

The appellee Johnson was allegedly injured in an automobile accident on February 7, 1980 in the course of his employment. The appellant, Equitable General Ins. Co., is the employer’s insurer not only for workers’ compensation coverage but also for the employer’s vehicular personal injury protection (PIP). Johnson was paid workers’ compensation benefits for the February 7 accident until March 1980. Johnson then apparently also filed a civil suit (Fulton No. 64829) against Equitable for personal injury insurance coverage. (See, as to coordination of such benefits, OCGA § 33-34-8 (Code Ann. § 56-3409b)).

At some time on or before July 11, 1980, Johnson’s attorney agreed to accept $608.75 for this lawsuit claim. On August 14,1980, Johnson’s attorney sent Equitable a letter referencing no lawsuit or specific cause except “Your insured: GAB Services Inc./Claimant: George Johnson/Date of Accident: 2/7/80,” and therewith demanded payment of a total of $1,221 in doctor’s bills. At that time, on August 14, the civil lawsuit (Fulton No. 64829) in which Johnson claimed under Equitable’s PIP coverage, was still pending. Six days later on August 20, Johnson’s attorney sent Equitable’s claims representative a letter referencing the civil lawsuit (Fulton No. 64829), and saying: “Iamhappy we were able to conclude the above-captioned matter, and I enclose herewith a copy of the Dismissal filed herein, which I trust will meet with your satisfaction.” The dismissal, dated August 20, “dismisses [Johnson’s] complaint____with prejudice in consideration for the payment of the sum of $608.75, and does hereby authorize the Clerk of this Court to mark said case and cause terminated with prejudice.”

Two months later, on October 20, Johnson again sued Equitable (Fulton No. 68001) alleging that he had “fully complied with [the policy] with regard to claims made for earnings and medical expenses” and stating that Equitable had “in bad faith denied or neglected to pay the said claims of Plaintiff’ for 30 days, thus entitling Johnson to a 25% penalty and attorney fees; the August 14 letter demanding $1,221 was attached to the complaint.

On October 23, Johnson’s attorney allegedly sent another letter demanding $1,250 for medical expenses and $2,020 for lost wages, for a total demand of $3,270. Equitable contends Johnson had also filed additional workers’ compensation claims for any injuries or losses in August 1980, and that thus a correlation of benefits was in issue. In March 1981, Equitable’s attorney and Johnson’s attorney engaged in settlement discussions whereby it was agreed between them that Equitable would pay the PIP basic limit, $5,000, to Johnson for all *217 claims. However, Johnson repudiated or refused to approve this settlement. Equitable moved to have the settlement enforced.

On June 23,1981, Johnson (without dismissing the pending No. 68001 suit) filed a third lawsuit (Fulton No. 76923) seeking the $3,270 he had allegedly demanded by letter of October 23. Equitable moved in July 1981 to dismiss this suit on the basis of prior pending action, and filed a brief citing Code Ann. § 3-601 (OCGA § 9-2-5) and two Georgia court decisions. Johnson fought this motion to dismiss on grounds that Equitable had failed to file a brief of legal authority. Johnson did not dismiss the prior pending action until September 1981. On September 23, he amended his third (remaining) lawsuit, No. 76923, to claim punitive damages for failure to pay in 60 days, in addition to 25% penalties and attorney fees, and attached thereto confusing exhibits containing his demands; but apparently these demanded the $1,250 and $2,020 allegedly claimed in the October 23, 1980 letter.

On February 3,1982, Johnson’s attorney made letter demand of $7,020 for lost wages. Johnson then on February 16 made a motion in limine and partial summary judgment seeking to establish that no settlement had been reached in March 1981, and to exclude all evidence of the March 1981 settlement negotiations in the “bad faith” trial.

But on March 31,1982, Johnson’s attorney by letters admitted to Equitable, for the first time, that the correlation of workers’ compensation and personal injury insurance benefits provisions of OCGA § 33-34-6 (Code Ann. § 56-3406b) were applicable, and that inasmuch as he had been paid $608.75 (on or before August 20,1980) and Equitable claimed $930 was all that was additionally (allegedly) owed, the total of these two figures was $1,538.75, leaving from the $5,000 policy limits a balance of $3,461.25 “which defines our demand.” Notwithstanding the confusion inherent in this “demand,” Equitable forthwith paid Johnson $3,461.25. Equitable filed a motion for summary judgment with respect to the substance of Johnson’s personal injury insurance claims.

In April 1982, Equitable filed a motion for partial summary judgment with respect to Johnson’s “bad faith” penalties claims. On August 4, the trial court granted Johnson’s motion for partial summary judgment that there had been no settlement, and granted Johnson’s motion that any settlement negotiations would be excluded, as irrelevant, from the trial on Equitable’s bad faith. Equitable’s motion for summary judgment on the issues of bad faith was denied. From these latter rulings, Equitable appeals. Held:

1. Under the circumstances we have described in such painful detail, the trial court erred in denying Equitable’s motion for *218 summary judgment as to the issues of penalties and punitive damages for bad faith. The record in this case clearly shows that the only time Equitable did not immediately, and within 30 days and'in good faith, pay Johnson’s reasonably proved and bona fide undisputed claims, was after Johnson’s claim letter of August 14, 1980, demanding $1,221. That claim letter was issued when a lawsuit (No. 64829) was then pending. The letter was vague and did not state whether the claimed amounts were in reference to the pending lawsuit or to some new matter, and moreover it did not indicate whether this was a claim that should be outside the purview of the then-pending (No. 64829) lawsuit. Johnson had happily accepted $608.75 with no demurrer concerning the August 14 claim demand for $1,221 and dismissed the lawsuit with prejudice on August 20. At best, Johnson’s claims actions were confused and confusing; the insurer cannot be faulted and penalized for being befuddled. There was at the very least a bona fide dispute as to whether there was an accord and satisfaction, or a waiver, of Johnson’s August 14 demand of $1,221 by his August 20 acceptance of $608.75 and dismissal of his suit with prejudice.

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Bluebook (online)
303 S.E.2d 757, 166 Ga. App. 215, 1983 Ga. App. LEXIS 2105, Counsel Stack Legal Research, https://law.counselstack.com/opinion/equitable-general-insurance-v-johnson-gactapp-1983.