Fulmer v. Insura Prop. & Cas. Co.

2002 Ohio 64, 94 Ohio St. 3d 85
CourtOhio Supreme Court
DecidedJanuary 16, 2002
Docket2000-1788
StatusPublished
Cited by12 cases

This text of 2002 Ohio 64 (Fulmer v. Insura Prop. & Cas. Co.) is published on Counsel Stack Legal Research, covering Ohio Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Fulmer v. Insura Prop. & Cas. Co., 2002 Ohio 64, 94 Ohio St. 3d 85 (Ohio 2002).

Opinion

[This decision has been published in Ohio Official Reports at 94 Ohio St.3d 85.]

FULMER, APPELLANT, v. INSURA PROPERTY & CASUALTY COMPANY, D.B.A. THE SHELBY INSURANCE GROUP, APPELLEE. [Cite as Fulmer v. Insura Prop. & Cas. Co., 2002-Ohio-64] Insurance—Underinsured motorist coverage—Insured gives underinsurance carrier notice of a tentative settlement prior to release—Release will not preclude recovery of underinsurance benefits, when—Insured satisfies exhaustion requirement in underinsured motorist provision in insurance policy, when. (No. 00-1788—Submitted October 3, 2001—Decided January 16, 2002.) APPEAL from the Court of Appeals for Seneca County, No. 13-99-65. __________________ SYLLABUS OF THE COURT 1. When an insured has given her underinsurance carrier notice of a tentative settlement prior to release, and the insurer has had a reasonable opportunity to protect its subrogation rights by paying its insured the amount of the settlement offer but does not do so, the release will not preclude recovery of underinsurance benefits. (McDonald v. Republic-Franklin Ins. Co. [1989], 45 Ohio St.3d 27, 543 N.E.2d 456, paragraph two of the syllabus, extended and followed; Bogan v. Progressive Cas. Ins. Co. [1988], 36 Ohio St.3d 22, 521 N.E.2d 447, paragraph five of the syllabus, overruled.) 2. An insured satisfies the exhaustion requirement in the underinsured motorist provision of her insurance policy when she receives from the underinsured tortfeasor’s insurance carrier a commitment to pay any amount in settlement with the injured party retaining the right to proceed against her underinsured motorist insurance carrier only for those amounts in excess of the tortfeasor’s available policy limits. (Bogan v. Progressive Cas. Ins. Co. SUPREME COURT OF OHIO

[1988], 36 Ohio St.3d 22, 521 N.E.2d 447, paragraph two of the syllabus, clarified and followed.) __________________ DOUGLAS, J. {¶ 1} Plaintiff-appellant, Catherine Fulmer, was injured when her automobile was struck by an automobile driven by Albert Kulics. Kulics’s negligence caused the collision. At the time of the accident, Kulics, the tortfeasor, was insured under a policy of automobile insurance with liability coverage limits of $50,000 per person. Fulmer was insured under a policy of automobile insurance issued by defendant-appellee, Insura Property & Casualty Insurance Company, that provided underinsured motorist coverage with a limit of $100,000 per person. {¶ 2} As is generally true of insurance contracts that provide underinsured motorist coverage, Fulmer’s contract with Insura contained an exhaustion clause and a subrogation clause. These clauses set forth prerequisites that Fulmer was required to meet before she could settle with the tortfeasor if Fulmer intended to pursue an underinsured motorist claim against Insura. Specifically, the exhaustion clause prohibited Fulmer from settling with a tortfeasor for less than the tortfeasor’s coverage limits unless, of course, Insura consented.1 The subrogation clause required Fulmer to protect Insura’s subrogation rights against the tortfeasor, i.e., it precluded Fulmer from executing a release of the tortfeasor without Insura’s

1. The Insura policy’s exhaustion clause provided: “We will pay compensatory damages which an insured is legally entitled to recover from the owner or operator of an uninsured [or underinsured] motor vehicle because of bodily injury caused by an accident. The owner’s or operator’s liability for these damages must arise out of the ownership, maintenance or use of the uninsured [or underinsured] motor vehicle. “We will pay under this coverage only if 1. or 2. below applies: “1. The limits of liability under any applicable bodily injury liability bonds or policies have been exhausted by payment of judgments or settlements; or “2. A tentative settlement has been made between an insured and the insurer of [the underinsured] vehicle * * * and we: “a. Have been given prompt written notice of such settlement; and “b. Advance payment to the insured in an amount equal to the tentative settlement within 30 days after receipt of notification.” (Boldface omitted.)

2 January Term, 2002

consent.2 According to the policy, Fulmer would forfeit her claim to underinsured motorist benefits if she failed to satisfy these provisions. {¶ 3} After negotiations with Fulmer’s attorney, the tortfeasor’s insurer offered $37,500 to settle Fulmer’s claim against the tortfeasor. Although Fulmer believed that her damages exceeded the tortfeasor’s policy limit of $50,000, she decided, for various reasons, to accept the offer and forgo the additional $12,500 available under the tortfeasor’s insurance policy. As is generally required in settlement agreements, Fulmer’s acceptance of the settlement offer required her to execute a release of all claims against the tortfeasor. {¶ 4} Because Fulmer intended to pursue underinsured motorist benefits from Insura for her damages in excess of the tortfeasor’s $50,000 liability limit, she advised Insura of the settlement offer and requested Insura’s consent. In the alternative, Fulmer requested that Insura pay her $37,500, the amount of the settlement offer, so that Insura could preserve its subrogation rights against the tortfeasor. {¶ 5} Insura refused to consent to the settlement, asserting that the amount offered did not exhaust the tortfeasor’s insurance limit. Insura also refused to pay Fulmer $37,500 to retain its subrogation rights against the tortfeasor because, it contended, Fulmer’s damages were less than the tortfeasor’s policy limit. {¶ 6} Thereafter, Fulmer, without Insura’s consent, settled the matter with the tortfeasor’s insurer for $37,500. Fulmer informed Insura of the settlement and requested arbitration to determine whether she was entitled to underinsured

2. The Insura policy’s subrogation clause provided: “If we make a payment under this policy and the person to or for whom payment was made has a right to recover damages from another we shall be subrogated to that right. That person shall do: “1. Whatever is necessary to enable us to exercise our rights; and “2. Nothing after loss to prejudice them.”

3 SUPREME COURT OF OHIO

motorist benefits, i.e., to determine whether she could prove that her damages exceeded the tortfeasor’s available insurance limit of $50,000. {¶ 7} Insura rejected Fulmer’s demand for arbitration, asserting that Fulmer had violated the exhaustion and subrogation clauses of her policy and thereby forfeited her rights to underinsured motorist benefits. Fulmer consequently filed a complaint against Insura, seeking a declaratory judgment that she was entitled to underinsured motorist benefits. {¶ 8} Insura moved for summary judgment and Fulmer filed a response in opposition. To support their respective positions with regard to the exhaustion issue, both parties relied on conflicting courts of appeals’ interpretations of this court’s holding in Bogan v. Progressive Cas. Ins. Co. (1988), 36 Ohio St.3d 22, 521 N.E.2d 447. Insura relied on the Third District Court of Appeals’ interpretation of Bogan set forth in Stahl v. State Farm Mut. Auto. Ins. Co. (1992), 82 Ohio App.3d 599, 612 N.E.2d 1260, to support its position that an insured satisfies an exhaustion clause only if she is able to show that the difference between the tortfeasor’s policy limit and the settlement amount was approximately equal to the amount saved in litigation expenses.

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2002 Ohio 64, 94 Ohio St. 3d 85, Counsel Stack Legal Research, https://law.counselstack.com/opinion/fulmer-v-insura-prop-cas-co-ohio-2002.