Guarantee Trust Life Insurance Co. v. Palsce

641 N.E.2d 1266, 1994 Ind. App. LEXIS 1431, 1994 WL 567848
CourtIndiana Court of Appeals
DecidedOctober 17, 1994
Docket71A03-9311-CV-382
StatusPublished
Cited by5 cases

This text of 641 N.E.2d 1266 (Guarantee Trust Life Insurance Co. v. Palsce) is published on Counsel Stack Legal Research, covering Indiana Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Guarantee Trust Life Insurance Co. v. Palsce, 641 N.E.2d 1266, 1994 Ind. App. LEXIS 1431, 1994 WL 567848 (Ind. Ct. App. 1994).

Opinion

OPINION

HOFFMAN, Judge.

Appellant-defendant Guarantee Trust Life Insurance Company (Guarantee) appeals from a judgment granted in favor of appel-lees-plaintiffs Catherine and David Palscee (Palsce). As extracted in part from Palsce v. Guarantee Trust Life Ins. Co. (1992), Ind. App., 588 N.E.2d 525, the facts relevant to this appeal are set forth below.

Catherine Palsee had health insurance at her place of work until she lost her job in 1986. In the fall semester of 1989, David Palsee, her son, brought home a brochure from his school offering a student accident insurance policy offered to the school by Guarantee. According to the brochure, two types of coverage were available, 24-hour coverage or at-school coverage. In bold print on the cover, the brochure stated, "Policy Maximum of $25,000 for Each Accident!" The brochure further explained that this was protection "[when [yJou need it" and that the 24-hour coverage was the best buy since it covers "away from school and summer vacation accidents." An "Important Notice to Parents" was provided explaining the "policy maximum per accident, for loss resulting directly and independently of all other causes from accidental bodily injury, covered under the Plan" was "$25,000.00."

The brochure then detailed the c-osts that would be covered for medical expenses and contained many exclusions and limitations. The bottom of the brochure stated that it was not a contract and that the insurance contract (the master policy) was on file at school. An application for insurance was attached to the brochure. Catherine read the brochure, filled out the application, and sent her $45.00 premium in for 24-hour coverage. She never attempted to read the master policy.

During the summer of 1990, David was involved in an accident causing permanent blindness in his right eye. As a result, he incurred medical bills in the amount of $11,-429.97. Catherine filed claims with Guarantee but was informed the policy covered only $1,000.00 for loss to an eye. Guarantee paid $1,099.57 for the medical bills and nothing for the loss of the eye.

Although the brochure had broadly advertised $25,000.00 maximum coverage for accidental loss, the policy severely limited the amount recoverable for specific types of losses. For instance, loss of life was $1,000.00, loss of hand or foot was $2,500.00, loss of both hands, feet, or sight in both eyes was $5,000.00, one hand and one foot was $5,000.00, and either hand or foot and the sight of one eye was $5,000.00. Most importantly, loss of sight in one eye was $1,000.00. None of these "specific" losses were included in the brochure, although it explicitly contained other policy information on medical expenses, excluded losses, and limitations on certain losses.

After a previous appeal resulting in reversal of summary judgment granted in favor of Guarantee, Palsce, 588 N.E.2d at 527, and the denial of its second motion for summary judgment, the case proceeded to a jury trial. At the close of evidence, Guarantee asked for but was denied judgment on the evidence. The jury returned a verdict in favor of the Palsees awarding them $25,000.00 in compensatory damages and $25,000.00 in punitive damages. This appeal ensued.

On appeal, Guarantee raises several issues for our review which we consolidate into three:

(1) whether law of the case precluded the Palsees' from prosecuting their fraud claim;
*1268 (2) whether there was sufficient evidence of fraud and the damages resulting therefrom; and
(3) whether the trial court erred by allowing an instruction encompassing the Indiana administrative regulations on deceptive advertising by an insurer.

Guarantee contends Paisce creates law of the case which precludes the Palsees' claim for fraud. Condensed, Guarantee's argument is that when representations in a promotional brochure act as the contract between the parties, the same language may not also be used as evidence of misrepresentation supporting a fraud claim.

Law of the case is a restriction which precludes re-examination of issues on remand and subsequent appeal which were either expressly or by necessary implication settled as a matter of law on prior review. Riggs v. Burell (1993), Ind., 619 N.E.2d 562, 564. The Palsees are correct that the above doctrine does not apply to estop them from bringing a fraud claim. Our reversal of Guarantee's summary judgment was favorable to the Palsees; only those issues which were clearly resolved adversely to Guarantee which it seeks to reassert again on appeal are barred. Id.

Also, Guarantee misinterprets Paisce In Palsce, the representations in Guarantee's promotional brochure were compared to the master policy. Only after finding Guarantee went to great lengths to place most of the ' policy provisions into the brochure thus making it appear to Catherine Palsee that those provisions fully corresponded to the contents and coverage of the policy, and also finding she relied on the representations in making her decision to purchase the policy, did we hold that Guarantee could not rely on the more narrow policy exclusions to deny the Palsees the broader coverage represented in the brochure. Id. at 527. Although we bound Guarantee by its representations in the brochure treating it as the contract between the parties, our decision in Pailsce neither expressly nor by necessary implication precluded the Palsces from pursuing their fraud claim.

Unlike contract obligations, tort duties arise by operation of law, not from an agreement between the parties. Erie Ins. Co. v. Hickman by Smith (1993), Ind., 622 N.E.2d 515, 519. Thus, although there exists circumstances where a contract can give rise to and support a fraud claim,

see e.g. id. (insurance contract supports claim for breach of duty of good faith);
Bud Wolf Chevrolet, Inc. v. Robertson (1988), Ind., 519 N.E.2d 135, 137 (extensively damaged vehicle repaired and misrepresented as new by dealer to induce sale at full price amounted to fraud supporting punitive damage award);
FD. Borkholder Co., Inc. v. Sandock (1980), 274 Ind. 612, 413 N.E.2d 567, 570-71 (fraud in breach of contract action for construction of concrete block addition); and
Hibschman Pontiac, Inc. v. Batchelor (1977), 266 Ind. 310, 362 N.E.2d 845, 848 (elements of fraud, malice, gross negligence or oppression found to exist in action for breach of automobile warranty where defendant dealer attempted to avoid making repairs by concealing de-feets during warranty period),

the two remedies are separate and distinct from each other,

see eg. Kenevan v. Empire Blue Cross & Blue Shield (S.D.N.Y.1992), 791 F.Supp.

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641 N.E.2d 1266, 1994 Ind. App. LEXIS 1431, 1994 WL 567848, Counsel Stack Legal Research, https://law.counselstack.com/opinion/guarantee-trust-life-insurance-co-v-palsce-indctapp-1994.