Hatton v. State Farm Mutual Insurance

521 F. Supp. 833, 1981 U.S. Dist. LEXIS 14141
CourtDistrict Court, S.D. Ohio
DecidedAugust 31, 1981
DocketC-3-80-162
StatusPublished

This text of 521 F. Supp. 833 (Hatton v. State Farm Mutual Insurance) is published on Counsel Stack Legal Research, covering District Court, S.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hatton v. State Farm Mutual Insurance, 521 F. Supp. 833, 1981 U.S. Dist. LEXIS 14141 (S.D. Ohio 1981).

Opinion

DECISION AND ENTRY CONDITIONALLY OVERRULING DEFENDANT’S MOTION FOR SUMMARY JUDGMENT; FURTHER PROCEDURES ORDERED OF COUNSEL

RICE, District Judge.

I. Introduction

This matter is before the Court on the motion of the Defendant State Farm Mutual Insurance Company (hereinafter State Farm) seeking Summary Judgment on Plaintiff’s First Claim for Relief, pursuant to Fed.R.Civ.Pro. 56. On April 8, 1980, Gordon Hatton filed a complaint against State Farm in the Montgomery County Court of Common Pleas, requesting damages for negligence and breach of contract. Defendant filed a petition for removal to this Court on April 29, 1980, based on diversity of citizenship, and Plaintiff has made no objection to removal.

In Plaintiff’s First Claim for Relief, he alleged that he had been an employee of the State Farm Mutual Automobile Insurance Company from June, 1968, to April 8, 1979, and that as part of his compensation, the Defendant provided coverage for accidental death and dismemberment under a group insurance plan known as Group Accidental Death and Dismemberment, Policy No. H600001 (hereinafter A.D.&.D. Policy). Among other benefits, the plan provided for permanent and total disability benefits when a plan member became disabled as a result of an accidental injury. Plaintiff was involved in a motor vehicle accident in April, 1978, which has resulted in his disability and confinement to a wheelchair. Plaintiff also alleged that between the time of his accident and the termination of his employment, the Defendant increased the amount of his effective disability coverage from $50,000 to $62,500, but failed to notify him that he could further increase the amount of his disability coverage to a maximum of $125,000. Accordingly, Plaintiff has asked that he be awarded the additional amount to which he would have been entitled, absent the negligence of and breach of contract by, Defendant.

On January 22, 1981, the Defendant filed a Motion for Summary Judgment with respect to this claim for relief, contending that the date for determining the benefits available to Plaintiff was the date of his accident, and that he could not have increased his coverage after that time. In the alternative, Defendant has argued that: *835 (1) the enrollment brochures accompanying the group disability policy required that an employee be actively at work for coverage to become effective; and (2) since Plaintiff did not return to active employment after his accident, he was not actively at work under the meaning of the policy, so as to be permitted to increase his coverage.

Plaintiff replied to Defendant’s Motion on March 2, 1981, indicating that genuine issues of material fact existed with regard to the nature of his employment status. First, Plaintiff contended that the brochure for Accidental Death and Dismemberment Policy is ambiguous because it utilizes two definitions of employee, by first stating that an employee is defined as a full-time employee, and by then requiring that an employee be actively at work for coverage to become effective. Because of this ambiguity, Plaintiff claims that the contract must be construed against the Defendant to permit Plaintiff to recover if he can establish that he was a full-time employee after his accident. Alternatively, the Plaintiff has argued that if the definition of actively at work must be utilized, he can be considered to have been an active employee because of the continuing nature of the employment relationship, and also because he was not determined to be disabled under the policy until April, 1979.

Subsequent to the submission of the above memoranda, the Court filed an entry on April 6,1981, noting that the Motion was not appropriate for determination, due to the failure of the parties to submit various items in a form required by Fed.R.Civ.Pro. 56. The Court outlined the items to which it referred, and permitted counsel twenty-one days to supplement the materials as directed. The Court also indicated that should the materials not be submitted, the Defendant’s motion would be overruled based on the present state of the file. In that entry, the Court also stated that the parties had failed to indicate why brochures issued in 1978 and 1979, after the formation of the insurance contract, could have been intended to be part of that agreement.

At this point, the Court notes that some of the materials submitted are still not in the form required by Fed.R.Civ.Pro. 56. First, although the affidavit of Robert Fed-den, submitted by Defendant on April 23, 1980, stipulates that the Accidental Death Area [sic] Dismemberment Policy, the brochures dated January 1, 1978, and January I, 1979, and the brochure entitled “Benefits,” all attached to the Plaintiff’s complaint, are true copies of the papers issued by State Farm to Defendant, no such copies were attached to the complaint when this case was removed to Federal Court. In addition, Plaintiff has submitted a group of eighteen exhibits, none of which is in the form required by Rule 56. The Court has been able to ascertain from the contents of the exhibits submitted by the Plaintiff that the documents therein are most likely what Plaintiff has represented them to be. Accordingly, in light of the proximity of the trial scheduled for this action, the Court has assumed that the documents and exhibits have been certified in the manner specified by Fed.R.Civ.Pro. 56(e). However, the Court’s speculation, no matter how well-founded, is not an appropriate substitute for compliance with the Federal Rules of Civil Procedure, and the Court once again orders counsel for Defendant and Plaintiff to submit the materials necessary for resolution of this matter in the form mandated by Rule 56, within fourteen days of notice of this entry. If counsel herein wonder why the Court is requiring such an exercise shortly before trial, the answer must be that this case should be in a proper procedural posture in the event that an appeal is taken from the determinations made by this Court. With the above assumption in mind, then, the Court now turns to consideration of: (1) the general legal principles applicable herein; (2) the undisputed facts of this case; and (3) an analysis of whether, under the facts and law as presented, the Defendant is entitled to summary judgment as a matter of law.

II. General Principles of Law

Before the Court addresses the facts pertinent herein, a short recitation of the stan *836 dards applicable to Defendant’s Motion would be in order. Fed.R. of Civ.Pro. 56(e) provides, with respect to summary judgment, that:

The judgment sought shall be rendered forthwith if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue of material fact and that the moving party is entitled to a judgment as a matter of law.

The rule is well established that in determining whether summary judgment is appropriate, “the pleadings are to be liberally construed in favor of the party opposing the motion,” . . . and “the court is required to take the view most favorable to the party opposing the motion, giving that party the benefit of all favorable inferences that may be drawn from the evidence.” McHenry v. Ford Motor Co.,

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Cite This Page — Counsel Stack

Bluebook (online)
521 F. Supp. 833, 1981 U.S. Dist. LEXIS 14141, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hatton-v-state-farm-mutual-insurance-ohsd-1981.