Medical Mutual of OH v. deSoto

Court of Appeals for the Sixth Circuit·Decided March 27, 2001·No. 99-3988·Unknown

Opinion

5(&200(1'(' )25 )8//7(;7 38%/,&$7,21 3XUVXDQW WR 6L[WK &LUFXLW 5XOH 

(/(&7521,& &,7$7,21  )(' $SS $ WK &LU )LOH 1DPH DD

81,7('67$7(6&28572)$33($/6 )257+(6,;7+&,5&8,7 BBBBBBBBBBBBBBBBB

0(',&$/ 0878$/ 2) 2+,2 ; 3ODLQWLII$SSHOOHH    1RV Y   !  '(1,6( '(6272 s26(  '(6272  'HIHQGDQWV$SSHOODQWV   1 $SSHDOIURPWKH8QLWHG6WDWHV'LVWULFW&RXUW IRUWKH1RUWKHUQ'LVWULFWRI2KLRDW&OHYHODQG 1Rn3DXO50DWLD&KLHI'LVWULFWsXGJH $UJXHG6HSWHPEHU 'HFLGHGDQG)LOHG0DUFK %HIRUH0(55,77.(11('<DQG*,/0$1&LUFXLW sXGJHV BBBBBBBBBBBBBBBBB &2816(/ $5*8('5REHUW(GG\*$//$*+(56+$53)8/721 1250$1&OHYHODQG2KLRIRU$SSHOODQWV6WHSKHQ) *ODGVWRQH )5$17= :$5' //3 &OHYHODQG 2KLR IRU $SSHOOHH  21 %5,()  5REHUW (GG\ sDQLFH $LWNHQ *$//$*+(56+$53)8/721 1250$1&OHYHODQG

  0HGLFDO0XWXDORI2KLR 1RV YGH6RWRHWDO

2KLR IRU $SSHOODQWV  6WHSKHQ ) *ODGVWRQH 0LFKDHO s +ROOHUDQ )5$17= :$5' //3 &OHYHODQG 2KLR IRU $SSHOOHH0DU\08WWHUEDFN7+(/(15(,' 35,(67 :DVKLQJWRQ '& &XUWLV $ &ROH 7+(/(1 5(,' 35,(67/RV$QJHOHV&DOLIRUQLDIRU$PLFXV&XULDH .(11('<sGHOLYHUHGWKHRSLQLRQRIWKHFRXUWLQZKLFK 0(55,77sMRLQHG*,/0$1s SS GHOLYHUHGD VHSDUDWHFRQFXUULQJRSLQLRQ BBBBBBBBBBBBBBBBBBBBBB $0(1'('23,1,21 BBBBBBBBBBBBBBBBBBBBBB .(11('< &LUFXLW sXGJH  7KLV (PSOR\HH 5HWLUHPHQW ,QVXUDQFHDQG6HFXULW\$FW (5,6$ DFWLRQFRPHVEHIRUHWKH FRXUW RQ WKH FRQVROLGDWHG DSSHDOV RI GHIHQGDQWV 'HQLVH GH6RWRDQGsRVHGH6RWRIURP  WKHGLVWULFWFRXUWjVJUDQWRI VXPPDU\ MXGJPHQW LQ IDYRU RI 0HGLFDO 0XWXDO RI 2KLR 002 ILQGLQJWKHGH6RWRVOLDEOHIRUXQSDLGUHLPEXUVHPHQW IXQGV GXH XQGHU 002jV ZHOIDUH EHQHILW SODQ DQG   LWV MXGJPHQW DZDUGLQJ 002 DWWRUQH\Vj IHHV SXUVXDQW WR  86& †  J    2Q DSSHDO WKH GH6RWRV DVVHUW WKH GLVWULFWFRXUWKDGQRSHUVRQDOMXULVGLFWLRQRYHUWKHP002 ZDVQRWHQWLWOHGWRUHLPEXUVHPHQWIRUWKHEHQHILWVLWSURYLGHG 0UVGH6RWRDQG&DOLIRUQLDODZLQSDUWLFXODUVHFWLRQ RIWKH&DOLIRUQLD&LYLO&RGHDSSOLHVWRDQ\FODLPWKDW002 PLJKW KDYH IRU UHLPEXUVHPHQW DQG SURKLELWV LW IURP UHFRYHULQJ WKH PHGLFDO H[SHQVHV LW SDLG RQ 0UV GH6RWRjV EHKDOIDULVLQJIURPWKHDOOHJHGPHGLFDOPDOSUDFWLFH %HFDXVHZHDJUHHWKDW&DOLIRUQLDODZJRYHUQVWKHFRQWUDFW EHWZHHQ0UVGH6RWRDQG002DQGSURKLELWV002IURP UHFRYHULQJ WKH PHGLFDO H[SHQVHV LW SDLG RQ EHKDOI RI 0UV

 :KLOH 002 SDLG RWKHU PHGLFDO H[SHQVHV DV ZHOO IRU WKH UHPDLQGHU RI WKLV RSLQLRQ ZH ZLOO UHIHU WR WKH PHGLFDO H[SHQVHV LQFXUUHG DV D UHVXOW RI WKH DOOHJHG PHGLFDO PDOSUDFWLFH DV mWKH PHGLFDO H[SHQVHVl 1RV 0HGLFDO0XWXDORI2KLR  YGH6RWRHWDO

GH6RWR ZH UHYHUVH WKH GLVWULFW FRXUWjV JUDQW RI VXPPDU\ MXGJPHQWLQIDYRURI002DQGUHPDQGZLWKLQVWUXFWLRQVWR HQWHUVXPPDU\MXGJPHQWLQIDYRURIWKHGH6RWRV:HDOVR YDFDWHWKHFRXUWjVMXGJPHQWDZDUGLQJDWWRUQH\VjIHHVLQOLJKW RIWKLVRSLQLRQ ,)$&76 7KLVFDVHSUHVHQWVDXQLTXHVHWRIFLUFXPVWDQFHV8QOLNH PRVW EHQHILW UHFRYHU\ FDVHV LQYROYLQJ JURXS LQVXUDQFH SROLFLHVLQZKLFKWKHLQVXUDQFHFRPSDQ\jVVXLWLVSUHPLVHG XSRQ WKH FRQWUDFW EHWZHHQ WKH FRPSDQ\ DQG WKH LQVXUHGjV HPSOR\HU RU RUJDQL]DWLRQ VHH /(( 5 5866  &28&+ 21 ,1685$1&(† GHG 002DSSHDUVWRSUHPLVHLWV VXLW XSRQ WKH &HUWLILFDWH LVVXHG WR 0UV GH6RWR  m7KH &HUWLILFDWHV LVVXHG XQGHU WKH >&OHYHODQG *URZWK $VVRFLDWLRQVjV&RXQVHORI6PDOOHU(QWHUSULVHV@FRQWUDFWDUH HPSOR\HH ZHOIDUH EHQHILW SODQV JRYHUQHG E\ >(5,6$@l $SSHOOHHjV%UDWm7KH3ODQ&HUWLILFDWHVWKDWIRUPWKHEDVLV IRUWKHSDUWLHVjFRQWUDFWXDOREOLJDWLRQVDQGWKXVJRYHUQWKLV ODZVXLWSURYLGHDVIROORZVl,GDW7KXVWKHUHDGHURI WKLVRSLQLRQVKRXOGNHHSLQPLQGWKDWRXUDQDO\VLVLVEDVHG XSRQ002jVUHSUHVHQWDWLRQWKDWWKH&HUWLILFDWHVFRQWUROLWV UHODWLRQVKLSZLWK0UVGH6RWR 002LVDPXWXDOLQVXUDQFHFRPSDQ\LQFRUSRUDWHGXQGHU WKHODZVRI2KLR$VVXFKLWSURYLGHVJURXSKHDOWKLQVXUDQFH SODQVJRYHUQHG E\ (5,6$IRU PHPEHU FRPSDQLHV RI WKH *UHDWHU&OHYHODQG*URZWK$VVRFLDWLRQVjV&RXQVHORI6PDOOHU (QWHUSULVHV  8QGHU WKDW DUUDQJHPHQW WKH HPSOR\HHV RI PHPEHU FRPSDQLHV DUH HOLJLEOH WR EHFRPH SDUWLFLSDQWV LQ 002jVZHOIDUHEHQHILWSODQ7REHFRPHDSDUWLFLSDQWDQ HOLJLEOHHPSOR\HHPXVWDSSO\DQGEHDSSURYHGIRUFRYHUDJH 7KH HPSOR\HH UHFHLYHV D &HUWLILFDWH ZKLFK DFFRUGLQJ WR 002jVEULHIRQDSSHDOFRQVWLWXWHVWKHSODQDQGJRYHUQVWKH UHODWLRQVKLSEHWZHHQWKH002DQGWKHHPSOR\HH 7KH IDFWXDO FLUFXPVWDQFHV JLYLQJ ULVH WR WKLV OLWLJDWLRQ EHJDQRQ'HFHPEHUZKHQ0UVGH6RWRXQGHUZHQW  0HGLFDO0XWXDORI2KLR 1RV 1RV 0HGLFDO0XWXDORI2KLR  YGH6RWRHWDO YGH6RWRHWDO

Free access — add to your briefcase to read the full text and ask questions with AI

Medical Mutual of OH v. deSoto, (6th Cir. 2001).

Medical Mutual of OH v. deSoto (Medical Mutual of OH v. deSoto) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.