Merritt v. State Farm Mutual Automobile Insurance

544 S.E.2d 180, 247 Ga. App. 442, 2001 Fulton County D. Rep. 357, 2000 Ga. App. LEXIS 1469
CourtCourt of Appeals of Georgia
DecidedDecember 28, 2000
DocketA00A2079, A00A2080
StatusPublished
Cited by9 cases

This text of 544 S.E.2d 180 (Merritt v. State Farm Mutual Automobile Insurance) 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
Merritt v. State Farm Mutual Automobile Insurance, 544 S.E.2d 180, 247 Ga. App. 442, 2001 Fulton County D. Rep. 357, 2000 Ga. App. LEXIS 1469 (Ga. Ct. App. 2000).

Opinion

Barnes, Judge.

Katherine Merritt sued State Farm Mutual Automobile Insurance Company and State Farm Fire & Casualty Company (State Farm) for fraud, misrepresentation, false swearing, and violations of the Racketeer Influenced & Corrupt Organizations Act (RICO), claiming that the insurance company failed to disclose the existence of a $1 million umbrella policy until after she had settled for what she thought were policy limits of $250,000. The trial court granted summary judgment to State Farm, concluding that the parties had no contract because the parties’ settlement agreement was contingent on the insurance company having disclosed all applicable policies. Therefore, the trial court held, Merritt had suffered no damages. Merritt appeals the grant of summary judgment, and State Farm cross-appeals contending the trial court erred by not clearly dismissing Merritt’s claims under OCGA § 51-12-6 when it dismissed Merritt’s other claims. For the reasons that follow, we reverse the grant of summary judgment to State Farm.

The underlying automobile collision occurred on November 29, 1996, when State Farm’s insured crossed the centerline and hit head-on the car in which Merritt was a passenger. Merritt, who was 18 and a college freshman at the time, suffered injuries to her head and face and has undergone numerous reconstructive facial surgeries. She is still a college student, but asserts that her cognitive functions are impaired.

On January 10, 1997, Merritt asked State Farm, pursuant to *443 OCGA § 33-3-28, for a statement under oath revealing all insurance policies under which coverage for this collision might be found. State Farm responded on January 14, 1997, with a certificate of coverage showing one automobile liability policy with maximum coverage of $250,000 per claim. In response to a second letter two days later specifically asking whether the insured had any umbrella coverage, State Farm replied on January 21, 1997, that all applicable policies had been disclosed.

On September 8, 1998, Merritt demanded $250,000 to settle her claim, stating that the demand was “contingent upon your insured’s policy limits with State Farm being $250,000 and the accuracy of your representation that there is no other insurance applicable to this claim.” State Farm initially countered with $200,000 on October 9, 1998, and Merritt reiterated her demand for “full policy limits” on October 14, 1998. On October 15, 1998, the company agreed to settle Merritt’s claim for “policy limits of $250,000.” This was sufficient to constitute an enforceable settlement of the claim. Herring v. Dunning, 213 Ga. App. 695 (446 SE2d 199) (1994).

After Merritt signed the insurance company’s release and draft for $250,000, but before her attorney signed and negotiated it, Merritt’s lawyer called State Farm’s insured directly on October 27,1998, to inquire once more whether he carried an umbrella policy. He disclosed that he did carry an additional $1 million umbrella policy with State Farm. State Farm then confirmed the existence of the umbrella policy, and both State Farm and its newly hired outside counsel informed Merritt she could keep the $250,000 as a partial payment on her claim while continuing to negotiate for more money.

Merritt demanded the entire amount of both policies on November 6, 1998, for a total of $1.25 million, in exchange for a release of claims not only against State Farm’s insured, but also against State Farm itself for what she termed “deliberate concealment” of the umbrella policy. State Farm countered with an offer of $400,000 on November 17, 1998. Merritt declined the offer and filed suit against the insured for damages resulting from the collision and against State Farm for fraud, misrepresentation, false swearing, and RICO violations.

The parties hotly contest whether State Farm’s failure to disclose the existence of the umbrella policy earlier was deliberate or accidental. State Farm contends that the failure to disclose the additional coverage was simply an “oversight,” which occurred because the umbrella policy was not listed on the computer files that State Farm’s claims representative checked when Merritt asked about coverage in January 1997.

A State Farm agent testified on deposition that the insured’s umbrella policy application had not been processed by underwriting *444 until December 22, 1996, after the collision at issue here, and would not have been listed on State Farm’s computer records when Merritt asked about coverage in January 1997. While the umbrella policy was effective the day the agent countersigned the declarations page on the application, State Farm has no procedure requiring the agent to note the coverage electronically. According to the company, until the information is manually entered into the computer files after the application is approved, the only way to discover the umbrella coverage would be to ask the agent directly. The record does not indicate why the agent was not asked about possible additional coverages.

Merritt, on the other hand, contends that State Farm’s failure to disclose the existence of the umbrella policy was deliberate. The application for the umbrella policy was received in underwriting on October 24, 1996. The underwriting operations superintendent for Atlanta and. the 13 surrounding counties testified that State Farm actually approved the personal umbrella policy that covers this collision on December 12,1996. She further testified that the policy information was entered into the company’s computer database the same day. Thus, not only was the policy in effect before the collision, but, according to this testimony, approval of the policy was also available in the database much earlier than State Farm’s agent testified.

Further, a notation on a card attached to the inside of the insured’s claim file noted that “a personal liability umbrella policy may exist,” although the adjuster handling the claim testified that he did not notice that the card was dated after the initial State Farm representative told Merritt no umbrella policy existed. The adjuster never investigated the applicable coverage, he said, because he “felt very comfortable from [his] review of the file that previous claims, claims handlers and supervisors or team leaders had addressed that issue and the only amount of coverage available was the $250,000.” The adjuster further testified that he had received no formal training on searching for umbrella policies.

Finally, Merritt cites the deposition testimony of State Farm’s insured as support for her contention that the company deliberately withheld information regarding the umbrella policy. The insured testified that when he spoke to his agent regarding the collision:

A: [The agent] jokingly said don’t tell anybody about the umbrella policy. I took it as a joke. And of course [the claims adjuster] was aware of the umbrella policy, because I’d mentioned it to him.
Q. When did you first mention it to [the claims adjuster]?
A. I really don’t recall which conversation.

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Cite This Page — Counsel Stack

Bluebook (online)
544 S.E.2d 180, 247 Ga. App. 442, 2001 Fulton County D. Rep. 357, 2000 Ga. App. LEXIS 1469, Counsel Stack Legal Research, https://law.counselstack.com/opinion/merritt-v-state-farm-mutual-automobile-insurance-gactapp-2000.