Motorists Mut. Ins. Co. v. Said

1992 Ohio 94
CourtOhio Supreme Court
DecidedMay 26, 1992
Docket1990-2285
StatusPublished
Cited by2 cases

This text of 1992 Ohio 94 (Motorists Mut. Ins. Co. v. Said) 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
Motorists Mut. Ins. Co. v. Said, 1992 Ohio 94 (Ohio 1992).

Opinion

___ _'_ __! !! _?_) _ ___ ____ ___________ : <_______________________________________________________________________________ _________________________________________________"___M_K_L_Y_Z_F_A_______T_L_P_L _U_?_W_Y_X__________________________________________ OPINIONS OF THE SUPREME COURT OF OHIO The full text of the opinions of the Supreme Court of Ohio are being electronically transmitted beginning May 27, 1992, pursuant to a pilot project implemented by Chief Justice Thomas J. Moyer. Please call any errors to the attention of the Reporter's Office of the Supreme Court of Ohio. Attention: Walter S. Kobalka, Reporter, or Justine Michael, Administrative Assistant. (614) 466-4961; in Ohio 1-800-826-9010. Corrections may be made to the full texts of the opinions after they have been released to the public electronically. The reader is therefore advised to check the bound volumes of Ohio St.3d published by West Publishing Company for the final version of these opinions. Motorists Mutual Insurance Company, Appellant and Cross-Appellee, v. Said, Appellee and Cross-Appellant. [Cite as Motorists Mut. Ins. Co. v. Said (1992), Ohio St. 3d .] Insurance -- Torts -- Contracts -- Cause of action for tort of bad faith based upon alleged failure of insurance company to satisfy a claim by its insured may be brought as a separate action apart from insured's action alleging breach of insurance contract, when -- Insurer's duty of good faith towards insured breached, how -- Cause of action for tort of bad faith arises, when -- "No lawful basis" for the intentional refusal to satisfy a claim, construed. 1. A cause of action for the tort of bad faith based upon an alleged failure of an insurance company to satisfy a claim by its insured may, under certain circumstances, be brought by its insured as a separate action, apart from an insured's action alleging breach of the insurance contract. (Hoskins v. Aetna Life Ins. Co. [1983], 6 Ohio St. 3d 272, 6 OBR 337, 452 N.E. 2d 1315, followed.) 2. An insurer has a duty of good faith towards its insured implied by law. This duty may be breached by an intentional failure by the insurer to perform under its contract with the insured. 3. A cause of action arises for the tort of bad faith when an insurer breaches its duty of good faith by intentionally refusing to satisfy an insured's claim where there is either (1) no lawful basis for the refusal coupled with actual knowledge of that fact or (2) an intentional failure to determine whether there was any lawful basis for such refusal. Intent that caused the failure may be inferred and imputed to the insurer when there is a reckless indifference to facts or proof reasonably available to it in considering the claim. 4. "No lawful basis" for the intentional refusal to satisfy a claim means that the insurer lacks a reasonable basis in law or fact for refusing to satisfy the claim. Where a claim is fairly debatable the insurer is entitled to refuse the claim as long as such refusal is premised on a genuine dispute over either the status of the law at the time of the denial or the facts giving rise to the claim. (No. 90-2285 -- Submitted December 3, 1991 -- Decided May 27, 1992.) Appeal and Cross Appeal from the Court of Appeals for Cuyahoga County, No. 57418. This appeal arises from an automobile accident involving an underinsured motorist on January 26, 1982 in which defendant- appellee and cross-appellant, Badr Said, the insured, sustained bodily injuries. On that date, Said and plaintiff-appellant and cross-appellee, Motorists Mutual Insurance Company ("Motorists"), were parties to a valid automobile insurance policy which provided uninsured and underinsured motorist coverage in the maximum amount of $100,000 per person. After settling with the tortfeasor's insurance company for the policy limits of $25,000, Said filed an underinsured motorist claim with his own insurance company. To support Said's claim, his attorney sent medical information he had regarding the claim to Cynthia Goodman, Motorists' claims adjuster. A copy of the emergency room report showed that after the accident Said, while evidently not showing any visible signs of injury, did complain of pain in his lower back, neck and stomach. Additionally, Said submitted to Motorists a report from one of his treating physicians which concluded that the insured's right inguinal hernia was also caused by the automobile accident. Medical bills, which totaled over $15,000 by June 1983, encompassed three hernia operations, physiotherapy, and medication. As of that date, Said was claiming lost wages of at least $35,000 due to the fact that he never returned to his job as a brakeman at Conrail after the accident. After conducting its own investigation concerning the extent of Said's damages, Motorists determined that the claim had a value of approximately $25,000 to $30,000. Motorists believed that Said had sustained merely a back sprain in the accident and that the hernias were unrelated. Given the offset for the $25,000 already paid by the tortfeasor's insurer, Motorists offered $5,000 to settle Said's claim. This offer was rejected. As a result of the parties' inability to reach a settlement, the insured made a demand for an arbitration hearing on the value of the underinsured motorist claim. After a hearing on October 19, 1984, the arbitration panel, unaware of the policy limitation, awarded the insured $118,152.72. Thereafter, on December 5, 1984, Motorists filed its complaint in the trial court seeking a jury determination on the total amount of compensatory damages sustained by Said in the accident. On December 27, 1984, Said filed his answer as well as a counterclaim against Motorists, alleging that Motorists had acted in bad faith in delaying the payment of the arbitrators' award.1 In his counterclaim, Said demanded punitive damages, as well as compensatory damages, as a result of the insurer's alleged bad faith. In January 1989, a bifurcated trial commenced before the jury as to the value of Said's underinsured motorist claim under the insurance contract, and the bad faith counterclaim. On January 11, 1989, the jury rendered a verdict for Said in the amount of $480,000 on Motorists' claim for determination of damages. This award was reduced to a $100,000 judgment, reflecting the insurance policy limits and was immediately paid by Motorists. Said's counterclaim on the issue of bad faith proceeded before the same jury which, on January 24, 1989, found in favor of Motorists. On appeal, the court of appeals reversed the trial court's judgment with respect to the insured's bad faith cause of action. In doing so, it held that the jury instruction regarding the standard of bad faith employed by the trial court was an incorrect statement of Ohio law. The trial court's judgment on Motorists' claim for determination of damages was affirmed. The cause is now before us pursuant to the allowance of a motion and cross-motion to certify the record. Gallagher, Sharp, Fulton & Norman, Thomas E. Dover and Timothy J. Fitzgerald, for appellant and cross-appellee. Robert P. Rutter, for appellee and cross-appellant. Murray & Murray Co., L.P.A., Dennis E. Murray, Sr. and Kirk J. Delli Bovi, urging affirmance for amicus curiae, Board of Erie County Commissioners. Freund, Freeze & Arnold, Jane M. Lynch and Francis S. McDaniel, urging reversal for amicus curiae, Ohio Association of Civil Trial Attorneys. Clark, Perdue & Roberts Co., L.P.A., and Edward L. Clark, urging reversal for amicus curiae, Ohio Academy of Trial Lawyers. Holmes, J. The current action presents for our review the following issue: what is the appropriate standard for demonstrating that an insurance carrier acted in bad faith in withholding payments due the insured under a policy of insurance.

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