Nationwide Mut. Ins. Co. v. Clay

525 So. 2d 1339, 1987 WL 512
CourtSupreme Court of Alabama
DecidedJune 26, 1987
Docket82-536, 82-917
StatusPublished
Cited by23 cases

This text of 525 So. 2d 1339 (Nationwide Mut. Ins. Co. v. Clay) is published on Counsel Stack Legal Research, covering Supreme Court of Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Nationwide Mut. Ins. Co. v. Clay, 525 So. 2d 1339, 1987 WL 512 (Ala. 1987).

Opinion

525 So.2d 1339 (1987)

NATIONWIDE MUTUAL INSURANCE COMPANY
v.
Henry Garrard CLAY.
NATIONWIDE MUTUAL INSURANCE COMPANY, a corporation
v.
Henry Garrard CLAY.

82-536, 82-917.

Supreme Court of Alabama.

June 26, 1987.
Rehearing Denied April 29, 1988.

*1340 Bert S. Nettles and Forrest S. Latta of Nettles, Barker, Janecky & Copeland, Mobile, and Geoffrey C. Hazard, Jr., New Haven, Conn., for appellant.

Fred W. Killion, Jr. and William W. Watts of Reams, Vollmer, Philips, Killion, Brooks & Schell, Mobile, and Patricia K. Olney, Merritt Island, Fla., for appellee.

Edgar M. Elliott III and Karon O. Bowdre of Rives & Peterson, Birmingham, for amicus curiae State Farm Mut. Auto. Ins. Co.

PER CURIAM.

This case comes to us again on remand from the Supreme Court of the United States. The judgment of this Court was vacated and the case was remanded to us for further consideration in light of Aetna Life Insurance Co. v. Lavoie, 475 U.S. 813, 106 S.Ct. 1580, 89 L.Ed.2d 823 (1986). In the Lavoie case, the judgment was vacated because one of the Justices of this Court had authored the opinion in a 5-4 decision involving the tort of bad faith when he contemporaneously was litigating a tort of bad faith claim against another insurance company. The Supreme Court of the United States concluded that as a participating judge in the Lavoie case, he was "a judge in his own case." As a result, his interest in the Lavoie case was "direct, personal, substantial, [and] pecuniary." Because of "due process" concerns, the Supreme Court opined that "the appearance of justice" would be best served if this Court proceeded to review the Lavoie case without participation by the offending Justice. By a *1341 subsequent mandate, we are now required to review the issues in the instant litigation in light of the principles enunciated in Lavoie.

No perimeters were set forth in the Supreme Court's vacation of our judgment in this case. As a result, plaintiff Clay suggested that the non-disqualified members of the Court merely affirm the decision and allow the former judgment to stand. This is because the decision in this case, as contrasted with that in Lavoie, was a 6-3 decision. The elimination of the offending Justice's vote would allow the judgment to stand because it would still have the sufficient five votes to constitute a majority. However, we concluded that a true "appearance of justice" mandated that we require a complete rebriefing, reargument, and redeliberation of this case with the participation of all nine Justices presently on this Court. The result of our deliberations is that the judgment of the trial court is affirmed.

Although our prior opinion in this case, 469 So.2d 533, contained an extensive statement of facts, we will, for purposes of this opinion, state again briefly the events leading up to the filing of this suit.

On June 14, 1966, Henry Garrard Clay, a practicing attorney, took out a disability income insurance policy with Paul Revere Insurance Company. Over ten years later, on December 8, 1976, Clay was contacted by a friend of his, Bill McDowell, an agent for Nationwide Mutual Insurance Company, about applying for a disability policy with Nationwide. In the application for insurance, Clay stated that his monthly income was $1,800.00. After Nationwide's doctor gave Clay a "clean bill of health," Nationwide issued Clay a disability income policy, effective January 19, 1977. Clay also promised to cancel a disability policy he had with Paul Revere Insurance Co.

Clay then contacted Paul Revere Insurance Company to cancel his policy of insurance with it. Upon receipt of Clay's notice of intent to cancel his disability policy, an agent of Paul Revere contacted Clay in an attempt to change his mind. After much discussion, Clay agreed to a new disability income policy with Paul Revere. According to the agent who sold Clay the policy, he told Clay that Paul Revere would cancel his old policy and take the same amount and incorporate it into a new policy. Clay then attempted to cancel his Nationwide policy, but could not get in touch with his agent, McDowell, because McDowell had been promoted and transferred to another town. A few weeks later, when Clay received a policy from Nationwide in the mail, he again attempted to contact McDowell to have this policy cancelled. It was at this time that Clay was first informed that McDowell had been promoted and that this was why he was having trouble contacting him.

On August 29, 1977, Clay first realized that he was having difficulty reading. On that day, he went to see Dr. Ross, an optometrist. Ross examined Clay and diagnosed cataracts. This was the first time anyone had diagnosed Clay as having cataracts. On September 7, Clay saw Dr. Harrison, who confirmed that he had cataracts. Dr. Harrison told him that the cataracts would get worse, and that eventually he would go blind. On this day, Clay closed his law office. Approximately three weeks later, Clay filed a disability claim with Nationwide. Clay's claim was assigned to Jim Otey, a Nationwide medical claims examiner. Clay first had communication with Otey in October of 1977. For a period of almost a year, Clay had extensive communications with Otey and with John Harker, a claims attorney for Nationwide. Several of Clay's phone calls to Otey and Harker were never returned, and when Clay was able to contact either person, he was often given what he called a "run around." Specifically, Clay was told that certain documents were not in his file when the person knew these documents were in his file. Also, certain letters and other papers necessary for the processing of his claim were stamped "filed" by Nationwide, but persons investigating the claim either did not find them or did not bother to take the time to check to see if indeed these papers were in the possession of Nationwide.

*1342 After several doctors had examined Clay and confirmed that he had cataracts, Harker agreed that Clay was disabled; however, Harker claimed that this was a pre-existing condition, and, therefore, said that Nationwide was not going to pay on the claim. Clay even corresponded with O.B. Carr of the Alabama Insurance Commission and complained about the treatment he was receiving from Nationwide. After two or three calls and letters from Carr, as well as numerous unanswered phone calls and letters from Clay, Harker finally authorized a payment of $1,300.00 to Clay on January 19, 1978. The check was not received by Clay until almost a month later. Even after payment of this $1,300.00, Nationwide was still three months in arrears. Furthermore, Nationwide was regularly withdrawing a monthly premium from Clay's checking account, even though Clay's policy had a waiver of premium provision that should have taken effect. Over the next four months, Clay had several more communications with Nationwide. At one point, Clay told Harker that he was contemplating filing suit, to which Harker replied, "go ahead, but you won't receive one nickel for ten years." Finally, after numerous attempts by Clay to have the matter resolved, he filed suit against Nationwide on July 14, 1978.

Even as late as October 1978, Clay was trying to have the automatic payment of his premium stopped. Nationwide's only response was that if he ceased making premium payments, he would not be entitled to further payments on his claim. In an interrogatory addressed to Nationwide as to why it was continuing to require Mr.

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Bluebook (online)
525 So. 2d 1339, 1987 WL 512, Counsel Stack Legal Research, https://law.counselstack.com/opinion/nationwide-mut-ins-co-v-clay-ala-1987.