Ocheltree v. Pike Mut. Ins. Co.

2022 Ohio 3304
Ohio Court of Appeals·Decided September 20, 2022·No. 2021CA00102 & 2022CA00009·Published

Opinion

COURT OF APPEALS

STARK COUNTY, OHIO

FIFTH APPELLATE DISTRICT

JOEY OCHELTREE, ET AL. : JUDGES:

:

: Hon. William B. Hoffman, P.J.

Plaintiffs-Appellants : Hon. John W. Wise, J.

: Hon. Patricia A. Delaney, J.

-vs- :

: Case No. 2021CA00102

: Consolidated with 2022CA00009 PIKE MUTUAL INSURANCE :

COMPANY :

:

:

Defendant-Appellee : OPINION

CHARACTER OF PROCEEDING: Appeal from the Stark County Court of Common Pleas, Case No.

2019CV01235

JUDGMENT: AFFIRMED

DATE OF JUDGMENT ENTRY: September 20, 2022

APPEARANCES:

For Plaintiffs-Appellants: For Defendant-Appellee:

SIDNEY N. FREEMAN RALPH F. DUBLIKAR 12370 Cleveland Ave., N.W. 400 South Main Street P.O. Box 867 North Canton, OH 44720 Uniontown, OH 44685

Delaney, J.

{¶1} Plaintiffs-Appellants Joey and Rochelle Ocheltree appeal the judgment entries of the Stark County Court of Common Pleas issued on August 26, 2021 and December 17, 2021.

FACTS AND PROCEDURAL HISTORY A Fire Leads to a Homeowner’s Insurance Coverage Conflict

{¶2} Plaintiffs-Appellants Joey and Rochelle Ocheltree were the named insureds under a homeowner’s insurance policy issued by Defendant-Appellee Pike Mutual Insurance Company covering the Ocheltrees’ home located in Alliance, Ohio (“the Policy”). The application for the Policy stated the replacement value of the insured property was $313,000. The Policy purchased by the Ocheltrees provided a dwelling coverage limit of $157,000. The ratio of the dwelling coverage limit to replacement value of the insured property was 50%.

{¶3} The Ocheltrees notified Pike Mutual of a fire loss which occurred to the insured property on July 11, 2018. The claims adjuster associated with Pike Mutual prepared an estimate that the replacement cost damage was $59,958.69 and the actual cash value of the loss (after deducting for depreciation) was $50,779.37. Pike Mutual informed the Ocheltrees that pursuant to the terms of the Policy, they were entitled to the actual cash value of the loss in the amount of $50,779.37. The relevant terms of the Policy state in pertinent part:

HOW MUCH WE PAY FOR LOSS OR CLAIM 1. Property Coverages

a. Our Limit – Subject to the deductible or other limitation that applies, “we”

pay the lesser of:

1) the “limit” that applies;

2) “your” interest in the property; or 3) the amount determined under the applicable Loss Settlement Terms.

***

e. Loss Settlement Terms – Subject to the “terms” shown above, “we”

settle losses according to the Replacement Cost Terms. If the Replacement Cost Terms do not apply, “we” settle losses according to the Actual Cash Value Terms.

1) Replacement Cost Terms

***

d) If the “limit” on the damaged building is less than 80% of its replacement cost at the time of loss, the larger of the following amounts is used in applying the “terms” under Our Limit:

(1) the actual cash value at the time of the loss; or (2) the part of the replacement cost of the damaged part which “our” “limit”

on the building bears to 80% of the full current replacement cost of the building.

***

2) Actual Cash Value Terms – Actual cash value includes a deduction for depreciation, however caused.

a) The Actual Cash Value Terms apply to all property not subject to the Replacement Cost Terms.

***

The Policy defines “limit” as, “the amount of coverage that applies.”

{¶4} The Ocheltrees disputed the amount of the insurance settlement from Pike Mutual. They hired counsel who negotiated with counsel for Pike Mutual to resolve the dispute. During the negotiation process, the Ocheltrees obtained two estimates and Pike Mutual obtained two estimates for repair, replacement costs, and actual cash value for the damage to the home. Each of the four estimates provided different values. The Ocheltrees and Pike Mutual could not come to a resolution.

The Ocheltrees’ Complaint for Declaratory Judgment and Damages

{¶5} On June 10, 2019, the Ocheltrees filed a complaint in the Stark County Court of Common Pleas against Pike Mutual. The complaint alleged three causes of action against Pike Mutual: (1) Declaratory Judgment, (2) Breach of Contract, and (3) Bad Faith. The complaint did not include a demand for a jury trial.

(1)Declaratory Judgment Claim

{¶6} In their claim for declaratory judgment, the Ocheltrees stated in pertinent part:

9. By correspondence dated May 30, 2019, Defendant wrongfully refused to provide coverage to the limits stated in the policy for the reasons stated therein, a true and correct copy of which is attached hereto as Exhibit “B.”

10. Plaintiffs have no adequate remedy at law, entitling them to relief under Ohio Rev. Code §2721.01, et seq.

Stark County, Case Nos. 2021CA00102 & 2022CA00009 5

***

WHEREFORE, Plaintiffs demand judgment as follows:

***

II. For a declaration under Ohio Rev. Code §2721.01, et seq., that Defendant is obligated to pay the full coverage due under the insurance contract, in an amount to be proven at trial in excess of TWENTY-FIVE THOUSAND AND NO/100 DOLLARS ($25,000.00).

(2)Breach of Contract

{¶7} The Ocheltrees raised a claim for breach of contract, in which they stated:

***

12. The acts of Defendant as aforesaid constitute a breach of the insurance contract (Exhibit “A”).

13. Plaintiffs are entitled to recovery for recovery [sic] of the full amount of the coverage to which Defendant is obligated.

***

WHEREFORE, Plaintiffs demand judgment as follows:

I. For damages in breach of contract for the full coverage due, in the amount to be proven at trial in excess of TWENTY-FIVE THOUSAND AND NO/100 DOLLARS ($25,000.00).

(3)Bad Faith

{¶8} Finally, in their claim for bad faith, the Ocheltrees stated in their complaint:

***

15. Defendant failed and refused to adjust and settle the claims involved in fulfilling its insurance contract with the Plaintiffs.

***

19. The aforesaid actions of Defendant were not predicated upon circumstances that furnish reasonable justification, in violation of the duty of good faith it owed to Plaintiffs.

***

22. Plaintiffs are entitled to damages in tort for the failure of Defendant to adjust and settle the subject claim in good faith, plus punitive damages and the reasonable fees and expenses of Plaintiffs’ attorneys in prosecuting this action.

Pre-Trial Proceedings

{¶9} On June 18, 2019, the Ocheltrees filed a request for jury demand “as to all matters so triable.” (Request for Jury Demand, June 18, 2019).

{¶10} On August 5, 2020, Pike Mutual filed a Motion to Order Appraisal. During the pre-trial proceedings, the trial court record appears to show the parties were attempting to come to an agreement as to value of the loss of the dwelling. The parties reached an impasse, however, as to the interpretation of the Policy term of “Appraisal”:

13. Appraisal – If “you” and “we” do not agree at to the value of the property of the amount of the loss, “you” and “we” will each select a competent appraiser within 20 days after receiving a written request from the other.

The two appraisers will select an umpire. If they do not agree on an umpire, the two appraisers will ask a judge of a court of record of the state in which

Stark County, Case Nos. 2021CA00102 & 2022CA00009 7 the appraisal is pending to make the selection. The written agreement of any two of these three will be binding and set the amount of the loss.

Pike Mutual requested the trial court order the parties to proceed with an appraisal pursuant to the terms of the Policy. The trial court held an oral hearing on the motion on August 20, 2020.

{¶11} The trial court issued a judgment entry on September 3, 2020, with its interpretation of the Policy term as to Paragraph 13. The trial court examined the Policy and found it did not define the meaning of “umpire” or “written agreement.” The trial court utilized the well-settled rules of insurance contract construction and found:

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Ocheltree v. Pike Mut. Ins. Co., 2022 Ohio 3304 (Ohio Ct. App. 2022).

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