Pallay v. Nationwide Insurance

846 N.E.2d 58, 165 Ohio App. 3d 242, 2005 Ohio 5932
CourtOhio Court of Appeals
DecidedOctober 31, 2005
DocketNo. 04 MA 50.
StatusPublished
Cited by4 cases

This text of 846 N.E.2d 58 (Pallay v. Nationwide Insurance) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pallay v. Nationwide Insurance, 846 N.E.2d 58, 165 Ohio App. 3d 242, 2005 Ohio 5932 (Ohio Ct. App. 2005).

Opinion

Waite, Judge.

{¶ 1} Appellant, Nationwide Mutual Insurance Company, appeals a decision of the Mahoning County Court of Common Pleas to grant summary judgment to appellee, John S. Pallay, in a claim involving underinsured-motorist (“UIM”) insurance benefits.

{¶ 2} The record reflects that appellee was a passenger in a vehicle being driven by his wife. Appellee’s wife caused an accident that resulted in injuries to appellee. Appellee and his wife were covered by an automobile insurance policy issued by Nationwide (the “Policy”). Appellee settled with Nationwide for the $100,000 liability limits of the Policy due to his wife’s liability for the accident. *244 Appellee then filed a complaint to recover $52,894.87 in UIM benefits to compensate him for the amount of a Medicare statutory lien he was obligated to pay out of the proceeds of the settlement.

{¶ 3} The trial court ruled, pursuant to Littrell v. Wigglesworth (2001), 91 Ohio St.3d 425, 746 N.E.2d 1077, that appellee’s Medicare statutory lien is not an expense of an insured and should not act to reduce UIM benefits. However, this court recently ruled otherwise in Mid-American Fire & Cas. Co. v. Broughton, 154 Ohio App.3d 728, 2003-Ohio-5305, 798 N.E.2d 1109. Perhaps more important, the clear language of the Policy prohibits a party from collecting both liability and UIM benefits for the same accident. Thus, the trial court should have granted Nationwide’s motion to dismiss, and the decision of the trial court is hereby reversed and judgment is entered for appellant Nationwide.

PROCEDURAL HISTORY

{¶ 4} This appeal involves what purports to be a review of a summary-judgment motion, but in reality is a review of a decision on a motion to dismiss. Although the trial court did grant summary judgment to appellee, there are no established facts of record in this case. The only “facts” referred to by the parties have been assumed for the sake of argument. Therefore, factual allegations in this matter must be viewed in the light of the aforementioned caveat.

{¶ 5} According to the complaint, appellee was injured in an automobile accident in Colorado on March 6, 1998. His wife, Giselle Pallay, was driving. Appellee was a passenger in the vehicle. Appellee and his wife owned and were the named insureds on a personal automobile liability insurance policy issued by Nationwide. The Policy had bodily injury liability limits of $100,000 per person and $300,000 per occurrence. The Policy also provided $100,000/$300,000 in UIM coverage.

{¶ 6} On December 19, 2002, appellee filed a complaint in the Mahoning County Court of Common Pleas. The complaint stated that appellee had incurred more than $73,000 in medical bills, of which $52,894.87 had been paid by Medicare and was subject to a federal statutory lien. Appellee also alleged that he had received the $100,000 policy liability limit in a settlement with Nationwide, but that he reserved his right to pursue UIM benefits under the Policy. A copy of the “Release and Settlement” of the claim was attached to the complaint.

{¶ 7} On March 4, 2003, Nationwide filed a Civ.R. 12(B)(6) motion to dismiss. Nationwide argued that the terms of the Policy limited recovery to $100,000 per accident; that the UIM section of the Policy states that the UIM limits will be reduced “by any amount paid by or for any liable parties”; that it is established case law that a person cannot recover both the liability limits and the UIM limits *245 from the same policy; that R.C. 3937.18(A)(2) requires that the UIM limits of an auto insurance policy be reduced by any amount available for payment under all applicable bodily injury liability policies covering persons liable to the insured; and that Littrell did not apply to the facts of this case, as alleged by appellee in his complaint.

{¶ 8} Instead of directly responding to this motion, on March 25, 2003, appellee filed a “Memorandum in Opposition to Summary Judgment.” Appellee requested that the court convert the Civ.R. 12(B)(6) motion into a motion for summary judgment, and also that appellee’s own motion be treated as a motion for summary judgment. The motion purports to adopt the “statement of facts” in Nationwide’s motion to dismiss, but Nationwide assumed for the sake of argument only that the facts alleged in appellee’s complaint were true in order to show that appellee could not prevail on those facts for purposes of its Civ.R. 12(B)(6) motion. Appellee provided no independent evidence in support of its motion, and his only argument was that Littrell should be applied to allow him to be reimbursed for the amount of his statutory Medicare lien.

{¶ 9} On March 27, 2003, Nationwide filed a “Reply Brief in Support of Motion to Dismiss.” The brief also opposed appellee’s motion for summary judgment. No new arguments were presented.

{¶ 10} On November 13, 2003, the trial court overruled Nationwide’s motion to dismiss.

{¶ 11} On November 13, 2003, in a separate judgment entry, the trial court overruled appellee’s motion for summary judgment.

{¶ 12} On November 24, 2003, Nationwide filed a brief in opposition to appellee’s motion for summary judgment, apparently not realizing.that the court had already ruled on the motion.

{¶ 13} On February 3, 2004, appellee filed a motion for reconsideration of the court’s decision not to grant appellee summary judgment. Appellee simply cited Littrell again and concluded that judgment should be rendered in his favor.

{¶ 14} On February 4, 2004, Nationwide also filed a motion for reconsideration. Nationwide argued that the case could be settled on the matters of law raised in Nationwide’s prior filings.

{¶ 15} On March 2, 2004, the trial court granted the motions for reconsideration. The court then ruled that Littrell governed the outcome of the case, and granted summary judgment to appellee in the amount of $52,894.87.

{¶ 16} Nationwide filed a timely appeal on March 15, 2004.

*246 ASSIGNMENT OF ERROR

{¶ 17} “The trial court erred when it overruled Nationwide’s motion to dismiss and granted Pallay’s motion for summary judgment.”

{¶ 18} Nationwide’s arguments are primarily aimed at reversing the trial court’s decision to overrule its Civ.R. 12(B)(6) motion to dismiss. If the trial court is reversed on that basis, in effect the trial court’s decision to grant summary judgment to appellee will also be reversed.

{¶ 19} When reviewing a judgment on a Civ.R. 12(B)(6) motion to dismiss for failure to state a claim upon which relief can be granted, an appellate court’s standard of review is de novo. Perrysburg v. Rossford, 103 Ohio St.3d 79, 2004-Ohio-4362, 814 N.E.2d 44, at ¶ 5. The court will look only to the complaint or, in a proper case, the copy of a written instrument upon which a claim is predicated, to determine whether the allegations are legally sufficient to state a claim. Slife v. Kundtz Properties

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Bluebook (online)
846 N.E.2d 58, 165 Ohio App. 3d 242, 2005 Ohio 5932, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pallay-v-nationwide-insurance-ohioctapp-2005.