Simmons v. American General Life & Accident Insurance

748 N.E.2d 122, 140 Ohio App. 3d 503, 2000 Ohio App. LEXIS 5317
CourtOhio Court of Appeals
DecidedNovember 17, 2000
DocketCourt of Appeals No. E-00-013, Trial Court No. 94-CV-446.
StatusPublished
Cited by5 cases

This text of 748 N.E.2d 122 (Simmons v. American General Life & Accident 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
Simmons v. American General Life & Accident Insurance, 748 N.E.2d 122, 140 Ohio App. 3d 503, 2000 Ohio App. LEXIS 5317 (Ohio Ct. App. 2000).

Opinion

Melvin L. Resnick, Judge.

This case is before the court on appeal from a judgment of the Erie County Court of Common Pleas granting appellees’ motion to certify this cause as a class action pursuant to Civ.R. 23. This cause was brought by plaintiffs-appellees, Julie Simmons in her individual capacity and on behalf of all persons similarly situated, against defendant-appellant, American General Life and Accident Insurance Company (“American”), to challenge the effect of a computer logic error on benefits available under lapsed “Graded Benefits” life insurance policies issued by American.

In 1986, appellant issued a Graded Benefits twenty-year life insurance policy, denominated Policy No. 116649096, to Manday Simmons, Julie Simmons’s mother. Manday Simmons stopped paying premiums on that policy in 1991, thereby allowing that policy to lapse. Pursuant to the terms of the Graded Benefits policy, the amount available to a beneficiary upon the death of the insured varies, depending on the date on which the policy lapses. If the policy lapses within three years after it is issued, the insured is provided with “extended term insurance” in an amount equal to the equity in the policy. This insurance exists for a specific period of time and then the policy terminates. If the Graded Benefits policy lapses after the third policy year, the insured is furnished “reduced paid up insurance” that pays a small death benefit at any time thereafter. Policy No. 116649096 was a “reduced paid up” policy upon lapse.

A computer logic error, first occurring in 1989 and compounded in 1991, exchanged the data related to the two lapse periods on approximately one thousand five hundred of American’s Graded Benefits life insurance policies. As a result, when Julie Simmons contacted American before Manday Simmons’s death on September 14, 1993, to inquire as to the status of and death benefit afforded under Policy No. 116649096, the computer printout indicated that this policy was an extended-term policy paying a death benefit of $8,235 until the term expired on October 22, 1993. Julie Simmons was provided with the same information after her mother’s death. However, American paid Manday’s benefi *506 ciaries only the “reduced paid up” death benefit of $936 as provided under Policy No. 116649096.

Consequently, Julie Simmons and her sister filed a complaint'against American claiming that the insurance company misrepresented the status and amount of their mother’s life insurance coverage under Policy No. 116649096. Later, appellees filed an amended complaint against American, converting their claims to a class action brought on behalf of all insureds affected by the computer logic error in determining the amount of the death benefit due under lapsed Graded Benefits life insurance policies. Appellees also filed a motion, pursuant to Civ.R. 23, to certify the instant cause as a class action based on the legal theories of fraud, negligent misrepresentation, negligence, and breach of contract. Appel-lees proposed a class consisting of the following persons:

“Persons who were insureds or beneficiaries of graded benefits (GB) policies underwritten by defendant who had their policy death benefits incorrectly calculated from either Extended Term insurance (ETI) to Reduced Paid-Up Insurance (RPU) or vice-versa after a lapse in premium payments where such delinquent policy payments were not subsequently paid by the insured.”

In its memorandum in opposition to the motion to certify, American pointed out that most of the members of the proposed class lacked standing to participate in the class action and argued that appellees’ case did not meet the prerequisites for certification under Civ.R. 23.

On February 3, 2000, the trial court granted appellees’ motion to certify. The court certified the following class:

“All persons, and all beneficiaries of deceased persons, who were insured during the class period from December 23, 1983 [fn.l] and thereafter, by an American General graded benefits (GB) life insurance policy which was or will be lapsed, forfeited, surrendered, or otherwise terminated where such GB policy is converted to reduced paid-up insurance, extended term insurance, or otherwise amended in value so as to effect either (a) a reduction in benefits or in the term for which benefits were paid or are due and payable to the policy beneficiaries; or (b) a reduction or increase in benefits or in the term for which coverage would otherwise remain in force or for which benefits would be paid and the policyholder, or representative of the policyholder, was notified or informed by American General or otherwise became aware of such alteration of benefits.”

In its footnote the trial court explained that the “class period” was calculated by using the fifteen-year statute of limitations for breach of contract. The court observed that the fifteen-year statute of limitations was also applicable to appellees, “breach of fiduciary duty” and “breach of good faith and fair dealing” *507 claims, neither of which was ever pleaded by appellees. On appeal of this judgment, American asks this court to consider the following assignment of error:

“The trial court erred in certifying plaintiffs claims as a class action because the class definition and the class claims do not meet the requirements of Civ.R. 23.”

A class action is an action filed, pursuant to Civ.R. 23, by a class representative on behalf of, or against, an entire group of persons with common issues that make a collective lawsuit more efficient. Hamilton v. Ohio Sav. Bank (1998), 82 Ohio St.3d 67, 80, 694 N.E.2d 442, 453-454. Before a case may be certified as a class action, a trial judge must make seven affirmative findings as to the requirements of Civ.R. 23, five of which are specifically set forth in the rule and two of which are implicit. Warner v. Waste Mgt., Inc. (1988), 36 Ohio St.3d 91, 521 N.E.2d 1091, paragraph one of the syllabus. The two implicit prerequisites are (1) that the class be identifiable and that the definition of the class be unambiguous, and (2) that the class representative(s) be a member or members of the class. Id. at 96, 521 N.E.2d at 1095-1096. Four of the explicit requirements are set forth in Civ.R. 23(A) and are numerosity, commonality, typicality, and that the representative will fairly and adequately protect the interest of the class. Id. at 97, 521 N.E.2d at 1096-1097. The analysis under this last prerequisite is divided into a consideration of the adequacy of the representative and the adequacy of counsel. Id. at 95, 521 N.E.2d at 1095. Finally, a trial court must find that one of the three Civ.R. 23(B) requirements is met before a class may be certified. Id. at 94, 521 N.E.2d at 1094-1095. The trial judge hás broad discretion to determine if a class action may be maintained, and that decision will not be disturbed on appeal without a showing of abuse of discretion. Marks v. C.P. Chem. Co. (1987), 31 Ohio St.3d 200, 31 OBR 398, 509 N.E.2d 1249, syllabus.

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Bluebook (online)
748 N.E.2d 122, 140 Ohio App. 3d 503, 2000 Ohio App. LEXIS 5317, Counsel Stack Legal Research, https://law.counselstack.com/opinion/simmons-v-american-general-life-accident-insurance-ohioctapp-2000.