Thompson v. United States Fidelity & Guaranty Co.

559 N.W.2d 288, 1997 Iowa Sup. LEXIS 73, 1997 WL 66179
CourtSupreme Court of Iowa
DecidedFebruary 19, 1997
Docket95-1680
StatusPublished
Cited by16 cases

This text of 559 N.W.2d 288 (Thompson v. United States Fidelity & Guaranty Co.) is published on Counsel Stack Legal Research, covering Supreme Court of Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Thompson v. United States Fidelity & Guaranty Co., 559 N.W.2d 288, 1997 Iowa Sup. LEXIS 73, 1997 WL 66179 (iowa 1997).

Opinion

LARSON, Justice.

In October 1991 Kirby Thompson fell two stories from the roof of a building and landed on a cement floor, severely breaking both arms. At that time, he was employed by McKiness General Contractors. United States Fidelity and Guaranty Company (USF&G) was the workers’ compensation carrier for McKiness. Thompson initially received workers’ compensation benefits, but USF&G later terminated them on the ground that Thompson was intoxicated at the time of the incident and that the intoxication was a “substantial factor” in causing his fall. See Iowa Code § 85.16(2) (1991). The intoxication defense was unsuccessful, and a deputy industrial commissioner ordered USF&G to reinstate the benefits. (USF&G did not challenge that order.) Thompson then sued USF&G for alleged bad faith in terminating his benefits. The district court directed a verdict for USF&G on the basis that Thompson’s claim was fairly debatable, and we affirm.

Thompson complains that it was error for the court to decide the question as one of law because he produced substantial evidence that USF&G had no reasonable basis for denying the claim. USF&G responds that under our cases the issue of whether a claim is fairly debatable is to be determined as a matter of law by the court, citing Morgan v. American Family Mutual Insurance Co., 534 N.W.2d 92, 96 (Iowa 1995) (“Whether a claim is fairly debatable is appropriately decided by the court as a matter of law.”), and Wetherbee v. Economy Fire & Casualty Co., 508 N.W.2d 657, 662 (Iowa 1993) (same). We disagree with Thompson’s assessment of the strength of his ease, but we also disagree with USF&G’s view that the “fairly debatable” issue is to be decided by the court as a matter of law in every case.

*290 I. The Law in General.

Federal courts applying Iowa law have considered our cases on bad-faith claims and have pointed to several apparent inconsistencies in them, see, e.g., Chadima v. National Fidelity Life Ins. Co., 55 F.3d 345, 345 (8th Cir.), cert. denied, — U.S. —, 116 S.Ct. 186, 133 L.Ed.2d 124 (1995), in which the federal court of appeals stated:

This diversity case presents the question of whether a judge or jury should decide whether an insurer had a reasonable basis for denying a claim in a first-party bad-faith action. Cases from the Iowa Supreme Court go both directions.

In Reedy v. White Consolidated Industries, Inc., 890 F.Supp. 1417, 1439 n. 13 (N.D.Iowa 1995), the federal district court stated:

This court is frustrated by the Iowa Supreme Court’s failure in Morgan ... to address ... and to resolve for itself precisely what part of the first-party bad-faith cause of action may be determined by the court and under what circumstances. The federal courts must continue to wait for guidance....

While isolated statements in our bad-faith eases appear to be inconsistent regarding the role of the court on a directed-verdict motion, the holdings of those cases are not. Some cases call for a ruling as a matter of law, while others require fact-findings. For example, we said in Morgan that the fairly debatable question was “appropriately decided by the court as a matter of law” because uncontroverted evidence showed that the claimant had not sought medical attention at the time of her accident, denied being unconscious, and did not make a claim for her injury for seventeen months. Also, there was expert testimony that her problems were not caused by the accident. We held that the claim was “fairly debatable” as a matter of law. Morgan, 534 N.W.2d at 97.

In Wetherbee, 508 N.W.2d at 662, we also said that the fairly debatable defense “is appropriately decided by the court” because the pivotal issue was purely one of law. The claimant under an uninsured motorist provision was time-barred from making a claim against a third-part tortfeasor. Thus, because the insured had no underinsurance claim as a matter of law, her claim for bad-faith failure to pay underinsurance benefits could not survive — clearly a proper issue for the court to decide as a matter of law.

On the other hand, some of our cases have said that the fairly debatable issue is not for the court to decide. See, e.g., Nassen v. National States Ins. Co., 494 N.W.2d 231 (Iowa 1992); Kiner v. Reliance Ins. Co., 463 N.W.2d 9 (Iowa 1990).

In Nassen we held that an insurance company’s “confusion” about the claim

could have been cleared up by a reading of the company’s own claim file. National States ignored crucial information in that file and shunned any information that plaintiffs representative sought to provide .... Under the circumstances, the question of bad faith was for the jury to decide.

494 N.W.2d at 236. In Nassen there was substantial evidence that the insurer lacked a reasonable basis for denial, based on its conduct in failing to properly investigate the claim — a ease that was clearly appropriate for the jury to decide.

As shown by these eases, the question of whether the fairly debatable issue was one for the court or the jury depends on the facts of the individual case. We agree with the federal court of appeals in Chadima, which stated:

Wetherbee [our case stating that issue may appropriately be decided by the court] can be read as giving the trial court the opportunity to decide as a matter of law in the appropriate circumstances whether the insurer had a reasonable basis for denying the claim, but not mandating the court to do so.

55 F.3d at 349 (emphasis added).

As Thompson has conceded, there are no unique rules that apply when a district court rules on a directed-verdict motion in a bad-faith case. In such a case, as in all others,

[t]ime-honored rules govern our review of such motions. The primary standard is that of substantial evidence; where no substantial evidence exists to support each *291 element of a plaintiff’s claim, directed verdict or judgment n.o.v. is proper. Substantial evidence is that which a “reasonable mind would accept as adequate to reach a conclusion.” Where reasonable minds could differ on an issue, directed verdict is improper and the case must go to the jury.

Stover v. Lakeland Square Owners Ass’n,

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Bluebook (online)
559 N.W.2d 288, 1997 Iowa Sup. LEXIS 73, 1997 WL 66179, Counsel Stack Legal Research, https://law.counselstack.com/opinion/thompson-v-united-states-fidelity-guaranty-co-iowa-1997.