v.
Nationwide Mutual Insurance Company
This cause was heard upon the record in the trial court. Each error assigned has been reviewed and the following disposition is made: {¶ 1} Appellant, Hartford Insurance Company ("Hartford"), appeals from the decision of the Wayne County Court of Common Pleas, which granted summary judgment to Appellees, Luanna, David, Jonathan, Jessica, and Juliet Dotterer. Appellant, Nationwide Mutual Insurance Company ("Nationwide"), appeals from the grant of summary judgment to Appellees. We reverse and remand for further proceedings consistent with this opinion.
{¶ 3} At the time of the accident, Luanna was employed by Barberton Citizens Hospital, which was insured under a commercial automobile policy issued by Hartford. David, Luanna's spouse, was insured under a business automobile policy and a farmowners policy issued by Nationwide. Jonathan, Jessica, and Juliet Dotterer are minor children of Luanna and David and reside with the couple.
{¶ 4} Appellees filed an action for declaratory judgment and damages. Their complaint was originally filed in the Summit County Court of Common Pleas; however, the action was transferred to the Wayne County Court of Common Pleas. Appellees sought declarations that (1) they are entitled to underinsured motorist coverage under a business automobile policy issued by Nationwide to David Dotterer, as a sole proprietor; (2) they are entitled to underinsured motorist coverage under a farmowners policy issued by Nationwide to David Dotterer, as a sole proprietor; and (3) they are entitled to underinsured motorist coverage under a commercial automobile policy issued by Hartford to Barberton Citizens Hospital.
{¶ 5} Nationwide, Hartford, and Appellees filed motions for summary judgment. On July 31, 2002, the trial court entered its judgment with respect to the Nationwide policies. The court found that Appellees are insureds under the business automobile policy and are entitled to UIM coverage. The trial court also determined that the farmowners policy is not an automobile liability policy, and, therefore, UIM coverage does not arise by operation of law, and Appellees are not entitled to UIM coverage under that policy. Nationwide appealed from this decision. Appellees have not appealed the trial court's determination that the farmowners policy is not an automobile or motor vehicle policy.
{¶ 6} On August 15, 2002, the trial court entered its judgment with respect to the Hartford policy. The court determined that Appellees are insureds under the policy pursuant to Scott-Pontzer v. Liberty Mut. Fire Ins. Co. (1999),
{¶ 7} The appeals were consolidated. Nationwide and Hartford each raises one assignment of error for review. We will discuss each in turn.
"The trial court erred in its determination that the plaintiffs are not excluded from coverage under the business auto policy issued to David Dotterer, a sole proprietorship."
{¶ 8} In its assignment of error, Nationwide essentially challenges the grant of summary judgment to Appellees. Nationwide asserts that the trial court erred when it determined that Appellees are entitled to UIM coverage under the business auto policy; specifically, Nationwide argues that the trial court erred when it determined that an exclusion in the policy was invalid and, therefore Appellees were entitled to coverage.
{¶ 9} We begin our discussion by noting the appropriate standard of review. An appellate court reviews an award of summary judgment de novo. Grafton v. Ohio Edison Co. (1996),
{¶ 10} Pursuant to Civil Rule 56(C), summary judgment is proper if:
"(1) No genuine issue as to any material fact remains to be litigated; (2) the moving party is entitled to judgment as a matter of law; and (3) it appears from the evidence that reasonable minds can come to but one conclusion, and viewing such evidence most strongly in favor of the party against whom the motion for summary judgment is made, that conclusion is adverse to that party." Temple v. Wean United, Inc. (1977),
50 Ohio St.2d 317 ,327 .
{¶ 11} To prevail on a motion for summary judgment, the party moving for summary judgment must be able to point to evidentiary materials that show that there is no genuine issue as to any material fact, and that the moving party is entitled to judgment as a matter of law. Dresher v. Burt (1996),
{¶ 12} Nationwide argues that Appellees are not entitled to UIM coverage because an exclusion in the policy precludes coverage. The policy contains an Ohio Uninsured Motorists Coverage — Bodily Injury endorsement, which provides the following exclusion of UIM coverage:
"This insurance does not apply to:
"5. `Bodily injury' sustained by:
"a. You while `occupying' or when struck by any vehicle owned by you that is not a covered `auto' for Uninsured Motorists coverage under this Coverage Form;
"b. Any `family member' while `occupying' or when struck by any vehicle owned by that `family member' that is not a covered `auto' for Uninsured Motorists Coverage under this Coverage Form; or
"c. Any `family member' while `occupying' or when struck by any vehicle owned by you that is insured for Uninsured Motorists Coverage on a primary basis under any other Coverage Form or policy."
{¶ 13} The trial court found that this exclusion violates R.C.
{¶ 14} The version of R.C.
"The trial court abused its discretion when it held that plaintiff-appellee was entitled to coverage under hartford's fire policy."
{¶ 15} In its assignment of error, Hartford challenges the grant of summary judgment to Appellees on the issue of UIM coverage under the policy issued to Barberton Citizens Hospital. Hartford generally argues that Appellees are not entitled to UIM coverage because they violated provisions of the policy, destroying Hartford's subrogation rights. Hartford further argues that Appellees are not legally entitled to recover damages from the tortfeasor, thereby precluding coverage under the policy.
{¶ 16} The trial court granted judgment to Appellees, finding that (1) Appellees are insureds for purposes of UIM coverage under the Hartford policy; (2) Appellees are entitled to legally recover damages from the tortfeasor; (3) Appellees are legally entitled to recover damages under the statute of limitations applicable to UIM claims; and (4) Appellees' claims are not barred by the notice and consent provisions in the policy.
{¶ 17} If an insurance contract is clear and unambiguous, its interpretation is a question of law. Red Head Brass, Inc. v. Buckeye Union Ins. Co. (1999),
{¶ 18} The business auto policy contains the following conditions regarding notice and consent:
"2. DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS
"a. In the event of `accident', claim, `suit' or `loss', you must give us or our authorized representative prompt notice of the `accident' or `loss'.
"***
"3. LEGAL ACTION AGAINST US
"No one may bring a legal action against us under this Coverage Form until:
"a. There was been full compliance with all the terms of this Coverage Form[.]"
{¶ 19} The policy also contains an endorsement entitled OHIO UNINSURED MOTORISTS COVERAGE — BODILY INJURY. The endorsement provides:
"E. CHANGES IN CONDITIONS
"The CONDITIONS of the policy for OHIO UNINSURED MOTORISTS INSURANCE are changes as follows:
"***
"2. DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS is changed by adding the following:
"***
"c. A person seeking Uninsured Motorists Coverage must also promptly notify us in writing of a tentative settlement between the `insured' and the insurer of the [uninsured motor vehicle] and allow us 30 days to advance payment to that insured in an amount equal to the tentative settlement to preserve our rights against the insurer, owner or operator of such [uninsured vehicle]."
{¶ 20} Hartford argues that these conditions preclude UIM coverage for the appellees. Appellees counter that the provisions do not bar UIM coverage, and the Section E.2.c. provision requiring notification of a tentative settlement is "poorly written, confusing, doubtful, uncertain, and ambiguous as to the requirements before and the consequences after settling with the tortfeasor who is an underinsured motorist."
{¶ 21} The plain language of the policy states that no claim shall be brought until the claimant has complied with all provisions. The plain language of the policy conditions in question requires both prompt notice to the insurer in the event of an accident, as well as prompt notice of a tentative settlement. Thus, the trial court erred when it determined that the policy does not bar UIM benefits because the appellees settled and released the tortfeasor and his insurer.
{¶ 22} The Ohio Supreme Court recently addressed the consequences of an insured's breach of policy conditions and the required analysis to determine whether such a breach relieves the insurer of its obligation to provide UIM coverage. See Ferrando v. Auto-Owners Mut. Ins. Co.,
{¶ 23} The Ohio Supreme Court has set forth a two-step analysis. First, the court must determine if the insured breached a consent-to-settle or other subrogation-related condition. Id. at ¶ 91. If a breach occurred, the court must then determine whether the insurer was prejudiced. Id. In determining prejudice of the insurer, a presumption arises that the unreasonable delay was prejudicial; however, the insured may rebut the presumption with evidence to the contrary. Id.
{¶ 24} Based upon the foregoing analysis, we sustain Hartford's assignment of error to the extent that the trial court erred when it determined that the policy did not bar UIM benefits because the appellees settled and released Bergdorf and his insurer. We therefore reverse the judgment entered in favor of Appellees and against Hartford, and remand the cause in order for the trial court to consider the two-step analysis from Ferrando in its determination as to whether Appellees breached the conditions of the policy, and if they did, if Hartford was prejudiced by the breach so as to preclude UIM coverage. We decline to address Hartford's remaining argument concerning whether the trial court erred by finding that Appellees were legally entitled to recover damages from the tortfeasor.
CARR, J. and BATCHELDER, J. CONCUR.