Justia Ohio Supreme Court Opinion Summaries
Articles Posted in Insurance Law
Westfield Ins. Co. v. Custom Agri Sys., Inc.
Younglove Construction entered into a contract with PSD Development for the construction of a feed-manufacturing plant. When PSD withheld payment, Younglove brought this diversity suit against PSD and three other defendants. In its answer, PSD alleged it had sustained damages as a result of defects in a steel grain bin constructed by Custom Agri Systems, Inc. as a subcontractor. Younglove filed a third-party complaint against Custom Agri Systems, Inc. for contribution and indemnity. Custom turned to its insurer, Westfield Insurance Company, to defend and indemnify it in the litigation. Westfield intervened to pursue a judgment declaring it had no such duty under the terms of its commercial general liability (CGL) policy with Custom. At issue was whether the claims against Custom sought compensation for "property damage" caused by an "occurrence" under the policy. The district court granted summary judgment for Westfield. On appeal, the federal court of appeals certified questions of state law to the Supreme Court. The Court answered by holding that claims of defective construction or workmanship brought by a property owner are not claims for "property damage" caused by an "occurrence" under a CGL. View "Westfield Ins. Co. v. Custom Agri Sys., Inc." on Justia Law
State ex rel. Brown v. Hoover Universal, Inc.
Employee was injured while working for Employer. Five years later, Employee was fired for violating the company's attendance policy. Employee's termination was later the basis for the Industrial Commission of Ohio's denial of his request for temporary total disability compensation (TTC). The Commission found that Employee's discharge amounted to a voluntary abandonment because it was consequence of behavior that Employee willingly undertook. The court of appeals reversed, holding that the deliberate misconduct necessary to support a finding of voluntary abandonment could not be imputed to Employee. The Supreme Court affirmed and issued a limited writ of mandamus that vacated the Commission's order and returned the cause to it for further consideration, as the hearing officer did not carefully examine the totality of the circumstances in finding that a simple allegation of misconduct existed to preclude temporary total disability compensation. View "State ex rel. Brown v. Hoover Universal, Inc." on Justia Law
State ex rel. Oakwood v. Indus. Comm’n
In 2008, Craig Ali was a police officer for appellant, the village of Oakwood. That spring, his department assigned him to perform traffic-control duties on a highway-construction project overseen by appellee, Kokosing Construction Company, Inc. Ali was injured while performing those duties. At issue was which entity was Ali's employer for purposes of his workers' compensation claim. A district hearing officer with the Industrial Commission of Ohio found that Kokosing was Ali's employer at the time of injury. A staff hearing officer reversed, finding the correct employer was Oakwood Village. The Supreme Court affirmed, holding (1) the commission, when confronted with two potential employers, may, but is not required to, use any of the State ex rel. Lord v. Daugherty and Fisher v. Mayfield factors it believes will assist analysis; (2) therefore, the commission did not abuse its discretion by not directly discussing the three enumerated Lord/Fisher factors; and (3) the staff hearing officer's decision was supported by evidence in the record. View "State ex rel. Oakwood v. Indus. Comm'n" on Justia Law
State ex rel. Hodge v. Ryan
Appellant Peggy Hodge sought to compel Appellee, the administrator of the Bureau of Workers' Compensation, to pay Vicki Hulbert, a licensed practical nurse, higher wages for the in-home care that Hulbert provided to her. A staff hearing officer (SHO) determined that he had no jurisdiction to order an increase. A few months later, Hodge again moved the Commission to increase Hulbert's wages. A district hearing officer (DHO) dismissed the motion of jurisdictional grounds, citing the SHO order. Thereafter, a different SHO affirmed the DHO's order. Hodge then sought a writ of mandamus against the bureau. The court of appeals denied the writ after finding, among other things, that Hodge's failure to appeal the SHO orders constituted a failure to exhaust her available administrative remedies. The Supreme Court affirmed, holding that the court of appeals was correct in denying the writ, as Hodge's failure to exhaust her administrative remedies precluded mandamus. View "State ex rel. Hodge v. Ryan" on Justia Law
State ex rel. George v. Indus. Comm’n
Employee suffered an industrial injury and received surgery on his right shoulder, after which Employee returned to work for self-insured Employer. Employee experienced renewed shoulder complaints four years later and asked Employer to add new shoulder conditions to Employee's workers' compensation claim and authorize surgery to correct them. Employer and the Industrial Commission denied Employee's request after finding that the proposed procedure was unrelated to the conditions allowed in Employee's workers' compensation claim. At issue on appeal was a doctor's report upon which the Commission based its decision. The court of appeals granted a limited writ in mandamus that ordered the Commission to reconsider the application after finding inconsistencies within the report. The Supreme Court reversed, concluding that none of the alleged inconsistencies noted in the doctor's report affected the viability of the doctor's opinion that further surgery was not reasonably related to the allowed conditions, and therefore, the report was evidence supporting the Commission's decision. View "State ex rel. George v. Indus. Comm'n" on Justia Law
Taylor v. Ernst & Young, L.L.P.
The superintendent of insurance, in her capacity as the liquidator of an insolvent insurer, filed an action in the county court of common pleas against an independent accounting firm that provided auditing services to the insurer, alleging negligence and that the firm had received preferential or fraudulent payments. The accounting firm moved to dismiss the complaint or to stay the proceedings and compel arbitration based on an arbitration clause that was contained in an engagement letter signed by the insurer and accounting firm. The trial court denied the motion. The court of appeals affirmed, holding that because the liquidator had not signed the arbitration agreement, there was a presumption against arbitration. The Supreme Court affirmed but in part for different reasons, holding that the liquidator was not bound by the insurer's agreement when the liquidator's claims did not arise from the contract that contained the arbitration provision. View "Taylor v. Ernst & Young, L.L.P." on Justia Law
State ex rel. Cinergy Corp. v. Heber
In 1970, while working for Employer, Employee was injured. In 1989, Employee retired. In 2008, Employee applied for permanent total disability (PTD) compensation. The Industrial Commission of Ohio concluded that Employee was permanently and totally disabled without ruling on the credibility of the assertion that Employee retired because of his injury or determining whether his retirement was voluntary or involuntary. The court of appeals granted Employer a limited writ of mandamus that vacated the Commission's order and ordered the Commission to reconsider the matter. The Supreme Court affirmed the court of appeals, holding that because a voluntary retirement from the work force prior to asserting PTD precludes the payment of compensation for that disability, the court of appeals was correct in ordering further consideration of whether Employee retired because of his injury and whether his retirement was voluntary.
View "State ex rel. Cinergy Corp. v. Heber" on Justia Law
Barbee v. Nationwide Mut. Ins. Co.
Appellees, members of the Barbee family, were involved in an automobile accident. Appellant, Nationwide Mutual Insurance Company, insured the automobile. The policy contained a provision that required an action for underinsured motorist coverage be brought against the insurer within three years of the date of the accident. After receiving a judgment against the tortfeasors and more than four years after the accident, the Barbees filed suit against Nationwide to recover the outstanding amounts on their judgments. Nationwide filed a motion for summary judgment, arguing that the Barbees' claims were barred for failure to bring the claims within the three-year period required by the policy's limitation period. The trial court denied the motion. The court of appeals affirmed. At issue on appeal was whether a conflict between Nationwide's limitation provision and other provisions in the policy, which required that proceeds from any other available insurance be exhausted, rendered the limitation provision unenforceable. The Supreme Court reversed, holding (1) the three-year limitation provision was unambiguous and enforceable, and (2) the provision did not conflict with co-existing policy provisions because exhaustion of the tortfeasor's liability limits was not a precondition to filing suit by the insured against his insurer within the limitation period. View "Barbee v. Nationwide Mut. Ins. Co." on Justia Law
State ex rel. Bell v. Brooks
Appellant Greg Bell requested that County Risk Sharing Authority (CORSA), a joint self-insurance pool whose members included the majority of Ohio's counties, provide him with certain CORSA records pursuant to Ohio Rev. Code 149.43 and Ohio Rev. Code 149.431. David Brooks, the managing director of property and casualty insurance for CORSA, refused to provide copies of the records, asserting that they were not public records and that CORSA was a private corporation and not a public office subject to section 149.43. Bell filed for writs of mandamus to compel Brooks to provide copies of the requested CORSA records. The court of appeals denied the requested writs. The Supreme Court (1) affirmed the judgment of the court of appeals insofar as it denied the writs relating to Bell's claim for CORSA's board meeting minutes on grounds that CORSA was not the functional equivalent of a public office for purposes of section 149.43, but (2) reversed to the extent that the court of appeals failed to consider Bell's records requests for CORSA's financial and compensation records as CORSA's status as a private, nonprofit corporation was not dispositive in regard to these claims. Remanded. View "State ex rel. Bell v. Brooks" on Justia Law
State ex rel. Tindira v. Ohio Police & Fire Pension Fund
Thomas Tindira was a member of Ohio Police and Fire Pension Fund (OP&F) while working as a police officer with Lakewood Police Department. Before he resigned from the department, Tindira filed his application for disability benefits with OP&F, including in his list of disabling conditions PTSD, anxiety disorder, and major depression. The OP&F board of trustees determined that Tindira was disabled but denied his claim for disability benefits. The court of appeals denied Tindira a writ of mandamus to compel appellees, OP&F and its board of trustees, to vacate the board's denial of his claim and to award him disability benefits and attorney fees. The Supreme Court reversed and granted the writ, holding that the pension fund and its board abused their discretion in denying disability benefits as Tindira had established his entitlement to the benefits. View "State ex rel. Tindira v. Ohio Police & Fire Pension Fund" on Justia Law