Opinion

Scott-Pontzer v. Liberty Mutual Fire Insurance

  • 85 Ohio St. 3d 660
  • 710 N.E.2d 1116
Court
Ohio Supreme Court
Filed
Jun 23, 1999
Status
Published
Author
Douglas
On the bench
Cook, Douglas, Moyer, Pfeifer, Resnick, Stratton, Sweeney
Cited by
636 cases
Authority
More cited than 99.8%

Overruled by Westfield Insurance v. Galatis, 100 Ohio St. 3d 216 (2003)

holding that spouse of employee killed in an automobile accident while acting outside the scope of his employment was entitled to recover underinsured motorists coverage under employer’s policy up to full amount of liability coverage where insurer failed to present the employer with written offer of underinsured motorists coverage in accordance with Ohio Revised Code § 3937.18

How later courts described this case

  • holding that spouse of employee killed in an automobile accident while acting outside the scope of his employment was entitled to recover underinsured motorists coverage under employer’s policy up to full amount of liability coverage where insurer failed to present the employer with written offer of underinsured motorists coverage in accordance with Ohio Revised Code § 3937.18
  • noting the Supreme Court holdings requiring that “excess liability insurance must comport with R.C. 3937.18 and thus uninsured (and underinsured) motorist coverage must be tendered” and that “failure by the insurer to offer such coverage results in the provision of such coverage by operation of law”
  • holding that "a corporation itself, cannot occupy an automobile, suffer bodily injury or death or operate a motor vehicle."
  • stating that if a court finds that the claimant "was not an insured under the polic[y], then [the] inquiry is at an end"

Written by the judges who cited it.

Later courts went against this

  • Overruled by Westfield Insurance v. Galatis, 100 Ohio St. 3d 216 (2003)

    85 Ohio St.3d 660, 710 N.E.2d 1116, 1119 (1999) overruled in part by Westfield Ins. Co. v. Galatis, 100 Ohio St.3d 216, 797 N.E.2d 1256 (2003).
    Ohio Supreme CourtNov 5, 200310 citing opinionsRead it
  • Questioned — as noted by 2 later courts

    Co. v. Galatis, 100 Ohio St. 3d 216,2003-Ohio-5849, the Ohio Supreme Court limited its holding inScott-Pontzer.
    2 citing opinions
  • Limited by Jones v. Federal Insurance Company, Unpublished Decision (12-15-2003), 2003 Ohio 6847 (2003)

    The Ohio Supreme Court recently limited its holding in Scott-Pontzer.
    Ohio Court of AppealsDec 15, 2003Read it

Distinguished

  • Distinguished by Pyros v. Loparo, Unpublished Decision (2-15-2005), 2005 Ohio 577 (2005)

    {¶ 32} Plaintiffs contend that Galatis should not be applied in this case because "Utica First has waived any claim that Scott-Pontzer is inapplicable here" and because "courts should apply Galatis prospectively only.
    Ohio Court of AppealsFeb 15, 2005Read it
  • Distinguished by Williams v. Jones, Unpublished Decision (10-12-2004), 2004 Ohio 5512 (2004)

    {¶ 14} We expressly reject Williams' argument that he possesses a contractual right that arose under Scott-Pontzer
    Ohio Court of AppealsOct 12, 2004Read it
  • Distinguished by Comeans v. Clark, Unpublished Decision (5-14-2004), 2004 Ohio 2420 (2004)

    Fire Ins.Co., 85 Ohio St.3d 660, 1999-Ohio-292, 710 N.E.2d 1116, is inapplicable; (2) the self-retention in the policy did not negate the applicability of R.C. 3937.18; and (3) a genuine issue of fact remained regarding whether the UM/UIM coverage within the policy was properly offered and rejected.
    Ohio Court of AppealsMay 14, 2004Read it
  • Distinguished by Snyder v. Westfield Insurance Co., Unpublished Decision (11-05-2003), 2003 Ohio 5904 (2003)

    Appellees have presented evidence indicating that Scott-Pontzer is inapplicable to the present matter.
    Ohio Court of AppealsNov 5, 2003Read it

The opinion

Douglas, J.

The parties present us with three issues for our determination. The first issue is whether Pontzer, as an employee of Superior Dairy, was an “insured,” for purposes of underinsured motorist coverage, under the policies issued to Superior Dairy by Liberty Fire and Liberty Mutual. If he was, then the second issue is whether Pontzer, for coverage to be afforded, would have had to be in the course of his employment at the time of the accident. The third question, which pertains only to the Liberty Mutual policy, is whether, after underinsured motorist coverage is inserted into a policy by operation of law, the exclusions in the policy that have been written in so as to apply to the coverage for liability also pertain to the underinsured coverage.

If we find Pontzer was not an insured under the policies, then our inquiry is at an end. If we find that he was an insured, then we must proceed to the question of “scope of employment.” If we find that for Pontzer to be covered he must have been in the scope of his employment, again our inquiry is at an end because it is stipulated that he was not. If, however, we find that Pontzer was an insured and that coverage ensued even though he was not in the course of his employ *663 ment at the time of the occurrence of the accident, then our inquiry as to coverage under the Liberty Fire policy is ended (there would be coverage) and we then must proceed to whether Pontzer was also covered under the Liberty Mutual policy given that there is, in that policy, a “scope of employment” requirement.

In discussing the foregoing, hereinafter “Liberty Fire” and “Liberty Mutual” will also be referred to jointly as “appellees,” since they submitted a joint brief to this court.

I. Liberty Fire Policy

In regard to the commercial automobile liability policy issued through Liberty Fire, appellees argue that the court of appeals erred in concluding that Pontzer was an insured. Appellees contend that the Liberty Fire policy unambiguously shows that Superior Dairy was the only named insured, that Pontzer could not be considered an insured under any language in the policy, and that, therefore, appellant cannot claim entitlement to underinsured motorist benefits. We disagree.

Regrettably, as so many of these types of cases do, this issue centers on construing certain words and phrases contained within the Liberty Fire policy. The declarations page of the Liberty Fire policy names Superior Dairy, Inc. as the named insured. The business auto coverage form of that policy states that “[tjhroughout this policy the words you and your refer to the [njamed [i]nsured shown in the [declarations.” The policy also contains an Ohio uninsured motorist coverage form that defines an “insured” for purposes of underinsured motorist coverage as follows:

“B. Who Is An Insured

“1. You.

“2. If you are an individual, any family member.

“3. Anyone else occupying a covered auto or a temporary substitute for a covered auto. The covered auto must be out of service because of its breakdown, repair, servicing, loss or destruction.

“4. Anyone for damages he or she is entitled to recover because of bodily injury sustained by another insured.”

It is well settled that an insurance policy is a contract and that the relationship between the insured and the insurer is purely contractual in nature. Nationwide Mut. Ins. Co. v. Marsh (1984), 15 Ohio St.3d 107, 109 , 15 OBR 261, 262, 472 N.E.2d 1061, 1062 . Appellees contend that the above-quoted policy language indicates the intent of the parties to the insurance contract to provide that Superior Dairy is the only named insured. According to appellees, the inclusion *664 of the phrase “[i]f you are an individual, any family member” removes any doubt that “you” refers to Superior Dairy and, thus, that Superior Dairy is the sole named insured. In other words, appellees contend that by the insertion of this conditional language a distinction is made between “you” and an “individual,” thereby clearly evincing the intent of the parties that the corporate entity, Superior Dairy, be the sole named insured. While that is one interpretation of the policy, it is not the only interpretation.

In King, 35 Ohio St.3d 208 , 519 N.E.2d 1380 , syllabus, Chief Justice Moyer, speaking for the court, said that “[w]here provisions of a contract of insurance are reasonably susceptible of more than one interpretation, they will be construed strictly against the insurer and liberally in favor of the insured.” (Citations omitted.) The language of the Liberty Fire policy under consideration here is, in our view, subject to various interpretations.

Contrary to appellees’ contentions, the policy language of the Liberty Fire policy can be interpreted to include company employees. Assuming arguendo that “you” does refer solely to Superior Dairy, this does not foreclose the inclusion of Pontzer as an insured under the policy. We note again, as we have often in the past, that uninsured motorist coverage, mandated by law pursuant to R.C. 3937.18, was designed by the General Assembly to protect persons, not vehicles. Martin v. Midwestern Group Ins. Co. (1994), 70 Ohio St.3d 478 , 639 N.E.2d 438 , paragraph one of the syllabus. Since R.C. 3937.18 mandates underinsured as well as uninsured motorist coverage, obviously the same rationale applies to underinsured motorist coverage. It would be contrary to previous dictates of this court for us now to interpret the policy language at issue here as providing underinsured motorist insurance protection solely to a corporation without any regard to persons. See Ady v. W. Am. Ins. Co. (1982), 69 Ohio St.2d 593 , 23 O.O.3d 495 , 433 N.E.2d 547 . Rather, it would be reasonable to conclude that “you,” while referring to Superior Dairy, also includes Superior’s employees, since a corporation can act only by and through real live persons. It would be nonsensical to limit protection solely to the corporate entity, since a corporation, itself, cannot occupy an automobile, suffer bodily injury or death, or operate a motor vehicle. Here, naming the corporation as the insured is meaningless unless the coverage extends to some person or persons — including to the corporation’s employees.

We recognize that insurers can draft policy language that provides varying arrays of coverage to any number of individuals. However, in drafting contracts of insurance, insurers must do so with language that is clear and unambiguous and that comports with the requirements of the law. See King, 35 Ohio St.3d 208 , 519 N.E.2d 1380 , and Martin, 70 Ohio St.3d 478 , 639 N.E.2d 438 .

*665 We therefore agree with the court of appeals that the language in the Liberty Fire policy concerning the identity of “insureds” is ambiguous. Courts universally hold that policies of insurance, which are in language selected by the insurer and which are reasonably open to different interpretation, will be construed most favorably to the insured. Further, as we said in Faruque v. Provident Life & Acc. Ins. Co. (1987), 31 Ohio St.3d 34 , 31 OBR 83, 508 N.E.2d 949 , syllabus, “[l]anguage in a contract of insurance reasonably susceptible of more than one meaning will be construed liberally in favor of the insured and strictly against the insurer.” Accordingly, we conclude that Pontzer, at the time of his death, was an insured under the Liberty Fire policy for purposes of underinsured motorist coverage.

II. Liberty Mutual Policy

We also conclude that Pontzer was an insured under the umbrella/excess policy issued to Superior Dairy through Liberty Mutual. Liberty Mutual failed to offer uninsured/underinsured motorist coverage under Superior Dairy’s umbrella/excess insurance policy. Thus, unlike the Liberty Fire policy, the Liberty Mutual umbrella policy did not contain an uninsured motorist coverage form that defined insureds for purposes of underinsured motorist coverage.

In Duriak v. Globe Am. Cas. Co. (1986), 28 Ohio St.3d 70, 72 , 28 OBR 168, 170, 502 N.E.2d 620, 622-623 , we held that excess liability insurance must comport with R.C. 3937.18 and thus uninsured (and underinsured) motorist coverage must be tendered. Further, in Gyori v. Johnston Coca-Cola Bottling Group (1996), 76 Ohio St.3d 565, 568 , 669 N.E.2d 824, 827 , we stated that failure by the insurer to offer such coverage results in the provision of such coverage by operation of law. Absent any showing that underinsured coverage was offered and rejected, such coverage is included in the policy. Therefore, we conclude that Pontzer, as an employee of Superior Dairy, was also an insured under Superior Dairy’s umbrella/excess insurance policy and that said policy includes underinsured motorist coverage, as such coverage is mandated by operation of law.

III. Scope of Employment

Having concluded that Pontzer was an insured under both policies at issue, we must now determine whether appellant is entitled to underinsured motorist benefits. Appellant argues that the court of appeals erred when it determined that underinsured motorist benefits under both the Liberty Fire and Liberty Mutual policies would be available to appellant only if her husband was acting during the scope of his employment when he was killed. We agree with appellant.

In King v. Nationwide Ins. Co., 35 Ohio St.3d at 214 , 519 N.E.2d at 1386 , we noted that “[i]n the construction of insurance contracts, ‘[wjhere exceptions, *666 qualifications or exemptions are introduced into an insurance contract, a general presumption arises to the effect that that which is not clearly excluded from the operation of such contract is included in the operation thereof.’ ” (Quoting Home Indemn. Co. v. Plymouth [1945], 146 Ohio St. 96 , 32 O.O. 30 , 64 N.E.2d 248 , paragraph two of the syllabus.) The Liberty Fire policy contains no language requiring that employees must be acting within the scope of their employment in order to receive underinsured motorist coverage. Thus, we find that appellant is entitled to underinsured motorist benefits under the Liberty Fire policy.

On the other hand, Liberty Mutual’s umbrella/excess insurance policy did restrict .coverage to employees acting within the scope of their employment. However, we have already found that Liberty Mutual had failed to offer underinsured motorist coverage through the umbrella policy issued to Superior Dairy. Thus, any language in the'Liberty Mutual umbrella policy restricting insurance coverage was intended to apply solely to excess liability coverage and not for purposes of underinsured motorist coverage. See, e.g., Demetry v. Kim (1991), 72 Ohio App.3d 692, 698 , 595 N.E.2d 997, 1001 . Therefore, there is no requirement in the umbrella policy that Pontzer had to be acting during the scope of his employment to qualify for underinsured motorist coverage. Therefore, appellant is entitled to underinsured motorist benefits under the Liberty Mutual umbrella policy as well.

IV.

We realize that the conclusion reached herein may be viewed by some as a result that was not intended by the parties to the insurance contracts at issue. Nonetheless, we believe that to adopt appellees’ position in this matter would clearly produce absurd results. For instance, appellees’ position is that only those employees occupying a “covered auto” are insureds under the Liberty Fire policy. Appellees’ attorney conceded during oral argument that this position precluded coverage for employees driving their personal motor vehicles while acting during the scope of their employment. As a result, through the doctrine of respondeat superior, Superior Dairy would be potentially liable, without the protections afforded by automobile liability insurance (not to mention uninsured/underinsured motorist coverage), for tortious conduct by such employees. It could hardly have been the intent of Superior Dairy to place itself in such a precarious position. In any event, as the law is clear in this regard, we will not guess at the intent of the parties to the insurance contract when the insurer introduces ambiguous terms into the policy.

Accordingly, we reverse the judgment of the court of appeals and we vacate the judgment of the trial court. We remand this matter to the trial court with *667 instructions to enter judgment in favor of appellant on the issue of coverage as to both policies.

Judgment reversed and cause remanded.

Resnick, F.E. Sweeney and Pfeifer, JJ., concur.

Moyer, C.J., and Cook, J., dissent.

Lundberg Stratton, J., dissents.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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