Lead Opinion
This action arises out of an automobile accident which occurred on June 3,1991 on Taylor Boulevard in Louisville, Jefferson County, Kentucky. Two vehicles were involved in the accident, one owned and operated by Appellee Hashim M. Alsabi and the other owned and operated by Fred Whalen. Appellee was the named insured of a policy of insurance issued by Kentucky Farm Bureau Mutual Insurance Company, which paid $7,238.90 in basic reparation benefits (BRB) for chiropractic bills incurred by Appellee. It is stipulated that the last BRB payment was made on
Whalen died of natural causes at the age of eighty-two on February 5, 1992. His will was admitted to probate by the Jefferson District Court on March 2, 1992. In her petition for probate, Whalen’s widow and sole beneficiary requested that she be appointed executrix of his estate. Instead, the district judge admitted the will to probate without appointing a personal representative. The probated will was filed as a public record in the office of the Jefferson County Court Clerk on March 10, 1992.
On February 3, 1994, Appellee filed this action against Fred Whalen and caused summons to issue against him at 2032 Ly-tle Street, Louisville, Kentucky, the address listed on the accident report. The summons was returned on February 16, 1994 with the notation that Whalen was deceased. Appellee’s attorney asserts that he did not learn of Whalen’s death until April 6, 1994. He did not move that the public administrator be appointed to administer Whalen’s estate pursuant to KRS 395.390 until September 22, 1994. The appointment was made on November 17, 1994. On January 19, 1995, Appellee filed an amended complaint substituting the public administrator as party defendant in place of Whalen.
The trial court granted summary judgment
I. LIMITATIONS.
As a general rule, a cause of action for personal injuries arising out of an automobile accident must be brought within two years after the date of injury or the last payment of basic reparation benefits. KRS 304.39-230(6). Thus, the period of limitations with respect to this 'cause of action expired on February 4, 1994, one day after the original complaint was filed. KRS 446.030(l)(a); Derossett v. Burgher, Ky.,
KRS 396.011 affords no relief in this case. Subsection (1) of that statute requires that a claim against an estate must be presented “within six (6) months after appointment of the personal representative....” Appellee notes that his amended complaint was filed within six months after the appointment of the public administrator. We need not address whether the filing of a complaint satisfies the requirement of a formal presentation of a claim; for KRS 396.011(1) clearly limits its applicability to claims against estates which are “not barred earlier by other statute[s] of limitations.” KRS 396.011(2)(b) excludes from the operation of that statute “[t]o the limits of the insurance protection only, any proceeding to establish liability of the decedent or the personal representative for which he is protected by liability insurance.” This only means that a claim of tort liability not preserved by a formal presentation of a claim within six months of the appointment of the personal representative is not
II. CR 15.03(2).
Appellee’s primary argument has always been the one which was adopted by the Court of Appeals, ie., that the amended complaint of January 19, 1995 related back to the date of the filing of the original complaint, February 3, 1994, thus was not barred by limitations. CR 15.03(2) provides as follows:
An amendment changing the party against whom a claim is asserted relates back if the condition of paragraph (1) is satisfied and, within the ■period, provided by law for commencing the action against him, the party to be brought in by amendment (a) has received such notice of the institution of the action that he will not be prejudiced in maintaining his defense on the merits, and (b) knew or should have known that, but for a mistake concerning the identity of the proper party, the action would have been brought against him. (Emphasis added.)
The period of limitations expired on February 4, 1994. Fred Whalen had been deceased for almost two years when this action was filed. The administrator of his estate did not exist as a legal entity until November 17, 1994, more than nine months after the expiration of the period of limitations.
[T]he relation back rule mandates that the party to be named in an amended pleading knew or should have known about the action brought against him. CR 15.03(2)(b). Actual, formal notice may not be necessary. Cf. Funk v. Wagner Machinery, Inc., Ky.App.,710 S.W.2d 860 (1986). Nevertheless, knowledge of the proceedings against him gained during the statutory period must be attributed to the defendant.
Nolph v. Scott, Ky.,
Although Appellee’s attorney filed in the record a copy of a letter he mailed to Allstate enclosing a copy of the complaint, that letter is dated February 4, 1994, the last day of the period of limitations, and presumably did not arrive in Allstate’s office on the same day it was mailed. (Unlike other correspondence from Appellee’s attorney to Allstate, this letter does not contain the notation that it was sent “VIA TELECOPIER”) Regardless, Allstate was not named as a party defendant in either the complaint or the amended complaint; thus, CR 15.03(2)(b) could not apply to it.
Appellee’s reliance on Richardson v. Dodson, Ky.,
Appellee suggests that Allstate should be estopped to rely on the issue of limitations, because its claims adjuster, Peggy Smith, failed to inform Appellee’s attorney of Fred Whalen’s demise. We note at the outset that this issue is not preserved for review. The Court of Appeals decided this case solely on the basis that CR 15.03(2) permitted the relation back of the amended complaint to the date the original complaint was filed. With respect to this issue, the Court of Appeals stated: “It is of no consequence that at the time Alsabi filed the litigation he was not aware of Whalen’s death.” Slip op., p. 3. Appellant requested review only of the issues of limitations and the effect of CR 15.03(2). Appellee did not file a cross-motion for discretionary review. As was stated in Commonwealth, Transportation Cabinet, Department of Highways v. Taub, Ky.,
We will not address issues raised but not decided by the Court below. It is the rule in this jurisdiction that issues raised on appeal but not decided will be treated as settled against the appellant in that court upon subsequent appeals unless the issue is preserved by cross-motion for discretionary review. CR 76.21(1); Nashville, C. & St.L. Ry. Co. v. Banks,168 Ky. 579 ,182 S.W. 660 (1916); and Eagle Fluorspar Co. v. Larue,237 Ky. 263 ,35 S.W.2d 303 (1931). In this case, counsel for Taub argued that the Secretary of Transportation is without power to certify a road for condemnation which is not in the six-year plan or expressly authorized by the General Assembly. This issue was touched upon by Taub in the Court of Appeals but not commented upon by the Court in its opinion. As such, the issue is deemed to have been decided adversely to Taub and his failure to file a cross-motion for discretionary review precluded further review in this Court.
Id. at- 51-52. See also Perry v. Williamson, Ky.,
On April 29, 1992, Appellee’s attorney notified Peggy Smith, the Allstate claims adjuster, that his office would be representing Appellee with respect to injuries sustained in the June 1991 accident. Whalen was already deceased at that time and his probated will was a public record in the Jefferson County Clerk’s Office.
The next correspondence in the record is a letter from Appellee’s attorney to Smith dated May 13, 1993. That letter contains the following file reference:
RE: Claim No. 2200555320 KPS
Date of Loss — June 3,1991
Your Insured — Fred Whalen
Our Client — Hashim Alsabi
The letter acknowledged and rejected a settlement offer of $2,000 .00 and advised that a counteroffer would be forthcoming within the week. The last paragraph of the letter contains the following:
Although the statute of limitations on this claim will not run until 1994 (because of the last payment made by the basic reparations [sic] obligor), I prefer to file a lawsuit (if necessary) within two years after the date of the accident. As you know, this accident was June 3, 1991, meaning the target date for either settling this claim or filing a lawsuit is June 2,1993.
The record does not reflect whether Ap-pellee’s attorney followed through on his promise of a counteroffer within the week. However, he did not file suit on his “target date” of June 2, 1993. The next correspondence between Appellee’s attorney and Allstate did not occur until October 15, 1993.
Meanwhile, on September 8, 1993, Fred Whalen’s daughter-in-law, an employee of the attorney vvho had handled the probate of Whalen’s estate, notified Peggy Smith by telephone that Whalen had died on
RE: Claim No.: 2200555320 KPS Insured: Fred Whalen
On October 15, 1993, Smith sent Ap-pellee’s attorney a letter reiterating the previous settlement offer of $2,000.00 and inquiring about any additional medical information. The letter contained the following file reference:
Claim Number: 2200555320 KPS
Loss Date: June 3,1991
Our Insured: FRED WHALEN
Location: TAYLOR BLVD, LOUISVILLE
Claimant: HASHIM ALSABI
Apparently, Appellee’s attorney did not respond to this letter; for on November 22, 1993, Smith sent him another letter containing the same file reference, which stated simply as follows:
“T am writing to follow up with you on your client Hashim Alsabi. Please provide an update.”
The next correspondence between Ap-pellee’s attorney and Allstate was the February 4, 1994 letter by which Appellee’s attorney forwarded Allstate a copy of the complaint filed in this action. That letter contained the following file reference:
RE: Claim No.: 2200555320
Loss Date: June 3,1991
Your Insured: Fred Whalen
Location: Taylor Blvd. Louisville
Claimant: Hashim Alsabi
Appellee argues that Smith’s renewed offers and inquiries regarding possible settlement without revealing that Whalen was deceased estops Allstate from now relying on the defense of limitations. Mere negotiations looking toward amicable settlement do not afford a basis for estoppel to plead limitations. Black v. Maglinger, Ky.,
An exception to this general rule may be found if a party remains silent when the duty to speak or disclose is imposed by law. Munday v. Mayfair Diagnostic Laboratory, supra, at 914, citing Security Trust Co. v. Wilson,
The facts of our case are more similar to those in Lingar v. Harlan Fuel Co.,
[O]ne may not omit to avail himself of readily accessible sources of information •concerning particular facts, and thereafter plead as an estoppel the silence of another who has been guilty of no act calculated to induce the party claiming ignorance to refrain from investigating. Appellant had a year in which to ascertain from the public records the true status of his employers, and in all probability a mere inquiry of them would have elicited the truth.
Id. at 659.
It is asserted that the file references in Smith’s post-September 8, 1993 letters, which refer to “Our insured: Fred Whalen,” rather than, e.g., “Our deceased insured: Fred Whalen,” were calculated to deceive Appellee’s attorney into believing that Whalen was still alive. Of course, every businessperson knows that file references are just that: something to assist both the sender’s and the addressee’s clerical employees in identifying the file into which this correspondence should be placed. Interestingly, even the September 8, 1993 letter to Smith from Whalen’s daughter-in-law informing Smith of Whalen’s demise contained the file reference: “Insured: Fred Whalen.” In fact, Fred Wfiialen was Allstate’s insured. Regardless of Whalen’s current mortal status, Allstate remained liable for any damages caused by his negligence which occurred during the policy period.
Appellee’s attorney did not raise this issue in his brief or argument before the circuit court, or in his brief or argument before the Court of Appeals, or in his brief filed in this Court. This issue was raised for the first time during oral argument, and Appellee’s attorney did not claim even then that he was misled by Allstate’s file reference. He cited it only as evidence of Allstate’s intent to mislead. In order to prevail on a theory of estoppel, there must be proof not only of an intent to induce inaction on the party to be es-topped, but also of reasonable reliance by the party claiming the estoppel. Adams v. Ison, supra, at 793.
In response to Appellant’s motion for summary judgment, it was the obligation of Appellee to present some evidence to support his theory of estoppel. CR 56.03, Gullett v. McCormick, Ky.,
Finally, it is asserted that the duty imposed by law on Smith to affirmatively inform Appellee’s attorney of Whalen’s demise is found in the Code of Professional Conduct applicable to licensed attorneys. SCR 3.130, et seq. In Kentucky Bar Association v. Geisler, Ky.,
Accordingly, we reverse the decision of the Court of Appeals and reinstate the judgment of the Jefferson Circuit Court.
Notes
. The administrator initially filed a motion to dismiss pursuant to CR 12.02. However, since documents outside the pleadings were presented to and considered by the trial judge, the motion was converted into one for summary judgment. CR 12.02; Ferguson v. Oates, Ky.,
Dissenting Opinion
dissenting.
Respectfully, I dissent.
The controlling issue in this case is whether alleged acts of misrepresentation, concealment or non-disclosure by the decedent’s insurance carrier, Allstate Insurance Co., were sufficient, on grounds of estoppel, to preclude summary judgment against respondent, Alsabi, and in favor of movant, the decedent’s administrator. Proper resolution of this issue requires an analysis of the relationship between an insured and an automobile liability insurance carrier to determine whether misconduct by the latter may be attributed to the former so as to prevent the running of statutes of limitations.
On or about June 3, 1991, respondent, Hashim M. Alsabi, and Fred Whalen, mov-ant’s decedent, were involved in a motor vehicle accident. Thereafter, respondent received basic reparation benefits from his no-fault carrier, but on February 4, 1992, the last of such payments was made. The next day, February 5, 1992, Fred Whalen, a man of eighty-two years, died of causes unrelated to the motor vehicle accident, and on March 2, 1992, his will was probated by order of the Jefferson District Court. There was no appointment of a personal representative and this circumstance prevailed until respondent obtained appointment of the public administrator in November of 1994, two and one-half years later.
On April 29, 1992, respondent’s counsel contacted Allstate, Whalen’s liability insurance carrier, concerning settlement of respondent’s personal injury claim. Thereafter, counsel for respondent negotiated with Ms. Peggy Smith, the Allstate adjuster handling the claim, concerning settlement. In a letter dated May 13, 1993, respondent’s counsel replied to Ms. Smith’s letter of April 26, 1993, and discussed the method of calculating the value of the claim and advised Ms. Smith that he would recommend rejection of her existing offer. Respondent’s counsel also established a target date for commencement of litigation if no settlement was achieved. Exactly when the Allstate adjuster, Ms. Smith, learned of Fred Whalen’s death is unknown, but there is no doubt that on or about September 8, 1993, she was so informed. On that date, Mrs. Crystal G. Whalen, the decedent’s daughter-in-law, wrote Ms. Smith confirming their conversation of that same date and in the letter stated that Mr. Whalen had passed away on February 5, 1992. In her letter, Crystal G. Whalen also expressed the concern of her mother-in-law, the decedent’s widow, as follows:
As I advised, Mrs. Whalen is concerned about exposure in the event this case cannot be settled within the policy limits of $25,000. This is a very real concern for an elderly woman. The Whalen family would appreciate every effort you can put forth to resolve this matter. To avoid litigation and exposure to theWhalen’s personal property, settlement would be appreciated.
Contacts continued between respondent’s counsel and Allstate concerning settlement. On October 15, 1993, Ms. Smith wrote respondent’s counsel a letter which referenced “our insured: Fred Whalen.” While the text of the letter concerned settlement, there was no disclosure that Mr. Whalen had died more than twenty months earlier and Ms. Smith reiterated a settlement offer, “Of course, our offer of settlement in the amount of $2,000 still stands.” About a month later, on November 22, 1993, a similar letter was written, likewise without any disclosure of Mr. Whalen’s death.
On February 3, 1994, in the Jefferson Circuit Court, respondent filed a personal injury claim against “Fred Whalen.” Process was issued but returned unserved on February 16, 1994, with the notation that Fred Whalen was deceased. All parties agree that the complaint was filed within the time allowed by law and that process was issued in good faith. Manifestly, however, the proper party defendant was not named and by the time the complaint was properly amended, time for bringing the claim had expired.
We must first consider the relationship between an insured and an automobile liability insurance carrier and determine whether misconduct by the latter may prevent the running of statutes of limitations in favor of the former. Here it is contended that alleged misconduct of Allstate prevented the statute of limitation from running in favor of movant, administrator of the estate of Fred Whalen, an Allstate insured.
The relationship between an insured and an automobile liability insurance carrier arises by contract. The essence of the contract is the payment of premium costs in return for promised indemnity, defense and associated services. The terms of the contract, however, are heavily regulated by the law as liability insurance is mandatory (KRS 304.39-080) and any inconsistency between the policy and the law will result in reformation of the policy to comply with the law. State Farm v. Mattox, Ky.,
We find no reason to excuse this matter because it is brought by a third party claimant. The action results from the bad faith in adjusting the claim. If a first-party carrier can be sued for bad faith, there is no reason why a third party carrier cannot also be sued.
Id. at 118.
While this Court has not heretofore directly answered whether the misconduct of an insurance carrier in adjusting a claim can be imputed to the insured so as to deny benefit of a statute of limitation, we have come close. In Miller v. Thacker, Ky.,
In view of the mandatory nature of automobile liability insurance, the comprehensive statutory and regulatory control of the industry, the broad discretion allowed insurers in settlement of claims, and public perception that the insurer controls the claims adjustment process, we should have no reluctance in holding that to the extent of available insurance coverage the insurance carrier is the agent of the insured and the death of the insured while legal obligations remain outstanding does not terminate the agency relationship. The foregoing is consistent with our public policy as expressed in KRS 396.011(2)(b).
The next step in the analysis is to determine whether misrepresentation, concealment or non-disclosure by Allstate, if proven to the satisfaction of the jury, would be sufficient to estop movant from asserting the statute of limitations defense. Initially, it should be observed that it is well settled that “a party may be estopped to plead limitation where he has induced inaction on the part of the plaintiff by his false representation or fraudulent concealment.” Burke v. Blair, Ky.,
Equity’s right to prevent by estoppel the pleading of limitations is historic and well recognized. Perhaps we have been over stringent in some of our prior opinions. In any event, since cases differ on their facts and the relationship and relative bargaining positions of the parties change, we can come no closer than saying that the relevant inquiry should be whether or not under all the facts and circumstances the plaintiff was justified in relying upon the representations and activities of the insurance adjuster in delaying fifing suit until time had run out.
Id. at 23.
As to misleading or failing to disclose, in Munday v. Mayfair Diagnostic Laboratory, Ky.,
This Court has recently dealt with the issue at hand where the misconduct was by plaintiffs counsel who did not disclose the death of her client to opposing counsel and settled the case as if the client were still living. In Kentucky Bar Association v. Geisler, Ky.,
I believe the majority is wrong when it excuses the misleading nature of Ms. Smith’s, the Allstate adjuster’s, letter with the facile explanation that “of course, every business person knows that file references are just that: something to assist both the sender’s and the addressee’s clerical employees in identifying the file into which this correspondence should be placed.” This view ignores the positive assertions contained in the letters by which Fred Whalen was identified in the present tense as “our insured” or like reference. Moreover, I believe the majority errs in asserting that “Fred Whalen was Allstate’s insured, whether alive or dead.” In my view, upon the death of an insured, the benefit of the insurance runs to the decedent’s estate or the decedent’s successor in interest.
The reality of modern motor vehicle injury claims adjustment places insurance claims adjusters in a central role. When the claim arises, the adjuster and the claimant usually deal directly with one another. If their negotiations fail, the adjuster negotiates with plaintiffs counsel, and even after litigation is begun, the adjuster frequently deals directly with plaintiffs counsel. While we have never held that claims adjustment constitutes the practice of law and limited that endeavor to members of the bar, neither should adjusters be free of the ethical strictures applicable to lawyers when their participation is a part of the judicial process. If insurance adjusters undertake to negotiate with personal injury claimants or their lawyers, honesty is not too much to require. As lawyers are held to the high ethical standards enunciated in Geisler, no less should be required of their adversaries in the claims adjustment process.
We have not overlooked Pospisil v. Miller, Ky.,
Our decision in Geisler represents the enlightened view that lawyers, while adversaries, have a duty to be truthful with one another. Lawyers may not withhold, mislead or misrepresent as to facts so fundamental as whether their clients in personal injury cases are living or dead. Geisler also recognized that an overtly false statement is not the only means of misrepresentation. For this, the Court quoted from Virzi v. Grand Trunk Warehouse & Cold Storage Co.,
This Court feels that candor and honesty necessarily require disclosure of such a significant fact as the death of one’s client. Opposing counsel does not have to deal with his adversary as he would deal in the marketplace. Standards of ethics require greater honesty, greater candor, and greater disclosure, even though it might not be in the interest of the client or his estate.
Virzi at 512.
Just as the standards of “the marketplace” no longer apply to dealings between lawyers in settlement negotiations, neither should they apply to insurance adjusters who serve as frontline insurance industry representatives. My view in this regard is strengthened by the recognition that while this Court has direct supervision of the ethical conduct of lawyers, we are without such direct power over insurance adjusters. Our supervision of these participants in the judicial process, for the purpose of enforcing reasonable ethical standards, must be by means of our interpretations of rules, statutes, and common law principles. It is our duty to assure that ethical misconduct not be rewarded.
This aspect of the majority opinion is profoundly disturbing. It seems to allow non-lawyers to act deceptively in their dealings with lawyers. To the extent that non-lawyers participate in the process of tort claim adjustment, they should be held to the same ethical standards as members of the Bar.
STUMBO and WINTERSHEIMER, JJ., join in this dissenting opinion.
. The essential allegations in Pospisil v. Miller are as follows:
The amendment was filed in due time. It charged that a representative of Miller’s insurance carrier told the plaintiff that his company had “assumed and recognized its liability to the plaintiff,” and that a settlement would be made with her when the bills were all in and when she had fully recovered. It is further alleged that he told her she would, in due course, be fully compensated if she did not consult or employ an attorney. The amendment further asserted that the plaintiff relying on these statements did not consult an attorney until two years after the accident.
