2003 Ohio 5457 | Ohio Ct. App. | 2003
{¶ 2} Appellants assert coverage under the Uninsured Motorist/Underinsured Motorist (UM/UIM) sections of both the Lumbermens Business Auto policy issued to their employer and Hartford's Business Auto policy issued to their daughter's employer, pursuant to the Supreme Court of Ohio's ruling in Scott-Pontzer v. Liberty Mut. Fire Ins. Co.,
{¶ 3} We find appellants' arguments as to Lumbermens and United lack merit, but that their argument as to Hartford has merit. Therefore, the judgment of the trial court is affirmed in part and reversed in part, according to the following opinion.
{¶ 5} On April 7, 1999, Plaintiff-Appellant Debra L. Hall (Hall) was operating a motor vehicle, of which she was the sole owner, on State Route 104 in Scioto Township, Pickaway County, Ohio. At the same time and place, Roberta Arnold (not a party in this case), an underinsured tortfeasor, negligently operated her vehicle so as to cause a collision with Hall's motor vehicle. As a result, Hall sustained various personal injuries, the extent and nature of which were still in dispute at the time of this appeal.
{¶ 6} At the time of the accident, Hall was employed by The Penn Traffic Company, which was insured under a Business Auto policy issued by Lumbermens. It was stipulated, however, that Hall was neither operating a company vehicle or acting within the scope of her employment during the accident. The Halls were also insured under two policies issued by United; one was a motor vehicle liability policy, the other was a Farm and Ranch policy. At the time of the accident, the Halls' daughter was employed by White Castle, which was insured under a Business Auto policy issued by Hartford.
{¶ 7} Debra L. and William E. Hall settled their claims with Ms. Arnold's insurance carrier for $12,500, her policy limit. Appellants also settled their claims with United, under their motor vehicle liability insurance policy, for $37,500, the limit of coverage granted by the UM/UIM section of that policy. Although having exhausted the limits of coverage available under the tortfeasor's policy, as well as their own, appellants argue that they still have not been made whole.
{¶ 8} Therefore, by their Complaint filed on February 14, 2001, and Amended Complaint filed on August 3, 2001, appellants claimed UM/UIM coverage under three other existing insurance policies: 1) the policy issued by Lumbermens, insuring The Penn Traffic Company, employer of both appellants; 2) appellants' Farm and Ranch policy issued by United; and 3) the policy issued by Hartford to White Castle, the employer of appellants' daughter.
{¶ 9} Lumbermens, United, and Hartford timely filed their answers, denying that underinsured motorist coverage existed either under the policies or by operation of law. The matter came before the Pickaway County Court of Common Pleas on motions for summary judgment filed by all parties involved. The trial court denied appellants' motion for summary judgment, but granted the motions for summary judgment as to each insurance provider.
{¶ 10} Specifically, the trial court held that: 1) appellants, pursuant to Scott-Pontzer, were "insureds" under the Lumbermens policy, but that two endorsements, when read together, excluded appellants from any coverage under the UM/UIM section of the Business Auto policy issued to their employer; 2) pursuant to R.C.
{¶ 12} First Assignment of Error: "The trial court erred in granting summary judgment in favor of Defendant, Lumbermens Mutual Casualty Company, finding that the Plaintiffs' claims were excluded pursuant to the other owned auto exclusionary language of the policy."
{¶ 13} Second Assignment of Error: "The trial court erred in granting summary judgment in favor of Defendant, The Hartford, by applying the H.B. 261 standards. Linko v. Indemnity Company of NorthAmerica (2000),
{¶ 14} Third Assignment of Error: "The trial court erred in granting summary judgment in favor of Defendant, United Ohio Insurance Company, by holding that the `residence employee' exclusion does not require an offering of UM/UIM coverage in a homeowner's (Farm Ranch) Policy."
{¶ 15} Lumbermens cross appealed the judgment of the trial court, assigning as error the following:
{¶ 16} First Cross Assignment of Error: "The trial court [erred] in concluding that the appellants were insureds under the Lumbermens Business Auto Policy issued to the Penn Traffic Company."
{¶ 17} Second Cross Assignment of Error: "The trial court erred in applying Ohio law to the Penn Traffic Company's insurance contract with Lumbermens negotiated and issued in the state of New York."
{¶ 18} Essentially, Lumbermens argues that the trial court erred by finding that appellants were "insureds" under the policy issued to appellants' employer, The Penn Traffic Company, on two grounds: 1) exclusions and endorsements in the policy excluding appellants as insureds; and 2) New York law, which Lumbermens argues is the applicable law in this case, rendering any Scott-Pontzer analysis inapplicable.
{¶ 19} Although we will consider Lumbermens' First Cross Assignment of Error within our analysis of appellants' First Assignment of Error pursuant to App.R. 3(C)(2), we are troubled with Lumbermens' Second Cross Assignment of Error. In essence, to sustain this error would require reversal of the trial court's judgment. According to Ohio App.R. 3(C)(1), "A person who intends to defend a judgment or order against an appeal taken by an appellant and who also seeks to change the judgment or order or, in the event the judgment or order may be reversed or modified, an interlocutory ruling merged into the judgment or order, shall file a notice of cross appeal within the time allowed by App.R. 4." Lumbermens failed to file a notice of cross appeal on this assignment of error. Therefore, because Lumbermens failed to perfect their cross appeal as to its Second Cross Assignment of Error, we dismiss it. See R.C.
{¶ 20} In each of their assignments of error, appellants are challenging the grant of summary judgment to each defendant-appellee, arguing that the policies issued by each insurer provide them UM/UIM coverage for their accident. Therefore, we will examine each policy separately to determine if summary judgment was appropriate.
{¶ 22} We conduct a de novo review of the trial court's decision to grant a motion for summary judgment. See Grafton v. Ohio Edison Co.
(1996),
1. Are Appellants "Insureds" Under the Lumbermens Policy?
{¶ 24} Under a separate endorsement entitled "Ohio Uninsured Motorists Coverage — Bodily Injury," the Lumbermens policy outlines the UM/UIM coverage. This endorsement expressly modifies the "Business Auto Coverage Form," among others. The endorsement also changes who is an insured for purposes of UM/UIM coverage through the following section therein:
{¶ 25} "Who Is An Insured
{¶ 26} "1. You.
{¶ 27} "2. If you are an individual, any `family member.'
{¶ 28} "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.
{¶ 29} "4. Anyone for damages he or she is entitled to recover because of `bodily injury' sustained by another `insured.'"
{¶ 30} The "Business Auto Coverage Form" contains the following provision: "Throughout this policy the words `you' and `your' refer to the Named Insured shown in the Declarations." The "COMMON POLICY DECLARATIONS" lists the "NAMED INSURED" as "The Penn Traffic Company." This is clearly a situation where Scott-Pontzer applies.
{¶ 31} In Scott-Pontzer v. Liberty Mut. Fire Ins. Co.,
{¶ 32} The Supreme Court of Ohio proceeded to examine whether an exclusion applied to bar UM/UIM coverage. Id.,
{¶ 33} In the case sub judice, the language used in the Lumbermens Business Auto policy UM/UIM endorsement was not unambiguous. In fact, the Lumbermens policy contains the same "you" term, defined to mean the same thing (i.e., named insured), and used in a similar section as inScott-Pontzer. See id.,
{¶ 35} The first section that Lumbermens points to is the definition of "insured" in the "Business Auto Coverage Form":
{¶ 36} "SECTION II — LIABILITY COVERAGE
{¶ 37} "A. COVERAGE We will pay all sums an `insured' legally must pay as damages because of `bodily injury' or `property damage' to which this insurance applies, caused by an `accident' and resulting from the ownership, maintenance or use of a covered `auto.'
{¶ 38} "1. Who Is An Insured. The following are `insureds':
{¶ 39} "a. You for any covered `auto.'
{¶ 40} "b. Anyone else while using with your permission a covered `auto' you own, hire, or borrow except:
{¶ 41} "* * *
{¶ 42} "2) Your `employee' if the covered `auto' is owned by that `employee' or a member of his or her household."
{¶ 43} The other section relied on by Lumbermens to exclude appellants as "insureds" is found in an endorsement captioned "Drive Other Car Coverage — Broadened Coverage for Named Individuals." This particular endorsement modifies several forms under the policy, including the Business Auto Coverage Form. The endorsement sets forth changes pertinent to UM/UIM coverage in section "C":
{¶ 44} "C. Changes in Auto Medical Payments And Uninsured And Underinsured Motorist Coverages
{¶ 45} "The following is added to WHO IS AN INSURED:
{¶ 46} "Any individual named in the Schedule and his or her `family members' are `insureds' while `occupying' or while a pedestrian when being struck by any `auto' you don't own except: Any `auto' owned by that individual or by any `family member.'"
{¶ 47} Lumbermens argues that these sections, coupled with the fact that the Business Auto policy was amended to include Richard King, an employee who regularly drove company vehicles, as an "insured" in the schedule, clear up any Scott-Pontzer ambiguity by explicitly excluding appellants from being insureds under the policy. We disagree.
{¶ 48} The first section cited by Lumbermens defines "insured" under the "Business Auto Coverage Form," but is contained under the liability section. Therefore, this definition of "who is an insured," being contained in the "Liability Coverage" section, would not apply to the UM/UIM endorsement. An insurance policy is a contract and the relationship between the parties is contractual. See Nationwide Mut.Ins. Co. v. Marsh (1984),
{¶ 49} The second section relied on by Lumbermens is the "Drive Other Car Coverage — Broadened Coverage for Named Individuals" endorsement, and section "C" contained therein. Section "C" under that endorsement purports to change the coverage under the UM/UIM endorsement. That section reads "[t]he following is added to who is an insured." (Emphasis added.) Lumbermens argues that because the schedule was amended to include Richard King as an "insured" under the schedule, that the term "you" is no longer ambiguous, thus taking the policy out of the ambit of Scott-Ponzter. See Westfield Ins. Co. v. Galatis, 9th Dist. No. 20784, 2002-Ohio-1502.
{¶ 50} However, the plain language of Section "C" explicitly and unambiguously states that it "add[s] to," rather than substitutes for, the definition of who is an insured in the UM/UIM endorsement under the Business Auto Coverage Form. See Addie v. Linville, 8th Dist. Nos. 80547, 80916, 2002-Ohio-5333, at ¶ 43. Moreover, the mere addition of specific individuals, whether in the common policy declarations or in a separate endorsement, does not, by itself, place the policy outside the scope of Scott-Pontzer. See Kasson v. Goodman, 6th Dist. No. L-01-1432, 2002-Ohio-3022, at ¶ 4 (stating, "Upon review of the declarations page and the definition of `insured' in the CIC auto policy, we find that the addition of two individual insureds does not remove the ambiguity created by the inclusion of corporate insureds."); see, also, Burkhartv. CNA Ins. Co., 5th Dist. No. 2001CA00265, 2002-Ohio-903 (holding that although specific individuals were named insureds under the Continental policies, such fact does not cure the ambiguity created when "you" refers to the corporation as the named insured).
{¶ 51} Therefore, the ambiguous "you" remains, and we must applyScott-Pontzer to relieve the ambiguity in favor of the insured. Therefore, we find that "you" still includes employees of The Penn Traffic Company, which is listed as the "NAMED INSURED." Moreover, although this "Broadened Coverage" endorsement attempts to modify the Business Auto Coverage Form, the UM/UIM endorsement itself separately modifies the Business Auto Coverage Form by defining "Who IS An Insured" for purposes of UIM coverage. Therefore, we find that appellants are "insureds" under the Lumbermens policy issued to their employer, The Penn Traffic Company.
{¶ 52} Lumbermens' First Cross Assignment of Error is overruled.
3. Does an Exclusion Apply to Bar Coverage to Appellants?
{¶ 53} Our inquiry turns now to whether an exclusion applies to preclude appellants from coverage under the UM/UIM endorsement. For its support, Lumbermens points to an exclusion contained in the UM/UIM endorsement, typically referred to in insurance parlance as the "other owned vehicle" exclusion, which states:
{¶ 54} "C. Exclusions
{¶ 55} "This insurance does not apply to:
{¶ 56} "* * *
{¶ 57} "5. `Bodily Injury' sustained by:
{¶ 58} "a. You while `occupying' or when struck by any vehicle owned by you that is not a covered `auto' for Uninsured Motorist Coverage under this Coverage Form." (Emphasis added.)
{¶ 59} Appellants contend that the exclusion relied on by Lumbermens to deny coverage does not comply with the applicable version of R.C.
{¶ 60} The pertinent section relied on by appellants is found at former R.C.
{¶ 61} "The coverages offered under division (A) of this section or selected in accordance with division (C) of this section may include terms and conditions that preclude coverage for bodily injury or death suffered by an insured under any of the following circumstances:
{¶ 62} "(1) While the insured is operating or occupying a motor vehicle owned by, furnished to, or available for the regular use of anamed insured, a spouse, or a resident relative of a named insured, if the motor vehicle is not specifically identified in the policy under which a claim is made, or is not a newly acquired or replacement motor vehicle covered under the terms of the policy under which the uninsured and underinsured motorist coverages are provided[.]" (Emphasis added.)
{¶ 63} Appellants argue that the statute allows for an insurance policy to exclude from UM/UIM coverage only those vehicles "owned by, furnished to, or available for the regular use of the name insured" that are not "specifically identified in the policy." R.C.
{¶ 64} Appellants rely primarily on two cases that have considered the "other owned vehicle" exclusion, Purvis v. Cincinnati Ins. Co., 2nd Dist. No. 2001-CA-104, 2002-Ohio-1803, and Kasson v. Goodman, 6th Dist. No. L-01-1432, 2002-Ohio-3022. The policies at issue in both Purvis and Kasson contained the "other owned vehicle" exclusion. However, the exclusions in those policies mirrored the language of R.C.
{¶ 65} The Lumbermens policy defines "you" as the "named insured."Scott-Pontzer indicated that the term "you" could reasonably be interpreted to include a corporation's employees, since a corporation can only act through "real live employees." Scott-Pontzer v. Liberty Mut.Fire Ins. Co.,
{¶ 66} Appellants further argue that if the exclusion is found to be valid under R.C. 3937.189(J)(1), that the term "you" is still ambiguous, and that the ambiguity should be resolved against the drafter of the policy language, i.e., Lumbermens. While the use of the word "you" in the exclusion is ambiguous, we feel that the ambiguity was resolved byScott-Pontzer. Certainly, it is appropriate for the term "you" to mean both the "insured" and "named insured." Appellants attempt to argue that where "you" is used to include coverage for them, that it should be interpreted as such, but where "you" is used to exclude coverage, that we should find that "you" refers solely to the named insured. Appellants seek to have their cake and eat it too. Under these circumstances, however, we cannot allow appellants such a sweeping benefit from the ambiguity. The preferred interpretation of the term "you" andScott-Pontzer is to apply "you" consistently throughout the policy. SeeMazza v. American Continental Ins. Co., 9th Dist. No. CA21192, 2003-Ohio-360, at ¶ 40; Niese v. Maag, 3rd Dist. No. 12-02-06, 2002-Ohio-6851, at ¶ 11; Weyda v. Pacific Employer's Ins. Co., 1st Dist. No. C-020410, 2003-Ohio-443, at ¶ 15. Therefore, because "you" referred to appellants under the definition of "insured" for inclusion under the policy, appellants are also included within the term "you" for purposes of the "other owned vehicle" exclusion.
{¶ 67} Our inquiry turns next to whether appellant was driving a "covered auto" for purposes of the exclusion. If she was not, then the exclusion will bar coverage. If she was, coverage will not be barred by the exclusion.
{¶ 68} "Covered autos" are defined for each coverage under Section I of the Business Auto Coverage Form. That section states "The symbols entered next to a coverage on the Declarations designate the only `autos' that are covered `autos.'" Under the UM/UIM coverage, the symbol "6" is entered for "covered autos." The symbol "6" covers the following autos:
{¶ 69} "OWNED `AUTOS' SUBJECT TO A COMPULSORY UNINSURED MOTORIST LAW. Only those `autos' you own that because of the law in the state where they are licensed or principally garaged are required to have and cannot reject Uninsured Motorist Coverage. This includes those `autos' you acquire ownership of after the policy begins provided they are subject to the same state uninsured motorists requirement."
{¶ 70} Former R.C.
{¶ 71} Thus, because appellant was driving an "auto" owned by her, which was not a covered auto, she was not covered under the UM/UIM endorsement of The Penn Traffic Company's Business Auto policy issued by Lumbermens since the "other owned vehicle" exclusion bars coverage to her.
{¶ 72} Appellants' First Assignment of Error is overruled.
C. Appellants' Second Assignment of Error — The Hartford Policy
{¶ 73} In their Second Assignment of Error, appellants seek coverage under the UM/UIM section of the Business Auto policy issued by Hartford to White Castle, the employer of appellants' daughter. Appellants claim that their daughter, as an employee of White Castle, is an insured under the policy, pursuant to Scott-Pontzer. The UM/UIM endorsement states:
{¶ 74} "B. WHO IS AN INSURED
{¶ 75} "1. You.
{¶ 76} "2. If you are an individual, any `family member.'"
{¶ 77} Accordingly, appellants argue and Hartford does not deny, that this section extends coverage to them by virtue of being a "family member" of an insured, i.e., their daughter. See Ezawa v. Yasuda Fire Marine Ins. Co. of Am.,
{¶ 78} Hartford, however, denied that coverage extends to appellants for two reasons: 1) Hartford offered and White Castle selected $25,000 of UIM coverage, the minimum in Ohio, but that appellants' prior recovery of $50,000 in damages exceeds the underinsured coverage under the policy; and 2) White Castle is effectively a self-insurer by virtue of a $500,000 policy deductible, and, therefore, it was exempt from complying with the requirements of R.C.
{¶ 79} The trial court granted summary judgment in favor of Hartford, ruling that White Castle executed a valid reduction form, and, based on R.C.
{¶ 80} Once again, we review the grant of summary judgment de novo. See Grafton, supra.
1. Gyori and Linko
{¶ 81}The version of R.C.
{¶ 82} If an insured did not wish to have UM/UIM coverage or to select UM/UIM coverage in a lesser amount than liability coverage, R.C.
{¶ 83} The form requirements for offer, acceptance, and rejection of UM/UIM coverage in Ohio have been litigated ad nauseam. In Gyori v.Johnston Coca-Cola Bottling Group, Inc. (1996),
{¶ 84} In Linko, supra, the Supreme Court of Ohio refined the requirements necessary to constitute an insurer's valid written offer stating that "a valid rejection requires a meaningful offer, i.e., an offer that is an offer in substance and not just in name." Therefore, the court listed four required elements for meaningful written offers. The elements required that the insurer: 1) inform the insured of the availability of UM/UIM coverage, 2)expressly set forth the premium for that coverage, 3)include a brief description of the coverage, and 4) expressly state the UM/UIM coverage limits in its offer. Id. at 447-448,
{¶ 85} In 1997, the General Assembly amended R.C.
{¶ 86} "A named insured or applicant may reject or accept both coverages as offered under division (A) of this section, or may alternatively select both such coverages in accordance with a schedule of limits approved by the superintendent. * * * A named insured's or applicant's written, signed rejection of both coverages as offered under division (A) of this section, or a named insured's or applicant's written, signed selection of such coverages in accordance with the schedule of limits approved by the superintendent, shall be effective on the day signed, shall create a presumption of an offer of coverages consistent with division (A) of this section, and shall be binding on all other named insureds, insureds, or applicants."
{¶ 87} It is within these parameters that we will examine first, the effective date of White Castle's selection of lower UM/UIM coverage, and second, whether Hartford's offer of UM/UIM coverage complied with the requirements of Linko.
{¶ 89} The 1997 amendments to R.C.
{¶ 91} In Minor v. Nichols, Jackson App. No. 01CA14, 2002-Ohio-3310, we stated the following with respect to the presumption granted by former R.C.
{¶ 92} "A presumption shifts the evidentiary burden of producing evidence, i.e., the burden of going forward, to the party against whom the presumption is directed. See Weissenberger, Ohio Evidence (2001) 44. However, a rebuttable presumption does not carry forward as evidence once the opposing party has rebutted the presumed fact. Forbes v. Midwest AirCharter, Inc.,
{¶ 93} In Minor, we held that the signed copy of the "UNINSURED/UNDERINSURED MOTORIST COVERAGE SELECTION/REJECTION/LIMITS SUMMARY form created a presumption of an offer of coverage consistent with R.C.
{¶ 94} However, we found that the form Minor relied on to rebut the presumption did not include the offer, but rather, that the offer was contained in a separate form entitled "UNINSURED/UNDERINSURED MOTORISTS SELECTION/REJECTION AND LIMITS." Minor v. Nichols, Jackson App. No. 01CA14, 2002-Ohio-3310, at ¶ 18. Therefore, Minor "could not look to the summary form to supply the terms of the offer." Id. Thus, we held that Minor did not carry her burden of rebutting the presumption of a valid offer created by R.C.
{¶ 95} In the case at bar, White Castle's signed selection of lower UM/UIM limits creates the presumption that Hartford validly offered UM/UIM coverage as mandated by R.C.
{¶ 96} Hartford presented White Castle with the reduction form and White Castle signed it. That form included a preliminary paragraph stating that UM/UIM bodily injury coverage must be offered to White Castle by law at a limit equal to the liability limits under the policy. The paragraph goes on to explain that "You may reject [UM/UIM-Bodily Injury] entirely, if you submit a signed rejection." Following that introductory paragraph are three sections, written in standard "boilerplate" language, entitled "UNINSURED MOTORIST COVERAGE — BODILY INJURY," "UNINSURED MOTORIST COVERAGE — PROPERTY DAMAGE," and "QUESTIONS ABOUT YOUR COVERAGE OPTIONS." We are concerned with the first paragraph dealing with coverage for bodily injury. That paragraph contains four separate paragraphs, stating the following:
{¶ 97} "Applies to: All motor vehicles covered by your policy.
{¶ 98} "Covers: You, if you are an individual named insured; Relatives living with you; and Other people in your motor vehicle.
{¶ 99} "Benefits: Uninsured Motorist Insurance in Ohio provides protection for bodily injury arising from the ownership, maintenance or use of an uninsured motor vehicle. An uninsured motor vehicle is one for which insurance does not provide the amounts required by the applicable law, or for which insurance limits meet the amounts required by law but are less than the limit of insurance of this coverage.
{¶ 100} "Limit: We recommend a limit equal to the Liability Insurance Limit you have chosen for your policy. Protection you provide yourself and occupants of your motor vehicle should equal the protection you provide others. Lower limits are available, but they cannot be less than the Financial Responsibility Limit of Ohio. You may reject Uninsured Motorist Coverage — Bodily Injury entirely, if you submit a signed request."
{¶ 101} On the second page of this form is a section entitled "UNINSURED MOTORIST COVERAGE — BODILY INJURY." Underneath that heading are four boxes, with options next to each box. The boxes allow for the insured to place an "X" next to the option it wishes to select for their policy. White Castle's agent placed an "X" next to the box labeled "Minimum amount available in Ohio." White Castle's agent then signed and dated the form.
{¶ 102} Applying the Linko requirements, we cannot find that this form embodies a complete written offer. In fact, Hartford did not argue that the offer was valid under Linko; it argued that the Linko requirements did not apply. After Kemper, supra, Hartford's argument fails. Linko requires that the insurer's offer contain the following: the availability of UM/UIM coverage, the premium for that coverage, a description of the coverage, and expressly state the UM/UIM coverage limits in its offer. See Linko v. Indemn. Co. of N. Am.,
{¶ 103} Accordingly, we find appellants have presented enough evidence to rebut the presumption conferred on Hartford by former R.C.
{¶ 105} Hartford's policy issued to White Castle contains a "DEDUCTIBLE — REIMBURSEMENT ENDORSEMENT" which expressly "modifies insurance provided under the: BUSINESS AUTO COVERAGE FORM — LIABILITY COVERAGE, GARAGE COVERAGE FORM — LIABILITY COVERAGE, [and] TRUCKERS COVERAGE FORM — LIABILITY COVERAGE." The deductible amount is for $500,000 per occurrence.
{¶ 106} The central determination of whether an entity is self-insured focuses on who bears the risk of loss. See Dalton v.Wilson, 10th Dist. No. 01AP-014, 2002-Ohio-4015, at ¶ 64. "Self-insurance is not insurance; it is the antithesis of insurance."Physicians Ins. Co. of Ohio v. Grandview Hosp. Med. Ctr. (1988)
{¶ 107} The General Assembly has set forth specific requirements to qualify as a self-insurer in the motor vehicle context. See R.C.
{¶ 108} In Grange, an employee of Refiners was fatally injured by an uninsured motorist while driving a truck in the course and scope of his employment. Refiners complied with state financial responsibility requirements for its truck fleet through a financial responsibility bond along with two policies for excess insurance coverage, none of which included UM/UIM coverage. Grange, the decedent's personal automobile insurer, settled with the decedent's estate and then filed a declaratory judgment action against Refiners, alleging that R.C.
{¶ 109} Chief Justice Celebrezze, writing for the court, framed the issue as "whether an employer, who meets Ohio's financial responsibility laws other than by purchasing a contract of liability insurance, must comply with the requirements concerning uninsured motorist coverage contained in R.C.
{¶ 110} The court further held that "since we find that [Refiners'] status was actually that of a bond principal and not a self-insurer, a conclusion that the requirements of R.C.
{¶ 111} In its brief, Hartford relies on numerous cases that liberally extend the holding in Grange to cover "fronting policies" with matching liability limits and deductibles. See Lafferty v. Reliance Ins.Co. (S.D.Ohio 2000),
{¶ 112} In the case sub judice, the policy does not involve a "fronting agreement" with matching deductible and liability limits. The policy merely contains a deductible reimbursement agreement, requiring Hartford to pay those amounts in excess of the stated deductible. Moreover, the policy's business auto form contains a bankruptcy clause, stating that "Bankruptcy or insolvency of the `insured' or the `insured's' estate will not relieve us of any obligations under this Coverage Form." All of this is evidence that White Castle did not retain one hundred percent of the risk of loss under the policy. Hartford was obligated to pay any claim that exceeded the deductible amount, or any claim in the event that White Castle became insolvent or filed for bankruptcy. The essential characteristic to qualify as a self-insurer in the practical sense is that "insured" bear the ultimate risk of loss, so that essentially none of the risk has shifted to the insurance company. Under their agreement, White Castle is not ultimately responsible for losses because the actual risk has shifted to Hartford. Therefore, White Castle is not "self-insured" in the practical sense. Both White Castle and Hartford were required to comply with R.C.
{¶ 113} We also believe that the deductible reimbursement cannot apply to limit UM/UIM coverage in this instance. First, by its own express words, the deductible reimbursement endorsement "modifies insurance provided under the: BUSINESS AUTO COVERAGE FORM — LIABILITY COVERAGE, * * *." Therefore, by its own words, Hartford wrote the deductible to apply to the business auto form solely for liability coverage, and not UM/UIM coverage. Second, we found that UM/UIM coverage existed by operation of law in the amount of the policy's liability coverage because Hartford's offer failed to comply with the requirements of Linko. In Scott-Pontzer, the Supreme Court of Ohio determined that "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" when UM/UIM coverage arises by operation of law. Scott-Pontzer v. Liberty Mut. Fire Ins. Co.,
{¶ 114} Appellants' Second Assignment of Error is sustained.
{¶ 116} The Supreme Court of Ohio, in Hillyer v. State Farm Fire Cas. Co.,
{¶ 117} Based on the Supreme Court of Ohio's holding and rational in Hillyer, the policy issued by United was not a "motor vehicle" liability policy subject to the requirements of former R.C.
{¶ 118} Appellants' Third Assignment of Error is overruled.
Judgment affirmed in part, reversed in part, and remanded for furtherproceedings.
This Court finds that there were reasonable grounds for this appeal.
It is further ordered that a special mandate issue out of this Court directing the PICKAWAY COUNTY COURT OF COMMON PLEAS to carry this judgment into execution.
Any stay previously granted by this Court is hereby terminated as of the date of this Entry.
A certified copy of this entry shall constitute the mandate pursuant to Rule 27 of the Rules of Appellate Procedure. Exceptions.
Harsha, J.: Concurs in Judgment and Opinion as to Assignment of Error III and Dismissal of Lumbermens Mutual Casualty Company's Cross Assignment of Error II; Concurs in Judgment Only in All Other Regards.
Abele, J.: Concurs in Judgment and Opinion as to Assignment of Error III; Concurs in Judgment Only as to Assignment of Error I and Cross Assignments of Error I and II; Dissents as to Assignment of Error II.