Title: Katz v. Ohio Ins. Guar. Assn.

State: ohio

Issuer: Ohio Supreme Court

Document:

[Cite as Katz v. Ohio Ins. Guar. Assn., 103 Ohio St.3d 4, 2004-Ohio-4109.] 
 
 
KATZ ET AL., APPELLEES, v. OHIO INSURANCE GUARANTY ASSOCIATION, 
APPELLANT. 
[Cite as Katz v. Ohio Ins. Guar. Assn., 103 Ohio St.3d 4, 2004-Ohio-
4109.] 
Insurance — Liability — Physicians — Medical doctor and professional-liability 
insurer may agree that the insurer’s liability for all damages sustained 
from the death of one person is subject to the monetary limit declared for 
“each claim,” irrespective of the number of wrongful-death claimants — 
Savoie v. Grange Mut. Ins. Co., limited. 
(No. 2003-0028 — Submitted November 19, 2003 — Decided August 18, 2004.) 
APPEAL from the Court of Appeals for Lucas County, No. L-02-1014, 150 Ohio 
App.3d 262, 2002-Ohio-6357. 
__________________ 
SYLLABUS OF THE COURT 
A medical doctor and a professional-liability insurer may agree that the 
insurer’s liability for all damages sustained from the death of one 
person is subject to the monetary limit declared for “each claim,” 
irrespective of the number of wrongful-death claimants. (Savoie v. 
Grange Mut. Ins. Co. [1993], 67 Ohio St.3d 500, 620 N.E.2d 809, 
limited.)    
__________________ 
 
MOYER, C.J. 
{¶ 1} Dr. Gordon Katz, appellee, is a licensed doctor of osteopathy.  
He was insured under medical professional liability policies issued by P.I.E. 
Mutual Insurance Company (“P.I.E.”) for the period July 1, 1993, through 
July 1, 1995.  The primary policy provided liability coverage of up to 
SUPREME COURT OF OHIO 
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$200,000 per claim with a $600,000 aggregate limit.  P.I.E. had also issued 
an excess insurance policy to Katz that provided an additional $1 million per 
claim with an aggregate limit for all claims of $1 million. 
{¶ 2} In 1995, Katz notified P.I.E. that claims arising out of the 
treatment of Teri Sue Robinson had been made against him.  In 1996, Susan 
Robinson (“Robinson”), appellee, filed an action in her capacity as 
administrator of Teri’s estate, alleging that Katz negligently rendered 
medical care to Teri.  Robinson included a survival claim to recover for 
Teri’s medical expenses and pain and suffering.  Robinson also asserted a 
wrongful death claim on behalf of three individuals: Teri’s mother, father, 
and brother. 
{¶ 3} P.I.E. thereafter became insolvent.  The parties agree that 
P.I.E.’s obligations to Katz in regard to Robinson’s claims are subject to the 
Ohio Insurance Guaranty Association Act, R.C. Chapter 3955 (“the Act”). 
{¶ 4} The Act created the Ohio Insurance Guaranty Association 
(“OIGA”), appellant herein, a nonprofit, unincorporated association.  R.C. 
3955.06(A).  OIGA collects funds from member insurers and administers 
those funds to protect insureds and third-party claimants from certain losses 
resulting from the insolvency of its members.  R.C. 3955.08(A)(3).  Pursuant 
to R.C. 3955.01(D)(2)(b) and 3955.08(A)(1), OIGA is responsible for 
paying “covered claims” up to a statutory limit of $300,000. 
{¶ 5} The cause before us is a declaratory judgment action filed by 
Katz pursuant to R.C. Chapter 2721.  Katz named OIGA and sought a 
declaration of OIGA’s limits of responsibility under the Act.  Katz alleged 
that a real and actual controversy exists as to how many covered claims have 
been in fact asserted against Katz: one survival claim and additionally one 
claim for each of Teri’s relatives entitled to recover under the wrongful-
January Term, 2004 
3 
death statute, per policy, or only one combined claim statutorily capped at 
$300,000. 
{¶ 6} Robinson intervened as a party plaintiff in the action.  Each of 
the parties filed a motion for summary judgment.  Katz and Robinson 
contended that there are at least four separate claims covered under each of 
the P.I.E. policies: the survival claim and claims on behalf of the decedent’s 
relatives, including her mother, father, and brother.  OIGA asserted that its 
exposure was limited to one payment of $300,000. 
{¶ 7} The primary policy included the following provision:  
{¶ 8} “V – LIMITS OF LIABILITY 
{¶ 9} “The Limits of Liability of The Company are as follows: 
{¶ 10} “A.  AS TO EACH CLAIM 
{¶ 11} “The Limit of Liability stated in the General Declarations, as 
applicable to ‘each claim,’ is the limit of The Company’s liability for all 
damages because of any one claim or suit or all claims or suits first made 
during the policy period because of injury to or death of any one person * * 
*.”  (Boldface sic.)  
{¶ 12} Katz conceded that this provision “might arguably limit 
coverage to a single limit for all claims arising out of one occurrence” 
(emphasis added) but contended that the provision was nevertheless 
unenforceable pursuant to Savoie v. Grange Mut. Ins. Co. (1993), 67 Ohio 
St.3d 500, 620 N.E.2d 809.  Similarly, in support of her motion for summary 
judgment, appellee Robinson asserted that Savoie controls to invalidate this 
provision. 
{¶ 13} The trial court entered summary judgment, recognizing four 
separate claims against the primary policy.  It found that the primary policy 
provided coverage of up to $200,000 for each of those claims, with a total 
aggregate limit of $600,000.  It declared OIGA liable to the same extent.  
SUPREME COURT OF OHIO 
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The trial court grounded its decision in Savoie, which held, “Liability policy 
provisions which purport to consolidate wrongful death damages suffered by 
individuals into one ‘each person’ policy limit are unenforceable.”  Id., 
paragraph one of the syllabus. 
{¶ 14} In regard to the excess policy, the trial court held, “[I]f any 
‘covered’ claim under the primary policy exceeds $200,000, that claimant is 
entitled to an additional ‘covered’ claim under the excess policy up to 
$300,000 with a total aggregate amount of coverage available to plaintiffs 
under the excess policy of $1,000,000.00.”  In so holding, the court rejected 
OIGA’s argument that it was liable to pay only a single statutory maximum 
of $300,000, notwithstanding the existence of both a primary policy and an 
excess policy. 
{¶ 15} The court of appeals affirmed the judgment of the trial court. 
{¶ 16} We reverse the judgment of the court of appeals in part.  We 
today limit the holding of the first paragraph of the syllabus of Savoie to 
cases presenting similar facts, i.e., cases involving claims against automobile 
insurance policies that contain “each person” limits.  Accordingly, a medical 
doctor and a professional liability insurer may agree that the insurer’s 
liability for all damages sustained from the death of one person is subject to 
the monetary limit declared for “each claim,” irrespective of the number of 
wrongful-death claimants.  Paragraph one of the Savoie syllabus does not 
apply to claims made against professional-liability insurance policies, 
whether those claims arose before or after October 20, 1994, the effective 
date of Am.Sub.S.B. No. 20.1   
                                                 
1.  {¶a} Am.Sub.S.B. No. 20 added R.C. 3937.44, which provides: 
{¶b}   “Any liability policy of insurance including, but not limited to, automobile liability or 
motor vehicle liability insurance that provides a limit of coverage for payment for damages for 
bodily injury, including death, sustained by any one person in any one accident, may, 
notwithstanding Chapter 2125. of the Revised Code, include terms and conditions to the effect that 
January Term, 2004 
5 
I 
OIGA Coverage Limits Under the P.I.E. Primary Policy 
{¶ 17} R.C. Chapter 3955 exists, in part, “to provide a mechanism 
for the payment of covered claims under certain insurance policies [and to] 
avoid excessive delay in payment and reduce financial loss to claimants or 
policyholders because of the insolvency of an insurer.”  R.C. 3955.03. 
{¶ 18} R.C. 3955.08(A)(1) provides that OIGA shall be obligated to 
the extent of “covered claims” existing within certain time limits relative to a 
determination that an insurer has become insolvent.  However, “[i]n no event 
shall the association be obligated to a policyholder or claimant in an amount 
in excess of the face amount of the policy from which the claim arises.”  Id.  
Moreover, OIGA is statutorily “deemed the insurer to the extent of its 
obligation on the covered claims and to such extent shall have all rights, 
duties, and obligations of the insolvent insurer as if the insurer had not 
become insolvent.”  R.C. 3955.08(A)(2).  Accordingly, under no 
circumstances is OIGA liable in an amount exceeding the amount for which 
P.I.E. itself would have been contractually liable.  We are thus required to 
interpret the P.I.E. policy to determine the application of its limits of liability 
to the case at bar. 
{¶ 19} OIGA argues that Section V(A) of the primary policy is a 
valid and enforceable contractual provision agreed to by both P.I.E. as 
insurer and Katz as insured.  Katz and Robinson argue that Savoie applies to 
invalidate this provision. 
                                                                                                                                     
all claims resulting from or arising out of any one person’s bodily injury, including death, shall 
collectively be subject to the limit of the policy applicable to bodily injury, including death, 
sustained by one person, and, for the purpose of such policy limit shall constitute a single claim.  
Any such policy limit shall be enforceable regardless of the number of insureds, claims made, 
vehicles or premiums shown in the declarations or policy, or vehicles involved in the accident.”   
145 Ohio Laws, Part I, 204, 210. 
 
 
  
SUPREME COURT OF OHIO 
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{¶ 20} The first paragraph of the syllabus in Savoie states:  “Each 
person who is presumed to have been damaged as a result of a wrongful 
death claim may, to the extent of his or her damages, collect from the 
tortfeasor’s liability policy up to its per person limits subject to any per 
accident limit.  Liability policy provisions which purport to consolidate 
wrongful death damages suffered by individuals into one ‘each person’ 
policy limit are unenforceable.”  Savoie, 67 Ohio St.3d 500, 620 N.E.2d 809, 
paragraph one of the syllabus.  OIGA argues that this proposition of law 
does not apply to medical-malpractice liability policies.  We agree. 
{¶ 21} The facts of Savoie involved claims made pursuant to 
automobile liability policies.  The first sentence of the majority opinion 
specifies that the case “raise[d] three questions of automobile insurance 
law.” (Emphasis added.)  Id. at 503, 620 N.E.2d 809.  Each of the three 
remaining syllabus paragraphs of the Savoie decision specifically refers to 
uninsured/underinsured insurance, which exists exclusively in automobile 
liability policies.  Every case cited in the syllabus of Savoie as being 
overruled, applied, followed, or limited2 involved interpretation of an 
automobile insurance policy. 
{¶ 22} Moreover, the first paragraph of the Savoie syllabus, upon 
which the appellees rely in contending that the consolidation clause in the 
P.I.E. policy is unenforceable, overrules State Farm Auto. Ins. Co. v. Rose 
(1991), 61 Ohio St.3d 528, 575 N.E.2d 459, and paragraphs one and two of 
the syllabus of Burris v. Grange Mut. Cos. (1989), 46 Ohio St.3d 84, 545 
                                                 
2.  State Farm Auto. Ins. Co. v. Rose (1991), 61 Ohio St.3d 528, 575 N.E.2d 459; Burris v. Grange 
Mut. Cos. (1989), 46 Ohio St.3d 84, 545 N.E.2d 83; Wood v. Shepard (1988), 38 Ohio St.3d 86, 
526 N.E.2d 1089; Hower v. Motorists Mut. Ins. Co. (1992), 65 Ohio St.3d. 442, 605 N.E.2d 15;  
Karabin v. State Auto. Mut. Ins .Co, (1984), 10 Ohio St.3d 163, 10 OBR 497, 462 N.E.2d 403;  
Dues v. Hodge (1988), 36 Ohio St.3d 46, 521 N.E.2d 789; Hill v. Allstate Ins. Co. (1990), 50 Ohio 
St.3d 243, 553 N.E.2d 658.   
January Term, 2004 
7 
N.E.2d 83.  Both Rose and the identified paragraphs in Burris establish law 
relative to automobile liability insurance provisions. 
{¶ 23} We acknowledge that a surviving spouse, the children, and 
the parents of a decedent are “rebuttably presumed to have suffered 
damages” resulting from wrongful death.  R.C. 2125.02(A)(1).  However, it 
does not follow that a claim for damages, even though legally viable, is 
necessarily within the coverage of a liability policy procured by a tortfeasor.  
See Savoie,  67 Ohio St.3d at 516, 620 N.E.2d 809 (Moyer, C.J., dissenting) 
(Section 19a, Article I of the Ohio Constitution, providing that wrongful-
death damages shall not be limited by law, does not mean that an insurer and 
an insured may not contract for limited levels of coverage).  Even in the 
context of automobile insurance law, Savoie was an aberration in terms of 
construing provisions in liability policies, as opposed to uninsured and 
underinsured insurance provisions.  Id. 
{¶ 24} In short, we refuse to extend the rationale of the first 
paragraph of Savoie beyond the context of automobile insurance cases. 
{¶ 25} In the case at bar, Katz purchased a primary policy with a 
limit of “$200,000 each claim” from P.I.E.  OIGA contends that Section 
V(A) of that policy was clearly included to cover circumstances in which 
one act of malpractice may result in multiple damage claims, such as may 
occur in a wrongful- death action.  Both Katz and Robinson have 
consistently argued that issues of interpretation of Section V(A) are 
irrelevant, in that the provision is nevertheless moot pursuant to Savoie.  Our 
decision today that Savoie does not invalidate Section V(A) revives the 
relevance of the issue in view of our established precedent that ambiguous 
insurance provisions are construed in favor of the insured. 
{¶ 26} In the case at bar, the Sixth District Court of Appeals 
determined that Section V(A) was a limits-of-liability provision.  We agree 
SUPREME COURT OF OHIO 
8 
insofar as the clause provides a monetary limit on P.I.E.’s obligation under 
the policy.  We do not, however, believe that Section V(A) is a consolidation 
clause for purposes of counting how many “claims” exist under the policy.  
There simply is no language in the clause indicating that all claims 
recognized as lawful under the wrongful-death statute are consolidated into 
“one claim” under the policy.  Section V(A) instead imposes a valid and 
enforceable $200,000 limit of liability on all claims resulting from the death 
of a single person, irrespective of the number of people recognized under 
law as having a wrongful-death claim.  It provides that the $200,000 limit 
applicable to “each claim,” as set forth in the declarations, caps P.I.E.’s 
exposure “for all damages because of * * * all claims * * * because of * * * 
death of any one person.”  (Emphasis added.)  In short, there remain at least 
four claims under the P.I.E. policy.  Each of those claims is a “covered 
claim” as defined in R.C. 3955.01(D)(1).  But had P.I.E. remained solvent, it 
would have been liable up to only a total maximum of $200,000 for all of 
those claims pursuant to Section V(A).  OIGA, per statute, is not obligated to 
pay more than that maximum. 
II 
OIGA Coverage Limits Under the P.I.E. Excess Policy 
{¶ 27} R.C. 3955.01 defines “covered claim” as follows:  
{¶ 28} “(D)(1)  ‘Covered claim’ means an unpaid claim * * * which 
arises out of and is within the coverage of an insurance policy to which 
sections 3955.01 to 3955.19 of the Revised Code apply * * *. 
{¶ 29} “(2) ‘Covered claim’ does not include any amount: 
{¶ 30} “* * * 
{¶ 31} “(b) In excess of three hundred thousand dollars on any 
claim.” 
January Term, 2004 
9 
{¶ 32} OIGA argues that it is irrelevant that Katz had procured two 
separate policies—one primary and one excess—in determining the statutory 
maximum of its indemnification liability.  It argues that Katz “purchased 
medical malpractice liability insurance coverage that had been divided by 
the carrier between a primary insurance policy and an excess insurance 
policy.”  It further argues that the “fact that the insurance coverage is 
provided through two integrated policies, rather than through a single policy, 
was of absolutely no significance” and that it is liable up to only one 
$300,000 statutory limit. 
{¶ 33} OIGA correctly asserts that the fact that there are two separate 
policies here does not affect the number of claims.  It does, however, affect the 
amount of P.I.E.’s exposure under the two policies and thus also the extent to 
which OIGA’s statutory maximum liability will be invoked.  Contrary to OIGA’s 
contention, however, the two policies cover not one claim, but four claims, as set 
forth in Section I of this opinion.  Hence OIGA’s maximum statutory exposure is 
$1.2 million, i.e., the statutory maximum of $300,000 per covered claim 
multiplied by four claimants. 
{¶ 34} Robinson presented four covered claims in her action against Katz: 
three wrongful-death claims and a survival claim.  As discussed previously, 
Section V(A) of the P.I.E. primary policy limits maximum recovery for all claims 
to $200,000 under that policy; contrary to OIGA’s contentions, the policy did not 
consolidate the claims to one claim. Because OIGA steps into P.I.E.’s shoes, it, 
too, has a $200,000 exposure under the primary policy. 
{¶ 35} Katz purchased an excess policy with a $1 million limit of liability 
per claim in addition to his primary policy.  Had P.I.E. remained solvent, it would 
have been liable for excess coverage up to a limit of $1 million under the excess 
policy.  We have recognized that OIGA “steps into the shoes of that insurer” 
when an insurer becomes insolvent, and it assumes all of the carrier’s obligations 
SUPREME COURT OF OHIO 
10 
except as otherwise provided in the Act.  Lake Hosp. Sys., Inc. v. Ohio Ins. Guar. 
Assn. (1994), 69 Ohio St.3d 521, 523, 634 N.E.2d 611.  The four claims Robinson 
made against Katz are subject not only to the coverage provided under the 
primary policy, but also to the additional coverage provided under the excess 
policy. To the extent that the claims arising from Katz’s alleged malpractice 
exhaust the $200,000 coverage under the P.I.E. primary policy, those claims are 
afforded additional coverage of up to $1 million under the excess policy.  Because 
OIGA steps into the shoes of P.I.E., its exposure under the P.I.E. excess policy is 
$1 million. OIGA’s maximum exposure under the two policies is thus $1.2 
million. 
{¶ 36} Pursuant to R.C. 3955.01(D)(2)(b), however, OIGA’s exposure is 
limited to $300,000 per covered claim. Because four covered claims are presented 
in this action, OIGA’s statutory exposure is $1.2 million.  That this exposure is 
coextensive with P.I.E.’s exposure, had P.I.E. remained solvent, under the 
primary and excess policies combined is a mathematical coincidence. 
III 
Conclusion 
{¶ 37} Section V(A) of the P.I.E. policy is not a consolidation 
clause, as it does not purport to consolidate all wrongful-death claims arising 
from the death of a single person—here, Teri Sue Robinson—into one claim 
for purposes of applying the policy limits.  It does, however, provide a 
limitation of P.I.E.’s total exposure for all claims under the primary policy.  
Accordingly, pursuant to R.C. 3955.08(A)(1), OIGA’s maximum exposure 
under the primary policy as to claims made in connection with the death of 
Teri Sue Robinson is $200,000. 
{¶ 38} The P.I.E. excess policy provided coverage with a $1 million 
per claim limit, with an aggregate limit for all claims of $1 million.  When 
the $200,000 available under the primary policy is combined with the 
January Term, 2004 
11 
$1,000,000 maximum exposure under the excess policy, the total liability 
under both P.I.E. policies is $1,200,000.  Pursuant to R.C. 3955.01(2)(b), 
however, OIGA is not liable to pay any individual claimant an amount in 
excess of $300,000. 
Judgment affirmed in part 
and reversed in part. 
 
BRYANT, F.E. SWEENEY and FARMER, JJ., concur. 
 
PFEIFER, J., concurs in part and dissents in part. 
 
LUNDBERG STRATTON, J., concurs in part and dissents in part 
 
O’CONNOR, J., concurs in part and dissents in part. 
 
PEGGY BRYANT, J., of the Tenth Appellate District, sitting for 
RESNICK, J. 
 
SHEILA G. FARMER, J., of the Fifth Appellate District, sitting for 
O’DONNELL, J. 
__________________ 
 
PFEIFER, J., concurring in part and dissenting in part. 
{¶ 39} The first syllabus paragraph of Savoie v. Grange Mut. Ins. Co. 
(1993), 67 Ohio St.3d 500, 620 N.E.2d 809, is not about automobile insurance 
policies; it is about whether parties may contract away the statutory and 
constitutional underpinnings of wrongful-death claims in Ohio.  This court wrote 
in Savoie that “[l]iability policy provisions which purport to consolidate wrongful 
death damages suffered by individuals are unenforceable because they directly 
violate the policy expressed by the General Assembly and this court.” Savoie, 67 
Ohio St.3d at 504, 620 N.E.2d 809.  Whether the decedent died in an automobile 
or on the operating table is immaterial.  The only relevant thing is that the 
decedent left behind survivors that are all rebuttably presumed pursuant to R.C. 
2125.02 to have suffered damages resulting from the wrongful death.  The claims 
of each person are recognized by law. 
SUPREME COURT OF OHIO 
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{¶ 40} Here, as in Savoie, the consolidation of wrongful-death damages 
suffered by different individuals is unlawful.  The aggregate limit of $600,000 
under the primary policy should have been available to the plaintiffs in this case. 
{¶ 41} I concur with the majority’s treatment of the excess policy.  Thus, 
the total amount of coverage available to the plaintiffs in this case and payable by 
OIGA should be $1.6 million. 
__________________ 
 
LUNDBERG STRATTON, J., concurring in part and dissenting in 
part. 
{¶ 42} I concur in the syllabus paragraph; however, I respectfully dissent 
from the majority’s analysis of the P.I.E. insurance contracts and its conclusion as 
to OIGA’s statutory exposure. 
{¶ 43} Plaintiffs asserted four claims against Dr. Katz, all derived from a 
single act of malpractice.  For purposes of insurance coverage under the P.I.E. 
primary policy, however, the express language of the policy limits the company’s 
liability “for all damages because of any one claim or suit or all claims or suits 
first made during the policy period because of injury to or death of any one 
person” to the limit for “each claim.”  I agree with Justice O’Connor that this is a 
clear and unambiguous consolidation clause.  Therefore, under the primary 
policy, P.I.E. would have been liable up to the single-claim limit of $200,000. 
{¶ 44} P.I.E.’s insolvency triggered OIGA’s obligation as “insurer to the 
extent of [the insurer’s] obligation on the covered claims.”  R.C. 3955.08(A)(2).  
A “covered claim” is defined as a claim “which arises out of and is within the 
coverage of an insurance policy * * * issued by an insurer which becomes * * * 
insolvent.”  (Emphasis added.)  R.C. 3955.01(D)(1).  It is limited by the language 
of the policy and the statutory cap of $300,000.  R.C. 3955.01(D)(2)(b).  In other 
words, OIGA steps into the shoes of P.I.E. up to a maximum of $300,000. 
January Term, 2004 
13 
{¶ 45} Nevertheless, the majority obligates OIGA to pay up to $1.2 
million for one medical malpractice action against Dr. Katz under the guise of 
four “covered claims” reaching Katz’s excess liability policy.  I do not agree that 
OIGA’s payment of $200,000 constitutes exhaustion of the primary policy for 
purposes of reaching Katz’s excess liability insurance policy.  However, even if 
an OIGA payment of $200,000 satisfied the exhaustion requirement in the 
primary policy in order to access coverage under the excess policy, I believe that 
OIGA is obligated to pay only an additional $100,000 because its liability is 
capped by statute at $300,000. 
{¶ 46} Katz’s excess liability policy provides a level of coverage above 
that of the primary policy.  The excess policy does not become an issue until the 
limits of the underlying primary policy are exhausted.  Had P.I.E. remained 
solvent, the excess policy would have provided an additional $1 million of 
liability coverage upon exhaustion of the primary coverage.  However, the excess 
policy applies “only if the underlying coverage is applicable and the claim is first 
made in accordance with the applicable provisions of the Underlying Insurance.”  
Except in limited instances, the excess policy incorporates provisions of the 
underlying insurance, including the primary policy’s consolidation clause. 
{¶ 47} The purpose of the OIGA is to prevent catastrophic loss by 
compensating claimants when an insurance company becomes insolvent.  PIE 
Mut. Ins. Co. v. Ohio Ins. Guar. Assn. (1993), 66 Ohio St.3d 209, 212, 611 N.E.2d 
313.  Although OIGA assumes the place of the insolvent insurer, it is not 
replacement insurance.  I believe that the majority’s interpretation has the 
potential to deplete OIGA funds by exposing OIGA to expansive, unanticipated 
liability that may jeopardize OIGA’s financial stability and the viability of its 
funds for other qualified claimants.  It will erode the system put in place by the 
General Assembly to protect policyholders and claimants who are affected by 
insolvent insurance companies.  This decision will also potentially affect all Ohio 
SUPREME COURT OF OHIO 
14 
insurance consumers as the cost of these multiple claims is ultimately passed on 
to them through increased premiums. 
{¶ 48} The General Assembly intended OIGA to pay what the insolvent 
insurer would have been obligated to pay, subject to a statutory maximum limit of 
$300,000 per claim.  Today’s majority ignores that limit in favor of expansive 
liability that obligates OIGA to the maximum insurance coverage that was 
available under the P.I.E. policies.  I do not agree with this interpretation.  
Therefore, to the extent that the majority recognizes more than one “covered 
claim,” I respectfully dissent. 
__________________ 
 
O’CONNOR, J., concurring in part and dissenting in part. 
{¶ 49} I concur with the syllabus announced by the majority that Savoie v. 
Grange Mut. Ins. Co. (1993), 67 Ohio St.3d 500, 620 N.E.2d 809, is an aberration 
that should be limited to cases with similar facts.  This aberration was spawned by 
earlier uninsured-underinsured motorist law, which the legislature revised by 
means of 1994 Am.Sub.S.B. No. 20, 145 Ohio Laws, Part I, 204, 210-212, and 
subsequent acts into the current R.C. 3937.18.  The current statute provides 
limited guidance for ascertaining OIGA’s liability under R.C. Chapter 3955 for a 
medical malpractice insurance policy issued by a now insolvent insurer. 
{¶ 50} I dissent because the survivorship and wrongful-death claims, 
which the majority effectively consolidates into one claim under the primary 
policy, should also be consolidated into one claim under the excess policy. 
Moreover, a single claim submitted to OIGA under an excess or umbrella policy 
may recover $300,000 more than what is available from the primary policy. I 
would award the plaintiffs $200,000 under the primary policy and $300,000 under 
the excess policy for a total of $500,000. 
{¶ 51} My disagreement with the majority begins with its treatment of the 
primary policy’s “Limits of Liability” section.  The majority correctly states that 
January Term, 2004 
15 
this section subjects the plaintiffs’ four claims to a single $200,000 limit under the 
primary policy, which has a $200,000 per-claim limit and an aggregate limit of 
$600,000.  The majority, however, states that the limits-of-liability section does 
not consolidate the claims.  The majority inconsistently holds both that there are 
four unconsolidated claims and that the four unconsolidated claims are 
collectively restricted to the one $200,000 per-claim limit of the primary policy.  
Subjecting multiple claims to a single limit is the very definition of claims 
consolidation.  The declarations page of the primary policy states that the policy 
will pay up to “$200,000 [for] each claim.”  The limits-of-liability section defines 
“each claim” as “all claims or suits * * * because of injury to or death of any one 
person.”  An analogous statute, R.C. 3937.18(G), provides that automobile 
liability insurance policies “may * * * include terms and conditions to the effect 
that all claims resulting from or arising out of any one person’s bodily injury, 
including death, shall collectively be subject to the limit of the policy applicable 
to bodily injury, including death, sustained by one person, and, for the purpose of 
such policy limit shall constitute a single claim.”  This form of consolidation is 
exactly what the P.I.E. primary policy accomplished.  Therefore, the limits-of-
liability section of the policy, Section V(A), is a clear and unambiguous 
consolidation clause.  See Clark v. Scarpelli (2001), 91 Ohio St.3d 271, 282, 744 
N.E.2d 719, and Saunders v. Mortensen, 101 Ohio St.3d 86, 2004-Ohio-24, 801 
N.E.2d 452, ¶ 16-17.  The policy even refers to the collective claims with the 
singular “each claim.”  Accordingly, the plaintiffs are jointly entitled to no more 
than $200,000 under the primary policy. 
{¶ 52} Second, I find that under R.C. Chapter 3955, a claim under an 
excess policy is a “covered claim” separate from a claim made under the primary 
policy and accordingly subject to an independent $300,000 limit.  R.C. 
3955.01(D)(1) defines “[c]overed claim” as an unpaid claim “which arises out of 
and is within the coverage of an insurance policy” to which Chapter 3955 applies.  
SUPREME COURT OF OHIO 
16 
(Emphasis added.)    This definition of “covered claim” restricts the term to a 
claim made under a single insurance policy.  An excess insurance policy is 
physically and legally separate from a primary policy.  Identical claims submitted 
under each policy constitute two “covered claims.” 
{¶ 53} Here, the coverage in the excess policy is provided “in accordance 
with the applicable provisions of the Underlying Insurance.”  Because I believe 
that the limits-of-liability section of the primary policy consolidated the plaintiffs’ 
claims,3 it follows that plaintiffs are jointly entitled to no more than $300,000 
under the excess policy. 
{¶ 54} I would allow $200,000 (per-claim policy limit) under the primary 
policy and $300,000 (“covered claim” statutory limit) under the excess policy for 
a total possible award of $500,000. 
{¶ 55} This award would be consistent with the stated purpose of R.C. 
Chapter 3955, which is to “reduce,” but not necessarily eliminate, “financial loss 
to claimants or policyholders because of the insolvency of an insurer.”  R.C. 
3955.03.  Contrary to the majority’s interpretation, the chapter is not intended to 
fully guarantee each covered insurance policy. 
__________________ 
 
Spengler Nathanson P.L.L., James R. Jeffery and Teresa L. Grigsby, for 
appellee Gordon L. Katz, D.O. 
 
Vorys, Sater, Seymour & Pease, L.L.P., F. James Foley and Michael 
Thomas, for appellant. 
 
 
J. Tracy Sniderhan, for appellee Susan Robinson. 
 
Dykema Gossett, P.L.L.C., William M. Thacker and Suzanne Sahakian, 
urging reversal for amicus curiae National Conference of Insurance Guaranty 
Funds. 
                                                 
3. The majority does not satisfactorily explain why it treats the plaintiffs’ claims collectively under 
the primary policy but separately under the excess policy.   
January Term, 2004 
17 
 
Berns, Ockner & Greenberger L.L.C., Sheldon Berns and Paul M. 
Greenberger, urging affirmance for amicus curiae William Witt, M.D. 
__________________