Court Opinion

ID: 9891666
Source: CourtListenerOpinion
Date Created: 2023-10-19 14:17:57.282087+00
Date Added: 2024-06-11T14:00:05.930509
License: Public Domain

[Cite as Rousana v. Nationwide Gen. Ins. Co., 2023-Ohio-3796.]

                              COURT OF APPEALS OF OHIO

                             EIGHTH APPELLATE DISTRICT
                                COUNTY OF CUYAHOGA

STEVEN ROUSANA,                                       :

                Plaintiff-Appellant,                  :
                                                                 No. 112478
                v.                                    :

NATIONWIDE GENERAL
INSURANCE COMPANY, ET AL.,                            :

                Defendants-Appellees.                 :

                               JOURNAL ENTRY AND OPINION

                JUDGMENT: AFFIRMED
                RELEASED AND JOURNALIZED: October 19, 2023

            Civil Appeal from the Cuyahoga County Court of Common Pleas
                                Case No. CV-21-957484

                                           Appearances:

                Anthony D. Jordan, for appellant.

                Bricker Graydon LLP and Jeffrey P. McSherry, for
                appellee.

EILEEN T. GALLAGHER, P.J.:

               Plaintiff-appellant, Steven Rousana (“Rousana”), appeals an order

granting summary judgment in favor of defendant-appellee, Nationwide General

Insurance Company (“Nationwide”). He claims the following errors:
1. The trial court erred in finding that the appellant did not support his uninsured
motorist claims by sufficient independent evidence pursuant to Smith v. Erie Ins.
Co., 148 Ohio St.3d 192 (2016).

2. The trial court erred in granting the appellee’s summary judgment motion against
appellant’s bad faith claim by basing its judgment on the breach of contract claim
where case law holds that the tort of bad faith is independent from the claim of
breach of contract.

3. The trial court erred by granting summary judgment on the appellant’s claim for
fraud and misrepresentation.

4. The trial court erred when it granted summary judgment against the appellant’s
claim for the intentional infliction of emotional distress.

            We affirm the trial court’s judgment.

                       I. Facts and Procedural History

            In March 2019, Rousana was involved in a motor vehicle accident

wherein he was rear-ended by another car. He alleges he sustained injuries as a

result of the accident and that the accident was caused by a “hit-skip” or unknown

driver. He presented a claim for uninsured motorist benefits to his auto insurer,

Nationwide, and Nationwide offered a sum of money to resolve the claim, but the

offer was not acceptable to Rousana. Consequently, Rousana filed a complaint

against Nationwide, alleging claims for breach of contract, bad-faith negotiations

and claims handling, fraud, and intentional infliction of emotional distress.

             During discovery, Nationwide took Rousana’s deposition. Rousana

identified two police reports and testified that the first report was made on March

27, 2019, the day of the accident (“first accident report”). (Rousana depo. tr. 60.)

Rousana told the investigating officer that the first accident report was “incorrect,”

and a second report was made on April 7, 2019 (“second accident report”). Rousana
testified that the second accident report was 99 percent accurate. (Rousana depo.

tr. 62.) The second accident report contains the following narrative description of

the accident:

Driver of Unit 2 [Christian Compton] states he was traveling eastbound on Train
Ave approaching 41 Street [sic] when driver of Unit 2 [Christian Compton] was
unable to slow down in time and struck Unit 1 [Rousana] in the right passenger side.
Unit 3 [unknown driver] was traveling behind Unit 2 [Christian Compton] and was
also unable to stop in time. Driver of Unit 3 [unknown driver] struck Unit 2
[Christian Compton] in the rear bumper, then proceed to leave the scene.

(Rousana depo. exhibit No. 2.) It is undisputed that Rousana was the driver of Unit

1, Christian Compton (“Compton”) was the driver of Unit 2, and that the driver of

Unit 3 is unknown. It is also undisputed that Compton was insured by State Farm.

             Nowhere in the narrative description does it state that Unit 3 first hit

Unit 2, which then caused Unit 2 to hit Unit 1. Rousana testified multiple times

during his deposition that he only felt one impact. He explained that the first

accident report was inaccurate because it indicated that he was struck twice.

(Rousana depo. at 41.) He stated, “I heard one hit, not two hits.” (Rousana depo. at

63-64.) Upon further questioning about the second accident report, Rousana

testified:

Q: So the driver of Unit 2 hit you first, right?

A: I heard one hit.

Q: Okay.

A: That’s all I heard.

Q: And that was when you — and that’s when you got hit, right?

A: Yeah, that’s it. Second hit I don’t hear nothing. Or third. Only one I hear.
Q: So you don’t know if Unit 2 was hit by 3 and pushed into you; is that right?

A: I’m not sure about that, no.

(Rousana depo. at 63, 69.)

             Nationwide filed a motion for summary judgment based on Rousana’s

testimony. Rousana filed a brief in opposition to the motion, which he supported

with his own affidavit and the expert report of William J. Warfel, Ph.D., C.P.C.U.,

C.L.U. After considering the parties’ briefs and evidence, the court granted summary

judgment in favor of Nationwide on all claims. In reaching its decision, the trial

court explained, among other things, that there was insufficient evidence

establishing that Nationwide breached its contract with Rousana because Rousana

failed to provide “independent corroborative evidence” demonstrating a breach.

The court further held that Rousana’s own testimony and statements to third

parties, by themselves, were not sufficient to prove his claims. Rousana now appeals

the trial court’s judgment.

                              II. Law and Analysis

                              A. Standard of Review

            Appellate review of summary judgments is de novo. Grafton v. Ohio

Edison Co., 77 Ohio St.3d 102, 105, 671 N.E.2d 241 (1996). Pursuant to Civ.R. 56(C),

summary judgment is appropriate when (1) there is no genuine issue of material

fact, (2) the moving party is entitled to judgment as a matter of law, and (3)

reasonable minds can come to but one conclusion and that conclusion is adverse to

the nonmoving party, the party being entitled to have the evidence construed most
strongly in his or her favor. Horton v. Harwick Chem. Corp., 73 Ohio St.3d 679,

653 N.E.2d 1196 (1995), paragraph three of the syllabus; Zivich v. Mentor Soccer

Club, 82 Ohio St.3d 367, 696 N.E.2d 201 (1998).

            The party moving for summary judgment bears the burden of showing

that there is no genuine issue of material fact and that he or she is entitled to

judgment as a matter of law. Dresher v. Burt, 75 Ohio St.3d 280, 662 N.E.2d 264

(1996). Once the moving party satisfies its burden, the nonmoving party “may not

rest upon the mere allegations or denials of the party’s pleadings, but the party’s

response, by affidavit or as otherwise provided in this rule, must set forth specific

facts showing that there is a genuine issue for trial.” Civ.R. 56(E); Mootispaw v.

Eckstein, 76 Ohio St.3d 383, 385, 667 N.E.2d 1197 (1996).

                      B. Uninsured Motorist Coverage

            In the first assignment of error, Rousana argues the trial court erred in

granting summary judgment in favor of Nationwide on his claim for uninsured

motorist (“UM”) coverage. He contends the court erred in finding that he did not

support his UM claim with sufficient corroborative evidence. He asserts that his

own testimony constitutes “independent corroborative evidence” of his entitlement

to UM coverage.

              Rousana’s claims are based on his rights under the contract of

insurance he had with Nationwide. “An insurance policy is a contract whose

interpretation is a matter of law.” Sharonville v. Am. Emps. Ins. Co., 109 Ohio St.3d

186, 2006-Ohio-2180, 846 N.E.2d 833, ¶ 6. Courts examine the insurance contract
as a whole and presume that the intent of the parties is reflected in the language

used in the policy. Westfield Ins. Co. v. Galatis, 100 Ohio St.3d 216, 2003-Ohio-

5849, 797 N.E.2d 1256, ¶ 11. We look to the plain and ordinary meaning of the

language used in the policy unless another meaning is clearly apparent from the

contents of the policy. Id. “When the language of a written contract is clear, a court

may look no further than the writing itself to find the intent of the parties.” Id.

              “Where, however, the provisions of an insurance policy are ‘reasonably

susceptible to more than one interpretation,’ the ambiguity in the policy language is

construed against the insurer and liberally in favor of the insured.” Raudins v.

Hobbs, 2018-Ohio-2309, 104 N.E.3d 1040, ¶ 26 (8th Dist.), quoting Sharonville at

¶ 6. In any case, a court is not permitted to alter a lawful contract by imputing an

intent contrary to that expressed by the parties. Shifrin v. Forest City Ents., Inc., 64

Ohio St.3d 635, 597 N.E.2d 499 (1992). Nor may the court employ a general rule of

liberal construction to create an ambiguity where one does not exist. Progressive

Ins. Co. v. Heritage Ins. Co., 113 Ohio App.3d 781, 784 682 N.E.2d 33

(8th Dist.1996), citing Karabin v. State Auto Mut. Ins. Co., 10 Ohio St.3d 163, 166,

462 N.E.2d 403 (1984).

              Part C of Rousana’s Nationwide policy governs UM coverage and

states, in relevant part:

A. We will pay compensatory damages which an “insured” is legally entitled to
recover from the owner of:

***
2. An “uninsured motor vehicle” as defined in Paragraph 3 of the definition of an
“uninsured motor vehicle” because of “bodily injury” sustained by an “insured.”

              Paragraph three of the definition of an “uninsured motor vehicle”

states, in relevant part:

“Uninsured motor vehicle” means a land motor vehicle or trailer * * * [w]hich is a
hit-and-run vehicle whose operator or owner cannot be identified and which hits *
* *

a. You or any “family member”;

b. A vehicle which you or any “family member” are occupying; or

c. “Your covered auto.”

              It is undisputed that Rousana is an “insured” under the Nationwide

policy. The issue here is whether there is evidence establishing that Rousana was

injured by an “uninsured motor vehicle.”

              R.C. 3937.18 governs UM coverage and states, in relevant part:

(B)(1) For purposes of any uninsured motorist coverage included in a policy of
insurance, an “uninsured motorist” is the owner or operator of a motor vehicle if any
of the following conditions applies:

***

(c) The identity of the owner or operator cannot be determined, but independent
corroborative evidence exists to prove that the bodily injury, sickness, disease, or
death of the insured was proximately caused by the negligence or intentional actions
of the unidentified operator of the motor vehicle. For purposes of division (B)(1)(c)
of this section, the testimony of any insured seeking recovery from the insurer shall
not constitute independent corroborative evidence, unless the testimony is
supported by additional evidence.

(Emphasis added.) R.C. 3937.18(B)(1)(c). Rousana’s Nationwide policy tracks the

language of R.C. 3937.18(B)(1)(c) and similarly provides:
The facts of the accident or intentional act must be proved. We will only accept
independent, corroborative evidence to prove that the “bodily injury,” sickness,
disease or death of the “insured” was proximately caused by negligence or
intentional actions of the unidentified operator of the motor vehicle. For the
purposes of this section, the testimony of any “insured” seeking recovery from the
insurer shall not constitute independent, corroborative evidence, unless the
testimony is supported by additional evidence.

(Emphasis added.) (Nationwide Policy, Part C — UM Coverage at C(3)(c).) Thus,

R.C. 3937.18(B)(1)(c) and the UM endorsement set forth in Part C of Rousana’s

Nationwide policy preclude the use of the insured’s testimony from being considered

as independent, corroborative evidence of the insured’s entitlement to UM coverage

under the insured’s own policy unless it is supported by “additional evidence.”

             Rousana nevertheless maintains the trial court erred by not

considering his testimony as evidence that Nationwide breached its promise to

provide him UM coverage under the policy. He cites Smith v. Erie Ins. Co., 148 Ohio

St.3d 192, 2016-Ohio-7742, 69 N.E.3d 711, in support of his argument. In Smith, the

court found that the trial court erred in granting summary judgment to the insurer

because under the policy language, the insured’s testimony may constitute

“independent corroborative evidence” if that testimony is supported by additional

evidence. Id. at ¶ 20. Moreover, the policy language at issue in Smith, which is

virtually identical to the policy language in Rousana’s Nationwide policy, only

required “additional evidence—not necessarily third-party testimony—supporting

the causation testimony of the insured.” Id. Thus, Rousana argues, his testimony

was sufficient to prove that Nationwide breached its promise to insure him against

injuries caused by an “uninsured motor vehicle.”
             We agree that Rousana’s testimony could be considered to establish

his UM claim if it is corroborated by “additional evidence.” The issue is not the

admissibility of this evidence. The problem is that Rousana’s testimony does not

support his claim for UM coverage because it does not establish that he was injured

by an uninsured motorist. Rousana testified that he only experienced one impact

during the accident and that he does not know if Unit 3, the unidentified driver who

left the scene, caused the accident. He also testified that he did not know if Unit 2

was hit by Unit 3, which pushed Unit 2 into Rousana’s car. (Rousana depo. at 63.).

He stated that he only heard “one hit” and that he was only hit by Unit 2. (Rousana

depo. at 63.). Therefore, his own testimony establishes that he was only struck by

Unit 2.

              It is undisputed that Unit 2 was operated by Compton, who was

insured by State Farm. Thus, Unit 2 was not an uninsured vehicle operated by an

uninsured motorist. Although the driver of Unit 3 may fit the definition of an

“uninsured motorist” under R.C. 3937.18(B)(1)(c) and Part C of the Nationwide

policy, Rousana’s testimony fails to establish that Unit 3 caused the accident and his

injuries.

              The two police reports documenting the crash also fail to support

Rousana’s claim that his injuries were caused by an uninsured motor vehicle. They

are wholly consistent with Rousana’s testimony that only Unit 2 (Compton’s insured

vehicle) struck Rousana. Moreover, neither of the two accident reports state that

Unit 3 first hit Unit 2 and pushed Unit 2 (Compton’s insured vehicle) into Rousana’s
vehicle. The first accident report does not even mention Unit 3. Therefore, the

police reports do not support Rousana’s claim that Unit 3 caused his injuries.

              Rousana contends that his experts establish that he has a valid UM

claim. He claims that his first expert, Dr. William J. Warfel, Ph.D., C.P.C.U., C.L.U.,

incorporated the medical expert report of Dr. Hyo Kim, and that together they prove

that Rousana was injured by an uninsured motorist. Nationwide moved to strike

Dr. Warfel’s expert report on grounds that it contains inadmissible hearsay and

conclusory legal assertions unsupported by facts or personal knowledge. The trial

court never ruled on the motion. Nevertheless, we agree that Dr. Warfel has no

personal knowledge regarding the cause of the accident. Rousana offered Dr.

Warfel’s opinion as an expert in claims handling; he is not an accident

reconstructionist. His opinions regarding the cause of the accident are based solely

on the police reports and are, therefore, inadmissible. See Butler v. Young, 8th Dist.

Cuyahoga No. 73549, 1999 Ohio App. LEXIS 32 (Jan. 14, 1999) (“Police reports and

private investigator’s statements are not materials authorized by Civ.R. 56(C) for

consideration on a motion for summary judgment.”).

              After reviewing all the evidence in the record, including Rousana’s

testimony, we find no evidence that Rousana is entitled to UM coverage because

there is no evidence that he is “legally entitled to recover” from an uninsured

motorist as required for UM coverage under Part C — (A)(1) of the Nationwide

policy. Having failed to demonstrate that he is entitled to UM coverage under the

policy, Rousana cannot establish a claim for breach of contract under the policy.
               Therefore, the first assignment of error is overruled.

                                    C. Bad Faith

               In the second assignment of error, Rousana argues the trial court

erred in granting Nationwide’s motion for summary judgment on his bad-faith

claim. He contends the trial court erroneously concluded that the bad-faith claim

was contingent on there being a valid breach-of-contract claim. He asserts that the

tort of bad faith is independent from his breach-of-contract claim.

               A bad-faith claim is an independent cause of action, but it is

nonetheless predicated on the relationship between an insurer and its insured. In

Hoskins v. Aetna Life Ins. Co., 6 Ohio St.3d 272, 452 N.E.2d 1315 (1983), the Ohio

Supreme court explained that an insurer has a duty to act in good faith in handling

the insured’s claim. Id. at 275. Liability for bad faith “arises from the breach of the

positive legal duty imposed by law due to the relationship of the parties.” Id., citing

Battista v. Lebanon Trotting Assn., 538 F.2d 111, 118 (6th Cir.1976) (construing

Ohio law). “This legal duty is the duty imposed upon the insurer to act in good faith

and its bad faith refusal to settle a claim is a breach of that duty and imposes liability

sounding in tort.” Id.

               However, the mere refusal to pay a claim does not automatically give

rise to bad faith liability. In Hoskins, the court further explained:

Mere refusal to pay insurance is not, in itself, conclusive of bad faith. But when an
insure[r] insists that it was justified in refusing to pay a claim of its insured because
it believed there was no coverage of the claim, “ * * * such a belief may not be an
arbitrary or capricious one. The conduct of the insurer must be based on
circumstances that furnish reasonable justification therefor.”
Id. at 277, quoting Hart v. Republic Mut. Ins. Co., 152 Ohio St. 185, 87 N.E.2d 347

(1949). See also Finger v. Liberty Mut. Personal Ins. Co., 8th Dist. Cuyahoga No.

112349, 2023-Ohio-2308, ¶ 48, quoting Barbour v. Household Life Ins. Co.,

N.D.Ohio No. 1:11 CV 110, 2012 U.S. Dist. LEXIS 46004, 13 (Apr. 2, 2012), quoting

Thomas v. Allstate Ins. Co., 974 F.2d 706, 711 (6th Cir.1992). (“‘“The test, therefore,

is not whether the insurer’s decision to deny benefits was correct but whether the

decision to deny benefits was arbitrary or capricious and there existed a reasonable

justification for the denial.”’”). Obviously, an insurer has a reasonable justification

for denying a claim if there is no coverage for the claim. See, e.g., Bailey v. Topline

Restaurants, Inc., 10th Dist. Franklin No. 11AP-359, 2012-Ohio-1759, ¶ 31 (Claims

for breach of contract and bad faith were moot where there was no coverage under

the insurance policy.).

              Rousana was not entitled to UM coverage under the Nationwide

policy because the undisputed evidence demonstrates that he was struck and

allegedly injured by an insured motorist. Nationwide, therefore, had a reasonable

justification for denying UM benefits; there was no coverage. Rousana cannot

establish a prima facie case of bad faith in the absence of a valid claim for coverage.

              The second assignment of error is overruled.

                                     D. Fraud

              In the third assignment of error, Rousana argues the trial court erred

in granting summary judgment in favor of Nationwide on his fraud claim. Rousana

alleged that Nationwide committed fraud when it advertised that “Nationwide is on
your side,” but then denied his claim and was “not on his side.” He argues that the

advertisements “proved to be a campaign of false misrepresentations of material

facts that he relied on.” (Appellant’s brief at 24.) He alleged in the complaint that

“Nationwide knowingly misrepresented material information about their respective

policy’s [sic] and for the payment of claims, as inducement for plaintiff’s business

and patronage.” (Complaint ¶ 30.) He also alleged that Nationwide made these

material misrepresentations “maliciously, and with knowledge of their falsity.”

(Complaint ¶ 32.)

              To establish a fraud claim, the plaintiff must demonstrate (1) a

representation or, where there is a duty to disclose, concealment of a fact; (2) which

is material to the transaction at hand; (3) made falsely, with knowledge of its falsity,

or with such utter disregard and recklessness as to whether it is true or false that

knowledge may be inferred; (4) with the intent of misleading another into relying

upon it; (5) justifiable reliance upon the representation or concealment; and (6) a

resulting injury proximately caused by the reliance. Gaines v. Preterm-Cleveland,

Inc., 33 Ohio St.3d 54, 55, 514 N.E.2d 709 (1987); Mobley v. James, 8th Dist.

Cuyahoga No. 108470, 2020-Ohio-380, ¶ 32.

              There is no evidence in the record demonstrating that Nationwide’s

advertisements provided any material misrepresentations regarding the terms of

Rousana’s insurance. We agree with the trial court, which noted in its judgment

entry that the slogan “Nationwide is on your side” is simply a slogan intended to

catch the attention of potential customers shopping for automobile insurance.
There is no evidence that the advertisements provided any detailed promises of

specific   coverages   or   that    Nationwide   knowingly    or   recklessly   made

misrepresentations.

              Nationwide provided a standard policy of automobile insurance.

Rousana failed to demonstrate that he was entitled to coverage under the policy

because he failed to establish that he was injured by an uninsured motorist. There

is no evidence that Nationwide promised to provide coverage for any and all injuries,

including those caused by insured drivers. There simply is no evidence of fraud.

              The third assignment of error is overruled.

               E. Intentional Infliction of Emotional Distress

              In the fourth assignment of error, Rousana argues the trial court erred

in granting summary judgment in favor of Nationwide on his claim for intentional

infliction of emotional distress.    Rousana alleged that Nationwide’s bad faith

handling of his claim caused him extreme emotional distress. (Complaint ¶ 28.)

              Intentional infliction of emotional distress occurs when “one who by

extreme and outrageous conduct intentionally or recklessly causes serious

emotional distress to another.” Yeager v. Local Union 20, Teamsters, 6 Ohio St.3d

369, 374, 453 N.E.2d 666 (1983), abrogated on other grounds, Welling v. Weinfeld,

113 Ohio St.3d 464, 2007-Ohio-2451, 866 N.E.2d 1051.

              To establish a claim of intentional infliction of emotional distress, a

plaintiff must prove that (1) the defendant either intended to cause emotional

distress, or knew or should have known that its conduct would result in serious
emotional distress to the plaintiff; (2) the defendant’s conduct was so extreme and

outrageous as to go beyond all possible bounds of decency and was such that it can

be considered utterly intolerable in a civilized community; (3) the defendant’s

actions proximately caused psychological injury to the plaintiff; and (4) the plaintiff

suffered serious emotional distress of a nature no reasonable person could be

expected to endure. Stancik v. Deutsche Natl. Bank, 8th Dist. Cuyahoga No. 102019,

2015-Ohio-2517, ¶ 43, citing Rhoades v. Chase Bank, 10th Dist. Franklin No. 10AP-

469, 2010-Ohio-6537, ¶ 15.

              In granting summary judgment to Nationwide on Rousana’s

intentional infliction of emotional distress claim, the trial court observed:

Plaintiff was involved in a car accident from which he remembers one impact on his
car. He contacted his insurance company, Nationwide, and put in a claim.
Nationwide offered him a payment, albeit one that Plaintiff considered low in
relation to the medical expenses he claimed he paid as a result of the injuries he
sustained. Finally, when the parties reached an impasse in their negotiations, this
lawsuit followed. While this Court does not discount the frustration Plaintiff feels
as a result of this process, his circumstances are not unique, as many injured
insureds resort to use of the judicial system in the hopes of obtaining a better offer
from their insurance company. In viewing these facts in a light most favorable to
Plaintiff, Nationwide’s conduct cannot be seen as “so outrageous in character, and
so extreme in degree, as to go beyond all possible bounds of decency, and to be
regarded as atrocious, and utterly intolerable in a civilized community.” McKee [v.
McCann, 8th Dist. Cuyahoga No. 104956, 2017-Ohio-7181,] ¶ 11.

We agree that Rousana’s disappointment with the claims process is not unique and
that Nationwide’s low settlement offer was reasonable in light of the fact that
Rousana’s UM claim was not covered under the policy. There is, therefore, no
evidence that Nationwide’s management of Rousana’s claim under these
circumstances “was so extreme and outrageous as to go beyond all possible bounds
of decency and was such that it can be considered utterly intolerable in a civilized
community.” Stancik at ¶ 43.

              Accordingly, the fourth assignment of error is overruled.
              Judgment affirmed.

      It is ordered that appellee recover from appellant the costs herein taxed.

      The court finds there were reasonable grounds for this appeal.

      It is ordered that a special mandate issue out of this court directing the

common pleas court to carry this judgment into execution.

      A certified copy of this entry shall constitute the mandate pursuant to Rule 27

of the Rules of Appellate Procedure.

EILEEN T. GALLAGHER, PRESIDING JUDGE

EMANUELLA D. GROVES, J., and
SEAN C. GALLAGHER, J., CONCUR