
May 23, 2008 - KENTUCKY COURT OF APPEALS DECISIONS (2008:26)
PUBLISHED (COA).
BEARDEN V. MAULDINDigested by Michelle Eisenmenger Mapes, DIana L. Skaggs + Associates.
JEWELL V. JEWELLDigested by Sarah Jost Nielsen, Diana L. Skaggs + Associates
NOT PUBLISHED (COA)
| 3 | ARCHER V.
POCKER 2005-CA-002098 NOT PUBLISHED: 106 DATE RENDERED: 5/23/2008 |
| 3 | EDGE V. COM 2006-CA-000360 NOT PUBLISHED: 98 DATE RENDERED: 5/23/2008 |
| 3 | 2006-CA-000840 NOT PUBLISHED: 108 DATE RENDERED: 5/23/2008 |
| 3 | 2006-CA-001180 NOT PUBLISHED: 101 DATE RENDERED: 5/23/2008 |
| 3 | DOUGLAS V.
UNIV. OF KY HOSP CIVIL PROCEDURE: Not properly served 2006-CA-002149 NOT PUBLISHED: 116 DATE RENDERED: 5/23/2008 Douglas initially filed a complaint with the Fayette Circuit Court Clerk on February 7, 2006. At that time, Douglas attempted service on the U.K. Physicians via certified mail through the office of the circuit clerk, as set forth in Kentucky Rule of Civil Procedure 4.01(a). In this instance, the certified mail was delivered to the University’s Obstetrics and Gynecology Department, but was not delivered directly to the U.K. Physicians named as defendants The University asserts that Lally was never appointed or designated by the U.K. Physicians to accept service of process on their behalf. In support of their position, the University of Kentucky (U.K.) filed the May 2, 2006, affidavit of John Allen, Department Administrator for the University of Kentucky Department of Obstetrics and Gynecology. We do believe that there is nothing in the record to dispute that Douglas made a good faith attempt to serve the U.K. Physicians. Unfortunately, neither CR 4 nor the case law provides a good faith exception to proper service under the civil rules. The law is clear that a summons is delivered to a person only when placed within his reach and he accepts it. Fleishman v. Goodman, 67 S.W.2d 691 (1934). |
| 3 | 2006-CA-002394 NOT PUBLISHED: 131 DATE RENDERED: 5/23/2008 |
| 3 | 2006-CA-002429 NOT PUBLISHED: 80 DATE RENDERED: 5/23/2008 |
| 3 | 2006-CA-002569 NOT PUBLISHED: 112 DATE RENDERED: 5/23/2008 |
| 3 | 2006-CA-002647 NOT PUBLISHED: 168 DATE RENDERED: 5/23/2008 |
| 3 | 2007-CA-000136 NOT PUBLISHED: 124 DATE RENDERED: 5/23/2008 |
| 3 | 2007-CA-000289 NOT PUBLISHED: 125 DATE RENDERED: 5/23/2008 |
| 3 | OHIO CASUALTY
INS.CO. V. DUCKWORTH INSURANCE: No fault and assigned claims plan 2007-CA-000295 NOT PUBLISHED: 121 DATE RENDERED: 5/23/2008 Under KRS 304.39-160(3), “if a person receives basic reparation benefits through the assigned claims plan, all benefits or advantages he receives or is entitled to receive as a result of the injury . . . are subtracted in calculating net loss.” Ohio Casualty argues that summary judgment is premature in this case without discovery as to how much Duckworth’s private health insurance paid toward his medical expenses in connection with this accident. According to Ohio Casualty, if it does not know the amount paid by Anthem, then it cannot calculate its net loss with respect to the claim. Ohio Casualty believes this lack of information formed a reasonable foundation for its delay in paying Duckworth’s medical expenses. KRS 304.39.210(1), the more specific and, thus, controlling statute, provides that the reparation obligor must pay benefits monthly as the claimant’s loss accrues. Loss accrues when medical expenses are incurred. These payments are considered overdue if not paid within thirty days of the insurer’s receipt of reasonable proof of the amount of loss. Noting that basic reparation benefits must be paid monthly and citing this statute, the Court of Appeals theorized in State Automobile Mutual Insurance Co. v. Outlaw, 575 S.W.2d 489 (Ky. App. 1978), that [a]ssuming that Outlaw [the claimant] had filed a claim for benefits soon after the accident and that the assigned claims bureau had promptly assigned her claim to State Auto [the reparation obligor], State Auto would not have had any right to make any deduction for any future medical assistance payments. KRS 304.39-210(3) directs the reparations obligor to pay [basic reparation benefits] without deducting [the claimant’s other benefits as set forth in KRS 304.39-160(3)] if the benefits have not been paid to the claimant before [the basic reparation benefits] are paid.”Morrison v. Kentucky Cent. Ins. Co., 731 S.W.2d 822, 825 (Ky. App. 1987). This is because the assigned reparation obligor is entitled to reimbursement from the person obligated to make the payments or from the claimant who received the benefits. KRS 304.39-210(3). Duckworth submitted copies of his medical bills to Ohio Casualty. According to KRS 304.39-020(5)(a), it is presumed that any medical bill submitted is reasonable. See also Outlaw, 575 S.W.2d at 493. Further, the submission of actual medical bills in connection with an accident is enough to satisfy the statutory requirement of reasonable proof of the fact and amount of the loss realized. Id. where Ohio Casualty’s argument falls short is in its assumption that it was not obligated to pay benefits due to Duckworth until after discovery was conducted to secure the amount of net loss. This proposition is directly contradicted by KRS 304.39-210(3) which unequivocally mandates that the reparation obligor, in this case Ohio Casualty, must timely pay the claimant as his loss accrues. But, despite this statutory obligation, the reparation obligor is entitled to reimbursement from that claimant in the amount of any other benefits or advantages received. See also KRS 304.39- 160(1). if Ohio Casualty could show that it had a reasonable foundation for delaying the payment of the claim, then it may avoid the penalties of interest and attorney’s fees. Automobile Club Insurance Co. v. Lainhart, 609 S.W.2d 692, 694 (Ky. App. 1980). A reasonable foundation for delay is defined as either the “assertion of a legitimate and bona fide defense by the reparation obligor” or, as relevant to this case, failure of the claimant to supply the obligor with reasonable proof of loss in a timely fashion. Id.at 695; see also Kentucky Farm Bureau Mutual Insurance Company v. Roberts, 603 S.W.2d 498, 499 (Ky. App. 1980); Outlaw, 575 S.W.2d at 494-495. Ohio Casualty does not assert that it had a bona fide defense for delaying payment to Duckworth. Ohio Casualty instead argues that it delayed payment because it did not have the opportunity to discover how much of Duckworth’s medical expenses the coverage provided by Anthem has paid.6 This does not constitute a reasonable foundation to delay payment Once Ohio Casualty received reasonable proof of loss, it was their obligation to pay these claims within thirty days. Ohio Casualty is entitled to seek reimbursement for any other benefits, such as those provided by health insurance, related to this accident later received by Duckworth. Accordingly, once Duckworth furnished Ohio Casualty with the reasonable proof of loss, Ohio Casualty was then under a statutory obligation to pay those claims within thirty days. The grant of summary judgment by the circuit court is, therefore, affirmed. |
| 3 | 2007-CA-000301 NOT PUBLISHED: 120 DATE RENDERED: 5/23/2008 |
| 3 | 2007-CA-000496 NOT PUBLISHED: 110 DATE RENDERED: 5/23/2008 |
| 3 | 2007-CA-000636 NOT PUBLISHED: 96 DATE RENDERED: 5/23/2008 |
| 3 | 2007-CA-000792 NOT PUBLISHED: 108 DATE RENDERED: 5/23/2008 |
| 3 | 2007-CA-000964 NOT PUBLISHED: 91 DATE RENDERED: 5/23/2008 |
| 3 | 2007-CA-000965 NOT PUBLISHED: 135 DATE RENDERED: 5/23/2008 |
| 3 | MAY V. MOORE PREMISES LIABILITY 2007-CA-000978 NOT PUBLISHED: 124 DATE RENDERED: 5/23/2008 Lorraine May, the appellant, appeals from a summary judgment entered against her in her lawsuit for personal injuries that she sustained on rental property owned by Dixie Moore. Dixie Moore, the original defendant/appellee, died on January 10, 2007, during the pendency of the case. The circuit court allowed revival of the action against Jay Moore in his capacity as administrator of the estate of Dixie Moore. Since the rental agreement governed, the court correctly determined that May could not recover for personal injuries and that her only sustainable claim for damages was the cost of repair to the electrical problem. Its reasoning was directly congruent with our decision in Pinkston, supra, which held as follows: [A] landlord is not liable for injuries caused by breach of a covenant to make repairs to a leased premises. Rather, the remedy for breach of an agreement to repair is the cost of repair. (Emphases added.) The evolution of Kentucky law as to the nature of this duty is ably recapitulated and summarized in Lambert v. Franklin Real Estate, Co., 37 S.W.3d 770, 775-776 (Ky. App. 2000) The dangerous condition of the electrical fixtures was both open, obvious, and known to May. Therefore, under established precedent, Moore owed no duty to May as a matter of law. As there is no cause of action for negligence, the issue of proximate cause is a moot point. May’s own negligent actions in standing on a chair cannot be imputed to Moore under any viable legal theory. Accordingly, we affirm the summary judgment of the Rowan Circuit Court. |
| 3 | 2007-CA-001368 NOT PUBLISHED: 121 DATE RENDERED: 5/23/2008 |
| 3 | 2007-CA-001376 NOT PUBLISHED: 110 DATE RENDERED: 5/23/2008 |
| 3 | FIELDS V.
TILFORD ATTORNEY FEE AGREEMENT 2007-CA-001547 NOT PUBLISHED: 103 DATE RENDERED: 5/23/2008 |
| 6 | 2007-CA-001598 NOT PUBLISHED: 99 DATE RENDERED: 5/23/2008 |
| 3 | 2007-CA-002057 NOT PUBLISHED: 90 DATE RENDERED: 5/23/2008 |
| 3 | 2007-CA-002141 NOT PUBLISHED: 118 DATE RENDERED: 5/23/2008 |
| 3 | 2007-CA-002511 NOT PUBLISHED: 104 DATE RENDERED: 5/23/2008 |
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