MARGARET COOMER V. CHARLIE PHELPS, ET AL
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2004-SC-0294-DG
MARGARET COOMER
V.
DATE
APPELLANT
ON REVIEW FROM COURT OF APPEALS
2003-CA-0643-MR
PULASKI CIRCUIT COURT NO . 2001-CI-1118
CHARLIE PHELPS ; AND
PROGRESSIVE NORTHWESTERN
INSURANCE COMPANY
APPELLEES
OPINION OF THE COURT BY JUSTICE ROACH
AFFIRMING
Iv INTRODUCTION
This case arises on appeal from the Pulaski Circuit Court which granted
summary judgment in favor of the Appellees, Charlie Phelps and Progressive
Northwestern Insurance Company ("Progressive"), Phelps's insurer. The Circuit Court's
decision, which was affirmed by the Court of Appeals, relied exclusively on a release
that the Appellant, Margaret Coomer, executed in favor of Mr. Phelps and his insurer.
Coomer challenges the validity of this release, and likewise the summary judgment, on
three independent grounds: (1) that the doctrine of mutual mistake should apply to
invalidate the release; (2) that the release is invalid as a result of constructive fraud ; and
(3) that Coomer did not have sufficient capacity to execute such a release . Coomer
also claims that she is entitled to damages as a result of Progressive's bad faith, as
allowed by Kentucky's Unfair Claims Settlement Practices Act . Having found no
adequate grounds to support invalidating the release or to support her claim of bad
faith, we affirm the Court of Appeals .
II . BACKGROUND
The facts underlying this case are largely undisputed by either party. On the
evening of July 25, 2001, after accompanying Phelps to dinner, Coomer was injured
when her left knee was struck by Phelps's car. There was no question as to Phelps's
liability for the accident . Coomer was treated that same night at the Lake Cumberland
Regional Hospital Emergency Room and was diagnosed with a bruised knee by the
emergency room physician . She was sent home from the hospital with a prescription
for Tylenol-3, which contains codeine, for her pain .
On July 26, 2001, Phelps reported the accident to his insurer, Progressive . That
same day, a representative of Progressive contacted Coomer for the purpose of settling
her bodily injury claim against Phelps. After questioning Coomer as to the extent of her
injuries, Progressive's agent offered a settlement of $250 .00 in exchange for a full
release of her claims. Coomer rejected the offer, informing the agent that she would
contact the company later to discuss any settlement . That same afternoon, Coomer
telephoned Progressive to discuss her claim, stating that she would accept a $500.00
settlement in exchange for her release . Progressive agreed to Coomer's offer of
settlement, and an agent for the company traveled to her house that evening to obtain
her release . While the agent was at her home, Coomer executed a full release in favor
of Phelps and Progressive in exchange for a check in the amount of $500.00 . Coomer
deposited the check in her bank account later in the week. There is no evidence that
Progressive contacted either Coomer's treating physician or Lake Cumberland Regional
Hospital in preparation for or in anticipation of settlement of her claim.
Approximately one week later, Coomer learned that the physician who had
treated her on the night of the accident had misdiagnosed her injury as a bruised knee
when, in fact, her leg had been fractured . She initiated a lawsuit against Phelps in the
Pulaski Circuit Court, claiming damages resulting from the injuries she sustained in the
car accident . Nearly a year later, Coomer amended her original complaint, naming
Progressive as a Defendant and alleging the company had engaged in bad faith during
the settlement of her claim . Shortly thereafter, Phelps filed, and Progressive joined, a
motion for summary judgment in the Circuit Court . That motion was granted as to both
defendants and was subsequently affirmed by the Court of Appeals . This Court granted
discretionary review to consider the case .
111111. ANALYSIS
A. Validity of the Release
1 . Mutual Mistake
In arguing that the effectiveness of her release should be ignored under the
doctrine of mutual mistake, Coomer essentially asks us to overturn a long-standing rule
of Kentucky law. In Trevathan v. Tesseneer , 519 S.W .2d 614 (Ky. 1975), our
predecessor Court held that a mutual mistake between parties to a release as to the
"nature and extent of [the Plaintiff's] injuries" was insufficient grounds on which to
invalidate a general release. Id . at 615. To retreat from this rule would cast great doubt
on the finality of releases in this state and unnecessarily complicate settlement
considerations . As the Court noted in Trevathan, "[t]his rule favors the orderly
settlement of disputes and avoids multiplicity of suits and the chaos which would result if
the releases were not treated seriously by the courts." Id . at 616 . We see no need to
retreat from this rule, thus we expressly reaffirm the holding of Trevathan. 1
In an effort to avoid this result, Coomer has also attempted to distinguish her
case from Trevathan. Coomer argues that she was suffering from a misdiagnosed,
patent injury whereas the plaintiff in Trevathan sought to invalidate her release on the
basis of an undiagnosed, latent injury that did not manifest until several months after the
release was executed . This is a distinction without a difference . Absent fraud,
incapacity, or other compelling evidence of wrongdoing, an injured party who executes
a release of claims is bound by the terms of that release . This rule applies regardless of
how the subsequently discovered injuries might have been characterized at the time of
the release.
Coomer argues that this Court should follow a recent trend in the law of other
jurisdictions to recognize mutual mistake as a proper ground for invalidating a release .
She also cites a decision of the Court of Appeals, Kendrick v. Bailey Vault Co ., Inc . , 944
S.W.2d 147 (Ky.App . 1997), that invalidated a workers' compensation settlement on the
basis of mutual mistake or constructive fraud, as an example of this trend . Kendrick ,
however, involved a dispute over workers' compensation, an area that is governed by
its own extensive and distinct body of law. This distinction was acknowledged, at least
While it might be argued that this case involved a unilateral mistake on the part
of Coomer, and not a mutual mistake as she alleges, we need not reach that issue
having reaffirmed Trevathan .
2 Ultimately, the Court did not choose between the two theories to justify its
reversal, though it did note that proceeding under "mutual mistake" might be "more
apropos . . . ." Kendrick , 944 S.W.2d at 150.
implicitly, by the Court of Appeals, which justified application of the mutual mistake
doctrine in Kendrick because it was "in line with the workers' compensation goal that
injured workers receive the benefits to which they are entitled." Id . a t 150 . The
application of mutual mistake in the context of these cases can be fairly attributed to
"the peculiar nature of workers' compensation ." AIK Selective Self Ins. Fund v. Bush, 74
S .W.3d 251, 257 (Ky. 2002). Thus, despite some similarity between the facts in
Kendrick and in this case, Kendrick's use of the mutual mistake doctrine is limited to the
field of workers' compensation and has no applicability outside that field.
2. Constructive Fraud
As an alternative to her theory of mutual mistake, Coomer argues that the
doctrine of constructive fraud should apply to invalidate her release . At the outset, it is
important to note that Coomer has never alleged that Phelps or Progressive engaged in
actual fraud in procuring her release . That being said, Coomer contends that the
doctrine of constructive fraud should apply to invalidate her release .
Coomer again cites Kendrick for the proposition that constructive fraud may be
sufficient to invalidate a settlement agreement . In Kendrick , as mentioned above, the
Court of Appeals invoked the doctrine of constructive fraud (along with mutual mistake)
to invalidate a settlement between the claimant and the insurance company. In that
case, both parties relied, at least in part, on the optimistic, but incorrect, prognosis of the
claimant's physician . The Court of Appeals indicated that the insurance company's
3 Since the issue of mutual mistake in a workers' compensation case is not
before this Court, we do not express an opinion on the soundness of the Court of
Appeals' holding in Kendrick .
reliance on the opinion of the claimant's doctor created, in essence, an agency
relationship between the company and the doctor. Consequently, the doctor's medical
misrepresentation was imputed to the insurance company, thus allowing the worker to
claim constructive fraud . As noted in the previous section, however, the holding in
Kendrick is limited to the context of workers' compensation cases and is not applicable
to this case .
This does not mean that the doctrine of constructive fraud is inapplicable to
cases outside of the workers' compensation field . Wood v. Kirby, 566 S.W.2d 751 (Ky.
1978), which was cited by the Court of Appeals in Kendrick , sets out a useful definition
of constructive fraud, "Constructive fraud arises through some breach of a legal duty
which, irrespective of moral guilt, the law would pronounce fraudulent because of its
tendency to deceive others, to violate confidence, or to injure public interests ." Wood ,
566 S.W.2d at 755 . Coomer has acknowledged in her brief that "a presumption of fraud
does not arise out of the bare fact that consideration was inadequate ; inadequacy alone
is not sufficient to show fraud in law or equity ." (Appellant's Br. a t 14 (internal citations
omitted) .) Despite having correctly stated this point of law, she has failed to identify a
legal duty that either Phelps or Progressive can be said to have violated . Such a
violation is a necessary prerequisite for any action premised on constructive fraud .
Coomer has failed to produce any evidence that Phelps or Progressive violated any
4 Again, since the issue of constructive fraud in a workers' compensation case is
not before this Court, we express no opinion as to the soundness of that portion of the
Court of Appeals' holding in Kendrick .
legal duty owed to her. As such, summary judgment on the issue of constructive fraud
was proper.
3. Coomer's Alleged Incapacity
Coomer also alleges that the release was ineffective due to her mental incapacity
at the time of its execution . She claims this incapacity resulted from a combination of
the severe pain of her injury and the medication she was prescribed for treatment of that
pain . Our cases have allowed that incapacity, when properly proven, may provide
sufficient grounds to invalidate a release . Louisville & Nashville R.R . Co . v. Lee, 154
Ky. 226, 157 S .W . 60, 62 (1913). This position was acknowledged in Trevathan v.
Tesseneer , 519 S .W.2d 614 (Ky. 1975), where the Court noted that "[s]ince the record
is devoid of any indication of fraud, overreaching, or physical impairment at the time of
execution , the simple question becomes whether . . . it may be invalidated on the
ground of mutual mistake." Id . at 615 (emphasis added) . As the Court of Appeals
correctly noted in its opinion, the prerequisite for capacity to execute a personal release
is the same as that required for any contract .
Coomer's bald allegation of incapacity, however, is insufficient to overcome the
motion for summary judgment. Coomer claims she was incompetent to execute the
release because she was experiencing a great deal of pain from the accident, was
prescribed and took more than the recommended dose of Tylenol-3, 5 and does not
remember reading or executing the release .
5 Though she notes her use of the narcotic, Tylenol-3, in support of her claim of
incapacity, Coomer asserts no specific claim that she was so intoxicated that this factor
alone would support invalidating the release .
As noted by the Court of Appeals, even though Coomer claims no recollection of
reading or executing the release, she could remember calling the adjuster's associate
and offering to settle her claim for $500.00, she could remember the adjuster returning
to her home with the check, and she acknowledges that her signature appears on the
release. Furthermore, when describing in her deposition the face-to-face encounter
with the adjuster, she stated : "He come in and I signed the release . He wished me
good luck." (Emphasis added .) Although she maintained that she did not remember
reading the release, when asked if she thought she would have read it, she responded :
"I'm quite sure I would have ."
Coomer's own testimony shows that she telephoned Progressive on her own
initiative, that she was lucid enough to negotiate a settlement twice that originally
offered by the company, that she recalls the negotiations, that she recalls the adjuster
coming to her house, and that she signed and likely would have read the release .
Though she claims not to remember actually reading or signing the release, her
recollection of other events surrounding her execution of the release are detailed, to say
the least.
We also note that Coomer cashed the settlement check a day or two after
executing the release. Additionally, the insurance adjuster's sworn affidavit states that
he found no reason to doubt Coomer's capacity or suspect that she was intoxicated .
Furthermore, Coomer has admitted that the $500 .00 settlement was fair given what she
believed at the time was a minor injury.
Even having reviewed the record in a light most favorable to Coomer, it is clear to
this Court that she has failed to establish a genuine issue of material fact as to her
competence to execute the release. This is insufficient to overcome summary judgment
under Steelvest, Inc. v. Scansteel Service Center, Inc . , 807 S .W.2d 476 (Ky. 1991) .
Summary judgment on this issue was proper.
B . Bad Faith
In addition to her suit for damages against Phelps, Coomer claims that
Progressive acted in bad faith in obtaining her release as prohibited by the Unfair
Claims Settlement Practices Act ("UCSPA") . KRS 304 .12-230 . While an action for
damages premised on violations of this statute is clearly permitted under Kentucky law,
see State Farm Mut. Auto . Ins. Co. v. Reeder , 763 S.W.2d 116 (Ky. 1998) (permitting a
private right of action for violations of KRS § 304 .12-230 pursuant to KRS § 446 .070),
such a claim does not lie in this case. Where, as here, an insurance company has
promptly agreed to a reasonable offer of settlement proposed by an injured third party
and there is no indication of fraud, there is no actionable claim for bad faith under the
statute .
Coomer alleges that Progressive violated the UCSPA's prohibition of bad faith in
two ways. Specifically, she contends that Progressive acted in bad faith by failing to
thoroughly investigate the merits of her claim before agreeing to settle and by providing
a settlement that was not "fair and equitable ." KRS 304 .12-230(6) .
In arguing that Progressive failed to adequately investigate her settlement claim,
Coomer relies on the combined authority of subsections three and four of the UCSPA,
each of which sets forth an example of an unfair settlement practice . See KRS 304.12
230(3) ("[flailing to adopt and implement reasonable standards for the prompt
investigation of claims arising under insurance policies") ; KRS 304.12-230(4) ("[r]efusing
to pay claims without conducting a reasonable investigation based upon all available
information") . Based on the preceding subsections of the Act, Coomer would have this
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court impose a duty on insurers to investigate the validity of any and all statements
offered to support claims by injured third parties during settlement negotiations . While
KRS 304.12-230(4) prohibits any refusal to pay a claim without first conducting a
reasonable investigation, no such obligation arises for an insurer that has agreed to the
payment demands of an injured party. Such a duty to "double-check" the basis of third
party claims would significantly and erroneously broaden an insurer's obligation of good
faith as set forth in the statute . See Motorists Mut. Ins. Co . v. Glass , 996 S .W.2d 437,
454 (Ky. 1997) ("The UCSPA does not require that a claim be evaluated, or that it be
evaluated correctly. It only requires that payment of a claim not be refused without
conducting a reasonable investigation based on all available information .").
Coomer's second contention, that KRS 304 .12-230(6) imposes a broad
obligation on insurers to reach settlements that are "fair and equitable," is equally
without merit . The full text of KRS 304.12-230(6) is as follows : "Not attempting in good
faith to effectuate prompt, fair and equitable settlements of claims in which liability has
become reasonably clear ." This does not necessarily mean that an insurer's proposed
settlement amount must always provide wholly accurate or complete compensation for
an injury . The statute only requires that an insurer make a good faith attempt to settle
any claim, for which liability is beyond dispute, for a reasonable amount. The language
of this provision is simply inadequate to establish a broad-based requirement that
insurance settlements must always be "fair and equitable" in the traditional sense .
Where, as here, there is no question of liability, settlement actually occurred within one
day of the accident, and, as admitted by the claimant, the settlement was "fair" in light of
the information known at the time, no action for bad faith exists under KRS 304.12230(6).
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In short, Coomer insists on an unprecedented, unwarranted, and unwise
expansion of the statutory bad faith cause of action . She simply cannot claim bad faith
on the part of Progressive when she received a settlement for the amount she
demanded . With the benefit of hindsight, it is easy to conclude that Coomer would have
been wise to avoid such a settlement, but improvidence alone is insufficient to justify a
bad faith claim .
IV. CONCLUSION
For the foregoing reasons, the judgment of the Court of Appeals is affirmed .
All concur.
COUNSEL FOR APPELLANT :
Bridget Leigh Dunaway
Taylor, Keller & Dunaway
802 North Main Street
PO Box 905
London, Kentucky 40743-0905
Amanda Lester Hill
Taylor, Keller, Dunaway & Tooms
1306 West Fifth Street
PO Box 905
London, Kentucky 40743-0905
COUNSEL FOR APPELLEE, CHARLIE PHELPS :
John W . Walters
771 Corporate Drive
Suite 905
Lexington, Kentucky 40503
Timothy Culver Feld
771 Corporate Drive
Suite 905
Lexington, Kentucky 40503
COUNSEL FOR APPELLEE, PROGRESSIVE NORTHWESTERN INSURANCE
COMPANY:
Donald L . Miller, II
Frost, Brown & Todd
400 West Market Street
32nd Floor
Louisville, Kentucky 40202
Diane Rose Conley
Frost, Brown & Todd
400 West Market Street
32nd Floor
Louisville, Kentucky 40202
Kristi Mildred Smith
Frost, Brown & Todd
2700 Lexington Financial Center
Lexington, Kentucky 40507
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