Stephen D. Paesani, Esq.
C. William Davis, Esq.
JUSTICE MAYNARD delivered the Opinion of the Court.
Maynard, Justice:
Ms. Knuckles entered into settlement negotiations with Wanda Watkins'
insurer, Nationwide, through Nationwide's representative, Sarah Long. David Johnston and
Dorcas Knuckles, as parents and natural guardians of the appellant, and Dorcas Knuckles,
as legal guardian, entered into a release and settlement agreement with Nationwide. The
agreement stated that the appellant acknowledged receipt of $10,000 cash along with
$18,391.73 for medical expenses and $1,000 under the medical payments coverage of the
policy. The agreement also provided that the appellant would receive a lump sum payment
in the amount of $20,340 on her eighteenth birthday. In return, the appellant released the
insured and the insurer from any further damages. The circuit court approved the settlement
agreement by order entered on August 6, 1997.
The appellant subsequently married and had a daughter. On her twentieth
birthday, June 5, 2000, the appellant, her husband, Ronald Nicholas Mills, and her husband
as next friend and father of her daughter, Alyssa Nicole Mills, and unborn children, Jane Doe
and John Doe, filed a complaint against Krista Watkins, Wanda Watkins, Sarah Long, and
Nationwide seeking to set aside the settlement agreement and obtain additional insurance
resources for medical expenses and loss of consortium and exemplary damages.
(See footnote 3)
Alternatively, the appellant sought to proceed against the insurer under the West Virginia
Unfair Trade Practices Act, W.Va. Code § 33-11-4 (1985) (UTPA).
(See footnote 4)
The appellant alleged
Long and Nationwide misrepresented the amount of coverage that was available to
compensate her for her injury. She specifically complained in her amended complaint, filed
on July 14, 2000, that Long intentionally and illegally failed to tell her that the combined
payments to all persons injured in the accident did not exhaust the policy limits. The
amended complaint also contained a count for fraud.
Long, Nationwide, and the Watkins filed motions to dismiss the complaint
attaching thereto copies of the release and settlement agreement and the court's August 6,
1997 order. On December 27, 2000, the circuit court dismissed the complaint, reserving unto
the appellant the opportunity to set forth with particularity the circumstances surrounding the
claim of fraud.
(See footnote 5)
The appellant abandoned her claim for fraud by declining to follow the
court's suggestion. Instead, she filed a motion asking the court to alter or amend its
judgment. She subsequently clarified her motion by requesting that her claims for additional
medical expenses and consortium be dismissed; she also requested that she be allowed to
refile her UTPA claims. On November 2, 2001, the circuit court denied relief. It is from this
order that the appellant appeals.
In dismissing the action, the circuit court relied on evidence outside the
pleadings. Attached as exhibits to the motions to dismiss were the release and settlement
agreement, the settlement order, the petition for settlement, and the order appointing a
guardian ad litem. In its December 27, 2000 order, the court specifically stated that it had
studied the motions to dismiss, the memoranda of law and exhibits submitted by the parties,
and other relevant legal authorities. Under these circumstances, Rule 12(b)(6) grants circuit
courts the authority to treat motions to dismiss as motions for summary judgment. The rule
states in pertinent part:
Moreover, this Court previously held:
On appeal, the appellant contends the circuit court erred by denying her motion
for relief from judgment. She supports her claim by stating that Nationwide made material
representations which she later learned were misrepresentations. In the interim, her legal
guardian relied upon the representations to settle her claim. As an injured third party, she
believes the misrepresentations may form the basis to bring a UTPA action against the
insurer and the tortfeasor who were both released in the settlement agreement. In her brief
filed on appeal, the appellant makes clear that she challenges only the circuit court's
dismissal of Counts VI and VII of her amended complaint. These counts read as follows:
By their actions as hereinabove stated, the Defendants
Long and Nationwide breached their duties as provided in
W.Va. Code § 33-11-4(9)(a), (e), (f), (g), (j), (m) and (n) with
such frequency as to indicate a general business practice.
The appellant also avers that the facts of her case are similar to the facts
contained in Elmore v. State Farm Mut. Auto. Ins. Co., 202 W.Va. 430, 504 S.E.2d 893
(1998). She reasons that this Court would not have reached the issues it ultimately ruled
upon in Elmore if Poling precluded such actions. However, the claim in Elmore could not
proceed because it was time barred. Nationwide argues that if the appellant had accepted the
circuit court's offer to plead fraud with specificity, then she could have, with sufficient proof,
rescinded the settlement agreement and proceeded against Nationwide under the UTPA or
attempted to recover her alleged damages. For the reasons set forth below, we do not believe
that Nationwide engaged in unfair claim settlement practices at the time the appellant's claim
settled.
Bad faith insurance practices were discussed by this Court in the Poling case.
In Poling, the plaintiff, Jeffrey Poling, was rear-ended by a drunk driver, William Bonar,
who was driving his father's vehicle without permission and without a valid driver's license.
The insurer of the Bonar vehicle finally settled with Poling after twelve months of repeated
attempts to resolve the property damage and personal injury claims. At the time of
settlement, the insurance company tendered a settlement agreement that contained a release
of both the tortfeasor and the insurer. Poling released the tortfeasor but refused to release
the insurance company.
Poling subsequently filed a lawsuit against the insurance company alleging bad
faith insurance practices. The insurance company argued that settlement of the underlying
tort claim precluded an unfair claim settlement practices legal action from being filed against
it. This Court disagreed and held:
The appellant overlooks the fact that the circuit court carefully followed the
guidelines set forth in W.Va. Code § 44-10-14 (1929). The appellant's mother, who
qualified as legal guardian, negotiated with the insurance company to settle the appellant's
claim for damages. The legal guardian requested permission from the court to settle the
claim before the settlement agreement was agreed upon and adopted by all parties. The
circuit court appointed a guardian ad litem to represent the interests of the appellant. The
guardian ad litem approved the agreement. The court found that the agreement was in the
best interest of the appellant and entered an order which approved the release and settlement
agreement. In other words, the court granted the legal guardian's petition which requested
permission to settle the claim. We find no fault with the procedure followed by the circuit
and believe it adequately protected the financial interest of the appellant.
We also reject the appellant's assertion that the facts of her case are similar to
the facts contained in Elmore v. State Farm Mut. Auto. Ins. Co., 202 W.Va. 430, 504 S.E.2d
893 (1998). In Elmore, Chester Workman drove his vehicle across the center line and
collided with a vehicle operated by Michael Elmore. Elmore's pregnant wife and unborn
child were killed. He and his three-year-old son were injured. Three passengers in the
Workman vehicle were injured and Chester Workman was killed in the accident. Workman
was insured by State Farm under a liability insurance policy with limits of $100,000 per
person and $300,000 per occurrence. Elmore was insured by Allstate under a policy of
underinsured motorist coverage.
State Farm's insurance adjuster contacted Elmore regarding his claims and
informed him that he would not receive the entire policy limit of $300,000 because $100,000
was being retained to settle the claims of the passengers in the Workman vehicle. State Farm
drafted releases which were presented to Elmore. At that time, Elmore informed the adjuster
that he would like to retain an attorney. The adjuster advised him that he did not need an
attorney and told him that he would receive the maximum amount available to him under the
policy. Elmore subsequently entered into a settlement and release, pro se, for the amount of
$200,000. He did not know that State Farm had previously paid only $57,500 to settle the
claims of the occupants of the Workman vehicle. Elmore then contacted his insurer, Allstate,
concerning underinsurance coverage (UIM). Allstate refused to admit or deny his claim for
approximately two years. Elmore subsequently hired an attorney and filed suit against the
Estate of Chester Workman, State Farm, and Allstate.
After the lawsuit was filed, Allstate claimed it was denying UIM coverage
because the State Farm policy limits were not exhausted. State Farm then agreed to rescind
the releases and paid Elmore the remaining $42,500 available under the Workman policy.
Four years after filing the first lawsuit, Elmore instituted a second legal action against State
Farm, Allstate, and the agents of both companies. The complaint alleged, inter alia, that
State Farm breached its fiduciary duty and an implied covenant of good faith and fair dealing
that was owed to Elmore as a third-party claimant. The circuit court certified the following
question:
This Court answered the certified question in the negative and held that [a]
third party has no cause of action against an insurance carrier for common law breach of the
implied covenant of good faith and fair dealing or for common law breach of fiduciary duty.
Syllabus, id. The Court went on to hold that third parties may, however, maintain actions
against insurance companies under the UTPA. This holding was clarified by quoting
Syllabus Point 4 of Dodrill v. Nationwide Mut. Ins. Co., 201 W. Va. 1, 491 S.E.2d 1 (1996),
which states:
After considering the record presented on appeal, we conclude that the
appellant entered into a settlement and release of the underlying case with both the tortfeasor
and the tortfeasor's insurer, Nationwide. While the appellant alleges that the insurer made
misrepresentations in the course of settling the underlying case, the settlement agreement
appears to release the insurer for any such conduct. In fact, the settlement agreement
contains the following paragraph:
Under these circumstances, we find no indication that Nationwide
misrepresented the insurance policy provisions relating to coverages during the time that
the underlying release and settlement agreement was negotiated and adopted by the parties
in this case. If we were to accept the theory urged upon us by the appellant, then every
guardian ad litem who fails to get the full policy limits for the infant claimants that he or she
represents could potentially be liable for malpractice. Moreover, any insurance company that
does not offer the policy limits and UIM policy limits to every infant claimant would be
liable under the UTPA when the infant reaches majority. Also, such a rule would have a
profound chilling effect on the willingness of insurance companies to settle cases; would
interfere with the prompt and early payment to plaintiffs who have suffered minor or non-
catastrophic injuries; and would leave open no practical or safe way to settle infants' claims.
We must have rules that foster and encourage the voluntary and fair resolution of disputes
and quick payment of claims.
Examining the record, we find no reason to alter our holding in Syllabus Point
2 of Poling when a fair and equitable settlement is properly reached in the case of a minor.
We, therefore, hold that when an infant is injured in an automobile accident and the infant's
legal guardian enters into a settlement agreement with an insurer by complying with the
dictates set forth in W.Va. Code § 44-10-14 (1929), the settlement is final as to that insurance
company at the time the circuit court approves the legal guardian's petition for permission
to settle the claim if the insurer is released in the settlement agreement and the insurer is
unaware of any misconduct which would constitute substantive grounds for a bad faith action
at the time the insurer agrees to the settlement. In the case at bar, Nationwide did not unfairly
settle the appellant's claim. The appellant's reliance upon the UTPA is unfounded.
Consequently, we find that the circuit court did not err by granting summary
judgment to Long, Nationwide, and the Watkins or by failing to alter or amend the judgment.
For the foregoing reasons, the judgment of the circuit court is affirmed.
Princeton, West Virginia
Richardson & Davis, PLLC
Attorney for Plaintiffs Below, Appellants Bluefield, West Virginia
Attorney for S. Long and Nationwide
CHIEF JUSTICE STARCHER
concurs and reserves the right to file a concurring opinion.
JUSTICE McGRAW
concurs, in part, and dissents, in part, and reserves the right to file a
separate opinion.
1. A cause of action for insurance bad faith may arise even if there has
been a settlement and release of the underlying case against the tortfeasor so long as the
release does not cover the insurer and the insurer is, or should be, aware of the possibility of
a bad faith action at the time it agrees to the settlement. Syllabus Point 2, Poling v.
Motorists Mut. Ins. Co., 192 W.Va. 46, 450 S.E.2d 635 (1994).
2. To maintain a private action based upon alleged violations of
W.Va.Code § 33-11-4(9) in the settlement of a single insurance claim, the evidence should
establish that the conduct in question constitutes more than a single violation of W.Va.Code
§ 33-11-4(9), that the violations arise from separate, discrete acts or omissions in the claim
settlement, and that they arise from a habit, custom, usage, or business policy of the insurer,
so that, viewing the conduct as a whole, the finder of fact is able to conclude that the practice
or practices are sufficiently pervasive or sufficiently sanctioned by the insurance company
that the conduct can be considered a 'general business practice' and can be distinguished by
fair minds from an isolated event. Syllabus Point 4, Dodrill v. Nationwide Mut. Ins. Co.,
201 W.Va. 1, 491 S.E.2d 1 (1996).
3. When an infant is injured in an automobile accident and the infant's
legal guardian enters into a settlement agreement with an insurer by complying with the
dictates set forth in W.Va. Code § 44-10-14 (1929), the settlement is final as to that insurance
company at the time the circuit court approves the legal guardian's petition for permission
to settle the claim if the insurer is released in the settlement agreement and the insurer is
unaware of any misconduct which would constitute substantive grounds for a bad faith action
at the time the insurer agrees to the settlement.
The appellant, Crystal Johnston Mills, appeals the November 2, 2001 order of
the Circuit Court of Mercer County. In its order, the circuit court declined to grant relief
from a previous order which granted summary judgment to Nationwide Mutual Insurance
Company, agent Sarah Long, Krista Watkins, and Wanda Watkins. Because the appellant,
by her legal guardian, settled and released all claims against the insured and the insurance
company in compliance with W.Va. Code § 44-10-14 (1929), we find no error.
On August 2, 1996, the appellant was one of two passengers who was injured
in a single-vehicle accident. At the time of the accident, Krista Watkins was driving a
vehicle that was owned by her mother, Wanda Watkins, and insured by Nationwide Mutual
Insurance Company (Nationwide). The appellant injured her left shoulder and incurred
medical expenses in the amount of $21,335.61. The appellant's mother, Dorcas Knuckles,
qualified as legal guardian.
(See footnote 1)
Pursuant to W.Va. Code § 44-10-14 (1929),
(See footnote 2)
the court appointed
attorney Ward Morgan to serve as guardian ad litem.
The standard of review applicable to an appeal from a
motion to alter or amend a judgment, made pursuant to W. Va.
R. Civ. P. 59(e), is the same standard that would apply to the
underlying judgment upon which the motion is based and from
which the appeal to this Court is filed.
Syllabus Point 1, Wickland v. American Travellers Life Ins., 204 W.Va. 430, 513 S.E.2d 657
(1998). In the present case, the circuit court dismissed the appellant's complaint under Rule
12(b)(6) of the West Virginia Rules of Civil Procedure [] for failure to state a claim upon
which relief can be granted and/or the defense of settlement and release.
If, on a motion asserting the defense numbered (6) to dismiss for
failure of the pleading to state a claim upon which relief can be
granted, matters outside the pleading are presented to and not
excluded by the court, the motion shall be treated as one for
summary judgment and disposed of as provided in Rule 56, and
all parties shall be given reasonable opportunity to present all
material made pertinent to such a motion by Rule 56.
Only matters contained in the pleading can be considered
on a motion to dismiss under Rule 12(b) R.C.P., and if matters
outside the pleading are presented to the court and are not
excluded by it, the motion should be treated as one for summary
judgment and disposed of under Rule 56 R.C.P. if there is no
genuine issue as to any material fact in connection therewith.
Syllabus Point 4, in part, United States Fidelity and Guaranty Co. v. Eades, 150 W.Va. 238,
144 S.E.2d 703 (1965). Because the circuit court considered matters outside the pleadings,
we find that the court's order must be treated as one granting summary judgment. It is well-
settled that [a] circuit court's entry of summary judgment is reviewed de novo. Syllabus
Point 1, Painter v. Peavy, 192 W.Va. 189, 451 S.E.2d 755 (1994).
By their actions as hereinabove stated, the Defendants
Nationwide and Long breached their duties under the West
Virginia Unfair Trade Practices Act to not misrepresent policy
coverages and provide truthful representations concerning
insurance benefits, as stated in W.Va. Code § 33-11-4(1)(a).
The appellant's principal argument on appeal is that the circuit court erred by
holding that the case of Poling v. Motorists Mut. Ins. Co., 192 W.Va. 46, 450 S.E.2d 635
(1994), precludes her UTPA cause of action. She argues that Poling is a case of inclusion
under which she should be allowed to bring her complaint because she was not aware of the
insurer's conduct at the time she released Nationwide in the settlement agreement. She
acknowledges that Poling involved an insurance company that was not released in the
settlement agreement and that this Court added that the insurer must be aware of the
possibility of a bad faith action at the time the settlement is reached before a UTPA cause of
action may be maintained. She, nonetheless, argues that Poling should not be read in a
manner which precludes her from asserting a UTPA cause of action.
A cause of action for insurance bad faith may arise even
if there has been a settlement and release of the underlying case
against the tortfeasor so long as the release does not cover the
insurer and the insurer is, or should be, aware of the possibility
of a bad faith action at the time it agrees to the settlement.
Syllabus Point 2, Poling, supra. The appellant in the case at bar encourages us to broaden
this holding to include cases such as hers in which the insurer was released in the settlement
agreement. We decline to do so.
Whether, under West Virginia law, there is a legally
cognizable cause of action by a third-party claimant against an
insurance carrier for common law breach of fiduciary duty and
for common law breach of the implied covenant of good faith
and fair dealing (common law bad faith).
To maintain a private action based upon alleged
violations of W.Va.Code § 33-11-4(9) in the settlement of a
single insurance claim, the evidence should establish that the
conduct in question constitutes more than a single violation of
W.Va.Code § 33-11-4(9), that the violations arise from separate,
discrete acts or omissions in the claim settlement, and that they
arise from a habit, custom, usage, or business policy of the
insurer, so that, viewing the conduct as a whole, the finder of
fact is able to conclude that the practice or practices are
sufficiently pervasive or sufficiently sanctioned by the insurance
company that the conduct can be considered a general business
practice and can be distinguished by fair minds from an
isolated event.
Elmore, 202 W.Va. at 439, 504 S.E.2d at 902.
The undersigned, and each of them, have read the
foregoing Agreement and fully understand it, and are aware of
the propriety and legal effect of executing the same, and neither
the Agreement nor the compromise and settlement recited herein
were induced by fraud, coercion, compulsion or mistake, nor is
this Agreement nor the compromise and settlement made by the
undersigned in reliance upon any statement or representation of
any of the parties hereby released, or their representatives,
agents or attorneys. (Emphasis added).
The appellant's parents, David Johnston and Dorcas Knuckles, signed the release and
settlement agreement with Nationwide's agent, Sarah Long. During oral argument before
this Court, Nationwide's attorney stated that the guardian ad litem advised the appellant's
legal guardian that this was the appellant's only bite at the apple. In sum, the appellant's
legal guardian, the guardian ad litem, and the circuit court believed that the settlement
sufficiently compensated the appellant for her injuries, and released the tortfeasor and
Nationwide from any future liability--including liability under the UTPA.
Affirmed.
Footnote: 1
Footnote: 2
In any case where an infant is injured in his person or his
property by another, the legal guardian of such infant may
negotiate with the person inflicting such injury for the settlement
of any claim for damages therefor. But the guardian shall, when
proceeding under this section, before making final settlement,
file his petition in equity with the circuit court of the county, or
judge thereof in vacation, in which he was appointed, for
permission to settle such claim, in which petition he shall state
the name and age of his ward, the nature and character of the
injury, and the facts relied upon by him to induce the court or
judge to approve such proposed settlement. The court, or judge
thereof in vacation, shall appoint a guardian ad litem for the
ward who shall answer the petition. Upon the hearing thereof,
the court or judge thereof in vacation, may grant or refuse the
petition by a proper order, as may seem just and proper.
Footnote: 3
Footnote: 4
W.Va. Code § 33-11-4(9)(a) (1985) states, No person shall commit or perform with
such frequency as to indicate a general business practice any of the following: (a)
Misrepresenting pertinent facts or insurance policy provisions relating to coverages at
issue[.]
Footnote: 5